Islam, Qazi S; Ahmed, Syed M; Islam, Mohammad A; Chowdhury, Anita S; Siddiquea, Bodrun N; Husain, Mohammad A
BRAC (formerly Bangladesh Rural Advancement Committee), in collaboration with the National Tuberculosis Control Programme, provides one full-day training on TB to make informal allopathic providers knowledgeable for managing TB in rural Bangladesh. This study explored the knowledge and practices of the providers receiving the above training in the control and prevention of TB. The study was conducted in 30 subdistricts, with 30 trained and 30 untrained providers randomly selected from each subdistrict. Approximately 3% (49/1800) did not provide complete information. Pre-tested structured and semi-structured questionnaires were used. TB was commonly perceived as a disease of only males (66.1%, 1157/1751). Only one-quarter knew about the bacterial cause of TB. Very few providers (2.1%, 36) had adequate knowledge regarding prevention of TB. They also lacked knowledge about TB treatment duration (71.6%, 1253), the meaning of DOTS (directly observed treatment, short course) (26.0%, 455) and multidrug resistance (20.6%, 360). Antibiotics (79.7%, 1396) and cough syrup (75.0%, 1313) were commonly prescribed by providers despite symptoms suggestive of TB. However, 70.2% (613) and 74.5% (650) of trained providers' knowledge and practice scores were equal to or more than the mean scores (≥6.97 and ≥6.6, respectively), whereas they were only 49.5% (435) and 64.2% (563), respectively, among untrained providers (ppreventing TB efficiently. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
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...
Sieverding, Maia; Liu, Jenny; Beyeler, Naomi
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.
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.
Smith, L F; Whitfield, M J
BACKGROUND. About one third of all pregnancies are unplanned and 20% of all pregnancies end in abortion. More than 170,000 legal abortions are performed in the United Kingdom annually. Nearly all general practitioners provide contraceptive advice; the most commonly used form of reversible contraception is the oral contraceptive pill. AIM. The aim of this study was to determine factors associated with women's knowledge of taking the contraceptive pill correctly and of emergency contraception, and to investigate if their knowledge could be improved in general practice by providing women with Family Planning Association information leaflets. METHOD. An uncontrolled intervention study was performed in one rural and one urban English general practice, using a self-completion questionnaire that was initially administered to women attending their general practitioner for oral contraception over six months from 1 October 1992. The questionnaire asked for: sociodemographic information; knowledge of how late women can be taking an oral contraceptive pill and still be protected against unplanned pregnancy; for how many days after being late with a pill they need to use other precautions; sources and methods of emergency contraception; and for how long the methods are effective after the primary contraceptive failure. After completing the questionnaire women were given two leaflets: one about how to take their prescribed contraceptive pill correctly and one about emergency contraception. Three to 12 months later the same questionnaire was administered in the same manner. RESULTS. Of 449 women completing the first questionnaire, 233 (52%) completed the second questionnaire. Initially 71% of 406 women taking an oestrogen/progestogen combined pill knew about the '12-hour rule' and 17% knew about the 'seven-day rule'; giving women information about the pill they were taking increased the extent of knowledge about these rules among 212 respondents to 82% (P emergency contraception
John-Stewart, Grace; Shah, Brandi; Wamalwa, Dalton; Maleche-Obimbo, Elizabeth; Kelley, Maureen
Abstract Optimal pediatric HIV disclosure impacts illness and developmental experiences while improving access to timely treatment. However, disclosure rates in high HIV prevalence countries remain low and there are limited data on best practices. We conducted a qualitative study of disclosure practices and interviewed healthcare providers from five pediatric HIV clinics in Kenya. We identified themes central to disclosure practices, rationale for approaches, barriers to implementing disclosure, and creative strategies to overcome challenges. We used these insights to develop a practice-based framework for disclosure that is sensitive to practical challenges. Overall, providers had limited training but extensive experience in disclosure, endorsed individualized disclosure practices, invested substantial time on disclosure despite clinical burden, and noted adverse outcomes associated with unplanned or abrupt disclosure. Providers advocated for an approach to disclosure that is child-centered but respects caregiver fears and values. Caregiver support was provided to enable caregivers to be the person who ultimately disclosed HIV status to children. Unplanned or abrupt disclosure to children was reported to have severe and persistent adverse impact and was a stimulus to accelerate disclosure in scenarios when providers believed children may be suspecting their diagnosis. Based on these expert insights, the framework we developed incorporates concurrent evaluation of child and caregiver readiness, identifies cues to prompt disclosure discussions, includes caregiver education and support, and utilizes a gradual approach of unveiling HIV diagnosis to the child. PMID:25216105
MacLennan, S J; Murdoch, S E; Cox, T
There is a growing body of evidence on the importance of work following a diagnosis of cancer and the need to provide better information, advice and related support to patients on work engagement. The aim of this study was to better understand the nature of those needs and to identify better ways to meet these for those with a urological cancer. The focus was on the issues that were common to three key stakeholder groups. Semi-structured interviews were conducted with stakeholders in North East Scotland: 12 individuals with kidney, bladder or prostate cancer, 10 healthcare providers and 10 managers from large organisations. Five key themes emerged from the Framework Analysis: perceived importance of work engagement; decision-making: treatment, work and cancer; roles and responsibilities; education and training; information, advice and support resources. The data confirmed that work engagement is important to those with urological cancer. It also made clear that the current provision of information and advice could be improved. Any such interventions should involve all three key stakeholder groups with greater clarity on their respective roles and responsibilities. Finally, any new system would be best integrated with existing care provision and supported by adequate education and training of those involved. © 2017 John Wiley & Sons Ltd.
Hollander, Sue M.
A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC)–accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, “general public” was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele. PMID:10658965
Dahl, Katja; Kesmodel, Ulrik; Hvidman, Lone
to empower women making an informed consent. Information on Down syndrome is often confined and limitations of screenings tests rarely mentioned. Understanding is better achieved by presenting the risk estimate as a numerical probability compared to a verbal explanation. Rates are better understood than......Prenatal care has gradually moved away from paternalism, to a state where patient autonomy and information is vital. It is known from other health care settings that the way information is presented affects understanding.The objective is to summarize current knowledge on aspects of informing...... 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...
Hötzel, Maria J; Cardoso, Clarissa S; Roslindo, Angélica; von Keyserlingk, Marina A G
The primary aim of this study was to assess the influence of provision of information on lay citizens' opinions regarding 2 common management practices, zero-grazing and cow-calf separation. To aid in the interpretation of the findings, our secondary aim was to explore the awareness and opinions of Brazilian citizens about these practices. We surveyed a convenience sample of Brazilian citizens (192 men and 208 women), recruited in a public place, with the majority stating that they were largely unfamiliar with animal production and lived in urban environments. Participants were presented short scenarios with information on the primary production factors and welfare concerns for and against zero-grazing (n = 200) or cow-calf separation (n = 200). Participants were then asked to state their position (reject, indifferent, or support), and to provide the reason(s) justifying their position. Immediately following, participants were provided a short statement describing either zero-grazing or cow-calf separation, depending on what question they responded to in the first part. Two closed questions (Q) followed each of these statements: (Q1) "Are you aware of this practice?" with choices yes, somewhat, or no, and (Q2) "What is your position regarding this practice?" with choices reject, indifferent, or support. Only 31 and 33% of the respondents were aware of zero-grazing and cow-calf separation, respectively. Previous awareness of existence of practice did not influence levels of support. Provision of information resulted in more people rejecting the practices of zero-grazing and cow-calf separation. Participants' main justifications to reject zero-grazing and cow-calf separation focused on perceived negative effects of practices on farm animal welfare and product quality, and loss of naturalness. Survey participants, Brazilians living in urban environments, with little or no association with dairy production, were generally unaware that many cows do not have access to
Smith, L F; Whitfield, M J
BACKGROUND. About one third of all pregnancies are unplanned and 20% of all pregnancies end in abortion. More than 170,000 legal abortions are performed in the United Kingdom annually. Nearly all general practitioners provide contraceptive advice; the most commonly used form of reversible contraception is the oral contraceptive pill. AIM. The aim of this study was to determine factors associated with women's knowledge of taking the contraceptive pill correctly and of emergency contraception, ...
Leece, Pamela; Buchman, Daniel Z; Hamilton, Michael; Timmings, Caitlyn; Shantharam, Yalnee; Moore, Julia; Furlan, Andrea D
Introduction In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Methods and analysis Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians. The intervention uses practical educational and self-assessment tools to provide prescribers with feedback on their current knowledge and practices, and resources to improve their practice. The evaluation approach uses a pretest and post-test design and includes both quantitative and qualitative methods at baseline and 6 months. We will recruit a purposive sample of approximately 10 family physicians in Ontario from diverse practice settings, who currently treat patients with long-term opioid therapy for chronic pain. Quantitative data will be analysed using basic descriptive statistics, and qualitative data will be analysed using the Framework Method. Ethics and dissemination The University Health Network Research Ethics Board approved this study. Dissemination plan includes publications, conference presentations and brief stakeholder reports. This evidence-informed, theory-driven intervention has implications for national application of opioid quality improvement tools in primary care settings. We are engaging experts and end users in advisory and stakeholder roles throughout our project to increase its national relevance, application and sustainability. The performance measures could be used as the basis for health system quality improvement
Rafferty, Pauline; Baker, David
This special issue explores information behaviour and practice in general, and specifically focuses on the implications for library and information services. Information seeking behaviour and information practice remain areas of importance in information science and librarianship, perhaps even more so in the digital age. This special issue is an opportunity to share ideas and scholarship and to explore models and methods. The papers chosen for inclusion cover a range of topics and approach them from a number of different epistemological and methodological positions demonstrating the liveliness
Leece, Pamela; Buchman, Daniel Z; Hamilton, Michael; Timmings, Caitlyn; Shantharam, Yalnee; Moore, Julia; Furlan, Andrea D
In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians. The intervention uses practical educational and self-assessment tools to provide prescribers with feedback on their current knowledge and practices, and resources to improve their practice. The evaluation approach uses a pretest and post-test design and includes both quantitative and qualitative methods at baseline and 6 months. We will recruit a purposive sample of approximately 10 family physicians in Ontario from diverse practice settings, who currently treat patients with long-term opioid therapy for chronic pain. Quantitative data will be analysed using basic descriptive statistics, and qualitative data will be analysed using the Framework Method. The University Health Network Research Ethics Board approved this study. Dissemination plan includes publications, conference presentations and brief stakeholder reports. This evidence-informed, theory-driven intervention has implications for national application of opioid quality improvement tools in primary care settings. We are engaging experts and end users in advisory and stakeholder roles throughout our project to increase its national relevance, application and sustainability. The performance measures could be used as the basis for health system quality improvement indicators to monitor opioid prescribing. Additionally, the
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
Piotti, Patrizia; Kaminski, Juliane
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
Now updated-your expert guide to twenty-first century information security Information security is a rapidly evolving field. As businesses and consumers become increasingly dependent on complex multinational information systems, it is more imperative than ever to protect the confidentiality and integrity of data. Featuring a wide array of new information on the most current security issues, this fully updated and revised edition of Information Security: Principles and Practice provides the skills and knowledge readers need to tackle any information security challenge. Taking a pract
Vladimir N. Shvedenko
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.
Mittelstaedt, Tyler S; Mori, Motomi; Lambert, William E; Saultz, John W
Becoming certified as a patient-centered medical home now requires practices to measure how effectively they provide continuity of care. To understand how continuity can be improved, we studied the association between provider practice characteristics and interpersonal continuity using the Usual Provider Continuity Index (UPC). We conducted a mixed-methods study of the relationship between provider practice characteristics and UPC in 4 university-based family medicine clinics. For the quantitative part of the study, we analyzed data extracted from monthly provider performance reports for 63 primary care providers (PCPs) between July 2009 and June 2010. We tested the association of 5 practice parameters on UPC: (1) clinic frequency; (2) panel size; (3) patient load (ratio of panel size to clinic frequency); (4) attendance ratio; and (5) duration in practice (number of years working in the current practice). Clinic, care team, provider sex, and provider type (physicians versus nonphysician providers) were analyzed as covariates. Simple and multiple linear regressions were used for statistical modeling. Findings from the quantitative part of the study were validated using qualitative data from provider focus groups that were analyzed using sequential thematic coding. There were strong linear associations between UPC and both clinic frequency (β = 0.94; 95% CI, 0.62-1.27) and patient load (β = -0.37; 95% CI, -0.48 to -0.26). A multiple linear regression including clinic frequency, patient load, duration in practice, and provider type explained more than 60% of the variation in UPC (adjusted R(2) = 0.629). UPC for nurse practitioners and physician assistants was more strongly dependent on clinic frequency and was at least as high as it was for physicians. Focus groups identified 6 themes as other potential sources of variability in UPC. Variability in UPC between providers is strongly correlated with variables that can be modified by practice managers. Our study
Špiranec, Sonja; Kos, Denis
Introduction: This paper provides a contribution to understandings of information literacy regarding context and transferability of information practices. Specifically, the paper analyses the subset of information practices in situations of student protests and addresses issues of transfer of information literacy practice from a highly formal…
... 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...
Stimson, G V
In this study of advertisements appearing in medical periodicals and by direct mail advertising to general practitioners, Dr. Stimson, a sociologist, concludes that from what is intended to provide therapeutic information hardly any therapeutic information is provided. He reminds the reader of the safeguards which surround all drug advertising by law and by the code of practice of the Association of the British Pharmaceutical Industry but these safeguards do not appear to control real or potential sins of omission. Frequently in these advertisements the literature relating to the drug is quoted but Dr. Stimson found that it was difficult to trace all the papers quoted in different types of medical library. (Some references quoted were to unpublished papers but surely the blame should be shared in this situation?) Dr. Stimson also gives a vivid and fascinating glimpse of what he calls the 'images and stereotypes' of the patients who, it is claimed, would benefit from the drug being advertised. Certainly most general practitioners must be aware that when they prescribe that image is displaced by an individual but the portrait gallery is indeed depressing. However, to balance these advertisements drug companies issue data sheets which must be more informative than advertisements and conform to regulations in their format. Unfortunately data sheets are only issued every 15 months whereas the 'average general practitioner is potentially exposed to 1,300 advertisements every month'. In other words, the data sheet and not the advertisement should be the guideline but it arrives too infrequently to offset the lack of therapeutic information contained in advertisements. PMID:870694
Practical Ontologies for Information Professionals provides an introduction to ontologies and their development, an essential tool for fighting back against information overload. The development of robust and widely used ontologies is an increasingly important tool in the fight against information overload. The publishing and sharing of explicit explanations for a wide variety of conceptualizations, in a machine readable format, has the power to both improve information retrieval and identify new knowledge. This new book provides an accessible introduction to the following: * What is an ontology? Defining the concept and why it is increasingly important to the information professional * Ontologies and the semantic web * Existing ontologies, such as SKOS, OWL, FOAF, schema.org, and the DBpedia Ontology * Adopting and building ontologies, showing how to avoid repetition of work and how to build a simple ontology with Protege * Interrogating semantic web ontologies * The future of ontologies and the role of the ...
Zeldes, Nathan; Baum, Neil
Most practices are inundated with an excess of information. This information overload, or "infoglut," results in distractions and a loss of productivity. This article will discuss the concept of infoglut and what every practice can do to manage the tsunami of information that threatens to consume our practices.
Information technology and innovative drainage management practices for selenium load reduction from irrigated agriculture to provide stakeholder assurances and meet contaminant mass loading policy objectives
Many perceive the implementation of environmental regulatory policy, especially concerning non-point source pollution from irrigated agriculture, as being less efficient in the United States than in many other countries. This is partly a result of the stakeholder involvement process but is also a reflection of the inability to make effective use of Environmental Decision Support Systems (EDSS) to facilitate technical information exchange with stakeholders and to provide a forum for innovative ideas for controlling non-point source pollutant loading. This paper describes one of the success stories where a standardized Environmental Protection Agency (EPA) methodology was modified to better suit regulation of a trace element in agricultural subsurface drainage and information technology was developed to help guide stakeholders, provide assurances to the public and encourage innovation while improving compliance with State water quality objectives. The geographic focus of the paper is the western San Joaquin Valley where, in 1985, evapoconcentration of selenium in agricultural subsurface drainage water, diverted into large ponds within a federal wildlife refuge, caused teratogenecity in waterfowl embryos and in other sensitive wildlife species. The fallout from this environmental disaster was a concerted attempt by State and Federal water agencies to regulate non-point source loads of the trace element selenium. The complexity of selenium hydrogeochemistry, the difficulty and expense of selenium concentration monitoring and political discord between agricultural and environmental interests created challenges to the regulation process. Innovative policy and institutional constructs, supported by environmental monitoring and the web-based data management and dissemination systems, provided essential decision support, created opportunities for adaptive management and ultimately contributed to project success. The paper provides a retrospective on the contentious planning
Boland, Stacey W.; Duren, Riley M.
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.
Steiner, Jordan J; Kynn, Jamie; Stylianou, Amanda M; Postmus, Judy L
Human trafficking is a global issue, with survivors representing all genders, ages, races, ethnicities, religions, and countries. However, little research exists that identifies effective practices in supporting survivors of human trafficking. The research that does exist is Western-centric. To fill this gap in the literature, the goal of this research was to understand practices used throughout the globe with adult human trafficking survivors. A qualitative approach was utilized. Providers from 26 countries, across six different continents, were interviewed to allow for a comprehensive and multi-faceted understanding of practices in working with survivors. Participants identified utilizing an empowerment-based, survivor, and human life-centered approach to working with survivors, emphasized the importance of engaging in community level interventions, and highlighted the importance of government recognition of human trafficking. Findings provide information from the perspective of advocates on best practices in the field that can be used by agencies to enhance human trafficking programming.
Gloeckner, M R; Starling, J R
Forty patients with a permanent colostomy, ileostomy, or ileal conduit were interviewed. Besides changes in sexual performance postoperatively, the authors specifically attempted to determine answers to other sexual variables such as attractiveness, appliance problems, and partner reactions. The extent of information provided to patients on sexuality prior to the permanent ostomy was also examined. There was a significant but predictable incidence of male impotence and female dyspareunia after surgery. Despite innumerable sexual variables, other than performance, which these patients faced postoperatively, 42 per cent received no information regarding sexuality at the time of ostomy surgery. most patients (97.5 per cent) stated that sexuality, including variables other than performance, should be discussed primarily by the surgeon prior to permanent ostomy surgery. The enterostomal therapist has an important role in the total patient adjustment in the long-term postoperative period.
Sarkany, David; Deitte, Lori
Feedback is an essential component of education. It is designed to influence, reinforce, and change behaviors, concepts, and attitudes in learners. Although providing constructive feedback can be challenging, it is a learnable skill. The negative consequences of destructive feedback or lack of feedback all together are far-reaching. This article summarizes the components of constructive feedback and provides readers with tangible skills to enhance their ability to give effective feedback to learners and peers. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
This article reports on a project, involving three New Zealand schools, which investigated teachers' understanding of information literacy and their associated classroom practices. Recently published work, while lamenting school students' lack of information literacy skills, including working with online resources, provides little research…
Quantum Information Processing (QIP) is expected to bring revolutionary enhancement to various technological areas. However, today's QIP applications are far from being practical. The problem involves both hardware issues, i.e., quantum devices are imperfect, and software issues, i.e., the functionality of some QIP applications is not fully understood. Aiming to improve the practicality of QIP, in my PhD research I have studied various topics in quantum cryptography and ion trap quantum computation. In quantum cryptography, I first studied the security of position-based quantum cryptography (PBQC). I discovered a wrong assumption in the previous literature that the cheaters are not allowed to share entangled resources. I proposed entanglement attacks that could cheat all known PBQC protocols. I also studied the practicality of continuous-variable (CV) quantum secret sharing (QSS). While the security of CV QSS was considered by the literature only in the limit of infinite squeezing, I found that finitely squeezed CV resources could also provide finite secret sharing rate. Our work relaxes the stringent resources requirement of implementing QSS. In ion trap quantum computation, I studied the phase error of quantum information induced by dc Stark effect during ion transportation. I found an optimized ion trajectory for which the phase error is the minimum. I also defined a threshold speed, above which ion transportation would induce significant error. In addition, I proposed a new application for ion trap systems as universal bosonic simulators (UBS). I introduced two architectures, and discussed their respective strength and weakness. I illustrated the implementations of bosonic state initialization, transformation, and measurement by applying radiation fields or by varying the trap potential. When comparing with conducting optical experiments, the ion trap UBS is advantageous in higher state initialization efficiency and higher measurement accuracy. Finally, I
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 ...
Klabunde, Carrie N; Clauser, Steven B; Liu, Benmei; Pronk, Nicolaas P; Ballard-Barbash, Rachel; Huang, Terry T-K; Smith, Ashley Wilder
Primary care physicians (PCPs) may not adequately counsel or monitor patients regarding diet, physical activity, and weight control (i.e., provide energy balance care). We assessed the organization of PCPs' practices for providing this care. The study design was a nationally representative survey conducted in 2008. The study setting was U.S. primary care practices. A total of 1740 PCPs completed two sequential questionnaires (response rate, 55.5%). The study measured PCPs' reports of practice resources, and the frequency of body mass index assessment, counseling, referral for further evaluation/management, and monitoring of patients for energy balance care. Descriptive statistics and logistic regression modeling were used. More than 80% of PCPs reported having information resources on diet, physical activity, or weight control available in waiting/exam rooms, but fewer billed (45%), used reminder systems (energy balance care. A total of 26% reported regularly assessing body mass index and always/often providing counseling as well as tracking patients for progress related to energy balance. In multivariate analyses, PCPs in practices with full electronic health records or those that bill for energy balance care provided this care more often and more comprehensively. There were strong specialty differences, with pediatricians more likely (odds ratio, 1.78; 95% confidence interval, 1.26-2.51) and obstetrician/gynecologists less likely (odds ratio, 0.28; 95% confidence interval, 0.17-0.44) than others to provide energy balance care. PCPs' practices are not well organized for providing energy balance care. Further research is needed to understand PCP care-related specialty differences.
Barboza, Katherine; Jensen, Ashley E.; Bennett, Katelyn J.; Sherman, Scott E.; Schwartz, Mark D.
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
Toms, Elaine G.
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)
Park, Alayna L.; Chorpita, Bruce F.; Regan, Jennifer; Weisz, John R
This study examined patterns of evidence-based treatment (EBT) implementation within community settings by evaluating integrity along separate dimensions of practice content (PC; a session included the prescribed procedure) and practice sequencing (a session occurred in the prescribed sequence) within a recent randomized effectiveness trial. We measured whether sessions showed integrity to PC and to flexible or linear practice sequences. Findings revealed that providers tended to incorporate ...
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 ...
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 ...
Informed consent is the core aspect of the patient-physician relationship. Since its beginnings, clinical bioethics was opposed to the authoritarian paternalism characteristic of medicine since the 19th century. The informed consent was developed to provide patients with sufficient information to allow autonomous decisions when faced with medical diagnostic and therapeutic alternatives. In spite of bioethics effort to perfect informed consent, the discipline has been unable to avoid informed consent from becoming an impersonal and administrative procedure. Even though the major goal of this procedure is to provide sufficient information to allow patients an objective weighting of benefits and risks of medical practice, the uncertainties of medicine make full disclosure unattainable. Collecting more information finally leads to indecision and ultimate trust in medical advice. The clinical encounter is fundamentally a fiduciary relationship, and bioethics ought to accept that its main objective is to strengthen the trust bond that is essential to the clinical encounter. This goal may become incompatible with the quest for unlimited autonomy. Patients often will only require information as long as they distrust that medical institutions and their professionals are considering their interests and needs. The main proposal of this article is to temper bioethics insistence on autonomy, and accept that patients essentially seek to be protected and cared for. Informed consent ought to relent its efforts at full autonomy to the benefit of trustworthiness in medicine, and trust in clinical practice.
Full Text Available The paper examines how Quantity Surveying practices can improve their business performance, market share and profit levels by embracing and evolving with the latest technological developments in electronic business practices and data/information analysis and exchange in the construction industry. Firms in the new millenium will need towork smarterto gain competitive advantage and electronic commerce provides probably the greatest scope for this to be achieved. More importantly, current project procurement trends strongly indicate that firms not able to communicating electronically at all levels with project participants will find it increasingly difficult to secure work. The results of three nationwide surveys of the Australian Quantity Surveying profession spanning from 1995 to 1999 are used to identify current business practices and technology utilisation by Quantity Surveying firms and to analyse whether firms are positioning themselves to meet future industryrequirements. The paper concludes with a range of Information Technology strategies aimed at improving business opportunities and performance for Quantity Surveying firms.
Langarizadeh, Mostafa; Moghbeli, Fatemeh; Aliabadi, Ali
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
Ornstein, Hal; Baum, Neil
Steve Jobs is inarguably the greatest inventor and creative genius since Thomas Edison. He provided technology that enhances communication on a global level. Jobs also provided ideas and suggestions that could work in any medical practice regardless of the size of the practice, the location of the practice, or the employment model. His advice can be transferred from a high-tech business that employs thousands to a high-touch medical practice that has only a few employees. This article will list a few of Jobs leadership characteristics and how they might apply to physicians, their teams, and their practices. Wouldn't you like to be the Steve Jobs of healthcare? If so, read on!
Urquhart, Christine; Tbaishat, Dina; Yeoman, Alison
This book adopts a holistic interpretation of information architecture, to offer a variety of methods, tools, and techniques that may be used when designing websites and information systems that support workflows and what people require when 'managing information'.
Adequate knowledge by health care providers of antiretroviral use and other PMTCT strategies will be required to ensure control of vertical transmission of the virus. Objective: To assess the knowledge and practice of PMTCT among health care providers in private health facilities in Ilorin, Nigeria. Method: This is a review of ...
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.
... LIBRARIES AND INFORMATION SCIENCE GOVERNMENT IN THE SUNSHINE ACT Procedures Governing Decisions About Meetings § 1703.206 Providing information to the public. Individuals or organizations interested in... 45 Public Welfare 4 2010-10-01 2010-10-01 false Providing information to the public. 1703.206...
... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Providing information to the public. 1206.8 Section 1206.8 Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND PROCEDURES OPEN MEETINGS Procedures § 1206.8 Providing information to the public. Information available to the...
Kermack, Andrea; Flannery, Mara; Tofighi, Babak; McNeely, Jennifer; Lee, Joshua D
Buprenorphine office-based opioid maintenance is an increasingly common form of treatment for opioid use disorders. However, total prescribing has not kept pace with the current opioid and overdose epidemic and access remains scarce among the underserved. This study sought to assess current provider attitudes and clinical practices among a targeted sample of primarily New York City public sector buprenorphine prescribers. A cross-sectional online survey purposefully sampled buprenorphine prescribers in NYC with a focus on those serving Medicaid and uninsured patient populations. Expert review of local provider networks, snowball referrals, and in-person networking generated an email list, which received a survey link. A brief 25-question instrument queried provider and practice demographics, prescribing practices including induction approaches and attitudes regarding common hot topics (e.g., buprenorphine diversion, prescriber patient limits, insurance issues, ancillary treatments). Of 132 email invitations, N=72 respondents completed (n=64) or partially completed (n=8) the survey between January and April 2016. Most (79%) were Medicaid providers in non-psychiatric specialties (72%), working in a hospital-based or community general practice (51%), and board-certified in addiction medicine or psychiatry (58%). Practice sizes were generally 100 patients or fewer (71%); many providers (64%) individually prescribed buprenorphine Buprenorphine diversion was not rated as an important practice barrier. In conclusion, this targeted survey of buprenorphine prescribers in NYC treating primarily underserved populations showed a consistent pattern of part-time prescribing to modest volumes of patients, routine use of unobserved buprenorphine induction, and primarily elective referrals to psychosocial counseling. Barriers to prescribing included prior authorization requirements, lack of clinical resources (space, staff) and psychiatric services. Federal and local efforts to
Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit
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....
Osborn, Chandra Y.; Kozak, Cindy; Wagner, Julie
Introduction: A continuing education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers' practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment. Methods: Participants completed assessments of attitudes, confidence,…
National Centre for Vocational Education Research (NCVER), 2015
This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…
The potential of antenatal care for reducing maternal morbidity and mortality and improving newborn survival and health is widely acknowledged. The study sought to investigate Health Care Providers knowledge and practice of focused antenatal care in a cottage Hospital Okpatu. Qualitative ethnographical research design ...
Gilmartin, Heather; Goyal, Anupama; Hamati, Mary C; Mann, Jason; Saint, Sanjay; Chopra, Vineet
Mindfulness practice, where an individual maintains openness, patience, and acceptance while focusing attention on a situation in a nonjudgmental way, can improve symptoms of anxiety, burnout, and depression. The practice is relevant for health care providers; however, the time commitment is a barrier to practice. For this reason, brief mindfulness interventions (eg, ≤ 4 hours) are being introduced. We systematically reviewed the literature from inception to January 2017 about the effects of brief mindfulness interventions on provider well-being and behavior. Studies that tested a brief mindfulness intervention with hospital providers and measured change in well-being (eg, stress) or behavior (eg, tasks of attention or reduction of clinical or diagnostic errors) were selected for narrative synthesis. Fourteen studies met inclusion criteria; 7 were randomized controlled trials. Nine of 14 studies reported positive changes in levels of stress, anxiety, mindfulness, resiliency, and burnout symptoms. No studies found an effect on provider behavior. Brief mindfulness interventions may be effective in improving provider well-being; however, larger studies are needed to assess an impact on clinical care. Published by Elsevier Inc.
Carter, Candice C.
This article reviews restorative practices (RP) as education in formal and informal contexts of learning that are fertile sites for cultivating peace. Formal practices involve instruction about response to conflict, while informal learning occurs beyond academic lessons. The research incorporated content analysis and a critical examination of the…
Spain, Margaret P; DeCristofaro, Claire; Smith, Carol A
To describe the use of a clinical decision-making work sheet as a tool to teach communication skills to advanced practice nurse (APN) students. Achievement of competencies in communication and documentation that utilize language and communication strategies that are shared with other health professionals promotes effective collaborative practice among members of the multidisciplinary provider team. Review of the recent Institute of Medicine report on health professions education and other health professional literature. The Clinical Decision-Making Work Sheet helps APN students effectively communicate in real-world clinical settings. The clinical work sheet allows nurse practitioner students to communicate more effectively and efficiently, using a vocabulary that is shared with other members of the multidisciplinary health care provider team. Use of the tool in students' clinical-rotation settings facilitates effective application and refinement of the clinical decision-making skills that students learned in the advanced health assessment course. Faculty have the responsibility to assist nurses as they transition from traditional nursing to APN roles. The work sheet facilitates learning the common language for data collection, clinical decision making, documentation, and reporting that is shared with other health professionals. Using the tool, students learn to efficiently organize information that supports communication and documentation that enhances their clinical problem-solving skills. Case presentation and documentation using the work sheet provide a basis for preceptor and student interaction and for student evaluation.
Chatterley, Trish; Storie, Dale; Chambers, Thane; Buckingham, Jeanette; Shiri, Ali; Dorgan, Marlene
Healthcare practitioners in Alberta and across Canada have varying levels of access to information resources depending on their institutional and professional affiliations, yet access to current health information is critical for all. To determine what information resources and services are provided by Albertan and Canadian professional health associations to their members. Representatives of professional colleges and associations were interviewed regarding information resources and services offered to members and perceptions of their members' information needs. National-level associations are more likely to provide resources than provincial ones. There is a clear distinction between colleges and associations in terms of information offered: colleges provide regulatory information, while associations are responsible for provision of clinical information resources. Only half of the associations interviewed provide members with access to licensed databases, with cost being a major barrier. There is considerable variation in the number of electronic resources and the levels of information support provided by professional health associations in Alberta and Canada. Access and usage vary among the health professions. National licensing of resources or creation of a portal linking to freely available alternatives are potential options for increasing access and awareness. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.
The last decade has seen a considerable growth in the application of e-learning courses in most higher education institutions and in companies that provide inhouse training for employees. Hereby recognition is given that modern information and telecommunication technologies can help educators to meet the dual
Dayananda, Ila; Walker, Dilys; Atienzo, Erika E; Haider, Sadia
Little is known about abortion practice in Mexico postlegalization of abortion in Mexico City in 2007. In 2009, we anonymously surveyed 418 Mexican health care providers at the Colegio Mexicano de Especialistas en Ginecologia y Obstetricia meeting using audio computer-assisted self-interview technology. The majority of respondents were obstetrician gynecologists (376, 90%), Catholic (341, 82%), 35-60 years old (332, 79%) and male (222, 53%) and worked with trainees (307, 74%). Prior to 2007, 11% (46) and 17% (71) provided medical and surgical abortions; now, 15% (62) and 21% (86) provide these services, respectively. Practitioners from Mexico City were more likely to provide services than those from other areas. Most medical abortion providers (50, 81%) used ineffective protocols. Surgical abortion providers mainly used either manual vacuum aspiration (39, 45%) or sharp curettage (27, 32%). Most abortion providers were trained in residency and wanted more training in medical (54, 87%) and surgical (59, 69%) abortion. Among nonproviders, 49% (175) and 27% (89) expressed interest in learning to perform medical and surgical abortion, respectively. Given the interest in learning to provide safe abortion services and the prevalent use of ineffective medical abortion regimens and sharp curettage, abortion training in Mexico should be strengthened. Copyright © 2012 Elsevier Inc. All rights reserved.
Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan
Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.
Jernigan, Amelia M; Tergas, Ana I; Satin, Andrew J; Fader, Amanda N
Obesity is associated with the development and risk of death from several women's cancers. The study objective was to describe and compare oncologic providers' attitudes and practices as they relate to obesity counseling and management in cancer survivors. Society of Gynecologic Oncology members (n = 924) were surveyed with the use of a web-based, electronic questionnaire. χ(2) and Fisher exact tests were used to analyze responses. Of the 240 respondents (30%), 92.9% were practicing gynecologic oncologists or fellows, and 5.1% were allied health professionals. Median age was 42 years; 50.8% of the respondents were female. Of the respondents, 42.7% reported that they themselves were overweight/obese and that ≥50% of their survivor patients were overweight/obese. Additionaly, 82% of the respondents believed that discussing weight would not harm the doctor-patient relationship. Most of the respondents (95%) agreed that addressing lifestyle modifications with survivors is important. Respondents believed that gynecologic oncologists (85.1%) and primary care providers (84.5%) were responsible for addressing obesity. More providers who were ≤42 years old reported undergoing obesity management training (P 42 years old (P = .017). After initial counseling, 81.5% of the respondents referred survivors to other providers for obesity interventions. Oncology provider respondents believe that addressing obesity with cancer survivors is important. Providers believed themselves to be responsible for initial counseling but believed that obesity interventions should be directed by other specialists. Further research is needed to identify barriers to care for obese cancer survivors and to improve physician engagement with obesity counseling in the "teachable moment" that is provided by a new cancer diagnosis. Copyright © 2013 Mosby, Inc. All rights reserved.
Fold, Niels; Allotey, Albert N.M.; Kalvig, Per
Artisanal mining is mainly carried out as an informal activity without a mining license, the payment of public fees or compliance with environmental and labour regulations. Although artisanal mining persists in most African countries, efforts by public authorities to formalize such activities have...... encountered numerous problems. This paper uses the Credibility Thesis to explain the persistence of the artisanal mining of aggregates in the Accra metropolitan area in Ghana. Aggregates are used in the construction of houses, and several artisanal quarries supply the highly fluctuating and unpredictable...... demand from individual house-owners. We identify complex but relatively stable endogenous ways of organising artisanal production and marketing in five quarries at different stages of consolidation and liquidation: sites are initially exploited but then gradually transformed into waste dumps or new...
Banwell, Linda; Ray, Kathryn; Coulson, Graham; Urquhart, Christine; Lonsdale, Ray; Armstrong, Chris; Thomas, Rhian; Spink, Sin; Yeoman, Alison; Fenton, Roger; Rowley, Jennifer
This article aims to provide a baseline for future studies on the provision and support for the use of digital or electronic information services (EIS) in further education. The analysis presented is based on a multi-level model of access, which encompasses access to and availability of information and communication technology (ICT) resources,…
This paper uses the example of foreign languages to explore the integration of critical information literacy into the curriculum of various disciplines. By closely examining the practices and values inherent in the foreign language information environment, the paper suggests that a critical vision of information literacy provides the most…
Mustafa A. Alssageer
Full Text Available Objective: To examine the opinions of Libyan doctors regarding the quality of drug information provided by pharmaceutical company representatives (PCRs during detailing visits. Method: An anonymous survey was conducted among 1,000 doctors from selected institutes in Tripoli, Benghazi and Sebha. Doctors were asked questions regarding the quality of information provided during drug-detailing visits. Results: A questionnaire return rate of 61% (608 returned questionnaires out of 1,000 was achieved. The majority (n=463, 76% of surveyed participants graded the quality of information provided as average. Approximately, 40% of respondents indicated that contraindications, precautions, interactions and adverse effects of products promoted by PCRs were never or rarely mentioned during promotional visits, and 65% of respondents indicated that an alternative drug to the promoted product was never or rarely mentioned by the representatives. More than 50% of respondents (n=310, 51% reported that PCRs were not always able to answer all questions about their products. Only seven respondents (1% believed that PCRs never exaggerated the uniqueness, efficacy or safety of their product. The majority of respondents (n=342, 56% indicated that verbal information was not always consistent with written information provided. Seven per cent of respondents (n=43 admitted that they did not know whether or not the verbal information provided by PCRs was consistent with written information. Conclusion: Doctors believe that the provision of drug information by PCRs in Libya is incomplete and often exaggerated. Pharmaceutical companies should ensure that their representatives are trained to a standard to provide reliable information regarding the products they promote.
Morris, Zoë Slote; Clarkson, Peter John
We argue that social marketing can be used as a generic framework for analysing barriers to the take-up of clinical guidelines, and planning interventions which seek to enable this change. We reviewed the literature on take-up of clinical guidelines, in particular barriers and enablers to change; social marketing principles and social marketing applied to healthcare. We then applied the social marketing framework to analyse the literature and to consider implications for future guideline policy to assess its feasibility and accessibility. There is sizeable extant literature on healthcare practitioners' non-compliance with clinical guidelines. This is an international problem common to a number of settings. The reasons for poor levels of take up appear to be well understood, but not addressed adequately in practice. Applying a social marketing framework brings new insights to the problem." We show that a social marketing framework provides a useful solution-focused framework for systematically understanding barriers to individual behaviour change and designing interventions accordingly. Whether the social marketing framework provides an effective means of bringing about behaviour change remains an empirical question which has still to be tested in practice. The analysis presented here provides strong motivation to begin such testing.
Archives and Records Management (ARM) literature surrounding Information Protection (IP) has been developed in relative isolation from the IP field. As a result, it has been unclear until now whether and to what extent ARM literature and practice is consistent with or divergent from IP literature and practice. This paper ...
eHealth is the use of information and communication technologies for health. mHealth is the use of mobile technology in health. As with all information technology (IT), advances in development are rapidly taking place. The application of such technology to individual ambulatory anaesthesia practice should improve the ...
Introduction: The present study presents a view of information literacy not primarily as skill but as different practices, situated within specific social and institutional contexts. It suggests that questions of authority of knowledge are central to understanding people's information practices. Method: First, the concept of information practices…
Granara, Brittany; Laurent, Jennifer
More than one third of American adults are obese. Extreme obesity is rapidly rising. Nine medications are approved for weight loss yet they remain underutilized with the focus primarily on lifestyle modifications. The objective was to determine current prescribing patterns and attitudes of weight loss medications in the management of obesity among primary care providers (PCPs). PCPs were surveyed to determine practice patterns, attitudes, barriers, and facilitators for prescribing weight loss medications. Ninety-four surveys were analyzed. Seventy-six percent of all PCPs did not prescribe weight loss medications for long-term weight loss and 58% of PCPs had negative perceptions of pharmacotherapy. Differences existed between prescribing patterns and attitudes of advanced practice clinicians and physicians. Safety concerns were the greatest barrier. Having 2+ comorbidities and severe obesity were facilitators for prescribing weight loss medications. Underutilization of pharmacotherapy suggests that PCPs may not have sufficient knowledge about medication safety profiles and efficacy. Delaying treatment until patients have reached a high level of morbidity may be less efficacious than earlier treatment. Education regarding effectiveness and risks of weight loss medications for obesity management is needed and earlier interventions with pharmacotherapy may prevent significant morbidity and mortality. ©2017 American Association of Nurse Practitioners.
This paper uses the example of foreign languages to explore the integration of critical information literacy into the curriculum of various disciplines. By closely examining the practices and values inherent in the foreign language information environment, the paper suggests that a critical vision of information literacy provides the most appropriate approach to help meet campus goals of educating students for transcultural competence. As such, the paper provides an example of the process and...
This study assessed the information services provided in special collections unit in federal and state University libraries in Nigeria. One research question was formulated to guide the study. Descriptive survey design was adopted in carrying out the study. A purposive sampling procedure was used to obtain a sample of 178 ...
Boggs, Sharon A. C.; And Others
A survey of 130 rural community pharmacists in Washington State found 70% in towns with five or fewer pharmacies; almost all provided nutrition information to their communities though only 20% had taken a nutrition course during pharmacy training. Most common questions concerned supplements and weight loss. Respondents relied on pharmacy journals,…
Student support is a major factor in distance education. This study was concerned with the use of ICT as a medium for providing student support at the University of Zambia. It was necessary to study the factors that would affect the application of ICT, in order to inform policy makers and managers of distance education which ...
Saporito, R A; Feldman, C A; Stewart, D C; Echoldt, H; Buchanan, R N
Participation in a self-administered quality assessment (SAQA) program led to changes in New Jersey dentists' perceptions of practice quality. Ninety-four percent indicated they discovered practice deficiencies. This study suggests that using a self-administered quality assessment program, such as the SAQA program, can lead to a better understanding of a practice's strengths and weaknesses.
Roehl-Anderson, Janice M
Add value to your organization via the mergers & acquisitions IT function As part of Deloitte Consulting, one of the largest mergers and acquisitions (M&A) consulting practice in the world, author Janice Roehl-Anderson reveals in M&A Information Technology Best Practices how companies can effectively and efficiently address the IT aspects of mergers, acquisitions, and divestitures. Filled with best practices for implementing and maintaining systems, this book helps financial and technology executives in every field to add value to their mergers, acquisitions, and/or divestitures via the IT
Spaargaren, G.; Koppen, van C.S.A.
Making consumption practices more sustainable means incorporating new ideas, information and products into existing consumption routines of citizen-consumers. For a successful incorporation process it is crucial that companies, as main providers of new products and services, develop an active
Hertzum, M.; Pejtersen, A. M.
Engineers get most of their information from colleagues and internal reports. This study investigates how engineers' information-seeking practices intertwine looking for informing documents with looking for informed people. Based on case studies in two product-development organisations we find...... that engineers search for documents to find people, search for people to get documents, and interact socially to get information without engaging in explicit searches, This intricate interplay between document and people sources can be explained by the nature of the design task, Many possible solutions...... the context of the design process is typically not available. Hence: people become a critical source of information because they can explain and argue about why specific decisions were made and what purpose is served by individual parts of the design. While document retrieval is a well-established field...
Muzumdar, Jagannath M; Pantaleo, Nicholas L
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.
McDonough, J P; McMullen, P; Philipsen, N
Generally, health care providers have viewed safety in terms of prevention of patient accidents. However, with the growth of patient consumerism and stress on quality improvement, the concept of "safety" has been expanded. This article examines the legal concept of informed consent and offers practical suggestions on increasing both patient and provider safety and improving quality of care. For reasons dictated by statute, case law, and professional ethics, informed consent should be part of the practice of every CRNA. With proper informed consent, misinformation, dissatisfaction, and subsequent legal action can be diminished. Information should be offered to the patient and family and reinforced with written educational materials and instructions. These procedures should be documented in the medical record to provide verification that the patient was informed of the risks and benefits and agreed to the procedure contemplated. Failure to do so could expose the CRNA to legal actions under legal theories that include not only negligence, but battery, and contract as well.
