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.
Bødker, Malene; Juul, Annegrete
Purpose – Telecare promises to deliver healthcare services more efficiently while, at the same time, improving the quality of care. The purpose of this paper is to challenge these promises by analysing the implications of introducing telecare in the rehabilitation of patients suffering from chron...
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
Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S [UC Davis Cancer Center, Sacramento, CA (United States)
Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream
Alhih, Mohammed; Ossiannilsson, Ebba; Berigel, Muhammet
Interaction plays a significant role to foster usability and quality in online education. It is one of the quality standard to reveal the evidence of practice in online distance education models. This research study aims to evaluate levels of interaction in the practices of distance education centres. It is aimed to provide online distance…
Shea Lee, Tan; Ariff, Mohd Shoki Md; Zakuan, Norhayati; Sulaiman, Zuraidah; Zameri Mat Saman, Muhamad
The increase adoption of Internet among young users in Malaysia provides high prospect for online seller. Young users aged between 18 and 25 years old are important to online sellers because they are actively involved in online purchasing and this group of online buyers is expected to dominate future online market. Therefore, examining online sellers’ website quality and online buyers’ purchase intention is crucial. Based on the Theory of planned behavior (TPB), a conceptual model of online sellers’ website quality and purchase intention of online buyers was developed. E-tailQ instrument was adapted in this study which composed of website design, reliability/fulfillment, security, privacy & trust, and customer service. Using online questionnaire and convenience sampling procedure, primary data were obtained from 240 online buyers aged between 18 to 25 years old. It was discovered that website design, website reliability/fulfillment, website security, privacy & trust, and website customer service positively and significantly influence intention of online buyers to continuously purchase via online channels. This study concludes that online sellers’ website quality is important in predicting online buyers’ purchase intention. Recommendation and implication of this study were discussed focusing on how online sellers should improve their website quality to stay competitive in online business.
Cuenca Almenar, C; The ATLAS collaboration; Hadavand, H; Ilchenko, Y; Kolos, S; Slagle, K; Taffard, A
Every minute the ATLAS detector is taking data, the monitoring framework serves several thousands physics events to monitoring data analysis applications, handles millions of histogram updates coming from thousands applications, executes over forty thousand advanced data quality checks for a subset of those histograms, displays histograms and results of these checks on several dozens of monitors installed in main and satellite ATLAS control rooms. The online data quality monitoring system has been of great help in providing quick feedback to the subsystems about the functioning and performance of the different parts of ATLAS by providing a configurable easy and fast visualization of all this information. The Data Quality Monitoring Display (DQMD) is a visualization tool for the automatic data quality assessment of the ATLAS experiment. It is the interface through which the shift crew and experts can validate the quality of the data being recorded or processed, be warned of problems related to data quality, an...
The Internet has fundamentally changed the way workers and firms are matched on the job market. Compared to newspapers and other traditional employment resources, online job boards presumably lead to better matches by providing a wider choice of job advertisements and more sophisticated methods for finding suitable vacancies. This study investigates the association of online job search and matching quality using individual-level data from the German Socio-Economic Panel (SOEP). My results sho...
This paper examines potential differences between Korean and American students in terms of their perception levels regarding online education support service quality, online learning acceptance, and satisfaction. Eight hundred and seventy-two samples, which were collected from students in online classes in the United States and Korea, were…
Cuenca Almenar, C; The ATLAS collaboration
With the delivery of the first proton-proton collisions by the LHC, the ATLAS collaboration had the opportunity to operate the detector under the environment it was designed for. These first events have been of great interest not only for the high energy physics outcome, but also as a means to perform a general commissioning of system. A highly scalable distributed monitoring framework assesses the quality of the data and the operational conditions of the detector, trigger and data acquisition system. Every minute of an ATLAS data taking session the monitoring framework serves several thousands physics events to monitoring data analysis applications, handles millions of histogram updates coming from thousands applications, executes over forty thousand advanced data quality checks for a subset of those histograms, displays histograms and results of these checks on several dozens of monitors installed in main and satellite ATLAS control rooms. The online data quality monitoring system has been of great help in ...
Cuenca Almenar, C; The ATLAS collaboration
With the delivery of the first proton-proton collisions by the LHC, the ATLAS collaboration had the opportunity to operate the detector under the environment it was designed for. These first events have been of great interest not only for the high energy physics outcome, but also as a means to perform a general commissioning of system. A highly scalable distributed monitoring framework assesses the quality of the data and the operational conditions of the detector, trigger and data acquisition system. Every minute of an ATLAS data taking session the monitoring framework serves several thousands physics events to monitoring data analysis applications, handles millions of histogram updates coming from thousands applications, executes over forty thousand advanced data quality checks for a subset of those histograms, displays histograms and results of these checks on several dozens of monitors installed in main and satellite ATLAS control rooms. The online data quality monitoring system has been of great help in ...
Matuga, Julia M.; Wooldridge, Deborah G.; Poirier, Sandra
This paper examines the critical issue of assuring quality online course delivery by examining four key components of online teaching and learning. The topic of course delivery is viewed as a cultural issue that permeates processes from the design of an online course to its evaluation. First, the authors examine and review key components of and…
Free online resources, many produced in the North American Pediatric Environmental Health Specialty Unit (PEHSU) network, covering general information, air quality, asthma, climate change, lead, mercury, mold, pesticides, and water.
In the early years of online retailing, having an online presence and low prices were believed to be key drivers of success. More recently, electronic service quality has become essential as an online marketing strategy. Online stores provide higher service quality to create online customer loyalty, improve customer satisfaction, and keep a…
McGahan, Steven J.; Jackson, Christina M.; Premer, Karen
The University of Nebraska at Kearney's Online Course Checklist is the main instrument for assessing the quality of online courses at UNK. A number of issues were faced when developing and deploying this quality assurance checklist at a small four-year university. The process including development, implementation, and revision is discussed along…
Full Text Available -1 Computer Science & Information Technology (CS & IT), Dubai, UAE, 23-24 January 2015 Quality assessment for online iris images Sisanda Makinana, Tendani Malumedzha, and Fulufhelo V Nelwamondo Modelling and Digital Science, CSIR, Pretoria, South...
Boone, J.; Schottmuller, C.
We provide a modeling framework to think about selective contracting in the health care sector. Two health care providers differ in quality and costs. When buying health insurance, consumers observe neither provider quality nor costs. We derive an equilibrium where health insurers signal provider
Boone, Jan; Schottmuller, C.
We provide a modeling framework to think about selective contracting in the health care sector. Two health care providers differ in quality and costs. When buying health insurance, consumers observe neither provider quality nor costs. We derive an equilibrium where health insurers signal provider
Feghhi, Daniel P; Komlos, Daniel; Agarwal, Nitin; Sabharwal, Sanjeev
Increased availability of medical information on the Internet empowers patients to look up answers to questions about their medical conditions. However, the quality of medical information available on the Internet is highly variable. Various tools for the assessment of online medical information have been developed and used to assess the quality and accuracy of medical web sites. In this study we used the LIDA tool (Minervation) to assess the quality of pediatric patient information on the AAOS (American Academy of Orthopaedic Surgeons) and POSNA (Pediatric Orthopaedic Society of North America) web sites. The accessibility, usability, and reliability of online medical information in the "Children" section of the AAOS web site and on the POSNA web site were assessed with use of the LIDA tool. Flesch-Kincaid (FK) and Flesch Reading Ease (FRE) values were also calculated to assess the readability of the pediatric education material. Patient education materials on each web site scored in the moderate range in assessments of accessibility, usability, and reliability. FK and FRE values indicated that the readability of each web site remained at a somewhat higher (more difficult) level than the recommended benchmark. The quality and readability of online information for children on the AAOS and POSNA web sites are acceptable but can be improved further. The quality of online pediatric orthopaedic patient education materials may affect communication with patients and their caregivers, and further investigation and modification of quality are needed. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.
Chen, Ming; Allebach, Jan
On-line fashion communities in which participants post photos of personal fashion items for viewing and possible purchase by others are becoming increasingly popular. Generally, these photos are taken by individuals who have no training in photography with low-cost mobile phone cameras. It is desired that photos of the products have high aesthetic quality to improve the users' online shopping experience. In this work, we design features for aesthetic quality inference in the context of online fashion shopping. Psychophysical experiments are conducted to construct a database of the photos' aesthetic evaluation, specifically for photos from an online fashion shopping website. We then extract both generic low-level features and high-level image attributes to represent the aesthetic quality. Using a support vector machine framework, we train a predictor of the aesthetic quality rating based on the feature vector. Experimental results validate the efficacy of our approach. Metadata such as the product type are also used to further improve the result.
Martínez-Argüelles, María-Jesús; Batalla-Busquets, Josep-Maria
This paper examines the influence that student perceived quality of service (PSQ) has on continuance intention and willingness to recommend a course in a fully online university. A holistic view of the service provided by the university is taken. It is not only the effect of the teaching which is examined, but also that of the administrative…
Full Text Available The development of online games is so high that leads many companies to compose games. To increase competitiveness, extra service is needed for the customers. Before giving service, online games provider has to know what factor that motivates player to buy online games and virtual items that are presented in order to increase competitiveness. The research is done by using case of online games perfect world, where the area of respondents is Jakarta and the age ranges between 15 to 24. This research involves survey for 186 respondents in which 30 respondents are for pilot test while 156 are for actual test. The data processing is used SEM which the measurement variables consist of effort expectancy, performance expectancy, perceived value, enjoyment story, enjoyment length, enjoyment graphic, enjoyment control, customization, purchase intention and actual purchase behavior. The result of research shows that motivation factor that has high effect to purchase intention is perceived value, enjoyment story, enjoyment length, enjoyment control and customization. While, purchase intention affects actual purchase behavior significantly
As the demands for public accountability increase for higher education, institutions must demonstrate quality within programs and processes, including those provided through online education. While quality may be elusive to specifically quantify, there have been several recommendations for identifying and defining quality online education that…
Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki
The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. We defined social media-based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media-based key quality factors for hospitals. To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and
Humphries, A W; Naisawald, G V
A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.
Taddeo, Mariarosaria; Floridi, Luciano
Online service providers (OSPs)-such as AOL, Facebook, Google, Microsoft, and Twitter-significantly shape the informational environment (infosphere) and influence users' experiences and interactions within it. There is a general agreement on the centrality of OSPs in information societies, but little consensus about what principles should shape their moral responsibilities and practices. In this article, we analyse the main contributions to the debate on the moral responsibilities of OSPs. By endorsing the method of the levels of abstract (LoAs), we first analyse the moral responsibilities of OSPs in the web (LoAIN). These concern the management of online information, which includes information filtering, Internet censorship, the circulation of harmful content, and the implementation and fostering of human rights (including privacy). We then consider the moral responsibilities ascribed to OSPs on the web (LoAON) and focus on the existing legal regulation of access to users' data. The overall analysis provides an overview of the current state of the debate and highlights two main results. First, topics related to OSPs' public role-especially their gatekeeping function, their corporate social responsibilities, and their role in implementing and fostering human rights-have acquired increasing relevance in the specialised literature. Second, there is a lack of an ethical framework that can (a) define OSPs' responsibilities, and (b) provide the fundamental sharable principles necessary to guide OSPs' conduct within the multicultural and international context in which they operate. This article contributes to the ethical framework necessary to deal with (a) and (b) by endorsing a LoA enabling the definition of the responsibilities of OSPs with respect to the well-being of the infosphere and of the entities inhabiting it (LoAFor).
Rodriguez, Michael C.; Ooms, Ann; Montañez, Marcel
Understanding factors in successful online course experiences can provide suggestions for instructors and students to promote improved learning experiences. A survey of 700 students regarding perceptions of online-learning quality was analyzed with a structural equation model. For students with online-learning experience, comfort with technology…
Jones, Craig H.; Slate, John R.
In this article, we discuss the development of online courses in higher education in terms of the in- structional quality and economic costs. In our conceptual analysis, we point out problems in developing online courses with sufficient quality due to limited funds being made available for online course development. Moreover, economic costs exist…
Gilkey, Melissa B.; Calo, William A.; Moss, Jennifer L.; Shah, Parth D.; Marciniak, Macary W.; Brewer, Noel T.
Background Receiving a healthcare provider’s recommendation is a strong predictor of HPV vaccination, but little is known empirically about which types of recommendation are most influential. Thus, we sought to investigate the relationship between recommendation quality and HPV vaccination among U.S. adolescents. Methods In 2014, we conducted a national, online survey of 1,495 parents of 11- to 17-year-old adolescents. Parents reported whether providers endorsed HPV vaccination strongly, encouraged same-day vaccination, and discussed cancer prevention. Using an index of these quality indicators, we categorized parents as having received no, low-quality, or high-quality recommendations for HPV vaccination. Separate multivariable logistic regression models assessed associations between recommendation quality and HPV vaccine initiation (≥1 dose), follow through (3 doses, among initiators), refusal, and delay. Results Almost half (48%) of parents reported no provider recommendation for HPV vaccination, while 16% received low-quality recommendations and 36% received high-quality recommendations. Compared to no recommendation, high-quality recommendations were associated with over nine times the odds of HPV vaccine initiation (23% vs. 74%, OR=9.31, 95% CI, 7.10–12.22) and over three times the odds of follow through (17% vs. 44%, OR=3.82, 95% CI, 2.39–6.11). Low-quality recommendations were more modestly associated with initiation (OR=4.13, 95% CI, 2.99–5.70), but not follow through. Parents who received high-versus low-quality recommendations less often reported HPV vaccine refusal or delay. Conclusions High-quality recommendations were strongly associated with HPV vaccination behavior, but only about one-third of parents received them. Interventions are needed to improve not only whether, but how providers recommend HPV vaccination for adolescents. PMID:26812078
Kodatt, Stephanie A.; Shenk, Jared E.; Williams, Mark L.; Horvath, Keith J.
Technology-delivered interventions addressing a broad range of problems for which clients present for therapy are proliferating. However, little is known of leadership dynamics that emerge in online group interventions. The purpose of this study was to assess the types of leadership qualities that would emerge in an online social support group intervention to improve medication adherence for men with HIV, and to characterize the demographic and psychosocial profiles of leaders. Written posts (n=616) from 66 men were coded using an adapted version of the Full Range Model of Leadership. Results showed that 10% (n=64) of posts reflected one of five leadership types, the most common of which was mentoring/providing feedback (40% of leadership posts). The next most common leadership style were instances in which encouragement was offered (30% of leadership posts). Leaders appeared to have lived with HIV longer and have higher Internet knowledge scores than non-leaders. Results indicate that online group interventions potentially may be useful to supplement traditional face-to-face treatment by providing an additional venue for group members to mentor and provide emotional support to each other. However, additional research is needed to more fully understand leadership qualities and group dynamics in other online group intervention settings. PMID:25642144
Yang, Yi; Durrington, Vance
With the prevalence of online learning, considerable concerns and problems arise, particularly as it relates to the quality of this mode of instruction. This study used a web-delivered survey based on the quality benchmarks published by Institution of Higher Education Policy to investigate student's perceptions regarding online course quality and…
Mohammad Al-Nasser; Rushami Zien Yusoff; Rabiul Islam; Abdullah Al-Nasser
Purchasing is considered a risky business specifically in the online purchasing environment. The research was designed to fill the gap in the existing body of knowledge regarding attitudes and differences in electronic service quality perception between two different geographical and cultural countries-Malaysia and Saudi Arabia-regarding online shopping. Specifically, this research extended previous effort done in an online shopping context by providing evidence that high service quality incr...
Roe, C. William; Toma, Alfred G.; Yallapragada, RamMohan R.
Online degree programs were probably pioneered by for-profit universities such as University of Phoenix. Many online degree programs were initially considered low quality academic programs compared to traditional programs. Therefore, many public and private universities were slow to adopt the online programs. However, gradually more and more…
Blood-Siegfried, Jane E; Short, Nancy M; Rapp, Carla Gene; Hill, Elizabeth; Talbert, Steve; Skinner, John; Campbell, Amy; Goodwin, Linda
All of the graduate students in the School of Nursing take some of their Master of Science courses online. A group of six School of Nursing faculty members and a graduate student received funding to determine best practices in online courses. The group developed an evaluation rubric to measure quality in the graduate online curriculum. They then applied the rubric to the core courses which are primarily offered online and are required for all graduate nursing students. The project had a positive impact on faculty by offering a tool useful for online course evaluation and development. Additionally it brought to attention the needs of faculty member development in online education.
Fisk, William; Seppanen, Olli
This paper summarizes the current scientific evidence that improved indoor environmental quality can improve work performance and health. The review indicates that work and school work performance is affected by indoor temperature and ventilation rate. Pollutant source removal can sometimes improve work performance. Based on formal statistical analyses of existing research results, quantitative relationships are provided for the linkages of work performance with indoor temperature and outdoor air ventilation rate. The review also indicates that improved health and related financial savings are obtainable from reduced indoor tobacco smoking, prevention and remediation of building dampness, and increased ventilation. Example cost-benefit analyses indicate that many measures to improve indoor temperature control and increase ventilation rates will be highly cost effective, with benefit-cost ratios as high as 80 and annual economic benefits as high as $700 per person.
Chokoshvili, Davit; Borry, Pascal; Vears, Danya F
PurposeExpanded carrier screening (ECS) for a large number of recessive disorders is available to prospective parents through commercial providers. This study aimed to analyze the content of marketing materials on ECS providers' websites.MethodsTo identify providers of ECS tests, we undertook a comprehensive online search, reviewed recent academic literature on commercial carrier screening, and consulted with colleagues familiar with the current ECS landscape. The identified websites were archived in April 2017, and inductive content analysis was performed on website text, brochures and educational materials, and video transcripts.ResultsWe identified 18 ECS providers, including 16 commercial genetic testing companies. Providers typically described ECS as an important family planning tool. The content differed in both the tone used to promote ECS and the accuracy and completeness of the test information provided. We found that most providers offered complimentary genetic counseling to their consumers, although this was often optional, limited to the posttest context, and, in some cases, appeared to be available only to test-positive individuals.ConclusionThe quality of ECS providers' websites could be improved by offering more complete and accurate information about ECS and their tests. Providers should also ensure that all carrier couples receive posttest genetic counseling to inform their subsequent reproductive decision making.Genet Med advance online publication, 14 December 2017; doi:10.1038/gim.2017.222.
"SourceOECD," the online/print subscription service of the Organisation for Economic Co-operation and Development, is examined. Solutions for providing access in library online catalogs are described, as are recent technical improvements to the online subscription service.
Online machine translation (MT) has empowered ordinary language users to have texts translated all by themselves. But are these users aware of the pitfalls? This article draws on a longitudinal study that explored the quality of output by online MT application Google Translate in the language combination ...
Budden, Connie B.; Budden, Heather L.; Hall, Michelle; Longman, Debbie G.
As the growth of online education offered by universities accelerates and spreads, universities are increasingly grappling with concerns related to widespread availability and the maintenance of academic quality. The "Quality Matters at Southeastern" Program fosters quality through a peer review process and offers a certification process…
Marijke Kral; Gino Camp; Esther van Popta; Robert Jan Simons; Rob L. Martens
This paper reviews studies of peer feedback from the novel perspective of the providers of that feedback. The possible learning benefits of providing peer feedback in online learning have not been extensively studied. The goal of this study was therefore to explore the process of providing online
Avery, Melissa D; Cohen, Bradley A; Walker, J D
Recent offerings of online courses have outpaced the evaluation of the quality of those offerings, particularly at the program level. The purpose of this project was to evaluate the quality of a set of 16 graduate nursing courses developed for three master's specialty programs. An interdisciplinary group of nursing faculty and instructional technologists collaborated in the development of a quality assessment tool and evaluated 16 online graduate nursing courses. Faculty members for each of the courses were interviewed as part of the process. The collaborative design and development process is discussed, as well as evaluation techniques and the data collection instrument. Examples of best practices and areas for improvement in online courses are presented. The findings will help others as they develop and evaluate online curricula. This project provides a model for interdisciplinary collaboration on the evaluation of online programs that can be reviewed, modified, and implemented at other institutions. Instruments are included as supplementary material.
Marshall, Elizabeth; York, Janet; Magruder, Kathryn; Yeager, Derik; Knapp, Rebecca; De Santis, Mark L; Burriss, Louisa; Mauldin, Mary; Sulkowski, Stan; Pope, Charlene; Jobes, David A
Due to the gap in suicide-specific intervention training for mental health students and professionals, e-learning is one solution to improving provider skills in the Veterans Affairs (VA) health system. This study focused on the development and evaluation of an equivalent e-learning alternative to the Collaborative Assessment and Management of Suicidality (CAMS) in-person training approach at a Veteran Health Affairs medical center. The study used a multicenter, randomized, cluster, and three group design. the development of e-CAMS was an iterative process and included pilot testing. Eligible and consenting mental health providers, who completed a CAMS pre-survey, were randomized. Provider satisfaction was assessed using the standard VA evaluation of training consisting of 20 items. Two post training focus groups, divided by learning conditions, were conducted to assess practice adoption using a protocol focused on experiences with training and delivery of CAMS. A total of 215 providers in five sites were randomized to three conditions: 69 to e-learning, 70 to in-person, 76 to the control. The providers were primarily female, Caucasian, midlife providers. Based on frequency scores of satisfaction items, both learning groups rated the trainings positively. In focus groups representing divided by learning conditions, participants described positive reactions to CAMS training and similar individual and institutional barriers to full implementation of CAMS. This is the first evaluation study of a suicide-specific e-learning training within the VA. The e-CAMS appears equivalent to the in-person CAMS in terms of provider satisfaction with training and practice adoption, consistent with other comparisons of training deliveries across specialty areas. Additional evaluation of provider confidence and adoption and patient outcomes is in progress. The e-CAMS has the potential to provide ongoing training for VA and military mental health providers and serve as a tutorial for
Full Text Available Online education programs in nursing are increasing rapidly. Faculty need to be competent in their role and possess the skills necessary to positively impact student outcomes. Existing research offers effective teaching strategies for online education; however, there may be some disconnect in the application of these strategies and faculty perceptions of associated outcomes. Focus groups were formed to uncover how nursing faculty in an online program define and describe teaching effectiveness and quality indicators in an asynchronous online environment. A semistructured interview format guided group discussion. Participants (n=11 included nurse educators from an online university with an average of 15 years of experience teaching in nursing academia and 6 years in an online environment. Teaching effectiveness, indicators of quality, and student success were three categories that emerged from the analysis of data. What materialized from the analysis was an overarching concept of a “dance” that occurs in the online environment. Effective online teachers facilitate, connect, lead, and work in synchrony with students to obtain indicators of quality such as student success, student improvement over time, and student application of knowledge to the professional role.
Frazer, Christine; Sullivan, Debra Henline; Weatherspoon, Deborah; Hussey, Leslie
Online education programs in nursing are increasing rapidly. Faculty need to be competent in their role and possess the skills necessary to positively impact student outcomes. Existing research offers effective teaching strategies for online education; however, there may be some disconnect in the application of these strategies and faculty perceptions of associated outcomes. Focus groups were formed to uncover how nursing faculty in an online program define and describe teaching effectiveness and quality indicators in an asynchronous online environment. A semistructured interview format guided group discussion. Participants (n = 11) included nurse educators from an online university with an average of 15 years of experience teaching in nursing academia and 6 years in an online environment. Teaching effectiveness, indicators of quality, and student success were three categories that emerged from the analysis of data. What materialized from the analysis was an overarching concept of a "dance" that occurs in the online environment. Effective online teachers facilitate, connect, lead, and work in synchrony with students to obtain indicators of quality such as student success, student improvement over time, and student application of knowledge to the professional role.
It's available on personal computers with a CD or through Internet access. Assess instantly the accessibility of your provider network or the most promising areas to establish a health service with new GIS tools.
Nambisan, Priya; Gustafson, David H; Hawkins, Robert; Pingree, Suzanne
Hospitals frequently evaluate their service quality based on the care and services provided to patients by their clinical and non-clinical staff.(1,2) However, such evaluations do not take into consideration the many interactions that patients have in online patient communities with the health-care organization (HCO) as well as with peer patients. Patients' interactions in these online communities could impact their perceptions regarding the HCO's service quality. The objective of this pilot study was to evaluate the impact of social support and responsiveness that patients experience in an HCO's online community on patients' perceptions regarding the HCO's service quality. The study data are collected from CHESS, a health-care programme (Comprehensive Health Enhancement Support System) run by the Centre for Health Enhancement System Studies at the University of Wisconsin-Madison. Findings show that the social support and the responsiveness received from peer patients in the online patient communities will impact patients' perceptions regarding the service quality of the HCO even when the organizational members themselves do not participate in the online discussions. The results indicate that interactions in such HCO-provided online patient communities should not be ignored as they could translate into patients' perceptions regarding HCOs' service quality. Ways to improve responsiveness and social support in an HCO's online patient community are discussed. © 2014 John Wiley & Sons Ltd.
Penne, E. Lars; Visser, Linda; van den Dorpel, Marinus A.; van der Weerd, Neelke C.; Mazairac, Albert H. A.; van Jaarsveld, Brigit C.; Koopman, Marion G.; Vos, Pieter; Feith, Geert W.; Kremer Hovinga, T; van Hamersvelt, Henk W.; Wauters, Inge M.; Bots, Michiel L.; Nube, Menso J.; ter Wee, Piet M.; Blankestijn, Peter J.; Grooteman, Muriel P. C.
During online hemodiafiltration, patients are directly infused with sterile substitution solutions to maintain fluid balance. Adequate water treatment and a well-organized quality control process are essential to provide non-pyrogenic fluids with consistent optimal quality. We sought to assess water
Penne, E. Lars; Visser, Linda; van den Dorpel, Marinus A.; van der Weerd, Neelke C.; Mazairac, Albert H. A.; van Jaarsveld, Brigit C.; Koopman, Marion G.; Vos, Pieter; Feith, Geert W.; Kremer Hovinga, Ton K.; van Hamersvelt, Henk W.; Wauters, Inge M.; Bots, Michiel L.; Nubé, Menso J.; ter Wee, Piet M.; Blankestijn, Peter J.; Grooteman, Muriel P. C.
During online hemodiafiltration, patients are directly infused with sterile substitution solutions to maintain fluid balance. Adequate water treatment and a well-organized quality control process are essential to provide non-pyrogenic fluids with consistent optimal quality. We sought to assess water
Penne, E.L.; Visser, L.; Dorpel, M.A. van den; Weerd, N.C. van der; Mazairac, A.H.; Jaarsveld, B.C. van; Koopman, M.G.; Vos, P.; Feith, G.W.; Kremer Hovinga, T.K.; Hamersvelt, H.W. van; Wauters, I.M.; Bots, M.L.; Nube, M.J.; Wee, P.M. ter; Blankestijn, P.J.; Grooteman, M.P.C.
During online hemodiafiltration, patients are directly infused with sterile substitution solutions to maintain fluid balance. Adequate water treatment and a well-organized quality control process are essential to provide non-pyrogenic fluids with consistent optimal quality. We sought to assess water
Sorensen, E. K.; Takle, E. S.; Moser, H. M.
This paper reports on a case-study on the implementation of “language games” as a pedagogical tool for analyzing, assessing and promoting the quality and the level of collaborative knowledge building in online learning dialogues. Part of the overall objective is to explore the use, strength...... to the benefits of other theoretical approaches. Applying an analytical perspective of language games, sequences of online dialogues are analyzed in order to understand their specific characteristics and to diagnose the quality of the collaborative knowledge building processes. To what extend do language games...... reveal true knowledge building in an online learning environment? Results of this study suggest that language games may function as a tool for diagnosing quality in online collaborative knowledge building processes. Furthermore, their possible use as an instructional tool for promoting more authentic...
Full Text Available The use of high quality disease surveillance data has become increasingly important for public health action against new threats. In response, countries have developed a wide range of disease surveillance systems enabled by technological advancements. The heterogeneity and complexity of country data systems have caused a growing need for international organizations such as the World Health Organization (WHO to coordinate the standardization, integration, and dissemination of country disease data at the global level for research and policy. The availability and consistency of currently available disease surveillance data at the global level are unclear. We investigated this for dengue surveillance data provided online by the WHO.We extracted all dengue surveillance data provided online by WHO Headquarters and Regional Offices (RO's. We assessed the availability and consistency of these data by comparing indicators within and between sources. We also assessed the consistency of dengue data provided online by two example countries (Brazil and Indonesia. Data were available from WHO for 100 countries since 1955 representing a total of 23 million dengue cases and 82 thousand deaths ever reported to WHO. The availability of data on DengueNet and some RO's declined dramatically after 2005. Consistency was lacking between sources (84% across all indicators representing a discrepancy of almost half a million cases. Within sources, data at high spatial resolution were often incomplete.The decline of publicly available, integrated dengue surveillance data at the global level will limit opportunities for research, policy, and advocacy. A new financial and operational framework will be necessary for innovation and for the continued availability of integrated country disease data at the global level.
Ruberto, Irene; Marques, Ernesto; Burke, Donald S; Van Panhuis, Willem G
The use of high quality disease surveillance data has become increasingly important for public health action against new threats. In response, countries have developed a wide range of disease surveillance systems enabled by technological advancements. The heterogeneity and complexity of country data systems have caused a growing need for international organizations such as the World Health Organization (WHO) to coordinate the standardization, integration, and dissemination of country disease data at the global level for research and policy. The availability and consistency of currently available disease surveillance data at the global level are unclear. We investigated this for dengue surveillance data provided online by the WHO. We extracted all dengue surveillance data provided online by WHO Headquarters and Regional Offices (RO's). We assessed the availability and consistency of these data by comparing indicators within and between sources. We also assessed the consistency of dengue data provided online by two example countries (Brazil and Indonesia). Data were available from WHO for 100 countries since 1955 representing a total of 23 million dengue cases and 82 thousand deaths ever reported to WHO. The availability of data on DengueNet and some RO's declined dramatically after 2005. Consistency was lacking between sources (84% across all indicators representing a discrepancy of almost half a million cases). Within sources, data at high spatial resolution were often incomplete. The decline of publicly available, integrated dengue surveillance data at the global level will limit opportunities for research, policy, and advocacy. A new financial and operational framework will be necessary for innovation and for the continued availability of integrated country disease data at the global level.
Ozdemir, Devrim; Loose, Rich
With the growing demand for quality online education in the US, developing quality online courses and online programs, and more importantly maintaining this quality, have been an inevitable concern for higher education institutes. Current literature on quality assurance in online education mostly focuses on the development of review models and…
Sangra, Albert; Fernandez-Michels, Pedro
Purpose: The paper seeks to describe the Catalan corporate e-learning providers from the perspective of quality perception, quality assessment and quality control. Design/methodology/approach: A literature review reveals key aspects of the definition of quality in e-learning. The results of the review constitute the basis for exploratory research…
Providing high-quality HIV care in a deeply rural setting – the Zithulele experience. C Young, B Gaunt. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.7196/sajhivmed.1035 · AJOL African Journals Online. HOW TO ...
Full Text Available Increasing the visibility of a journal is the key to increasing quality. The International Network for the Availability of Scientific Publications works with journal editors in the global South to publish their journals online and to increase the efficiency of the peer review process. Editors are trained in using the Open Journals System software and in online journal management and strategy so they have the tools and knowledge needed to initiate a ‘virtuous cycle' in which visibility leads to an increase in the number and quality of submissions and in turn, increased citations and impact. In order to maximise this increase in quality, it must be supported by strong editorial office processes and management. This article describes some of the issues and strategies faced by the editors INASP works with, placing a particular emphasis on Nepal Journals Online. Key words: INASP; Open Journals System; Journals Online Projects; Nepal Journals Online; journal visibility; peer review DOI: 10.3126/dsaj.v3i0.2786 Dhaulagiri Journal of Sociology and Anthropology Vol.3 2009 175-184
Maynard, Pamela L; Rohrer, James E; Fulton, Lawrence
Online university students are a growing population whose health has received minimal attention. The purpose of this cross-sectional Internet survey was to identify risk factors for the health status among online university students. This online survey collected data from 301 online university students through a large, US-based participant pool and LinkedIn. Health status was measured using 3 elements of health-related quality of life (HRQOL): self-rated overall health (SRH), unhealthy days, and recent activity limitation days. All 3 measures were dichotomized. The odds of poor SRH were higher for people who reported a body mass index in the overweight and obese categories (odds ratio [OR] = 2.99, P students who are low income, in disadvantaged racial groups, who are overweight, smoke, and who do not exercise. © The Author(s) 2014.
Cajita, Maan Isabella; Rodney, Tamar; Xu, Jingzhi; Hladek, Melissa; Han, Hae-Ra
The ubiquity of the Internet is changing the way people obtain their health information. Although there is an abundance of heart failure information online, the quality and health literacy demand of these information are still unknown. The purpose of this study is to evaluate the quality and health literacy demand (readability, understandability, and actionability) of the heart failure information found online. Google, Yahoo, Bing, Ask.com, and DuckDuckGo were searched for relevant heart failure Web sites. Two independent raters then assessed the quality and health literacy demand of the included Web sites. The quality of the heart failure information was assessed using the DISCERN instrument. Readability was assessed using 7 established readability tests. Finally, understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Print Materials. A total of 46 Web sites were included in this analysis. The overall mean quality rating was 46.0 ± 8.9 and the mean readability score was 12.6 grade reading level. The overall mean understandability score was 56.3% ± 16.2%. Finally, the overall mean actionability score was 34.7% ± 28.7%. The heart failure information found online was of fair quality but required a relatively high health literacy level. Web content authors need to consider not just the quality but also the health literacy demand of the information found in their Web sites. This is especially important considering that low health literacy is likely prevalent among the usual audience.
Joshua Mugambwa; George William Mugerwa; Wilson Williams Mutumba; Claire Muganzi; Bridget Namubiru; Yusuf Waswa; Isaac Newton Kayongo
.... This research took a case study of Nsamizi Training Institute of Social Development (NTISD) to determine the relationship between privately provided accommodation service quality and customer satisfaction...
Kaderli, Reto; Pfortmueller, Carmen A; Businger, Adrian P
In the last decade assessing the quality of healthcare has become increasingly important across the world. Switzerland lacks a detailed overview of how quality management is implemented and of its effects on medical procedures and patients' concerns. This study aimed to examine the systematics of quality management in Switzerland by assessing the providers and collected parameters of current quality initiatives. In summer 2011 we contacted all of the medical societies in Switzerland, the Federal Office of Public Health, the Swiss Medical Association (FMH) and the head of Swiss medical insurance providers, to obtain detailed information on current quality initiatives. All quality initiatives featuring standardised parameter assessment were included. Of the current 45 initiatives, 19 were powered by medical societies, five by hospitals, 11 by non-medical societies, two by the government, two by insurance companies or related institutions and six by unspecified institutions. In all, 24 medical registers, five seals of quality, five circles of quality, two self-assessment tools, seven superior entities, one checklist and one combined project existed. The cost of treatment was evaluated by four initiatives. A data report was released by 24 quality initiatives. The wide variety and the large number of 45 recorded quality initiatives provides a promising basis for effective healthcare quality management in Switzerland. However, an independent national supervisory authority should be appointed to provide an effective review of all quality initiatives and their transparency and coordination.
Background: The umpteenth threats to change of healthcare provider by dissatisfied patients on formal sector health insurance are well known and can be a proxy indicator for the need for quality improvement in service delivery. Objective: This study was aimed at evaluating patientsf satisfaction with quality of care provided ...
Liu, Xiao-Lu; Guo, Qiang; Hou, Lei; Cheng, Can; Liu, Jian-Guo
How to design an accurate algorithm for ranking the object quality and user reputation is of importance for online rating systems. In this paper we present an improved iterative algorithm for online ranking object quality and user reputation in terms of the user degree (IRUA), where the user's reputation is measured by his/her rating vector, the corresponding objects' quality vector and the user degree. The experimental results for the empirical networks show that the AUC values of the IRUA algorithm can reach 0.9065 and 0.8705 in Movielens and Netflix data sets, respectively, which is better than the results generated by the traditional iterative ranking methods. Meanwhile, the results for the synthetic networks indicate that user degree should be considered in real rating systems due to users' rating behaviors. Moreover, we find that enhancing or reducing the influences of the large-degree users could produce more accurate reputation ranking lists.
The Cryogenic Underground Observatory for Rare Events (CUORE) is a large neutrinoless double beta decay search experiment. Currently CUORE is actively taking data at the Laboratori Nazionali del Gran Sasso (LNGS). These searches can address fundamental questions about the nature of the neutrino and may provide insight into the observed matter-antimatter asymmetry in the universe leading to beyond standard model physics via lepton number violation. CUORE is the largest array of crystal bolometers in the world, containing a total of 988 TeO2 crystals with a mass of 742kg and is expected to achieve a sensitivity on the 130Te 0 νββ half-life of T1 / 2 = 9 × 1025 years (90% C.L.) after 5 years of operation. The large number of individual crystals in CUORE presents challenges for monitoring data quality and determination of time periods of detector behavior suitable for analysis. We will discuss the current state of the online run diagnostic system that allows for easy monitoring of all crystals, provides an overview of performance over time, and gives an ability to set flags for periods of bad detector behavior as well as set phone and email alarms on various cryostat parameters.
Fanger, Povl Ole
Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...
Hixon, Emily; Barczyk, Casimir; Ralston-Berg, Penny; Buckenmeyer, Janet
The purpose of this paper is to explore whether experienced online students (who have completed seven or more online courses) perceive the quality of their courses differently than novice online students (who have completed three or fewer online courses) or students with an intermediate level of online course experience (those who have completed…
De Groot, Lauren; Harris, Ilene; Regehr, Glenn; Tekian, Ara; Ingledew, Paris-Ann
The Internet is increasingly a source of information for pancreatic cancer patients. This disease is usually diagnosed at an advanced stage; therefore, timely access to high-quality information is critical. Our purpose is to systematically evaluate the information available to pancreatic cancer patients on the internet. An internet search using the term "pancreatic cancer" was performed, with the meta-search engines "Dogpile", "Yippy" and "Google". The top 100 websites returned by the search engines were evaluated using a validated structured rating tool. Inter-rater reliability was evaluated using kappa statistics and results were analyzed using descriptive statistics. Amongst the 100 websites evaluated, etiology/risk factors and symptoms were the most accurately covered (70 and 67% of websites). Prevention, treatment and prognosis were the least accurate sections (55, 55 and 43% of websites). Prevention and prognosis were also the least likely to be covered with 63 and 51 websites covering these, respectively. Only 40% of websites identified an author. Twenty-two percent of websites were at a university reading level. The majority of online information is accurate but incomplete. Websites may lack information on prognosis. Many websites are outdated and lacked author information, and readability levels are inappropriate. This knowledge can inform the dialogue between healthcare providers and patients.
Gómez-Rey, Pilar; Barbera, Elena; Fernández-Navarro, Francisco
This article explores the quality of the online learning experience based on the Sloan-C framework and the Online Learning Consortium's (OLC) quality scorecard. The OLC index has been implemented to evaluate quality in online programs from different perspectives. Despite this, the opinions of learners are ignored, and it is built using feedback…
The purpose of this qualitative study was to examine the Distance Learning Quality Issues published by the American Assembly of Collegiate Schools of Business International (AACSB-International) to document the various characteristics that high-quality online courses must possess. A content analysis methodology was employed to examine the seven…
Full Text Available Purpose: E-Government, as a new bond linking the government and the public, has gradually become the focus of innovation in government services. The paper focuses on the e-Government service quality issues from the perspective of users. Design/methodology/approach: From the aspects of online service quality perception and offline service quality perception, based on IS Success model and SERQUAL model, e-Government Services Quality model has been set up with information quality, system quality and service quality as key factors. Then, the survey method was applied to collect data and then to test the model. Findings: It was found that users’ perception of offline service quality has a significant effect on improving their perception of online service quality, and online service quality perception has a significant effect on public satisfaction of e-Government services; information clarity, system security and stability, interactive services and “one-stop” services all have a significant effect on public satisfaction of e-Government services. However, offline service quality perception has certain positive effect on public satisfaction of e-Government services but not dramatically. Research limitations/implications: Mobile e-Government as an important direction of the development of e-Government, in the future, we will study more about mobile e-Government services channels. Originality/value: This study further develops the theory of information system service quality, and also provides a theoretical reference for government departments. On the one hand, based on the characteristics of e-government system, information quality, system quality and service quality in the previous system service model are further discussed; on the other hand, both online and offline services are taken into consideration in the information system service model, thus establishing the e-government services quality model and making an in-depth study of the
Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas
Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier
Yeaman, Paul A; Ford, James L; Kim, Kye Y
Providing quality palliative care is a daunting task profoundly impacted by diminished patient capacity at the end of life. Alzheimer disease (AD) is a disorder that erases our memories and is projected to increase dramatically for decades to come. By the time the patients with AD reach the end stage of the disease, the ability of patients to provide pertinent subjective complaints of pain and discomfort would have vanished. Historical perspectives of palliative care, exploration of the AD process, ethical issues, and crucial clinical considerations are provided to improve the understanding of disease progression and quality of care for patients with end-stage AD.
Cannon, Ethalinda K S; Birkett, Scott M; Braun, Bremen L; Kodavali, Sateesh; Jennewein, Douglas M; Yilmaz, Alper; Antonescu, Valentin; Antonescu, Corina; Harper, Lisa C; Gardiner, Jack M; Schaeffer, Mary L; Campbell, Darwin A; Andorf, Carson M; Andorf, Destri; Lisch, Damon; Koch, Karen E; McCarty, Donald R; Quackenbush, John; Grotewold, Erich; Lushbough, Carol M; Sen, Taner Z; Lawrence, Carolyn J
The purpose of the online resource presented here, POPcorn (Project Portal for corn), is to enhance accessibility of maize genetic and genomic resources for plant biologists. Currently, many online locations are difficult to find, some are best searched independently, and individual project websites often degrade over time-sometimes disappearing entirely. The POPcorn site makes available (1) a centralized, web-accessible resource to search and browse descriptions of ongoing maize genomics projects, (2) a single, stand-alone tool that uses web Services and minimal data warehousing to search for sequence matches in online resources of diverse offsite projects, and (3) a set of tools that enables researchers to migrate their data to the long-term model organism database for maize genetic and genomic information: MaizeGDB. Examples demonstrating POPcorn's utility are provided herein.
Full Text Available Privately provided accommodation is a growing service in Uganda’s higher education sector due to education liberalization and demand for education. This research took a case study of Nsamizi Training Institute of Social Development (NTISD to determine the relationship between privately provided accommodation service quality and customer satisfaction. Specifically, the objectives of the study were (a to find out the relationship between security and NTISD students’ satisfaction with privately provided accommodation, and (b to find out the hierarchical level of importance of NTISD student satisfaction of the three service quality dimensions (reliability, security, and tangibles with privately provided accommodation. Using quantitative and qualitative modes of data analysis and a sample of 300 students from 20 private hostels, this study established a strong positive significant relationship between security and satisfaction regarding privately provided accommodation. This implies that accommodation service providers should increase the quality of security so as to increase the satisfaction of students regarding privately provided accommodation. The study established the hierarchical order of importance from the most important service quality dimension, respectively, as follows: reliability, security, and tangibles. Therefore, private accommodation service managers should pay extra attention to the dimensions in the same order.
Bartlett, Will; Allen, Pauline; Pérotin, Virginie; Turner, Simon; Zamora, Bernarda; Matchaya, Greenwell; Roberts, Jennifer
The overall objective of the research project has been to assess the impact of provider diversity on quality and innovation in the NHS. The specific research aims were to identify the differences in performance between non-profit Third Sector organisations, for-profit private enterprises, and incumbent public sector institutions within the NHS as providers of health care services, as well as the factors that affect the entry and growth of new private and Third Sector providers.\\ud The study u...
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.
Adams, April Michele
The study investigated the faculty perception of quality in online courses. The areas considered were media richness, interaction, synchronism, self-efficacy, online teaching experience, and education level. Participants included members of three online Yahoo groups that were designed for online faculty members. There were 510 total members…
Mo, Changyeun; Kim, Giyoung; Lim, Jongguk
The consumption of fresh-cut agricultural produce in Korea has been growing. The browning of fresh-cut vegetables that occurs during storage and foreign substances such as worms and slugs are some of the main causes of consumers' concerns with respect to safety and hygiene. The purpose of this study is to develop an on-line system for evaluating quality of agricultural products using hyperspectral imaging technology. The online evaluation system with single visible-near infrared hyperspectral camera in the range of 400 nm to 1000 nm that can assess quality of both surfaces of agricultural products such as fresh-cut lettuce was designed. Algorithms to detect browning surface were developed for this system. The optimal wavebands for discriminating between browning and sound lettuce as well as between browning lettuce and the conveyor belt were investigated using the correlation analysis and the one-way analysis of variance method. The imaging algorithms to discriminate the browning lettuces were developed using the optimal wavebands. The ratio image (RI) algorithm of the 533 nm and 697 nm images (RI533/697) for abaxial surface lettuce and the ratio image algorithm (RI533/697) and subtraction image (SI) algorithm (SI538-697) for adaxial surface lettuce had the highest classification accuracies. The classification accuracy of browning and sound lettuce was 100.0% and above 96.0%, respectively, for the both surfaces. The overall results show that the online hyperspectral imaging system could potentially be used to assess quality of agricultural products.
Weaver, Ruth Harding
Reviews research on characteristics and resources of family child caregivers providing high quality care. Focuses on regulation, lifelong learning in early childhood education, psychological well-being, commitment to child care, supportive child care connections, and a solid financial foundation. Maintains that consumer education can help parents…
Wong, Michelle S; Gudzune, Kimberly A; Bleich, Sara N
To examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association. We conducted a cross-sectional analysis with 2009-2010 medical expenditures panel survey-household component (N=25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient-provider communication measures, and whether patient race/ethnicity modifies this relationship. Compared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04). Our study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality. Curricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Boucher, Nathan A; Mcmillen, Marvin A; Gould, James S
Quality medical care is a clinical and public health imperative, but defining quality and achieving improved, measureable outcomes are extremely complex challenges. Adherence to best practice invariably improves outcomes. Nonphysician medical providers (NPMPs), such as physician assistants and advanced practice nurses (eg, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, and certified nurse midwives), may be the first caregivers to encounter the patient and can act as agents for change for an organization's quality-improvement mandate. NPMPs are well positioned to both initiate and ensure optimal adherence to best practices and care processes from the moment of initial contact because they have robust clinical training and are integral to trainee/staff education and the timely delivery of care. The health care quality aspects that the practicing NPMP can affect are objective, appreciative, and perceptive. As bedside practitioners and participants in the administrative and team process, NPMPs can fine-tune care delivery, avoiding the problem areas defined by the Institute of Medicine: misuse, overuse, and underuse of care. This commentary explores how NPMPs can affect quality by 1) supporting best practices through the promotion of guidelines and protocols, and 2) playing active, if not leadership, roles in patient engagement and organizational quality-improvement efforts.