Haun, Jolie N; Hathaway, Wendy; Chavez, Margeaux; Antinori, Nicole; Vetter, Brian; Miller, Brian K; Martin, Tracey L; Kendziora, Lisa; Nazi, Kim M; Melillo, Christine
Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustained use by VA clinical care team members and veterans. Objectives A collaborative project solicited input from VA clinical care teams about their local practices using SM to provide access to proactive patient-centered care for veterans and enhance workflow. Methods This project implemented a single-item cross-sectional qualitative electronic survey via internal e-mail to local coordinators in all 23 Veterans Integrated Service Networks (VISNs). Content analysis was used to manage descriptive data responses. Descriptive statistics described sample characteristics. Results VA clinical care team members across 15 of 23 VISNs responded to the questionnaire. Content analysis of 171 responses produced two global domains: (1) benefits of SM and (2) SM best practices. Benefits of SM use emphasize enhanced and efficient communication and increased access to care. Care team members incorporate SM into their daily clinical practices, using it to provide services before, during, and after clinical encounters as a best practice. SM users suggest improvements in veteran care, clinical team workflow, and efficient use of health resources. Clinical team members invested in the successful implementation of SM integrate SM into their daily practices to provide meaningful and useful veteran-centered care and improve workflow. Conclusion VA clinical care team members can use SM proactively to create an integrated SM culture. With adequate knowledge and motivation to proactively use this technology, all clinical team members within the VA system can replicate best practices shared by other clinical care teams to generate meaningful and useful interactions with SM
People with disabilities use various assistance devices to improve their capacity to lead independent and fulfilling lives. Service dogs can be crucial lifesaving companions for their owners. As the use of service dogs increases, nurses are more likely to encounter them in healthcare settings. Service dogs are often confused with therapy or emotional support dogs. While some of their roles overlap, service dogs have distinct protection under the American Disabilities Act (ADA). Knowing the laws and proper procedures regarding service dogs strengthens the abilities of healthcare providers to deliver holistic, patient-centered care. This article provides background information about use of dogs, and discusses benefits to patients and access challenges for providers. The author reviews ADA laws applicable to service dog use and potential challenges and risks in acute care settings. The role of the healthcare professional is illustrated with an exemplar, along with recommendations for future research and nursing implications related to care of patients with service dogs.
To explore and identify precedent factors that may influence nursing students' oral hygiene practice in hospitalised patients, by using an adaptation of the Precede Model. A quantitative approach with a descriptive design was adopted in this pilot study. A questionnaire was designed and implemented as a self-report method of data collection. A convenience sample of 37 second-year diploma nursing students in an Irish teaching hospital participated in the study. The clinical area and the practices within it are influential factors in the provision of oral hygiene. Students are exposed to and influenced by outdated and non-research-based practices. Role modelling is an effective means of motivating and reinforcing student practices. However, qualified nurses' practices need to be critically reviewed before assuming that they can act as role models in assisting students to implement research-based oral hygiene. Formal education, current practices, socialisation and role modelling may influence students' behaviour in relation to oral hygiene. The results should be tentatively reviewed by clinical staff as an indication of current practices.
Grobe, M. [Alberta Geological Survey, Edmonton, AB (Canada). Earth Systems Section
The mission of the Alberta Geological Survey (AGS) is to provide, data, information, knowledge, and advice about the geology of Alberta needed by government, industry, and the public for earth-resource stewardship and sustainable development in Alberta. This presentation discussed the provision of geoscience information for geoexchange technology implementation in Alberta. Surficial and bedrock geology influences the selection, installation cost and performance of geoexchange systems. The AGS is currently examining the feasibility of transforming geological maps to geothermal property maps for geoexchange design purposes and decision making by policy makers and industry. Shallow or ground-source geothermal energy in Alberta and the role of geoscience information were presented. The role of the AGS and its activities were outlined. The presentation also identified a project approach to two studies, notably a geoscience needs and utilities assessment as well as a pilot study in the Edmonton area. Data compilation and maps of the pilot study were presented. Last, the presentation discussed drilling, sampling and thermal testing in an area of thick drift over bedrock. It was determined that quality geoscience information is an important factor for site assessment and proper geoexchange design and decision making. The sharing data and experience for better decision making was found to be an important benefit. tabs., figs.
... provide other information and granting immunity. 1025.39 Section 1025.39 Commercial Practices CONSUMER... Process § 1025.39 Orders requiring witnesses to testify or provide other information and granting immunity... witness or deponent to testify or provide other information upon being granted immunity from prosecution...
Full Text Available This paper uses the example of foreign languages to explore the integration of critical information literacy into the curriculum of various disciplines. By closely examining the practices and values inherent in the foreign language information environment, the paper suggests that a critical vision of information literacy provides the most appropriate approach to help meet campus goals of educating students for transcultural competence. As such, the paper provides an example of the process and role of the librarian in integrating critical information literacy into disciplinary fields and proposes that this approach could be effective in global learning initiatives.
A fast paced workshop designed for senior public health decision makers and clinical leaders implementing information systems to support delivery of public health programs. The tutorial will introduce public health information systems and provide best practices for implementing solutions related to immunization, communicable disease case management and outbreak management. Using a combination of formats, the tutorial will: • Highlight key functionality of public health information systems. • Review global crises currently exposing gaps and deficiencies in public health information. • Examine governance, planning, and implementation priorities. • Highlight considerations supporting implementations nationally and in special populations. • Provide real, actionable lessons learned to take away and apply in the real world.
Yuon, Egor; Soukhanov, Mikhail; Markov, Kirill
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
Dr Jason Cooper
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.
When health care providers and migrant patients do not share a common language, informal interpreters - usually family members of the patients - come along to bridge the language gap. While patients usually feel comfortable with having an informal interpreter, this type of interpreter-mediated
Federal agencies are under pressure to do more with less--to improve the services they provide to the public, with greater accountability for achieving results, more quickly and at lower cost. In a 1994 study of leading organizations, the General Accounting Office (GAO) identified 11 strategic information management (SIM) practices, which became the foundation of the Clinger-Cohen Act of 1996. In 1997, the Federal Chief Information Officers (CIO) Council and the Industry Advisory Council prepared 20 case studies demonstrating the use of information technology to achieve a positive return on investment within the federal government. Focusing on these 20 case studies, this research first looked for evidence that supported or refuted each of GAO's SIM practices. Second, the research looked for best practices that may be unique to a federal environment. Third, the study identified other best practices.
Dorner, Daniel G; Calvert, Philip J
If you want to provide an information service that truly fulfils your users' needs, this book is essential reading. The book supports practitioners in developing an information needs analysis strategy and offers the necessary professional skills and techniques to do so.
Full Text Available What is the nature of information? What is its role in Contemporary Cosmopolitan Civil Society? What is the basis for the widespread current belief that we live in an ‘information society’? The present article will examine these questions through an examination of the historical origins of established ‘scientized’ views of information in the philosophy of the Enlightenment. It describes how postmodern and poststructuralist critique of such positivist approaches led to profound paradigmatic and methodological shifts in the social and information studies fields in recent decades. It consider how the emergence of social constructivist approaches to information research drawing on discourse analysis, practice theory and ethnographic theories and methodologies has led to a have led researchers to a radically different understanding of central concepts such as: the influence of emergent information and communication technologies on contemporary society; the relationship between knowledge and power, the nature of expertise and authoritative information; a re-thinking of community and consensus; a re-interpretation of notions of space and place in information dissemination, sharing and use and a reconsideration of the role of the researcher. The article illustrates this changing research landscape through reference to the work of scholars in the Cosmopolitan Civil Societies Research Centre at the University of Technology, Sydney, published in the Centre’s journal.
Uncertainty in clinical encounters is inevitable and despite this uncertainty clinicians must still work with patients to make diagnostic and treatment decisions. Explicit diagnostic reasoning based on probabilities will optimise information in relation to uncertainty. In clinical diagnostic encounters, there is often pre-existing information that reflects the probability any particular patient has a disease. Diagnostic testing provides extra information that refines diagnostic probabilities. However, in general diagnostic tests will be positive in most, but not all cases of disease (sensitivity) and may not be negative in all cases of disease absence (specificity). Bayes rule is an arithmetic method of using diagnostic testing information to refine diagnostic probabilities. In this method, when probabilities are converted to odds, multiplication of the odds of disease before diagnostic testing, by the positive likelihood ratio (LR+), the sensitivity of a test divided by 1 minus the specificity refines the probability of a particular diagnosis. Similar arithmetic applies to the probability of not having a disease, where the negative likelihood ratio is the specificity divided by 1 minus the sensitivity. A useful diagnostic test is one where the LR+ is greater than 5-10. This can be clarified by creating a contingency table for hypothetical groups of patients in relation to true disease prevalence and test performance predicted by sensitivity and specificity. Most screening tests in populations with a low prevalence of disease have a very high ratio of false positive results to true positive results, which can also be illustrated by contingency tables. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Awad, Ahmed; Woungang, Isaac
This book introduces novel research targeting technical aspects of protecting information security and establishing trust in the digital space. New paradigms, and emerging threats and solutions are presented in topics such as application security and threat management; modern authentication paradigms; digital fraud detection; social engineering and insider threats; cyber threat intelligence; intrusion detection; behavioral biometrics recognition; hardware security analysis. The book presents both the important core and the specialized issues in the areas of protection, assurance, and trust in information security practice. It is intended to be a valuable resource and reference for researchers, instructors, students, scientists, engineers, managers, and industry practitioners. .
Blue, Christine M; Funkhouser, D Ellen; Riggs, Sheila; Rindal, D Brad; Worley, Donald; Pihlstrom, Daniel J; Benjamin, Paul; Gilbert, Gregg H
The purpose of this study was to quantify, within the National Dental Practice-Based Research Network, current utilization of dental hygienists and assistants with expanded functions and quantify network dentists' attitudes toward a new nondentist provider model - the dental therapist. National Dental Practice-Based Research Network practitioner-investigators participated in a single, cross-sectional administration of a questionnaire. Current nondentist providers are not being utilized by network practitioner-investigators to the fullest extent allowed by law. Minnesota practitioners, practitioners in large group practices, and those with prior experience with expanded-function nondentist providers delegate at a higher rate and had more-positive perceptions of the new dental therapist model. Expanding scopes of practice for dental hygienists and assistants has not translated to the maximal delegation allowed by law among network practices. This finding may provide insight into dentists' acceptance of newer nondentist provider models. © 2013 American Association of Public Health Dentistry.
Background The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Discussion Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. Summary KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs. PMID:23171660
Full Text Available Abstract Background The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Discussion Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. Summary KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs.
Novotná, Gabriela; Dobbins, Maureen; Henderson, Joanna
The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs.
Newnham, Harvey; Barker, Anna; Ritchie, Edward; Hitchcock, Karen; Gibbs, Harry; Holton, Sara
To systematically review the available evidence about hospital discharge communication practices and identify which practices were preferred by patients and healthcare providers, improved patient and provider satisfaction, and increased patients' understanding of their medical condition. OVID Medline, Web of Science, ProQuest, PubMed and CINAHL plus. Databases were searched for peer-reviewed, English-language papers, published to August 2016, of empirical research using quantitative or qualitative methods. Reference lists in the papers meeting inclusion criteria were searched to identify further papers. Of the 3489 articles identified, 30 met inclusion criteria and were reviewed. Much research to date has focused on the use of printed material and person-based discharge communication methods including verbal instructions (either in person or via telephone calls). Several studies have examined the use of information technology (IT) such as computer-generated and video-based discharge communication practices. Utilizing technology to deliver discharge information is preferred by healthcare providers and patients, and improves patients' understanding of their medical condition and discharge instructions. Well-designed IT solutions may improve communication, coordination and retention of information, and lead to improved outcomes for patients, their families, caregivers and primary healthcare providers as well as expediting the task for hospital staff.
Full Text Available The wetland has a strategic role in national development. The potential uses of the wetland are varied such as for agriculture, fisheries, industries, and forestry. The intensive use of the wetland for agricultural development in Sumatera, Kalimantan, Sulawesi, and Papua through transmigration projects has been run since in 1973. Unfortunately, not all the projects were well developed, causing the social, economic, and physical environmental problems. These problems resulted in the negative impact for the life of the transmigration people. For that reason, the community empowerment for the unlucky transmigration people by handling the physical and non physical aspects is very important. This paper will describe the importance of providing spatial data and information biophysical wetland as an initial step in empowering people who live in the wetland resource.
Vladimir D. Secerin
Full Text Available The thesis of importance of informative constituent Comes into question as non-material assets in a postindustrial economy. Importance of limitations is shown in realization of technological processes to want of authenticity, objectivity and timeliness of actualization of knowledge of specialists. As recommendations on providing of accordance of actuality of on-line tutorial to the level of technological development on a production at the limitations determined by the system requirements of educational standard “From a teacher to a student”, the chart of forming of the creative thinking of student is offered as nooswear technologies are in organization of feed-back “From a student to a teacher “.
Weberschock, T; Valipour, A; Ochsendorf, F
Involuntary childlessness is a common problem. In about 50% of cases, inadequate semen quality plays a relevant role. A semen analysis provides information regarding exocrine function of the male reproductive organs of the testes, epidydimis, seminal vesicles, prostate gland, and vas deferens. These parameters can only be interpreted in conjunction with medical history and physical examination. Then they can be useful to identify relevant disorders or the causes of these disturbances. The fundamental principles for the interpretation of a semen analysis are easily learned and traditionally belong to the field of dermatology. This article explains the variables which are examined in a routine semen analysis as well as the reference values. Furthermore, common causes for deviations from the normal values are discussed to allow decision-making for further diagnostic workup. The interpretation of these values must always take into account the situation of the couple.
Jacquiod, Samuel Jehan Auguste; Stenbæk, Jonas; Santos, Susana S.
Despite the critical ecological roles of microeukaryotes in terrestrial ecosystems, most descriptive studies of soil microbes published so far focused only on specific groups. Meanwhile, the fast development of metagenome sequencing leads to considerable data accumulation in public repositories......, 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...... on metagenomic microeukaryote DNA. Choosing the correct annotation procedure and reference database has proven to be crucial, as it considerably limits the risk of wrong assignments. In addition, a significant and pronounced effect of the DNA extraction method on the taxonomical structure of soil microeukaryotes...
Full Text Available Treating morphologically complex words (MCWs as atomic units in translation would not yield a desirable result. Such words are complicated constituents with meaningful subunits. A complex word in a morphologically rich language (MRL could be associated with a number of words or even a full sentence in a simpler language, which means the surface form of complex words should be accompanied with auxiliary morphological information in order to provide a precise translation and a better alignment. In this paper we follow this idea and propose two different methods to convey such information for statistical machine translation (SMT models. In the first model we enrich factored SMT engines by introducing a new morphological factor which relies on subword-aware word embeddings. In the second model we focus on the language-modeling component. We explore a subword-level neural language model (NLM to capture sequence-, word- and subword-level dependencies. Our NLM is able to approximate better scores for conditional word probabilities, so the decoder generates more fluent translations. We studied two languages Farsi and German in our experiments and observed significant improvements for both of them.
Arthur Nunes Ferreira Neto
Full Text Available This article deals with the generation and application of ontological metamodels of frameworks of best practices in IT. The ontological metamodels represent the logical structures and fundamental semantics of framework models and constitute adequate tools for the analysis, adaptation, comparison and integration of the frameworks of best practices in IT. The MetaFrame methodology for the construction of the metamodels, founded on the discipline of the conceptual metamodelling and on the extended Entity/Relationship methodology is described herein, as well as the metamodels of the best practices for the outsourcing of IT, the eSCM-SP v2.01 (eSourcing Capability Model for Service Providers and the eSCM-CL v1.1 (eSourcing Capability Model for Client Organizations, constructed according to the MetaFrame methodology.
Churi, Shobha; Abraham, Lovin; Ramesh, M; Narahari, M G
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
Hämäläinen, Liisa; Rowland, Hannah M; Mappes, Johanna; Thorogood, Rose
Video playback is becoming a common method for manipulating social stimuli in experiments. Parid tits are one of the most commonly studied groups of wild birds. However, it is not yet clear if tits respond to video playback or how their behavioural responses should be measured. Behaviours may also differ depending on what they observe demonstrators encountering. Here we present blue tits (Cyanistes caeruleus) videos of demonstrators discovering palatable or aversive prey (injected with bitter-tasting Bitrex) from coloured feeding cups. First we quantify variation in demonstrators' responses to the prey items: aversive prey provoked high rates of beak wiping and head shaking. We then show that focal blue tits respond differently to the presence of a demonstrator on a video screen, depending on whether demonstrators discover palatable or aversive prey. Focal birds faced the video screen more during aversive prey presentations, and made more head turns. Regardless of prey type, focal birds also hopped more frequently during the presence of a demonstrator (compared to a control video of a different coloured feeding cup in an empty cage). Finally, we tested if demonstrators' behaviour affected focal birds' food preferences by giving individuals a choice to forage from the same cup as a demonstrator, or from the cup in the control video. We found that only half of the individuals made their choice in accordance to social information in the videos, i.e., their foraging choices were not different from random. Individuals that chose in accordance with a demonstrator, however, made their choice faster than individuals that chose an alternative cup. Together, our results suggest that video playback can provide social cues to blue tits, but individuals vary greatly in how they use this information in their foraging decisions.
Full Text Available Video playback is becoming a common method for manipulating social stimuli in experiments. Parid tits are one of the most commonly studied groups of wild birds. However, it is not yet clear if tits respond to video playback or how their behavioural responses should be measured. Behaviours may also differ depending on what they observe demonstrators encountering. Here we present blue tits (Cyanistes caeruleus videos of demonstrators discovering palatable or aversive prey (injected with bitter-tasting Bitrex from coloured feeding cups. First we quantify variation in demonstrators’ responses to the prey items: aversive prey provoked high rates of beak wiping and head shaking. We then show that focal blue tits respond differently to the presence of a demonstrator on a video screen, depending on whether demonstrators discover palatable or aversive prey. Focal birds faced the video screen more during aversive prey presentations, and made more head turns. Regardless of prey type, focal birds also hopped more frequently during the presence of a demonstrator (compared to a control video of a different coloured feeding cup in an empty cage. Finally, we tested if demonstrators’ behaviour affected focal birds’ food preferences by giving individuals a choice to forage from the same cup as a demonstrator, or from the cup in the control video. We found that only half of the individuals made their choice in accordance to social information in the videos, i.e., their foraging choices were not different from random. Individuals that chose in accordance with a demonstrator, however, made their choice faster than individuals that chose an alternative cup. Together, our results suggest that video playback can provide social cues to blue tits, but individuals vary greatly in how they use this information in their foraging decisions.
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...
Full Text Available The purpose of this paper is to present some directions to perform the risk man-agement for information security. The article follows to practical methods through question-naire that asses the internal control, and through evaluation based on existing controls as part of vulnerability assessment. The methods presented contains all the key elements that concurs in risk management, through the elements proposed for evaluation questionnaire, list of threats, resource classification and evaluation, correlation between risks and controls and residual risk computation.
Manojlovich, Milisa; Adler-Milstein, Julia; Harrod, Molly; Sales, Anne; Hofer, Timothy P; Saint, Sanjay; Krein, Sarah L
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
Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.
Health information exchange (HIE) can support several aspects of public health practice by increasing the availability, timeliness, and comprehensiveness individual-level patient information. The potential benefits to disease monitoring, disaster response, and other public health activities served...... as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using...... qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. We derived the codes for the template analysis through a literature review. HIE supported public health activities consistent with expectations in the literature...
Goldberg, Holly Bianca; Shorten, Allison
The objective of this study was to determine whether differences exist between patient and provider perceptions regarding the decision-making process around use of epidural analgesia during childbirth. The dyadic patient-provider Decisional Conflict Scale was modified to measure first-time mother (n = 35) and maternity care provider (n = 52) perceptions. Providers perceived a greater degree of informed decision making than patients (84.97 vs. 79.41, p = .04) and were more likely to recall they upheld patients' rights to make informed choices than patients were to perceive their rights had been upheld (85.95 vs. 71.73, p < .01). This incongruity highlights the need to align legal principles with practice to create mutual agreement between stakeholder perceptions of informed decision making.
Grispen, Janaica E J; Ickenroth, Martine H P; de Vries, Nanne K; van der Weijden, Trudy; Ronda, Gaby
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.
Kolthoff, Sie Karen; Hestbech, Mie Sara; Jørgensen, Karsten Juhl
OBJECTIVE: To investigate whether invitations for publicly funded cervical screening provide sufficient information to enable an informed choice about participation. DESIGN: Cross-sectional study using a checklist of 23 information items on benefits and harms from cervical screening and the risks...... OUTCOME MEASURES: Number of information items presented in invitations for cervical screening. RESULTS: We contacted 21 coordinating units from 11 countries and 20 (95%) responded. Of these, four units did not issue invitations, but the remaining 16 coordinating units in 10 different countries supplied...... a sample. The invitations for cervical screening were generally information poor and contained a median of only four out of 23 information items possible (17%), ranging from 0 to 12 (0-52%). The most important harms of cancer screening, overdiagnosis and overtreatment, were typically downplayed...
O. S. Solovjov
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.
Armstrong, Amy E; Fonstad, Rachel; Spellman, Stephen; Tullius, Zoe; Chaudhury, Sonali
More than 35 000 umbilical cord blood (UCB) transplants have been performed worldwide, prompting the development of private and public banks to collect and store UCB cells. We hypothesized that pediatricians, who are uniquely poised to discuss UCB banking (UCBB) during prenatal or sibling visits, rarely do so. Through distribution of a 26-question electronic survey to general and subspecialty pediatric providers, we assessed baseline knowledge and conversations about UCBB. A total of 473 providers completed the survey; only 22% of physicians ever discussed UCBB with expectant parents. The majority responded that autologous UCB transplants were indicated in malignant (73%) and nonmalignant (61%) conditions; however, these are rare indications. Providers practicing >10 years were more likely to address UCBB ( P ≤ .001), whereas younger and female general pediatric providers were significantly less likely ( P < .001). Overall, pediatric providers rarely speak to families about UCBB, and we believe that they can be better informed to its current clinical utility.
Brewster, Liz; Sen, Barbara
Information prescriptions (IPs) are part of a Department of Health (DH) initiative to improve patient care. IPs aim to meet health information needs by providing personalised, high quality patient information about conditions and treatment. This paper identifies current online IP provision and evaluates a sample of IP websites against the original DH aims of IP provision; British Medical Association usability criteria; and information seeking vignettes. Five UK and one international IP website were randomly selected as a sample. Two checklists designed to appraise the websites were used to review each IP provider. Two patient information seeking vignettes were developed to enable the websites to be assessed from a patient-centred perspective. Information prescriptions currently vary in content, accessibility and quality. National IP websites score more highly than local IP websites, which are often weak on content for specific conditions and poorly designed but strong on signposting to local services. Guidelines for IP provision need to be improved to ensure higher quality, more easily accessible information is available. A synthesis of expertise included in national and local websites would improve usability for patients. IP websites should conform to standards of web design and accessibility. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.
Belcher, Claire; Hudpsith, Victoria; Doerr, Stefan; Santin, Cristina
Building an understanding of the impact of a wildfire is critical to the management of ecosystems. Aspects of fire severity such as the amount of soil heating, can relate to post-fire ecosystem recovery. Yet, there is no quantitative measure of this in current post-burn fire severity assessments, which are mostly qualitative ground-based visual assessments of organic matter loss, and as such can be subjective and variable between ecosystems. In order to develop a unifying fire severity assessment we explore the use of charcoal produced during a wildfire, as a tool. Charcoal has been suggested to retain some information about the nature of the fire in which it was created and one such physical property of charcoal that can be measured post-fire is its ability to reflect light when studied under oil using reflectance microscopy. The amount of light reflected varies between charcoals and is thought to be explained by the differential ordering of graphite-like phases within the char however, to what aspects of a fire's nature this alteration pertains is unknown. We have explored the formation of charcoal reflectance in 1) laboratory-based experiments using an iCone calorimeter and in 2) experimental forest scale and natural wildland fires occurring in Canada in spring 2015. In our laboratory experiments we assessed the formation and evolution of charcoal reflectance during pre-ignition heating, peak fire intensity through to the end of flaming and the transition to oxidative/smoldering heating regimes. In the prescribed and natural wildland fires we positioned the same woods used in our laboratory experiments, rigged with thermocouples in the path of oncoming fires in order to assess the resulting charcoal reflectance in response to the heating regime imposed by the fire on the samples. In this presentation we will outline our approach, findings and discuss the potential for charcoal reflectance to provide a tool in post-fire assessments seeking to determine levels of
Jain, Lakhmi; Watada, Junzo; Howlett, Robert
This book contains innovative research from leading researchers who presented their work at the 17th International Conference on Knowledge-Based and Intelligent Information and Engineering Systems, KES 2013, held in Kitakyusha, Japan, in September 2013. The conference provided a competitive field of 236 contributors, from which 38 authors expanded their contributions and only 21 published. A plethora of techniques and innovative applications are represented within this volume. The chapters are organized using four themes. These topics include: data mining, knowledge management, advanced information processes and system modelling applications. Each topic contains multiple contributions and many offer case studies or innovative examples. Anyone that wants to work with information repositories or process knowledge should consider reading one or more chapters focused on their technique of choice. They may also benefit from reading other chapters to assess if an alternative technique represents a more suitable app...
Vatenmacher, Michael; Isaac, Shabtai; Svoray, Tal
This study seeks to attain a better understanding of the information that is required by governments to prepare for earthquakes, and of the constraints they face in obtaining this information. The contributions of the study are two-fold. A survey that was conducted among those responsible for earthquake preparedness actions in different governmental agencies and at different levels revealed on the one hand a desire for information on a broad range of topics, but on the other hand that no resources were allocated in practice to gather this information. A Geographic Information System-based process that was developed following the survey, allowed the required information on seismic hazards and loss and damage risks to be rapidly collected, mapped and integrated. This supported the identification of high-priority areas, for which a more detailed analysis could be initiated. An implementation of the process showed promise, and confirmed its feasibility. Its relative simplicity may ensure that an earthquake preparedness process is initiated by governments that are otherwise reluctant to allocate resources for this purpose.
Full Text Available Our main purpose in this paper is to start a process of a systemic definition of the notion of information and to provide some initial practical consequences of it. We will try to do that providing: 1 a conceptual definition, following Ackoff's (1962 description and method of such a kind of definition, and 2 following Peirce's (1931-5,1958 conception of "meaning", where the practical consequences should be included. To our knowledge, no attempt has been done up to the present neither to find a Peircean meaning to the notion of information, nor to start a process of describing a systemic notion of information. Consequently, we will try to integrate the different definitions made on information. But to integrate we should first differentiate what is to be integrated. Thus, we will typify information conceptions in subjective and objective, providing brief description and analysis of each type, integrating them in the context of a systemic notion of information, and drawing the respective pragmatic consequences, as required by Peirce, for any meaning description, and by a pragmatic-teleological systemic epistemology (Churchmann, 1971
Churi, Shobha; Abraham, Lovin; Ramesh, M.; Narahari, M. G.
Aim: 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. Settings and Design: This was a prospective observational study. Materials and Methods: 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 telephon...
Full Text Available The Conversational Plenary Session began with a clear agenda of describing the process and challenge of developing eLearning and eTraining. After a brief discussion of the benefits and challenges of the modality, the conversation quickly segued to a highly spirited conversation related to consulting and the negative implications when one calls oneself a consultant. In fact, this became an integral theme of multiple discussions throughout the rest of the conference. This author strives to identify a selection of literature which supports the viewpoint that consulting does indeed inform best practices in academia. Those professors with up-to-the-minute consultancies in their fields offer an enriched experience for their students.
В. В. Степко
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
Heidarian, Ahmadali; Mason, David
Health information technology (HIT) has the potential to fundamentally change the practice of optometry and the relationship between optometrists and patients and to improve clinical outcomes. This paper aims to provide data on how health information technology is currently being used in New Zealand optometric practices. Also this paper aims to explore the potential benefits and barriers to the future adoption of health information technology in New Zealand. One hundred and six New Zealand optometrists were surveyed about their current use of health information technology and about potential benefits and barriers. In addition, 12 semi-structured interviews were carried out with leaders of health information technology in New Zealand optometry. The areas of interest were the current and intended use of HIT, the potential benefits of and barriers to using HIT in optometric offices and the level of investment in health information technology. Nearly all optometrists (98.7 per cent) in New Zealand use computers in their practices and 93.4 per cent of them use a computer in their consulting room. The most commonly used clinical assessment technology in optometric practices in New Zealand was automated perimeter (97.1 per cent), followed by a digital fundus/retinal camera (82.6 per cent) and automated lensometer (62.9 per cent). The pachymeter is the technology that most respondents intended to purchase in the next one to five years (42.6 per cent), followed by a scanning laser ophthalmoscope (36.8 per cent) and corneal topographer (32.9 per cent). The main benefits of using health information technology in optometric practices were improving patient perceptions of ‘state of the art’ practice and providing patients with information and digital images to explain the results of assessment. Barriers to the adoption of HIT included the need for frequent technology upgrades, cost, lack of time for implementation, and training. New Zealand optometrists are using HIT
... provide other information and granting immunity. 2.15 Section 2.15 Commercial Practices FEDERAL TRADE... and granting immunity. (a) The Bureau Director, Deputy Directors, and Assistant Directors in the... issuance of an order requiring a witness to testify or provide other information granting immunity under...
... provide other information and granting immunity. 3.39 Section 3.39 Commercial Practices FEDERAL TRADE... granting immunity. (a) Where Commission complaint counsel desire the issuance of an order requiring a witness or deponent to testify or provide other information and granting immunity under 18 U.S.C. 6002...
Beshears, John; Choi, James J.; Laibson, David; Madrian, Brigitte C.; Milkman, Katherine L.
Using a field experiment in a 401(k) plan, we measure the effect of disseminating information about peer behavior on savings. Low-saving employees received simplified plan enrollment or contribution increase forms. A randomized subset of forms stated the fraction of age-matched coworkers participating in the plan or age-matched participants contributing at least 6% of pay to the plan. We document an oppositional reaction: the presence of peer information decreased the savings of nonparticipants who were ineligible for 401(k) automatic enrollment, and higher observed peer savings rates also decreased savings. Discouragement from upward social comparisons seems to drive this reaction. PMID:26045629
... part to participants by making it available on the TSP Web site. A participant can request paper copies of that information from the TSP by calling the ThriftLine, submitting a request through the TSP Web site, or by writing to the TSP record keeper. ...
Peter, Johannes; Leichner, Nikolas; Mayer, Anne-Kathrin; Krampen, Günter
This paper presents an approach to information literacy instruction in colleges and universities that combines online and classroom learning (Blended Learning). The concept includes only one classroom seminar, so the approach presented here can replace existing one-shot sessions at colleges and universities without changes to the current workflow.…
The main purpose of establishing library in any academic environment is to serve as the information centre to the community of users. But many have failed to serve this purpose after spending lots of money due to some reason and the other. This survey study is aimed at assessing Effectiveness of Reference Services in ...
Dunning, R.J.; Grayson, A.
Purpose – The purpose of this paper is to renew a research agenda considering the impact that information providers’ processes are having on the housing market; in particular to develop a research agenda around the role of the Internet in shaping households’ perceptions of the spatial nature of housing markets. Design/methodology/approach – This paper reviews the existing literature. It uses preliminary extensive survey findings about the role of the Internet in housing search to hypothesise ...
To ensure the likely success of an organisation’s Information Security Governance, discipline leaders recommend that organisations follow the guidelines as set out in Information Security Governance best practice documents. Best practices and related documents from the Information Security Governance discipline, as well as best practices and related documents from the Corporate Governance and Information Technology Governance disciplines, all include sections pertaining to Information Securit...
Full Text Available Paul Smith’s College provides library hours and workstation availability using SMS Text Messages. The service was implemented using an easy and affordable web-based API for SMS sending and receiving, from twilio.com. A new class of ‘cloud-based‘ SMS vendors make simple SMS-based services efficient and cost-effective to implement, and have many possible applications in the library environment. A simple PHP example is provided which supplies workstation availability over SMS based on a database of computer availability from a previous Code4Lib Journal Article.
Burger, Joanna; Nakata, Kimi; Liang, Laura; Pittfield, Taryn; Jeitner, Christian
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
Burger, Joanna; Nakata, Kimi; Liang, Laura; Pittfield, Taryn; Jeitner, Christian
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.
da Costa, Marta Cocco; Lopes, Marta Julia Marques
The present article refers to a qualitative study that was performed with the objective to identify and analyze the practice of healthcare professionals regarding rural women victims of violence, under the perspective of comprehensive care, in cities located in southern Rio Grande do Sul state. Participants were healthcare professionals and workers from health services who work in rural areas. The information was generated through interviews and analyzed using the thematic mode. In regards to care elements provided to rural women who are victims of violence, the study pointed out not only the relational strategies - welcoming, attachment and dialogue - but also the construction of collective actions through group activities, recognized as supporting health promotion, as well as individual and collective empowerment in the dimension of violent events. It was found that the professionals' care practices are aimed at focusing care on the rural women, establishing a relationship between the worker and client to produce comprehensiveness of care.
From the parent population of micro and small business enterprises, seven municipal areas of the geopolitical zone were randomly sampled. Research instrument used for collecting data was the questionnaire which was constructed along the theoretical frame of the study. Hypotheses were formulated to provide basis for ...
Major topics studied were on communicable diseases (22%), environmental health (11%), demography/family planning (10%), nutrition (9%), pharmacy & drug testing (8%) using quantitative methods (86%). Conclusion: Ethiopian Journal of Health Sciences served its primary purpose providing scientific and technological ...
Stol, Yrrah H; Asscher, Eva C A; Schermer, Maartje H N
Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good' health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. In 2015, we interviewed twenty Dutch health check providers on criteria for 'good' health checks, and the role these criteria play in their practices. Providers unanimously formulate a number of minimal criteria: Checks must focus on (risk factors for) treatable/preventable disease; Tests must be reliable and clinically valid; Participation must be informed and voluntary; Checks should provide more benefits than harms; Governmental screenings should be cost-effective. Aspirational criteria mentioned were: Follow-up care should be provided; Providers should be skilled and experienced professionals that put the benefit of (potential) users first; Providers should take time and attention. Some criteria were contested: People should be free to test on any (risk factor for) disease; Health checks should only be performed in people at high risk for disease that are likely to implement health advice; Follow up care of privately funded tests should not drain on collective resources. Providers do not always fulfil their own criteria. Their reasons reveal conflicts between criteria, conflicts between criteria and other ethical values, and point to components in the (Dutch) organisation of health care that hinder an ethical provision of health checks. Moreover, providers consider informed consent a criterion that is hard to establish in practice. According to providers, personal health checks should meet the same criteria as population screenings, with the exception of cost-effectiveness. Providers do not always fulfil their own criteria. Results indicate that in thinking about the ethics of health
Acharya, Amit; Shimpi, Neel; Mahnke, Andrea; Mathias, Richard; Ye, Zhan
The authors conducted this study to identify the most relevant patient dental information in a medical-dental integrated electronic health record (iEHR) necessary for medical care providers to inform holistic treatment. The authors collected input from a diverse sample of 65 participants from a large, regional health system representing 13 medical specialties and administrative units. The authors collected feedback from participants through 11 focus group sessions. Two independent reviewers analyzed focus group transcripts to identify major and minor themes. The authors identified 336 of 385 annotations that most medical care providers coded as relevant. Annotations strongly supporting relevancy to clinical practice aligned with 18 major thematic categories, with the top 6 categories being communication, appointments, system design, medications, treatment plan, and dental alerts. Study participants identified dental data of highest relevance to medical care providers and recommended implementation of user-friendly access to dental data in iEHRs as crucial to holistic care delivery. Identification of the patients' dental information most relevant to medical care providers will inform strategies for improving the integration of that information into the medical-dental iEHR. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.
Mboineki, Joanes Faustine; Zhang, Weihong
The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.
Tolnai, Sandra; Dolležal, Lena-Vanessa; Klump, Georg M
Informational masking (IM) describes the insensitivity of detecting a change in sound features in a complex acoustical environment when such a change could easily be detected in the absence of distracting sounds. IM occurs because of the similarity between deviant sound and distracting sounds (so-called similarity-based IM) and/or stimulus uncertainty stemming from trial-to-trial variability (so-called uncertainty-based IM). IM can be abolished if similarity-based or uncertainty-based IM are minimized. Here, we modulated similarity-based IM using binaural cues. Standard/deviant tones and distracting tones were presented sequentially, and level-increment thresholds were measured. Deviant tones differed from standard tones by a higher sound level. Distracting tones covered a wide range of levels. Standard/deviant tones and distracting tones were characterized by their interaural time difference (ITD), interaural level difference (ILD), or both ITD and ILD. The larger the ITD or ILD was, the better similarity-based IM was overcome. If both interaural differences were applied to standard/deviant tones, the release from IM was larger than when either interaural difference was used. The results show that binaural cues are potent cues to abolish similarity-based IM and that the auditory system makes use of multiple available cues. (c) 2015 APA, all rights reserved).
Full Text Available Madeline McCarren,1 Elaine L Twedt,1 Faizmohamed M Mansuri,2 Philip R Nelson,3 Brian T Peek3 1Pharmacy Benefits Management Services, Department of Veterans Affairs, Hines, IL, 2Wilkes-Barre VA Medical Center, Wilkes-Barre, PA, 3Charles George VA Medical Center, Asheville, NC, USA Purpose: Minimal-risk randomized trials that can be embedded in practice could facilitate learning health-care systems. A cluster-randomized design was proposed to compare treatment strategies by assigning clusters (eg, providers to “favor” a particular drug, with providers retaining autonomy for specific patients. Patient informed consent might be waived, broadening inclusion. However, it is not known if providers will adhere to the assignment or whether institutional review boards will waive consent. We evaluated the feasibility of this trial design.Subjects and methods: Agreeable providers were randomized to “favor” either hydrochlorothiazide or chlorthalidone when starting patients on thiazide-type therapy for hypertension. The assignment applied when the provider had already decided to start a thiazide, and providers could deviate from the strategy as needed. Prescriptions were aggregated to produce a provider strategy-adherence rate.Results: All four institutional review boards waived documentation of patient consent. Providers (n=18 followed their assigned strategy for most of their new thiazide prescriptions (n=138 patients. In the “favor hydrochlorothiazide” group, there was 99% adherence to that strategy. In the “favor chlorthalidone” group, chlorthalidone comprised 77% of new thiazide starts, up from 1% in the pre-study period. When the assigned strategy was followed, dosing in the recommended range was 48% for hydrochlorothiazide (25–50 mg/day and 100% for chlorthalidone (12.5–25.0 mg/day. Providers were motivated to participate by a desire to contribute to a comparative effectiveness study. A study promotional mug, provider information
What is the impact of open access on science communication? How can scientists effectively engage and interact with the public? What role can science communication have when scientific controversies arise? Practising science communication in the information age is a collection of newly-commissioned chapters by leading scholars and practitioners of science communication. It considers how scientists communicate with each other as part of their professional practice, critically evaluating how this forms the basis of the documenting of scientific knowledge, and investigating how open access publication and open review are influencing current practices. It also explores how science communication can play a crucial role when science is disputed, investigating the role of expertise in the formation of scientific controversy and consensus. The volume provides a theoretically informed review of contemporary trends and issues that are engaging practitioners of science communication, focusing on issues such as the norms...
Víctor CORCOBA MAGAÑA
Full Text Available In this paper, we propose a solution to reduce the stress level of the driver, minimize fuel consumption and improve safety. The system analyzes the driving style and the driver’s workload during the trip while driving. If it discovers an area where the stress increases and the driving style is not appropriate from the point of view of energy efficiency and safety for a particular driver, the location of this area is saved in a shared database. On the other hand, the implemented solution warns a particular user when approaching a region where the driving is difficult (high fuel consumption and stress using the shared database based on previous recorded knowledge of similar drivers in that area. In this case, the proposal provides an optimal deceleration profile if the vehicle speed is not adequate. Therefore, he or she may adjust the vehicle speed with both a positive impact on the driver workload and fuel consumption. The Data Envelopment Analysis algorithm is used to estimate the efficiency of driving and the driver’s workload in in each area. We employ this method because there is no preconceived form on the data in order to calculate the efficiency and stress level. A validation experiment has been conducted using both a driving simulator and a real environment with 12 participants who made 168 driving tests. The system reduced the slowdowns (38%, heart rate (4.70%, and fuel consumption (12.41% in the real environment. The proposed solution is implemented on Android mobile devices and does not require the installation of infrastructure on the road. It can be installed on any model of vehicle.
Doran, Diane M; Haynes, R Brian; Kushniruk, André; Straus, Sharon; Grimshaw, Jeremy; Hall, Linda McGillis; Dubrowski, Adam; Di Pietro, Tammie; Newman, Kristine; Almost, Joan; Nguyen, Ha; Carryer, Jennifer; Jedras, Dawn
To evaluate the usability of mobile information terminals, such as personal digital assistants (PDAs) or Tablet personal computers, to improve access to information resources for nurses and to explore the relationship between PDA or Tablet-supported information resources and outcomes. The authors evaluated an initiative of the Nursing Secretariat, Ontario Ministry of Health and Long-Term Care, which provided nurses with PDAs and Tablet PCs, to enable Internet access to information resources. Nurses had access to drug and medical reference information, best practice guidelines (BPGs), and to abstracts of recent research studies. The authors took place over a 12-month period. Diffusion of Innovation theory and the Promoting Action on Research Implementation in Health Services (PARIHS) model guided the selection of variables for study. A longitudinal design involving questionnaires was used to evaluate the impact of the mobile technologies on barriers to research utilization, perceived quality of care, and on nurses' job satisfaction. The setting was 29 acute care, long-term care, home care, and correctional organizations in Ontario, Canada. The sample consisted of 488 frontline-nurses. Nurses most frequently consulted drug and medical reference information, Google, and Nursing PLUS. Overall, nurses were most satisfied with the Registered Nurses Association of Ontario (RNAO) BPGs and rated the RNAO BPGs as the easiest resource to use. Among the PDA and Tablet users, there was a significant improvement in research awareness/values, and in communication of research. There was also, for the PDA users only, a significant improvement over time in perceived quality of care and job satisfaction, but primarily in long-term care settings. It is feasible to provide nurses with access to evidence-based practice resources via mobile information technologies to reduce the barriers to research utilization.
Stephen M. Schueller
Full Text Available A growing number of Internet sites and mobile applications are being developed intended for use in clinical practice. However, during the development process (e.g., creating features and determining use cases, the needs and interests of providers are often overlooked. We explored providers' interests using a mixed-methods approach incorporating both qualitative and quantitative research methods. A first study used an interview approach to identify the challenges providers faced, tools they used, and any use of computers and apps specifically. Fifteen providers from both the United States and Canada completed the interview and recordings were transcribed and analyzed using a constructivist grounded theory approach. Four primary themes were identified including challenges, potential tools, access and usability. A second study used a brief survey completed by 132 providers at a large healthcare system to explore current use of and potential interest in Internet and mobile technologies. Although many providers (80.9% reported recommending some form of technology to patients, these were mostly Internet websites that were predominantly informational/psychoeducational in nature. Overall, these studies combine to suggest a strong interest in websites and apps for use in clinical settings while highlighting potential areas (ease of use, patient security and privacy that should be considered in the design and deployment of these tools.
Felin, Elina; Jukola, Elias; Raulo, Saara; Heinonen, Jaakko; Fredriksson-Ahomaa, Maria
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
Gary L. Cochran
Full Text Available BackgroundHealth information exchange (HIE systems are implemented nationwide to integrate health information and facilitate communication among providers. The Nebraska Health Information Initiative is a state-wide HIE launched in 2009. Objective The purpose of this study was to conduct a comprehensive assessment of health care providers’ perspectives on a query-based HIE, including barriers to adoption and important functionality for continued utilization. MethodsWe surveyed 5618 Nebraska health care providers in 2013. Reminder letters were sent 30 days after the initial mailing. ResultsA total of 615 questionnaires (11% were completed. Of the 100 current users, 63 (63% indicated satisfaction with HIE. The most common reasons for adoption among current or previous users of an HIE (N = 198 were improvement in patient care (N = 111, 56% as well as receiving (N = 95, 48% and sending information (N = 80, 40% in the referral network. Cost (N = 233, 38% and loss of productivity (N = 220, 36% were indicated as the ‘major barriers’ to adoption by all respondents. Accessing a comprehensive patient medication list was identified as the most important feature of the HIE (N = 422, 69%. ConclusionsThe cost of HIE access and workflow integration are significant concerns of health care providers. Additional resources to assist practices plan the integration of the HIE into a sustainable workflow may be required before widespread adoption occurs. The clinical information sought by providers must also be readily available for continued utilization. Query-based HIEs must ensure that medication history, laboratory results and other desired clinical information be present, or long-term utilization of the HIE is unlikely.
Heyman, R E; Wojda, A K; Eddy, J M; Haydt, N C; Geiger, J F; Slep, A M Smith
Over 1 in 5 dental patients report moderate to severe dental fear. Although the efficacy of cognitive-behavioral treatment (CBT) for dental fear has been examined in over 20 randomized controlled trials-with 2 meta-analyses finding strong average effect sizes ( d > 1)-CBT has received almost no dissemination beyond the specialty clinics that tested it. The challenge, then, is not how to treat dental fear but how to disseminate and implement such an evidence-based treatment in a way that recognizes the rewards and barriers in the US health care system. This mixed-method study investigated the potential of disseminating CBT through care from a mental health provider from within the dental home, a practice known as evidence-based collaborative care (EBCC). Two preadoption studies were conducted with practicing dentists drawn from a self-organized Practice-Based Research Network in the New York City metropolitan area. The first comprised 3 focus groups ( N = 17), and the second involved the administration of a survey ( N = 46). Focus group participants agreed that CBT for dental fear is worthy of consideration but identified several concerns regarding its appeal, feasibility, and application in community dental practices. Survey participants indicated endorsement of factors promoting the use of EBCC as a mechanism for CBT dissemination, with no factors receiving less than 50% support. Taken together, these findings indicate that EBCC may be a useful framework through which an evidence-based treatment for dental fear treatment can be delivered.
Lau, Denys T; Joyce, Brian; Clayman, Marla L; Dy, Sydney; Ehrlich-Jones, Linda; Emanuel, Linda; Hauser, Joshua; Paice, Judith; Shega, Joseph W
Managing and administering medications to relieve pain and symptoms are common, important responsibilities for informal caregivers of patients receiving end-of-life care at home. However, little is known about how hospice providers prepare and support caregivers with medication-related tasks. This qualitative study explores the key approaches that hospice providers use to facilitate medication management for caregivers. Semistructured, open-ended interviews were conducted with 22 providers (14 nurses, four physicians, and four social workers) from four hospice organizations around an urban setting in the midwestern U.S. Based on the interviews, the following five key approaches emerged, constituting how the hospice team collectively helped caregivers manage medications: 1) establishing trust; 2) providing information; 3) promoting self-confidence; 4) offering relief (e.g., provided in-home medication assistance, mobilized supportive resources, and simplified prescriptions); and 5) assessing understanding and performance. Each hospice discipline used multiple approaches. Nurses emphasized tailoring information to individual caregivers and patients, providing in-home assistance to help relieve caregivers, and assessing caregivers' understanding and performance of medication management during home visits. Physicians simplified medication prescriptions to alleviate burden and reassured caregivers using their perceived medical authority. Social workers facilitated medication management by providing emotional support to promote self-confidence and mobilizing resources in caregivers' support networks and the community at large. Hospice nurses, physicians, and social workers identified distinct, yet overlapping, approaches in aiding caregivers with medication management. These findings emphasize the importance of interdisciplinary teamwork among hospice providers. Future research should investigate how common, standardized, effective, and efficient these approaches are in
Full Text Available Abstract Background Globally, the monitoring of prompt and effective treatment for malaria with artemisinin combination therapy (ACT is conducted largely through household surveys. This measure; however, provides no information on case management processes at the health facility level. The aim of this review was to assess evidence from health facility surveys on malaria prescribing practices using ACT, in the presence and absence of ACT stock, at time and place where treatment was sought. Methods A systematic search of published literature was conducted. Findings were collated and data extracted on proportion of patients prescribed ACT and alternative anti-malarials in the presence and absence of ACT stock. Results Of the 14 studies identified in which ACT prescription for uncomplicated malaria in the public sector was evaluated, just six, from three countries (Kenya, Uganda and Zambia, reported this in the context of ACT stock. Comparing facilities with ACT stock to facilities without stock (i ACT prescribing was significantly higher in all six studies, increasing by a range of 21.3% in children Conclusions Prescriber practices vary based on ACT availability. Although ACT prescriptions increased and alternative anti-malarials prescriptions decreased in the presence of ACT stock, ACT was prescribed in the absence, and alternative anti-malarials were prescribed in the presence of, ACT. Presence of stock alone does not ensure that treatment guidelines are followed. More health facility surveys, together with qualitative research, are needed to understand the role of ACT stock-outs on provider prescribing behaviours and preferences.
Clark, Phillip G
Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.
Maxwell, O.J.R.; Miguel-Pacheco, G.G.; Newsome, R.; Randall, L. V.; Remnant, J.G.; Thomas, H J; Huxley, J.N.
Lameness in cattle has significant consequences for welfare, health and productivity. More research is now being done on lameness and this article, the first in a two-part series, provides an update on research-based advances in the field published from around the world over the past five years. These developments have improved our understanding of lameness in cattle and can inform clinical practice and the control of lameness on-farm. The second article, to be published in a subsequent issue...
Gantz, Stephen D
The Basics of IT Audit: Purposes, Processes, and Practical Information provides you with a thorough, yet concise overview of IT auditing. Packed with specific examples, this book gives insight into the auditing process and explains regulations and standards such as the ISO-27000, series program, CoBIT, ITIL, Sarbanes-Oxley, and HIPPA. IT auditing occurs in some form in virtually every organization, private or public, large or small. The large number and wide variety of laws, regulations, policies, and industry standards that call for IT auditing make it hard for organizations to consistent
Alexander A. Galushkin
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.
Informal instructional approaches have long been an important component of a complete education in general and of music education in particular. But informal approaches have often been subject to bandwagon over-enthusiasm, with proponents inflating their virtues beyond what the concept appears to warrant. In this paper I will, first, examine the…
Bennett, Nancy L.; Casebeer, Linda L.; Zheng, Shimin; Kristofco, Robert
Introduction: As they care for patients, physicians raise questions, but they pursue only a portion of them. Without the best information and evidence, care and patient safety may be compromised. Understanding when and why problems prompt physicians to look for information and integrate results into their knowledge base is critical and shapes one…
Wong, Ming Chao; Yee, Kwang Chien; Turner, Paul
Improving clinical communication is imperative to improving the quality and safety of patient care. Significant efforts have been made to improve clinical communication and patient safety, guided by the mantra of "the right information, to the right person, in the right place, at the right time". The design and implementation of information communication technologies (ICTs) has been considered as one of the major developments in improving patient care. Clinical communication in today's clinical practice is complex and involves multi-disciplinary teams using different types of media for information transfer. This paper argues that traditional communication theories fail to adequately capture and describe contemporary clinical communicative practices or to provide insight into how information transferred is actually assimilated and/or utilised for patient care. This paper argues for the need to more fully consider underlying assumptions about the role of information in clinical communication and to recognise how the attributes of information receivers, especially where ICTs are deployed influence outcomes. The paper presents a discussion regarding the need to consider information receivers as the foundation for clinical communication improvement and future design and development of ICTs to improve patient care.
Pérez, Carlos; Orduña, Juan M; Soriano, Francisco R
A common problem of some information technology courses is the difficulty of providing practical exercises. Although different approaches have been followed to solve this problem, it is still an open issue, specially in security and computer network courses. This paper proposes NETinVM, a tool based on nested virtualization that includes a fully functional lab, comprising several computers and networks, in a single virtual machine. It also analyzes and evaluates how it has been used in different teaching environments. The results show that this tool makes it possible to perform demos, labs and practical exercises, greatly appreciated by the students, that would otherwise be unfeasible. Also, its portability allows to reproduce classroom activities, as well as the students' autonomous work.
Full Text Available The Internet has become a major source of health information and has the potential to offer many benefits for both human and animal health. In order for impact to be positive, however, it is critical that users be able to access reliable, trustworthy information. Although more pet owners are using the Internet to research animal health information than ever before, there remains limited research surrounding their online activities or the ability to influence owners’ online search behaviors. The current study was designed to assess the online behaviors and perceptions of pet owners after receiving either general or topic-specific information prescriptions as part of their veterinary appointment. Results indicate that nearly 60% of clients accessed the suggested websites and nearly all of these clients reported positive feelings about this addition to their veterinary services. These results suggest that offering information prescriptions to clients can facilitate better online searches by clients and positively impact both animal health and client satisfaction.
Kwag, Koren Hyogene; González-Lorenzo, Marien; Banzi, Rita; Bonovas, Stefanos; Moja, Lorenzo
The complexity of modern practice requires health professionals to be active information-seekers. Our aim was to review the quality and progress of point-of-care information summaries-Web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. We aimed to evaluate product claims of being evidence-based. We updated our previous evaluations by searching Medline, Google, librarian association websites, and conference proceedings from August 2012 to December 2014. We included Web-based, regularly updated point-of-care information summaries with claims of being evidence-based. We extracted data on the general characteristics and content presentation of products, and we quantitatively assessed their breadth of disease coverage, editorial quality, and evidence-based methodology. We assessed potential relationships between these dimensions and compared them with our 2008 assessment. We screened 58 products; 26 met our inclusion criteria. Nearly a quarter (6/26, 23%) were newly identified in 2014. We accessed and analyzed 23 products for content presentation and quantitative dimensions. Most summaries were developed by major publishers in the United States and the United Kingdom; no products derived from low- and middle-income countries. The main target audience remained physicians, although nurses and physiotherapists were increasingly represented. Best Practice, Dynamed, and UptoDate scored the highest across all dimensions. The majority of products did not excel across all dimensions: we found only a moderate positive correlation between editorial quality and evidence-based methodology (r=.41, P=.0496). However, all dimensions improved from 2008: editorial quality (P=.01), evidence-based methodology (P=.015), and volume of diseases and medical conditions (PUptoDate scored the highest across all dimensions, while others that were marketed as evidence
... engagement in environment and sustainability concerns. Preliminary research on museum education practices established that these are primarily expert-led and centred on exhibitions and outreach, with limited participation by the community. The study was initiated after a brief experience of working on community radio ...
A practice-based learning model, involving self-directed learning, critical self-reflection, intentional active learning, and learning community, provides a way to structure informal continuing professional education (CPE) that occurs in practice. As individuals assume more responsibility for their learning, the legitimacy of informal CPE should…
Hinko, Kathleen A.; Madigan, Peter; Miller, Eric; Finkelstein, Noah D.
University educators (UEs) have a long history of teaching physics not only in formal classroom settings but also in informal outreach environments. The pedagogical practices of UEs in informal physics teaching have not been widely studied, and they may provide insight into formal practices and preparation. We investigate the interactions between…
Raja, Sheela; Hoersch, Michelle; Rajagopalan, Chelsea F; Chang, Priscilla
and Overview Dentists frequently treat patients who have a history of traumatic events. These traumatic events (including childhood sexual abuse, domestic violence, elder abuse and combat history) may influence how patients experience oral health care and may interfere with patients' engagement in preventive care. The purpose of this article is to provide a framework for how dentists can interact sensitively with patients who have survived traumatic events. The authors propose the trauma-informed care pyramid to help engage traumatized patients in oral health care. Evidence indicates that all of the following play an important role in treating traumatized patients: demonstrating strong behavioral and communication skills, understanding the health effects of trauma, engaging in interprofessional collaboration, understanding the provider's own trauma-related experiences and understanding when trauma screening should be used in oral health practice. Dental patients with a history of traumatic experiences are more likely to engage in negative health habits and to display fear of routine dental care. Although not all patients disclose a trauma history to their dentists, some patients might. The trauma-informed care pyramid provides a framework to guide dental care providers in interactions with many types of traumatized patients, including those who choose not to disclose their trauma history in the context of oral health care.
Huizing, A.; Cavanagh, M.
Introduction. The purpose of this paper is to introduce to information science in a coherent fashion the core premises of contemporary practice theory, and thus to engage the information research community in further debate and discussion. Method. Contemporary practice-based approaches are
Examines to what extent the skills and techniques of evidence-based practice are transferable to the areas of professional practice of librarians and information professionals? Is it desirable for information professionals to integrate research findings into their day-to-day decision making?
菊川, 健; 川淵, 明美; 小川, 亮; キクカワ, タケシ; カワフチ, アケミ; オガワ, リョウ; Takeshi, Kikukawa; Akemi, Kawafuchi; Ryo, Ogawa
In the National Institute of Multimedia Education, a database system for audio-visual resources has been developed in order to effectively utilize available resources and data. JEMISS (Japan Educational Media Information Service System) is a bibliographical database for domestic educational media such as 16 mm films, video and slide materials, which involves statement of copyrights. JEMISS has been offered to universities and research institutions through the Science Information Computer Netw...
It has become increasingly accepted that important digital data must be retained and shared in order to preserve and promote knowledge, advance research in and across all disciplines of scholarly endeavor, and maximize the return on investment of public funds. To meet this challenge, colleges and universities are adding data services to existing infrastructures by drawing on the expertise of information professionals who are already involved in the acquisition, management and preservation of data in their daily jobs. Data services include planning and implementing good data management practices, thereby increasing researchers’ ability to compete for grant funding and ensuring that data collections with continuing value are preserved for reuse. This volume provides a framework to guide information professionals in academic libraries, presses, and data centers through the process of managing research data from the planning stages through the life of a grant project and beyond. It illustrates principle...
Pielak, Karen L; McIntyre, Cheryl C; Tu, Andrew W; Remple, Valencia P; Halperin, Beth; Buxton, Jane A
This paper is a report of a study conducted to examine the attitudes, beliefs, behavioural intentions and self-reported behaviour of nurses and physicians relating to key immunization behaviours and compare the findings for nurses and physicians. Immunization is an important and effective public health intervention. Understanding immunization providers' attitudes and beliefs toward immunization has the potential to improve educational efforts and lead to behavioural change. A postal survey was conducted with all immunization providers in British Columbia, Canada, in 2005. The survey elicited data on demographics, practice characteristics, attitudes, perceived social norms and perceived behavioural control related to key immunization behaviours. Responses were received from 344 nurses and 349 physicians. The response rate was 67% for nurses and 22% for physicians. More nurses than physicians thought that administering all recommended vaccines at one visit was important (89.2% vs. 63.2%P vaccines (82.4% vs. 48.7%P vaccines at one visit (98.8% vs. 73.8%P vaccine each year was important (88.9%, 87.1% respectively P = 0.65). The foundational work done to develop the survey tool can be used to modify it so that survey findings can be validated according to the Theory of Planned Behaviour. The results could inform the development of behavioural change interventions targeting the identified determinants of immunization provider behaviour.
Emily Adhiambo Okonjo
Full Text Available The aim of this study was to establish the relationship between procurement risk management practices and supply chain performance among mobile phone service providers in Kenya. The study specifically set out to establish the extent to which mobile phone service providers have implemented procurement risk management practices and to determine the relationship between procurement risk management practices and supply chain performance. The study adopted a descriptive study design by collecting data from the four (4 mobile telecommunication companies in Kenya using a self-administered questionnaire. Means, standard deviation, and regression analysis were used to analyze the data collected. The study established that most of the mobile phone service providers in Kenya had implemented procurement risk management practices. It was also clear that there was a very significant relationship between procurement risk management practices and supply chain performance.
Ojo, Adebowale Ifeoluwa
The significance of health information management practice to the effectiveness of a healthcare delivery system cannot be overemphasised. A well-structured and coordinated health information management system has been known to generate the information needed for decision-making at all levels of healthcare delivery. However, the state of health information management in Nigeria, as is the case in most African countries, is a cause for concern. Observation and past studies have highlighted challenges facing the practice of health information management in Africa to be centred around the quality of professional training, inadequately qualified practitioners, disgruntled practitioners, government's indifference towards the practice, lack of policies and inadequate technological infrastructure among others. This article examines some of the challenges facing health information management practice in Nigeria and makes recommendations that may uplift the profession.
The World Health Organization's (WHO) definition of eHealth. (a term also used by the National Department of Health,. South Africa) is the use of information and communication technologies for health. Biomedical informatics is defined as. “the interdisciplinary, scientific field that studies and pursues the effective uses of ...
might be used to inform and extend museum-based community engagement in environment and sustainability concerns. Preliminary ..... funds. Radio, however, has the facility (air-time) to reach out to the community, but may lack the technical knowledge in environment and sustainability issues. Therefore, the museum.
Full Text Available Background: Capability to provide care can be recognized as the combination of nursing knowledge, skills, and attitude of care which is dynamic. Objective: This study aims to explore the perceptions of practical nurses towards updating capability to provide care. Methods: A descriptive qualitative study was conducted to explore the deep understanding of practical nurses towards updating capability to provide care. Data were gathered using in-depth interview with 25 practical nurses from different areas of practices, three times focus group discussion (FGD and participant-observation. Qualitative content analysis model was applied to anaylze the data. Result: There were two themes emerged from data: 1 Internal perceptions of updating capacity to provide care, with three subthemes: Having great expectation, Being confidence as a professional nurse, and Developing Self-Initiation, 2 External contexts driving perception of practicing nurses, with two subthemes: Giving best care and Acquiring requirement. Conclusions: The findings indicated that updating capacity to provide care supports practical nurses to provide better nursing services to patients and meet the regulation of nursing professionalism.
The Phys21 report, ``Preparing Physics Students for 21st Century Careers,'' provides guidance for physics programs to improve their degree programs to make them more relevant for student career choices. Undertaking such changes and assessing impact varies widely by institution, with many departments inventing assessments with each periodic departmental or programmatic review. American Physical Society has embarked on a process to integrate information from Phys21, the results of other national studies, and educational research outcomes to generate a best-practices guide to help physics departments conduct program review, assessment, and improvement. It is anticipated that departments will be able to use this document to help with their role in university-level accreditation, and in making the case for improvements to departmental programs. Accreditation of physics programs could stem from such a document, and I will discuss some of the thinking of the APS Committee on Education in creating this guide, and how they are advising APS to move forward in the higher education landscape that is increasingly subject to standards-based evaluations. I will describe plans for the design, review, and dissemination of this guide, and how faculty can provide input into its development. This material is based upon work supported by the National Science Foundation under Grant No. 1540570. Opinions expressed do not necessarily reflect those of the NSF.
Reynolds, Rae Brana; McCoy, Kimberly
Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs), generally referred to as Advanced Practice Providers (APPs), are fundamental to interdisciplinary oncology care. As the projected demand for oncology services is anticipated to outpace the supply of oncologists, APPs will become increasingly vital in the delivery of oncology care and services. The training, education, and scope of practice for APPs gives the interdisciplinary care team professionals that deliver high-quality clinical services and provide valuable contributions and leadership to health care quality improvement initiatives. Optimizing the integration of APPs in oncology care offers immense advantages towards improvement of clinical outcomes.
The research problem addressed in this quantitative correlational study was the inadequacy of sound information security management (ISM) practices in K-12 school districts, despite their increasing ownership of information assets. Researchers have linked organizational and sociotechnical factors to the implementation of information security…
Pastakia, Sonak D; Vincent, William R; Manji, Imran; Kamau, Evelyn; Schellhase, Ellen M
To compare the clinical consultations provided by American and Kenyan pharmacy students in an acute care setting in a developing country. The documented pharmacy consultation recommendations made by American and Kenyan pharmacy students during patient care rounds on an advanced pharmacy practice experience at a referral hospital in Kenya were reviewed and classified according to type of intervention and therapeutic area. The Kenyan students documented more interventions than American students (16.7 vs. 12.0 interventions/day) and provided significantly more consultations regarding human immunodeficiency virus (HIV) and antibiotics. The top area of consultations provided by American students was cardiovascular diseases. American and Kenyan pharmacy students successfully providing clinical pharmacy consultations in a resource-constrained, acute-care practice setting suggests an important role for pharmacy students in the reconciliation of prescriber orders with medication administration records and in providing drug information.
Hawkins, C Matthew; Bowen, Michael A; Gilliland, Charles A; Walls, D Gail; Duszak, Richard
The numbers of nurse practitioners and physician assistants are increasing throughout the entire health care enterprise, and a similar expansion continues within radiology. Some practices have instead embraced radiologist assistants. The increased volume of services rendered by this growing nonphysician provider subset of the health care workforce within and outside of radiology departments warrants closer review. The authors evaluate the recent literature and offer recommendations to radiology practices regarding both regulatory and scope-of-practice issues related to these professionals. Additionally, billing and compliance issues for care provided by nurse practitioners, physician assistants, and radiologist assistants are detailed. An analysis of the integration of these professionals into interventional and diagnostic radiology practices, as well as potential implications for medical education, is provided in the second part of this series. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Passfield, Louis; Hopker, James G
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.
A. A. Kuzkin
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.
Chen, Fang-Pei; Wu, Hui-Ching; Huang, Chun-Jen
This study examined influences of causal attributions of schizophrenia and perceived and internalized mental illness stigma on perceived working alliance with, and informational support received from doctors practicing Western psychiatry in the Taiwanese social-cultural context. This cross-sectional quantitative study used a non-probability, purposive sampling technique to recruit 212 Taiwanese diagnosed with schizophrenia from Taiwanese Alliance of the Mentally Ill, 4 community mental health rehabilitation centres and 2 psychiatric hospitals between July 2012 and March 2013. Linear regression models were used for analysis. The results showed that environmental attributions were positively associated with both perceived working alliance and perceived informational support, while supernatural attributions were negatively associated with perceived working alliance and perceived informational support. Perceived stigma had a negative association with perceived working alliance. The discrimination domain of internalized stigma specifically had a positive association with perceived working alliance, while the withdraw domain had a negative association with perceived informational support. Findings inform the importance of culturally sensitive practices in developing an effective working relationship. Western psychiatric care providers need to explore consumers' casual attributions of mental illness and understand the impact of stigma so that providers may successfully engage consumers in care and provide tailored illness education and information.
Anzhelika G. GERASYMENKO
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.
courants de doctrine ont été étudiés : la planification opérationnelle, le renseignement interarmées, la gestion des risques , les opérations...interests, particularly in and around the capital city of Port Angeles. Because of Canada’s leading role in Caribba, and the fact that Canada has the...providing the ruling party. The major population centres are in the capital city of Port Angeles (1.6 million), a port city on the southwest coast
Potter, Pamela J.
Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties of evidence in the context of patient preference and condition as well as practitioner knowledge and experience. This article offers an EIP approach to energy therapies, namely, Therapeutic Touch (TT), Healing Touch (HT), and Reiki, as supportive interventions in cancer care; a description of the author’s professional experience with TT, HT, and Reiki in practice and research; an overview of the three energy healing modalities; a review of nine clinical studies related to oncology; and recommendations for EIP. These studies demonstrate a response to previous research design critiques. Findings indicate a positive benefit for oncology patients in the realms of pain, quality of life, fatigue, health function, and mood. Directionality of healing in immune response and cell line studies affirms the usual explanation that these therapies bring harmony and balance to the system in the direction of health. Foremost, the research literature demonstrates the safety of these therapies. In order to consider the varieties of evidence for TT, HT, and Reiki, EIP requires a qualitative examination of patient experiences with these modalities, exploration of where these modalities have been integrated into cancer care and how the practice works in the oncology setting, and discovery of the impact of implementation on provider practice and self-care. Next steps toward EIP require fleshing out the experience of these modalities by patients and health-care providers in the oncology care setting. PMID:25031994
Ballermann, Mark; Shaw, Nicola T; Mayes, Damon C; Gibney, R T Noel
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.
Archives and Records Management (ARM) literature surrounding Information Protection (IP) has been developed in relative isolation from the IP field. As a result, it has been unclear until now whether and to what extent ARM literature and practice is consistent with or divergent from IP literature and practice. This paper.
Zeni, Lorenzo; Yang, Guangya; Tarnowski, Germán Claudio
A practical parameter estimation procedure for a real excitation system is reported in this paper. The core algorithm is based on genetic algorithm (GA) which estimates the parameters of a real AC brushless excitation system with limited information about the system. Practical considerations...
Usher-Smith, Juliet A; Silarova, Barbora; Ward, Alison; Youell, Jane; Muir, Kenneth R; Campbell, Jackie; Warcaba, Joanne
It is estimated that approximately 40% of all cases of cancer are attributable to lifestyle factors. Providing people with personalised information about their future risk of cancer may help promote behaviour change. To explore the views of health professionals on incorporating personalised cancer risk information, based on lifestyle factors, into general practice. Qualitative study using data from six focus groups with a total of 24 general practice health professionals from the NHS Nene Clinical Commissioning Group in England. The focus groups were guided by a schedule covering current provision of lifestyle advice relating to cancer and views on incorporating personalised cancer risk information. Data were audiotaped, transcribed verbatim, and then analysed using thematic analysis. Providing lifestyle advice was viewed as a core activity within general practice but the influence of lifestyle on cancer risk was rarely discussed. The word 'cancer' was seen as a potentially powerful motivator for lifestyle change but the fact that it could generate health anxiety was also recognised. Most focus group participants felt that a numerical risk estimate was more likely to influence behaviour than generic advice. All felt that general practice should provide this information, but there was a clear need for additional resources for it to be offered widely. Study participants were in support of providing personalised cancer risk information in general practice. The findings highlight a number of potential benefits and challenges that will inform the future development of interventions in general practice to promote behaviour change for cancer prevention. © British Journal of General Practice 2017.
Boakye, Omenaa; Birney, Arden; Suter, Esther; Phillips, Leah Adeline; Suen, Victoria Ym
This study explored which health care providers could be involved in centralized intake for patients with nonspecific low back pain to enhance access, continuity, and appropriateness of care. We reviewed the scope of practice regulations for a range of health care providers. We also conducted telephone interviews with 17 individuals representing ten provincial colleges and regulatory bodies to further understand providers' legislated scopes of practice. Activities relevant to triaging and assessing patients with low back pain were mapped against professionals' scope of practice. Family physicians and nurse practitioners have the most comprehensive scopes and can complete all restricted activities for spine assessment and triage, while the scope of registered nurses and licensed practical nurses are progressively narrower. Chiropractors, occupational therapists, physiotherapists, and athletic therapists are considered experts in musculoskeletal assessments and appear best suited for musculoskeletal specific assessment and triage. Other providers may play a complementary role depending on the individual patient needs. These findings indicate that an interprofessional assessment and triage team that includes allied health professionals would be a feasible option to create a centralized intake model. Implementation of such teams would require removing barriers that currently prevent providers from delivering on their full scope of practice.
Bates, Mari; Black, Clarence; Blair, Franchesica; Davis, Laquanda; Ingram, Steven; Lane, DaQuandra; McElderry, Alicia; Peagler, Bianca; Pickett, Jamie; Plettenberg, Cheryl; Hart-Hester, Susan
Introduction Undergraduate students’ progress toward achievement of learning outcomes and entry-level competencies is an essential ingredient in efforts to meet the needs of the evolving national healthcare information infrastructure. Therefore, studies to evaluate variance in outcome assessment methods and perceived adequacy of educational curricula used by health information management (HIM) programs are vital. This study examined perceptions of HIM students, faculty, and individuals employed in healthcare regarding educational experiences and career preparation. Methods A convenience sample of attendees from the American Health Information Management Association (AHIMA) national conference in Atlanta, Georgia, was obtained. A survey was developed on the basis of a review of current literature related to the assessment of HIM educational programming. The authors used a prepared script to describe the study purpose and survey when approaching potential respondents. Completion of the survey was voluntary. Results Of the 100 surveys distributed, 58 were returned. Twenty-six respondents were employed in healthcare, 25 were students, and 7 were HIM faculty members; no respondents were HIM program directors. Ninety-six percent of the student respondents indicated that the programs’ HIM curriculum prepared them for an entry-level position, while 86 percent of the faculty respondents and 70 percent of the respondents employed in healthcare agreed with this statement. More than half (56 percent) of the respondents who were employed in healthcare indicated that they needed additional training when they entered their first entry-level position. The majority of the respondents indicated that they were not matched with a mentor during their educational experience. Conclusions This research supports the complementary roles that educational coursework and practical experiences provide individuals within the HIM field. However, additional research is needed to assess the
Schwarz, Heidi B; Fritz, Joseph V; Govindarajan, Raghav; Penfold Murray, Rebecca; Boyle, Kathryn B; Getchius, Thomas S D; Freimer, Miriam
There are many factors driving health care reform, including unsustainable costs, poor outcomes, an aging populace, and physician shortages. These issues are particularly relevant to neurology. New reimbursement models are based on value and facilitated by the use of multidisciplinary teams. Integration of advanced practice providers (APPs) into neurology practice offers many advantages with new models of care. Conversely, there are many and varied challenges financially and logistically with these practice models. The American Academy of Neurology has formed a Work Group to address the needs of both neurologists and neurologic APPs and monitor the effect of APPs on quality and cost of neurologic care.
Patricia A.H. Williams
Full Text Available Information governance is becoming an important aspect of organisational accountability. In consideration that information is an integral asset of most organisations, the protection of this asset will increasingly rely on organisational capabilities in security. In the medical arena this information is primarily sensitive patient-based information. Previous research has shown that application of security measures is a low priority for primary care medical practice and that awareness of the risks are seriously underestimated. Consequently, information security governance will be a key issue for medical practice in the future. Information security governance is a relatively new term and there is little existing research into how to meet governance requirements. The limited research that exists describes information security governance frameworks at a strategic level. However, since medical practice is already lagging in the implementation of appropriate security, such definition may not be practical although it is obviously desirable. This paper describes an on-going action research project undertaken in the area of medical information security, and presents a tactical approach model aimed at addressing information security governance and the protection of medical data.
Othman, Noordin; Vitry, Agnes I; Roughead, Elizabeth E; Ismail, Shaiful B; Omar, Khairani
.... However, studies have shown that the quality of this information is often low. No study has assessed the medicines information provided by pharmaceutical representatives to doctors in Malaysia and no recent evidence in Australia is present...
Stein, Bradley D; Kogan, Jane N; Essock, Susan; Fudurich, Stephanie
This qualitative study examined consumer preferences regarding the content and use of provider performance data and other provider information to aid in consumers' decision making. Focus groups were conducted with 41 adults who were consumers of mental health care, and discussions were transcribed and analyzed with standard qualitative research methods. Consumers supported trends toward enhancing information about providers and its availability. Several key themes emerged, including the need for easily accessible information and the most and least useful types of information. Current efforts to share provider performance information do not meet consumer preferences. Modest changes in the types of information being shared and the manner in which it is shared may substantially enhance use of such information. Such changes may help consumers to be more informed and empowered in making decisions about care, improve the quality of the care delivered, and support the movement toward a more recovery-focused system of care.
Full Text Available Omenaa Boakye,1 Arden Birney,1 Esther Suter,1 Leah Adeline Phillips,2 Victoria YM Suen3 1Workforce Research and Evaluation, Alberta Health Services, Calgary, 2College of Licensed Practical Nurses of Alberta, Edmonton, 3Addiction and Mental Health SCN, Alberta Health Services, Edmonton, AB, Canada Purpose: This study explored which health care providers could be involved in centralized intake for patients with nonspecific low back pain to enhance access, continuity, and appropriateness of care. Methods: We reviewed the scope of practice regulations for a range of health care providers. We also conducted telephone interviews with 17 individuals representing ten provincial colleges and regulatory bodies to further understand providers' legislated scopes of practice. Activities relevant to triaging and assessing patients with low back pain were mapped against professionals' scope of practice. Results: Family physicians and nurse practitioners have the most comprehensive scopes and can complete all restricted activities for spine assessment and triage, while the scope of registered nurses and licensed practical nurses are progressively narrower. Chiropractors, occupational therapists, physiotherapists, and athletic therapists are considered experts in musculoskeletal assessments and appear best suited for musculoskeletal specific assessment and triage. Other providers may play a complementary role depending on the individual patient needs. Conclusion: These findings indicate that an interprofessional assessment and triage team that includes allied health professionals would be a feasible option to create a centralized intake model. Implementation of such teams would require removing barriers that currently prevent providers from delivering on their full scope of practice. Keywords: scope of practice review, low back pain, integrated service model, centralized intake, interprofessional team
Hagan, José E; Gaonkar, Narayan; Doshi, Vikas; Patni, Anas; Vyas, Shailee; Mazumdar, Vihang; Kosambiya, J K; Gupta, Satish; Watkins, Margaret
India is responsible for 30% of the annual global cohort of unvaccinated children worldwide. Private practitioners provide an estimated 21% of vaccinations in urban centers of India, and are important partners in achieving high vaccination coverage. We used an in-person questionnaire and on-site observation to assess knowledge, attitudes, and practices of private immunization service providers regarding delivery of immunization services in the urban settings of Surat and Baroda, in Gujarat, India. We constructed a comprehensive sampling frame of all private physician providers of immunization services in Surat and Baroda cities, by consulting vaccine distributors, local branches of physician associations, and published lists of private medical practitioners. All providers were contacted and asked to participate in the study if they provided immunization services. Data were collected using an in-person structured questionnaire and directly observing practices; one provider in each practice setting was interviewed. The response rate was 82% (121/147) in Surat, and 91% (137/151) in Baroda. Of 258 participants 195 (76%) were pediatricians, and 63 (24%) were general practitioners. Practices that were potential missed opportunities for vaccination (MOV) included not strictly following vaccination schedules if there were concerns about ability to pay (45% of practitioners), and not administering more than two injections in the same visit (60%). Only 22% of respondents used a vaccination register to record vaccine doses, and 31% reported vaccine doses administered to the government. Of 237 randomly selected vaccine vials, 18% had expired vaccine vial monitors. Quality of immunization services in Gujarat can be strengthened by providing training and support to private immunization service providers to reduce MOVs and improve quality and safety; other more context specific strategies that should be evaluated may involve giving feedback to providers on quality of services
Ismail Shaiful B; Roughead Elizabeth E; Vitry Agnes I; Othman Noordin; Omar Khairani
Abstract Background Pharmaceutical representatives provide medicines information on their promoted products to doctors. However, studies have shown that the quality of this information is often low. No study has assessed the medicines information provided by pharmaceutical representatives to doctors in Malaysia and no recent evidence in Australia is present. We aimed to compare the provision of medicines information by pharmaceutical representatives to doctors in Australia and Malaysia. Metho...
Mosites, Emily; Carpenter, L Rand; McElroy, Kristina; Lancaster, Mary J; Ngo, Tue H; McQuiston, Jennifer; Wiedeman, Caleb; Dunn, John R
Tennessee has a high incidence of Rocky Mountain spotted fever (RMSF), the most severe tick-borne rickettsial illness in the United States. Some regions in Tennessee have reported increased illness severity and death. Healthcare providers in all regions of Tennessee were surveyed to assess knowledge, attitudes, and perceptions regarding RMSF. Providers were sent a questionnaire regarding knowledge of treatment, diagnosis, and public health reporting awareness. Responses were compared by region of practice within the state, specialty, and degree. A high proportion of respondents were unaware that doxycycline is the treatment of choice in children ≤ 8 years of age. Physicians practicing in emergency medicine, internal medicine, and family medicine; and nurse practitioners, physician assistants, and providers practicing for < 20 years demonstrated less knowledge regarding RMSF. The gaps in knowledge identified between specialties, designations, and years of experience can help target education regarding RMSF.
Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J
Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may
Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan
Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal
Kazmerski, Traci M; Borrero, Sonya; Sawicki, Gregory S; Abebe, Kaleab Z; Jones, Kelley A; Tuchman, Lisa K; Weiner, Daniel J; Pilewski, Joseph M; Orenstein, David M; Miller, Elizabeth
To investigate the attitudes and practices of cystic fibrosis (CF) providers toward sexual and reproductive health (SRH) care in young women with CF. Adult and pediatric US CF providers were sent an online survey exploring their attitudes toward SRH importance, SRH care practices, and barriers/facilitators to SRH care in adolescent and/or young adult women. Descriptive statistics and logistic regression were used to analyze results. Attitudes toward the importance of SRH care in patients with CF and self-report of practice patterns of SRH discussion. Respondents (n = 196) were 57% pediatric (111/196) and 24% adult physicians (48/196) and 19% nurse practitioners (NPs)/physician assistants (PAs) (37/196). Ninety-four percent of respondents believed SRH was important for female patients with CF (184/196). More than 75% believed SRH care should be standardized within the CF care model (147/196) and 41% believed the CF team should have the primary role in SRH discussion and care (80/196). For many CF-specific SRH topics, discrepancies emerged between how important respondents believed these were to address and how often they reported discussing these topics in practice. Significant differences in SRH attitudes and practices were present between adult and pediatric physicians. The most significant barriers to SRH care identified were lack of time (70%, 137/196) and the presence of family in clinic room (54%, 106/196). Potential facilitators included training materials for providers (68%, 133/196) and written (71%, 139/196) or online (76%, 149/196) educational resources for patients. CF providers perceive SRH topics as important to discuss, but identify barriers to routine discussion in current practice. Providers endorsed provider training and patient educational resources as means to improve SRH delivery. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Dev, Dipti A; Speirs, Katherine E; Williams, Natalie A; Ramsay, Samantha; McBride, Brent A; Hatton-Bowers, Holly
Supporting children's self-regulation in eating through caregivers' practice of responsive feeding is paramount to obesity prevention, and while much attention has been given to supporting children's self-regulation in eating through parents' responsive feeding practices in the home setting, little attention has been given to this issue in childcare settings. This qualitative study examines childcare providers' perspectives on using responsive feeding practices with young children (2-5years). Individual semi-structured interviews were conducted with providers until saturation was reached. Data was analyzed using thematic analysis. The final sample included 18 providers who were employed full-time in Head Start or state-licensed center-based childcare programs, cared for children (2-5y), and were directly responsible for serving meals and snacks. Providers were primarily (67%) employed in childcare programs that served children from low-income families and received reimbursement for meals and snacks from the US Department of Agriculture's Child and Adult Care Food Program. Three factors emerged that shaped childcare providers' experiences using responsive feeding practices: the providers' perspectives about whether or not young children can self-regulate food intake, their understanding of Child and Adult Care Food Program (CACFP) portion size regulations, and the availability of food at the center where they worked. Future research should examine how childcare providers' understanding of children's ability to self-regulate their food intake, the appropriate use of the CACFP regulations in relationship to serving sizes, and having food available to offer seconds promotes providers' use of responsive feeding practices in center-based childcare programs and children's dietary behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.
Matthew J Gibson
Full Text Available Objectives: The primary objective of the study is to identify the barriers to providing Introductory Pharmacy Practice Experiences (IPPEs in the hospital setting. Methods: Potential barriers to IPPEs were identified via literature review and interviews with current IPPE preceptors from various institutions. Based on this information, an electronic survey was developed and distributed to IPPE preceptors in order to assess student, preceptor, logistical and college or school of pharmacy related barriers that potentially exist for providing IPPE in the hospital setting. Results: Sixty-eight of the 287 eligible survey respondents (24% completed the electronic survey. Seventy-six percent of respondents agreed or strongly agreed that available time was a barrier to precepting IPPE students even though a majority of respondents reported spending a third or more of their day with an IPPE student when on rotation. Seventy-three percent of respondents disagreed or strongly disagreed that all preceptors have consistent performance expectations for students, while just 46% agreed or strongly agreed that they had adequate training to precept IPPEs. Sixty-five percent of respondents agreed that IPPE students have the ability to be a participant in patient care and 70% of preceptors believe that IPPE students should be involved in patient care. Conclusions: Conducting IPPEs in the institutional setting comes with challenges. Based on the results of this study, experiential directors and colleges/schools of pharmacy could make a positive impact on the quality and consistency of IPPEs by setting student expectations and training preceptors on appropriate and consistent expectations for students. Type: Original Research
Hanoch, Yaniv; Pachur, Thorsten
Nurses are increasingly being called upon to be the conveyers of important statistical information to patients. This trend is particularly evident in the domains of genetics and cancer screening. These new roles, however, demand new competencies, such as the ability to solve statistical problems, and the skill to communicate the answers effectively, as effective communication is an important ingredient in shared decision making. Genetic testing, perhaps more than other medical domains, relies heavily on the use of statistics. Being able to convey statistical information effectively is vital. In this paper, we illustrate the problems health care professionals have had in tackling and communicating statistical information. We introduce the natural frequencies method of solving Bayesian inference problems and review empirical evidence that shows the superiority of this format. Being able to transform probabilities into natural frequencies facilitates correct Bayesian inferences. It is argued that the conventional approach to educating nurses in Bayesian problem solving should be reconsidered and their statistical curriculum should be supplemented with instruction in using the natural frequency format.
It traces the origin of library and information science education in Nigeria, underscoring the apparent proliferation and its implications. It observes the trend in library and information science practice whereby the advent of new technologies has had a tremendous impact on the traditional service delivery; leading to some ...
Burn, Katharine; Mutton, Trevor
This review examines the kinds of relationship between research and practice that have been envisaged in programmes designed to provide opportunities for beginning teachers to engage in "research-informed clinical practice". Although the terminology varies, scope for inclusion is defined by an intention to facilitate and deepen the…
Full Text Available Nursing informatics skills are required at all levels of nursing practice. Of those basic skills, management of information through the electronic health record (EHR is paramount. Previous research has explored computer literacy of nurses but has not investigated the competencies that relate specifically to information management. The purpose of this research study was to gather practicing nurses’ views of current information management competencies published by the Technology Informatics Guiding Education Reform (TIGER initiative, as they pertain to new graduates. A convenience sample of members from the InspireNet online user group was surveyed. The results suggest that overall, nurses tend to agree with the information management competencies; however, informatics education is most needed for those who have been practicing nursing for longer, rather than for novice nurses.
Full Text Available A Security Maturity Model (SMM) provides an organisation with a distinct Information Security framework. Organisations that conform to these models are likely to pursue satisfactory Information Security. Additionally, the use of Security Maturity...
Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah
To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.