Martin, Lisa A; Debbink, Michelle; Hassinger, Jane; Youatt, Emily; Harris, Lisa H
The Providers Share Workshop (PSW) provides abortion providers safe space to discuss their work experiences. Our objectives were to assess changes in abortion stigma over time and explore how stigma is related to aspects of professional quality of life, including compassion satisfaction, burnout and compassion fatigue for providers participating in the workshops. Seventy-nine providers were recruited to the PSW study. Surveys were completed prior to, immediately following and 1 year after the workshops. The outcome measures were the Abortion Provider Stigma Survey and the Professional Quality of Life (ProQOL) survey. Baseline ProQOL scores were compared to published averages using t tests. Changes in abortion stigma and aspects of professional quality of life were assessed by fitting a two-level random-effects model with repeated measures at level 1 (period-level) and static measures (e.g., demographic data) at level 2 (person-level). Potential covariates included age, parenting status, education, organizational tenure, job type and clinic type (stand-alone vs. hospital-based clinics). Compared to other healthcare workers, abortion providers reported higher compassion satisfaction (t=2.65, p=.009) and lower burnout (t=5.13, pabortion stigma as a significant predictor of lower compassion satisfaction, higher burnout and higher compassion fatigue. Participants in PSW reported a reduction in abortion stigma over time. Further, stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue, suggesting that interventions aimed at supporting the abortion providing workforce should likely assess abortion stigma. Stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue among abortion care providers. Therefore, strengthening human resources for abortion care requires stigma reduction efforts. Participants in the PSWs show reductions in stigma over time. Copyright © 2014 Elsevier Inc. All rights reserved.
establish eLoyalty. The target population of this study was South African tourism accommodation establishments who advertised on online tourism portals during 2005. A personalised branded HTML email with a clickable link to the online survey was mailed to all respondents. One hundred and nine valid responses were received. A multi-item questionnaire was used to measure the relationship between eService quality, eValue, eSatisfaction and eLoyalty pertaining to online tourism portals utilised by the respondents. The findings imply that online tourism portals would increase their eLoyalty (and thus increase profits if they first satisfied their suppliers’ needs by providing them with a secure, visually pleasing user interface with which they could identify. Secondly, there is a need for online tourism portals to provide services that add value, making it easy for suppliers to add and change details on their own pages, as well as ensuring that their suppliers receive a substantial income stream through the portal.
e-mail: email@example.com. Abstract. Urban transport has ... (ii) Should bus prices be subsidized in order to provide a quality public transport system? (iii) How large is the modal shift in favour ..... been derived through a speed-flow relationship function, with a car free flow speed of 45 km/h, peak traffic speed of 24 km/h and ...
Martin, Florence; Ndoye, Abdou; Wilkins, Patricia
Quality Matters is recognized as a rigorous set of standards that guide the designer or instructor to design quality online courses. We explore how Quality Matters standards guide the identification and analysis of learning analytics data to monitor and improve online learning. Descriptive data were collected for frequency of use, time spent, and…
Kim, Moon Sung; Lee, Kangjin; Chao, Kaunglin; Lefcourt, Alan; Cho, Byung-Kwan; Jun, Won
We developed a push-broom, line-scan imaging system capable of simultaneous measurements of reflectance and fluorescence. The system allows multitasking inspections for quality and safety attributes of apples due to its dynamic capabilities in simultaneously capturing fluorescence and reflectance, and selectivity in multispectral bands. A multitasking image-based inspection system for online applications has been suggested in that a single imaging device that could perform a multitude of both safety and quality inspection needs. The presented multitask inspection approach in online applications may provide an economically viable means for a number of food processing industries being able to adapt to operate and meet the dynamic and specific inspection and sorting needs.
Ghadiyaram, Deepti; Bovik, Alan C
Most publicly available image quality databases have been created under highly controlled conditions by introducing graded simulated distortions onto high-quality photographs. However, images captured using typical real-world mobile camera devices are usually afflicted by complex mixtures of multiple distortions, which are not necessarily well-modeled by the synthetic distortions found in existing databases. The originators of existing legacy databases usually conducted human psychometric studies to obtain statistically meaningful sets of human opinion scores on images in a stringently controlled visual environment, resulting in small data collections relative to other kinds of image analysis databases. Toward overcoming these limitations, we designed and created a new database that we call the LIVE In the Wild Image Quality Challenge Database, which contains widely diverse authentic image distortions on a large number of images captured using a representative variety of modern mobile devices. We also designed and implemented a new online crowdsourcing system, which we have used to conduct a very large-scale, multi-month image quality assessment (IQA) subjective study. Our database consists of over 350 000 opinion scores on 1162 images evaluated by over 8100 unique human observers. Despite the lack of control over the experimental environments of the numerous study participants, we demonstrate excellent internal consistency of the subjective data set. We also evaluate several top-performing blind IQA algorithms on it and present insights on how the mixtures of distortions challenge both end users as well as automatic perceptual quality prediction models. The new database is available for public use at http://live.ece.utexas.edu/research/ChallengeDB/index.html.
Jones, Dussy L.
The purpose of this study is to describe and examine various Internet-based science curricula in terms of their educational value and comprehensiveness. Thirteen online homeschool providers' science curricula were analyzed through an examination of the content and organization of instruction and through a comparison with the seven National Science Education Standards (NSES) in order to assess the pedagogical and developmental appropriateness of online science curriculum, to find the ideological perspectives exhibited by each curriculum, and to identify implications for the future of homeschooling regarding children who use an online science curriculum as the basis of their science education. The results reveal that only a few online schools incorporate all seven NSES in their science curriculum; most online schools' content and instruction have a traditional/behavioral perspective; and the Systematizer theoretical perspective was prevalent in online schools' science curricula. This study investigates the issue of whether online homeschooling can accurately be termed homeschooling. A discussion of education and schooling according to Holt (1976), Illich (1972), and Moore and Moore (1975) explore this issue. The findings from this discussion suggest that the online homeschool movement may be an undiscovered form of "schooling" and that parents, educators, researchers, curriculum developers, and specialists should be aware of the implications online homeschooling has on homeschooling's philosophy of education.
Alferes, J.; Poirier, P.; Lamaire-Chad, C.
procedure is presented that combines univariate off-line and on-line methods to assess water quality sensors and to detect and replace doubtful data. While the off-line concept uses control charts for quality control, the on-line methods aim at outlier and fault detection by using autoregressive models...
Sander, Sara K.
This study explored the relationship between emotional intelligence and students' perceptions of quality of online adjunct faculty and the relationship between emotional intelligence and the job satisfaction of online adjunct faculty. Online adjunct faculty participants completed the Trait Emotional Intelligence Questionnaire--Short Form…
Bardach, Naomi S; Hibbard, Judith H; Greaves, Felix; Dudley, R Adams
In the context of the Affordable Care Act, there is extensive emphasis on making provider quality transparent and publicly available. Online public reports of quality exist, but little is known about how visitors find reports or about their purpose in visiting. To address this gap, we gathered website analytics data from a national group of online public reports of hospital or physician quality and surveyed real-time visitors to those websites. Websites were recruited from a national group of online public reports of hospital or physician quality. Analytics data were gathered from each website: number of unique visitors, method of arrival for each unique visitor, and search terms resulting in visits. Depending on the website, a survey invitation was launched for unique visitors on landing pages or on pages with quality information. Survey topics included type of respondent (eg, consumer, health care professional), purpose of visit, areas of interest, website experience, and demographics. There were 116,657 unique visitors to the 18 participating websites (1440 unique visitors/month per website), with most unique visitors arriving through search (63.95%, 74,606/116,657). Websites with a higher percent of traffic from search engines garnered more unique visitors (P=.001). The most common search terms were for individual hospitals (23.25%, 27,122/74,606) and website names (19.43%, 22,672/74,606); medical condition terms were uncommon (0.81%, 605/74,606). Survey view rate was 42.48% (49,560/116,657 invited) resulting in 1755 respondents (participation rate=3.6%). There were substantial proportions of consumer (48.43%, 850/1755) and health care professional respondents (31.39%, 551/1755). Across websites, proportions of consumer (21%-71%) and health care professional respondents (16%-48%) varied. Consumers were frequently interested in using the information to choose providers or assess the quality of their provider (52.7%, 225/427); the majority of those choosing a
The LHCb experiment at the LHC (CERN) has been optimised for high precision measurements of the beauty quark sector. Its main objective is to precisely determine and over-constrain the parameters of the CKM mixing matrix, and to search for further sources of CP violation and new physics beyond the Standard Model in rare B-decays. Efficient particle identification at high purities over a wide momentum range from around 1 to ~100GeV/c is vital to many LHCb analyses. Central to the LHCb particle identification strategy are two Ring Imaging CHerenkov (RICH) detectors which use Silica Aerogel and C4F10 and CF4 gas radiators. A rigorous quality control scheme is being developed to insure that the data recorded by the RICH detector meets the stringent requirements of the physics analyses. The talk summarises the LHCb RICH online monitoring and data-quality strategy. Multiple dedicated algorithms are deployed to detect any potential issue already during data-taking ranging from integrity checks, mis-alignments to cha...
to the oral and written communication channels of the system, leaving the students with only the possibility to listen. It is a somewhat limiting view that leads to a superficial use of the system. Furthermore, this view brings with it a very narrow definition of the learning process which becomes an exchange......Fast net connections are rapidly becoming available to people and organizations around the world. At the same time, prices on computers and related equipment is dropping. This has paved the way for web conference systems that provide users with easy access to live online communication but that also...... limited to physical class rooms, but can go global via virtual class rooms that can be created in the available web conference system. Most web conference systems provide presentation functions enabling users to show slides, share files and engage in oral and visual communication with the other...
Watson, John; Gemin, Butch
Online learning is growing rapidly as states and districts are creating new online schools, and existing programs are adding new courses and students. The growth reflects the spreading understanding that online courses and programs can serve a wide variety of students and needs. These include: (1) Creating opportunities for small and rural school…
Crozier-Shaw, Geoff; Queally, Joseph M; Quinlan, John F
Metal-on-metal total hip arthroplasty (THA) has generated much attention in the media because of early failure of certain implant systems. This study assessed the quality, accuracy, and readability of online information on metal-on-metal THA. The search terms "metal-on-metal hip replacement" and "metal hip replacement" were entered into the 3 most popular search engines. Information quality was assessed with the DISCERN score and a specific metal-on-metal THA content score. Accuracy of information was assessed with a customized score. Readability of the websites was assessed with the Flesch-Kincaid grade level score. A total of 61 unique websites were assessed. For 56% of websites, the target audience was patients. Media or medicolegal sources accounted for 44% of websites. As assessed by DISCERN (range, 16-80) and metal-on-metal THA (range, 0-25) scores, quality of the websites was moderate at best (47.1 and 9.6, respectively). Accuracy (range, 0-8) of the information presented also was moderate, with a mean score of 6.6. Media and medicolegal websites had the lowest scores for both quality and accuracy, despite making up the greatest proportion of sites assessed. Only 1 website (2%) had a Flesch-Kincaid grade level at or less than the recommended level of 8th grade. This study found that online information on metal-on-metal THA was of poor quality, often was inaccurate, and was presented at an inappropriately high reading level, particularly for media and medicolegal websites. Health care providers should counsel patients on the quality of information available and recommend appropriate online resources. [Orthopedics. 2017; 40(2):e262-e268.]. Copyright 2016, SLACK Incorporated.
Jenaro, C.; Vega, V.; Flores, N.; Cruz, M.
Background: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this…
Full Text Available The article is devoted to the problem of assessing the quality of higher education. In the Russian Federation recently quality assessment of educational services provided by state-accredited universities is carried out by the state represented by the Ministry of education and science. State universities have simulated internal systemseducation quality assessment in accordance with the methodology proposed by the Ministry of education and science. Currently more attention is paid to the independent assessment of education quality which is the basis of professional public accreditation. The project "EQUASP" financed within the framework of the TEMPUS programme is directed to the problem of implementing the methodology of the online model of independent higher education quality assessment in the practice of Russian universities. The proposed model for assessing the quality of education is based on usage of 5 standards. The authors have done a comparative analysis of the model of higher education quality assessment existing in Vyatka State University and the model of education quality assessing offered by European universities-participants of the project EQUASP. The authors have presented the main results of investigation of this problem and some suggestions for improving the model of education quality assessment used by Vyatka State University.
Stracke, Christian M.; Kameas, Achilles; Vassiliadis, Bill; Sgouropoulou, Cleo; Texeira, António Moreira; Pinto, Maria do Carmo; Vidal, Gérard
This paper introduces the Quality Reference Framework (QRF) for the improvement of Massive Open Online Courses (MOOCs) and Open Online Education. It is developed by the European Initiative MOOQ led by the Open University of the Netherlands. The vision of MOOQ is to contribute to fostering quality in
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.
Holm, Rochelle H
Small-scale projects to provide clean drinking water undertaken in the developing world can contribute to significantly improving the livelihood of rural communities. There has been a historical tendency to poorly plan such projects leading to an unsustainable future. Recent history indicates three simple steps to ensuring successful and enduring clean water projects. First, identification of need by the indigenous community provides ownership in the project. Second, a partnership between key individuals in the indigenous community with the donor provides for ambassadors on both sides of the project. Finally, an exit strategy by the donors for the indigenous communities ensures local sustainability for the future. The study site is the village of Geisha in northern Malawi, Africa. Sustainable implementation approaches are discussed in this case study as well as the various lessons learned. Improved project processes ensure sustainable small-scale water quality projects by donor organizations in developing countries. © 2011, The Author(s). Ground Water © 2011, National Ground Water Association.
Betancourt, Joseph R
The goal of this paper is to define cultural competence and present a practical framework to address crosscultural challenges that emerge in the clinical encounter, with a particular focus on the issue of nonadherence. English-language literature, both primary and reports from various agencies, and the author's personal experiences in clinical practice. Relevant literature on patient-centered care and cultural competence. There is a growing literature that delineates the impact of sociocultural factors, race, ethnicity, and limited-English proficiency on health and clinical care. The field of cultural competence focuses on addressing these issues. Health care providers need a practical set of tools and skills that will enable them to provide quality care to patients during a brief encounter, whatever differences in background that may exist. Cultural competence has evolved from the gathering of information and making of assumptions about patients on the basis of their sociocultural background to the development of skills to implement the principles of patient-centered care. This patient-based approach to cross-cultural care consists of first, assessing core cross-cultural issues; second, exploring the meaning of the illness to the patient; third, determining the social context in which the patient lives; and fourth, engaging in negotiation with the patient to encourage adherence. Addressing adherence is a particularly challenging issue, the determinants of which are multifactorial, and the ESFT (explanatory/social/fears/treatment) model--derived from the patient-based approach--is a tool that identifies barriers to adherence and provides strategies to address them. It obviously is impossible to learn everything about every culture and that should not be expected. Instead, we should learn about the communities we care for. More important, we should have a framework that allows us to provide appropriate care for any patient--one that deals with issues of adherence
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.
Lindsay E. Wright
Full Text Available With the expansion of online trainings today, Extension professionals have an opportunity to reach child care providers in more convenient ways. However, having convenient, reliable Internet access can be a barrier to online training for some child care providers, especially those with limited financial resources. This study investigated child care providers’ ability to access online training through convenient, reliable Internet access by asking 494 child care providers in Georgia about their access to and comfort with the Internet. Participants completed a brief 12-question survey that included questions about their Internet access and use for both personal and professional purposes (i.e., whether or not they have Internet access, where they have access, how often they use it, and how comfortable they feel using it. The majority of child care providers reported having Internet access (89.68% and feeling comfortable using the Internet (68.62%, and therefore, have the technological resources to participate in online professional development.
Full Text Available Introduction: Measuring parental satisfaction is of major importance for pediatric hospitals and the key component of evaluating the quality of services provided to health services. Aim: To assess the degree of parental satisfaction from the care provided to their hospitalized children.Methodology: A descriptive study conducted using a convenience sample of parents of hospitalized children in two public pediatric hospitals in Athens. Data collection was completed in a period of 3 months. 352 questionnaires were collected (response rate 88%. The Pyramid Questionnaire for parents of hospitalized children was used which estimates the degree of parental satisfaction from the care provided to their hospitalized child.Results: More parents were satisfied with health care professionals’ behavior (81,9%, the supplied care (78,2% and the information provision to parents regarding the hospitalized child’s disease (71,9%. In contrast, less parents were satisfied with their hospitalized child’s involvement in care (52,3% and the accessibility to the hospital (39,5%. The overall parental satisfaction ranged in very good level (76,8% and it was higher on hospital A (78,8%, among married parents (77,4% and those not al all concerned or concerned less for child’s illness (83,1%. Logistic regression model showed that hospitalization in hospital B and the great concern for child’s illness and its complications decreased ovewrall satisfaction by 24% and 17% respectively. Conclusions: The assessment of the degree of parental satisfaction is the most important indicator of hospitals’ proper functioning. From our study certain areas need improvement, such as: the parental involvement in child’s care, information provision, the accessibility to the hospital, the communication and the interpersonal health care in order greater satisfaction to be achieved.
Mirapeix, Jesús; García-Allende, P Beatriz; Cobo, Adolfo; Conde, Olga M; López-Higuera, José M
An online welding quality system based on the use of imaging spectroscopy is proposed and discussed. Plasma optical spectroscopy has already been successfully applied in this context by establishing a direct correlation between some spectroscopic parameters, e.g., the plasma electronic temperature and the resulting seam quality. Given that the use of the so-called hyperspectral devices provides both spatial and spectral information, we propose their use for the particular case of arc welding quality monitoring in an attempt to determine whether this technique would be suitable for this industrial situation. Experimental welding tests are presented, and the ability of the proposed solution to identify simulated defects is proved. Detailed spatial analyses suggest that this additional dimension can be used to improve the performance of the entire system.
Porter, Toni; Reiman, Kayla; Nelson, Christina; Sager, Jessica; Wagner, Janna
This article presents findings from a quasi-experimental evaluation of quality with a sample of 28 family child care providers in the All Our Kin Family Child Care Network, a staffed family child care network which offers a range of services including relationship-based intensive consultation, and 20 family child care providers who had no…
Fan, Kenneth L; Avashia, Yash J; Dayicioglu, Deniz; DeGennaro, Vincent A; Thaller, Seth R
Immediately after the January 2010 earthquake in Haiti, plastic surgeons provided disaster relief services through the University of Miami Miller School of Medicine for 5 months. To improve surgical care and promote awareness of plastic surgery's role in humanitarian assistance, an online communication platform (OCP) was initiated. An OCP is a Web-based application combining Web blogging, picture uploading, news posting, and private messaging systems into a single platform. The purpose of this study was to analyze the use of OCP during disaster relief. Surgeries performed during the period from January 13 to May 28, 2010, were documented. The OCP was established with 4 priorities: ease of use, multimedia integration, organization capabilities, and security. Web traffic was documented. A 17-question survey was administered to 18 plastic surgeons who used the OCP after 1 year to assess their attitudes and perceptions. From January 13 to May 28, 2010, 413 operations were performed at the field hospital. Of the overall number of procedures, 46.9% were performed by plastic surgery teams. In a year, beginning from January 12, 2011, the OCP had 1117 visits with 530 absolute unique visitors. Of 17 plastic surgeons, 71% responded that the OCP improved follow-up and continuity of care by debriefing rotating plastic surgery teams. One hundred percent claimed that the OCP conveyed the role of plastic surgeons with the public. Results demonstrate the necessity of OCP during disaster relief. Online communication platform permitted secure exchange of surgical management details, follow-up, photos, and miscellaneous necessary recommendations. Posted experiences and field hospital progress assisted in generating substantial awareness regarding the significant role and contribution played by plastic surgeons in disaster relief.
Rhebergen, Martijn D. F.; Hulshof, Carel T. J.; Lenderink, Annet F.; van Dijk, Frank J. H.
Common information facilities do not always provide the quality information needed to answer questions on health or health-related issues, such as Occupational Safety and Health (OSH) matters. Barriers may be the accessibility, quantity and readability of information. Online Question & Answer (Q&A)
Rhebergen, M.D.F.; Hulshof, C.T.J.; Lenderink, A.F.; van Dijk, F.J.H.
ABSTRACT: BACKGROUND: Common information facilities do not always provide the quality information needed to answer questions on health or health-related issues, such as Occupational Safety and Health (OSH) matters. Barriers may be the accessibility, quantity and readability of information. Online
Whitaker, William David
A comprehensive, online, data quality monitoring software package has been developed for the muon system at the European Center for Nuclear Research's (CERN's) Compact Muon Solenoid (CMS) experiment. The package was written in Java, C++, and HTML. It provides real-time, RPC performance feedback in an easy to use graphic user interface (GUI).
Full Text Available The effective management of pain is a complex and costly global issue, requiring a range of innovative educational strategies to enable culturally appropriate and high-quality health care provision. In response to this issue, the Pain Management Research Institute at the University of Sydney (Sydney, Australia has established several strategic alliances with other overseas universities to deliver online postgraduate education in pain management. The present article discusses the rationale for joining forces, and the approach adopted in creating and maintaining these alliances. It also provides insights into the benefits, challenges and opportunities associated with collaborative educational initiatives of this nature, from institutional, academic and student perspectives.
Glas, Cornelis A.W.
In computerized adaptive testing, updating item parameter estimates using adaptive testing data is often called online calibration. This study investigated how to evaluate whether the adaptive testing data used for online calibration sufficiently fit the item response model used. Three approaches
Hayward, Stephen; Pjesky, Rex
This paper uses a blind grading process to test if the performance of online students were different from traditional students using a term paper from an economics graduate course. Consistent with the literature, no significant difference was found between the scores of online students and those of traditional students. Also consistent with the…
Kamerling, Cornelis Ph; Fast, Martin F; Ziegenhein, Peter; Menten, Martin J; Nill, Simeon; Oelfke, Uwe
Firstly, this study provides a real-time implementation of online dose reconstruction for tracked volumetric arc therapy (VMAT). Secondly, this study describes a novel offline quality assurance tool, based on commercial dose calculation algorithms. Online dose reconstruction for VMAT is a computationally challenging task in terms of computer memory usage and calculation speed. To potentially reduce the amount of memory used, we analyzed the impact of beam angle sampling for dose calculation on the accuracy of the dose distribution. To establish the performance of the method, we planned two single-arc VMAT prostate stereotactic body radiation therapy cases for delivery with dynamic MLC tracking. For quality assurance of our online dose reconstruction method we have also developed a stand-alone offline dose reconstruction tool, which utilizes the RayStation treatment planning system to calculate dose. For the online reconstructed dose distributions of the tracked deliveries, we could establish strong resemblance for 72 and 36 beam co-planar equidistant beam samples with less than 1.2% deviation for the assessed dose-volume indicators (clinical target volume D98 and D2, and rectum D2). We could achieve average runtimes of 28-31 ms per reported MLC aperture for both dose computation and accumulation, meeting our real-time requirement. To cross-validate the offline tool, we have compared the planned dose to the offline reconstructed dose for static deliveries and found excellent agreement (3%/3 mm global gamma passing rates of 99.8%-100%). Being able to reconstruct dose during delivery enables online quality assurance and online replanning strategies for VMAT. The offline quality assurance tool provides the means to validate novel online dose reconstruction applications using a commercial dose calculation engine. © 2017 The Authors. Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.