Jeevan, R; Birch, J; Armstrong, A P
Travelling abroad for surgery is a phenomenon reported internationally. It is particularly likely for aesthetic procedures not undertaken routinely by national health services. We assessed the impact of these patients presenting to the UK National Health Service (NHS) with concerns or complications on their return. All 326 UK consultant members of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) were asked to complete a short questionnaire about patients that had presented to the NHS with complications or concerns following surgery abroad. The results were subsequently presented to the Department of Health (DH). 203 (62%) UK consultant plastic surgeons responded. 76 (37%) of the 203 respondents had seen such patients in their NHS practice, most commonly following breast or abdominal procedures. A quarter underwent emergency surgery, a third out-patient treatment and a third elective surgical revision. In response to these findings, the DH clarified that NHS teams should provide emergency care to such patients but should not undertake any elective revision procedures. Travelling abroad for aesthetic surgery may reduce its cost. However, aesthetic procedures have high minor complication rates, and peri-operative travel is associated with increased risks. Fully informed consent is unlikely when patients do not meet their surgeon prior to paying and travelling for surgery, and national health services are used to provide a free safety net on their return. To help minimise the potential risks, BAPRAS has clarified the responsibilities of the NHS and is acting to better inform UK patients considering travelling abroad. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Hernández-Del Amo, Elena; Menció, Anna; Gich, Frederic; Mas-Pla, Josep; Bañeras, Lluís
Natural attenuation processes alleviate the impact of fertilization practices on groundwater resources. Therefore, identifying the occurrence of denitrification has become a requirement for water quality management. Several approaches are useful for this purpose, such as isotopic and microbiological methods, each of them providing distinct but complementary information about denitrification reactions, attenuation rates and their occurrence in the aquifer. In this paper, we investigate the contribution of both approaches to describe denitrification in a consolidated rock aquifer (limestone and marls), with a porosity related to fracture networks located in the northeastern sector of the Osona basin (NE Spain). Isotopic methods indicated the origin of nitrate (fertilization using manure) and that denitrification occurred, reaching a reduction of near 25% of the nitrate mass in groundwater. The studied area could be divided in two zones with distinct agricultural pressures and, consequently, nitrate concentrations in groundwater. Denitrification occurred in both zones and at different levels, indicating that attenuation processes took place all along the whole hydrogeological unit, and that the observed levels could be attributed to a larger flow path or, in a minor extent, to mixing processes that mask the actual denitrification rates. Microbiological data showed a correlation between denitrifier genes and the isotopic composition. However, the groundwater microbiome and the distribution of denitrifying bacteria did not reveal a major influence on the denitrification level observed by isotopic methods. This focuses the interest of microbiological analysis to identify functional genes within the bacteria present in the aquifer. Results indicated that isotopic methods provide information of the overall denitrification ability of the hydrogeological unit, and that genomic data represent the processes actually acting nearby the well. A combination of both approaches is
Kozlov, Elissa; Eghan, Claude; Moran, Sheila; Herr, Keela; Reid, M Carrington
To investigate how inpatient palliative care teams nationwide currently screen for and treat psychological distress. A web-based survey was sent to inpatient palliative care providers of all disciplines nationwide asking about their practice patterns regarding psychological assessment and treatment. Descriptive statistics were used to characterize the sample and responses, and analysis of variance was conducted to determine whether certain disciplines were more likely to utilize specific treatment modalities. A total of N = 236 respondents were included in the final analyses. Providers reported that they encounter psychological distress regularly in their practice and that they screen for distress using multiple methods. When psychological distress is detected, providers reported referring patients to an average of 3 different providers (standard deviation = 1.46), most frequently a social worker (69.6%) or chaplain (65.3%) on the palliative care team. A total of 84.6% of physicians and 54.5% of nurse practitioners reported that they prescribe anxiolytics or selective serotonin reuptake inhibitors to patients experiencing psychological distress. This study revealed significant variability and redundancy in how palliative care teams currently manage psychological distress. The lack of consistency potentially stems from the variability in the composition of palliative care teams across care settings and the lack of scientific evidence for best practices in psychological care in palliative care. Future research is needed to establish best practices in the screening and treatment of psychological distress for patients receiving palliative care.
Falk, G A
Reviews of the medical school curriculum in the UK and Ireland have recommended the introduction of student-selected components (SSCs). The Department of Surgery in The Royal College of Surgeons in Ireland (RCSI) has introduced a 6-week surgical SSC, which aims to develop practical clinical skills, provide mentorship and prepare students for internship.
Infection Control Manager Nurse Manager, Family Practice Clinic Infection Control Assistant Manager Clinical Nurse, Obstetrical Ward Clinical...172 Air Force health care providers at a mid- level medical treatment facility including: medical doctors (MD), doctors of osteopathy (DO...of osteopathy , physician assistants, nurse practitioners and independent duty medical technicians. Knowledge of tuberculosis skin testing: shall be
Lanigan, Jane D.
Objective: To examine the association between child care practices and child care provider knowledge and beliefs about their role in supporting children's healthful eating. Design: Longitudinal design using survey and observation data from baseline and year 1 of the Encouraging Healthy Activity and Eating in Childcare Environments (ENHANCE) pilot…
Havik, Else M.; Kooijman, Aart C.; Steyvers, Frank J. J. M.
The effectiveness of different types of verbal information provided by electronic travel aids was studied in a real-life setting. Assessments included wayfinding performance and the preferences of 24 visually impaired users. The participants preferred a combination of route information and environmental information, even though this information…
Garoufallou, Emmanouel; Balatsoukas, Panos; Siatri, Rania; Zafeiriou, Georgia; Asderi, S.; Ekizoglou; P.
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…
Sakai, Hitomi; Katsumata, Noriyuki; Takahashi, Miyako
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.
Maria Miruna Rădan-Gorska
Full Text Available This article is an ethnographic account of the informal practices I encountered during my fieldwork in three touristic destinations in the Romanian countryside. In these places, as in other parts of rural Romania, over half of the accommodation units are unregistered, making tourism ‘on the black’ [market] widespread. This research is focused on unregistered businesses, as well as on those that aim to be law-abiding, but sometimes engage in informal practices. A typology of informal practices is outlined, dividing them into intended, unintended, and contextual. These categories are illustrated with evidence from interview data and from mass media accounts. Informality is discussed in relation to the legislative framework and to the actions of those authorities responsible with enforcing regulations. Local sense-making strategies are taken into account in explaining informal practices, as well as the wider national and historical contexts. The positive and negative implications of informality are examined and the article concludes by making a number of suggestions that could help to develop more appropriate norms and policies regarding rural guesthouses.
Heijmans, Naomi; van Lieshout, Jan; Wensing, Michel
Although a wide range of preventive and clinical interventions has targeted cardiovascular risk management (CVRM), outcomes remain suboptimal. Therefore, the question is what additional determinants of CVRM and outcomes can be identified and addressed to optimize CVRM. In this study, we aimed to identify new perspectives for improving healthcare delivery and explored associations between information exchange networks of health care providers and evidence-based CVRM. This observational study was performed parallel to a randomized clinical trial which aimed to improve professional performance of practice nurses in the Netherlands. Information exchange on medical policy for CVRM ("general information networks") and CVRM for individual patients ("specific information networks") of 180 health professionals in 31 general practices was measured with personalized questionnaires. Medical record audit was performed concerning 1620 patients in these practices to document quality of care delivery and two risk factors (systolic blood pressure (SBP) and LDL cholesterol level). Hypothesized effects of five network characteristics (density, frequency of contact, centrality of CVRM-coordinators, homophily on positive attitudes for treatment target achievement, and presence of an opinion leader for CVRM) constructed on both general and specific information exchange networks were tested and controlled for practice and patient factors using logistic multilevel analyses. Odds for adequate performance were enhanced in practices with an opinion leader for CVRM (OR 2.75, p based CVRM is associated with homophily of clinical attitudes and presence of opinion leaders in primary care teams. These results signal the potential of social networks to be taken into account in further attempts to improve the implementation of evidence-based care for CVRM. Future research is needed to identify and formulate optimal strategies for using opinion leaders to improve CVRM. Future interventions may be
Schroeder, J.V.; Mayer, G.
In the last 20 years, federal, state and local regulations have provided regulatory incentives for industry to better manage environmental, health and safety (EHS) practices. In order for voluntary EHS management practices to move beyond compliance and continue improving, specific, quantifiable benefits must result. That is, companies must achieve some competitive advantage from implementing EHS improvements that are considered voluntary. Recently, many private companies and public agencies have been giving significant consideration toward the implementation of an EHS management information system (EMIS). Currently considered voluntary, the automation of EHS data collection, storage, retrieval and reporting is subject to the same benefit expectations that other EHS improvements are subject to. The benefits resulting from an EMIS typically result from a reduction in either direct or indirect costs. Direct costs, consisting primarily of labor hours, permit fees, disposal costs, etc., are definable and easily to quantify. Indirect costs, which are comprised of reduced risks and liabilities, are less easily quantifiable. In fact, many have abandoned hope of ever quantifying expected benefits from indirect costs, and simply lump all indirect benefits into a qualitative, catch-all category called intangible benefits. However, by statistically analyzing individual risk events over an expected project life, anticipated benefits can be objectively and accurately quantified. Through the use of a case study, this paper will describe the process of quantifying direct and indirect benefits resulting from the implementation of an EMIS. The paper will describe the application of a statistical model to estimate indirect benefits and will demonstrate how the results of the benefit quantification can be used to make sound, business based decisions based on a required rate of return/return on investment.
Kurimoto, Fuki; Hori, Satoko; Satoh, Hiroki; Miki, Akiko; Sawada, Yasufumi
For drug fostering and evolution, it is important to collect information directly from patients on the efficacy and safety of drugs as well as patient needs. At present, however, information gathered by healthcare professionals, pharmaceutical companies, or governments is not sufficient. There is concern that patients may fail to recognize the importance of providing information voluntarily. The present study was conducted to provide drug information to patients/consumers, to enlighten them on the importance of providing drug information by themselves, and to develop an Internet website, called "Minkusu," for collecting drug information from patients. This website is based on a registration system (free of charge). It is designed to provide information on proper drug use, and to collect opinions about drugs. As of May 31, 2012, a total of 1149 people had been registered. The male/female ratio of registered members was approximately 1:1, and patients/consumers accounted for 23%. According to the results of a questionnaire survey, several patient/consumer members appreciated the usefulness of the information service, and they took an opportunity to know of the concepts of drug development and evolution (Ikuyaku, in Japanese) through the information services provided by this site. In conclusion, the developed information system would contribute to the proper use of drugs by patients/consumers and to the promotion of drug development and evolution.
Benner, Debbie; Burgess, Mary; Stasios, Maria; Brosch, Becky; Wilund, Ken; Shen, Sa; Kistler, Brandon
Eating during hemodialysis treatment remains a controversial topic. It is perceived that more restrictive practices in the United States contribute to poorer nutritional status and elevated mortality compared with some other parts of the world. However, in-center food practices in the United States have not been previously described. In 2011, we conducted a survey of clinic practices and clinician (dietitian, facility administrator, and medical director) opinions related to in-center food consumption within a large dialysis organization. After the initial survey, we provided clinicians with educational materials about eating during treatment. In 2014, we performed a follow-up survey. Differences in practices and opinions were analyzed using chi-squared tests and logistic regression. In 2011, 343 of 1199 clinics (28.6%) did not allow eating during treatment, 222 clinics (18.2%) did not allow drinking during treatment, and 19 clinics (1.6%) did not allow eating at the facility before or after treatment. In 2014, the proportion of clinics that did not allow eating during treatment had declined to 22.6% (321 of 1422 clinics), a significant shift in practice (Pnutritional status. Among clinicians, a higher percentage encouraged eating during treatment (53.1% versus 37.4%; P<0.05), and facility administrators and medical directors were less concerned about the seven reasons commonly cited for restricting eating during treatment in 2014 compared with 2011 (P<0.05 for all). We found that 28.6% and 22.6% of hemodialysis clinics within the United States restricted eating during treatment in 2011 and 2014, respectively, a rate more than double that found in an international cohort on which we previously published. However, practices and clinician opinions are shifting toward allowing patients to eat. Additional research is warranted to understand the effect that these practices have on patient outcomes and outline best practices. Copyright © 2016 by the American Society of
Mursu, Anja; Luukkonen, Irmeli; Toivanen, Marika; Korpela, Mikko
Introduction: The purpose of information systems is to facilitate work activities: here we consider how Activity Theory can be applied in information systems development. Method. The requirements for an analytical model for emancipatory, work-oriented information systems research and practice are specified. Previous research work in Activity…
McMenemy, David; Burton, Paul
This book looks at all of the ethical issues facing information and library professionals in one overarching, and practically-focused, text. As such, it is of great benefit to both practitioners and to LIS students. The focus of the book is two-fold: (1) It contains a detailed discussion of the issues that impact on the day-today practice of information workers in the 21st century; and (2) contains case studies discussing potential solutions to ethical problems faced. The book provides sections which work like flowcharts leading from ethical issues through decision points to proposed solutions
Gordon, E J; Mullee, J; Beauvais, N; Warren, E; Theodoropoulos, N; McNatt, G; Rassiwala, J; Ison, M G
Transplant providers must understand the definition of increased risk donor (IRD) organs to effectively educate transplant candidates and obtain informed consent. This study surveyed non-physician providers from 20 transplant centers about their educational and informed consent practices of IRD kidneys. An anonymous, web-based survey about the content and timing of education and informed consent for potential recipients of IRD kidneys, providers' knowledge of IRD kidneys, and provider and center characteristics was completed by most (67%; 90 of 135) of those invited to participate; 87 responses were included in analysis. Most (80%) reported understanding the concept of IRD kidneys. However, few reported sufficient knowledge of the Organ Procurement and Transplantation Network definition of IRDs, risk factors, screening tests, window periods, and infection transmission rates. Most (56%) felt uncomfortable with obtaining specific informed consent for IRD kidneys. Most respondents received informal education about IRD kidneys (78%), and recognized the need for (98%) and were interested in receiving (99%) further education on this topic. Non-physician transplant providers need and are interested in better education about IRD kidneys to effectively educate patients and obtain patients' informed consent. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available Libraries share information with each other, through interlibrary loan services, so that their library users can access more of the world of information than is available in any one library. When supported with enough budget, staff and authority to do so, library resource sharing specialists can facilitate information access in a variety of traditional and innovative ways, including and beyond lending and borrowing print and digital information. Best practices, trends and new solutions for library resource sharing are reviewed. International cooperation is also highlighted.
Full Text Available This article makes a critical analysis of new media art working with data interfaces and visualisation – data practice or data art. Pursuing the distinction between information and data, it is demonstrated that data art often turns away from information in an attempt to present the data itself. In the process, data art constructs figures of data as unmediated, immanent, material and underdetermined. A critical analysis of these figures underpins reflections on the wider significance and potential of such data practices.
The variety and increasing availability of hypermedia information systems, which are used in stationary applications like operators’ consoles as well as mobile systems, e.g. driver information and navigation systems in automobiles form a foundation for the mediatization of the society. From the human engineering point of view this development and the ensuing increased importance of information systems for economic and private needs require careful deliberation of the derivation and application of ergonomics methods particularly in the field of information systems. This book consists of two closely intertwined parts. The first, theoretical part defines the concept of an information system, followed by an explanation of action regulation as well as cognitive theories to describe man information system interaction. A comprehensive description of information ergonomics concludes the theoretical approach. In the second, practically oriented part of this book authors from industry as well as from academic institu...
Conradi, Lisa; Agosti, Jen; Tullberg, Erika; Richardson, Lisa; Langan, Heather; Ko, Susan; Wilson, Charles
This paper will provide information on a recent Breakthrough Series Collaborative (BSC) conducted by the National Child Traumatic Stress Network on Using Trauma-Informed Child Welfare Practice to Improve Foster Care Placement Stability. Information on this particular BSC will be provided, followed by initial findings gathered from an evaluation of…
Cacace, Mirella; Ettelt, Stefanie; Brereton, Laura; Pedersen, Janice S; Nolte, Ellen
This article provides details on a report that reviews and discusses information systems reporting on the quality or performance of providers of healthcare ("quality information systems") in seven countries: Denmark, England, Germany, Italy, the Netherlands, Sweden and the United States. Data collection involves a review of the published and grey literature and is complemented by information provided by key informants in the selected countries using a detailed questionnaire. Quality information systems typically address a number of audiences, including patients (or respectively the general public before receiving services and becoming patients), commissioners, purchasers and regulators. We observe that as the policy context for quality reporting in countries varies, so also does the nature and scope of quality information systems within and between countries. Systems often pursue multiple aims and objectives, which typically are (a) to support patient choice (b) to influence provider behaviour to enhance the quality of care (c) to strengthen transparency of the provider-commissioner relationship and the healthcare system as a whole and (d) to hold healthcare providers and commissioners to account for the quality of care they provide and the purchasing decisions they make. We emphasise that the main users of information systems are the providers themselves as the publication of information provides an incentive for improving the quality of care. Finally, based on the evidence reviewed, we identify a number of considerations for the design of successful quality information systems, such as the clear definition of objectives, ensuring users' accessibility and stakeholder involvement, as well as the need to provide valid, reliable and consistent data.
Ismail Shaiful B
Full Text Available Abstract Background Pharmaceutical representatives provide medicines information on their promoted products to doctors. However, studies have shown that the quality of this information is often low. No study has assessed the medicines information provided by pharmaceutical representatives to doctors in Malaysia and no recent evidence in Australia is present. We aimed to compare the provision of medicines information by pharmaceutical representatives to doctors in Australia and Malaysia. Methods Following a pharmaceutical representative's visit, general practitioners in Australia and Malaysia who had agreed to participate, were asked to fill out a questionnaire on the main product and claims discussed during the encounter. The questionnaire focused on provision of product information including indications, adverse effects, precautions, contraindications and the provision of information on the Pharmaceutical Benefit Scheme (PBS listings and restrictions (in Australia only. Descriptive statistics were produced. Chi-square analysis and clustered linear regression were used to assess differences in Australia and Malaysia. Results Significantly more approved product information sheets were provided in Malaysia (78% than in Australia (53% (P Conclusions Information on indications and dosages were usually provided by pharmaceutical representatives in Australia and Malaysia. However, risk and harmful effects of medicines were often missing in their presentations. Effective control of medicines information provided by pharmaceutical representatives is needed.
Sazonets Olga M.
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.
Fitch, Rebecca C; Harnack, Lisa J; Neumark-Sztainer, Dianne R; Story, Mary T; French, Simone A; Oakes, J Michael; Rydell, Sarah A
To gather consumer input about approaches to providing energy composition information for foods on fast-food restaurant menus. We asked a subset of individuals (n = 150) in an experimental study about the influence of nutrition labeling on fast-food meal choices to evaluate calorie information on mock fast-food menus in various formats. Three community sites in the Minneapolis-St. Paul, Minnesota, metropolitan area. Adolescents and adults who ate fast food at least once per week were recruited. Via a series of open- and close-ended questions, participants gave feedback about several formats for providing energy composition information for foods on fast-food restaurant menus. Means and frequencies were calculated, and chi2 tests were conducted. When asked to compare a menu that provided calorie information for each menu item with a menu that provided the number of minutes of running that would be required to burn the calories contained in each menu item, 71.0% of participants preferred the calorie information over the physical activity information. Participants also compared two approaches to providing caloric reference information on the menu (average daily calorie needs per day vs. per meal), and 61.3% preferred the calorie needs-per-meal format. Our results may be useful in designing approaches to providing energy composition information for foods on fast-food restaurant menus.
Eliseo, Laura J; Murray, Kate A; White, Laura F; Dyer, Sophia; Mitchell, Patricia A; Fernandez, William G
Occupational injuries are an important source of morbidity for emergency medical services (EMS) providers. Previous work has shown that employee perceptions of an organization's commitment to safety (i.e., safety climate) correlate with adherence to safe practices. To assess the association between perceived safety climate and compliance with safety procedures in an urban EMS system with >100,000 calls/year. EMS providers were issued a self-administered survey that included questions on demographics, years of experience, perceived safety climate, and adherence to safety procedures. Safety climate was assessed with a 20-item validated instrument. Adherence to safety procedures was assessed with a nine-item list of safety behaviors. Strict adherence to safety procedures was defined as endorsing "agree" or "strongly agree" on 80% of items. The effect of safety climate on compliance with safe practices was estimated using multiple logistic regression. One hundred ninety-six of 221 providers (89%) completed surveys; 74% were male; the median age was 36-40 years; and the median amount of experience was 8 years. One hundred twenty-seven of 196 respondents (65%) reported strict adherence to safe work practice. Factor analysis confirmed the original six-factor grouping of questions; frequent safety-related feedback/training was significantly associated with safe practices (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.01-4.51). EMS workers perceiving a high degree of perceived safety climate was associated with twofold greater odds of self-reported level of strict adherence to safe work practices. Frequent safety-related feedback/training was the one dimension of safety climate that had the strongest association with adherence to safe workplace behaviors.
Eby, David W; Molnar, Lisa J; Kostyniuk, Lidia P; St Louis, Renée M; Zanier, Nicole
The study aim was to gain a better understanding of the characteristics of informal caregivers who provide transportation assistance and to explore the types and frequency of this assistance. A telephone survey was administered to a representative sample of 268 informal caregivers (age 45-80) who provide transportation assistance to older adults (age 70 and older) in Michigan. Responses were analyzed overall and by the caregiver sex and care recipient age. Informal transportation caregivers were: most often women; on average 61 years old; generally college educated; employed full- or part-time jobs; relatively healthy; providing care to a parent/family member 1-4 times per week, living close to the care recipient; and providing assistance by giving rides. Less than one-half of caregivers sought information to help them provide assistance. No significant burden was reported and there were few differences by sex of the caregiver of the age group of the care recipient.
David W Eby
Full Text Available The study aim was to gain a better understanding of the characteristics of informal caregivers who provide transportation assistance and to explore the types and frequency of this assistance. A telephone survey was administered to a representative sample of 268 informal caregivers (age 45-80 who provide transportation assistance to older adults (age 70 and older in Michigan. Responses were analyzed overall and by the caregiver sex and care recipient age. Informal transportation caregivers were: most often women; on average 61 years old; generally college educated; employed full- or part-time jobs; relatively healthy; providing care to a parent/family member 1-4 times per week, living close to the care recipient; and providing assistance by giving rides. Less than one-half of caregivers sought information to help them provide assistance. No significant burden was reported and there were few differences by sex of the caregiver of the age group of the care recipient.
Harris, Bronwyn; Eyles, John; Goudge, Jane
In this article, we consider the conduct of post-apartheid health care in a policy context directed toward entrenching democracy, ensuring treatment-adherent patients, and creating a healthy populace actively responsible for their own health. We ask how tuberculosis treatment, antiretroviral therapy, and maternal services are delivered within South Africa's health system, an institutional site of colonial and apartheid injustice, and democratic reform. Using Foucauldian and post-Foucauldian notions of governmentality, we explore provider ways of doing to, for, and with patients in three health subdistricts. Although restorative provider engagements are expected in policy, older authoritarian and paternalistic norms persist in practice. These challenge and reshape, even 'undo' democratic assertions of citizenship, while producing compliant, self-responsible patients. Alongside the need to address pervasive structural barriers to health care, a restorative approach requires community participation, provider accountability, and a health system that does with providers as much as providers who do with patients.
Full Text Available Jamie S Massengill,1 John L Kittredge2 1JSM Medical, Edmond, OK, USA; 2Michiana Spine, Sports and Occupational Rehab, PC, Mishawaka, IN, USA Abstract: An estimated one million individuals in the US are diagnosed with herpes zoster (HZ; shingles each year. Approximately 20% of these patients will develop postherpetic neuralgia (PHN, a complex HZ complication characterized by neuropathic pain isolated to the dermatome that was affected by the HZ virus. PHN is debilitating, altering physical function and quality of life, and commonly affects vulnerable populations, including the elderly and the immunocompromised. Despite the availability of an immunization for HZ prevention and several approved HZ treatments, the incidence of PHN is increasing. Furthermore, management of the neuropathic pain associated with PHN is often suboptimal, and the use of available therapeutics may be complicated by adverse effects and complex, burdensome treatment regimens, as well as by patients' comorbidities and polypharmacy, which may lead to drug–drug interactions. Informed and comprehensive assessments of currently available pharmacological treatment options to achieve effective pain control in the primary care setting are needed. In this article, we discuss the situation in clinical practice, review currently recommended prevention and treatment options for PHN, and outline practical considerations for the management of this neuropathic pain syndrome, with a focus on optimal, individual-based treatment plans for use in the primary care setting. Keywords: herpes zoster, postherpetic neuralgia, primary care, clinical practice, pharmacological treatment, practical guidelines
Shetty, Gina; Sanchez, Julian A; Lancaster, Johnathan M; Wilson, Lauren E; Quinn, Gwendolyn P; Schabath, Matthew B
There are limited data on lesbian, gay, bisexual, and transgender (LGBT) healthcare experiences and interactions with the providers. This study assessed knowledge, attitudes, and practice behaviors of oncology providers regarding LGBT health. A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. 108 providers participated in the survey (28% response rate). LGBT cultural competency at the institution. Results from the open comments section identified multiple misconceptions. This study revealed knowledge gaps about LGBT health risks. Cultural competency training may aid oncology providers to understand the need to inquire about patients' gender identity and sexual orientation. Health care providers who incorporate the routine collection of gender identity and sexual orientation (SOGI) in their patient history taking may improve patient care by offering tailored education and referrals. While identifying as LGBT does not in itself increase risk for adverse health outcomes, this population tends to have increased risk behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Lum, Paula J; Little, Sherri; Botsko, Michael; Hersh, David; Thawley, Robert E; Egan, James E; Mitty, Jennifer; Boverman, Joshua; Fiellin, David A
Pain syndromes are common in HIV-infected patients, who also are commonly affected by opioid-use disorders. Although opioids can treat pain, prescribers must consider the consequences of iatrogenic or missed addiction diagnoses. In an anonymous online survey, we asked a national sample of HIV providers about their demographics, experience, and patients, and their practices and attitudes about chronic opioid therapy, addiction, and confidence recognizing opioid analgesic abuse. One hundred six providers reported 28% of their patients had chronic pain; 21% received opioid analgesics; 37% were HIV infected by injecting drug use; and 12% were addicted to prescription opioids. Few providers followed recommended guidelines for chronic opioid therapy in nonmalignant pain. Mean provider confidence was 6.3 on a scale of 10. Higher confidence was associated with provider sex (P opioids (P = 0.005), and prescribing buprenorphine (P = 0.009). HIV providers seldom follow recommended guidelines for opioid prescribing and have limited confidence in their ability to recognize opioid analgesic abuse. Clinical practices developed to reduce misuse and increase early detection and treatment of opioid dependence are associated with higher confidence. The implementation of guidelines to improve the quality of opioid prescribing in HIV clinics may aid in the diagnosis of addictive disorders and prevent their adverse outcomes.
Report #2006-P-00021, March 30, 2006. We found that the Office of Water (OW) substantially complied with many of the information security controls reviewed and had implemented practices to ensure production servers are monitored.
Jain, Sejal V; Simakajornboon, Narong; Glauser, Tracy A
Sleep disorders significantly affect the lives of children with epilepsy. Limited data exist about provider practices concerning detection and correct diagnosis of sleep problems in epilepsy. The authors conducted this study to identify and correlate sleep screening methods, referral practices, referral reasons and final sleep diagnoses. They identified that 94% of the providers who had referred patients to the sleep center of a major children's hospital used routine screening and 70% of them used 2 to 3 screening questions. This method, however, underidentified the patients at risk for sleep disorders. Moreover, in 40% of the children, sleep disorder was incorrectly anticipated, based on the initial symptoms. Of these children, 10% had no sleep disorder and 30% had unexpected sleep disorder. The authors conclude that better screening methods should be used for sleep disorders. Once identified, these patients should have formal sleep evaluation and management. Further studies are needed to develop screening questionnaires.
Risks for patients and consumers can be minimized depending on how they are provided appropriate drug information. Therefore, from the viewpoint of hospital pharmacists, I would like to report on how information should be provided in order to minimize patient risk. For example, there is an ongoing opinion that the provision of easy-to-understand drug information to patients and consumers "does not appear necessary". The reasons for this include the following: Because the level of understanding varies greatly among patients, it is difficult to define what "easy-to-understand" information entails; rather, it may cause misunderstanding. These problems occur repeatedly if they are resolved by individual institutions. Therefore, it is essential to standardize the drug information provided to patients, that is, to establish a system to transmit drug information to patients and consumers. Regardless of whether the development of a hospital information system is in progress or not, it can be said that the development of such information systems is gradually spreading outside of hospitals and the situation is changing. From the viewpoint of patients, medical services are not limited to those from hospitals. Patient-centered collaboration between hospitals/clinics and pharmacies (but not the collaboration between hospital pharmacists and community pharmacists (why not?)) can provide good medical services only if patient information is shared. It is essential to establish a system for providing a drug guide for patients, in order to have patients understand drug information. The preparation of Drug Information for Patients would provide health care specialists a communication tool that helps minimize patient risk.
Fuhrer, M J; Grabois, M
As part of a mail survey of physiatrists' views of conducting research, respondents were queried regarding information sources that influenced their introducing a clinical innovation into their practices in the past two years. Complete information was obtained from 356 individuals. The reported practice innovations were categorized as follows: (a) evoked potentials (6% of respondents); (b) electrophysiologic diagnostic procedures other than evoked potentials (19%); (c) other diagnostic/assessment procedures (11%); (d) transcutaneous nerve stimulation (6%); (e) physical treatment procedures other than transcutaneous nerve stimulation (22%); (f) medication (5%); (g) psychologic or social intervention (4%); and (h) altered methods of service delivery (27%). Considered across all practice innovation categories, the average relative importance (in descending order) of the information sources was as follows: (1) discovery in the individual's own practice; (2) a meeting, lecture, or continuing education course; (3) a clinical coworker; (4) a write-up in the clinical literature; (5) the individual's own research; (6) a patient; (7) a write-up in the research literature; (8) a textbook; and (9) the representative of a drug firm or equipment manufacturer. Additional findings concern variables which distinguished a group of 43 individuals who reported introducing no innovation into their practices for the preceding two years, compared to the 356 individuals who did so.
Meyer, Eric T; Kyriakidou-Zacharoudiou, Avgousta; Power, Lucy; Williams, Peter; Venters, Will; Terras, Melissa; Wyatt, Sally
In many ways, the physical sciences are at the forefront of using digital tools and methods to work with information and data. However, the fields and disciplines that make up the physical sciences are by no means uniform, and physical scientists find, use, and disseminate information in a variety of ways. This report examines information practices in the physical sciences across seven cases, and demonstrates the richly varied ways in which physical scientists work, collaborate, and share information and data. This report details seven case studies in the physical sciences. For each case, qualitative interviews and focus groups were used to understand the domain. Quantitative data gathered from a survey of participants highlights different information strategies employed across the cases, and identifies important software used for research. Finally, conclusions from across the cases are drawn, and recommendations are made. This report is the third in a series commissioned by the Research Information Network...
Most differences, shortcomings and contradictions regarding voluntary informed consent for participation in clinical research relate to the South African-specific guidance documents, i.e. South African Guidelines for Good Practice in the Conduct of Clinical Trials with Human Participants in South Africa (2006) and Ethics in ...
Antonijevic, Smiljana; Cahoy, Ellysa Stern
This paper presents findings of a Mellon Foundation-funded study conducted at Penn State University in University Park during Fall 2012 that explored scholars' information practices across disciplines encompassing the sciences, humanities, and social sciences. Drawing on results of the Web-based survey and ethnographic interviews, we present…
Verhoeven, AAH; Jong, BMD
Background. As a result of changes in information technology and the rapid growth of publications methods of searching the literature have changed. Systematic searching of the growing literature has become very important. It is not known whether researchers in general practice search systematically,
Yanchar, Stephen C.; Hawkley, Melissa N.
This qualitative study explored the nature of informal learning in professional instructional designers' everyday work activities. Based on intensive interviews with six full-time practitioners, and using a hermeneutic form of data analysis, this study produced seven themes concerning the practices, tensions, and ironies associated with this…
Objective. To examine doctors' practices with regard to informed consent. Design. Cross-sectional, descriptive survey. Participants 'and setting. All full-time consultants and registrars in the Departments of Medicine, Obstetrics and Gynaecology, Paediatrics and Child Health, Paediatric Surgery and Surgery at the University ...
... and motivations for interdisciplinary academic offerings, trends towards interdisciplinary LIS curricula, and challenges of interdisciplinary academic programmes. My ultimate purpose is to inform policy, theory and practice in the design and implementation of LIS interdisciplinary academic programmes in Africa. Innovation ...
Miles, Steven, Pohl, Axel; Stauber, Barbara; Walther, Andreas; Banha, Rui Manuel Bargiela; Gomes, Maria Do Carmo
The roles of cultural practice and informal learning in young people's transitions to work and adulthood were explored in case studies of performing arts programs in Mannheim, Germany; Liverpool, England; and Lisbon, Portugal. Expert interviews, participant observation, and documentary analysis were conducted to explore how the pedagogical model…
Dingman, Deirdre A; Schulz, Mark R; Wyrick, David L; Bibeau, Daniel L; Gupta, Sat N
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.
.... 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...
花岡, 智恵; Hanaoka, Chie
In this paper, we investigate whether expected bequests from elderly parents affects the probability of children providing informal care, using Japanese micro data. We found that elderly parents with home equity were more likely to receive informal care from their children compared to those without. The results imply that the assets of the elderly may affect the probability of receiving informal care from their children.
Havik, Else M.; Kooijman, Aart C.; Steyvers, Frank J. J. M.
The effectiveness of different types of verbal information provided by electronic travel aids was studied in a real-life setting. Assessments included wayfinding performance and the preferences of 24 visually impaired users. The participants preferred a combination of route information and
limited by the availability, quality, scope, and methodological inconsistencies of the included studies. CONCLUSIONS: A systematic assessment of the extent of substandard case management practices of malaria in pregnancy is required, as well as quality improvement interventions that reach all providers administering antimalarial drugs in the community. Pregnant women need access to information on which anti-malarial drugs are safe to use at different stages of pregnancy. Please see later in the article for the Editors' Summary.
Bell, C A; Duncan, G; Saini, B
The past decade has seen a significant increase in private sector provision of tuberculosis (TB)care. While patients often seek and select treatment from private providers at significant out-of-pocket expense,treatment outcomes remain largely unknown. To investigate the knowledge, attitudes and practices of private sector TB care providers in high burden countries. Medline, PubMed, Embase, International Pharmaceutical Abstracts and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched using Medical Subject Headings terms,Emtree terms and key words. Searches were limited to the English language and published between 1998 and week 2 of November 2009. Studies were included if they reported the knowledge, attitudes or practice behaviours of private health care providers working in one of 22 high-TB-burden countries. Each included study was critically assessed using a structured data extraction tool. Data extracted included the study setting, objective, design, sample, response rate, outcomes and limitations. The 34 studies that met review inclusion criteriaen compassed diverse study methods and designs.All categories of TB care providers lacked comprehensive knowledge of national treatment guidelines. Procedures for referral, treatment monitoring, record keeping and case holding were not systematically implemented.However, there was a high degree of willingness to collaborate with national TB programmes. Research using standardised data collection methods may assist in identifying gaps in knowledge and practice among all providers of TB care. Further studies in developing and evaluating needs-based interventions should be undertaken; systematic reviews of such studies may then assist in strategic decision making in public-private mix DOTS expansion.
Demetriades, Andreas K; Alg, Varinder Singh; Hardwidge, Carl
Trigeminal neuralgia has a variety of treatments with variable efficacy. Sufferers present to a spectrum of disciplines. While traditional delivery of medical information has been by oral/printed communication, up to 50-80% patients access the internet for information. Confusion, therefore, may arise when seeking treatment for trigeminal neuralgia. We evaluated the quality of information on the internet for trigeminal neuralgia using the DISCERN© instrument. Only 54% websites had clear objectives; 42% delivered on these. A total of 71% provided relevant information on trigeminal neuralgia, 54% being biased/unbalanced; 71% not providing clear sources of information. No website detailed the side-effect profile of treatments; 79% did not inform patients of the consequences/natural history if no treatment was undertaken; it was unclear if patients could anticipate symptoms settling or when treatment would be indicated. Internet information on trigeminal neuralgia is of variable quality; 83% of sites assessed were of low-to-moderate quality, 29% having 'serious shortcomings.' Only two sites scored highly, only one being in the top 10 search results. Websites on trigeminal neuralgia need to appreciate areas highlighted in the DISCERN© instrument, in order to provide balanced, reliable, evidence-based information. To advise patients who may be misguided from such sources, neurosurgeons should be aware of the quality of information on the internet.
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.
Full Text Available Abstract Background Information exchange networks for chronic illness care may influence the uptake of innovations in patient care. Valid and feasible methods are needed to document and analyse information exchange networks in healthcare settings. This observational study aimed to examine the usefulness of methods to study information exchange networks in primary care practices, related to chronic heart failure, diabetes and chronic obstructive pulmonary disease. Methods The study was linked to a quality improvement project in the Netherlands. All health professionals in the practices were asked to complete a short questionnaire that documented their information exchange relations. Feasibility was determined in terms of response rates and reliability in terms of reciprocity of reports of receiving and providing information. For each practice, a number of network characteristics were derived for each of the chronic conditions. Results Ten of the 21 practices in the quality improvement project agreed to participate in this network study. The response rates were high in all but one of the participating practices. For the analysis, we used data from 67 health professionals from eight practices. The agreement between receiving and providing information was, on average, 65.6%. The values for density, centralization, hierarchy, and overlap of the information exchange networks showed substantial variation between the practices as well as between the chronic conditions. The most central individual in the information exchange network could be a nurse or a physician. Conclusions Further research is needed to refine the measure of information networks and to test the impact of network characteristics on the uptake of innovations.
Vamos, Cheryl A; Walsh, Margaret L; Thompson, Erika; Daley, Ellen M; Detman, Linda; DeBate, Rita
Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers' information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient's complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse.
Bos, Derek; Abara, Emmanuel; Parmar, Malvinder S.
Introducton: Kidney stone recurrence is common. Preventive measures can lead to improved quality of life and costs savings to the individual and healthcare system. Guidelines to prevent recurrent kidney stones are published by various urological societies. Adherence to guidelines amongst healthcare professionals in general is poor, while adherence to preventive management guidelines regarding stone disease is unknown. To understand this issue, we conducted an online study to assess the knowledge, attitudes, and practice patterns of healthcare practitioners in Northern Ontario. Methods: We used the database of healthcare providers affiliated with the Northern Ontario School of Medicine, in Sudbury (East Campus) and Thunder Bay (West Campus), Ontario. We designed the survey based on current best practice guidelines for the management of recurrent kidney stones. Questions covered 3 domains: knowledge, attitudes, and practice patterns. Demographic data were also collected. The survey was distributed electronically to all participants. Results: A total of 68 healthcare providers completed the survey. Of these, most were primary care physicians (72%). To keep uniformity, we analyzed the data of this homogenous group. A total of 70% of the respondents were aware of the current guidelines; however, only 43% applied their knowledge in clinical practice. Most participants lacked confidence while answering most items in the attitude domain. Conclusions: Most primary care physician respondents were aware of the appropriate preventive measures for recurrent kidney stones; however, they do not appear to apply this knowledge effectively in clinical practice. A low response rate is a limitation of our study. Further studies involving a larger sample size may lead to information sharing and collaborative care among healthcare providers. PMID:25485006
Bos, Derek; Abara, Emmanuel; Parmar, Malvinder S
Kidney stone recurrence is common. Preventive measures can lead to improved quality of life and costs savings to the individual and healthcare system. Guidelines to prevent recurrent kidney stones are published by various urological societies. Adherence to guidelines amongst healthcare professionals in general is poor, while adherence to preventive management guidelines regarding stone disease is unknown. To understand this issue, we conducted an online study to assess the knowledge, attitudes, and practice patterns of healthcare practitioners in Northern Ontario. We used the database of healthcare providers affiliated with the Northern Ontario School of Medicine, in Sudbury (East Campus) and Thunder Bay (West Campus), Ontario. We designed the survey based on current best practice guidelines for the management of recurrent kidney stones. Questions covered 3 domains: knowledge, attitudes, and practice patterns. Demographic data were also collected. The survey was distributed electronically to all participants. A total of 68 healthcare providers completed the survey. Of these, most were primary care physicians (72%). To keep uniformity, we analyzed the data of this homogenous group. A total of 70% of the respondents were aware of the current guidelines; however, only 43% applied their knowledge in clinical practice. Most participants lacked confidence while answering most items in the attitude domain. Most primary care physician respondents were aware of the appropriate preventive measures for recurrent kidney stones; however, they do not appear to apply this knowledge effectively in clinical practice. A low response rate is a limitation of our study. Further studies involving a larger sample size may lead to information sharing and collaborative care among healthcare providers.
Othman, Noordin; Vitry, Agnes I; Roughead, Elizabeth E; Ismail, Shaiful B; Omar, Khairani
Pharmaceutical representatives provide medicines information on their promoted products to doctors. However, studies have shown that the quality of this information is often low. No study has assessed the medicines information provided by pharmaceutical representatives to doctors in Malaysia and no recent evidence in Australia is present. We aimed to compare the provision of medicines information by pharmaceutical representatives to doctors in Australia and Malaysia. Following a pharmaceutical representative's visit, general practitioners in Australia and Malaysia who had agreed to participate, were asked to fill out a questionnaire on the main product and claims discussed during the encounter. The questionnaire focused on provision of product information including indications, adverse effects, precautions, contraindications and the provision of information on the Pharmaceutical Benefit Scheme (PBS) listings and restrictions (in Australia only). Descriptive statistics were produced. Chi-square analysis and clustered linear regression were used to assess differences in Australia and Malaysia. Significantly more approved product information sheets were provided in Malaysia (78%) than in Australia (53%) (P pharmaceutical representatives. Contraindications, precautions, drug interactions and adverse effects were often omitted in the presentations (range 25% - 41%). General practitioners in Australia and Malaysia indicated that in more than 90% of presentations, pharmaceutical representatives partly or fully answered their questions on contraindications, precautions, drug interactions and adverse effects. More general practitioners in Malaysia (85%) than in Australia (60%) reported that pharmaceutical representatives should have mentioned contraindications, precautions for use, drug interaction or adverse effects spontaneously (P presentations, general practitioners reported the pharmaceutical representatives failed to mention information on PBS listings to general
Ali, Mujtaba; Adams, Alexandra; Hossain, Md Anwar; Sutin, David; Han, Benjamin Hyun
There are an estimated 3.5 million Muslims in North America. During the holy month of Ramadan, healthy adult Muslims are to fast from predawn to after sunset. While there are exemptions for older and sick adults, many adults with diabetes fast during Ramadan. However, there are risks associated with fasting and specific management considerations for patients with diabetes. We evaluated provider practices and knowledge regarding the management of patients with diabetes who fast during Ramadan. A 15-question quality improvement survey based on a literature review and the American Diabetes Association guidelines was developed and offered to providers at the outpatient primary care and geriatric clinics at an inner-city hospital in New York City. Forty-five providers completed the survey. Most respondents did not ask their Muslim patients with diabetes if they were fasting during the previous Ramadan. Knowledge of fasting practices during Ramadan was variable, and most felt uncomfortable managing patients with diabetes during Ramadan. There is room for improvement in educating providers about specific cultural and medical issues regarding fasting for patients with diabetes during Ramadan. © The Author(s) 2015.
Full Text Available This article highlights the importance of indicators (as net working capital, working capital requirements and net cash by means of which it is considered in the context of financial balances capitalization information released by the balance sheet of an entity tourist profile. Theoretical concepts presented in a logical sequence are combined with the practical example transposed Turism Covasna company. The results of the analysis are interpreted while trying to formulate solutions to the economic and financial viability of the entity.
Full Text Available In this article, we explore the policies and processes of selection and recruitment from the perspective of equality. Focusing on tacit ideas of the ‘ideal worker,’ ideal recruitment, and selection that direct the recruitment process, we examine the ways in which implicit ideas and recruitmentrelated settings of daily interaction become informal practices of inequality. In this analysis, we rely on the conceptual framework of inequality regimes. The qualitative analysis of the semi-structured interviews focuses on the categories of gender, ethnicity, and age. We identified three categories of informal practices of inequality, which we have named as recruitment by the book, relocation of responsibility, and recruiting by addressing the difference. The findings suggest that although recruiters follow the legislation concerning equal treatment in recruitment, they do so because they want to avoid problems and possible litigation rather than because they are committed to promoting equality as an end in itself. However, equality promotion requires that gender, ethnicity, and age equality is itself the goal. If equality serves other goals, such as avoiding litigation or boosting business, the everyday practices of recruitment may turn into informal practices of inequality.
Sushko, O. P.; Kaznin, A. A.; Babkin, A. V.; Bogdanov, D. A.
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.
Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian
Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789
As part of the Syngress Basics series, The Basics of Information Security provides you with fundamental knowledge of information security in both theoretical and practical aspects. Author Jason Andress gives you the basic knowledge needed to understand the key concepts of confidentiality, integrity, and availability, and then dives into practical applications of these ideas in the areas of operational, physical, network, application, and operating system security. The Basics of Information Security gives you clear-non-technical explanations of how infosec works and how to apply these princi
Lee Xia Sheng
Full Text Available Quality, time and cost are the three most important elements in any construction project. Building information that comes timely and accurately in multiple dimensions will facilitate a refined decision making process which can improve the construction quality, time and cost. 5 dimensional Building Information Modelling or 5D BIM is an emerging trend in the construction industry that integrates all the major information starting from the initial design to the final construction stage. After that, the integrated information is arranged and communicated through Virtual Design and Construction (VDC. This research is to gauge the practicability of 5D BIM with an action research type pilot study by the means of hands-on modelling of a conceptual bungalow design based on one of the most popular BIM tools. A bungalow is selected as a study subject to simulate the major stages of 5D BIM digital workflow. The whole process starts with developing drawings (2D into digital model (3D, and is followed by the incorporation of time (4D and cost (5D. Observations are focused on the major factors that will affect the practicability of 5D BIM, including the modelling effort, inter-operability, information output and limitations. This research concludes that 5D BIM certainly has high level practicability which further differentiates BIM from Computer Aided Design (CAD. The integration of information not only enhanced the efficiency and accuracy of process in all stages, but also enabled decision makers to have a sophisticated interpretation of information which is almost impossible with the conventional 2D CAD workflow. Although it is possible to incorporate more than 5 dimensions of information, it is foreseeable that excessive information may escalate the complexity unfavourably for BIM implementation. 5D BIM has achieved a significant level of practicability; further research should be conducted to streamline implementation. Once 5D BIM is matured and widely
van Oppen P
Full Text Available Abstract Background There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST is a brief psychological treatment tailored for use in a primary care setting. PST is provided by nurses, and earlier research has shown that it is a treatment at least as effective as usual care. However, research outcomes are not totally satisfying. This protocol describes a randomized clinical trial on the effectiveness of PST provided by nurses for patients in general practice. The results of this study, which currently being carried out, will be presented as soon as they are available. Methods/design This study protocol describes the design of a randomized controlled trial to investigate the effectiveness and cost-effectiveness of PST and usual care compared to usual care only. Patients, 18 years and older, who present psychological problems and are frequent attenders in general practice are recruited by the research assistant. The participants receive questionnaires at baseline, after the intervention, and again after 3 months and 9 months. Primary outcome is the reduction of symptoms, and other outcomes measured are improvement in problem solving skills, psychological and physical well being, daily functioning, social support, coping styles, problem evaluation and health care utilization. Discussion Our results may either confirm that PST in primary care is an effective way of dealing with emotional disorders and a promising addition to the primary care in the UK and USA, or may question this assumption. This trial will allow an evaluation of the effects of PST in practical circumstances and in a rather heterogeneous group of primary care patients. This study delivers scientific support for this use and therefore indications for optimal treatment and referral.
... 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...
.../or per diem for programs to assist homeless veterans' transition to independent living and to... AFFAIRS Proposed Information Collection (Homeless Providers Grant and Per Diem Program) Activity; Comment.... Titles a. Homeless Providers Grant and Per Diem Program, Capital Grant. Application, VA Form 10-0361-CG...
Cohen, Fred; Rogers, Deanna T.; Neagoe, Vicentiu
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.
Harper, Cynthia C; Henderson, Jillian T; Schalet, Amy; Becker, Davida; Stratton, Laura; Raine, Tina R
Abstinence-only education has had little demonstrable impact on teenagers' sexual behaviors, despite significant policy and funding efforts. Given the struggle over resources to improve teenagers' reproductive health outcomes, the views of clinicians serving teenagers at high risk for unintended pregnancy and STDs merit particular attention. In 2005, a qualitative study with 31 clinicians serving low-income, at-risk patients was conducted. A semistructured interview guide was used to ask clinicians about adolescent pregnancy, HIV and STD prevention counseling, and when they include abstinence. Thematic content analysis was used to examine the content of the counseling and the techniques used in different situations. Providers reported offering comprehensive counseling, presenting abstinence as a choice for teenagers, along with information about contraceptives and condoms. Several providers mentioned that with young, sexually inexperienced teenagers, they discuss delaying sexual activity and suggest other ways to be affectionate, while giving information on condoms. Providers explained how they assess whether teenagers feel ready to be sexually active and try to impart skills for healthy relationships. Some described abstinence as giving teenagers a way to opt out of unwanted sexual activity. Many support abstinence if that is the patient's desire, but routinely dispense condoms and contraceptives. Overall, providers did not give abstinence counseling as a rigid categorical concept in their preventive practices, but as a health tool to give agency to teenagers within a harm reduction framework. Their approach may be informative for adolescent policies and programs in the future.
Skillman, Susan M; Andrilla, C Holly A; Patterson, Davis G; Fenton, Susan H; Ostergard, Stefanie J
This study assessed electronic health record (EHR) and health information technology (HIT) workforce resources needed by rural primary care practices, and their workforce-related barriers to implementing and using EHRs and HIT. Rural primary care practices (1,772) in 13 states (34.2% response) were surveyed in 2012 using mailed and Web-based questionnaires. EHRs or HIT were used by 70% of respondents. Among practices using or intending to use the technology, most did not plan to hire new employees to obtain EHR/HIT skills and even fewer planned to hire consultants or vendors to fill gaps. Many practices had staff with some basic/entry, intermediate and/or advanced-level skills, but nearly two-thirds (61.4%) needed more staff training. Affordable access to vendors/consultants who understand their needs and availability of community college and baccalaureate-level training were the workforce-related barriers cited by the highest percentages of respondents. Accessing the Web/Internet challenged nearly a quarter of practices in isolated rural areas, and nearly a fifth in small rural areas. Finding relevant vendors/consultants and qualified staff were greater barriers in small and isolated rural areas than in large rural areas. Rural primary care practices mainly will rely on existing staff for continued implementation and use of EHR/HIT systems. Infrastructure and workforce-related barriers remain and must be overcome before practices can fully manage patient populations and exchange patient information among care system partners. Efforts to monitor adoption of these skills and ongoing support for continuing education will likely benefit rural populations. © 2014 National Rural Health Association.
During disasters, clinicians may be forced to play dual roles, as both a provider and an allocator of scarce resources. At present, a clear framework to govern resource stewardship at the bedside is lacking. Clinicians who find themselves practicing in this ethical gap between clinical and public health ethics can experience significant moral distress. One provider describes her experience allocating an oxygen tank in the intensive care unit at a hospital in Port-au-Prince, Haiti, immediately following the 2010 earthquake. Using a clinical vignette and reflective narrative she attempts to identify the factors that influenced her allocation decision, opening up the factors for commentary and debate by an ethicist. A better paradigm for the ethical care of patients during disasters is needed to better guide provider choices in the future.
Ingravallo, F; Kim, K H; Han, Y H; Volta, A; Chiari, P; Taddia, P; Kim, J S
To investigate nurses' opinions and practices of providing information in a global context through cultural comparison. Providing sufficient information to patients about nursing interventions and plans is essential for patient-centred care. While many countries have specific legislation making information delivery to patients a legal duty of nurses, no such legislation exists in both the Republic of Korea and Italy; nurses' only guidance is the deontological code. This was a cross-sectional survey study involving a convenience sample of 174 Korean nurses and 121 Italian nurses working in internal medicine and surgery at university hospitals. Data were collected using a self-administered questionnaire between February and November 2014. The questionnaire assessed demographic and professional characteristics, and difficulties and practices regarding information provision. Korean and Italian nurses significantly differed in all demographic and professional characteristics. More Korean than Italian participants reported that their role in providing information was well explained within their teams, but both groups reported the same level and type of difficulties in delivering information. Nurses in both countries regularly informed patients about medications and nursing procedures, but provided information about nursing care plans less frequently. Few nurses frequently provided information to relatives instead of patients. Despite cultural, demographic and professional differences between Korean and Italian nurses, their difficulties and practices in information delivery to patient were similar. Hospital managers and policymakers should be aware that nurse-patient communication can be impaired by organizational factors, patient characteristics or the interaction among providers. Educational interventions and strategies are needed to increase information provision to patients about nursing care plans. © 2017 International Council of Nurses.
The advent of various information retrieval (IR) technologies and approaches to storage and retrieval provide communities with opportunities for mass documentation, digitization, and the recording of information in different forms. This book introduces and contextualizes these developments and looks at supporting research in IR.
Brennan, David S; Spencer, A John
Provider-patient relations may influence the nature of care provided. The aim of this study was to examine dentist preferences for patients, relate these to characteristics of dentists and practices, and to services provided. A random sample of Australian dentists completed mailed questionnaires (response = 60.3%). Four factor-based subscales and an overall scale (Selectivity) were derived from a 37-item battery. The 4 subscales comprised treatment adherence (behavior relevant to the treatment situation), personal adaptability (willingness to cooperate when expected to do so), social interactiveness (positive affect, communicativeness, and appreciativeness), and enabling characteristics (willing and able to pay, and good dental knowledge). Reliability was adequate (Cronbach's alpha = 0.71-0.90). Treatment adherence was associated with higher orthodontic rates, but a lower extraction rate; social interactiveness was associated with higher extraction and denture rates; personal adaptability was associated with higher orthodontic rates, but lower general/miscellaneous service rates; enabling characteristics was associated with higher endodontic and crown and bridge rates; selectivity was associated with higher rates of diagnostic, preventive, and total services per visit. The associations with service rates indicated that provider preferences were related to treatment behavior that could affect the mix of services, indicating that the nature of care provided may be influenced by the provider-patient relation.
Ellis, Michael J; Ritchie, Lesley; Selci, Erin; Chu, Stephanie; McDonald, Patrick; Russell, Kelly
Concussion is an emerging public health concern, but care of patients with a concussion is presently unregulated in Canada. Independent, blinded Google Internet searches were conducted for the terms "concussion" and "concussion clinic" and each of the Canadian provinces and territories. The first 10 to 15 concussion healthcare providers per province were identified. A critical appraisal of healthcare personnel and services offered on the provider's Web site was conducted. Fifty-eight concussion healthcare providers were identified using this search methodology. Only 40% listed the presence of an on-site medical doctor (M.D.) as a member of the clinical team. Forty-seven percent of concussion healthcare providers advertised access to a concussion clinic, program, or center on their Web site. Professionals designated as team leaders, directors, or presidents among concussion clinics, programs, and centers included a neuropsychologist (15%), sports medicine physician (7%), neurologist (4%), and neurosurgeon (4%). Services offered by providers included baseline testing (67%), physiotherapy (50%), and hyperbaric oxygen therapy (2%). This study indicates that there are numerous concussion healthcare providers in Canada offering diverse services with clinics operated by professionals with varying levels of training in traumatic brain injury. In some cases, the practices of these concussion clinics do not conform to current expert consensus guidelines.
Kumar, Manish; Mostafa, Javed; Ramaswamy, Rohit
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.
Cheng, Chun-Ting; Lin, Chiu-Chu
Obtaining informed consent and ensuring patient autonomy are critical to implementing a patient-centered model of healthcare. Informed consent is a complex process of communication that includes three elements: disclosure, competence in making decisions, and voluntariness. However, individual patient factors, doctor-patient interaction, and cultural issues are known to influence the process of obtaining informed consent. Individual patient factors include the ability of patients to understand and determine their intent; doctor-patient interaction includes communication skills; and cultural issues include the expectations of patients with regard to family involvement in medical decision-making and in decision-making motives. After assessing the relevant influencing factors, healthcare providers typically provide patients with comprehensive information on the benefits and risks of treatment as well as related alternatives. Moreover, healthcare providers typically provide patients with audio/video, Internet, and written information with illustrations based on individual patient needs. In addition to the above, we suggest that healthcare providers proactively adopt the perspective of patients in order to better encourage patients to address questions, to engage with patients in more productive discussions, and to take the initiative to explain and clarify patients' questions in order to minimize anxiety. This approach will help ensure that patients are adequately informed and free from coercion so that they make appropriate healthcare-related decisions. However, even under this optimal situation, healthcare providers must emphasize the needs of their patients and respect their decisions.
Liles, Iyanna; Haddad, Lisa B; Lathrop, Eva; Hankin, Abigail
Almost half of all pregnancies in the United States are unintended; these pregnancies are associated with adverse outcomes. Many reproductive-age females seek care in the emergency department (ED), are at risk of pregnancy, and are amenable to contraceptive services in this setting. Through a pilot study, we sought to assess ED providers' current practices; attitudes; and knowledge of emergency contraception (EC) and nonemergency contraception (non-EC), as well as barriers with respect to contraception initiation. ED physicians and associate providers in Georgia were e-mailed a link to an anonymous Internet questionnaire using state professional databases and contacts. The questionnaire included Likert scales with multiple-choice questions to assess study objectives. Descriptive statistics were generated as well as univariate analyses using χ(2) and Fisher exact tests. A total of 1232 providers were e-mailed, with 119 questionnaires completed. Participants were predominantly physicians (80%), men (59%), and individuals younger than 45 years (59%). Common practices were referrals (96%), EC prescriptions (77%), and non-EC prescriptions (40%). Common barriers were perceived as low likelihood for follow-up (63%), risk of complications (58%), and adverse effects (51%). More than 70% of participants correctly identified the highly effective contraceptive methods, 3% identified the correct maximum EC initiation time, and 42% correctly recognized pregnancy as a higher risk than hormonal contraception use for pulmonary embolism. Most ED providers in this pilot study referred patients for contraception; however, there was no universal contraceptive counseling and management. Many ED providers in this study had an incorrect understanding of the efficacy, risks, and eligibility associated with contraceptive methods. This lack of understanding may affect patient access and be a barrier to patient care.
Plath, Jasper; Siebenhofer, Andrea; Schulz-Rothe, Sylvia; Güthlin, Corina
Background Colonoscopy is recommended for persons with a familial risk of colorectal cancer (CRC) before they reach 55 years of age. The aim of this analysis was to ask affected persons aged 40-54 years whether they had found out about early detection of CRC and from which institutions and media they would like to obtain such information. Methods Analysis of data from a cross-sectional study: In a general practice setting, those with a positive family history of CRC were asked to provide written information. Results In total, 191 persons with a positive family history of CRC participated in the study: 59.6% had already found out about early detection of CRC. Out of this, 67.0% had received information from their physicians. Most of the participants wanted information on early detection of CRC to be provided by the general practitioner (98.9% completely or mostly agree), and by health insurers (74.5% completely or mostly agree). The participants would rather not prefer to receive information from public institutions such as the public health department (69.5% not or mostly not agree) and private organizations such as self-help groups (80.9% not or mostly not agree). Approximately half would prefer to receive such information via TV. More men than women would prefer to source such information from the internet (completely or mostly agree: 66.7 vs. 43.8%), or newspapers and magazines (completely or mostly agree: 53.6 vs. 41.8%). Conclusion A survey in a general practice setting found that more than half of persons with familial risk of CRC had already obtained information on early detection. The setting of the survey on preferred information sources possibly encouraged participants to put general practitioners in the first place. Furthermore, the results of this nationwide unique cohort of persons aged 40-54 with a familial risk of CRC show that their information-seeking behavior was not more pronounced than average and that men and women can be provided with
Piscotty, Ronald J; Kalisch, Beatrice; Gracey-Thomas, Angel
To report additional mediation findings from a descriptive cross sectional study to examine if nurses' perceptions of the impact of healthcare information technology on their practice mediates the relationship between electronic nursing care reminder use and missed nursing care. The study used a descriptive design. The sample (N = 165) was composed of registered nurses working on acute care hospital units. The sample was obtained from a large teaching hospital in Southeast Michigan in the fall of 2012. All eligible nursing units (n = 19) were included. The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Healthcare Information Technology Scale were used to collect data to test for mediation. Mediation was tested using the method described by Baron and Kenny. Multiple regression equations were used to analyze the data to determine if mediation occurred between the variables. Missed nursing care, the outcome variable, was regressed on the predictor variable, reminder usage, and the mediator variable impact of technology on nursing practice. The impact of healthcare information technology (IHIT) on nursing practice negatively affected missed nursing care (t = -4.12, p impact of healthcare information technology mediates the relationship between nursing care reminder use and missed nursing care. The findings are beneficial to the advancement of healthcare technology in that designers of healthcare information technology systems need to keep in mind that perceptions regarding impacts of the technology will influence usage. Many times, information technology systems are not designed to match the workflow of nurses. Systems built with redundant or impertinent reminders may be ignored. System designers must study which reminders nurses find most useful and which reminders result in the best quality outcomes. © 2015 Sigma Theta Tau International.
Liu, Jian-Ming; Xu, Ru-Xiang; Hu, Yong-Sheng; Ren, Lian-Kun; Qiao, Hui; Ding, Hu; Liu, Zhi-Liang
Most patients with epilepsy want to learn as much as possible about the disease, and many have turned to the internet for information. Patients are likely to use information obtained from the internet to control their epilepsy, but little is known about the accuracy of this information. In this survey, we have assessed the feasibility and usability of internet-based interventions for the treatment of epilepsy. Data were collected from an internet search. Different search terms were used to obtain general information on epilepsy together with information about medication, types of epilepsy, treatment, women's health, and other information. The accuracy of the information was evaluated by a group of experts. A total of 1320 web pages were assessed. The majority were websites related to health. A large number (80.2%) of web pages contained content related to the search term. A significant number of web pages 450/1058 (42.5%) claimed to provide information from a credible source; however, only 206/1058 (19.5%) of the information was accurate and complete; 326/1058 (30.8%) was accurate but incomplete; 328/1058 (31.0%) was correct but nonstandard, and 198/1058 (18.8%) was inaccurate. The authenticity of the information was not significantly different between the two search engines (χ2 = 0.009, P = 0.924). No significant difference was observed in the information obtained from a specialist or nonspecialist source (χ2 = 7.538, P = 0.057). There was also no correlation between the quality of the information and the priority (χ2 = 6.880, P = 0.076). Searching for information about epilepsy on the internet is convenient, but the information provided is not reliable. Too much information is inaccurate or for advertisement purposes, and it is difficult for patients to find the useful information. Turning to the internet for medical knowledge may be harmful. Physicians should be aware that their patients may search for information on the internet and guide them to safe
Full Text Available Background: Most patients with epilepsy want to learn as much as possible about the disease, and many have turned to the internet for information. Patients are likely to use information obtained from the internet to control their epilepsy, but little is known about the accuracy of this information. In this survey, we have assessed the feasibility and usability of internet-based interventions for the treatment of epilepsy. Methods: Data were collected from an internet search. Different search terms were used to obtain general information on epilepsy together with information about medication, types of epilepsy, treatment, women′s health, and other information. The accuracy of the information was evaluated by a group of experts. Results: A total of 1320 web pages were assessed. The majority were websites related to health. A large number (80.2% of web pages contained content related to the search term. A significant number of web pages 450/1058 (42.5% claimed to provide information from a credible source; however, only 206/1058 (19.5% of the information was accurate and complete; 326/1058 (30.8% was accurate but incomplete; 328/1058 (31.0% was correct but nonstandard, and 198/1058 (18.8% was inaccurate. The authenticity of the information was not significantly different between the two search engines (χ2 = 0.009, P = 0.924. No significant difference was observed in the information obtained from a specialist or nonspecialist source (χ2 = 7.538, P = 0.057. There was also no correlation between the quality of the information and the priority (χ2 = 6.880, P = 0.076. Conclusions: Searching for information about epilepsy on the internet is convenient, but the information provided is not reliable. Too much information is inaccurate or for advertisement purposes, and it is difficult for patients to find the useful information. Turning to the internet for medical knowledge may be harmful. Physicians should be aware that their patients may search for
Hweissa, N Ab; Lim, J N W; Su, T T
In Libya, cervical cancer is ranked third as the most frequent cancer among women with early diagnosis being shown to reduce morbidity and mortality. Health-care providers can influence women's screening behaviours, and their lack of recommendations for screening can be one of the barriers that affect women's participation in screening programmes. This study aims to assess the health-care provider's perception around cervical cancer screening. In-depth, face-to-face interviews were conducted with 16 health-care providers, from both public and private sectors in Az-Zawiya city, Libya, between February and July of 2014. The interviews were recorded and transcribed, then analysed using thematic analysis. Our findings suggest that health-care providers did not provide sufficient information regarding cervical cancer screening for women who attend health-care facilities. The results highlight the role played by health-care professionals in motivating women to attend cervical cancer screening programs, and the need for health education of health-care providers to offer a precious advice regarding the screening. On the other hand, health-care providers highlighted that implementation of reminding system of cervical cancer screening will support them to improve screening attendance. In addition, health-care providers stressed the necessity for educational and awareness campaigns of cervical cancer screening among Libyan women. © 2016 John Wiley & Sons Ltd.
Lupiáñez-Villanueva, Francisco; Hardey, Michael; Torrent, Joan; Ficapal, Pilar
To identify doctors' utilization of ICT; to develop and characterise a typology of doctors' utilization of ICT and to identify factors that can enhance or inhibit the use of these technologies within medical practice. An online survey of the 16,531 members of the Physicians Association of Barcelona who had a registered email account in 2006 was carried out. Factor analysis, cluster analysis and binomial logit model were undertaken. Multivariate statistics analysis of the 2199 responses obtained revealed two profiles of adoption of ICT. The first profile (38.61% of respondents) represents those doctors who place high emphasis on ICT within their practice. This group is thus referred to as 'integrated doctors'. The second profile (61.39% of respondents) represents those doctors who make less use of ICT so are consequently labelled 'non-integrated doctors'. From the statistical modelling, it was observed that an emphasis on international information; emphasis on ICT for research and medical practice; emphasis on information systems to consult and prescribe; undertaking teaching/research activities; a belief that the use of the Internet improved communication with patients and practice in both public and private health organizations play a positive and significant role in the probability of being an 'integrated doctor'. The integration of ICT within medical practice cannot be adequately understood and appreciated without examining how doctors are making use of ICT within their own practice, organizational contexts and the opportunities and constraints afforded by institutional, professional and patient expectations and demands. 2010 Elsevier Ireland Ltd. All rights reserved.
Mavronicolas, Heather A; Laraque, Fabienne; Shankar, Arti; Campbell, Claudia
Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.
Buys, Laurie; Aird, Rosemary; van Megen, Kimberley; Miller, Evonne; Sommerfeld, Jeffrey
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.
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
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.
Surmaitis, Ryan M; Amaducci, Alexandra; Henry, Kathryn; Jong, Michael; Kiernan, Emily A; Kincaid, Hope; Houck, Lindsay J; Sabbatini, Sandra J; Greenberg, Marna Rayl; Katz, Kenneth D
This study aimed to determine the current attitudes, perceptions, and practices of emergency medicine providers and nurses (RNs) regarding the discharge of adult patients from the emergency department (ED) after administration of opioid analgesics. A cross-sectional survey was administered at 3 hospital sites with a combined annual ED census of >180,000 visits per year. All 59 attending emergency physicians (EPs), 233 RNs, and 23 advanced practice clinicians (APCs) who worked at these sites were eligible to participate. Thirty-five EPs (59.3%), 88 RNs (37.8%), and 14 APCs (60.9%) completed the survey for an overall response rate of 51.75%. Most respondents were female (95 [69.9%]). The factor ranked most important to consider when discharging a patient from the ED after administration of opioids was the patient's functional status and vital signs (median, 2.00; interquartile range, 2.00-3.50). More RNs (84 [96.6%]) than EPs (29 [82.9%]) reported that developing an ED policy or guideline for safe discharge after administration of opioids is important to clinical practice (P = 0.02). Only 8 physicians (23.5%) reported that they did not prescribe intramuscular morphine, and 15 (42.9%) reported that they did not prescribe intramuscular hydromorphone. EPs (7 [20.0%]) and RNs (3 [3.4%]) differed in regard to whether they were aware if any patients to whom they administered an opioid had experienced an adverse drug-related event (P = 0.01). Most EPs (24 [68.6%]) and RNs (54 [61.4%]) believed that the decision for patient discharge should be left to both the emergency medicine provider and the RN. Most study participants believed that developing a policy or guideline for safe discharge after administration opioids in the ED is important to clinical practice. Only a few physicians reported that they did not prescribe intramuscular hydromorphone or morphine. Most participants believed the discharge decision after administration of opioids in the ED should be primarily
Full Text Available Information technology has had a tremendous impact on the outlook of our professional lives. The Internet has revolutionised the speed of access to information with touch of a button. This article discusses the various aspects of information technology which are changing and enhancing our professional lives. It provides tips to enable the busy practising clinician to use the available resources effectively. Problems such as reliability of information on the web and how to assess the quality of such matter are also discussed.
Pylypiv, Nadiia; Motyl, Vasyl
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 fo...
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.
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 information sources (experts and friends/relatives) have influence on patients perception of information expensiveness. The use of experts source tends to increase the probability of 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.
Full Text Available Abstract Background Many physicians are transitioning from paper to electronic formats for billing, scheduling, medical charts, communications, etc. The primary objective of this research was to identify the relationship (if any between the software selection process and the office staff's perceptions of the software's impact on practice activities. Methods A telephone survey was conducted with office representatives of 407 physician practices in Oregon who had purchased information technology. The respondents, usually office managers, answered scripted questions about their selection process and their perceptions of the software after implementation. Results Multiple logistic regression revealed that software type, selection steps, and certain factors influencing the purchase were related to whether the respondents felt the software improved the scheduling and financial analysis practice activities. Specifically, practices that selected electronic medical record or practice management software, that made software comparisons, or that considered prior user testimony as important were more likely to have perceived improvements in the scheduling process than were other practices. Practices that considered value important, that did not consider compatibility important, that selected managed care software, that spent less than $10,000, or that provided learning time (most dramatic increase in odds ratio, 8.2 during implementation were more likely to perceive that the software had improved the financial analysis process than were other practices. Conclusion Perhaps one of the most important predictors of improvement was providing learning time during implementation, particularly when the software involves several practice activities. Despite this importance, less than half of the practices reported performing this step.
Christine M Hughes
Full Text Available INTRODUCTION: Molluscum contagiosum is a common superficial skin infection caused by the poxvirus, Molluscum Contagiosum virus. The study objective is to obtain a better understanding of physician practices and experiences with molluscum contagiosum in order to focus informational and guidance material. METHODS: A cross-sectional survey to assess medical practitioners' knowledge and practices with molluscum contagiosum was conducted using the 2009 DocStyles survey. Questions regarding category and number of molluscum contagiosum patients seen, treatments used and advice given to patients were included in the survey. RESULTS: Dermatologists saw the most cases, with the majority seeing 51-100 molluscum contagiosum cases/year. The most common cases seen were children with multiple lesions and adults with genital lesions. Respondents were most likely to recommend treatment to immunocompromised individuals, HIV patients, adults with genital lesions and children with multiple lesions. Cryotherapy was the top choice for all specialties with the exception of OB/GYNs, whose top choice was curettage. "Avoid intimate contact until lesions resolve", "Avoid touching lesions to reduce further spread", and "Don't be concerned, this will go away" were the top advice choices. DISCUSSION: Most survey respondents have dealt with molluscum contagiosum in their practice during the previous year. Overall, respondents picked appropriate choices for treatment and advice given; however some ineffective or unnecessary treatments were chosen and recommendations to prevent spread were chosen infrequently. Knowledge gaps for appropriate transmission precaution advice might cause unnecessary spread or autoinoculation. This survey has demonstrated that molluscum contagiosum is a common infection seen by many types of practitioners and therefore guidance on treatment considerations and infection control is valuable.
Kaufmann, J O; Smit, J W; Huisman, W; Idema, R N; Bakker, E; Giordano, P C
After a first survey in 2001, the Dutch Association of Hematological Laboratory Research (VHL) advised its members to adopt a basic protocol for haemoglobinopathy carrier detection and to provide genetic information with all positive results to allow health-care professionals to inform carriers about potential genetic risks. This article reports on the compliance with these recommendations and their consequences. Clinical chemists of all 106 Dutch laboratories were invited to answer a survey on patient population, diagnostic techniques used, (self-reported) knowledge, use and effect of the additional information. The average increase in diagnostic output was over 60% and the recommended basic protocol was applied by 65% of the laboratories. Over 84% of the laboratories reported to be aware of the additional recommendations and 77% to be using them. Most laboratories with limited diagnostic requests were still sending their cases to other laboratories and included the genetic information received from these laboratories in their diagnostic reports. The effect of information on subsequent 'family analysis' was estimated to be between 26 and 50%. The present study shows an increase in diagnostic potential for haemoglobinopathy over the last decade, especially in the larger cities. Low 'family testing' rates were mostly found in areas with lower carrier prevalence or associated with local reluctance to pass the information to carriers. In spite of a dramatic improvement, too many carriers are still not informed because of lack of awareness among health-care providers and more education is needed. © 2012 John Wiley & Sons Ltd.
Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy
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
LaGrone, L N; Isquith-Dicker, L N; Huaman Egoavil, E; Herrera-Matta, J J; Fuhs, A K; Ortega Checa, D; Revoredo, F; Rodriguez Castro, M J A; Mock, C N
Dual-practice, simultaneous employment by healthcare workers in the public and private sectors is pervasive worldwide. Although an estimated 30 per cent of the global burden of disease is surgical, the implications of dual practice on surgical care are not well understood. Anonymous in-depth individual interviews on trauma quality improvement practices were conducted with healthcare providers who participate in the care of the injured at ten large hospitals in Peru's capital city, Lima. A grounded theory approach to qualitative data analysis was employed to identify salient themes. Fifty interviews were conducted. A group of themes that emerged related to the perceived negative and positive impacts of dual practice on the quality of surgical care. Participants asserted that the majority of physicians in Lima working in the public sector also worked in the private sector. Dual practice has negative impacts on physicians' time, quality of care in the public sector, and surgical education. Dual practice positively affects patient care by allowing physicians to acquire management and quality improvement skills, and providing incentives for research and academic productivity. In addition, dual practice provides opportunities for clinical innovations and raises the economic status of the physician. Surgeons in Peru report that dual practice influences patient care negatively by creating time and human resource conflicts. Participants assert that these conflicts widen the gap in quality of care between rich and poor. This practice warrants redirection through national-level regulation of physician schedules and reorganization of public investment in health via physician remuneration. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.
Dolce, Maria C
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.
Geller, Berta M.; Skelly, Joan M.; Dorwaldt, Anne L.; Howe, Kathleen D.; Dana, Greg S.; Flynn, Brian S.
Background Rural populations as well as less educated people in the U.S. are less likely to receive colorectal cancer (CRC) screening than people living in urban areas and more educated people. Methods We tested a computer tablet, Patient/Provider Communication Assistant (PPCA), which collected data, educated patients, and printed personalized notes to patients and providers encouraging conversation about CRC screening. Mixed model analyses using a pre-post quasi-experimental design compared patient results during the comparison and intervention periods in 5 rural primary care practices on provider discussion about CRC screening, provider recommendation, and patient intention to be screened. Models including age, education and literacy measures as covariates were examined. Results Providers talked with patients about CRC screening in general, and colonoscopy specifically more frequently after the PPCA than with the comparison group (p values =.04 and .01, respectively). Providers recommended CRC screening more often to patients in the intervention group than to the comparison group (p=.02). Patients planned to be screened and specifically with colonoscopy more frequently following the intervention than in the comparison group (p=.003). There were no interactions between group and any of the covariates. Ninety-five percent of the patients regardless of age or education found the PPCA easy to use. Conclusion Results indicated increased provider discussion and recommendation, and patients' intentions to obtain CRC screening, and in particular colonoscopy, for patients exposed to the intervention, regardless of the patients' age or literacy levels. The PPCA is a promising intervention method that is acceptable to rural patients. PMID:18725831
Bhuyan, Soumitra S; Chandak, Aastha; Gupta, Niodita; Isharwal, Sudhir; LaGrange, Chad; Mahmood, Asos; Gentry, Dan
The American Urological Association, American Cancer Society, and American College of Physicians recommend that patients and providers make a shared decision with respect to prostate-specific antigen (PSA) testing for prostate cancer (PCa). The goal of this study is to determine the extent of patient-provider communication for PSA testing and treatment of PCa and to examine the patient specific factors associated with this communication. Using recent data from the Health Information National Trends Survey, this study examined the association of patient characteristics with four domains of patient-provider communication regarding PSA test and PCa treatment: (1) expert opinion of PSA test, (2) accuracy of PSA test, (3) side effects of PCa treatment, and (4) treatment need of PCa. The current results suggested low level of communication for PSA testing and treatment of PCa across four domains. Less than 10% of the respondents report having communication about all four domains. Patient characteristics like recent medical check-up, regular healthcare provider, global health status, age group, marital status, race, annual household income, and already having undergone a PSA test are associated with patient-provider communication. There are few discussions about PSA testing and PCa treatment options between healthcare providers and their patients, which limits the shared decision-making process for PCa screening and treatment as recommended by the current best practice guidelines. This study helps identify implications for changes in physician practice to adhere with the PSA screening guidelines. © The Author(s) 2015.
Cooper, Devon; Kim, JungSoo; Duderstadt, Karen; Stewart, Ray; Lin, Brent; Alkon, Abbey
Dental caries is the most prevalent chronic childhood disease in the United States. Dental caries affects the health of 60-90% of school-aged children worldwide. The prevalence of untreated early childhood dental caries is 19% for children 2-5 years of age in the U.S. Some factors that contribute to the progression of dental caries include socioeconomic status, access to dental care, and lack of anticipatory guidance. The prevalence of dental caries remains highest for children from specific ethnic or racial groups, especially those living in underserved areas where there may be limited access to a dentist. Although researchers have acknowledged the various links between oral health and overall systemic health, oral health care is not usually a component of pediatric primary health care. To address this public health crisis and oral health disparity in children, new collaborative efforts among health professionals is critical for dental disease prevention and optimal oral health. This evaluation study focused on a 10-week interprofessional practice and education (IPE) course on children's oral health involving dental, osteopathic medical, and nurse practitioner students at the University of California, San Francisco. This study's objective was to evaluate changes in knowledge, confidence, attitude, and clinical practice in children's oral health of the students completed the course. Thirty-one students participated in the IPE and completed demographic questionnaires and four questionnaires before and after the IPE course: (1) course content knowledge, (2) confidence, (3) attitudes, and (4) clinical practice. Results showed a statistically significant improvement in the overall knowledge of children's oral health topics, confidence in their ability to provide oral health services, and clinical practice. There was no statistically significant difference in attitude, but there was an upward trend toward positivity. To conclude, this IPE evaluation showed that
Full Text Available Dental caries is the most prevalent chronic childhood disease in the United States. Dental caries affects the health of 60–90% of school-aged children worldwide. The prevalence of untreated early childhood dental caries is 19% for children 2–5 years of age in the U.S. Some factors that contribute to the progression of dental caries include socioeconomic status, access to dental care, and lack of anticipatory guidance. The prevalence of dental caries remains highest for children from specific ethnic or racial groups, especially those living in underserved areas where there may be limited access to a dentist. Although researchers have acknowledged the various links between oral health and overall systemic health, oral health care is not usually a component of pediatric primary health care. To address this public health crisis and oral health disparity in children, new collaborative efforts among health professionals is critical for dental disease prevention and optimal oral health. This evaluation study focused on a 10-week interprofessional practice and education (IPE course on children’s oral health involving dental, osteopathic medical, and nurse practitioner students at the University of California, San Francisco. This study’s objective was to evaluate changes in knowledge, confidence, attitude, and clinical practice in children’s oral health of the students completed the course. Thirty-one students participated in the IPE and completed demographic questionnaires and four questionnaires before and after the IPE course: (1 course content knowledge, (2 confidence, (3 attitudes, and (4 clinical practice. Results showed a statistically significant improvement in the overall knowledge of children’s oral health topics, confidence in their ability to provide oral health services, and clinical practice. There was no statistically significant difference in attitude, but there was an upward trend toward positivity. To conclude, this IPE
Pace, Adriana; Buttigieg, Sandra C
Purpose The purpose of this paper is to analyse hospital dashboards' visibility of information at different management levels to improve quality and performance in an acute general hospital. Design/methodology/approach Data were generated via 21 semi-structured interviews across different management levels. Findings All management levels had greater visibility of information, could make informed decisions, and registered performance improvement. Specifically, waiting time improved, however since introduction of hospital dashboards was work-in-progress at time of study, managers could not record improvement in terms of cost reductions, clinical effectiveness, patient safety and patient satisfaction. Different managerial levels had different visibility with top management having the greatest. Research limitations/implications In single case studies, where only one context is used, the findings cannot be reproduced in different contexts; even though most of the results could be matched with the current literature. Practical implications The need to have balanced key performance indicators that take into account other facets of improvements, apart from time, has been emphasised. Furthermore, if middle and departmental managers have greater visibility, this would allow them to work towards a strategic fit between the departments that they manage with the rest of the hospital. Originality/value There is scant literature regarding performance dashboards' enhancement of visibility of information at different management levels. Furthermore, according to the authors' knowledge, no other paper has tried to identify and discuss the different levels of information, which should be visible from bedside to board namely to management, clinicians and public.
This commentary considers the shift in evidence-informed practice away from the individual practitioner to an acknowledgement that context is also important. The view of practitioner as 'rational agent' capable of searching, appraising and translating research evidence into individual practice has dominated the literature. However, a growing body of research leads us to question whether evidence use is indeed an individual activity. Key research studies were purposively selected to build the case for the arguments made. Apart from attitude, there is little to indicate that any potential individual determinants influence research use. Views of what constitutes evidence for evidence-based practice have become more inclusive and sophisticated. Evidence tends to be contextually bound and individually interpreted and particularized within that context. As such, evidence use is beginning to be recognized more widely as a contingent process, which varies across setting and time. A number of contextual factors have been found to be potentially influential including culture and leadership. CONCLUSION(S) AND IMPLICATIONS FOR NURSING MANAGEMENT: It cannot be assumed that evidence-based resources such as clinical guidelines will be accepted at face value by practitioners. Developing the skills of individuals to critically appraise research will not automatically lead to greater evidence use. Reviewing organizations' capacity for evidence-informed practice as a system property and cultural factor may lead to insights about the barriers and facilitators to evidence use. Investing in the capability of key individuals at multiple levels of the organization as leaders of evidence-based practice activities may be one promising organizational strategy.
There is a growing recognition among secondary educators and administrators that students need to have a science education that provides connections between familiar classes like biology, chemistry, and physics. Because of this waxing interest in an integrative approach to the sciences, there is a broader push for school districts to offer classes geared towards the earth sciences, a field that incorporates knowledge and skills gleaned from the three core science subjects. Within the contexts of a regular secondary school day on a traditional schedule (45- to 50-minute long classes), it is challenging to engage students in rigorous field-based learning, critical for students to develop a deeper understanding of geosciences content, without requiring extra time outside of the regular schedule. We suggest instruction using common, manmade features like drainage retention ponds to model good field practices and provide students with the opportunity to calculate basic hydrologic budgets, take pH readings, and, if in an area with seasonal rainfall, make observations regarding soils by way of trenching, and near-surface processes, including mass wasting and the effects of vegetation on geomorphology. Gains in student understanding are discussed by analyzing the difference in test scores between exams provided to the students after they had received only in-class instruction, and after they had received field instruction in addition to the in-class lectures. In an advanced setting, students made measurements regarding ion contents and pollution that allowed the classes to practice lab skills while developing a data set that was analyzed after field work was completed. It is posited that similar fieldwork could be an effective approach at an introductory level in post-secondary institutions.
Piero C. Giordano
Full Text Available The aims of this study are: i to enquire whether informing healthy hemoglobinopathy carriers about their condition is a welcome initiative in The Netherlands; ii to study whether using information letters and thorough explanation is associated with presence or absence of undesired feelings or emotions. We have approached 100 multi-ethnic carriers previously diagnosed in our lab. All subjects had previously received our information letter through their physician who was supposed to have provided an explanation of the letter if required. We have enquired whether the subjects had experienced negative or positive emotions after receiving our diagnosis and explanation and to which degree, if they were sufficiently informed and satisfied and if they would have considered prevention in case of risk. The rate negative versus positive feelings was calculated using a numerical distribution. We have registered negative feelings in a rate that was directly proportional to the lack of information. While the number of registered negative feelings in well-informed carriers was very low it was more present in badly informed. Nevertheless, all participants found carrier information a welcome initiative and over 80% of them declared to be in favor of prenatal diagnosis in case of risk.
Oakley, N.; Daudert, B.
Accessing scientific data through an online portal can be a frustrating task. The concept of making web interfaces easy to use known as "usability" has been thoroughly researched in the field of e-commerce but has not been explicitly addressed in the atmospheric sciences. As more observation stations are installed, satellite missions flown, models run, and field campaigns performed, large amounts of data are produced. Portals on the Internet have become the favored mechanisms to share this information and are ever increasing in number. Portals are often created without being tested for usability with the target audience though the expenses of testing are low and the returns high. To remain competitive and relevant in the provision of atmospheric data, it is imperative that developers understand design elements of a successful portal to make their product stand out among others. This presentation informs the audience of the benefits and basic principles of usability for web pages presenting atmospheric data. We will also share some of the best practices and recommendations we have formulated from the results of usability testing performed on two data provision web sites hosted by the Western Regional Climate Center.
Pearson, Steven D; Moreno, Ricardo; Trnka, Yvona
OBJECTIVE To study the process, outcomes, and time spent on informal consultations provided by gastroenterologists to the primary care general internists of an HMO. DESIGN Observational study. SETTING A large, urban staff-model HMO. PATIENTS/PARTICIPANTS Seven gastroenterologists constituting the total workforce of the gastroenterology department of the HMO. MEASUREMENTS AND MAIN RESULTS Data on 91 informal consultations were obtained, of which 55 (60%) involved the acute management of a patient with new symptoms or test results, and 36 (40%) were for questions related to nonacute diagnostic test selection or medical therapy. Questions regarding patients previously unknown to the gastroenterology department accounted for 74 (81%) of the consultations. Formal referral was recommended in only 16 (22%) of these cases. As judged by the time data gathered on the 91 consultations, the gastroenterologists spent approximately 7.2 hours per week to provide informal consultation for the entire HMO. CONCLUSIONS Gastroenterologists spend a significant amount of time providing informal consultation to their general internist colleagues in this HMO. The role informal consultation plays in the workload of physicians and in the clinical care of populations is an important question for health care system design, policy, and research. PMID:9686708
Behar-Horenstein, Linda S; Garvan, Cyndi W; Moore, Thomas E; Catalanotto, Frank A
Valid and reliable instruments to measure and assess cultural competence for oral health care providers are scarce in the literature, and most published scales have been contested due to a lack of item analysis and internal estimates of reliability. The purposes of this study were, first, to develop a standardized instrument to measure dental students' knowledge of diversity, skills in culturally competent patient-centered communication, and use of culture-centered practices in patient care and, second, to provide preliminary validity support for this instrument. The initial instrument used in this study was a thirty-six-item Likert-scale survey entitled the Knowledge, Efficacy, and Practices Instrument for Oral Health Providers (KEPI-OHP). This instrument is an adaption of an initially thirty-three-item version of the Multicultural Awareness, Knowledge, and Skills Scale-Counselor Edition (MAKSS-CE), a scale that assesses factors related to social justice, cultural differences among clients, and cross-cultural client management. After the authors conducted cognitive and expert interviews, focus groups, pilot testing, and item analysis, their initial instrument was reduced to twenty-eight items. The KEPI-OHP was then distributed to 916 dental students (response rate=48.6 percent) across the United States to measure its reliability and assess its validity. Both exploratory and confirmatory factor analyses were conducted to test the scale's validity. The modification of the survey into a sensible instrument with a relatively clear factor structure using factor analysis resulted in twenty items. A scree test suggested three expressive factors, which were retained for rotation. Bentler's comparative fit and Bentler and Bonnett's non-normed indices were 0.95 and 0.92, respectively. A three-factor solution, including efficacy of assessment, knowledge of diversity, and culture-centered practice subscales, comprised of twenty-items was identified. The KEPI-OHP was found to
This book provides a selection of documentary background information on areas of the Information Highway debate that are particularly relevant to libraries. The book is designed for librarians who are online but have little time to explore the general areas of information policy, and for those not yet connected to the Internet who need to…
Full Text Available Background: Studies have sought to define information needs of health workers within very specific settings or projects. Lacking in the literature is how hospitals in low-income settings are able to meet the information needs of their staff and the use of information communication technologies (ICT in day-to-day information searching. Objective: The study aimed to explore where professionals in Kenyan hospitals turn to for work-related information in their day-to-day work. Additionally, it examined what existing solutions are provided by hospitals with regard to provision of best practice care. Lastly, the study explored the use of ICT in information searching. Design: Data for this study were collected in July 2012. Self-administered questionnaires (SAQs were distributed across 22 study hospitals with an aim to get a response from 34 health workers per hospital. Results: SAQs were collected from 657 health workers. The most popular sources of information to guide work were fellow health workers and printed guidelines while the least popular were scientific journals. Of value to health workers were: national treatment policies, new research findings, regular reports from surveillance data, information on costs of services and information on their performance of routine clinical tasks; however, hospitals only partially met these needs. Barriers to accessing information sources included: ‘not available/difficult to get’ and ‘difficult to understand’. ICT use for information seeking was reported and with demographic specific differences noted from the multivariate logistic regression model; nurses compared to medical doctors and older workers were less likely to use ICT for health information searching. Barriers to accessing Internet were identified as: high costs and the lack of the service at home or at work. Conclusions: Hospitals need to provide appropriate information by improving information dissemination efforts and providing an
Jantz, Ronald C.