Page, Rebecca M; Besmer, Michael D; Epting, Jannis; Sigrist, Jürg A; Hammes, Frederik; Huggenberger, Peter
We have studied the dynamics of water quality in three karst springs taking advantage of new technological developments that enable high-resolution measurements of bacterial load (total cell concentration: TCC) as well as online measurements of abiotic parameters. We developed a novel data analysis approach, using self-organizing maps and non-linear projection methods, to approximate the TCC dynamics using the multivariate data sets of abiotic parameter time-series, thus providing a method that could be implemented in an online water quality management system for water suppliers. The (TCC) data, obtained over several months, provided a good basis to study the microbiological dynamics in detail. Alongside the TCC measurements, online abiotic parameter time-series, including spring discharge, turbidity, spectral absorption coefficient at 254nm (SAC254) and electrical conductivity, were obtained. High-density sampling over an extended period of time, i.e. every 45min for 3months, allowed a detailed analysis of the dynamics in karst spring water quality. Substantial increases in both the TCC and the abiotic parameters followed precipitation events in the catchment area. Differences between the parameter fluctuations were only apparent when analyzed at a high temporal scale. Spring discharge was always the first to react to precipitation events in the catchment area. Lag times between the onset of precipitation and a change in discharge varied between 0.2 and 6.7h, depending on the spring and event. TCC mostly reacted second or approximately concurrent with turbidity and SAC254, whereby the fastest observed reaction in the TCC time series occurred after 2.3h. The methodological approach described here enables a better understanding of bacterial dynamics in karst springs, which can be used to estimate risks and management options to avoid contamination of the drinking water. Copyright © 2017 Elsevier B.V. All rights reserved.
Kilburn, Brandon; Kilburn, Ashley; Davis, Dexter
E-service quality of online higher education reflects the student's perception of quality of online exchanges across four dimensions: fulfillment, efficiency, system availability and privacy. This study links e-service quality to intentions to remain loyal as mediated by perceived value in an online higher education environment. AMOS is used to…
Murray, Timothy E; Mansoor, Tayyaub; Bowden, Dermot J; O'Neill, Damien C; Lee, Michael J
Investigators aimed to assess online information describing uterine artery embolization (UAE) to examine the quality and readability of websites patients are accessing. A list of applicable, commonly used searchable terms was generated, including "Uterine Artery Embolization," "Fibroid Embolization," "Uterine Fibroid Embolization," and "Uterine Artery Embolisation." Each possible term was assessed across the five most-used English language search engines to determine the most commonly used term. The most common term was then investigated across each search engine, with the first 25 pages returned by each engine included for analysis. Duplicate pages, nontext content such as video or audio, and pages behind paywalls were excluded. Pages were analyzed for quality and readability using validated tools including DISCERN score, JAMA Benchmark Criteria, HONcode Certification, Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Gunning-Fog Index. Secondary features such as age, rank, author, and publisher were recorded. The most common applicable term was "Uterine Artery Embolization" (492,900 results). Mean DISCERN quality of information provided by UAE websites is "fair"; however, it has declined since comparative 2012 studies. Adherence to JAMA Benchmark Criteria has reduced to 6.7%. UAE website readability remains more difficult than the World Health Organization-recommended 7-8th grade reading levels. HONcode-certified websites (35.6%) demonstrated significantly higher quality than noncertified websites. Quality of online UAE information remains "fair." Adherence to JAMA benchmark criteria is poor. Readability is above recommended 7-8th grade levels. HONcode certification was predictive of higher website quality, a useful guide to patients requesting additional information. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Hou, Jiran; Shim, Minsun
Provider-patient communication is an important factor influencing patients' satisfaction and health outcomes. This study draws upon the uses and gratification theory to examine how individuals' perception of communication with healthcare providers is associated with their Internet use for health-related activities. Using the data from the 2007 Health Information National Trends Survey (HINTS), we found that as individuals perceived their communication with providers to be less patient-centered, they were more likely to engage in various types of online health activities, such as using websites for healthy lifestyles, searching for healthcare providers, and seeking health information. Trust in online health information was also found to be a significant predictor of online health activities. The results of this study emphasized the important role of provider-patient communication in motivating individuals to turn to the Internet for health purposes.
Full Text Available The main goal of VoIP services is to provide a reliable and high-quality voice transmission over packet networks. In order to prove the quality of VoIP transmission, several approaches were designed. In our approach, we are concerned about on-line monitoring of RTP and RTCP traffic. Based on these data, we are able to compute main VoIP quality metrics including jitter, delay, packet loss, and finally R-factor and MOS values. This technique of VoIP quality measuring can be directly incorporated into IPFIX monitoring framework where an IPFIX probe analyses RTP/RTCP packets, computes VoIP quality metrics, and adds these metrics into extended IPFIX flow records. Then, these extended data are stored in a central IPFIX monitoring system called collector where can be used for monitoring purposes. This paper presents a functional implementation of IPFIX plugin for VoIP quality measurement and compares the results with results obtained by other tools.
de Vries, B.R.; Leenes, R.E.; Zeleznikow, J.; Zeleznikow, J.; Lodder, A.R.
However, in order to determine BATNAs online, we need a proper understanding of exactly what is a BATNA. This paper argues that current understanding of what comprises BATNAs is insufficient for the intended purposes.
Boyer, Celia; Geissbuhler, Antoine
Created in 1995 in response to consumer enthusiasm for the World Wide Web, Health On the Net FoundationHealth On the Net Foundation: http://www.healthonnet.org/ has developed solutions to address the problem of potentially dangerous online health and medical information. Then as now, no international legal framework regulated online content, and consumers needed to be given the means to check the reliability and the relevance of health information [[1
Weiler, Spencer C.
Online instruction offers students a convenient way to access higher education. However, convenience must never trump quality when it comes to participation in a graduate program. Synchronous learning activities in graduate online courses are an effective way to enhance the learning experiences of all students, and especially those from different…
Holt, Dale; Palmer, Stuart; Munro, Judy; Solomonides, Ian; Gosper, Maree; Hicks, Margaret; Sankey, Michael; Allan, Garry; Hollenbeck, Robert
The paper presents the findings of the first year of a nationally funded Australian Learning and Teaching Council (ALTC) project on the quality management of online learning environments by and through distributed leadership. The project is being undertaken by five Australian universities with major commitments to online and distance education.…
Bruce, Jordan G; Tucholka, Jennifer L; Steffens, Nicole M; Neuman, Heather B
Breast cancer patients commonly use the internet as an information resource. Our objective was to evaluate the quality of online information available to support patients facing a decision for breast surgery. Breast cancer surgery-related queries were performed (Google and Bing), and reviewed for content pertinent to breast cancer surgery. The DISCERN instrument was used to evaluate websites' structural components that influence publication reliability and ability of information to support treatment decision-making. Scores of 4/5 were considered "good." 45 unique websites were identified. Websites satisfied a median 5/9 content questions. Commonly omitted topics included: having a choice between breast conservation and mastectomy (67%) and potential for 2nd surgery to obtain negative margins after breast conservation (60%). Websites had a median DISCERN score of 2.9 (range 2.0-4.5). Websites achieved higher scores on structural criteria (median 3.6 [2.1-4.7]), with 24% rated as "good." Scores on supporting decision-making questions were lower (2.6 [1.3-4.4]), with only 7% scoring "good." Although numerous breast cancer-related websites exist, most do a poor job providing women with essential information necessary to actively participate in decision-making for breast cancer surgery. Providing easily- accessible, high-quality online information has the potential to significantly improve patients' experiences with decision-making. © 2015 Wiley Periodicals, Inc.
... among consumers at the moment. There are some previous studies discussing consumer trust on hotels being reviewed on online review sites, but the roles of information quality, homophily, and consumer risk propensity as antecedents of trust...
Stracke, Christian M.
Paper Presentation at the 25th EDEN Annual Conference 2016, Budapest, Hungary, by Stracke, C. M. (2016, 16 June): "MOOCs are dead! Open Education and the Quality of Online Courses Towards a Common QRF"
Noorshella, Che Nawi; Abdullah, Al Mamun; Nursalihah, Ahmad Raston
e-Service quality (eSQ) is increasingly recognized as an important aspect, as well as the key to determining the competitive advantage and factor in the long-term retention of firms operating online...
BACKGROUND: Chronic Non-Communicable Diseases are among the major causes of morbidity and mortality worldwide. However, access to and quality of health care for patients is very low in developing countries including Ethiopia. Hospitals and Health Centers are the main sources of health care for such patients in ...
Jackson, M.; Tunnell, Cd
Within the Muon Ionization Cooling Experiment (MICE), the MICE Analysis User Software (MAUS) framework performs both online analysis of live data and detailed offline data analysis, simulation, and accelerator design. MAUS consists of four key components: inputters to handle input of live, archived or simulated data; transforms to analyse data; mergers to summarise transformed data in the form of histograms and tables; and outtputters to save this summarised data as images or tabular data. MAUS supports parallel data transformation in a map-reduce-inspired approach, however, the requirements of online reconstruction precluded adoption of a traditional map-reduce solution. A document-oriented database is used to cache transformed data, prior to merging, to support concurrent merging and visualisation of data. In MAUS, both offline and online analysis are implemented and executed in the same way, thereby removing the need for MICE to maintain and use two sets of analysis software, a common requirement elsewhere in experimental particle physics.
Coutinho, Karl; Stensland, Kristian; Hyun, Grace
In 2012, the American Academy of Pediatrics (AAP) newborn circumcision policy statement expressed that although benefits outweigh risks, final decisions lie with parents. Although health information on the Internet is plentiful, the quality and availability of information on circumcision, including dissemination of AAP and AUA policy statements, is unknown. We analyzed English and Spanish circumcision websites to evaluate their overall quality, detail, accuracy, and bias. In April 2013, three search engines were queried for English and Spanish circumcision websites, which were analyzed utilizing the DISCERN Plus scale for content quality as well as additional study-specific criteria. We analyzed 214 websites (141 English, 73 Spanish). Most websites in both languages had very good content quality and were neutral regarding circumcision. Regardless of language, only 21% of sites mentioned the updated AAP guidelines. Surprisingly, the AUA circumcision policy statement did not appear in the top results. Spanish sites were more likely to give good descriptions of circumcision procedures than English sites (p Internet is of very good quality, but different English and Spanish characteristics possibly reflect cultural bias, which may explain the disparate rates of circumcision between different groups in the USA. The AAP's circumcision policy statement was referenced by a minority (20%) of websites, and AUA's policy statement was not even part of the top results. The AUA should have a more active role in providing accurate and comprehensive online information to parents regarding circumcision. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Full Text Available Searching through online review sites becomes an alternative for consumers to obtain product information. The efficiency and effectiveness in finding quality information on the online review sites contributes to the popularity of online review sites among consumers at the moment. There are some previous studies discussing consumer trust on hotels being reviewed on online review sites, but the roles of information quality, homophily, and consumer risk propensity as antecedents of trust and online purchase intention are still questionable. The purpose of this study is to investigate how information quality, homophily, and consumer risk propensity affect consumer trust on hotels being reviewed on online review sites and on intention to make a reservation. A survey involving 430 young travelers from 16 countries was conducted in popular tourist destination. Results confirm that information quality influences consumers’ trust on hotel being reviewed and intention to make reservation. Moreover, consumer online trust is also found to affect intention to make reservation.
Ehrmann, Stephen C.; Collins, Mauri
Suggests that most instructors, administrators, and software developers assume that online interaction collaboration among students must follow the same format as traditional interaction in face-to-face classrooms. Describes examples of virtual classrooms that use the Web to create new kinds of possibilities for collaboration and learning. (LRW)
anymore, but has become everyone's business. Garcia (2009: 205) illustrates the state of affairs when he says: “[Online] MT embodies the trinity of our brave new web world: free, instantaneous, and easy to use.” The latest Google Translate mobile application is further testimony to this: any smartphone user can now use the ...
Collins, Linda J.; Liang, Xin
Funded by Race to the Top, a federal education initiative, the Department of Education of a Midwestern state in the U.S. launched statewide implementation of online teacher professional development (OTPD) to apply formative instructional practices (FIP) to enhance classroom instruction. Central to the design and implementation of OTPD was the need…
The course design and development process (often referred to here as the "production process") at Embry-Riddle Aeronautical University (ERAU-Worldwide) aims to produce turnkey style courses to be taught by a highly-qualified pool of over 800 instructors. Given the high number of online courses and tremendous number of live sections…
Sørensen, Klavs Martin
analysis. An on-line NIR instrument is presented, capable of performing in high production speed (1200 measurements per hour). The system is calibrated against a GC-MS standard, yielding an error comparable to the accuracy of the reference. Boar taint detection has become a hot topic, as an EU ban......This thesis deals with process analytical technology and how it can be implemented in the meat industry through on-line grading of chemical meat quality. The focus will be on two applications, namely the rapid quality control of fat quality and the development of a method for on-line detection...... of boar taint. The chemical makeup of fat has a large effect on meat cut quality. Fat quality has traditionally been determined by methylation of a tissue sample followed by chromatography on a GC-MS system, elucidating the composition of the individual fatty acids. As this procedure typically takes far...
Kalz, Marco; Kreijns, Karel; Walhout, Jaap; Castaño-Munoz, Jonatan; Espasa, Anna; Tovar, Edmundo
While MOOCS have emerged as a new form of open online education around the world, research is stilling lagging behind to come up with a sound theoretical basis that can cover the impact of socio-economic background variables, ICT competences, prior experiences and lifelong learning profile, variance in intentions, environmental influences, outcome…
Abdu Shamsu Dauda
Full Text Available This paper focuses on the role of Facebook use, interactivity with politicians, quality of information and political interest as the predictors of online political participation among youth. The paper argues that Facebook use, interactivity, quality of information and political interests have the potential to engender online political participation among Nigerian youth. Also, by offering them an avenue for acquiring political information necessary for making an informed political decision through deliberations on Facebook; in order to bring new political changes and group mobilization. Therefore, the study was implemented with survey questionnaires collected from youth in Bauchi metropolis (N= 372. Findings reveal that Facebook use, quality of information and political interest positively correlates with online political participation while interactivity with the politicians did not significantly influence online political participation among youth.
Alnafea, Shatha; Fedele, Stefano; Porter, Stephen; Ni Riordain, Richeal
To evaluate the quality and readability of online information about the treatment of burning mouth syndrome (BMS). An internet search using the phrase "burning mouth syndrome treatment" was carried out on the Google search engine (www.google.co.uk) on 8 June 2015, and the first 100 websites listed were examined. Data collection included DISCERN score, the Journal of the American Medical Association (JAMA) benchmarks for website analysis score, the presence of the Health on the Net (HON) Foundation seal, and the Flesch Reading Ease Score (FRES). Descriptive statistics were performed using Microsoft Office Excel. The search strategy initially yielded 635,000 links; following the application of the exclusion criteria, 53 sites remained for analysis. The overall DISCERN score varied between websites, with half of all websites achieving an overall score of 2 and none of these websites achieving the maximum score of 5. The mean score ± standard deviation (SD) was 2.4 ± 0.7. Only 10 (18.9%) of the websites achieved the four JAMA benchmarks while 3 (5.7%) of the websites did not achieve any of them. Only 9 (17%) displayed the HON seal. The FRES of the websites ranged from 32.4 to 82.2; the mean ± SD rating was 55.4 ± 10.7, which is considered to reflect fairly difficult reading. The information available online about BMS is of questionable quality and content. Perhaps engaging patients in determining what type and format of information they desire when searching online for health information could guide clinicians and researchers alike in providing reliable and readable information sources.
Wiley, K E; Steffens, M; Berry, N; Leask, J
The Internet is increasingly a source of health information for parents, who use the Internet alongside health care providers for immunisation information. Concerns have been raised about the reliability of online immunisation information, however to date there has been no audit of the quality or quantity of what is available to Australian parents. The objective of this study was to address this gap by simulating a general online search for immunisation information, and assessing the quality and quantity of the web sites returned by the search. We used Google trends to identify the most common immunisation search terms used in Australia. The ten most common terms were entered into five search engines and the first ten non-commercial results from each search collated. A quality assessment tool was developed using the World Health Organization Global Advisory Committee on Vaccine Safety (GACVS) criteria for assessing the quality of vaccine safety web sites, and used to assess and score the quality of the sites. Seven hundred web pages were identified, of which 514 were duplicates, leaving 186 pages from 115 web sites which were audited. Forty sites did not include human immunisation information, or presented personal opinion about individuals, and were not scored. Of the 75 sites quality scored, 65 (87%) were supportive of immunisation, while 10 (13%) were not supportive. The overall mean quality score was 57/100 (range 14/100 to 92/100). When stratified by pro and anti-vaccination stance, the average quality score for pro-vaccine sites was 61/100, while the average score for anti-vaccine sites was 30/100. Pro-vaccine information could be divided into three content groups: generalist overview with little detail; well-articulated and understandable detail; and lengthy and highly technical explanations. The main area found to be lacking in pro-vaccine sites was lack of transparent authorship. Our findings suggest a need for information which is easily found
Pietragalla, Barbara; Sigg, Christian; Güsewell, Sabine; Clot, Bernard
Long-term phenological observations are now recognized as important indicators for climate change impact studies. With the increased need for phenological data, there is also an increased need for higher data quality. Since 1951 MeteoSwiss has been operating a national phenological observation network. Currently the network consists of about 150 active stations observing up to 69 different phenophases. An important aim of a running three years project at MeteoSwiss is a further increase of the quality of the collected data. The higher data quality will be achieved by an automated procedure performing plausibility checks on the data and by online data-entry. Further measures such as intensified observer instructions and collection of more detailed metadata also contribute to a high data quality standard. The plausibility checks include the natural order of the phenophases within a species and also between different species (with regard to possible natural deviation). Additionally it will be checked if the observed date differs by less than two standard deviations from the average for this phenophase at the altitude of the station. A value outside of these limits is not necessarily a false value, since occurrences of extreme values will be beyond these limits. Therefore, within this check of the limits, the timing of the season of the respective year will also be taken into account. In case of an implausible value a comparison with other stations of the same region and sea level is proposed. A further possibility of data quality control could be to model the different phenophases statistically and to use this model for estimating the likelihood of observed values. An overall exploratory data analysis is currently performed providing a solid basis to implement the best possible methods for the plausibility checks. Important advantages of online data-entry are the near real-time availability of the data as well as the avoidance of various kinds of typical mistakes
Gyu Min Lee
Full Text Available To identify the major factors contributing to the quality of commercial gochujang (fermented red pepper paste, metabolites were profiled by mass spectrometry. In principal component analysis, cereal type (wheat, brown rice, and white rice and species of hot pepper (Capsicum annuum, C. annuum cv. Chung-yang, and C. frutescens affected clustering patterns. Relative amino acid and citric acid levels were significantly higher in wheat gochujang than in rice gochujang. Sucrose, linoleic acid, oleic acid, and lysophospholipid levels were high in brown-rice gochujang, whereas glucose, maltose, and γ-aminobutyric acid levels were high in white-rice gochujang. The relative capsaicinoid and luteolin derivative contents in gochujang were affected by the hot pepper species used. Gochujang containing C. annuum cv. Chung-yang and C. frutescens showed high capsaicinoid levels. The luteolin derivative level was high in gochujang containing C. frutescens. These metabolite variations in commercial gochujang may be related to different physicochemical phenotypes and antioxidant activity.
Küçükdurmaz, Fatih; Gomez, Miguel M; Secrist, Eric; Parvizi, Javad
The Internet has become the most widely-used source for patients seeking information more about their health and many sites geared towards this audience have gained widespread use in recent years. Additionally, many healthcare institutions publish their own patient-education web sites with information regarding common conditions. Little is known about how these resources impact patient health, though, as they have the potential both to inform and to misinform patients regarding their prognosis and possible treatments. In this study we investigated the reliability, readability and quality of information about femoracetabular impingement, a condition which commonly affects young patients. The terms "hip impingement" and "femoracetabular impingement" were searched in Google® in November 2013 and the first 30 results were analyzed. The LIDA scale was used to assess website accessibility, usability and reliability. The DISCERN scale was used to assess reliability and quality of information. The FRE score was used to assess readability. The patient-oriented sites performed significantly worse in LIDA reliability, and DISCERN reliability. However, the FRE score was significantly higher in patient-oriented sites. According to our results, the websites intended to attract patients searching for information regarding femoroacetabular impingement are providing a highly accessible, readable information source, but do not appear to apply a comparable amount of rigor to scientific literature or healthcare practitioner websites in regard to matters such as citing sources for information, supplying methodology and including a publication date. This indicates that while these resources are easily accessed by patients, there is potential for them to be a source of misinformation.
This article uses the example of one of the best-known global payment systems provided by an online platform, PayPal, to analyze the role of private legal orders in creating new markets beyond jurisdictional borders. It shows that a relatively uniform legal order reduces risks involved in
Planar, Dolors; Moya, Soledad
Formative feedback has great potential for teaching and learning in online undergraduate programmes. There is a large number of courses where the main source of feedback is provided by the instructor. This is particularly seen in subjects where assessments are designed based on specific activities which are the same for all students, and where the…
Lu, Naiji; Wu, Hong
Health care service is a high-credence service and patients may face difficulties ascertaining service quality in order to make choices about their available treatment options. Online health communities (OHCs) provide a convenient channel for patients to search for physicians' information, such as Word-of-Mouth (WOM), particularly on physicians' service quality evaluated by other patients. Existing studies from other service domains have proved that WOM impacts consumer choice. However, how patients make a choice based on physicians' WOM has not been studied, particularly with reference to different patient characteristics and by using real data. One thousand eight hundred fifty three physicians' real data were collected from a Chinese online health community. The data were analyzed using ordinary least squares (OLS) method. The study found that functional quality negatively moderated the relationship between technical quality and patient choice, and disease risk moderated the relationship between physicians' service quality and patient choice. Our study recommends that hospital managers need to consider the roles of both technical quality and functional quality seriously. Physicians should improve their medical skills and bedside manners based on the severity and type of disease to provide better service.
Smidt, Esther; Li, Rui; Bunk, Jennifer; Kochem, Timothy; McAndrew, Ashley
The purpose of the present study is to understand administrator, faculty, and student perceptions of quality in distance education courses. We explored the following research question: What is the meaning of "quality" in an online course to administrators, faculty, and students? Survey data from 10 academic administrators, 113 online…
Noroozi, Omid; Biemans, Harm; Mulder, Martin
Teachers often complain about the quality of students' written essays in higher education. This study explores the relations between scripted online peer feedback processes and quality of written argumentative essay as they occur in an authentic learning situation with direct practical relevance.
Holt, Dale; Palmer, Stuart; Gosper, Maree; Sankey, Michael; Allan, Garry
This article reports on the findings of senior leadership interviews in a nationally funded project on distributed leadership in the quality management of online learning environments (OLEs) in higher education. Questions were framed around the development of an OLE quality management framework and the situation of the characteristics of…
Schairer, William W; Kahlenberg, Cynthia A; Sculco, Peter K; Nwachukwu, Benedict U
With the growing opioid crisis in the United States, there has been a push to reduce the utilization of opioids in favor of multimodal analgesia options. The purpose of this study was to evaluate the quality of online resources that patients may use to learn about pain control after total knee arthroplasty (TKA). We identified websites using a combination of search terms about TKA and pain control. A novel grading rubric was created with 25 maximum points, consisting of items that were deemed important for patients to know about the subject. Three authors then independently graded websites and the results averaged. Flesch-Kinkaid reading level was also evaluated. After identifying 166 unique websites, 32 met final inclusion criteria. The overall scores were low-4.7 of 25 total points (18.8%), written at an average 10th grade level. Subgroup scores were 50% for route of administration, 40% for types of analgesia, 23% for opioid-specific items, and 30% for general guidance. Only about half discussed the risks of opioid dependency. The top 3 website total scores ranged from 10.7-12.5 of 25 points. There is a paucity of online information for TKA patients to read about pain control. Most websites provide limited educational content, particularly about opioids. Higher quality information is needed to help patients make decisions with their physicians and to help combat the opioid epidemic. Given the lack of quality information available, there is an opportunity for subspecialty organizations to take a leadership role in such efforts. Copyright © 2017 Elsevier Inc. All rights reserved.
Ismail, Zuriati; Salim, Naomie; Huspi, Sharin Hazlin
Compared to traditional materials or journals, user-generated contents are not peer-reviewed. Lack of quality control and the explosive growth of web contents make the task of finding quality information on the web especially critical. The existence of new facilities for producing web contents such as forum makes this issue more significant. This study focuses on online forums threads or discussion, where the forums contain valuable human-generated information in a form of discussions. Due to the unique structure of the online forum pages, special techniques are required to organize and search for information in these forums. Quality biased retrieval is a retrieval approach that search for relevant document and prioritized higher quality documents. Despite major concern of quality content and recent development of quality biased retrieval, there is an urgent need to understand how quality content is being judged, for retrieval and performance evaluation purposes. Furthermore, even though there are various studies on the quality of information, there is no standard framework that has been established. The primary aim of this paper is to contribute to the understanding of human quality judgment in assessing online forum contents. The foundation of this study is to compare and evaluate different frameworks (for quality biased retrieval and information quality). This led to the finding that many quality dimensions are redundant and some dimensions are understood differently between different studies. We conducted a survey on crowdsourcing community to measure the importance of each quality dimensions found in various frameworks. Accuracy and ease of understanding are among top important dimensions while threads popularity and contents manipulability are among least important dimensions. This finding is beneficial in evaluating contents of online forum.
Obada Daniel RARES
The aim of this paper is to explore the relationship between online flow, also called optimal experience, perceived quality of a restaurant e-commerce website, and customer’s purchase intention. First, we reviewed flow, perceived quality, and purchase intention studies in the literature, and proposed a conceptual model of the hypothesized relationships between our variables. Afterwards, we identified in the literature measuring methods and scales for online flow, perceived quality and custome...
Kuwata, Shigeki; Taniguchi, Shin-ichi; Kato, Atsuko; Inoue, Kazuoki; Yamamoto, Naoya; Ohkura, Tsuyoshi; Teramoto, Kei; Shigemasa, Chiaki; Kondoh, Hiroshi
This study presented a newly developed online groupware system, Metaboli-Net, to yield counseling guidance on diet and exercise to patients with metabolic syndrome. A distinctive feature adopted in the system to maintain the retention rate of patients was the social network service (SNS) that enables the patients to share their dietary and relevant health information with other participants in the same group on the network. A pilot study was conducted to prove the effectiveness of the system in improving the patient's lifestyle and dietary health awareness. SNS also contributed to the participant's adherence to intervention programs.
Tang, Zhao-qi; Liu, Ying; Shu, Ru-xin; Yang, Kai; Zhao, Long-lian; Zhang, Lu-da; Zhang Ye-hui; Li, Jun-hui
In this paper, the 7 different origin before redrying raw tobacco & after redrying sheet tobacco's online near infrared spectroscopy were collected from sorting & redrying production line specifically for "ZHONGHUA" brand. By using the projection model bulit by different origin tobacco's online spectroscopy and the method of variance and correlation analysis, we studied the uniformity and similarity quality characteristics change before and after the redrying of tobacco, which can provide support for understanding the quality of the tobacco material and cigarette product formulations. This study show that selecting about 10,000 by equally spaced sampling time from a huge number of online near infrared spectroscopy, for modeling are feasible, and representative. After manual sorting, threshing, and redrying, the uiformity of each origin tobacco near-infrared spectroscopy can be increased by 10%~35%, homogeneity of the tobacco leaf has been significantly improved. After redrying, the similar relationship embodied in the origin also have significant changes, overall it reduce significantly, that shows the quality differences embodied by origin significantly improve, which can provide greater space for formulations, it shows the need for high-quality Chinese cigarette production requires large amounts of financial and human resources to implement cured tobacco processing. The traditional means of chemical analysis, it takes a lot of time and effort, it is difficult to control the entire processing chain, Near Infrared Spectroscopy with its rapid, non-destructive advantage, not only can achieve real-time detection and quality control, but also can take full advantage of near-infrared spectroscopy information created in the production process, which is a very promising online analytical detection technology in many industries especially in the agricultural and food processing industries.
Bo Højris; Sarah Christine Boesgaard Christensen; Hans-Jørgen Albrechtsen; Christian Smith; Mathis Dahlqvist
Today, microbial drinking water quality is monitored through either time-consuming laboratory methods or indirect on-line measurements. Results are thus either delayed or insufficient to support proactive action. A novel, optical, on-line bacteria sensor with a 10-minute time resolution has been developed. The sensor is based on 3D image recognition, and the obtained pictures are analyzed with algorithms considering 59 quantified image parameters. The sensor counts individual suspended partic...
Özlem H. Ersin
Full Text Available Objectives: The objective of this study was to explore the conformity of online sites with established quality standards. Methods: Online pharmacies with the NABP Verified Internet Pharmacy Practice Sites (VIPPS designation were scrutinized for their conformity with select criteria established by the National Association of Board of Pharmacies (NABP and FDA consumer guidelines. Results: 36 VIPPS certified online pharmacy sites were included in the study. The sites were examined against VIPPS and FDA standards. The criteria related to the design and content of the web site and to the pharmaceutical services being offered through the site. Lack of clear terminological distinction between “online pharmacy” (a business and “online site” (a tool for a business was problematic. Sites did not adhere to uniform design principles. The scope and availability of pharmaceutical services for online consumers were not readily apparent. Conclusion: The very legitimacy of existing criteria for online pharmacies remains to be established. Significant opportunities exist to improve the quality and scope of policies and to tie them more closely to longstanding best-practices in areas such as web usability and pharmaceutical care. Revision recommendations for VIPPS criteria are discussed. Type: Original Research
International Association for K-12 Online Learning, 2011
The mission of the International Association for K-12 Online Learning (iNACOL) is to ensure all students have access to a world-class education and quality online learning opportunities that prepare them for a lifetime of success. "The Online Learning Definitions Project" is designed to provide states, districts, online programs, and…
Keogh, C J; McHugh, S M; Clarke Moloney, M; Hannigan, A; Healy, D A; Burke, P E; Kavanagh, E G; Grace, P A; Walsh, S R
Controversy exists relating to carotid endarterectomy (CEA) versus carotid artery stenting (CAS). We aimed to assess the quality of online patient information relating to both. The Google search engine was searched for "carotid endarterectomy" and "carotid stenting". The first 50 webpages returned were assessed. The Gunning Fog Index (GFI) and Flesch Reading Ease Score (FRES) were calculated to assess readability. The LIDA tool (Minervation Ltd., Oxford, U.K.) was used to assess accessibility, usability and reliability. 20% (n = 10) of the webpages returned for CEA were from peer reviewed sources with 34% (n = 17) posted by hospitals or health services. Comparatively, for CAS, 40% (n = 20) were peer reviewed with 16% (n = 8) posted by hospitals or health services. GFI and FRES scores indicated webpages for both CEA and CAS had poor general readability. Webpages for CEA were easier to read than those for CAS (mean FRES difference of 6.7 (95% CI 0.51 to 12.93, p = 0.03). Median LIDA scores demonstrated acceptable reliability, accessibility and usability of information for both CEA and CAS webpages. The more readable webpages were not associated with higher LIDA scores for either CEA or CAS webpages. Webpages providing information on carotid disease management must be made more readable. Online information currently available to patients regarding CAS is more difficult to read and comprehend than CEA. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Sebrow, Dov; Lavery, Hugh J; Brajtbord, Jonathan S; Hobbs, Adele; Levinson, Adam W; Samadi, David B
To describe a novel, low-cost, online health-related quality of life (HRQOL) survey that allows for automated follow-up and convenient access for patients in geographically diverse locations. Clinicians and investigators have been encouraged to use validated HRQOL instruments when reporting outcomes after radical prostatectomy. The institutional review board approved our protocol and the use of a secure web site (http://www.SurveyMonkey.com) to send patients a collection of validated postprostatectomy HRQOL instruments by electronic mail. To assess compliance with the electronic mail format, a pilot study of cross-sectional surveys was sent to patients who presented for follow-up after robotic-assisted laparoscopic prostatectomy. The response data were transmitted in secure fashion in compliance with the Health Insurance Portability and Accountability Act. After providing written informed consent, 514 patients who presented for follow-up after robotic-assisted laparoscopic prostatectomy from March 2010 to February 2011 were sent the online survey. A total of 293 patients (57%) responded, with an average age of 60 years and a median interval from surgery of 12 months. Of the respondents, 75% completed the survey within 4 days of receiving the electronic mail, with a median completion time of 15 minutes. The total survey administration costs were limited to the web site's $200 annual fee-for-service. An online survey can be a low-cost, efficient, and confidential modality for assessing validated HRQOL outcomes in patients who undergo treatment of localized prostate cancer. This method could be especially useful for those who cannot return for follow-up because of geographic reasons. Copyright © 2012 Elsevier Inc. All rights reserved.
Full Text Available Customer service is crucially important for online shopping platforms (OSPs such as eBay and Taobao. Based on the well-established service quality instruments and the scenario of the specific case on Taobao, this paper focuses on exploring the service quality of an OSP with an aim of revealing customer perceptions of the service quality associated with the provided functions and investigating their impacts on customer loyalty. By an empirical study, this paper finds that the “fulfillment and responsiveness” function is significantly related to the customer loyalty. Further analytical study is conducted to reveal that the optimal service level on the “fulfillment and responsiveness” function for the risk averse OSP uniquely exists. Moreover, the analytical results prove that (i if the customer loyalty is more positively correlated to the service level, it will lead to a larger optimal service level, and (ii the optimal service level is independent of the profit target, the source of uncertainty, and the risk preference of the OSP.
Full Text Available This paper studies the problem of dynamically modeling the quality of web service. The philosophy of designing practical web service recommender systems is delivered in this paper. A general system architecture for such systems continuously collects the user-service invocation records and includes both an online training module and an offline training module for quality prediction. In addition, we introduce matrix factorization-based online and offline training algorithms based on the gradient descent algorithms and demonstrate the fitness of this online/offline algorithm framework to the proposed architecture. The superiority of the proposed model is confirmed by empirical studies on a real-life quality of web service data set and comparisons with existing web service recommendation algorithms.
Michael E. Ward
Full Text Available Some faculty members are reluctant to offer online courses because of significant concerns relative to the impact of such formats on the quality of instruction, learning, and participant interaction. Faculty members from The University of Southern Mississippi implemented synchronous interactive online instruction (SIOI in the spring of 2007. This article explores the rationale for use of the particular technology, faculty conclusions regarding implementation of the technology, and the impact of the technology on instruction and learning. Comparisons by students of the quality of the learning experience in this environment with the quality of learning in face-to-face and asynchronous online learning environments were also analyzed.The study finds that instructors and students view SIOI favourably. The mean student ratings for the dimensions of instructional quality were the same for SIOI and face-to-face course formats in all but one dimension, but mean ratings for SIOI and face-to-face formats were consistently higher than those for asynchronous online instruction. The single exception was for the dimension, ease of access to the course; the SIOI and asynchronous online formats were rated higher than the face-to-face format in this quality dimension. These findings suggest that it is possible to achieve levels of effectiveness in an online instructional format similar to those that are realized in face-to-face delivery. However, there is slight, though not statistically significant, evidence of concern about the quality of student collaboration in SIOI-enabled courses. Thus, instructors will need to capitalize on available mechanisms for interaction and collaboration.
Arif, Nadia; Ghezzi, Pietro
Offering breast cancer patients treatment choice has become a priority as the involvement of patients in the decision-making process is associated with improved physical and psychological outcomes. As the Internet is increasingly being used by patients as a source of medical information, it is important to evaluate the quality of information relating to breast cancer on the Internet. We analysed 200 websites returned by google.co.uk searching "breast cancer treatment options" in terms of their typology and treatment options described. These were related to standard measures of health information quality such as the JAMA score and the presence of quality certifications, as well as readability. We found that health portals were of higher quality whilst commercial and professional websites were of poorer quality in terms of JAMA criteria. Overall, readability was higher than previously reported for other conditions, and Google ranked websites with better readability higher. Most websites discussed surgical and medical treatments. Few websites, with a large proportion being of commercial typology, discussed complementary and alternative medicine. Google ranked professional websites low whilst websites from non-profit organizations were promoted in the ranking. Copyright © 2017 Elsevier Ltd. All rights reserved.
Hu, Ze; Zhang, Zhan; Yang, Haiqin; Chen, Qing; Zuo, Decheng
Recently, online health expert question-answering (HQA) services (systems) have attracted more and more health consumers to ask health-related questions everywhere at any time due to the convenience and effectiveness. However, the quality of answers in existing HQA systems varies in different situations. It is significant to provide effective tools to automatically determine the quality of the answers. Two main characteristics in HQA systems raise the difficulties of classification: (1) physicians' answers in an HQA system are usually written in short text, which yields the data sparsity issue; (2) HQA systems apply the quality control mechanism, which refrains the wisdom of crowd. The important information, such as the best answer and the number of users' votes, is missing. To tackle these issues, we prepare the first HQA research data set labeled by three medical experts in 90days and formulate the problem of predicting the quality of answers in the system as a classification task. We not only incorporate the standard textual feature of answers, but also introduce a set of unique non-textual features, i.e., the popular used surface linguistic features and the novel social features, from other modalities. A multimodal deep belief network (DBN)-based learning framework is then proposed to learn the high-level hidden semantic representations of answers from both textual features and non-textual features while the learned joint representation is fed into popular classifiers to determine the quality of answers. Finally, we conduct extensive experiments to demonstrate the effectiveness of including the non-textual features and the proposed multimodal deep learning framework. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available This study describes the development and validation of quality indicators for analyzing forums interactions in an online course in biology teaching. The aim is to evaluate the quality of communication so as to strengthen the tutor’s role and help students learn fundamental biology concepts while enhancing their collaboration competencies. The indicators are used to analyze cognitive, metacognitive and relational aspects, drawing on a content analysis methodology. The model appears to have a wide range of possible applications in other online courses.
Wang, Dean; Jayakar, Rohit G; Leong, Natalie L; Leathers, Michael P; Williams, Riley J; Jones, Kristofer J
Objective Patients commonly use the Internet to obtain their health-related information. The purpose of this study was to investigate the quality, accuracy, and readability of online patient resources for the management of articular cartilage defects. Design Three search terms ("cartilage defect," "cartilage damage," "cartilage injury") were entered into 3 Internet search engines (Google, Bing, Yahoo). The first 25 websites from each search were collected and reviewed. The quality and accuracy of online information were independently evaluated by 3 reviewers using predetermined scoring criteria. The readability was evaluated using the Flesch-Kincaid (FK) grade score. Results Fifty-three unique websites were evaluated. Quality ratings were significantly higher in websites with a FK score >11 compared to those with a score of ≤11 ( P = 0.021). Only 10 websites (19%) differentiated between focal cartilage defects and diffuse osteoarthritis. Of these, 7 (70%) were elicited using the search term "cartilage defect" ( P = 0.038). The average accuracy of the websites was high (11.7 out of maximum 12), and the average FK grade level (13.4) was several grades higher than the recommended level for readable patient education material (eighth grade level). Conclusions The quality and readability of online patient resources for articular cartilage defects favor those with a higher level of education. Additionally, the majority of these websites do not distinguish between focal chondral defects and diffuse osteoarthritis, which can fail to provide appropriate patient education and guidance for available treatment. Clinicians should help guide patients toward high-quality, accurate, and readable online patient education material.
Quality assurance in the education sector is the systematic review of educational programmes to ensure that acceptable standards of education, scholarship and infrastructure are being maintained. The current vision and strategic direction of many organisations has raised the importance of using technology to create ...
Graham, Todd; Witschge, Tamara
Many advocates of deliberative democracy see in the Internet a new opportunity for the development of public spaces, public spheres, and places where deliberation can take place. An important element of the notion of the public sphere in general and of deliberation specifically, is the quality of
Short, Camille E; Gelder, Charlotte; Binnewerg, Lena; McIntosh, Megan; Turnbull, Deborah
While the internet is considered a promising avenue for providing physical activity support to prostate cancer survivors, little is known about the accessibility of quality websites in the real world. This work aimed to explore what websites prostate cancer survivors are likely to find when seeking physical activity support online and to evaluate their quality using evidenced-based criteria. A search strategy was developed in consultation with prostate cancer survivors (n = 44) to reflect the most common ways they are likely to search the internet. The search was then conducted by a single reviewer, and identified websites were assessed for quality by two reviewers using an evidence-based quality assessment tool developed for this study. Discrepancies were resolved by a third reviewer. Of the 45 identified websites, 13 (29%) received a high quality rating, 22 (49%) received a moderate rating and 10 (22%) received a low quality rating. Higher-quality websites tended to have a .org or .gov domain and tended to be located using searches specific to prostate cancer or prostate cancer and exercise. Very few websites contained complete information regarding the physical activity guidelines for cancer survivors, and no websites provided comprehensive behaviour change support. There are some good-quality physical activity websites accessible to men with prostate cancer. However, they may be difficult to find and/or require updating to include complete recommendations and more behaviour change support. Efforts to improve physical activity information online and strategies to direct prostate cancer survivors to higher-quality websites and support services are needed to ensure safety and efficacy.
Tembuyser, Lien; Dequeker, Elisabeth M C
Quality assurance is an indispensable element in a molecular diagnostic laboratory. The ultimate goal is to warrant patient safety. Several risks that can compromise high quality procedures are at stake, from sample collection to the test performed by the laboratory, the reporting of test results to clinicians, and the organization of effective external quality assessment schemes. Quality assurance should therefore be safeguarded at each level and should imply a holistic multidisciplinary approach. This review aims to provide an overview of good quality assurance practices and discusses certain risks and recommendations to promote and improve quality assurance for both diagnostic laboratories and for external quality assessment providers. The number of molecular targets is continuously rising, and new technologies are evolving. As this poses challenges for clinical implementation and increases the demand for external quality assessment, the formation of an international association for improving quality assurance in molecular pathology is called for.
Adelstein, David; Barbour, Michael
In 2011, the International Association for K-12 Online Learning released the second iteration of the "National Standards for Quality Online Courses." These standards have been used by numerous institutions and states around the country to help design and create K-12 online courses. However, there has been no reported research on the…
Black, Erik; Light, Jennifer; Paradise Black, Nicole; Thompson, Lindsay
The majority of workers, regardless of age or occupational status, report engaging in personal Internet use in the workplace. There is little understanding of the impact that personal Internet use may have on patient care in acute clinical settings. The objective of this study was to investigate the volume of one form of personal Internet use-online social networking (Facebook)-generated by workstations in the emergency department (ED) in contrast to measures of clinical volume and severity. The research team analyzed anonymous network utilization records for 68 workstations located in the emergency medicine department within one academic medical center for 15 consecutive days (12/29/2009 to 1/12/2010). This data was compared to ED work index (EDWIN) data derived by the hospital information systems. Health care workers spent an accumulated 4349 minutes (72.5 hours) browsing Facebook, staff cumulatively visited Facebook 9369 times and spent, on average, 12.0 minutes per hour browsing Facebook. There was a statistically significant difference in the time spent on Facebook according to time of day (19.8 minutes per hour versus 4.3 minutes per hour, P<.001). There was a significant, positive correlation between EDWIN scores and time spent on Facebook (r=.266, P<.001). Facebook use constituted a substantive percentage of staff time during the 15-day observation period. Facebook use increased with increased patient volume and severity within the ED.
Meng, Lexuan; Chaudhary, Sanjay K.; Guerrero, Josep M.
Customers may have different power quality requirements, thus, the economic operational strategy can try to provide them with distinctive quality levels as customized service. An optimization based method is proposed in this paper to realize this functionality, offering the possibility...
Elizabeth M. Borycki
Full Text Available This special issue of the Knowledge Management & E-Learning: An International Journal is dedicated to describing “Advances in Healthcare Provider and Patient Training to Improve the Quality and Safety of Patient Care.” Patient safety is an important and fundamental requirement of ensuring the quality of patient care. Training and education has been identified as a key to improving healthcare provider patient safety competencies especially when working with new technologies such as electronic health records and mobile health applications. Such technologies can be harnessed to improve patient safety; however, if not used properly they can negatively impact on patient safety. In this issue we focus on advances in training that can improve patient safety and the optimal use of new technologies in healthcare. For example, use of clinical simulations and online computer based training can be employed both to facilitate learning about new clinical discoveries as well as to integrate technology into day to day healthcare practices. In this issue we are publishing papers that describe advances in healthcare provider and patient training to improve patient safety as it relates to the use of educational technologies, health information technology and on-line health resources. In addition, in the special issue we describe new approaches to training and patient safety including, online communities, clinical simulations, on-the-job training, computer based training and health information systems that educate about and support safer patient care in real-time (i.e. when health professionals are providing care to patients. These educational and technological initiatives can be aimed at health professionals (i.e. students and those who are currently working in the field. The outcomes of this work are significant as they lead to safer care for patients and their family members. The issue has both theoretical and applied papers that describe advances in patient
Orizio, Grazia; Merla, Anna; Schulz, Peter J; Gelatti, Umberto
Online pharmacies are companies that sell pharmaceutical preparations, including prescription-only drugs, on the Internet. Very little is known about this phenomenon because many online pharmacies operate from remote countries, where legal bases and business practices are largely inaccessible to international research. The aim of the study was to perform an up-to-date and comprehensive review of the scientific literature focusing on the broader picture of online pharmacies by scanning several scientific and institutional databases, with no publication time limits. We searched 4 electronic databases up to January 2011 and the gray literature on the Internet using the Google search engine and its tool Google Scholar. We also investigated the official websites of institutional agencies (World Health Organization, and US and European centers for disease control and drug regulation authorities). We focused specifically on online pharmacies offering prescription-only drugs. We decided to analyze and report only articles with original data, in order to review all the available data regarding online pharmacies and their usage. We selected 193 relevant articles: 76 articles with original data, and 117 articles without original data (editorials, regulation articles, or the like) including 5 reviews. The articles with original data cover samples of online pharmacies in 47 cases, online drug purchases in 13, consumer characteristics in 15, and case reports on adverse effects of online drugs in 12. The studies show that random samples with no specific limits to prescription requirements found that at least some websites sold drugs without a prescription and that an online questionnaire was a frequent tool to replace prescription. Data about geographical characteristics show that this information can be concealed in many websites. The analysis of drug offer showed that online a consumer can get virtually everything. Regarding quality of drugs, researchers very often found
Firschein, Oscar; Summit, Roger K.
DIALOG, an interactive, computer-based information retrieval language, consists of a series of computer programs designed to make use of direct access memory devices in order to provide the user with a rapid means of identifying records within a specific memory bank. Using the system, a library user can be provided access to sixteen distinct and…
Full Text Available Abstract Background Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1 post-operative AIS patients or surgical candidates (10-18 years (n = 11, (2 their parents (n = 6 and (3 health care providers (n = 11. This paper reports on the findings from focus groups with health care providers. Methods Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Results Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1 create the website with the target audience in mind; (2 clearly state the purpose of the website and organize website content
Macculloch, Radha; Nyhof-Young, Joyce; Nicholas, David; Donaldson, Sandra; Wright, James G
Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1) post-operative AIS patients or surgical candidates (10-18 years) (n = 11), (2) their parents (n = 6) and (3) health care providers (n = 11). This paper reports on the findings from focus groups with health care providers. Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1) create the website with the target audience in mind; (2) clearly state the purpose of the website and organize website content to support the user; (3) offer a
Smith, David E.; Mitry, Darryl J.