Discussion of digital library projects at Rutgers University focuses on publishing bibliographic databases on the Web to provide access to information sources not likely to be published elsewhere. Describes the reusable technology platform concept, bibliographic platform architecture, metadata approach, data entry, and managing the process.…
... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry and Food and Drug Administration... Food, Drug, and Cosmetic Act; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice... entitled ``Draft Guidance for Industry and Food and Drug Administration Staff: Providing Information About...
Nazari, Behzad; Ninknejad, Sahar
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…
... 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...
Timmers, Caroline; Veldkamp, Bernard
Three studies are presented on attention paid to feedback provided by a computer-based assessment for learning on information literacy. Results show that the attention paid to feedback varies greatly. In general the attention focuses on feedback of incorrectly answered questions. In each study approximately fifty percent of the respondents paid…
Buffer, Janet; Kendall, Patricia; Medeiros, Lydia; Schroeder, Mary; Sofos, John
Objective: To determine content, education channels, and motivational factors that influence what health professionals teach about safe food handling to populations who are highly susceptible for foodborne illnesses. To assess the differences in information provided by health professionals to highly susceptible populations. Design: Descriptive,…
Jones, William Henry
One of the goals of the Project Integration Architecture (PIA) effort is to provide the ability to propagate information between disparate applications. With this ability, applications may then be formed into an application graph constituting a super-application. Such a super-application would then provide all of the analysis appropriate to a given technical system. This paper reports on a small demonstration of this concept in which a Computer Aided Design (CAD) application was connected to an inlet analysis code and geometry information automatically propagated from one to the other. The majority of the work reported involved not the technology of information propagation, but rather the conversion of propagated information into a form usable by the receiving application.
Full Text Available This qualitative ethnographic study examines five American teenagers’ historical and current digitally-mediated multiliteracy practices within digital popular culture. The participants included three male and two female students of a private high school in the Midwestern United States. The study is framed by the notion that literacy is a socially, culturally, and historically situated discursive construct rather than a purely individualized cognitive endeavor. This social constructivist theory of literacy emphasizes the social conditions necessary to navigate the economic, social, and political worlds of the 21st century. The purpose of the study was to explore the students’ multiliteracy practices that they enact through their activities within digital popular culture. Data collection methods included synchronous interviews facilitated by video conferencing tools as well as observation of the participants’ online activities and member checks conducted via email and instant messaging. The analytic strategy employed during this study was informed by Clarke’s (2005 situational analysis method. The study’s findings indicate that literacy practices in which the study participants have engaged through informal learning activities within digital youth culture have had a much greater impact on enabling them to cultivate the multimodal literacies necessary within a postmodern digital era than have their formal educational experiences.
Full Text Available This qualitative ethnographic study examines five American teenagers’ historical and current digitally-mediated multiliteracy practices within digital popular culture. The participants included three male and two female students of a private high school in the Midwestern United States. The study is framed by the notion that literacy is a socially, culturally, and historically situated discursive construct rather than a purely individualized cognitive endeavor. This social constructivist theory of literacy emphasizes the social conditions necessary to navigate the economic, social, and political worlds of the 21st century. The purpose of the study was to explore the students’ multiliteracy practices that they enact through their activities within digital popular culture. Data collection methods included synchronous interviews facilitated by video conferencing tools as well as observation of the participants’ online activities and member checks conducted via email and instant messaging. The analytic strategy employed during this study was informed by Clarke’s (2005 situational analysis method. The study’s findings indicate that literacy practices in which the study participants have engaged through informal learning activities within digital youth culture have had a much greater impact on enabling them to cultivate the multimodal literacies necessary within a postmodern digital era than have their formal educational experiences
Fairbrother, Hannah; Curtis, Penny; Goyder, Elizabeth
Children's health and wellbeing is high on the research and policy agenda of many nations. There is a wealth of epidemiological research linking childhood circumstances and health practices with adult health. However, echoing a broader picture within child health research where children have typically been viewed as objects rather than subjects of enquiry, we know very little of how, in their everyday lives, children make sense of health-relevant information. This paper reports key findings from a qualitative study exploring how children understand food in everyday life and their ideas about the relationship between food and health. 53 children aged 9-10, attending two socio-economically contrasting schools in Northern England, participated during 2010 and 2011. Data were generated in schools through interviews and debates in small friendship groups and in the home through individual interviews. Data were analysed thematically using cross-sectional, categorical indexing. Moving beyond a focus on what children know the paper mobilises the concept of health literacy (Nutbeam, 2000), explored very little in relation to children, to conceptualise how children actively construct meaning from health information through their own embodied experiences. It draws on insights from the Social Studies of Childhood (James and Prout, 2015), which emphasise children's active participation in their everyday lives as well as New Literacy Studies (Pahl and Rowsell, 2012), which focus on literacy as a social practice. Recognising children as active health literacy practitioners has important implications for policy and practice geared towards improving child health.
Benn, Peter; Chapman, Audrey R
Noninvasive prenatal testing (NIPT) through the analysis of cell-free DNA in maternal plasma has rapidly changed screening for fetal chromosome abnormalities. We review practical and ethical challenges associated with the transition, progress in their resolution, and identify new emerging difficulties. NIPT is an advanced screening test for trisomies 21, 18, and 13 that was initially limited to women at high risk for an affected pregnancy. It is now recognized as suitable for all women. The testing has been expanded to include sex chromosome abnormalities and some microdeletion syndromes. Some ethicists are concerned about inclusion of disorders that have less severe phenotypes. Clinical providers have experienced difficulty in maintaining an up-to-date knowledge about the scope of NIPT, differences between tests, who should be offered the testing, performance of tests, reasons for false-positive results, and optimal patient management following positive results. Some of the practical difficulties associated with the introduction can be attributed to this knowledge gap. There remain some important ethical issues associated with NIPT. We believe that the same ethical and legal principles that were considered in the justification of conventional prenatal screening can be used to assess the appropriateness of additional NIPT applications.
Pauer, Frédéric; Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas Of; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias
The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases
Kawasaki, Y; Tamaura, Y; Akamatsu, R; Sakai, M; Fujiwara, K
Nursing staff have an important role in patients' nutritional care. The aim of this study was to demonstrate how the practice of sharing a patient's nutritional status with colleagues was affected by the nursing staff's attitude, knowledge and their priority to provide nutritional care. The participants were 492 nursing staff. We obtained participants' demographic data, the practice of sharing patients' nutritional information and information about participants' knowledge, attitude and priority of providing nutritional care by the questionnaire. We performed partial correlation analyses and linear regression analyses to describe the relationship between the total scores of the practice of sharing patients' nutritional information based on their knowledge, attitude and priority to provide nutritional care. Among the 492 participants, 396 nursing staff (80.5%) completed the questionnaire and were included in analyses. Mean±s.d. of total score of the 396 participants was 8.4±3.1. Nursing staff shared information when they had a high nutritional knowledge (r=0.36, Pnutritional care practice was not significantly associated with the practice of sharing information. Knowledge and attitude were independently associated with the practice of sharing patients' nutrition information with colleagues, regardless of their priority to provide nutritional care. An effective approach should be taken to improve the practice of providing nutritional care practice.
Full Text Available Abstract Background A variety of international organizations, professional groups and individuals are promoting evidence-informed obstetric care in China. We measured change in obstetric practice during vaginal delivery that could be attributed to the diffusion of evidence-based messages, and explored influences on practice change. Methods Sample surveys of women at postnatal discharge in three government hospitals in Shanghai and one in neighbouring Jiangsu province carried out in 1999, repeated in 2003, and compared. Main outcome measures were changes in obstetric practice and influences on provider behaviour. "Routine practice" was defined as more than 65% of vaginal births. Semi-structured interviews with doctors explored influences on practice. Results In 1999, episiotomy was routine at all four hospitals; pubic shaving, rectal examination (to monitor labour and electronic fetal heart monitoring were routine at three hospitals; and enema on admission was common at one hospital. In 2003, episiotomy rates remained high at all hospitals, and actually significantly increased at one; pubic shaving was less common at one hospital; one hospital stopped rectal examination for monitoring labour, and the one hospital where enemas were common stopped this practice. Mobility during labour increased in three hospitals. Continuous support was variable between hospitals at baseline and showed no change with the 2003 survey. Provider behaviour was mainly influenced by international best practice standards promoted by hospital directors, and national legislation about clinical practice. Conclusion Obstetric practice became more evidence-informed in this selected group of hospitals in China. Change was not directly related to the promotion of evidence-based practice in the region. Hospital directors and national legislation seem to be particularly important influences on provider behaviour at the hospital level.
Full Text Available Injury is one of the most common reasons why a child is hospitalised. Information gained from injury surveillance activities provides an estimate of the injury burden, describes injury event circumstances, can be used to monitor injury trends over time, and is used to design and evaluate injury prevention activities. This perspective article provides an overview of child injury surveillance capabilities within New South Wales (NSW, Australia, following a stocktake of population-based injury-related data collections using the Evaluation Framework for Injury Surveillance Systems. Information about childhood injury in NSW is obtained from multiple administrative data collections that were not specifically designed to conduct injury surveillance. Obtaining good information for child injury surveillance in NSW will involve better coordination of information from agencies that record information about childhood injury. Regular reporting about childhood injury to provide a comprehensive profile of injuries of children and young people in the state should be considered, along with the provision and/or linkage of child injury information from multiple data collections. This could support the development of a suite of injury performance indicators to monitor childhood injury reduction strategies across NSW.
Warmelink, J Catja; Wiegers, Therese A; de Cock, T Paul; Klomp, Trudy; Hutton, Eileen K
interactions with physicians (GPs, obstetricians and paediatricians). Midwives with more work experience were more satisfied with their collaboration with GPs. Midwives from the southern region of the Netherlands were more satisfied with collaboration with GPs and obstetricians. Compared to the urban areas, in the rural or mixed areas the midwives were more satisfied regarding their collaboration with MCA(O)s and clinical midwives. Midwives from non-Dutch origin were less satisfied with the collaboration with paediatricians. No relations were found between the overall mean satisfaction of collaboration and work-related and personal characteristics and attitude towards work. Inter-professionals relations in maternity care in the Netherlands can be enhanced, especially the primary care midwives' interactions with physicians and with maternity care providers in the northern and central part of the Netherlands, and in urban areas. Future exploratory or deductive research may provide additional insight in the collaborative practice in everyday work setting. Copyright © 2017 Elsevier Ltd. All rights reserved.
Pacheco, Matheus M; Newell, Karl M
The practice of a motor task has been conceptualized as a process of search through a perceptual-motor workspace. The present study investigated the influence of information and task constraints on the search strategy as reflected in the sequential relations of the outcome in a discrete movement virtual projectile task. The results showed that the relation between the changes of trial-to-trial movement outcome to performance level was dependent on the landscape of the task dynamics and the influence of inherent variability. Furthermore, the search was in a constrained parameter region of the perceptual-motor workspace that depended on the task constraints. These findings show that there is not a single function of trial-to-trial change over practice but rather that local search strategies (proportional, discontinuous, constant) adapt to the level of performance and the confluence of constraints to action. Copyright © 2017 Elsevier B.V. All rights reserved.
Dietrichson, Jens; Anell, Anders; Dackehag, Margareta
Providing equal access to health care is an important objective in most health care systems. It is especially pertinent in systems like the Swedish primary care market, where providers are free to establish themselves in any part of the country. To improve equity in access to care, 15 out 21 county...... capitation on the supply of private primary care centers. We use a dataset that combines information on all primary care centers in Sweden during 2005-2013, the payment system and other conditions for establishing new primary care centers used in the county councils, and demographic, geographic......-adjusted capitation significantly increase the number of private primary care centers in areas with relatively high Care Need Index values. The adjustment results in a changed distribution of private centers within county councils; the total number of private centers does not increase in county councils using care...
Black, Betty S; Brandt, Jason; Rabins, Peter V; Samus, Quincy M; Steele, Cynthia D; Lyketsos, Constantine G; Rosenblatt, Adam
This study's goal was to identify factors associated with providing either informed consent or assent for research in individuals at high risk for cognitive impairment. Cross-sectional baseline data were used to identify predictors of consent or assent status. The study was conducted at 22 assisted living facilities in Maryland. A stratified random sample of 198 assisted living residents participated in the study. Residents' consent or assent status was documented as providing informed consent, written assent, or verbal assent/no objection. Potential predictors included residents' demographic characteristics, measures of physical and mental health status, and neuropsychological test performance. Most participants provided written assent (32.8%) or verbal assent/no objection (30.3%) rather than informed consent (36.9%). Although many resident characteristics correlated with consent or assent status based on bivariate analyses, few variables distinguished those who provided written assent from those in the verbal assent/no objection group. On the basis of multiple discriminant analysis, the best predictors of consent or assent status were Mini-Mental State Exam scores, impairments in instrumental activities of daily living, and dementia diagnosis, which together classified correctly 63.6% of residents. The relatively small proportion of participants who could provide informed consent highlights the importance of assessing decisional capacity for research in a high-risk population and identifying an appropriate surrogate decision maker to provide proxy consent if needed. Consensus on how to define assent is lacking, and specific measures of assent capabilities are needed to better characterize the assent capacity continuum.
Ma, Xiaogang; Fox, Peter; Tilmes, Curt; Jacobs, Katherine; Waple, Anne
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.
Dekens, C; Fontaine, C; Carpentier, E; Barcat, L; Gondry, J; Tourneux, P
Women hospitalized for preterm labor require clear information about prematurity. This study assessed whether or not specific written information about prematurity delivered at admission to the unit combined with an oral explanation from a pediatrician would decrease women's anxiety compared to an oral explanation alone. This was a prospective, single-center observational study. Women were included in the high-risk pregnancies department and distributed into two groups: receiving "only oral" information for a prenatal clinical consultation with a senior pediatrician or receiving "combined" oral information+a booklet about prematurity given to the women at admission. The primary endpoint was the change in anxiety-state (before and after the information procedure) evaluated by the State Trait Anxiety Inventory-Y (STAI-Y). The anxiety score before receiving information did not differ between the two groups (STAI-Y-A "combined" group: 46.7±3.0 vs. "only oral" group: 42.7±2.74; P=0.55). After consultation with a pediatrician, the acute anxiety-state score STAI-Y-A decreased significantly in the "combined" group (-6.7±1.9) compared to the "only oral" group (-2.5±4.6; Pinformation from a pediatrician reduced patients' anxiety more than oral information alone. Given that the psychology of the mother interacts with the pregnancy, it is necessary to provide clear and adapted information. Giving a booklet appears to be one of the modalities to improve information. Other modalities such as video documents have to be studied. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Pereira, Filipa; Salvi, Mireille; Verloo, Henk
Cat. We will consider publications in English, French, Spanish, and Portuguese. The electronic database searches were completed in April 2017. Retrieved articles are currently being screened, and the entire study is expected to be completed by November 2017. This systematic scoping review will provide a greater understanding of the beliefs, knowledge, implementation, and integration of EBPs among primary HCPs. The findings will inform clinical practice and help to draw a global picture of the EBP research topics that are relevant to primary care providers.
Bodemer, Nicolai; Müller, Stephanie M; Okan, Yasmina; Garcia-Retamero, Rocio; Neumeyer-Gromen, Angela
The media is a powerful tool for informing the public about health treatments. In particular, the Internet has gained importance as a widely valued source for health information for parents and adolescents. Nonetheless, traditional sources, such as newspapers, continue to report on health innovations. But do websites and newspaper reports provide balanced information? We performed a systematic media analysis to evaluate and compare media coverage of the human papillomavirus (HPV) vaccine on websites and in newspapers in Germany and Spain. We assessed to what extent the media provide complete (pros and cons), transparent (absolute instead of relative numbers), and correct information about the epidemiology and etiology of cervical cancer as well as the effectiveness and costs of the HPV vaccine. As a basis for comparison, a facts box containing current scientific evidence about cervical cancer and the HPV vaccine was developed. The media analysis included 61 websites and 141 newspaper articles in Germany, and 41 websites and 293 newspaper articles in Spain. Results show that 57% of German websites and 43% of German newspaper reports communicated correct estimates of epidemiological data, whereas in Spain 39% of the websites and 20% of the newspaper did so. While two thirds of Spanish websites explicitly mentioned causes of cervical cancer as well as spontaneous recovery, German websites communicated etiological information less frequently. Findings reveal that correct estimates about the vaccine's effectiveness were mentioned in 10% of German websites and 6% of German newspaper reports; none of the Spanish newspaper reports and 2% of Spanish websites reported effectiveness correctly. Only German websites (13%) explicitly referred to scientific uncertainty regarding the vaccine's evaluation. We conclude that the media lack balanced reporting on the dimensions completeness, transparency, and correctness. We propose standards for more balanced reporting on websites and
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
Stacy, Sara T; Cartwright, Macey; Arwood, Zjanya; Canfield, James P; Kloos, Heidi
Students rarely practice math outside of school requirements, which we refer to as the "math-practice gap". This gap might be the reason why students struggle with math, making it urgent to develop means by which to address it. In the current paper, we propose that math apps offer a viable solution to the math-practice gap: Online apps can provide access to a large number of problems, tied to immediate feedback, and delivered in an engaging way. To substantiate this conversation, we looked at whether tablets are sufficiently engaging to motivate children's informal math practice. Our approach was to partner with education agencies via a community-based participatory research design. The three participating education agencies serve elementary-school students from low-SES communities, allowing us to look at tablet use by children who are unlikely to have extensive access to online math enrichment programs. At the same time, the agencies differed in several structural details, including whether our intervention took place during school time, after school, or during the summer. This allowed us to shed light on tablet feasibility under different organizational constraints. Our findings show that tablet-based math practice is engaging for young children, independent of the setting, the student's age, or the math concept that was tackled. At the same time, we found that student engagement was a function of the presence of caring adults to facilitate their online math practice.
Cass, Sarah; Ball, Lauren; Leveritt, Michael
Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term 'basic' varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.
Ahuja, Jaspreet K C; Moshfegh, Alanna J; Holden, Joanne M; Harris, Ellen
The USDA food and nutrient databases provide the basic infrastructure for food and nutrition research, nutrition monitoring, policy, and dietary practice. They have had a long history that goes back to 1892 and are unique, as they are the only databases available in the public domain that perform these functions. There are 4 major food and nutrient databases released by the Beltsville Human Nutrition Research Center (BHNRC), part of the USDA's Agricultural Research Service. These include the USDA National Nutrient Database for Standard Reference, the Dietary Supplement Ingredient Database, the Food and Nutrient Database for Dietary Studies, and the USDA Food Patterns Equivalents Database. The users of the databases are diverse and include federal agencies, the food industry, health professionals, restaurants, software application developers, academia and research organizations, international organizations, and foreign governments, among others. Many of these users have partnered with BHNRC to leverage funds and/or scientific expertise to work toward common goals. The use of the databases has increased tremendously in the past few years, especially the breadth of uses. These new uses of the data are bound to increase with the increased availability of technology and public health emphasis on diet-related measures such as sodium and energy reduction. Hence, continued improvement of the databases is important, so that they can better address these challenges and provide reliable and accurate data.
Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T
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.
Spivack, Jordan G; Swietlik, Maggie; Alessandrini, Evaline; Faith, Myles S
This study evaluated primary care providers' (PCPs, pediatricians, and nurse practitioners) knowledge, current practices, and perceived barriers to childhood obesity prevention and treatment, with an emphasis on first-year well-child care visits. A questionnaire was distributed to 192 PCPs in the primary care network at The Children's Hospital of Philadelphia (CHOP) addressing (i) knowledge of obesity and American Academy of Pediatrics (AAP) guidelines, (ii) anticipatory guidance practices at well visits regarding nutrition and exercise, and (iii) perceived barriers to childhood obesity treatment and prevention. Eighty pediatricians and seven nurse practitioners responded, and a minority correctly identified the definition (26%) and prevalence (9%) of childhood overweight and AAP guidelines for exercise (39%) and juice consumption (44%). Most PCPs (81%) spent 11-20 min per well visit during the first 2 years, and 79% discussed diet, nutrition, and exercise for > or =3 min. Although >95% of PCPs discussed juice, fruits and vegetables, sippy cups, and finger foods during the first year, over 35% never discussed fast food, TV, or candy, and 55% never discussed exercise. Few rated current resources as adequate to treat or prevent childhood obesity. Over 90% rated the following barriers for obesity prevention and treatment as important or very important: parent is not motivated, child is not motivated, parents are overweight, families often have fast food, watch too much TV, and do not get enough exercise. In conclusion, there is much room to improve PCPs' knowledge of obesity and AAP guidelines. Although PCPs rate fast-food consumption, TV viewing, and lack of exercise as important treatment barriers, many never discussed these topics during the first year.
Marr, T David; Pinelli, Nicole R; Jarmul, Jamie A; Waldron, Kayla M; Eckel, Stephen F; Cicci, Jonathan D; Bates, Jill S; Amerine, Lindsey B
Pharmacy practice models that foster pharmacists' accountability for medication-related outcomes are imperative for the profession. Comprehensive medication management (CMM) is an opportunity to advance patient care. The objective of this study was to evaluate the impact of a CMM practice model in the acute care setting on organizational, patient, and financial outcomes. Three adult service lines focused on at-risk patients identified using internal risk stratification methodology were implemented. Core CMM elements included medication reconciliation, differentiated clinical pharmacy services, inpatient MTM consultations, discharge services, and documentation. Mixed methods compared the effect of the CMM model before and after implementation. Historical patients served as comparative controls in an observational design. Pharmacists completed a 60-minute interview regarding their experiences. Qualitative data were analyzed using thematic coding to characterize perception of the model. Three pharmacists implemented the model on cardiology, hematology/oncology, and surgery transplant services and provided services to 75 patients during the study. A total of 145 medication-related problems were identified and resolved. CMM was associated with a nonsignificant reduction of 8.8% in 30-day hospital readmission rates ( P = 0.64) and a 24.9% reduction in 30-day hospital utilization ( P = 0.41) as well as a significant reduction of 86.5% in emergency department visits ( P = 0.02). Patients receiving discharge prescriptions from our outpatient pharmacies increased by 21.4%, resulting in an 11.3% increase in discharge prescription capture and additional revenue of $5780. Themes identified from qualitative interviews included CMM structure, challenges, value, and resources. This study demonstrated successful implementation of a CMM model that positively affected organizational, patient, and financial outcomes.
Yasuhara, Tomohisa; Konishi, Motomi; Nishida, Takahiro; Kushihata, Taro; Sone, Tomomichi; Kurio, Wasako; Yamamoto, Yumi; Nishikawa, Tomoe; Yanada, Kazuo; Nakamura, Mitsutaka
Learning chemistry is cumulative: basic knowledge and chemical calculation skills are required to gain understanding of higher content. However, we often suffer from students' lack of learning skills to acquire these concepts. One of the reasons is the lack of adequate training in the knowledge and skills of chemistry, and one of the reasons for this lack is the lack of adequate evaluation of training procedures and content. Team-based learning (TBL) is a strong method for providing training in the knowledge and skills of chemistry and reaffirms the knowledge and skills of students of various levels. In our faculty, TBL exercises are provided for first-year students concurrently with lectures in physical chemistry and analytical chemistry. In this study, we researched the adoption of a peer evaluation process for this participatory learning model. Questionnaires taken after TBL exercises in the previous year showed a positive response to TBL. Further, a questionnaire taken after TBL exercises in the spring semester of the current year also yielded a positive response not only to TBL but also to peer evaluation. In addition, a significant correlation was observed between the improvement of students' grades in chemistry classes and the feeling the percentage (20%) of peer evaluation in overall evaluation low (logistic regression analysis, p=0.022). On the basis of the findings, we argue that TBL provides a generic, practical learning environment including an effective focus on learning strategy and evaluation of knowledge, skills, and attitudes, and studies on the educational effects of TBL and peer evaluation.
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.
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.
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
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
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 was to determine whether patient comprehension of telemedicine-enabled research informed consent is noninferior to standard face-to-face (F2F) research informed consent. 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 noninferior comprehension compared with standard consent. This study was conducted as part of a parent clinical trial evaluating the effectiveness of 0.12% oral chlorhexidine gluconate 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 F2F consent. Telemedicine connectivity was provided using a commercially available interface (REACH platform, Vidyo Inc.) 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. A total of 131 patients were randomized (n = 64, telemedicine), and 101 QuIC surveys were completed. Comprehension of research informed consent using telemedicine was not inferior to F2F 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. Telemedicine is noninferior to F2F consent for delivering research informed consent, with no detected
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.
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.
Kratzke, Cynthia; Wilson, Susan
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 Health educators and clinicians must promote mobile messages for Hispanics and non-Hispanics for mammography adherence, breast cancer prevention education, and best practices to manage screening appointments.
Slater, Penelope J; Fielden, Philippa E; Bradford, Natalie K
The Oncology Family App supports families across the vast state of Queensland, Australia, with easy access to vital information, including management plans for a deteriorating child, patient specific information and other resources. This article describes the development and evaluation of this mobile app. The app was developed and tested in collaboration with parents, caregivers, and clinicians and released in November 2015. This first version featured "Statewide Hospital Contacts," including phone numbers, links to Google maps, and 24-hour emergency contacts with click to call functionality; "When to Call" describing symptoms to look out for in a deteriorating child; "Blood Results Table"; and "Information" listing recommended websites, health care team contacts, appointments, and notes. The app was evaluated through interviews with parents, caregivers and patients and download metrics. Six months after the app release, 68% of the 38 parents and caregivers surveyed had downloaded the app. The most used modules were "Blood Results Table," "When to Call," and "Statewide Hospital Contacts," but families reported using all features available. Families were enthusiastic about the support the app provided and gave useful feedback to direct future development. Using mobile health technology to support families is a novel, but rapidly growing concept. Family and caregiver feedback showed that the Oncology Family App was an efficient and convenient way to provide much needed information. A new version of the app is under development and evaluation of outcomes will be ongoing.
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.
CyberPsychology and Behavior 8, 3 (2005), 187-211.  T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508  G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8...3 (2005), 220- 230.  F.D. Rose, B.M. Brooks & A.A. Rizzo, Virtual Reality in Brain Damage Rehabilitation: Review, CyberPsychology and Behavior
Tertoolen, G.; Verstraten, E.C.H. [Section of Social and Organizational Psychology, University of Utrecht, Utrecht (Netherlands)
In a field experiment the authors attempted to stimulate car users to come to a more selective use of their vehicle by means of providing information and feedback about different negative consequences of their car use. Attitude change was observed but the experimental treatments did not lead to behavioural changes. Attempts to influence car use arouse psychological resistance. Therefore, effects opposite to those intended occurred. We discuss the possible implications of the results for policy-making. 1 fig., 2 refs.
Kim, Bong-Hee; Kang, Hee-Young; Choi, Eun-Young
This study evaluated the effects of handholding and spoken information provided on the anxiety of patients undergoing percutaneous vertebroplasty under local anaesthesia. A surgical intervention usually entails physical discomfort and psychological burden. Furthermore, patients under local anaesthesia are conscious during the surgical intervention, which leads to more anxiety, as patients are aware of their surroundings in the operating theatre. A quasi-experimental design with a nonequivalent control group was utilised. Amsterdam preoperative anxiety scale assessed psychological anxiety, while blood pressure and pulse were measured to evaluate physiological anxiety. Participants were 94 patients undergoing percutaneous vertebroplasty in a spine hospital in Gwangju Metropolitan City, South Korea. Thirty patients were assigned to Experimental Group I, 34 to the Experimental Group II and 30 to the control group. During a surgical intervention, nurses held the hands of those in Experimental Group I and provided them with spoken information. Patients in Experimental Group II experienced only handholding. Psychological anxiety in Experimental Group I was low compared to those in Experimental Group II and the control group. In addition, there were significant decreases in systolic blood pressure in both Experimental Groups compared to the control group. Handholding and spoken information provided during a surgical intervention to mitigate psychological anxiety, and handholding to mitigate physiological anxiety can be used in nursing interventions with patients undergoing percutaneous vertebroplasty. Handholding and providing nursing information are possibly very useful interventions that are easily implemented by circulating nurses during a surgical intervention. In particular, handholding is a simple, economical and appropriate way to help patient in the operating theatre. © 2015 John Wiley & Sons Ltd.
Júlia Alves e Souza
Full Text Available This study aims to identify the practices of information disclosure about operating segments presented by Brazilian companies. The years 2010 and 2011 are covered, and 2010 was the first year of this kind of compulsory disclosure by Brazilian public companies. The descriptive research is developed using the content analysis of companies’ financial statements, with reference from the requirements contained in Pronouncement CPC 22. The data, referring to the financial statements of the companies, are collected in the website of the Comissão de Valores Mobiliários (CVM. The study covers 272 companies active in the BM&FBOVESPA, distributed into 20 economic sectors, totaling 544 financial statements analyzed. It was concluded that there was no uniformity in the segments disclosure practices of the companies, as expected (once that exist the discretion allowed by CPC 22. Differences are identified both at the types of disclosures as at the level of detail of the same. Some of the companies hadn't even directly mentioned the existence of operating segments. It is also noted that the level of disclosure of companies have not explored all the points mentioned by the Pronouncement, and thus the results show there was not full compliance with the requirements of CPC 22 by these companies, and the disclosure practices have a low level of detail and are superficial in several respects.
Opel, Douglas J; Robinson, Jeffrey D; Heritage, John; Korfiatis, Carolyn; Taylor, James A; Mangione-Smith, Rita
To determine the feasibility of using direct observation of provider-parent immunization discussions and to characterize provider communication practices with vaccine-hesitant parents. Over a 6 month period in 2010, we videotaped immunization discussions between pediatric providers and vaccine-hesitant parents during health supervision visits involving children 2-15 months old (N=24) in the Seattle area, Washington, USA. Videotapes were analyzed using the qualitative method of conversation analysis. We approached 96 parents seen by 9 different providers. Of those who were eligible (N=56), we enrolled 43% (N=24). Four videotaped visits were excluded from analysis for failure to obtain parental HIPAA authorization. Of the remaining 20 visits, there were ≥2 visits each that involved children aged 2, 4, 6, 9, 12, and 15 months, and all videotaped visits contained at least a brief immunization discussion. We identified 6 communication practices and several behavior types within each practice relevant to immunization: Practice 1, providers' initiations of the topic of vaccination; Types: participatory or presumptive format; Practice 2, parents' responses to providers' topic initiations; Types: strong or weak acceptance or resistance; Practice 3, providers' follow-ups to parent's responses; Types: no, immediate, or delayed pursuit; Practice 4, parents' vaccine-related questions or statements; Types: fact- or concern-based; Practice 5, providers' explicit solicitations of parent's questions/concerns; Types: designed to discourage or encourage discussion; and Practice 6, parents' responses to providers' solicitations of questions/concerns; Types: no question or fact- or concern-based inquiry. Direct observation of immunization discussions in the primary care pediatric setting is feasible and yields insight into several provider-parent immunization communication practices that are worthy of further study to determine which are effective at improving parental acceptance of
Dani, Francesca R; Foster, Kevin R; Zacchi, Francesca; Seppä, Perttu; Massolo, Alessandro; Carelli, Annalisa; Arévalo, Elisabeth; Queller, David C; Strassmann, Joan E; Turillazzi, Stefano
Inclusive fitness theory predicts that members of non-clonal societies will gain by directing altruistic acts towards their closest relatives. Multiple mating by queens and multiple queens creates distinct full-sister groups in many hymenopteran societies within which nepotism might occur. However, the weight of empirical data suggests that nepotism within full-sister groups is absent. It has been suggested that a lack of reliable recognition markers is responsible. In this paper, we investigated whether epicuticular lipids could provide reliable cues for intracolony kin recognition in two species of social wasps, the paper wasp Polistes dominulus and the hornet Vespa crabro. Epicuticular lipids have previously been shown to be central to kin recognition at the nest level, making them excellent candidates for within-nest discrimination. We genotyped individuals using DNA microsatellites and analysed surface chemistry by gas chromatography-mass spectrometry. We find that in both species epicuticular lipids typically could provide enough information to distinguish related nest-mates from unrelated nest-mates, a difference that occurs in colonies with multiple queens. However, in V. crabro, where colonies may be composed by different patrilines, information for discrimination between full sisters and half-sisters is weaker and prone to errors. Our data suggest that epicuticular lipids at best provide reliable information for intracolony nepotistic discrimination in multiple-queen colonies composed of unrelated lines.
Gupta, Monica; Chauhan, Kriti; Singhvi, Tanvi; Kumari, Manisha; Grover, Rajesh Kumar
Automated cell counters have become more and more sophisticated with passing years. The numerical and graphic data both provide useful clues for suspecting a diagnosis especially when the workload is very high. We present our experience of useful information provided by graphic displays of an automated cell counter in hematological malignancies in a cancer hospital where a large number of complete blood count (CBC) requests are received either before or during chemotherapy. This study was conducted to assess the usefulness of hematology cell counter, viz. WBC-Diff (WBC differential), WBC/BASO (WBC basophil) and IMI (immature myeloid information) channel scatter plots, and the flaggings generated in various hematological malignancies. The graphic displays have been compiled over a period of 1 year (October 2015-September 2016) from blood samples of various solid and hematological malignancies (approximately 400 per day) received for routine CBC in the laboratory. Approximately 50 000 scattergrams have been analyzed during the study period. The findings were confirmed by peripheral blood smear examination. The scattergram analysis on XE-2100 is very sensitive as well as specific for diagnosing acute leukemia, viz. acute myeloid leukemia, acute lymphoblastic leukemia; chronic myeloproliferative disorders, viz. chronic myeloid leukemia; and chronic lymphoproliferative disorder especially chronic lymphocytic leukemia. It is suggested that the laboratories using the hematology analyzers be aware of graphic display patterns in addition to flaggings generated which provide additional information and give clue toward the diagnosis even before peripheral smear examination. © 2018 Wiley Periodicals, Inc.
Saddiqi, H A; Jabbar, A; Babar, W; Sarwar, M; Iqbal, Z; Cabaret, J
A questionnaire survey was conducted to determine the worm control practices and anthelmintic usage of 150 key respondents involved in sheep and goat production in the arid Thal area of Pakistan. The information was collected by visiting farms, and interviewing the key respondents which included veterinary officers (n = 15), veterinary assistants (n = 51), traditional practitioners (n = 24), and small and large scale sheep/goat farm herders and owners (n = 60). Among all interviewed animal healthcare providers, the veterinary officers had the highest level of awareness of parasitic infection and advocated the use of modern available anthelmintics according to the predefined schedule. The farmers on the other hand, had the lowest level of knowledge about parasitic infections. They used modern anthelmintics at low frequencies (every six months) following an unusual practice of diluting the medicine. Veterinary assistants had a medium level of awareness about the parasitic infections using anthelmintic treatments when they deemed necessary rather than following a predefined treatment schedule. Traditional practitioners were also aware of parasitic infections and used traditional anthelmintics or a combination of the traditional and modern anthelmintics. The animal health providers had a different awareness and knowledge of parasitic infections which resulted in contrasting proposals for its' control. The farmers used worm control measures in accordance with their own views and those of animal healthcare advisors, combining modern and traditional treatments. This study provides the first insight into the differing views of those animal healthcare providers who form the basis for effective parasitic control within the sheep and goat industry of an arid region.
Full Text Available A questionnaire survey was conducted to determine the worm control practices and anthelmintic usage of 150 key respondents involved in sheep and goat production in the arid Thal area of Pakistan. The information was collected by visiting farms, and interviewing the key respondents which included veterinary officers (n = 15, veterinary assistants (n = 51, traditional practitioners (n = 24, and small and large scale sheep/goat farm herders and owners (n = 60. Among all interviewed animal healthcare providers, the veterinary officers had the highest level of awareness of parasitic infection and advocated the use of modern available anthelmintics according to the predefined schedule. The farmers on the other hand, had the lowest level of knowledge about parasitic infections. They used modern anthelmintics at low frequencies (every six months following an unusual practice of diluting the medicine. Veterinary assistants had a medium level of awareness about the parasitic infections using anthelmintic treatments when they deemed necessary rather than following a predefined treatment schedule. Traditional practitioners were also aware of parasitic infections and used traditional anthelmintics or a combination of the traditional and modern anthelmintics. The animal health providers had a different awareness and knowledge of parasitic infections which resulted in contrasting proposals for its control. The farmers used worm control measures in accordance with their own views and those of animal healthcare advisors, combining modern and traditional treatments. This study provides the first insight into the differing views of those animal healthcare providers who form the basis for effective parasitic control within the sheep and goat industry of an arid region.
Timmins, Fiona; Neill, Freda; Murphy, Maryanne; Begley, Thelma; Sheaf, Greg
Spirituality is receiving unprecedented attention in the nursing literature. Both the volume and scope of literature on the topic is expanding, and it is clear that this topic is of interest to nurses. There is consensus that the spiritual required by clients receiving health ought to be an integrated effort across the health care team. Although undergraduate nurses receive some education on the topic, this is ad hoc and inconsistent across universities. Textbooks are clearly a key resource in this area however the extent to which they form a comprehensive guide for nursing students and nurses is unclear. This study provides a hitherto unperformed analysis of core nursing textbooks to ascertain spirituality related content. 543 books were examined and this provides a range of useful information about inclusions and omissions in this field. Findings revealed that spirituality is not strongly portrayed as a component of holistic care and specific direction for the provision of spiritual care is lacking. Fundamental textbooks used by nurses and nursing students ought to inform and guide integrated spiritual care and reflect a more holistic approach to nursing care. The religious and/or spiritual needs of an increasingly diverse community need to be taken seriously within scholarly texts so that this commitment to individual clients' needs can be mirrored in practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gries, C.; Vanderbilt, K.; Reid, D.; Melendez-Colom, E.; San Gil, I.
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
Huber, Sigbert; Baumgarten, Andreas; Birli, Barbara; Englisch, Michael; Tulipan, Monika; Zechmeister-Boltenstern, Sophie
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
Wibe, Torunn; Ekstedt, Mirjam; Hellesø, Ragnhild
To investigate the practices of hospital professionals in providing information to patients and to professionals in primary care at patient discharge from hospital. We used a qualitative methodology with individual face-to-face interviews with 22 hospital physicians and nurses. We identified two themes in the information practices of health care professionals at patient discharge from hospital: (i) producing information in parallel processes and (ii) challenges in tailoring information to different recipients. Hospital routines and professional norms prescribing that discharge information should take place in parallel processes by hospital physicians and by nurses impede transparency and interdisciplinary coordination in primary care. A strong focus on providing patients only with information that is tailored for them neglects the interest patients may have in seeing what information about them is transmitted to primary care. Hospital routines and professional culture are important factors to consider in efforts to promote more transparent health care for patients and improved interdisciplinary communication. This is not only a matter of attitudes in the individual health care professional. In the development of solutions for electronic exchange of information in health care, all these factors should be taken into account.
Lisa M. Shook
Full Text Available Background: Approximately 100,000 persons with sickle cell disease (SCD live in the United States, including 15,000 in the Midwest. Unfortunately, many patients experience poor health outcomes due to limited access to primary care providers (PCPs who are prepared to deliver evidence-based SCD care. Sickle Treatment and Outcomes Research in the Midwest (STORM is a regional network established to improve care and outcomes for individuals with SCD living in Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin. Methods: STORM investigators hypothesized that Project ECHO® methodology could be replicated to create a low-cost, high-impact intervention to train PCPs in evidence-based care for pediatric and young adult patients with SCD in the Midwest, called STORM TeleECHO. This approach utilizes video technology for monthly telementoring clinics consisting of didactic and case-based presentations focused on the National Heart, Lung and Blood Institute (NHLBI evidence-based guidelines for SCD. Results: Network leads in each of the STORM states assisted with developing the curriculum and are recruiting providers for monthly clinics. To assess STORM TeleECHO feasibility and acceptability, monthly attendance and satisfaction data are collected. Changes in self-reported knowledge, comfort, and practice patterns will be compared with pre-participation, and 6 and 12 months after participation. Conclusions: STORM TeleECHO has the potential to increase implementation of the NHLBI evidence-based guidelines, especially increased use of hydroxyurea, resulting in improvements in the quality of care and outcomes for children and young adults with SCD. This model could be replicated in other pediatric chronic illness conditions to improve PCP knowledge and confidence in delivering evidence-based care.
Jarvis, Fiona; Clemson, Lindy Maxted; Mackenzie, Lynette
One of the many difficulties a person with dementia can experience is difficulty with way finding and subsequently getting lost in the community. Prescriptions of assistive technology are a key role for occupational therapists. This study aimed to describe the attitudes and practices of occupational therapists in recommending and using assistive technology for persons with dementia who have difficulties with way finding in the community. An online survey was distributed to members of Occupational Therapy Australia NSW and included 25 items on demographics, frequency of use of assistive technology and assessment. A total of 85 occupational therapists responded to the survey. Significant differences were identified in the approaches used, the types of assistive technology used and the evaluation of outcomes, between community-based and hospital-based occupational therapists. Over half of the participants had never prescribed any of the assistive devices listed in the survey for people with dementia. The most frequently prescribed assistive devices were low-tech items that were already freely available to carers and other professions. Therapists used a conservative approach to problem solving with their clients with dementia. There is a limited understanding from occupational therapists about available interventions for people with dementia. Implications for Rehabilitation There is limited awareness on how assistive technology might be used to support occupational performance for persons with dementia. This survey suggests that occupational therapists experience barriers in identifying and providing appropriate assistive technology for this group. Access to targeted education and online resources for occupational therapists is recommended to provide better awareness of the types of assistive technology available to assist persons with dementia and their caregivers.
O'Brien, Myles W; Shields, Christopher A; Oh, Paul I; Fowles, Jonathon R
The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% exercise counselling during routine client encounters (48% vs 72% in most sessions; p exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.
Low, Chinyao; Hsueh Chen, Ya
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.
Choi, Jeeyae; Lapp, Cathi; Hagle, Mary E
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.
Koller, Ulrich; Waldstein, Wenzel; Schatz, Klaus-Dieter; Windhager, Reinhard
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.
Boker, Abdulaziz; Brownell, Laurence; Donen, Neil
To compare three anxiety scales; the anxiety visual analogue scale (VAS), the anxiety component of the Amsterdam preoperative anxiety and information scale (APAIS), and the state portion of the Spielburger state-trait anxiety inventory (STAI), for assessment of preoperative anxiety levels in same day admission patients. Patients completed the three anxiety assessment scales both before and after seeing the anesthesiologist preoperatively. The scales used were the STAI, the six-question APAIS, and the VAS. APAIS was further subdivided to assess anxiety about anesthesia (sum A), anxiety about surgery (sum S) and a combined anxiety total (i.e., sum C = sum A + sum S). These scales were compared to one another. Pearson's correlation (pair-wise deletion) was used for validity testing. Cronbach's alpha analysis was used to test internal validity of the various components of the APAIS scale. A correlation co-efficient (r) > or = 0.6 and P scale sets were completed by 197 patients. There was significant and positive correlation between VAS and STAI r = 0.64, P anxiety components of the APAIS (sum C) and desire for information were 0.84 and 0.77 respectively. In addition to VAS, the anxiety component of APAIS (sum C) is a promising new practical tool to assess preoperative patient anxiety levels.