In this article, the authors describe an analytical inquiry into the cost and quality issues of online pedagogy in university education. Using economic theory, pedagogical insight, survey findings, experiments, and other studies that researchers have reported in the literature, the authors address these issues, identify answers, and present…
Rotundo, Enrico; Blank, M.; Moser, C.; Leopold, H.
The Internet has fundamentally changed how work gets done in the 21st century. For example, people increasingly spend time on the Internet where they share and develop knowledge in online communities. Yet, little is known about how high-quality knowledge comes about in these communities. This is
The Internet has become one of the main means of communication used by people who search for health-related information. The quality of online health-related information affects the users’ knowledge, their attitude, and their risk or health behaviour in complex ways and influences a substantial number of users in their decisions regarding diagnostic and treatment procedures.
Full Text Available The Internet has become one of the main means of communication used by people who search for health-related information. The quality of online health-related information affects the users’ knowledge, their attitude, and their risk or health behaviour in complex ways and influences a substantial number of users in their decisions regarding diagnostic and treatment procedures.
Sorensen, Elsebeth K.; Takle, Eugene S.; Moser, Heather M.
This paper reports on a case study on the implementation of "language games" as a pedagogical tool for analyzing, assessing and promoting the quality and the level of collaborative knowledge building in online learning dialogues. Part of the overall objective is to explore the use, strength, weaknesses, and limitations of using the…
Sebastianelli, Rose; Swift, Caroline; Tamimi, Nabil
The authors examined how six factors related to content and interaction affect students' perceptions of learning, satisfaction, and quality in online master of business administration (MBA) courses. They developed three scale items to measure each factor. Using survey data from MBA students at a private university, the authors estimated structural…
Shortt, S. E. D.; Guillemette, Jean-Marc; Duncan, Anne Marie; Kirby, Frances
Introduction: The rapid increase in the use of the Internet for continuing education by physicians suggests the need to define quality criteria for accredited online modules. Methods: Continuing medical education (CME) directors from Canadian medical schools and academic researchers participated in a consensus process, Modified Nominal Group…
Jarrell, Charles M.
Researchers and marketers lack information about possible relationships between service quality and online brand equity in intangible and often undifferentiated service businesses. The services sector of the economy is large with 72% of the economic output and 80% of the workers in the United States in 2007. Within the services sector, Internet…
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.
Donna M. Kridelbaugh
Full Text Available Citizen science is becoming even more accessible to the general public through technological advances in the development of mobile applications, facilitating information dissemination and data collection. With the advent of “big data,” many citizen-science projects designed to help researchers sift through piles of research data now exist entirely online, either in the form of playing a game or via other digital avenues. Recent trends in citizen science have also focused on “crowdsourcing” solutions from the general public to help solve societal issues, often requiring nothing more than brainstorming and a computer to submit ideas. Online citizen science thus provides an excellent platform to expand the accessibility of experiential learning opportunities for a broad range of nonmajor science students at institutions with limited resources (e.g., community colleges. I created an activity for a general microbiology lecture to engage students in hands-on experiences via participation in online citizen-science projects. The objectives of the assignment were for students to: 1 understand that everyone can be a scientist; 2 learn to be creative and innovative in designing solutions to health and science challenges; and 3 further practice science communication skills with a written report. This activity is designed for introductory science courses with nonmajor science students who have limited opportunities to participate in undergraduate research experiences.
Mugisha, John Frank; Reynolds, Heidi
Provider perspectives on the quality of family planning services have been overlooked in quality of care research and interventions. This qualitative study was carried out in four districts in Uganda, a country where lack of access to quality family planning services remains a challenge. Using four focus group discussions, 16 provider in-depth interviews and nine manager in-depth interviews, this study documented providers' perceptions of quality of care and of barriers to quality services at the organisational and societal levels. To guide study development, analysis and interpretation, the authors relied on an ecological framework where providers' abilities are shaped by the larger organisational and societal environments in which providers live and work. Providers felt that organisational factors, such as supply availability, workload and their own knowledge and skills, affected their abilities to offer quality care. At the same time, providers were challenged by societal factors such as male partner participation, financial constraints, misconceptions and leadership support. While making changes to the elements of quality care that clients experience is important, it is not sufficient in view of the organisational and social barriers. Across the different levels of the ecological framework, providers face barriers to providing quality family planning services that are synergistic. Solutions to improve quality of care must address also limitations at the organisational and societal levels since efforts to overcome a particular constraint are less likely to be successful if this interdependence is not taken into account.
Full Text Available Adolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world's adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents.This cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015.At the national level 13.9% (95%CI: 6.9-26.0 of healthcare units provide low quality, 68.6% (95%CI: 58.4-77.3 medium quality and 17.5% (95%CI: 11.9-25.0 high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best.The study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care.
Background Japanese nurses are increasingly required to read published international research in clinical, educational, and research settings. Language barriers are a significant obstacle, and online machine translation (MT) is a tool that can be used to address this issue. We examined the quality of Google Translate® (English to Japanese and Korean to Japanese), which is a representative online MT, using a previously verified evaluation method. We also examined the perceived usability and current use of online MT among Japanese nurses. Findings Randomly selected nursing abstracts were translated and then evaluated for intelligibility and usability by 28 participants, including assistants and research associates from nursing universities throughout Japan. They answered a questionnaire about their online MT use. From simple comparison of mean scores between two language pairs, translation quality was significantly better, with respect to both intelligibility and usability, for Korean-Japanese than for English-Japanese. Most respondents perceived a language barrier. Online MT had been used by 61% of the respondents and was perceived as not useful enough. Conclusion Nursing articles translated from Korean into Japanese by an online MT system could be read at an acceptable level of comprehension, but the same could not be said for English-Japanese translations. Respondents with experience using online MT used it largely to grasp the overall meanings of the original text. Enrichment in technical terms appeared to be the key to better usability. Users will be better able to use MT outputs if they improve their foreign language proficiency as much as possible. Further research is being conducted with a larger sample size and detailed analysis. PMID:23151362
Anazawa, Ryoko; Ishikawa, Hirono; Park, M J; Kiuchi, Takahiro
Japanese nurses are increasingly required to read published international research in clinical, educational, and research settings. Language barriers are a significant obstacle, and online machine translation (MT) is a tool that can be used to address this issue. We examined the quality of Google Translate® (English to Japanese and Korean to Japanese), which is a representative online MT, using a previously verified evaluation method. We also examined the perceived usability and current use of online MT among Japanese nurses. Randomly selected nursing abstracts were translated and then evaluated for intelligibility and usability by 28 participants, including assistants and research associates from nursing universities throughout Japan. They answered a questionnaire about their online MT use. From simple comparison of mean scores between two language pairs, translation quality was significantly better, with respect to both intelligibility and usability, for Korean-Japanese than for English-Japanese. Most respondents perceived a language barrier. Online MT had been used by 61% of the respondents and was perceived as not useful enough. Nursing articles translated from Korean into Japanese by an online MT system could be read at an acceptable level of comprehension, but the same could not be said for English-Japanese translations. Respondents with experience using online MT used it largely to grasp the overall meanings of the original text. Enrichment in technical terms appeared to be the key to better usability. Users will be better able to use MT outputs if they improve their foreign language proficiency as much as possible. Further research is being conducted with a larger sample size and detailed analysis.
Full Text Available Abstract Background Japanese nurses are increasingly required to read published international research in clinical, educational, and research settings. Language barriers are a significant obstacle, and online machine translation (MT is a tool that can be used to address this issue. We examined the quality of Google Translate® (English to Japanese and Korean to Japanese, which is a representative online MT, using a previously verified evaluation method. We also examined the perceived usability and current use of online MT among Japanese nurses. Findings Randomly selected nursing abstracts were translated and then evaluated for intelligibility and usability by 28 participants, including assistants and research associates from nursing universities throughout Japan. They answered a questionnaire about their online MT use. From simple comparison of mean scores between two language pairs, translation quality was significantly better, with respect to both intelligibility and usability, for Korean-Japanese than for English-Japanese. Most respondents perceived a language barrier. Online MT had been used by 61% of the respondents and was perceived as not useful enough. Conclusion Nursing articles translated from Korean into Japanese by an online MT system could be read at an acceptable level of comprehension, but the same could not be said for English-Japanese translations. Respondents with experience using online MT used it largely to grasp the overall meanings of the original text. Enrichment in technical terms appeared to be the key to better usability. Users will be better able to use MT outputs if they improve their foreign language proficiency as much as possible. Further research is being conducted with a larger sample size and detailed analysis.
Garrison, Brian Wade
After providing access to over 100 video interviews conducted by a professor with notable entertainers and personalities from film through an institutional repository, an experiment was conducted to discover whether a larger audience could be gained by adding a subset of 32 of these videos to YouTube. The results, over 400,000 views, indicate that…
Milner, Rachel; Parrish, Jonathan; Wright, Adrienne; Gnarpe, Judy; Keenan, Louanne
In a large-enrollment, introductory biochemistry course for nonmajors, the authors provide students with formative feedback through practice questions in PDF format. Recently, they investigated possible benefits of providing the practice questions via an online game (Brainspan). Participants were randomly assigned to either the online game group…
Conclusion: According to our results, the websites intended to attract patients searching for information regarding femoroacetabular impingement are providing a highly accessible, readable information source, but do not appear to apply a comparable amount of rigor to scientific literature or healthcare practitioner websites in regard to matters such as citing sources for information, supplying methodology and including a publication date. This indicates that while these resources are easily accessed by patients, there is potential for them to be a source of misinformation.
Pagán-Ortiz, Marta E.; Dharma E. Cortés; Rudloff, Noelle; Weitzman, Patricia; Levkoff, Sue
One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, since linguistically and culturally appropriate information is often not available. In response to these needs, we developed a website for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and ...
Højris, Bo; Christensen, Sarah Christine Boesgaard; Albrechtsen, Hans-Jørgen
Today, microbial drinking water quality is monitored through either time-consuming laboratory methods or indirect on-line measurements. Results are thus either delayed or insufficient to support proactive action. A novel, optical, on-line bacteria sensor with a 10-minute time resolution has been...... developed. The sensor is based on 3D image recognition, and the obtained pictures are analyzed with algorithms considering 59 quantified image parameters. The sensor counts individual suspended particles and classifies them as either bacteria or abiotic particles. The technology is capable of distinguishing...... conditions such as pollution events in drinking water....
Pagán-Ortiz, Marta E; Cortés, Dharma E; Rudloff, Noelle; Weitzman, Patricia; Levkoff, Sue
One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, because linguistically and culturally appropriate information is often not available. In response to these needs, we developed a web site for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and then evaluated by caregivers residing in 3 countries. Findings suggest trends that exposure to information may be related to a higher sense of mastery and a reduction of depressive symptomatology.
Critchley, Christine; Nicol, Dianne; Otlowski, Margaret; Chalmers, Don
The success of personalised medicine depends upon the public's embracing genetic tests. Tests that claim to predict an individual's future health can now be accessed via online companies outside of conventional health regulations. This research assessed the extent to which the public embrace direct-to-consumer (DTC) genetic tests relative to those obtained by a conventional medical practitioner (MP). It also examined the reasons for differences across providers using a randomised experimental telephone survey of 1000 Australians. Results suggest that people were significantly less likely to approve of, and order a DTC genetic test administered by a company compared to a MP because they were less trusting of companies' being able to protect their privacy and provide them with access to genetic expertise and counselling. Markets for DTC genetic tests provided by companies would therefore significantly increase if trust in privacy protection and access to expertise are enhanced through regulation. © The Author(s) 2014.
Sleath, Betsy; Sayner, Robyn; Vitko, Michelle; Carpenter, Delesha M; Blalock, Susan J; Muir, Kelly W; Giangiacomo, Annette L; Hartnett, Mary Elizabeth; Robin, Alan L
The purpose of this study was to: (a) describe the extent to which ophthalmologists and glaucoma patients discuss vision quality-of-life during office visits, and (b) examine the association between patient and ophthalmologist characteristics and provider-patient communication about vision quality-of-life. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients' visits were video-tape recorded and quality-of-life communication variables were coded. Generalized estimating equations were used to analyze the data. Two hundred and seventy-nine patients participated. Specific glaucoma quality-of-life domains were discussed during only 13% of visits. Older patients were significantly more likely to discuss one or more vision quality-of-life domains than younger patients. African American patients were significantly less likely to make statements about their vision quality-of-life and providers were less likely to ask them one or more vision quality-of-life questions than non-African American patients. Eye care providers and patients infrequently discussed the patient's vision quality-of-life during glaucoma visits. African American patients were less likely to communicate about vision quality-of-life than non-African American patients. Eye care providers should make sure to discuss vision quality-of-life with glaucoma patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Muhammad Asrar Fathoni
Full Text Available Implementasi sitem informasi KRS-Online dalam perkuliahan digunakan untuk membantu proses penyusunan KRS oleh setiap mahasiswa Universitas Muhammadiyah Malang. Penelitian ini bertujuan untuk mengukur dan menguji variabel-variabel serta indikator yang memperngaruhi kesuksesan sistem informasi KRS-Online UMM. Model penelitian ini mengadopsi model penelitian Delone and Mclean IS Success. Satu set kuisoner yang disusun dalam penelitian ini disebarkan kepada 100 responden yang memiliki kualifikasi sebagai mahasiswa pengguna sistem KRS-Online.Uji validitas dan uji reliabilitas dilakukan untuk memperoleh data yang valid dan reliabel. Hasil penelitian menunjukkan bahwa kualitas sistem memiliki pengaruh yang signifikan antara terhadap kepuasan pengguna, kualitas informasi memiliki pengaruh yang signifikan terhadap kepuasan pengguna, kualitas layanan memiliki pengaruh yang signifikan terhadap kepuasan pengguna dan kepuasan pengguna memiliki pengaruh yang signifikan terhadap net benefit. Berdasarkan hasil analisa, kesuksesan sistem informasi KRS-Online UMM memiliki presentase sebesar 70,5% yang artinya kesuksesan sistem informasi KRS-Online UMM berada pada tingkatan “sukses”.
Galetakis, Michael J. [Technical University of Crete, Dept. of Mineral Resources Engineering, University Campus, 73 100 Hania (Greece); Pavloudakis, Francis F. [Public Power Corporation SA, General Division of Mines, Kifisou and Dyrrahiou 89, 104 43 Athens (Greece)
A sustainable coal industry needs to achieve a number of objectives including improvements in utilization of deposits, energy efficiency, and environmental performance during combustion. The ''Clean Coal Concept'' promises to combine the secure and low cost electricity supply offered by hard coal and lignite with adequate environmental precautions. In this context, modern quality control systems, which are greatly based on the on-line analyzers, play an important role in achieving sustainability targets. This paper examines the possibility of using commercial on-line analysis systems for monitoring the mineral matter content of low quality lignite mined from the lignite basin of Megalopolis, Peloponnese, Greece. The effect of the accuracy of the on-line analyzers to process control, when used for the characterization of low rank coals with complex and variable composition, is investigated by carrying out numerous bench- and pilot-scale trials. Pilot-scale trials were based on a dual energy gamma-ray transmission analyzer, which was installed on the conveyor belt that transports lignite from the mine pit to the homogenization stockyard. All measurement data were compared to data gathered during the realisation of similar trials in the lignite mines of Ptolemais Basin, Northern Greece. Results indicated that the accuracy of the on-line measurements was not satisfactory and did not allow lignite quality monitoring in real time. The achieved inferior accuracy of the on-line measurement's accuracy, compared to previous applications at other mining sites, was related to the intense variation of the mineral matter content of lignite and lignite composition, which distorted the calibration of the analyzer. The latter is based on certain assumptions regarding the average mass absorption coefficient of the organic and mineral matter contained in the lignite. Further experimental work is needed to investigate solutions for successful implementation of
Che Nawi Noorshella
Full Text Available e-Service quality (eSQ is increasingly recognized as an important aspect, as well as the key to determining the competitive advantage and factor in the long-term retention of firms operating online. This study, therefore, is aimed at identifying the key determinants of eSQ among the small online apparel businesses in Malaysia. This study used a cross-sectional design, and data were collected from 765 customers who purchased apparel online at the point-of-purchase. Findings of this study indicate that “product information quality,” “website design,” “security and privacy,” and “expected consumer service” are the key determinants of eSQ among small online apparel businesses in Malaysia. The implication for the owner-managers of the apparel businesses in Malaysia is that they must be aware of the significance of the key eSQ indicators while designing their businesses, to attract and retain customers.
Momeni, Naghmeh; Rabbat, Michael
The friendship paradox is the phenomenon that in social networks, people on average have fewer friends than their friends do. The generalized friendship paradox is an extension to attributes other than the number of friends. The friendship paradox and its generalized version have gathered recent attention due to the information they provide about network structure and local inequalities. In this paper, we propose several measures of nodal qualities which capture different aspects of their activities and influence in online social networks. Using these measures we analyse the prevalence of the generalized friendship paradox over Twitter and we report high levels of prevalence (up to over 90% of nodes). We contend that this prevalence of the friendship paradox and its generalized version arise because of the hierarchical nature of the connections in the network. This hierarchy is nested as opposed to being star-like. We conclude that these paradoxes are collective phenomena not created merely by a minority of well-connected or high-attribute nodes. Moreover, our results show that a large fraction of individuals can experience the generalized friendship paradox even in the absence of a significant correlation between degrees and attributes.
Full Text Available The friendship paradox is the phenomenon that in social networks, people on average have fewer friends than their friends do. The generalized friendship paradox is an extension to attributes other than the number of friends. The friendship paradox and its generalized version have gathered recent attention due to the information they provide about network structure and local inequalities. In this paper, we propose several measures of nodal qualities which capture different aspects of their activities and influence in online social networks. Using these measures we analyse the prevalence of the generalized friendship paradox over Twitter and we report high levels of prevalence (up to over 90% of nodes. We contend that this prevalence of the friendship paradox and its generalized version arise because of the hierarchical nature of the connections in the network. This hierarchy is nested as opposed to being star-like. We conclude that these paradoxes are collective phenomena not created merely by a minority of well-connected or high-attribute nodes. Moreover, our results show that a large fraction of individuals can experience the generalized friendship paradox even in the absence of a significant correlation between degrees and attributes.
Full Text Available Online instructional ratings are taken by many with a grain of salt. This study analyzes the ability of said ratings to estimate the official (university-administered instructional ratings of the same respective university instructors. Given self-selection among raters, we further test whether more online ratings of instructors lead to better prediction of official ratings in terms of both R-squared value and root mean squared error. We lastly test and correct for heteroskedastic error terms in the regression analysis to allow for the first robust estimations on the topic. Despite having a starkly different distribution of values, online ratings explain much of the variation in official ratings. This conclusion strengthens, and root mean squared error typically falls, as one considers regression subsets over which instructors have a larger number of online ratings. Though (public online ratings do not mimic the results of (semi-private official ratings, they provide a reliable source of information for predicting official ratings. There is strong evidence that this reliability increases in online rating usage.
Astri Drange Hole
Full Text Available This paper examines empirically if there is a link between quality of care in the Norwegian nursing home industry and exposure of the industry to competition. Exposing public care to competition implies that the responsibility for providing care services is shared between public authorities and private actors. In Norway, exposure to competition means tender competition. Suppliers bid for a contract issued by the Norwegian authorities for a limited number of years. Quality of care in an institution is the major competitive factor. The provider categories of elderly care are: 1 care provided by institutions run by municipalities, 2 care provided by institutions run by private companies, which have won a tender competition, 3 care provided by institutions run by private companies owned by private families, voluntary religious or idealistic organizations. Nurse-to-patient ratio is used as a proxy for quality of care. The regression analysis indicates a relationship between quality of care and exposure to competition. The quality of care in provider category 2 is significantly lower than in provider category 1, but there are more variations in the quality of care in provider category 1 than in provider category 2. We find the lowest quality of care in provider category 1. There is also a relationship between the quality of care in an institution and the educational level of the staff, the location, the workforce, and the size of an institution. Finally, there is a relationship between the quality of care in an institution and the real and the required capacity, and the financial status in a region.
De Paepe, Liesbeth; Zhu, Chang; Depryck, Koen
This study critically addresses the assumptions made by educators and providers in the field of Dutch second language (L2) acquisition about the online learning of Dutch L2. These include assumptions about advantages and disadvantages of online language learning, such as flexibility, learner autonomy, enhanced opportunities for remediation and…
Nov, Oded; Arazy, Ofer; Anderson, David
Online citizen science offers a low-cost way to strengthen the infrastructure for scientific research and engage members of the public in science. As the sustainability of online citizen science projects depends on volunteers who contribute their skills, time, and energy, the objective of this study is to investigate effects of motivational factors on the quantity and quality of citizen scientists' contribution. Building on the social movement participation model, findings from a longitudinal empirical study in three different citizen science projects reveal that quantity of contribution is determined by collective motives, norm-oriented motives, reputation, and intrinsic motives. Contribution quality, on the other hand, is positively affected only by collective motives and reputation. We discuss implications for research on the motivation for participation in technology-mediated social participation and for the practice of citizen science.
Lambert, K; Mullan, J; Mansfield, K; Koukomous, A; Mesiti, L
Dietary modification is critical in the self-management of chronic kidney disease. The present study describes the accuracy, quality and health literacy demand of renal diet information for adults with kidney disease obtained from the Internet and YouTube (www.youtube.com). A comprehensive content analysis was undertaken in April and July 2015 of 254 eligible websites and 161 YouTube videos. The accuracy of the renal diet information was evaluated by comparing the key messages with relevant evidence-based guidelines for the dietary management of people with kidney disease. The DISCERN tool (www.discern.org.uk) was used to evaluate the quality of the material. Health literacy demand was evaluated using the Patient Education Material Assessment Tool (www.ahrq.gov/professionals/prevention-chronic-care/improve/self-mgmt/pemat/index.html) and seven validated readability calculators. The most frequent renal diet topic found online was generic dietary information for people with chronic kidney disease. The proportion of renal diet information obtained from websites that was accurate was 73%. However, this information was mostly of poor quality with extensive shortcomings, difficult to action and written with a high health literacy demand. By contrast, renal diet information available from YouTube was highly understandable and actionable, although only 18% of the videos were accurate, and a large proportion were of poor quality with extensive shortcomings. The most frequent authors of accurate, good quality, understandable, material were government bodies, dietitians, academic institutions and medical organisations. Renal diet information found online that is written by government bodies, dietitians, academic institutions and medical organisations is recommended. Further work is required to improve the quality and, most importantly, the actionability of renal diet information found online. © 2017 The British Dietetic Association Ltd.
Greene, Jessica; Hibbard, Judith H; Overton, Valerie
This study examined the impact of Fairview Health Services' primary care provider compensation model, in which 40 percent of compensation was based on clinic-level quality outcomes. Fairview Health Services is a Pioneer accountable care organization in Minnesota. Using publicly reported performance data from 2010 and 2012, we found that Fairview's improvement in quality metrics was not greater than the improvement in other comparable Minnesota medical groups. An analysis of Fairview's administrative data found that the largest predictor of improvement over the first two years of the compensation model was primary care providers' baseline quality performance. Providers whose baseline performance was in the lowest tertile improved three times more, on average, across the three quality metrics studied than those in the middle tertile, and almost six times more than those in the top tertile. As a result, there was a narrowing of variation in performance across all primary care providers at Fairview and a narrowing of the gap in quality between providers who treated the highest-income patient panels and those who treated the lowest-income panels. The large quality incentive fell short of its overall quality improvement aim. However, the results suggest that payment reform may help narrow variation in primary care provider performance, which can translate into narrowing socioeconomic disparities. Project HOPE—The People-to-People Health Foundation, Inc.
Crisp, Dimity; Griffiths, Kathleen; Mackinnon, Andrew; Bennett, Kylie; Christensen, Helen
Internet-based interventions are increasingly recognized as effective for the treatment and prevention of depression; however, there is a paucity of research investigating potential secondary benefits. From a consumer perspective, improvements in indicators of wellbeing such as perceived quality of life may represent the most important outcomes for evaluating the effectiveness of an intervention. This study investigated the 'secondary' benefits for self-esteem, empowerment, quality of life and perceived social support of two 12-week online depression interventions when delivered alone and in combination. Participants comprised 298 adults displaying elevated psychological distress. Participants were randomised to receive: an Internet Support Group (ISG); an automated Internet psycho-educational training program for depression; a combination of these conditions; or a control website. Analyses were performed on an intent-to-treat basis. Following the automated training program immediate improvements were shown in participants׳ self-esteem and empowerment relative to control participants. Improvements in perceived quality of life were reported 6-months following the completion of the intervention when combined with an ISG. These findings provide initial evidence for the effectiveness of this online intervention for improving individual wellbeing beyond the primary aim of the treatment. However, further research is required to investigate the mechanisms underlying improvement in these secondary outcomes. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.
Tartaglione, Jason P; Rosenbaum, Andrew J; Abousayed, Mostafa; Hushmendy, Shazaan F; DiPreta, John A
The Internet is one of the most widely utilized resources for health-related information. Evaluation of the medical literature suggests that the quality and accuracy of these resources are poor and written at inappropriately high reading levels. The purpose of our study was to evaluate the quality, accuracy, and readability of online resources pertaining to hallux valgus. Two search terms ("hallux valgus" and "bunion") were entered into Google, Yahoo, and Bing. With the use of scoring criteria specific to hallux valgus, the quality and accuracy of online information related to hallux valgus was evaluated by 3 reviewers. The Flesch-Kincaid score was used to determine readability. Statistical analysis was performed with t tests and significance was determined by P values hallux valgus" (P = .045). Quality and accuracy were significantly higher in resources authored by physicians as compared to nonphysicians (quality, P = .04; accuracy, P hallux valgus is poor and written at inappropriate reading levels. Furthermore, the search term used, authorship, and presence of commercial bias influence the value of these materials. It is important for orthopaedic surgeons to become familiar with patient education materials, so that appropriate recommendations can be made regarding valuable resources. Level IV. © 2015 The Author(s).
Underhill, Meghan L.; Kiviniemi, Marc T.
Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening…
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
Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias
Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.
Mozafarpour, Sarah; Norris, Briony; Borin, James; Eisner, Brian H
To evaluate the quality and readability of online information on ureteral stents. Google.com was queried using the search terms "ureteric stent", "ureteral stent", "double J stent" and, "Kidney stent" derived from Google AdWords. Website popularity was determined using Google Rank and the Alexa tool. Website quality assessment was performed using the following criteria: Journal of the American Medical Association (JAMA) benchmarks, Health on the Net (HON) criteria, and a customized DISCERN questionnaire. The customized DISCERN questionnaire was developed by combining the short validated DISCERN questionnaire with additional stent-specific items including definition, placement, complications, limitations, removal and "when to seek help". Scores related to stent items were considered as the "stent score" (SS). Readability was evaluated using five readability tests. Thirty-two websites were included. The mean customized DISCERN score and "stent score" were 27.1 ± 7.1 (maximum possible score = 59) and 14.6 ± 3.8 (maximum possible score = 24), respectively. A minority of websites adequately addressed "stent removal" and "when to seek medical attention". Only two websites (6.3%) had HON certification (drugs.com, radiologyinfo.org) and only one website (3.3%) met all JAMA criteria (bradyurology.blogspot.com). Readability level was higher than the American Medical Association recommendation of sixth-grade level for more than 75% of the websites. There was no correlation between Google rank, Alexa rank, and the quality scores (P > 0.05). Among the 32 most popular websites on the topic of ureteral stents, online information was highly variable. The readability of many of the websites was far higher than standard recommendations and the online information was questionable in many cases. These findings suggest a need for improved online resources in order to better educate patients about ureteral stents and also should inform physicians that popular websites may
Green, Marybeth; Cifuentes, Lauren
This study examined the effects of the inclusion of online follow-up and online peer interaction with a face-to face workshop on quality of support plan and completion of a support plan by Texas school librarians. The study used a posttest-only control group experimental design with randomly assigned self-selected participants. Three online…
Full Text Available Objective – To explore how and when individuals with chronic health conditions seek out health information online, and the challenges they encounter when doing so. Design – Qualitative study employing thematic analysis. Setting – Urban Western Australia. Subjects – 17 men and women between 19 and 85 years of age with at least 1 chronic health condition. Methods – Participants were recruited in late 2013 at nine local pharmacies, through local radio, media channels, and a university's social media channels. Participants were adult English speakers who had looked for information on their chronic health condition(s using the Internet. Semi-structured face-to-face interviews were conducted with each participant, audio recorded, and transcribed. The transcripts were coded in QSR Nvivo using two different processes – an initial data-driven inductive approach to coding, followed by a theory driven analysis of the data. Main Results – Three major themes emerged: trust, patient activation, and relevance. Many of the participants expressed trust both in health professionals and in the efficacy of search engines like Google. However, there was uncertainty about the quality of some of the health information sources found. Searching for information online was seen by some participants as a way to feel more empowered about their condition(s and treatment, but they reported frustration in finding information that was relevant to their specific condition(s given the volume of information available. Low health literacy emerged in participant interviews as an intrinsic barrier to effective online searches for health information, along with low patient motivation and lack of time. The many extrinsic barriers identified included difficulty determining the quality of information found, the accessibility of the information (e.g., journal paywalls, and poor relationships with health care providers. Conclusion – Individuals look for online health
José Ramón Sarmiento Guede
.... Here, Guede identifies the new classification from a qualitative perspective of new tourist service providers in the online environment and analyzes the impact of social network on the structure...
Full Text Available The paper summarizes main results of partial research aimed at detection of the key factors affecting quality in the sector of tourism services providers, namely tour operators and travel agencies. A primary questionnaire survey was conducted; the researched factors were distributed in the context of service quality dimensions (Grönroos model; the dimensions were tested in relation to sex, age and education of the respondents (ANOVA; Brown-Forsythe test. Assurance was identified as the most important dimension. The output of the study is determining the significance of individual quality factors from the perspective of a potential customer when selecting a service provider.
Leitner, G; Lavi, Y; Merin, U; Lemberskiy-Kuzin, L; Katz, G
The potential for application of online devices for providing real-time analysis of milk-clotting parameters during milking was studied. The experiment tested established relationships between glandular-level bacterial infection and milk-clotting parameters as evaluated by visible or near-infrared spectroscopy. The parameters yielded by the AfiLab (S.A.E. Afikim, Afikim, Israel) online device were shown to be applicable to derivation of real-time estimations of milk-clotting parameters on the individual cow level. The ability of the AfiLab to perform this task was validated online and statistically by calibration against laboratory testing procedures. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Luck, Jeff; York, Laura S; Bowman, Candice; Gale, Randall C; Smith, Nina; Asch, Steven M
Peer-to-peer collaboration within integrated health systems requires a mechanism for sharing quality improvement lessons. The Veterans Health Administration (VA) developed online compendia of tools linked to specific cancer quality indicators. We evaluated awareness and use of the toolkits, variation across facilities, impact of social marketing, and factors influencing toolkit use. A diffusion of innovations conceptual framework guided the collection of user activity data from the Toolkit Series SharePoint site and an online survey of potential Lung Cancer Care Toolkit users. The VA Toolkit Series site had 5,088 unique visitors in its first 22 months; 5% of users accounted for 40% of page views. Social marketing communications were correlated with site usage. Of survey respondents (n = 355), 54% had visited the site, of whom 24% downloaded at least one tool. Respondents' awareness of the lung cancer quality performance of their facility, and facility participation in quality improvement collaboratives, were positively associated with Toolkit Series site use. Facility-level lung cancer tool implementation varied widely across tool types. The VA Toolkit Series achieved widespread use and a high degree of user engagement, although use varied widely across facilities. The most active users were aware of and active in cancer care quality improvement. Toolkit use seemed to be reinforced by other quality improvement activities. A combination of user-driven tool creation and centralized toolkit development seemed to be effective for leveraging health information technology to spread disease-specific quality improvement tools within an integrated health care system. Copyright © 2015 by American Society of Clinical Oncology.
Højris, Bo; Christensen, Sarah Christine Boesgaard; Albrechtsen, Hans-Jørgen; Smith, Christian; Dahlqvist, Mathis
Today, microbial drinking water quality is monitored through either time-consuming laboratory methods or indirect on-line measurements. Results are thus either delayed or insufficient to support proactive action. A novel, optical, on-line bacteria sensor with a 10-minute time resolution has been developed. The sensor is based on 3D image recognition, and the obtained pictures are analyzed with algorithms considering 59 quantified image parameters. The sensor counts individual suspended particles and classifies them as either bacteria or abiotic particles. The technology is capable of distinguishing and quantifying bacteria and particles in pure and mixed suspensions, and the quantification correlates with total bacterial counts. Several field applications have demonstrated that the technology can monitor changes in the concentration of bacteria, and is thus well suited for rapid detection of critical conditions such as pollution events in drinking water.
Højris, Bo; Christensen, Sarah Christine Boesgaard; Albrechtsen, Hans-Jørgen; Smith, Christian; Dahlqvist, Mathis
Today, microbial drinking water quality is monitored through either time-consuming laboratory methods or indirect on-line measurements. Results are thus either delayed or insufficient to support proactive action. A novel, optical, on-line bacteria sensor with a 10-minute time resolution has been developed. The sensor is based on 3D image recognition, and the obtained pictures are analyzed with algorithms considering 59 quantified image parameters. The sensor counts individual suspended particles and classifies them as either bacteria or abiotic particles. The technology is capable of distinguishing and quantifying bacteria and particles in pure and mixed suspensions, and the quantification correlates with total bacterial counts. Several field applications have demonstrated that the technology can monitor changes in the concentration of bacteria, and is thus well suited for rapid detection of critical conditions such as pollution events in drinking water.
Adolfsson, S. [Univ. of Karlskrono/Ronneby (Sweden). Dept. of Signal Processing]|[Lund Univ. (Sweden). Dept. of Production and Materials Engineering; Bahrami, A. [Technology Center of Kronoberg, Vaexjoe (Sweden)]|[Lund Univ. (Sweden); Bolmsjoe, G. [Lund Univ. (Sweden); Claesson, I. [Univ. of Karlskrono/Ronneby (Sweden)
This paper addresses the problems involved in the automatic monitoring of the weld quality produced by robotized short-arc welding. A simple statistical change detection algorithm for the weld quality, the repeated Sequential Probability Ratio Test (SPRT), was used. The algorithm may similarly be viewed as a cumulative sum (CUSUM) type test, and is well-suited to detecting sudden minor changes in the monitored test statistic. The test statistic is based on the variance of the weld voltage, wherein it will be shown that the variance decreases when the welding process is not operating under optimal conditions. The performance of the algorithm is assessed through the use of experimental data. The results obtained from the algorithm show that it is possible to detect changes in weld quality automatically and on-line.
Ueliton da Costa Leonidio
Full Text Available This paper’s objective is to evaluate the perceived quality of the Website of an online bookstore using the Barnes and Vidgen Model. Implemented over the Internet, this empirical research collected data on the perceived quality of the Website, used to sell products and online services. The questionnaire used to gather the data was answered by a convenience sample of 213 respondents. The importance of quality attributes and the dimension of perceived quality were investigated. The results indicate that the three dimensions named Reliability, Usability and Information were the most noticeable.
Lowenthal, Patrick R.; Hodges, Charles B.
The concept of the massive, open, online course (MOOC) is not new, but high-profile initiatives have moved MOOCs into the forefront of higher education news over the past few years. Members of institutions of higher education have mixed feelings about MOOCs, ranging from those who want to offer college credit for the successful completion of MOOCs…
Full Text Available This research aims are to find out how well the service quality of PT Indosat Jakarta, how loyal are the customers, and how far the effect of the service quality toward the customers loyalty Indosat in Jakarta. The category of this research are descriptive and verification with surveys method by using a convenience sampling. The sample sizes is 120 respondents of Indosat customers. Therefore, the data collecting technique used are from secondary data, interview, observation and questionnaires. The result of this research based on hypothetical test indicates that there is a effect between the service quality and the customer loyalty. The conclusion of this research is that the performance of the service quality provided by Indosat is still under the customer expectation. It is suggested to the management of PT. Indosat, to improve and maintain their service quality in the dimension that is regard as important, as well the customer’s loyalty level.
Full Text Available To detect the flaws of bearing steel ball and sort its quality on-line, a kind of online quality detecting and sorting system for bearing steel ball is developed, which based on the eddy current inspection theory. The design of scheme, circuit and mechanical structure of the system is described in detail. PSD(Phase Sensitive Detection is applied to pick up the signal of cracks and restrain interferential signal. The flaws will be quantificational analysed based on the X-R orthogonal decomposition technology which include the size and depth information of flaws. By analysing and processing the amplitude and phase of the defect signal, the flaws can be found with high accuracy and low error-detected ratio. ARM and MCU Processor ensures the real-time ability of discriminating algorithm. The CPLD is used for generating reference signal which can be easy to get synchronous with the source signal. It has good properties of real-time to detect the quality of bearing steel ball.
Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin
The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service.
Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran
Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach's Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors' offices had the highest quality gap of -1.420 ± 0.82 and -1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were -0.883 ± 0.67, -0.882 ± 0.83, and -0.804 ± 0.62, respectively. There was a significant relationship between peoples' perceptions and expectations concerning the quality of health services and their educational levels. The higher gaps in quality in hospitals and in doctors' offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors.
Biancone, Tricia L; Farquharson, Kelly; Justice, Laura M; Schmitt, Mary Beth; Logan, Jessica A R
This study had two aims: (a) to describe the quality of language intervention provided by school-based speech-language pathologists (SLPs) to children with language impairment in the primary grades with respect to the quality of emotional support, instructional support, and proactive management during SLP-child interactions, and (b) to determine if key characteristics of the SLPs are predictors of variance in intervention quality. Participants were 174 children nested within 40 SLPs' caseloads from various districts in two Midwestern states involved in a larger study of speech-language therapy practices in the public schools. A total of 208 videotaped language intervention sessions were coded for emotional support, instructional support, and proactive management using the Classroom Assessment Scoring System (CLASS; Pianta, La Paro, & Hamre, 2008). The quality of language intervention varied widely and was generally mid-range to high with respect to emotional support and proactive management, and low to mid-range in terms of instructional support. The quality of interactions varied and a large percentage of the observed variance in quality was attributed to SLPs. Time pressure was a strong predictor of the quality of emotional support, instructional support, and proactive management, and job satisfaction was a significant predictor of instructional support and proactive management. This descriptive information about school-based language intervention highlights the impact of the individual SLP in terms of the quality of the interactions taking place and the potential need to ease job pressures and promote job satisfaction. Readers will be able to: (1) identify and define three aspects of SLP-child interaction quality during intervention as framed in this study using the CLASS observation tool (Pianta, La Paro, et al., 2008); (2) discuss the relevance of those three aspects of quality to children with LI; and (3) identify SLP-level factors that significantly predict
Bussmann, Susan; Johnson, Sandra R.; Oliver, Richard; Forsythe, Kerry; Grandjean, Miley; Lebsock, Michelle; Luster, Tyler
What constitutes excellence in teaching for university faculty when they are expected or required to create quality online courses? This is a question that will increasingly be asked of members of promotion and tenure committees as market pressures demand entire degrees be delivered online. Developing a quality online course is a significant…
Full Text Available This paper presents a multi-period optimization model for high margin and zero salvage products in online distribution channels with classifying customers based on number of products required. Taking hotel customers as an example, one is regular customers who reserve rooms for one day, and the other is long term stay (LTS customers who reserve rooms for a number of days. LTS may guarantee a specific amount of demand and generate opportunity income for a certain number of periods, meanwhile with risk of punishment incurred by overselling. By developing an operational optimization model and exploring the effects of parameters on optimal decisions, we suggest that service providers should make decisions based on the types of customers, number of products required, and duration of multi-period to reduce the loss of reputation and obtain more profit; at the same time, multi-period buying customers should buy products early. Finally, the paper conducts a numerical experiment, and the results are consistent with prevailing situations.
Xu, Ming; Jiao, Yan; Li, Xiaoming; Cao, Qingfeng; Wang, Xiaoyang
This paper presents a multi-period optimization model for high margin and zero salvage products in online distribution channels with classifying customers based on number of products required. Taking hotel customers as an example, one is regular customers who reserve rooms for one day, and the other is long term stay (LTS) customers who reserve rooms for a number of days. LTS may guarantee a specific amount of demand and generate opportunity income for a certain number of periods, meanwhile with risk of punishment incurred by overselling. By developing an operational optimization model and exploring the effects of parameters on optimal decisions, we suggest that service providers should make decisions based on the types of customers, number of products required, and duration of multi-period to reduce the loss of reputation and obtain more profit; at the same time, multi-period buying customers should buy products early. Finally, the paper conducts a numerical experiment, and the results are consistent with prevailing situations. PMID:26147663
Xu, Ming; Jiao, Yan; Li, Xiaoming; Cao, Qingfeng; Wang, Xiaoyang
This paper presents a multi-period optimization model for high margin and zero salvage products in online distribution channels with classifying customers based on number of products required. Taking hotel customers as an example, one is regular customers who reserve rooms for one day, and the other is long term stay (LTS) customers who reserve rooms for a number of days. LTS may guarantee a specific amount of demand and generate opportunity income for a certain number of periods, meanwhile with risk of punishment incurred by overselling. By developing an operational optimization model and exploring the effects of parameters on optimal decisions, we suggest that service providers should make decisions based on the types of customers, number of products required, and duration of multi-period to reduce the loss of reputation and obtain more profit; at the same time, multi-period buying customers should buy products early. Finally, the paper conducts a numerical experiment, and the results are consistent with prevailing situations.
Jackson, E. B.; Proffitt, Melissa S.
A novel on-line database for capturing most of the information obtained during piloted handling qualities experiments (either flight or simulated) is described. The Hyperlinked Overview of Piloted Evaluations (HOPE) web application is based on an open-source object-oriented Web-based front end (Ruby-on-Rails) that can be used with a variety of back-end relational database engines. The hyperlinked, on-line data book approach allows an easily-traversed way of looking at a variety of collected data, including pilot ratings, pilot information, vehicle and configuration characteristics, test maneuvers, and individual flight test cards and repeat runs. It allows for on-line retrieval of pilot comments, both audio and transcribed, as well as time history data retrieval and video playback. Pilot questionnaires are recorded as are pilot biographies. Simple statistics are calculated for each selected group of pilot ratings, allowing multiple ways to aggregate the data set (by pilot, by task, or by vehicle configuration, for example). Any number of per-run or per-task metrics can be captured in the database. The entire run metrics dataset can be downloaded in comma-separated text for further analysis off-line. It is expected that this tool will be made available upon request
Woolderink, Marla; Bindels, Jill A P M; Evers, Silvia M A A; Paulus, Aggie T G; van Asselt, Antoinette D I; van Schayck, Onno C P
Mental illnesses affect many people around the world, either directly or indirectly. Families of persons suffering from mental illness or addiction suffer too, especially their children. In the Netherlands, 864,000 parents meet the diagnostic criteria for a mental illness or addiction. Evidence shows that offspring of mentally ill or addicted parents are at risk for developing mental disorders or illnesses themselves. The Kopstoring course is an online 8-week group course with supervision by 2 trained psychologists or social workers, aimed to prevent behavioral and psychological problems for children (aged 16 to 25 years) of parents with mental health problems or addictions. The course addresses themes such as roles in the family and mastery skills. An online randomized controlled trial (RCT) was conducted to assess the effectiveness of the Kopstoring course. The aim was to gain knowledge about expectations, experiences, and perspectives of participants and providers of the online Kopstoring course. A process evaluation was performed to evaluate the online delivery of Kopstoring and the experiences and perspectives of participants and providers of Kopstoring. Interviews were performed with members from both groups. Participants were drawn from a sample from the Kopstoring RCT. Thirteen participants and 4 providers were interviewed. Five main themes emerged from these interviews: background, the requirements for the intervention, experience with the intervention, technical aspects, and research aspects. Overall, participants and providers found the intervention to be valuable because it was online; therefore, protecting their anonymity was considered a key component. Most barriers existed in the technical sphere. Additional barriers existed with conducting the RCT, namely gathering informed consent and gathering parental consent in the case of minors. This study provides valuable insight into participants' and providers' experiences and expectations with the online
Baji, Petra; Rubashkin, Nicholas; Szebik, Imre; Stoll, Kathrin; Vedam, Saraswathi
In Central and Eastern Europe, many women make informal cash payments to ensure continuity of provider, i.e., to have a "chosen" doctor who provided their prenatal care, be present for birth. High rates of obstetric interventions and disrespectful maternity care are also common to the region. No previous study has examined the associations among informal payments, intervention rates, and quality of maternity care. We distributed an online cross-sectional survey in 2014 to a nationally representative sample of Hungarian internet-using women (N = 600) who had given birth in the last 5 years. The survey included items related to socio-demographics, type of provider, obstetric interventions, and experiences of care. Women reported if they paid informally, and how much. We built a two-part model, where a bivariate probit model was used to estimate conditional probabilities of women paying informally, and a GLM model to explore the amount of payments. We calculated marginal effects of the covariates (provider choice, interventions, respectful care). Many more women (79%) with a chosen doctor paid informally (191 euros on average) compared to 17% of women without a chosen doctor (86 euros). Based on regression analysis, the chosen doctor's presence at birth was the principal determinant of payment. Intervention and procedure rates were significantly higher for women with a chosen doctor versus without (cesareans 45% vs. 33%; inductions 32% vs. 19%; episiotomy 75% vs. 62%; epidural 13% vs. 5%), but had no direct effect on payments. Half of the sample (42% with a chosen doctor, 62% without) reported some form of disrespectful care, but this did not reduce payments. Despite reporting disrespect and higher rates of interventions, women rewarded the presence of a chosen doctor with informal payments. They may be unaware of evidence-based standards, and trust that their chosen doctor provided high quality maternity care. Copyright © 2017 Elsevier Ltd. All rights reserved.
Weaver, Ruth Harding
Examined the personal characteristics and resources in 65 licensed family child care providers' lives that influence developmentally enhancing caregiving and professional commitment. Unique predictors to higher quality of care were higher levels of formal education and training, college coursework in early childhood education, higher psychological…
Hackmann, Donald G.