Lindvall, Agneta; Kristensson, Jimmie; Willman, Ania; Holst, Göran
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity" found on pages 24-31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe how older adults with multimorbidity experience care provided from informal
Full Text Available The complex interrelationships commonly enacted as a consequence of project team activity take a number of different forms, including those formally dictated by contract conditions. However it is becoming increasingly apparent that project performance is affected by informal relationships, though their investigation is notoriously difficult. This paper proposes that these difficulties arise partly from the nature of the informalities themselves, but also as a consequence of the philosophical position taken by researchers and their consequent methodological/paradigmatic posture, and its impact upon those being studied. It consequently proposes a subjectivist investigative framework that accommodates multiple philosophical points of departure, matching them to a range of alternative methodologies, and indicates the desirability of blending to reflect the peculiarities of each context under investigation. The framework also accommodates the practicalities of putting complex methodologies into action. The paper concludes that this framework presents opportunities to conduct rigorous in-situ investigations of informality at work, leading to authentic and deep insights that would otherwise remain unseen
Northington, LaDonna; Lyman, Beth; Guenter, Peggi; Irving, Sharon Y; Duesing, Lori
Enteral feeding tubes are used in pediatric patients to deliver nutrition, fluids or medications. The literature related to short-term feeding tube (nasogastric [NG], hereafter known as NGT, or orogastric [OGT],) use in pediatric homecare patients is sparse. This descriptive study sought to gather baseline information about these children and how their feeding tubes are managed at home. Specifically, we sought to better understand how the tubes are placed and the method(s) used for tube placement verification. Two surveys were distributed: one to parents and one to homecare providers who have direct patient contact. Responses were obtained from 144 parents and 66 homecare providers. Over half of the children were 12months of age or younger and had a 6 Fr feeding tube. Over 75% (108) had an NGT for 1year or less. Predominantly parents replaced the NGT but a few children self-inserted their tubes. Feeding tube placement was verified by auscultation (44%) or measurement of gastric pH (25%) in the parent's survey. Twenty-six percent of parents indicated they had misplaced an NGT at least once and 35 parents described symptoms of pulmonary misplacement. The homecare provider data indicated auscultation (39%) and pH measurement of gastric contents (28%) to verify NG tube placement location. Study results confirms a need for consistency of practice among health care professionals and in parent education for those children who require NGTs at home. It is troubling that auscultation is still widely used for NGT location confirmation despite practice alerts that warn against its use. Copyright © 2017 Elsevier Inc. All rights reserved.
Paynter, Jessica M.; Ferguson, Sarah; Fordyce, Kathryn; Joosten, Annette; Paku, Sofia; Stephens, Miranda; Trembath, David; Keen, Deb
A number of autism intervention practices have been demonstrated to be effective. However, the use of unsupported practices persists in community early intervention settings. Recent research has suggested that personal, professional and workplace factors may influence intervention choices. The aim of this research was to investigate knowledge and…
Chandrasekaran, Neeraja; Gressick, Kimberly; Singh, Vivek; Kwal, Jaclyn; Cap, Natalia; Koru-Sengul, Tulay; Curry, Christine L
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.
Full Text Available This paper provides guidance and an example for carrying out research using an interpretive framework. Until quite recently, there has been little available in the IS literature to guide the interpretive researcher to build theory of IS practice. While structured as a typical research paper, this paper is different in that the focus is on conceptual issues and the research methods rather than the findings. Unlike positivist research, there is no accepted general model for communicating interpretive research. Similarly, few guidelines exist for conducting the inductive process central to interpretive research. Throughout the paper, issues relating to the choice and application of the methods in terms of conducting inductive research are discussed. Overall, the focus provides an in-depth discussion of the particular interpretive research that I undertook so that other researchers can read of an example that may be similar to their own and therefore guide their work.
Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W
There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis (MS), yet uptake is low. We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Participants were adults with MS who had mild-or-moderate disability and 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, namely interactions between patients and healthcare providers and needs and wants of patients. Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.
Lowther, R. P.; Brill, M.
A scenario-based distributed information system for operationally building the Global Earth Observing System of Systems (GEOSS) is presented as part of Northrop Grumman's participation in the GEOSS ten- year Architecture Implementation Pilot plan. Northrop Grumman is responding to the application challenge of implementing GEOSS capabilities by adding several U.S. Global Earth Observing (USGEO) data providers through architecture development and multiple scenario demonstrations, one of which is Natural Disaster Response. The scenarios ensure responders collaborate with the Group on Earth Observations (GEO) Societal Benefit Area working groups and external agencies. A six-stage disaster cycle is executed for a major hurricane and flooding scenario on the Port of Houston that incorporates multiple user communities and demonstrates how communities of practice may be applied to extend information sharing in response to disasters. The scenario is user driven and uses products derived from existing earth observing systems. The enterprise model for this hurricane and flooding scenario depicts an end-to-end approach to executing disaster response management. The centrality of the community portal in creating a coordinated disaster response cannot be overstated. Northrop Grumman has reached interoperability agreements with multiple community data providers whose goal is to make their data and products accessible as "persistent exemplars" within GEOSS to global users and decision makers. As multiple GEO community members integrate their data and services into GEOSS, the whole of GEOSS becomes much more than the sum of its components; however, GEOSS must deliver high-value information easily understood by decision makers through smart source selection. When this occurs, and GEOSS becomes operational, the information gap will narrow between systems, providers, analysts, and decision makers.
Petrin, Christine; Kahan, Scott; Turner, Monique; Gallagher, Christine; Dietz, William H
Relatively few patients receive obesity counselling consistent with the USPSTF guidelines, and many health care professionals (HCPs) are biased in their attitudes towards obesity management. A national sample of family physicians, internists, OB/GYN physicians, and nurse practitioners (NPs) completed a web-based survey of beliefs, practice, and knowledge regarding obesity management. A majority of HCPs believe that it is both the patient's and the provider's responsibility to ensure that the patient is counselled about obesity. Obesity (77%), obesity-related diseases (79%), or obesity-related risk factors (71%) prompt HCPs to offer obesity counselling; 59% of HCPs wait for the patient to broach the subject of their weight. Increased blood pressure (89%) and heart disease risks (90%) are the most common themes in counselling. Across all HCPs except NPs "exercise" is discussed more frequently than "physical activity" (85% vs 81%), "diet" more frequently than "eating habits" (77% vs 75%), and "obesity" more frequently than "unhealthy weight" (60% vs 45%). NPs are more likely to discuss physical activity, eating habits, and unhealthy weight instead. To improve counselling for obesity, HCPs reported needing more time (70%), training in obesity management (53%), improved reimbursement (53%), and better tools to help patients recognise obesity risks (50%). Obesity-related diseases, risk factors, or obesity alone predict obesity counselling amongst HCPs. Better training in weight management and tools to help patients recognise risks appear to be key elements in helping patients compare the risks of what they may consider invasive therapy against the risks of continued obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Kahn, Steven A; Davis, Sarah A; Banes, Caroline T; Dennis, Bradley M; May, Addison K; Gunter, Oliver D
Teaching hospitals often employ advanced practice providers (nurse practitioners and physician assistants or APPs) to counteract residents' work-hour restrictions. With increased utilization of APPs in labor-intense areas, such as intensive care units (ICUs), APPs may have an impact on resident education and experience. No studies have investigated the direct role an APP plays on the training experience of a surgical resident in the ICU. An institutional review board-approved survey was emailed to residents in Accreditation Council for Graduate Medical Education-accredited general surgery programs. Surveys asked about demographics, residency and/or ICU characteristics, and the effects of APPs on patient care, workflow, and educational experience. Regression analysis determined predictors of resident perception. A total of 354 of 1178 residents responded to the survey (30%). Some residents felt that nurses calling APPs preferentially for patient-care issues interfered with education (17%) and residents' ability to follow patients (12%) and was associated with overall detrimental effects to ICU experience on regression (odds ratio, 3.7; confidence interval, 1.5-9.1). Most residents reported positive effects of APPs, such as reduced resident workload (79.8%), teaching protocols and/or guidelines (60.3%), enhanced patient care (60.3%), and enhanced communication (50.5%). When asked how APPs affected their overall ICU experience, 48.4% reported positive effects, 20.6% reported "no effect," and 31% reported detrimental effects. Only a minority of residents perceived that APPs detract from training, particularly those who felt excluded when nurses preferentially contact APPs with patient-care issues. APPs have the potential to enhance training and ICU experience, as reflected in many of the responses. Strategies to maintain direct nurse and resident communication might preserve residents' perception of the educational value of APPs. Copyright © 2015 Elsevier Inc. All
Kraft, Stephanie A; Constantine, Melissa; Magnus, David; Porter, Kathryn M; Lee, Sandra Soo-Jin; Green, Michael; Kass, Nancy E; Wilfond, Benjamin S; Cho, Mildred K
Participant understanding is a key element of informed consent for enrollment in research. However, participants often do not understand the nature, risks, benefits, or design of the studies in which they take part. Research on medical practices, which studies standard interventions rather than new treatments, has the potential to be especially confusing to participants because it is embedded within usual clinical care. Our objective in this randomized study was to compare the ability of a range of multimedia informational aids to improve participant understanding in the context of research on medical practices. We administered a web-based survey to members of a proprietary online panel sample selected to match national US demographics. Respondents were randomized to one of five arms: four content-equivalent informational aids (animated videos, slideshows with voice-over, comics, and text) and one no-intervention control. We measured knowledge of research on medical practices using a summary knowledge score from 10 questions based on the content of the informational aids. We used analysis of variance and paired t-tests to compare knowledge scores between arms. There were 1500 completed surveys (300 in each arm). Mean knowledge scores were highest for the slideshows with voice-over (65.7%), followed by the animated videos (62.7%), comics (60.7%), text (57.2%), and control (50.3%). Differences between arms were statistically significant except between the slideshows with voice-over and animated videos and between the animated videos and comics. Informational aids that included an audio component (animated videos and slideshows with voice-over) had higher knowledge scores than those without an audio component (64.2% vs 59.0%, p aids with a character-driven story component (animated videos and comics) and those without. Our results show that simple multimedia aids that use a dual-channel approach, such as voice-over with visual reinforcement, can improve participant
Jiménez, Felipe; Naranjo, Jose Eugenio; Serradilla, Francisco; Pérez, Elisa; Hernández, María Jose; Ruiz, Trinidad; Anaya, José Javier; Díaz, Alberto
Inappropriate speed is a relevant concurrent factor in many traffic accidents. Moreover, in recent years, traffic accidents numbers in Spain have fallen sharply, but this reduction has not been so significant on single carriageway roads. These infrastructures have less equipment than high-capacity roads, therefore measures to reduce accidents on them should be implemented in vehicles. This article describes the development and analysis of the impact on the driver of a warning system for the safe speed on each road section in terms of geometry, the presence of traffic jams, weather conditions, type of vehicle and actual driving conditions. This system is based on an application for smartphones and includes knowledge of the vehicle position via Ground Positioning System (GPS), access to intravehicular information from onboard sensors through the Controller Area Network (CAN) bus, vehicle data entry by the driver, access to roadside information (short-range communications) and access to a centralized server with information about the road in the current and following sections of the route (long-range communications). Using this information, the system calculates the safe speed, recommends the appropriate speed in advance in the following sections and provides warnings to the driver. Finally, data are sent from vehicles to a server to generate new information to disseminate to other users or to supervise drivers’ behaviour. Tests in a driving simulator have been used to define the system warnings and Human Machine Interface (HMI) and final tests have been performed on real roads in order to analyze the effect of the system on driver behavior. PMID:26805839
Full Text Available Inappropriate speed is a relevant concurrent factor in many traffic accidents. Moreover, in recent years, traffic accidents numbers in Spain have fallen sharply, but this reduction has not been so significant on single carriageway roads. These infrastructures have less equipment than high-capacity roads, therefore measures to reduce accidents on them should be implemented in vehicles. This article describes the development and analysis of the impact on the driver of a warning system for the safe speed on each road section in terms of geometry, the presence of traffic jams, weather conditions, type of vehicle and actual driving conditions. This system is based on an application for smartphones and includes knowledge of the vehicle position via Ground Positioning System (GPS, access to intravehicular information from onboard sensors through the Controller Area Network (CAN bus, vehicle data entry by the driver, access to roadside information (short-range communications and access to a centralized server with information about the road in the current and following sections of the route (long-range communications. Using this information, the system calculates the safe speed, recommends the appropriate speed in advance in the following sections and provides warnings to the driver. Finally, data are sent from vehicles to a server to generate new information to disseminate to other users or to supervise drivers’ behaviour. Tests in a driving simulator have been used to define the system warnings and Human Machine Interface (HMI and final tests have been performed on real roads in order to analyze the effect of the system on driver behavior.
Jiménez, Felipe; Naranjo, Jose Eugenio; Serradilla, Francisco; Pérez, Elisa; Hernández, María Jose; Ruiz, Trinidad; Anaya, José Javier; Díaz, Alberto
Inappropriate speed is a relevant concurrent factor in many traffic accidents. Moreover, in recent years, traffic accidents numbers in Spain have fallen sharply, but this reduction has not been so significant on single carriageway roads. These infrastructures have less equipment than high-capacity roads, therefore measures to reduce accidents on them should be implemented in vehicles. This article describes the development and analysis of the impact on the driver of a warning system for the safe speed on each road section in terms of geometry, the presence of traffic jams, weather conditions, type of vehicle and actual driving conditions. This system is based on an application for smartphones and includes knowledge of the vehicle position via Ground Positioning System (GPS), access to intravehicular information from onboard sensors through the Controller Area Network (CAN) bus, vehicle data entry by the driver, access to roadside information (short-range communications) and access to a centralized server with information about the road in the current and following sections of the route (long-range communications). Using this information, the system calculates the safe speed, recommends the appropriate speed in advance in the following sections and provides warnings to the driver. Finally, data are sent from vehicles to a server to generate new information to disseminate to other users or to supervise drivers' behaviour. Tests in a driving simulator have been used to define the system warnings and Human Machine Interface (HMI) and final tests have been performed on real roads in order to analyze the effect of the system on driver behavior.
More than two-thirds of NHS psychotherapy departments now use questionnaires in assessment of new patients. Their content is described for the first time. Most are primarily designed to gather biographical information but salient questions are frequently omitted. These questionnaires have suffered from being designed and used in isolation. Psychotherapy service providers need to consider how collaboration will enable questionnaires to be more effective during their assessments and to assist research into which historical factors are of greatest prognostic significance among newly referred patients.
Rayess, Hani; Zuliani, Giancarlo F; Gupta, Amar; Svider, Peter F; Folbe, Adam J; Eloy, Jean Anderson; Carron, Michael A
The number of patients using the internet to obtain health information is growing. This material is unregulated and heterogeneous and can influence patient decisions. To compare the quality, readability, and technical aspects of online information about neck-lifts provided by private practice websites vs academic medical centers and reference sources. In this cross-sectional analysis conducted between November 2015 and January 2016, a Google search of the term neck-lift was performed, and the first 45 websites were evaluated. The websites were categorized as private practice vs other. Private websites (PWs) included sites created by private practice physicians. Other websites (OWs) were created by academic medical centers or reference sources. Quality, readability, and technical aspects of online websites related to neck-lifts. Quality was assessed using the DISCERN criteria and the Health on the Net principles (HONcode). Readability was assessed using 7 validated and widely used criteria. Consensus US reading grade level readability was provided by a website (readabilityformulas.com). Twelve technical aspects were evaluated based on criteria specified by medical website creators. Forty-five websites (8 OWs [18%] and 37 PWs [82%]) were analyzed. There was a significant difference in quality between OWs and PWs based on the DISCERN criteria and HONcode principles. The DISCERN overall mean (SD) scores were 2.3 (0.5) for OWs and 1.3 (0.3) for PWs (P analysis, the mean (SD) was 8.6 (1.8) (range, 5-11) for OW, and the mean (SD) was 5.8 (1.7) (range, 2-9) for PW. The mean (SD) readability consensus reading grade level scores were 11.7 (1.9) for OWs and 10.6 (1.9) for PWs. Of a total possible score of 12, the mean (SD) technical scores were 6.3 (1.8) (range, 4-9) for OWs and 6.4 (1.5) (range, 3-9) for PWs. Compared with PWs, OWs had a significantly higher quality score based on both the DISCERN criteria and HONcode principles. The mean readability for OWs and PWs was
Full Text Available Background: Regular IEC programs during antenatal and intranatal period, through individual or group approach, brings desirable changes in health practices of people, resulting in a healthy mother and a healthy baby. Materials and Methods: This study was conducted to assess the level of IEC services regarding pregnancy and child care, received by the women at an MCH clinic of an urban health center, where the study subjects comprised 400 antenatal (AN and postnatal (PN women and mothers of children under five years. Results: Warning signs of danger was explained to only 10% of the AN and PN women. Advice regarding family planning appeared to be the most frequently covered, though that too was explained to less than half of the subjects. About one third of the women were advised on breast feeding. Only 8% of the mothers had been told about all issues regarding pregnancy and child care. Breast feeding and weaning was properly explained to 85.7 and 81.1% of the total mothers of U5 children. Advice regarding subsequent nutrition was given to 60.9% of mothers. About only a quarter of the total mothers were advised on home management of diarrhea and acute respiratory infections. Very few mothers were counseled about the growth pattern of the children and none were shown the growth chart. Only 12.9% of the mothers were informed about all issues. Conclusion: IEC regarding maternal and child care other than feeding practices is a neglected service in the health facility where the study was conducted.
Iqbal, Sajid; Gul, Raisa; Lakhani, Arusa; Rizvi, Nusrat Fatima
Written feedback can facilitate students' learning in several ways. However, the teachers' practices of written feedback may be affected by various factors. This study aimed to explore the nurse teachers' accounts of their perceptions and practices of providing written feedback. A descriptive exploratory design was employed in the study. A…
Anthony, Denise L; Stablein, Timothy
The purpose of this paper is to explore different health care professionals' discourse about privacy - its definition and importance in health care, and its role in their day-to-day work. Professionals' discourse about privacy reveals how new technologies and laws challenge existing practices of information control within and between professional groups in health care, with implications not only for patient privacy, but also for the role of information control in professions more generally. The authors conducted in-depth, semi-structured interviews with n=83 doctors, nurses, and health information professionals in two academic medical centers and one veteran's administration hospital/clinic in the Northeastern USA. Interview responses were qualitatively coded for themes and patterns across groups were identified. The health care providers and the authors studied actively sought to uphold the protection (and control) of patient information through professional ethics and practices, as well as through the use of technologies and compliance with legal regulations. They used discourses of professionalism, as well as of law and technology, to sometimes accept and sometimes resist changes to practice required in the changing technological and legal context of health care. The authors found differences across professional groups; for some, protection of patient information is part of core professional ethics, while for others it is simply part of their occupational work, aligned with organizational interests. This qualitative study of physicians, nurses, and health information professionals revealed some differences in views and practices for protecting patient information in the changing technological and legal context of health care that suggest some professional groups (doctors) may be more likely to resist such changes and others (health information professionals) will actively adopt them. New technologies and regulations are changing how information is used in health
te Moller, N C R; Brommer, H; Liukkonen, J; Virén, T; Timonen, M; Puhakka, P H; Jurvelin, J S; van Weeren, P R; Töyräs, J
Arthroscopy enables direct inspection of the articular surface, but provides no information on deeper cartilage layers. Optical coherence tomography (OCT), based on measurement of reflection and backscattering of light, is a diagnostic technique used in cardiovascular surgery and ophthalmology. It provides cross-sectional images at resolutions comparable to that of low-power microscopy. The aim of this study was to determine if OCT is feasible for advanced clinical assessment of lesions in equine articular cartilage during diagnostic arthroscopy. Diagnostic arthroscopy of 36 metacarpophalangeal joints was carried out ex vivo. Of these, 18 joints with varying degrees of cartilage damage were selected, wherein OCT arthroscopy was conducted using an OCT catheter (diameter 0.9 mm) inserted through standard instrument portals. Five sites of interest, occasionally supplemented with other locations where defects were encountered, were arthroscopically graded according to the International Cartilage Repair Society (ICRS) classification system. The same sites were evaluated qualitatively (ICRS classification and morphological description of the lesions) and quantitatively (measurement of cartilage thickness) on OCT images. OCT provided high resolution images of cartilage enabling determination of cartilage thickness. Comparing ICRS grades determined by both arthroscopy and OCT revealed poor agreement. Furthermore, OCT visualised a spectrum of lesions, including cavitation, fibrillation, superficial and deep clefts, erosion, ulceration and fragmentation. In addition, with OCT the arthroscopically inaccessible area between the dorsal MC3 and P1 was reachable in some cases. Arthroscopically-guided OCT provided more detailed and quantitative information on the morphology of articular cartilage lesions than conventional arthroscopy. OCT could therefore improve the diagnostic value of arthroscopy in equine orthopaedic surgery. Copyright © 2013 Elsevier Ltd. All rights reserved.
Schreuder, B.; van Oppen, P.C.; van Marwijk, H.W.J.; Smit, J.H.; Stalman, W.A.B.
Background: There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs) experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST) is a brief psychological
Schreuders, B.; van Oppen, P.C.; van Marwijk, H.W.J.; Smit, J.H.; Stalman, W.A.B.
Background: There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs) experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST) is a brief psychological
Schreuders, B.; Oppen, van P.C.; Marwijk, van H.W.J.; Smit, J.H.; Stalman, W.A.B.
BACKGROUND: There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs) experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST) is a brief psychological
Alvarez-Bermejo, J A; Hernández-Capel, D M; Belmonte-Ureña, L J; Roca-Piera, J
Ensuring the quality of services provided in centres where dependent persons are seen by specialist services, by improving and enhancing how information -salary, control of tasks, patients' records, etc.- is shared between staff and carers. A web information system has been developed and experimentally deployed to accomplish this. The accuracy of the system was evaluated by assessing how confident the employees were with it rather than relying on statistical data. It was experimentally deployed since January 2009 in Asociación de Personas con Discapacidad "El Saliente" that manages several day centres in Almeria, for dependent persons over 65 years old, particularly those affected by Alzheimer' disease. Incidence data was collected during the experimental period. A total of 84% of the employees thought that the system helped to manage documents, administrative duties, etc., and 92.4% said they could attend to really important tasks because the system was responsible for alerting them of every task, such as medication timetables, checking all patients were present (to prevent an Alzheimer affected person leaving the centre) etc. During this period the incidences reported were reduced by about a 30%, although data is still partially representative. As the life expectancy of the population gets longer, these centres will increase. Providing systems such as the one presented here would be of great help for administrative duties (sensitive data protection...) as well as ensuring high quality care and attention.
Dittus Robert S
Full Text Available Abstract Background Physicians reading the medical literature attempt to determine whether research studies are valid. However, articles with negative results may not provide sufficient information to allow physicians to properly assess validity. Methods We analyzed all original research articles with negative results published in 1997 in the weekly journals BMJ, JAMA, Lancet, and New England Journal of Medicine as well as those published in the 1997 and 1998 issues of the bimonthly Annals of Internal Medicine (N = 234. Our primary objective was to quantify the proportion of studies with negative results that comment on power and present confidence intervals. Secondary outcomes were to quantify the proportion of these studies with a specified effect size and a defined primary outcome. Stratified analyses by study design were also performed. Results Only 30% of the articles with negative results comment on power. The reporting of power (range: 15%-52% and confidence intervals (range: 55–81% varied significantly among journals. Observational studies of etiology/risk factors addressed power less frequently (15%, 95% CI, 8–21% than did clinical trials (56%, 95% CI, 46–67%, p Conclusion Prominent medical journals often provide insufficient information to assess the validity of studies with negative results.
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.
Homma, Keiichi; Suzuki, Koji; Sugawara, Hideaki
Autophagy is a process of self-digestion generally observed in eukaryotes and has been shown to play crucial roles for survival under starvation and removal of deleterious substances. Despite great advances that have been made, many problems in mechanisms of autophagy remain unsolved. As a large number of autophagy-related proteins are identified in each species, a database that collects data, identifies their homologs in other species and makes them available will contribute to research advancement. As no such resources exist, we built the Autophagy database (http://tp-apg.genes.nig.ac.jp/autophagy) to provide basics, up-to-date information on relevant literature, and a list of autophagy-related proteins and their homologs in 41 eukaryotes. From the database, the user can search for proteins by keywords or sequences to obtain a wealth of data including functional and structural information and find possible functional homologs of proteins whose functions have been demonstrated in other species. As proteins that bind the phospholipid, phosphatidyl inositol 3-phosphate (PI3P) are essential for autophagy to proceed, we carried out an original analysis to identify probable PI3P-binding proteins, and made the list available from the database. The database is expected to give impetus to further research on autophagy by providing basic and specialized data on the subject.
López-Picazo, J J; de Dios Cánovas-García, J; Antúnez, C; Marín, J; Antequera, M M; Vivancos, L; Martínez, B; Legaz, A; Navarro, D; Leal, M
Dementia units (DU) provide comprehensive and specialised care to patients with dementia. However, assessment in these units normally focuses on patient management. The aim of this study was to determine satisfaction of the caregivers of patients managed in a DU and how they rated DU care. We created a self-administered questionnaire which was completed by 236 caregivers visiting the DU in 2015. The questionnaire included 6 dimensions (accessibility, organisation, professionalism, relationship with staff, information, and facilities); data were analysed using problem rates. A total of 53.4% caregivers completed the questionnaire; most were women, patients' spouses, or first-degree relatives. The overall problem rates was 15.0% (95% CI, 13.9-16.1), with sizeable differences between dimensions: from 0.1% (95% CI, 0.0-0.4) for 'relationship with staff' and 'professionalism' to 49.3% (95% CI, 45.4-53.2) for 'information'. Waiting times over 30minutes were perceived as excessive. Information problems were not directly related to patient management. Satisfaction was scored 8.29/10 (median 8; SD 1.45); 77.3% (95% CI, 69.8-74.8) of respondents were highly satisfied. Ninety-nine percent of the caregivers stated that they would recommend the DU. This questionnaire provides interesting data on care quality as perceived by patients' caregivers. Our results have allowed us to identify problems and implement corrective actions. Our questionnaire has proved to be a useful tool for evaluating and improving care quality in DUs. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
McGowan, Jessie; Hogg, William; Rader, Tamara; Salzwedel, Doug; Worster, Danielle; Cogo, Elise; Rowan, Margo
A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence-based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web-based platform and using hand-held devices and computers with Web access. Librarians were given technical training in evidence-based medicine, including how to summarise evidence. To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians. Evaluation included librarian interviews and a clinician exit satisfaction survey. Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important 'lessons learned' in the clinical use of hand-held devices, knowledge translation and training for clinicians and librarians. The Just-in-Time Librarian Consultation Service showed that it was possible to provide evidence-based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.
French, N. H.; Erickson, T.; McKenzie, D.
A major goal of the North American Carbon Program is to resolve uncertainties in understanding and managing the carbon cycle of North America. As carbon modeling tools become more comprehensive and spatially oriented, accurate datasets to spatially quantify carbon emissions from fire are needed, and these data resources need to be accessible to users for decision-making. Under a new NASA Carbon Cycle Science project, Drs. Nancy French and Tyler Erickson, of the Michigan Technological University, Michigan Tech Research Institute (MTRI), are teaming with specialists with the USDA Forest Service Fire and Environmental Research Applications (FERA) team to provide information for mapping fire-derived carbon emissions to users. The project focus includes development of a web-based system to provide spatially resolved fire emissions estimates for North America in a user-friendly environment. The web-based Decision Support System will be based on a variety of open source technologies. The Fuel Characteristic Classification System (FCCS) raster map of fuels and MODIS-derived burned area vector maps will be processed using the Geographic Data Abstraction Library (GDAL) and OGR Simple Features Library. Tabular and spatial project data will be stored in a PostgreSQL/PostGIS, a spatially enabled relational database server. The browser-based user interface will be created using the Django web page framework to allow user input for the decision support system. The OpenLayers mapping framework will be used to provide users with interactive maps within the browser. In addition, the data products will be made available in standard open data formats such as KML, to allow for easy integration into other spatial models and data systems.
Steinman, Lesley; Doescher, Mark; Keppel, Gina A.; Pak-Gorstein, Suzinne; Graham, Elinor; Haq, Aliya; Johnson, Donna B.; Spicer, Paul
The objective of this study was to explore Somali mothers’ beliefs and practices around infant feeding and education, towards developing a culturally informed infant nutrition curriculum for health providers. Four focus groups were conducted to explore: (1) beliefs about infant feeding, hunger and ideal weight; (2) feeding practices; (3) nutrition education approaches; and (4) provider/mother interactions. Thirty-seven Somali mother participants identified the following themes within these topics: (1) strategies for assessing hunger, satiety and when to feed; shared beliefs that plump babies are healthy, leading to worry about infant weight; (2) context of breast milk adequacy, difficulties breastfeeding and environmental and cultural barriers to breastfeeding, leading to nearly universal early supplementation with formula; (3) preferred education approaches include provider visits with interpreters, Somali language educational materials and advice from older, experienced family members; and (4) desired health provider skills include: listening, explaining, empathy, addressing specific concerns, repeating important information, offering preventive advice and sufficient visit time. This study presents knowledge about Somali beliefs and practices that can directly guide discussions with these families. Given that these infants appear on a trajectory towards obesity, influencing infant feeding practices in the Somali community is a good upstream approach to preventing obesity. These findings will underpin a new infant nutrition curriculum for health providers. PMID:20055931
Sanders, David; Lambert, Gareth; Graham-Jones, J; Tewkesbury, Giles; Onuh, S.; Ndzi, David; Ross, Carl
Design/methodology/approach – A pattern recognition system recognizes shipbuilding parts using shape contour information. Fourier-descriptors provide information and neural networks make decisions about shapes. Findings – The system has distinguished between various parts and programs have been generated so that the methods have proved to be valid approaches. Practical implications – The new system used a rudimentary curvature metric that measured Euclidean distance between two points in a wi...
Hegstad, L N; Zsohar, H
Does psychomotor practice affect the student's ability to perform venipuncture? This was the primary question in a study conducted to compare two versions of an instructional program--a no-practice version and a costly version that involved practice on the simulated arm. The initial study was composed of 40 (20 each group) Junior nursing students enrolled in a baccalaureate program. The instructional program for both groups included a handout of the task-by-task description of the procedure; a performance check list, a 10-minute color videotape demonstrating the entire process, and a live demonstration on a simulated arm. Each group took a post test which covered the cognitive aspects of the task. The practice group was able to practice on the simulated arm prior to evaluation on a live subject. The cognitive scores for both groups were near 90% and the performance scores above 80%. Since there was no significant difference between the groups the study was repeated with another group of students from the same school. This group differed slightly from the original group in that they had no experience with venipuncture. The second study contained 34 students and the cognitive scores were 91% for both groups and above 80% for the performance scores. The results indicated that the least costly version was equally effective and presents nursing education with an opportunity to evaluate skills teaching to determine the most effective, efficient and/or economical method to teach skills.
Olatosi, J O; Adekola, O O; Anaegbu, N C; Adesida, A; Rotimi, M K
Informed consent is an integral part of a surgical and anaesthetic procedure, failure to obtain it may result in grave medico-legal implications. To determine the attitudes of Nigerian anaesthetists to informed consent. The study population included physician anaesthetists who attended a continuous medical education programme in November 2015. The target was to cover over 50% of anaesthetists by convenience sampling. The responses to the questions were recorded and descriptive statistics were employed to calculate the various qualitative variables under study. Fifty-six respondents were analysed, the majority were in the age group 31-40 years (37.5%), consultants were 51.79%, and males constituted 75%. The respondents agreed that the main purposes of informed consent included a need to improve the doctor/patient relationship in 36(64.29%), inform the patient about the desired benefits of the procedure in 32(57.14%), provide the doctor with greater protection against medical litigation in 32(57.14%), and to respect the patient's right of autonomy in 30(53.57%). The general consensus among the respondents was that the anaesthetist should explain to the patient what the procedure entails 40(71.43%), what the procedure aims to achieve and additional procedures that are likely to be necessary to the patient 41(73.21%). It was also agreed that there should be disclosure of all major risks/complications with incidence >1/20 in 29(51.79%) respondents, incidence >1/100 in 20(35.71%), incidence >1/1000, and incidence >1/10000 were 17(30.36%). The respondents who agreed that it is necessary to take consent before performing surgery or anaesthesia on patients and explained the procedure to patients were 48(85.71%). We determined that informed consent was an integral part of a surgical procedure. which helped to improve doctor/patient relationship, respected the patient's right of autonomy and provided the surgeon and anaesthetists with greater protection against medical
Koenig, Kristi L; Shastry, Siri; Mzahim, Bandr; Almadhyan, Abdulmajeed; Burns, Michael J
Mumps is a highly contagious viral infection that became rare in most industrialized countries following the introduction of measles-mumps-rubella (MMR) vaccine in 1967. The disease, however, has been re-emerging with several outbreaks over the past decade. Many clinicians have never seen a case of mumps. To assist frontline healthcare providers with detecting potential cases and initiating critical actions, investigators modified the "Identify-Isolate-Inform" tool for mumps infection. The tool is applicable to regions with rare incidences or local outbreaks, especially seen in college students, as well as globally in areas where vaccination is less common. Mumps begins with a prodrome of low-grade fever, myalgias and malaise/anorexia, followed by development of nonsuppurative parotitis, which is the pathognomonic finding associated with acute mumps infection. Orchitis and meningitis are the two most common serious complications, with hearing loss and infertility occurring rarely. Providers should consider mumps in patients with exposure to a known case or international travel to endemic regions who present with consistent signs and symptoms. If mumps is suspected, healthcare providers must immediately implement standard and droplet precautions and notify the local health department and hospital infection control personnel.
Hamilton, Karen E Stc; Coates, Vivien; Kelly, Billy; Boore, Jennifer R P; Cundell, Jill H; Gracey, Jacquie; McFetridge, Brian; McGonigle, Mary; Sinclair, Marlene
To evaluate methods of performance assessment through an international literature review and a survey of current practice. Over the past two decades health care organizations have focussed on promoting high quality care in conjunction with retaining motivated staff. Cognisant of such initiatives, we sought to evaluate assessment methods for qualified staff according to their utility in the working environment. A systematic literature search was completed and each paper independently reviewed. All health care organizations in Northern Ireland submitted details of their performance assessments. Each was critically appraised using a utility index. Performance was not universally defined. A broad range of assessments were identified, each method had advantages and disadvantages. Although many lacked rigorous testing, areas of good practice were also noted. No single method is appropriate for assessing clinical performance. Rather, this study endorses proposals for a multi-method strategy to ensure that performance assessment demonstrates all attributes required for effective nursing and midwifery practice.
This study has demonstrated that although an information need could trigger off an information activity, the subsequent information processes could only be sustained by the value of information. The value of information is therefore the core category, while the moderation of constraints and interaction with sources for latent ...
Mortimer, Andrew J
Computer Weekly Professional Series: Information Structure Design for Databases: A Practical Guide to Data modeling focuses on practical data modeling covering business and information systems. The publication first offers information on data and information, business analysis, and entity relationship model basics. Discussions cover degree of relationship symbols, relationship rules, membership markers, types of information systems, data driven systems, cost and value of information, importance of data modeling, and quality of information. The book then takes a look at entity relationship mode
Association of provider opioid prescribing practices and the Centers for Medicare and Medicaid Services hierarchical condition category score: A retrospective examination of correlation between the volume of provider-prescribed opioid medications and provider panel complexity
Full Text Available Objective: Opioids are being prescribed at increasing rates in primary care practices, and among individual providers there is significant variability in opioid prescribing. Primary care practices also vary significantly in complexity of their patients, ranging from healthy patients to those with multiple comorbidities. Our objective was to examine individual primary care providers for an association between their opioid prescribing and the complexity/risk of their panel of patients (a panel of patients is a group of patients whose medical care is the responsibility of a specific healthcare provider or care team. Methods: We retrospectively examined 12 months of opioid prescription data from a primary care practice. We obtained counts of opioids prescribed by providers in the Mayo Clinic, Rochester, Minnesota primary care practice. For patients paneled (assigned to family medicine and internal medicine, we used the Centers for Medicare and Medicaid Services hierarchical condition category patient risk score as a measure of patient complexity. After adjusting the opioid counts for panel patient count (to get opioid counts per patient, we used linear regression analysis to determine the correlation between the hierarchical condition category risk and the amount of opioid prescribed by individual providers. Results: Among our combined 103 primary care providers, opioid unit counts prescribed per patient were highly correlated with the providers’ hierarchical condition category panel risk score (r2 = 0.54. After excluding three outliers, r2 was 0.74. With and without the outliers, the correlation was very significant (p 0.45 showed significant correlation with hierarchical condition category (r2 = 0.26; p = 0.001. Conclusion: When examining differences in primary care providers’ opioid prescribing practices, the Centers for Medicare and Medicaid Services endorsed risk score (the hierarchical condition category score can help
de Wet Carl
Full Text Available Abstract Background A significant minority of patients do not receive all the evidence-based care recommended for their conditions. Health care quality may be improved by reducing this observed variation. Composite measures offer a different patient-centred perspective on quality and are utilized in acute hospitals via the ‘care bundle’ concept as indicators of the reliability of specific (evidence-based care delivery tasks and improved outcomes. A care bundle consists of a number of time-specific interventions that should be delivered to every patient every time. We aimed to apply the care bundle concept to selected QOF data to measure the quality of evidence-based care provision. Methods Care bundles and components were selected from QOF indicators according to defined criteria. Five clinical conditions were suitable for care bundles: Secondary Prevention of Coronary Heart Disease (CHD, Stroke & Transient Ischaemic Attack (TIA, Chronic Kidney Disease (CKD, Chronic Obstructive Pulmonary Disease (COPD and Diabetes Mellitus (DM. Each bundle has 3-8 components. A retrospective audit was undertaken in a convenience sample of nine general medical practices in the West of Scotland. Collected data included delivery (or not of individual bundle components to all patients included on specific disease registers. Practice level and overall compliance with bundles and components were calculated in SPSS and expressed as a percentage. Results Nine practices (64.3% with a combined patient population of 56,948 were able to provide data in the format requested. Overall compliance with developed QOF-based care bundles (composite measures was as follows: CHD 64.0%, range 35.0-71.9%; Stroke/TIA 74.1%, range 51.6-82.8%; CKD 69.0%, range 64.0-81.4%; and COPD 82.0%, range 47.9-95.8%; and DM 58.4%, range 50.3-65.2%. Conclusions In this small study compliance with individual QOF-based care bundle components was high, but overall (‘all or nothing’ compliance was
Luo, Yunhan; Chen, Zhe; Li, Yan; Di, Hongwei; Li, Zhen; Bai, Chunhe; Tang, Jieyuan; Zhang, Jun; Yi, Xiao
The course of optoelectronic information science is a diverse science and technology with wide range of disciplines, intensive technology, and strong applicability. As a result, the practice teaching in undergraduate education occupies the strategic important position, which is a key link in the process of innovative talents cultivation of photoelectric information, plays a unique and irreplaceable role by any other teaching methods. In order to meet the requirements of national innovative talents of photoelectric information, the complete teaching reform strategy was put forward by combining with the higher education policy and development strategy of teaching and professional characteristics. The goal of the experimental teaching reform is to cultivate innovative talents and to construct the photoelectric information industry chain system of experimental teaching platform and cultivating creative personnel. The key clue is the photoelectric information surrounding photoelectric information, like "generation - modulation - transformation - detection - procession" which will be realized by resource integration and complementary among cross disciplines, and focusing on scientific research support for the teaching and the combination of professional knowledge and practical application. This teaching reform scheme presented in the paper will provide very good demonstration effect in the curriculum reform of other photoelectric information related courses.
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.
Carolina Luisa dos Santos Vieira
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.
Akcay Yasemin D
Full Text Available Abstract Background Recent findings suggest a role of oxidative stress in the pathogenesis of Behcet's disease (BD, but the utility of oxidative stress-associated assays in offering diagnostic information or in the monitoring of disease activity is largely unassessed. Objective and methods We aimed to measure oxidative and inflammatory markers, along with the markers of reactive nitrogen species, S-nitrosothiols and 3-nitrotyrosine, in BD patients (n = 100 and healthy volunteers (n = 50. These markers were evaluated in regard to their role in the pathogenesis of BD as well as their relation to clinical presentation, disease activity and duration. Results Median values for erythrocyte sedimentation rate (ESR, C-reactive protein, leukocyte count, and IL-18 levels, as well as myeloperoxidase (MPO activity, were statistically higher in the patient group compared to controls. Some inflammation markers (ESR, neutrophil and leukocyte counts were statistically higher (p 0.05 in all statistical comparisons, nor was there any difference in median levels of these oxidative stress markers in active disease versus disease remission. S-nitrosothiols and 3-nitrotyrosine were undetectable in BD plasma. Conclusions The application of oxidative stress-associated measures to BD blood samples offered no supplemental diagnostic or disease activity information to that provided by standard laboratory measures of inflammation. S-nitrosothiols and 3-nitrotyrosine appeared not to be markers for active BD; thus the search for biochemical markers that will indicate the active period should be continued with larger studies.
Shinkai, Soya; Nozaki, Tadasu; Maeshima, Kazuhiro; Togashi, Yuichi
The mammalian genome is organized into submegabase-sized chromatin domains (CDs) including topologically associating domains, which have been identified using chromosome conformation capture-based methods. Single-nucleosome imaging in living mammalian cells has revealed subdiffusively dynamic nucleosome movement. It is unclear how single nucleosomes within CDs fluctuate and how the CD structure reflects the nucleosome movement. Here, we present a polymer model wherein CDs are characterized by fractal dimensions and the nucleosome fibers fluctuate in a viscoelastic medium with memory. We analytically show that the mean-squared displacement (MSD) of nucleosome fluctuations within CDs is subdiffusive. The diffusion coefficient and the subdiffusive exponent depend on the structural information of CDs. This analytical result enabled us to extract information from the single-nucleosome imaging data for HeLa cells. Our observation that the MSD is lower at the nuclear periphery region than the interior region indicates that CDs in the heterochromatin-rich nuclear periphery region are more compact than those in the euchromatin-rich interior region with respect to the fractal dimensions as well as the size. Finally, we evaluated that the average size of CDs is in the range of 100-500 nm and that the relaxation time of nucleosome movement within CDs is a few seconds. Our results provide physical and dynamic insights into the genome architecture in living cells.
Liu, Xiao; Liu, Anfeng; Huang, Changqin
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%.
Arya, Bhawna; Glickstein, Julie S; Levasseur, Stéphanie M; Williams, Ismeé A
To determine whether pediatric cardiologists and parents of older children with congenital heart disease (CHD) share similar expectations regarding the education and counseling that should be provided to parents of children with CHD in both the prenatal and neonatal period. Consenting parents of older children with CHD (age >3 years) and cardiologists ranked the importance of education topics on a scale of 1 (unimportant) to 10 (very important). The rankings of parents and cardiologists were compared using Student's t-test. We had 38 cardiologists and 41 parents complete the questionnaire. There was a statistically significant difference in rankings between cardiologist and parents of children with CHD (PParents consistently ranked topics as more important than cardiologists with a mean difference in rank score of 0.85 ±0.3. In the prenatal period, the most significant differences between parents and cardiologists were noted for information related to the child's quality of life. For neonatal counseling, the most significant differences were noted for information regarding follow-up care and the parent's ability to describe the child's CHD to medical personnel. Parents of older children with CHD would prefer to receive more counseling and education in the prenatal and newborn period than cardiologists perceive is wanted. © 2012 Wiley Periodicals, Inc.
Griep, E.C.; Noordman, J.; Dulmen, S. van
WHAT IS KNOWN ON THE SUBJECT?: A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them. WHAT THIS PAPER ADDS
Griep, E.C.M.; Noordman, J.; Dulmen, A.M. van
WHAT IS KNOWN ON THE SUBJECT? A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them.
Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph
This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals' readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support…
Dinehart, Laura; Kenny, Maureen C.
This study sought to assess child abuse knowledge and reporting practices of a diverse sample of early care and education (ECE) practitioners. One hundred and thirty-seven practitioners in the state of Florida completed the "Early Childhood Educators Child Abuse Questionnaire." Results revealed that only a minority of participants have…
Khubchandani, Jagdish; Telljohann, Susan K.; Price, James H.; Dake, Joseph A.; Hendershot, Candace
Background: This study assessed the perceptions and practices of school nurses regarding adolescent dating violence (ADV). Methods: The membership list of the National Association of School Nurses was used to identify a national random cross-sectional sample of high school nurses in the United States (N?=?750). A valid and reliable survey…
DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn
Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…
Ysunza, Pablo Antonio; Bloom, David; Chaiyasate, Kongkrit; Rontal, Matthew; VanHulle, Rachel; Shaheen, Kenneth; Gibson, Donald
The state of the art for correcting velopharyngeal insufficiency (VPI) is a surgical procedure which is customized according to findings on imaging procedures: multiplanar videofluoroscopy (MPVF) and flexible videonasopharyngoscopy (FVNP). Recently, the use of MPVF has been challenged because of the potential risk of using ionizing radiation, especially in children. To study whether using a protocol for performing MPVF can effectively decrease radiation dose in patients with VPI while providing useful information for planning surgical correction of VPI in combination with FVNP. The methodology used for performing the imaging procedures is described as well as the effectiveness of the surgical procedure. Eighty - nine patients (Age range = 3-17 years; median = 5.5 years) with VPI resulting from multiple etiologies were studied. All patients underwent MPVF and FVNP for planning surgical correction of VPI. Radiation dosage data in each case was recorded. Forty of the 89 patients also completed a postoperative evaluation. Eleven out of the remaining 49 patients have not completed a postoperative evaluation and 38 patients are still pending surgical correction. Radiation dosage ranged from 1.00 to 8.75 miliSieverts (mSv); Mean = 2.88 mSv; SD = 1.575 mSv. Preoperative nasometry demonstrated mean nasalance ranging from 41%-95%; Mean = 72.30; SD = 4.54. Postoperatively mean nasalance was within normal limits in 36 (90%) out of 40 cases, ranging from 21% to 35%; Mean = 28.10; SD = 5.40. Nasal emission was eliminated postoperatively in all cases. MPVF provides useful information for planning the surgical procedure aimed at correcting VPI. The combination of MPVF and FVNP is a reliable procedure for assessing velopharyngeal closure and to surgically correcting VPI with a highly successful outcome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Gleyze, P; Coudane, H
Providing information to surgery patients is a form of health-care governed by clearly defined therapeutic and medicolegal rules, and in particular in France by the Act of March 4, 2002 and the Code of Good Practice. The patient's right to information is implemented in a face-to-face consultation, which should be fully codified, and in a specific clinical examination, followed by information regarding the affected organ, pathology, treatment options, possible surgery, and the preconditions, risks and results associated with the procedure. Information should be personalized and as complete as possible, communicating the state of knowledge as validated by scientific societies and medical institutions. State of the art technology (dedicated website, on-line information suites, etc.) is indispensable but needs to be mastered and to adhere to the guidelines of the Council of the National Order of Medicine. Information traceability, the retraction period and proof of content of the information are essential. A signed document delivered in an informative atmosphere optimizes the exercise. Patient information is an ethical and medicolegal obligation, but above all is the expression and demonstration of the health-care potential of the practitioner and our contribution to reducing the information gap, reinforcing the cement holding our society together. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Roberts, James R; Freeland, Katherine D; Kolasa, Maureen S; McElligott, James T; Darden, Paul M
Immunisation coverage of children by 19 months of age in US primary care practices is below the desired goal of 80%. In order to improve this rate, primary care providers must first understand the specific processes of immunisation delivery within their office settings. This paper aims to identify key components in identifying strategies for quality improvement (QI) of immunisation delivery. We surveyed a South Carolina Pediatric Practice Research Network (SCPPRN) representative for each of six paediatric practices. The surveys included questions regarding immunisation assessment, medical record keeping, opportunities for immunisation administration and prompting. Subsequently, research staff visited the participating practices to directly observe their immunisation delivery process and review patient charts in order to validate survey responses and identify areas for QI. Most survey responses were verified using direct observation of actual practice or chart review. However, observation of actual practice and chart review identified key areas for improvement of immunisation delivery. Although four practices responded that they prompted for needed immunisations at sick visits, only one did so. We also noted considerable variation among and within practices in terms of immunising with all indicated vaccines during sick visits. In addition, most practices had multiple immunisation forms and all administered immunisations were not always recorded on all forms, making it difficult to determine a child's immunisation status. For any QI procedure, including immunisation delivery, providers must first understand how the process within their practice actually occurs. Direct observation of immunisation processes and medical record review enhances survey responses in identifying areas for improvement. This study identified several opportunities that practices can use to improve immunisation delivery, particularly maintaining accurate and easy-to-locate immunisation records
... other information and granting immunity. 511.39 Section 511.39 Transportation Other Regulations Relating... testify or provide other information and granting immunity. (a) A party who desires the issuance of an order requiring a witness to testify or provide other information upon being granted immunity from...
Russell-Rose, Tony; Chamberlain, Jon
Healthcare information professionals play a key role in closing the knowledge gap between medical research and clinical practice. Their work involves meticulous searching of literature databases using complex search strategies that can consist of hundreds of keywords, operators, and ontology terms. This process is prone to error and can lead to inefficiency and bias if performed incorrectly. The aim of this study was to investigate the search behavior of healthcare information professionals, uncovering their needs, goals, and requirements for information retrieval systems. A survey was distributed to healthcare information professionals via professional association email discussion lists. It investigated the search tasks they undertake, their techniques for search strategy formulation, their approaches to evaluating search results, and their preferred functionality for searching library-style databases. The popular literature search system PubMed was then evaluated to determine the extent to which their needs were met. The 107 respondents indicated that their information retrieval process relied on the use of complex, repeatable, and transparent search strategies. On average it took 60 minutes to formulate a search strategy, with a search task taking 4 hours and consisting of 15 strategy lines. Respondents reviewed a median of 175 results per search task, far more than they would ideally like (100). The most desired features of a search system were merging search queries and combining search results. Healthcare information professionals routinely address some of the most challenging information retrieval problems of any profession. However, their needs are not fully supported by current literature search systems and there is demand for improved functionality, in particular regarding the development and management of search strategies.
Giannakopoulos, Christos; Kotroni, Vasso; Lagouvardos, Kostas; Korakaki, Evi; Hatzaki, Maria; Tenentes, Vassilis; Roussos, Anargyros; Karali, Anna; Goodess, Clare
In EU project CLIMRUN, there has been a continuous interaction with stakeholders and end-users to develop new and improved tools to extract useful and useable information tailored to the needs of specific sectors. In this work, we review the provision of climate information services required in the Mediterranean country of Greece where forest fires represent a major hazard. Intense terrain, sparsely vegetated with typical Mediterranean flora makes Greece a fire prone environment. That, in addition to the abandonment of rural lands and extreme weather conditions due to climate change the last few decades, constitutes an issue of an annual cycle of catastrophe from forest fires. An iterative and bottom-up (i.e. stakeholder led) approach for optimizing the two-way information transfer between climate experts and stakeholders has been adopted from the start of the project with a workshop in Athens helping to define the framework for the forest fires case study. The main objectives of this workshop were to better understand who the wildfires stakeholders are and what they need from climate services. After the first workshop three main categories of stakeholders were identified: short term fire planners, long term policy makers and education stakeholders. To address the needs of these stakeholders' categories the following actions were taken: 1. In collaboration with the forecasting team at the National Observatory of Athens, an application providing fire risk forecasts for the following 3 days (http://cirrus.meteo.noa.gr/forecast/bolam/index.htm) was developed, to address the needs of short term fire planners. 2. A web-based application providing long term fire risk and other fire related indices changes due to climate change (time horizon up to 2050 and up to 2100) was developed in collaboration with the Greek WWF office, to address the needs of long term fire policy makers (http://www.oikoskopio.gr/map/). 3. Finally, an educational tool was built in order to
Dévieux, Jessy G; Saxena, Anshul; Rosenberg, Rhonda; Klausner, Jeffrey D; Jean-Gilles, Michèle; Madhivanan, Purnima; Gaston, Stéphanie; Rubens, Muni; Theodore, Harry; Deschamps, Marie-Marcelle; Koenig, Serena P; Pape, Jean William
Haiti has the highest number of people living with HIV infection in the Caribbean/Latin America region. Medical male circumcision (MMC) has been recommended to help prevent the spread of HIV. We sought to assess knowledge, attitudes, practices and beliefs about MMC among a sample of health care providers in Haiti. A convenience sample of 153 health care providers at the GHESKIO Centers in Haiti responded to an exploratory survey that collected information on several topics relevant to health providers about MMC. Descriptive statistics were calculated for the responses and multivariable logistic regression was conducted to determine opinions of health care providers about the best age to perform MMC on males. Bayesian network analysis and sensitivity analysis were done to identify the minimum level of change required to increase the acceptability of performing MMC at age less than 1 year. The sample consisted of medical doctors (31.0%), nurses (49.0%), and other health care professionals (20.0%). Approximately 76% showed willingness to offer MMC services if they received training. Seventy-six percent believed that their male patients would accept circumcision, and 59% believed infancy was the best age for MMC. More than 90% of participants said that MMC would reduce STIs. Physicians and nurses who were willing to offer MMC if provided with adequate training were 2.5 (1.15-5.71) times as likely to choose the best age to perform MMC as less than one year. Finally, if the joint probability of choosing "the best age to perform MMC" as one year or older and having the mistaken belief that "MMC prevents HIV entirely" is reduced by 63% then the probability of finding that performing MMC at less than one year acceptable to health care providers is increased by 35%. Participants demonstrated high levels of knowledge and positive attitudes towards MMC. Although this study suggests that circumcision is acceptable among certain health providers in Haiti, studies with larger and
Doudenkova, Victoria; Bélisle Pipon, Jean-Christophe
Although there is consensus on the fact that ionizing radiation used in radiological examinations can affect health, the stochastic (random) nature of risk makes it difficult to anticipate and assess specific health implications for patients. The issue of radiation protection is peculiar as any dosage received in life is cumulative, the sensitivity to radiation is highly variable from one person to another, and between 20 % and 50 % of radiological examinations appear not to be necessary. In this context, one might reasonably assume that information and patient consent would play an important role in regulating radiological practice. However, there is to date no clear consensus regarding the nature and content of-or even need for-consent by patients exposed to ionizing radiation. While law and ethics support the same principles for respecting the dignity of the person (inviolability and integrity), in the context of radiology practice, they do not provide a consistent message to guide clinical decision-making. This article analyzes the issue of healthcare professionals' duty to inform and obtain patient consent for radiological examinations. Considering that both law and ethics have as one of their aims to protect vulnerable populations, it is important that they begin to give greater attention to issues raised by the use of ionizing radiation in medicine. While the situation in Canada serves as a backdrop for a reflective analysis of the problem, the conclusions are pertinent for professional practice in other jurisdictions because the principles underlying health law and jurisprudence are fairly general.
Dendrou, Calliope A; McVean, Gil; Fugger, Lars
Neuroinflammation is emerging as a central process in many neurological conditions, either as a causative factor or as a secondary response to nervous system insult. Understanding the causes and consequences of neuroinflammation could, therefore, provide insight that is needed to improve therapeutic interventions across many diseases. However, the complexity of the pathways involved necessitates the use of high-throughput approaches to extensively interrogate the process, and appropriate strategies to translate the data generated into clinical benefit. Use of 'big data' aims to generate, integrate and analyse large, heterogeneous datasets to provide in-depth insights into complex processes, and has the potential to unravel the complexities of neuroinflammation. Limitations in data analysis approaches currently prevent the full potential of big data being reached, but some aspects of big data are already yielding results. The implementation of 'omics' analyses in particular is becoming routine practice in biomedical research, and neuroimaging is producing large sets of complex data. In this Review, we evaluate the impact of the drive to collect and analyse big data on our understanding of neuroinflammation in disease. We describe the breadth of big data that are leading to an evolution in our understanding of this field, exemplify how these data are beginning to be of use in a clinical setting, and consider possible future directions.
Full Text Available Understanding knowledge work and supporting it with information systems (ISs are challenging tasks. Knowledge work has changed substantially recently and studies on how knowledge work is currently performed are scarce. Ethnography is the most suitable qualitative research method for studying knowledge work, yet too time-consuming, costly and unfocused for the fast changing IS domain. Moreover, results from qualitative studies need to be transformed into artefacts useful for IS requirements engineering and design. This paper proposes a procedure for collaborative ethnography to study knowledge work practices and inform IS requirements gathering and design illustrated with the case of a collaborative ethnographic study of seven organisations in four European countries performed in a large-scale international IS research and development project. The paper also critically discusses the procedure’s applicability and limitations.
Verneau, Fabio; Caracciolo, Francesco; Coppola, Adele; Lombardi, Pasquale
Food choice and consumption behaviour are influenced by many interacting factors. In this paper we present an empirical effort to enhance understanding of the neophobia-neophilia forces affecting food choice. Starting from the analysis of consumer preferences for some of the most familiar highly processed foods, namely fat-reduced, functional (enriched drinks and yogurt) and ready-to-eat frozen food, our study investigates the role of traditional demographic variables vs attitudes to new food technologies in predicting the consumption behaviour of a sample of Italians buying such products. Consumer attitudes toward food technologies were collected by means of the Food Technology Neophobia Scale (FTNS). Moreover, this paper explicitly analyses the value of the information provided by the FTNS. Underlying the research is the hypothesis that the FTNS may contribute to provide a comprehensive picture of the driving forces behind consumers' behavioural responses towards processed foods which are the end-result of mature technologies. The four FTNS components, once measured and used independently, help clarify the influence on food choices of each neophobia-neophilia force (risk perception and novelty seeking, media influence, own health and environmental concerns) into a single, comprehensive framework. Copyright © 2013 Elsevier Ltd. All rights reserved.
Katz, Mira L; Broder-Oldach, Ben; Fisher, James L; King, Justin; Eubanks, Kathy; Fleming, Kelly; Paskett, Electra D
Colorectal cancer (CRC) screening rates remain low among low-income minority populations. To evaluate informed decision making (IDM) elements about CRC screening among low-income minority patients. Observational data were collected as part of a patient-level randomized controlled trial to improve CRC screening rates. Medical visits (November 2007 to May 2010) were audio-taped and coded for IDM elements about CRC screening. Near the end of the study one provider refused recording of patients' visits (33 of 270 patients). Among all patients in the trial, agreement to be audio taped was 43.5 % (103/237). Evaluable patient (n = 100) visits were assessed for CRC screening discussion occurrence, IDM elements, and who initiated discussion of each IDM element. Patients were African American (72.2 %), female (63.7 %), with annual household incomes IDM elements was five; however, only two visits included five elements. The most common IDM element discussed in addition to the nature of the decision was the assessment of the patient's understanding in 16 (33.3 %) of the visits that included a CRC discussion. A patient activation intervention initiated CRC screening discussions with health care providers; however, limited IDM occurred about CRC screening during medical visits of minority and low-income patients.
Kaufman, Sanda; Ozawa, Connie P; Shmueli, Deborah F
Evaluating participatory decision processes serves two key purposes: validating the usefulness of specific interventions for stakeholders, interveners and funders of conflict management processes, and improving practice. However, evaluation design remains challenging, partly because when attempting to serve both purposes we may end up serving neither well. In fact, the better we respond to one, the less we may satisfy the other. Evaluations tend to focus on endogenous factors (e.g., stakeholder selection, BATNAs, mutually beneficial tradeoffs, quality of the intervention, etc.), because we believe that the success of participatory decision processes hinges on them, and they also seem to lend themselves to caeteris paribus statistical comparisons across cases. We argue that context matters too and that contextual differences among specific cases are meaningful enough to undermine conclusions derived solely from comparisons of process-endogenous factors implicitly rooted in the caeteris paribus assumption. We illustrate this argument with an environmental mediation case. We compare data collected about it through surveys geared toward comparability across cases to information elicited through in-depth interviews geared toward case specifics. The surveys, designed by the U.S. Institute of Environmental Conflict Resolution, feed a database of environmental conflicts that can help make the (statistical) case for intervention in environmental conflict management. Our interviews elicit case details - including context - that enable interveners to link context specifics and intervention actions to outcomes. We argue that neither approach can "serve both masters." Copyright © 2013 Elsevier Ltd. All rights reserved.
Hall, Angela; Palmer, Emma
The Nuffield Foundation's Practical Work for Learning project takes the position that practical work is not a pedagogic approach in its own right, but that its affordances for learning depend on how successfully other pedagogies are applied to practical lessons. The design process used in the project is made explicit, illustrating…
... and information in languages other than English? 37.35 Section 37.35 Labor Office of the Secretary of... Communication § 37.35 What are a recipient's responsibilities to provide services and information in languages... services or information in a language other than English in order to be effectively informed about, or able...
Conclusions We have shown that in Scotland there is a high level of testing and recording of all the important information regarding patients with recorded CHD, irrespective of whether practices have fully electronic records, paper-based records, or a mixture of the two. If practices have fully electronic patient records, the information can be extracted easily, but unless there is a standard template, the information can only be viewed in isolation and is of little value for comparative purposes.
Tan, Edwin C K; Stewart, Kay; Elliott, Rohan A; George, Johnson
Integration of pharmacists into primary care general practice clinics has the potential to improve interdisciplinary teamwork and patient care; however this practice is not widespread. The aim of this study was to review the effectiveness of clinical pharmacist services delivered in primary care general practice clinics. A systematic review of English language randomized controlled trials cited in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and International Pharmaceutical Abstracts was conducted. Studies were included if pharmacists had a regular and ongoing relationship with the clinic; delivered an intervention aimed at optimizing prescribing for, and/or medication use by, clinic patients; and were physically present within the clinic for all or part of the intervention, or for communication with staff. The search generated 1484 articles. After removal of duplicates and screening of titles and abstracts against inclusion criteria, 131 articles remained. A total of 38 studies were included in the review and assessed for quality. Seventeen studies had common endpoints (blood pressure, glycosylated hemoglobin, cholesterol and/or Framingham risk score) and were included in meta-analyses. Twenty-nine of the 38 studies recruited patients with specific medical conditions, most commonly cardiovascular disease (15 studies) and/or diabetes (9 studies). The remaining 9 studies recruited patients at general risk of medication misadventure. Pharmacist interventions usually involved medication review (86.8%), with or without other activities delivered collaboratively with the general practitioner (family physician). Positive effects on primary outcomes related to medication use or clinical outcomes were reported in 19 studies, mixed effects in six studies, and no effect in 13 studies. The results of meta-analyses favored the pharmacist intervention, with significant improvements in blood pressure, glycosylated hemoglobin, cholesterol and Framingham
This article describes the ways in which practice development can aid Nurse Managers to enhance both efficiency and effectiveness, focussing particularly on the care of older people with delerium and dementia. Practitioners caring for this group of patients in acute general hospitals need specialist skills, particularly skills in working with the unusual ('challenging') behaviours that these patients often exhibit. These skills are rarely present at the point of registration but practice development techniques can facilitate the acquisition of appropriate skills with resultant benefits for both patients and organization. The study contains an outline of the ways in which a practice development approach can be delivered and appraised: the theories are outlined, strategies for delivery of the techniques are described and methods of evaluation are suggested. These theories and techniques are being applied in a project in Portsmouth called 'Rise to the Challenge', which has the specific aim of improving the care of people with delerium and dementia in an acute hospital setting. This project is currently running and will be evaluated in the summer of 2008.
Yeo, Theresa Pluth; Phillips, Janice; Delengowski, Anne; Griffiths, Margaret; Purnell, Larry
More than 37 million persons or 12.4% of the U.S. population are older than 65 years. These numbers are expected to reach 71.5 million (20% of the population) by 2030. This older population is becoming more racially and ethnically diverse as the overall minority and culturally diverse populations increase. Although the incidence and mortality rates from several major cancers have declined due to advances in cancer care, these advances have lagged among the underserved and more vulnerable racially and culturally diverse populations. Moreover, the disparity between the gender and the racial mix of nurses and the overall population continues to widen. Thus, a growing need for professional nurses and advanced practice nurses with formal educational preparation in all areas of oncology nursing exists. This article (a) highlights significant cancer disparities among diverse populations, (b) describes how cultural belief systems influence cancer care and decision making, and (c) explicates the need to prepare advanced practice nurses for careers that include cancer care of diverse and vulnerable populations through formal oncology educational programs. The "Top 10" reasons for becoming an advanced practice nurse specializing in the oncologic care of patients from diverse and underserved populations are presented. Copyright © 2011 Elsevier Inc. All rights reserved.
Houle, Sherilyn; MacKeigan, Linda
As the population ages, and individuals desire to remain in their homes as long as possible, the need for in-home care is expected to increase. However, pharmacists have rarely been included in studies of in-home care, and little is known about the prevalence or effectiveness of pharmacists' home-based services in Canada. To identify pharmacy practices in Canada that regularly provide in-home patient care and to identify specific services provided, remuneration obtained, and barriers and facilitators influencing the provision of home-based care. A link to a web-based survey was posted in e-newsletters of provincial, territorial, and national pharmacy associations in Canada. In addition, pharmacists known to the researchers as providing in-home clinical services were contacted directly. The survey was open from October to December 2015. Practices or organizations that performed at least one home visit per week for clinical purposes, with documentation of the services provided, were eligible to participate. One response per practice or organization was allowed. Seventeen practices meeting the inclusion criteria were identified, representing community, hospital, and clinic settings. Home visits were most commonly performed for individuals with complex medication regimens or nonadherence to medication therapy. The most common services were conducting medication reconciliation and reviews and counselling patients about medication adherence. No practices or organizations billed patients for these services, yet lack of remuneration was an important barrier identified by many respondents. Although 12 (71%) of the respondents collected data for evaluative purposes, collection of clinical or health system outcome data was rare. Few Canadian pharmacy practices that provide in-home patient care at least once a week could be identified. Data collection suitable to establish an evidence base for this service was infrequently performed by practices and organizations providing
Chambers, Naomi; Sheaff, Rod; Mahon, Ann; Byng, Richard; Mannion, Russell; Charles, Nigel; Exworthy, Mark; Llewellyn, Sue
The direction of health service policy in England is for more diversification in the design, commissioning and provision of health care services. The case study which is the subject of this paper was selected specifically because of the partnering with a private sector organisation to manage whole system redesign of primary care and to support the commissioning of services for people with long term conditions at risk of unplanned hospital admissions and associated service provision activities. The case study forms part of a larger Department of Health funded project on the practice of commissioning which aims to find the best means of achieving a balance between monitoring and control on the one hand, and flexibility and innovation on the other, and to find out what modes of commissioning are most effective in different circumstances and for different services. A single case study method was adopted to explore multiple perspectives of the complexities and uniqueness of a public-private partnership referred to as the "Livewell project". 10 single depth interviews were carried out with key informants across the GP practices, the PCT and the private provider involved in the initiative. The main themes arising from single depth interviews with the case study participants include a particular understanding about the concept of commissioning in the context of primary care, ambitions for primary care redesign, the importance of key roles and strong relationships, issues around the adoption and spread of innovation, and the impact of the current changes to commissioning arrangements. The findings identified a close and high trust relationship between GPs (the commissioners) and the private commissioning support and provider firm. The antecedents to the contract for the project being signed indicated the importance of leveraging external contacts and influence (resource dependency theory). The study has surfaced issues around innovation adoption in the healthcare context
The aim of this qualitative study was to analyse counselling with regard to prenatal screening in midwifery consultations in the Netherlands where a national prenatal screening programme has only existed since 2007, after years of social and political debates. The methodology is based on in situ observations of 25 counselling consultations in four midwifery practices in two main cities in the Netherlands. The results of this study show that, since midwives are obliged to offer information on Down syndrome screening to all pregnant women (2007), they have to deal with the communication of medical screening information using biostatistical concepts to explain risks, calculations, probabilities and chromosomal anomalies. In order to avoid the risk of medicalization of their consultation, midwives develop strategies that allow them to integrate this new biomedical discourse while maintaining their low medicalized approach of midwife-led care. One of their main strategies is to switch from 'alarming' biomedical messages to 'reassuring words' in order to manage the anxiety induced by the information and to keep the control over their low medicalized consultation. They also tend to distance themselves from the obligation to talk about screening. The way midwives handle these counselling consultations allows them to respect their obligation to propose information, and to remain faithful to their struggle to protect the natural process of pregnancy as well as their professional autonomy. © The Author(s) 2014.
Powell, Arfon G M T; Paterson-Brown, Simon; Drummond, Gordon B
Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used. We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics. The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as "too esoteric", the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate. Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and "fitness for purpose", and avoid omission of vital knowledge.
Granderson, Jessica; Lin, Guanjing; Piette, Mary Ann
Energy information systems are the web-based software, data acquisition hardware, and communication systems used to store, analyze, and display building energy data. They often include analysis methods such as baselining, benchmarking, load profiling, and energy anomaly detection. This report documents a large-scale assessment of energy information system (EIS) uses, costs, and energy benefits, based on a series of focused case study investigations that are synthesized into generalizable findings. The overall objective is to provide organizational decision makers with the information they need to make informed choices as to whether or not to invest in an EIS--a promising technology that can enable up to 20 percent site energy savings, quick payback, and persistent low-energy performance when implemented as part of best-practice energy management programs.
Liu, Xiao; Liu, Anfeng; Huang, Changqin
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%. PMID:28085097
Full Text Available Nowadays, economic development is characterized by increasing of contradictions between ecological and economic systems. As a result, the necessity of unity achievement is growing in the existence of ecological and economic values as one of the main conditions of the concept of sustainable development. For this purpose it is important to implement and create an ecological and economic management system at the enterprise to ensure ecological and economic efficiency. There is a need to improve accounting as a system of measuring economic phenomena and processes for a high level of ecological and economic management. The research is aimed at the development of theoretical and methodological approaches to accounting management for ecological quality of products based on the definition of the essence of the concept as an object of management under conditions of sustainable development, identification and systematization of factors of increasing the ecological quality of products and their management features, accounting identification of costs for ecological quality of products. According to the results of the research, it is established that the ecological quality of products is a combination of properties, which ensure excellent performance of assigned functions and the presence in products of those properties and characteristics that promote the maximum satisfaction of consumer needs and inquiries. The existing order of organization of accounting in Ukraine does not provide the provision of necessary information for the management of the ecological quality of products. The proposed directions of development of elements of the expense accounting method for the ecological quality of products will promote the expansion of information support for the adoption of substantiated and effective management decisions regarding the activities of business entities in accordance with the provisions of the concept of sustainable development.
Full Text Available 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%.
Epstein, R H; Dexter, F
Perioperative interruptions generated electronically from anaesthesia information management systems (AIMS) can provide useful feedback, but may adversely affect task performance if distractions occur at inopportune moments. Ideally such interruptions would occur only at times when their impact would be minimal. In this study of AIMS data, we evaluated the times of comments, drugs, fluids and periodic assessments (e.g. electrocardiogram diagnosis and train-of-four) to develop recommendations for the timing of interruptions during the intraoperative period. The 39,707 cases studied were divided into intervals between: 1) enter operating room; 2) induction; 3) intubation; 4) surgical incision; and 5) end surgery. Five-minute intervals of no documentation were determined for each case. The offsets from the start of each interval when >50% of ongoing cases had completed initial documentation were calculated (MIN50). The primary endpoint for each interval was the percentage of all cases still ongoing at MIN50. Results were that the intervals from entering the operating room to induction and from induction to intubation were unsuitable for interruptions confirming prior observational studies of anaesthesia workload. At least 13 minutes after surgical incision was the most suitable time for interruptions with 92% of cases still ongoing. Timing was minimally affected by the type of anaesthesia, surgical facility, surgical service, prone positioning or scheduled case duration. The implication of our results is that for mediated interruptions, waiting at least 13 minutes after the start of surgery is appropriate. Although we used AIMS data, operating room information system data is also suitable.
Full Text Available This paper contributes to the debate on the role of the informal sector in solid waste management by examining the effectiveness of informal sector solid waste management practices in transforming waste into nonwaste in the city of Gweru in Zimbabwe. The study focused on 589 informal enterprises that were surveys using questionnaire interviews and focus group discussions with key informants. Analysis of solid waste management in the informal sector of Gweru has revealed that large amounts of waste are generated indicating poor material efficiency in the enterprises, especially in food market areas where huge amounts of biodegradable material and vegetable wastes are generated and disposed of haphazardly. Analysis of the key factors that include solid waste generation rates, collection frequencies and transportation, waste minimisation, and reduction practices showed that the current waste management system is unsustainable in the long run. The municipality of Gweru needs to provide more resources for financing, training, and manpower to enable effective provision of an environmentally friendly solid waste management system in the city, including the informal sector.
Stark, Lauren M; Power, Michael L; Turrentine, Mark; Samelson, Renee; Siddiqui, Maryam M; Paglia, Michael J; Strassberg, Emmie R; Kelly, Elizabeth; Murtough, Katie L; Schulkin, Jay
...% of patients reported receiving a recommendation. Age, education, a medical provider's recommendation, and educational materials were found to positively influence patient beliefs about the influenza...
Gendron, Marie-Pierre; Martin, Brigitte; Oraichi, Driss; Bérard, Anick
Medication use during pregnancy and lactation is prevalent. However, current knowledge of the risks and benefits of medication use during pregnancy and lactation is incomplete as the best available evidence has been obtained from cohort studies of inadvertent exposures and registries. This situation may partly explain health care providers' (HCP) risk perceptions and thus the increasing number of calls to Teratogen Information Services (TIS). The objectives of this study were (1) to identify the medication classes for which HCP are seeking counseling from the IMAGe center, a Quebec TIS; (2) to identify the medical conditions for which medication classes were used during pregnancy and lactation; (3) to identify and quantify predictors of medication information requests during pregnancy and lactation. A retrospective analysis of data was conducted within the population served by the IMAGe center, a TIS based at CHU Ste-Justine in Montreal, Quebec, Canada, that serves the French population of Canada. To be included, calls had to be received between January 1, 2004 and April 30, 2007, and the subject of the call had to be directly associated with the exposure, or not, of a pregnant or breastfeeding woman to medication. Multivariate generalized estimating equation (GEE) regression models were performed to identify the predictors of medication requests. A total of 11, 076 requests regarding medication exposure during pregnancy, 12 055 requests regarding pregnant women before the exposure took place, and 13, 364 requests regarding lactation were included for analyses. Pregnant women were most frequently exposed to antidepressants (17.3), antibiotics (6.3%), and benzodiazepines (5.3%). Prior to drug exposure, the most frequent inquiries by HCP were on antibiotics (11.0%), anti-inflammatory drugs (6.0%), and antiemetics (5.1%). Inquiries concerning lactating women most frequently requested information on the drug classes of antidepressants (10.8%), antibiotics (9.1%), and
Lee, Eun Young; Lee, Chang-Keun; Lee, Tae Hoon; Chung, Son Mi; Kim, Seong Ho; Cho, You Sook; Yoo, Bin; Moon, Hee-Bom
To investigate whether the anti-beta(2)-glycoprotein I (anti-beta(2)GPI) antibody may provide additional information in patients with thrombosis in conjunction with the lupus anticoagulant (LAC) or anticardiolipin (aCL) antibody. We selected 235 patients whose plasma were tested for the presence of all three antiphospholipid (aPL) antibodies (LAC, aCL, and anti-beta(2)GPI) and were positive for at least one aPL antibody from January 2000 to December 2001. The LAC test was performed using dilute activated thromboplastin time reagent (dAPTT) and dilute Russell viper venom time reagent (dRVVT). ACL (IgG/IgM) and anti-beta(2)GPI (IgG/IgM) were detected by enzyme-linked immunosorbent assay (ELISA). Clinical data were collected and analysed in all patients with aPL antibody. Of the 235 patients with aPL, thrombosis was detected in 76 patients (28.0%). Of the 76 patients with thrombosis, 29 were positive for LAC, 9 for aCL, 7 for anti-beta(2)GPI, 3 for LAC+aCL, 9 for aCL+anti-beta(2)GPI, 11 for LAC+anti-beta(2)GPI, and 8 for LAC+aCL+anti-beta(2)GPI. The rate of thrombosis was significantly different (p=0.01) among single positive patients (45/163, 27.6%), double positive patients (23/60, 38.3%), and triple positive patients (8/12, 66.7%). In single positive patients, the rate of thrombosis was highest in LAC positive patients (29/85, 34.1%). In double positive patients, the LAC+anti-beta(2)GPI positive group (11/24, 45.8%) and aCL+anti-beta(2)GPI positive group (9/22, 40.9%) had higher rates of thrombosis than the LAC+aCL positive group (3/14, 21.4%). Single positivity for anti-beta(2)GPI explained 9.2% of thrombotic events in the absence of LAC or aCL. Double or triple positivity for aPLs were associated with a higher rate of thrombosis than single positivity for aPL. Our results suggest that anti-beta(2)GPI provides additional information in patients with thrombosis in conjunction with LAC or aCL.
Gharpure, Kunda; Thawani, Vijay; Sontakke, Smita; Chaudhari, Kiran; Bankar, Mangesh; Diwe, Rajendra
There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. The final year students of Bachelor of Pharmacy (B. Pharm) from four colleges of Nagpur were enrolled for the study after informed consent. Their base knowledge was assessed through a written test which comprised of 27 objective questions related to rational pharmacy practice. This was followed by a series of seven articles on rational medicine use, published in leading local English news daily. The participants were reminded to read them on the day of publication of each article. As a backup, the articles were displayed on the notice board of respective colleges. Second intervention was a half day interactive session where series of six lectures were delivered to the participants on the right and wrong approaches in pharmacy practice. Posters about the do's and dont's of rational pharmacy practice were also displayed at the venue. The session was followed by a repeat test using the same pre-test to assess the change. Pre and post intervention data was compared using Fisher's Exact test. It was observed that the intervention did bring about a positive change in the attitude and knowledge of the final year Pharmacy students about rational pharmacy practice. The role of a pharmacist in health care provision is usually overlooked in India. Hence there is strong need for reinforcement in final year B. Pharm when most of the students go in for community service. Such interventions will be helpful in bringing about a positive change towards rational practice of pharmacy. This study showed that a properly timed and meticulously implemented intervention brings
Full Text Available There is growing appreciation among health and social care providers, especially those working in community-based programs with women or young people with substance use problems and/or who have experienced violence, maltreatment, or trauma, that a high number of their program participants may have been prenatally exposed to alcohol or have fetal alcohol spectrum disorder (FASD. This article provides a conceptualization of the key components of an FASD-informed approach. Drawing on the emerging literature and the author's research identifying the support needs and promising approaches in working with women, young adults, and adults with FASD, as well as evaluations of FASD-related programs, the article discusses what an FASD-informed approach is, why it is centrally important in working with women, adults, and young people who may have FASD, underlying principles of an FASD-informed approach, and examples of FASD-informed adaptations to practice, programming, and the physical environment. In this discussion, the benefits of using an FASD-informed approach for service providers and women living with FASD and their families, as well as conceptualization of FASD-informed policy and systems are highlighted.
Ashdown, Heather; Jalloh, Chelsea; Wylie, John L
Newcomer and street-involved youth provided their perspective on the design and content of a sexual education workshop. Following the workshop, focus group discussions were held with 80 youth from four youth-serving agencies. Youth expressed increased levels of confidence and empowerment, consistent with recent criticism that a focus on specific behaviors as intervention outcome measures may miss important psychosocial changes in participants. Some youth views on cultural adaptation of workshops were not consistent with current views expressed by some adult educators, highlighting the need to ensure a youth perspective is captured during intervention development. Finally, the dichotomous views that youth expressed regarding workshop activities emphasizes a research gap related to how best to adapt interventions to different cognitive capacities, literacy levels, and learning styles. Information of this kind is relevant in terms of knowledge translation from youth to program planners and educators. © The Author(s) 2015.
Tang, Longmei; Wu, Shangchun; Li, Jiong
/doctor' [1.99 (1.01,3.92), 2.32 (1.22,4.40) and 2.34 (1.06,5.17), respectively]. Conclusions: The majority of providers could provide PAFP counselling to women undergone an abortion, but some of them had insufficient time to make it available. Education, knowledge about fertility and reproductive health...
Sudhinaraset, May; Briegleb, Christina; Aung, Moe; Khin, Hnin Su Su; Aung, Tin
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
McCarren M; Twedt EL; Mansuri FM; Nelson PR; Peek BT
Madeline McCarren,1 Elaine L Twedt,1 Faizmohamed M Mansuri,2 Philip R Nelson,3 Brian T Peek3 1Pharmacy Benefits Management Services, Department of Veterans Affairs, Hines, IL, 2Wilkes-Barre VA Medical Center, Wilkes-Barre, PA, 3Charles George VA Medical Center, Asheville, NC, USA Purpose: Minimal-risk randomized trials that can be embedded in practice could facilitate learning health-care systems. A cluster-randomized design was proposed to compare treatment strategies by assigning clusters...
Healthcare organisations have a responsibility for ensuring that the governance of workplace settings creates a culture that supports good professional practice. Encouraging such a culture needs to start from an understanding of the factors that make it difficult for health professionals to raise issues of concern in relation to patient safety. The focus of this study is to determine whether a customised education intervention, developed as part of the study, with interns and senior house officers (SHOs) can imbue a culture of medical professionalism in relation to patient safety and support junior doctors to raise issues of concern, while shaping a culture of responsiveness and learning.
Koenig, Christopher J; Maguen, Shira; Daley, Aaron; Cohen, Greg; Seal, Karen H
Handoffs are communication processes that enact the transfer of responsibility between providers across clinical settings. Prior research on handoff communication has focused on inpatient settings between provider teams and has emphasized patient safety. This study examines handoff communication within multidisciplinary provider teams in two outpatient settings. To conduct an exploratory study that describes handoff communication among multidisciplinary providers, to develop a theory-driven descriptive framework for outpatient handoffs, and to evaluate the strengths and weaknesses of different handoff types. Qualitative, in-depth, semi-structured interviews with 31 primary care, mental health, and social work providers in two Department of Veterans Affairs (VA) Medical Center outpatient clinics. Audio-recorded interviews were transcribed and analyzed using Grounded Practical Theory to develop a theoretical model of and a descriptive framework for handoff communication among multidisciplinary providers. Multidisciplinary providers reported that handoff decisions across settings were made spontaneously and without clear guidelines. Two situated values, clinic efficiency and patient-centeredness, shaped multidisciplinary providers' handoff decisions. Providers reported three handoff techniques along a continuum: the electronic handoff, which was the most clinically efficient; the provider-to-provider handoff, which balanced clinic efficiency and patient-centeredness; and the collaborative handoff, which was the most patient-centered. Providers described handoff choice as a practical response to manage constituent features of clinic efficiency (time, space, medium of communication) and patient-centeredness (information continuity, management continuity, relational continuity, and social interaction). We present a theoretical and descriptive framework to help providers evaluate differential handoff use, reflect on situated values guiding clinic communication, and guide
... Hypotheses.There is currently a sound theoretical foundation for the evaluation of informative hypotheses using Bayes factors, p-values and the generalized order restricted information criterion...
Poulos, Christopher J; Gazibarich, Boris M; Eagar, Kathy
Providing information technology solutions to clinicians to support their work practices benefits clinicians, administrators and patients. We present our 8-year experience with an inexpensive information management system which provides clinical and business process support for clinicians and bed managers. The system has been used by an area rehabilitation and aged care service to manage inpatient consultations and patient flow across nine hospitals. Performance monitoring of the time from referral to consultation, the number, type and outcome of consultations, and the time taken to access a rehabilitation or subacute bed is also provided. Read-only access to the system for clinicians and bed managers outside the rehabilitation and aged care service allows greater transparency.
Jensen, Jørgen Dejgård; Ronit, Karsten
Information asymmetries between producers and consumers exist with respect to nutritional characteristics of foods and beverages. This paper aims to analyze firms’ methods to supply nutritional information, focusing on three specific food industries: breakfast cereals, snacks and soft drinks...
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 ...
Nail-Chiwetalu, Barbara; Bernstein Ratner, Nan
Objectives: This study assessed the information-seeking practices and needs of speech-language pathologists (SLPs). Improved understanding of these needs can inform librarians and educators to better prepare students in principles and methods of evidence-based practice (EBP) and, through continuing education (CE), promote the integration of EBP into clinical practice of SLPs.
Yamamoto, Tomoka; Yuda, Tomoko; Arimoto, Akie; Sejima, Ei; Kawahara, Yoshihiro; Washiyama, Atsushi; Futagami, Koujiro
Drug information (DI) services is an essential resource for pharmacists to provide counseling to patients and guide appropriate medication use. We devised a DI practical training course that incorporated an inquiry-based practical training program and evaluated its effectiveness. A total of 91 fifth-year students in Pharmaceutical Sciences at Fukuoka University took part in the following DI sessions based on specific behavioral objectives (SBOs) for DI in the Model Core Curriculum for Practical Training: inquiry practice, simulated pharmacy and therapeutics committee, DI newsletter, use of emergency and safety information, off-label use in clinical trials, PRE-AVOID (Be prepared to avoid the adverse drug reactions), adverse drug reactions, and small group discussions about drug poisoning. The level of understanding of the SBOs for DI training was >4.2 for each item assessed, and the level of satisfaction for each practice was >3.9. This DI practical training successfully facilitated students' ability to provide DI. The number of students interested in DI services significantly increased (p<0.01). After the DI practical training, many students made statements such as "I realized that DI services is a very important job" and "I feel that pharmacists have much to contribute to DI services by evaluating the most appropriate information from a pharmacist's standpoint." It appears that students recognized the pharmacist's role and importance of DI services in clinical practice through the DI training. These results suggest that this DI practical training program was effective.
Siengsukon, Catherine F; Al-Dughmi, Mayis; Stevens, Suzanne
Sleep disturbances occur in one third of the US population, and the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control has deemed insufficient sleep to be a public health problem. Knowledge about sleep and skills to screen sleep disorders and to promote sleep health have been recommended for physical therapists. Furthermore, in survey studies, physical therapists overwhelmingly agree that sleep is important for health and poor sleep impairs function. Sleep is critical for the proper functioning of the body, including immune function, tissue healing, pain modulation, cardiovascular health, cognitive function, and learning and memory. Sleep disruptions occur across the life span and in individuals with various conditions that are typically treated by physical therapists. Therefore, the purpose of this perspective paper is to (1) discuss the relevance of sleep to physical therapist practice, (2) recommend tools to screen for the 3 most common sleep disorders, and (3) provide suggestions for how therapists can integrate sleep health in prevention, health promotion, and wellness interventions. © 2017 American Physical Therapy Association.
The economic losses associated with flooding are huge and rising. As a result, there is increasing attention for strategic flood risk assessments at the global scale. In response, the last few years have seen a large growth in the number of global flood models. At the same time, users and practitioners require flood risk information in a format that is easy to use, understandable, transparent, and actionable. In response, we have developed the Aqueduct Global Flood Analyzer (wri.org/floods). The Analyzer is a free, online, easy to use, tool for assessing global river flood risk at the scale of countries, states, and river basins, using data generated by the state of the art GLOFRIS global flood risk model. The Analyzer allows users to assess flood risk on-the-fly in terms of expected annual urban damage, and expected annual population and GDP affected by floods. Analyses can be carried out for current conditions and under future scenarios of climate change and socioeconomic development. We will demonstrate the tool, and discuss several of its applications in practice. In the past 15 months, the tool has been visited and used by more than 12,000 unique users from almost every country, including many users from the World Bank, Pacific Disaster Center, Red Cross Climate Centre, as well as many journalists from major international news outlets. Use cases will be presented from these user communities. We will also present ongoing research to improve the user functionality of the tool in the coming year. This includes the inclusion of coastal flood risk, assessing the costs and benefits of adaptation, and assessing the impacts of land subsidence and urban extension on risk.
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.
Haering, Ed; Plotkin, Ken
Supersonic aircraft generate shock waves that move outward and extend to the ground. As a cone of pressurized air spreads across the landscape along the flight path, it creates a continuou