This article reviews U.S. administrative licensure regulations, focusing on type of school leader licensure, provider types, and leadership quality. Licensure obtained through university-based and alternative routes is examined. Due to limited research on alternative school administrative licensure, regulations in medicine, psychology,…
Gerritsen, Sarah; Dean, Brianna; Morton, Susan M B; Wall, Clare R
To describe food provision and evaluate menus in New Zealand childcare services, determining associations with service characteristics and/or cost of menu. Licensed services in three regions of New Zealand participated in an online survey, uploading a weekly menu where applicable. Menus were scored for compliance with guidelines on quantity, variety and quality of foods served. Bivariate and multivariate associations between menu score and service characteristics were analysed. A total of 257 services participated (30% of 847 services invited). Food was provided daily in 56%, with 34% providing lunch and snacks daily. Of the 57 full menus analysed, only three (5%) met all 10 scoring criteria (mean score of 6.8/10). Higher menu scores were statistically associated with employing a cook, high and low (not medium) neighbourhood deprivation, the Heart Foundation's Healthy Heart Award program; there was no association with food costs. The Healthy Heart Award remained statistically associated with higher menu score after adjustment for other service characteristics. Most menus did not meet current nutrition guidelines for quantity, variety, and limiting 'sometimes' and 'occasional' foods. Implications for public health: This study provides a baseline for monitoring menu compliance in New Zealand and evidence for nutrition promotion and menu improvement programmes in early education. © 2017 The Authors.
Dejesus, Ramona S; Vickers, Kristin S; Howell, Lisa A; Stroebel, Robert J
The collaborative care model has been shown in studies to be effective in achieving sustained treatment outcomes in chronic disease management. Its success is highly dependent on active patient engagement, provider endorsement and effective care management. This study sought to ask patients and providers what qualities they look for in a care manager. A questionnaire with 3 open ended questions was mailed out randomly to 1000 patients residing in Olmsted County, MN identified through the registry to have type 2 diabetes mellitus. Forty-two primary care providers received similar questionnaire with 2 open ended questions. Answers were qualitatively analyzed using coding and identification of major themes. One hundred seventy-five patients and 22 providers responded. Both groups listed being knowledgeable, having good communication skills and certain personality traits as common themes on what are desirable qualities in a care manager. Patients felt that a care manager would be most helpful by being accessible. Providers listed undesirable qualities to include not being a team player and not knowing practice limitations. Both patients and providers have clear expectations of a care manager which carry significant implications in recruiting and training care managers for chronic disease management. Copyright © 2012 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Bshary, Redouan; Grutter, Alexandra S; Willener, Astrid S T; Leimar, Olof
Service providers may vary service quality depending on whether they work alone or provide the service simultaneously with a partner. The latter case resembles a prisoner's dilemma, in which one provider may try to reap the benefits of the interaction without providing the service. Here we present a game-theory model based on the marginal value theorem, which predicts that as long as the client determines the duration, and the providers cooperate towards mutual gain, service quality will increase in the pair situation. This prediction is consistent with field observations and with an experiment on cleaning mutualism, in which stable male-female pairs of the cleaner wrasse Labroides dimidiatus repeatedly inspect client fish jointly. Cleaners cooperate by eating ectoparasites off clients but actually prefer to cheat and eat client mucus. Because clients often leave in response to such cheating, the benefits of cheating can be gained by only one cleaner during a pair inspection. In both data sets, the increased service quality during pair inspection was mainly due to the smaller females behaving significantly more cooperatively than their larger male partners. In contrast, during solitary inspections, cleaning behaviour was very similar between the sexes. Our study highlights the importance of incorporating interactions between service providers to make more quantitative predictions about cooperation between species.
Antczak, Paul; Jacinto,Gilda; Simek, Jimmy
The National Aeronautics and Space Administration's (NASA) agency-wide movement to cultivate a quality workplace is the basis for Lewis Research Center to implement Total Quality Fundamentals (TQF) initiatives. The Lewis Technical Services Directorate (TSD) introduced the Total Quality Fundamentals (TQF) workshops to its work force as an opportunity to introduce the concepts and principles of TQF. These workshops also provided the participants with the opportunity to dialogue with fellow TSD employees and managers. This report describes, through the perspective of the Lewis TSD TQF Coaches, how the TQF work- shop process was accomplished in TSD. It describes the structure for addressing the need, implementation process, input the TSD Coaches provided, common themes and concerns raised, conclusions, and recommendations. The Coaches concluded that these types of workshops could be the key to open the communication channels that are necessary to help everyone at Lewis understand where they fit in the organization. TQF workshops can strengthen the participant's connection with the Mission, Vision of the Center, and Vision of the Agency. Reconunendations are given based on these conclusions that can help the TSD Quality Board develop attainable measures towards a quality workplace.
Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Jakobsen, Rita; Sørlie, Venke
Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. The aim of this study is to illuminate multi-ethnic healthcare providers' lived experiences of their own working relationship, and its importance to quality care for people with dementia. The study is part of a greater participatory action research project: 'Hospice values in the care for persons with dementia'. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation. Participants and research context: Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins. Ethical considerations: The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services. The results show that good working relationships, characterized by understanding each other's vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings. The results are discussed in the light of Lögstrup's relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech. The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance.
Przylog, Adam; Stroka, Magdalena A; Engel, Susanne; Linder, Roland
In 2009 a new system for the objective evaluation of nursing homes was introduced in Germany. The so-called nursing transparency agreement (Pflege-Transparenzvereinbarungen) was introduced to provide a reliable tool for an objective comparison of inpatient (PTVS) and outpatient (PTVA) care; however, the new regulations have been the subject of a broad discussion regarding reliability, efficiency and objectivity. To overcome the lack of objective health outcomes, this study used administrative data from Germany's largest health insurance fund, the Techniker Krankenkasse, in order to analyze the association between the quality ratings and objective quality measures on an individual level. This is the first study that provides empirical evidence on this topic using administrative data. The administrative dataset contained information on several individual characteristics as well as data on injuries, poisoning and other extrinsic effects on care-dependent individuals over the age of 64 years who were living in a nursing home in 2009. Based on these data an objective measure was constructed to test whether higher quality ratings of nursing homes led to a better quality of care of the respective patients using non-linear regression models. The results of the estimated models showed no significant evidence of such a relationship, neither considering the probability nor the number of injuries, poisoning and other extrinsic effects. Significant effects were only observed for gender and specific diseases. The results of this study support the argument that the current rating procedure for nursing homes has to be refined. Using quality indicators in combination with the administrative data could possibly contribute to such an enhancement.
Bahadori, Mohammadkarim; Raadabadi, Mehdi; Heidari Jamebozorgi, Majid; Salesi, Mahmood; Ravangard, Ramin
The healthcare organizations need to develop and implement quality improvement plans for their survival and success. Measuring quality in the healthcare competitive environment is an undeniable necessity for these organizations and will lead to improved patient satisfaction. This study aimed to measure the quality of provided services for patients with chronic kidney disease in Kerman in 2014. This cross-sectional, descriptive-analytic study was performed from 23 January 2014 to 14 February 2014 in four hemodialysis centers in Kerman. All of the patients on chronic hemodialysis (n = 195) who were referred to these four centers were selected and studied using census method. The required data were collected using the SERVQUAL questionnaire, consisting of two parts: questions related to the patients' demographic characteristics, and 28 items to measure the patients' expectations and perceptions of the five dimensions of service quality, including tangibility, reliability, responsiveness, assurance, and empathy. The collected data were analyzed using SPSS 21.0 through some statistical tests, including independent-samples t test, one-way ANOVA, and paired-samples t test. The results showed that the means of patients' expectations were more than their perceptions of the quality of provided services in all dimensions, which indicated that there were gaps in all dimensions. The highest and lowest means of negative gaps were related to empathy (-0.52 ± 0.48) and tangibility (-0.29 ± 0.51). In addition, among the studied patients' demographic characteristics and the five dimensions of service quality, only the difference between the patients' income levels and the gap in assurance were statistically significant (P < 0.001). Overall, the results of the present study showed that the expectations of patients on hemodialysis were more than their perceptions of provided services. The healthcare providers and employees should pay more attention to the patients' opinions and
Staunton, Peter F; Baker, Joseph F; Green, James; Devitt, Aiden
A cross-sectional study. The aim of this study was to evaluate the quality of online scoliosis information available on the video sharing site YouTube. The Internet is an increasingly utilized resource for accessing information about a variety of heath conditions. YouTube is a video sharing platform used to both seek and distribute information. A search for "scoliosis" was carried out using YouTube's search engine and data were collected on the first 50 videos returned. A JAMA score to determine currency, authorship, source and disclosure, and scoliosis-specific score that measures the amount of information on the diagnosis and treatment options (as devised by Mathur et al in 2005; scored 0-32) was recorded for each video to measure quality objectively. In addition, the number of views, number of comments, and feedback positivity was documented for each. Data analysis was conducted using R 3.1.4/R Studio 0.98 with control for the age of each video in analysis models. The average number of views per video was 71,152 with an average length of 7 minutes 32 seconds. Thirty-six percent of the videos fell under the authorship category of personal experience. The average JAMA score was 1.32/4 and average scoliosis specific score was 5.38/32. There was a positive correlation between JAMA score and number of views (P = 0.003). However, in contrast, there was a negative correlation between scoliosis-specific score and number of views (P = 0.01). Online health information has historically been poor and our study shows that in an environment like YouTube that lacks a peer review process, the quality of scoliosis information is low. Further work is needed to determine whether accessing information on YouTube can play a role in patient care other than simple education pertaining to the disease and its management. 3.
Diederichs, Sylvia; Korona, Anna; Staaden, Antje; Kroutil, Wolfgang; Honda, Kohsuke; Ohtake, Hisao; Büchs, Jochen
Media containing yeast extracts and other complex raw materials are widely used for the cultivation of microorganisms. However, variations in the specific nutrient composition can occur, due to differences in the complex raw material ingredients and in the production of these components. These lot-to-lot variations can affect growth rate, product yield and product quality in laboratory investigations and biopharmaceutical production processes. In the FDA's Process Analytical Technology (PAT) initiative, the control and assessment of the quality of critical raw materials is one key aspect to maintain product quality and consistency. In this study, the Respiration Activity Monitoring System (RAMOS) was used to evaluate the impact of different yeast extracts and commercial complex auto-induction medium lots on metabolic activity and product yield of four recombinant Escherichia coli variants encoding different enzymes. Under non-induced conditions, the oxygen transfer rate (OTR) of E. coli was not affected by a variation of the supplemented yeast extract lot. The comparison of E. coli cultivations under induced conditions exhibited tremendous differences in OTR profiles and volumetric activity for all investigated yeast extract lots of different suppliers as well as lots of the same supplier independent of the E. coli variant. Cultivation in the commercial auto-induction medium lots revealed the same reproducible variations. In cultivations with parallel offline analysis, the highest volumetric activity was found at different cultivation times. Only by online monitoring of the cultures, a distinct cultivation phase (e.g. glycerol depletion) could be detected and chosen for comparable and reproducible offline analysis of the yield of functional product. This work proves that cultivations conducted in complex media may be prone to significant variation in final product quality and quantity if the quality of the raw material for medium preparation is not thoroughly
Barber, Claire E H; Marshall, Deborah A; Alvarez, Nanette; Mancini, G B John; Lacaille, Diane; Keeling, Stephanie; Aviña-Zubieta, J Antonio; Khodyakov, Dmitry; Barnabe, Cheryl; Faris, Peter; Smith, Alexa; Noormohamed, Raheem; Hazlewood, Glen; Martin, Liam O; Esdaile, John M
Patients with rheumatoid arthritis (RA) have a high risk of premature cardiovascular disease (CVD). We developed CVD quality indicators (QI) for screening and use in rheumatology clinics. A systematic review was conducted of the literature on CVD risk reduction in RA and the general population. Based on the best practices identified from this review, a draft set of 12 candidate QI were presented to a Canadian panel of rheumatologists and cardiologists (n = 6) from 3 academic centers to achieve consensus on the QI specifications. The resulting 11 QI were then evaluated by an online modified-Delphi panel of multidisciplinary health professionals and patients (n = 43) to determine their relevance, validity, and feasibility in 3 rounds of online voting and threaded discussion using a modified RAND/University of California, Los Angeles Appropriateness Methodology. Response rates for the online panel were 86%. All 11 QI were rated as highly relevant, valid, and feasible (median rating ≥ 7 on a 1-9 scale), with no significant disagreement. The final QI set addresses the following themes: communication to primary care about increased CV risk in RA; CV risk assessment; defining smoking status and providing cessation counseling; screening and addressing hypertension, dyslipidemia, and diabetes; exercise recommendations; body mass index screening and lifestyle counseling; minimizing corticosteroid use; and communicating to patients at high risk of CVD about the risks/benefits of nonsteroidal antiinflammatory drugs. Eleven QI for CVD care in patients with RA have been developed and are rated as highly relevant, valid, and feasible by an international multidisciplinary panel.
Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L
Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.
Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T
The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.
Dawson, Amy E.; Bernstein, Bianca L.; Bekki, Jennifer M.
This chapter outlines the psychosocial aspects of mentoring that help women combat the barriers they commonly face in science, technology, engineering, and mathematics (STEM). The authors describe the "Career"WISE online resilience training and how it can address the shortage of effective mentors and role models who have been shown to…
Post, Jerri L.
The problem explored in this study focused on the attitudes of nurse educators toward online degrees in relation to hiring practices. With the proliferation of online courses and degrees, research has shown that the acceptability of online degrees has become a concern for graduates of online programs seeking jobs and for potential employers. A…
van Dijk Frank JH
Full Text Available Abstract Background Common information facilities do not always provide the quality information needed to answer questions on health or health-related issues, such as Occupational Safety and Health (OSH matters. Barriers may be the accessibility, quantity and readability of information. Online Question & Answer (Q&A network tools, which link questioners directly to experts can overcome some of these barriers. When designing and testing online tools, assessing the usability and applicability is essential. Therefore, the purpose of this study is to assess the usability and applicability of a new online Q&A network tool for answers on OSH questions. Methods We applied a cross-sectional usability test design. Eight occupational health experts and twelve potential questioners from the working population (workers were purposively selected to include a variety of computer- and internet-experiences. During the test, participants were first observed while executing eight tasks that entailed important features of the tool. In addition, they were interviewed. Through task observations and interviews we assessed applicability, usability (effectiveness, efficiency and satisfaction and facilitators and barriers in use. Results Most features were usable, though several could be improved. Most tasks were executed effectively. Some tasks, for example searching stored questions in categories, were not executed efficiently and participants were less satisfied with the corresponding features. Participants' recommendations led to improvements. The tool was found mostly applicable for additional information, to observe new OSH trends and to improve contact between OSH experts and workers. Hosting and support by a trustworthy professional organization, effective implementation campaigns, timely answering and anonymity were seen as important use requirements. Conclusions This network tool is a promising new strategy for offering company workers high quality information
Rhebergen, Martijn D F; Hulshof, Carel T J; Lenderink, Annet F; van Dijk, Frank J H
Common information facilities do not always provide the quality information needed to answer questions on health or health-related issues, such as Occupational Safety and Health (OSH) matters. Barriers may be the accessibility, quantity and readability of information. Online Question & Answer (Q&A) network tools, which link questioners directly to experts can overcome some of these barriers. When designing and testing online tools, assessing the usability and applicability is essential. Therefore, the purpose of this study is to assess the usability and applicability of a new online Q&A network tool for answers on OSH questions. We applied a cross-sectional usability test design. Eight occupational health experts and twelve potential questioners from the working population (workers) were purposively selected to include a variety of computer- and internet-experiences. During the test, participants were first observed while executing eight tasks that entailed important features of the tool. In addition, they were interviewed. Through task observations and interviews we assessed applicability, usability (effectiveness, efficiency and satisfaction) and facilitators and barriers in use. Most features were usable, though several could be improved. Most tasks were executed effectively. Some tasks, for example searching stored questions in categories, were not executed efficiently and participants were less satisfied with the corresponding features. Participants' recommendations led to improvements. The tool was found mostly applicable for additional information, to observe new OSH trends and to improve contact between OSH experts and workers. Hosting and support by a trustworthy professional organization, effective implementation campaigns, timely answering and anonymity were seen as important use requirements. This network tool is a promising new strategy for offering company workers high quality information to answer OSH questions. Q&A network tools can be an addition
Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.
Amanda Aparecida Silva; José Maria Pacheco de Souza; Flávio Notarnicola da Silva Borges; Frida Marina Fischer
OBJECTIVE: To evaluate working conditions associated with health-related quality of life (HRQL) among nursing providers. METHODS: Cross-sectional study conducted in a university hospital in the city of São Paulo, Southeastern Brazil, during 2004-2005. The study sample comprised 696 registered nurses, nurse technicians and nurse assistants, predominantly females (87.8%), who worked day and/or night shifts. Data on sociodemographic information, working and living conditions, lifestyles, and hea...
Full Text Available Abstract Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of
Autin, Ludovic; Tufféry, Pierre
The Protein Movie Generator (PMG) is an online service able to generate high-quality pictures and animations for which one can then define simple storyboards. The PMG can therefore efficiently illustrate concepts such as molecular motion or formation/dissociation of complexes. Emphasis is put on the simplicity of animation generation. Rendering is achieved using Dino coupled to POV-Ray. In order to produce highly informative images, the PMG includes capabilities of using different molecular representations at the same time to highlight particular molecular features. Moreover, sophisticated rendering concepts including scene definition, as well as modeling light and materials are available. The PMG accepts Protein Data Bank (PDB) files as input, which may include series of models or molecular dynamics trajectories and produces images or movies under various formats. PMG can be accessed at http://bioserv.rpbs.jussieu.fr/PMG.html.
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.
Beaulieu, Marie-Dominique; Geneau, Robert; Del Grande, Claudio; Denis, Jean-Louis; Hudon, Eveline; Haggerty, Jeannie L; Bonin, Lucie; Duplain, Réjean; Goudreau, Johanne; Hogg, William
To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Three regions of Quebec. Health care professionals and staff of 5 PC practices. Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees depending on clinic characteristics: developing a shared vision of high-quality care; aligning resource use with that vision; and balancing professional aspirations and population needs. The leadership of the physician lead was crucial. The external environment was perceived as a source of pressure and dilemmas rather than as a source of support in these matters. Irrespective of their models, PC practices' pursuit of high-quality care is based on a vision in which accessibility is a key component, balanced by appropriate management of available resources and of external environment expectations. Current PC reforms often create tensions rather than support PC practices in their pursuit of high-quality care. Copyright© the College of Family Physicians of Canada.
Schwartz Communications, LLC, executes a successful PR campaign to position Subimo, a provider of online healthcare decision tools, as a leader in the industry that touts names such as WebMD.com and HealthGrades.com. Through a three-pronged media relations strategy, Schwartz and Subimo together branded the company as an industry thought-leader.
Pasternak, Grzegorz; Greenman, John; Ieropoulos, Ioannis
Standard Biological Oxygen Demand (BOD) analysis requires 5 days to complete. To date, microbial fuel cell biosensors used as an alternative method for BOD assessment requires external apparatus, which limits their use for on-line monitoring in remote, off-grid locations. In this study, a self-powered, floating biosensor was developed for online water quality monitoring. This approach eliminated the need for external apparatus and maintenance that would otherwise be required by other techniques. The biosensor was able to detect urine in freshwater and turn ON a visual and sound cues (85 dB). The energy needed to operate the biosensor was produced by the system itself with the use of electroactive microorganisms, inside microbial fuel cells. The Chemical Oxygen Demand (COD) was used as a fast method of biosensor validation. When urine concentration exceeded the lower threshold, corresponding to a COD concentration of 57.7 ± 4.8 mgO 2 L -1 , the biosensor turned the alarm ON. The shortest observed actuation time, required to switch ON the alarm was 61 min, when the urine concentration was 149.7 ± 1.7 mgO 2 L -1 . Once the sensor was switched ON, the signal was emitted until the urine organic load decreased to 15.3 ± 1.9 mgO 2 L -1 . When ON, the microbial fuel cell sensor produced a maximum power of 4.3 mW. When switched OFF, the biosensor produced 25.4 μW. The frequency of the signal was proportional to the concentration of urine. The observed frequencies varied between 0.01 and 0.59 Hz. This approach allowed to correlate and quantitatively detect the presence of water contamination, based on signal frequency. The sensor was operating autonomously for 5 months. This is the first report of a self-powered, autonomous device, developed for online water quality monitoring.
Jin, Xiaowei; Wang, Zijian; Wang, Yeyao; Lv, Yibing; Rao, Kaifeng; Jin, Wei; Giesy, John P; Leung, Kenneth M Y
The potential use of toxicity data for nonnative species to derive water quality criteria is controversial because it is sometimes questioned whether criteria based on species from one geographical region provide appropriate protection for species in a different region. However, this is an important concept for the development of Chinese water quality criteria or standards. Data were assembled on 38 chemicals for which values were available for both native and nonnative species. Sensitivities of these organisms were compared based on the 5% hazardous concentration values and the species sensitivity distribution from a literature review. Results of the present study's analysis showed that there is approximately 74% certainty that use of nonnative species to generate water quality criteria would be sufficiently protective of aquatic ecosystems in China. Without applying any assessment factor to the water quality criteria generated from nonnative species, the uncertainty would be 26% when the native Chinese species might be under protection. Applying an assessment factor of 10 would offer adequate protection to native Chinese species for approximately 90% of tested chemicals and thus reduce the uncertainty from 26% to 10%. © 2015 SETAC.
Full Text Available Consumer’s perceptions about the health care services play an important role when choosing a hospital. The quality of service is crucial to both the outpatients and the service providers. The dimensions of the service quality are reliability, responsiveness, assurance, empathy, and tangibles. Customer’s expectations and experiences vary with services. When there is a shortfall between expectation of service level and perception of actual service delivery, it is called customer gap. The causes of customer gap include; not knowing what customers expect, not selecting the right service designs and standards, not delivering to service standards and not matching performance to promises. This paper focuses on the level of service quality rendered by SRM’s hospital, the patient-physicians’ relationship and to examine the pre and post service of outpatients in the SRM’s hospital. A structured questionnaires and interviews were constructed to provide answers to the research questions using a sample size of 50 [employees and outpatients]. It was found out that some outpatients were satisfied with the services rendered by the hospital with reservations for more improvement. It was also found out that, there were gaps between the outpatients’ expectation and perception about the service rendered by the hospital. It was recommended that a competent marketing executive should be employed since marketing is the voice of the healthcare industry.
McClellan, Sean R; Snowden, Lonnie
This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.
Wang, Dongwen; Luque, Amneris E
The New York State HIV-HCV-STD Clinical Education Initiative (CEI) has developed a large repository of online resources and disseminated them to a wide range of healthcare providers. To evaluate the CEI online education program and in particular to compare the self-reported measures by clinicians from different disciplines, we analyzed the data from 1,558 course completions in a study period of three months. The results have shown that the overall evaluations by the clinicians were very positive. Meanwhile, there were significant differences across the clinical disciplines. In particular, physicians and nurse practitioners were the most satisfied. In contrast, pharmacists and case/care managers recorded lower than average responses. Nurses and counselors had mixed results. Nurse practitioners' responses were very similar to physicians on most measures, but significantly different from nurses in many aspects. For more effective knowledge dissemination, online education programs should consider the unique needs by clinicians from specific disciplines.
Vargas, Christina R; Ricci, Joseph A; Lee, Michelle; Tobias, Adam M; Medalie, Daniel A; Lee, Bernard T
The transgender population is disproportionally affected by health disparities related to access to care. In many communities, transgender specialists are geographically distant and locally available medical professionals may be unfamiliar with unique needs of transgender patients. As a result, use of Internet resources for information about gender affirming surgery is particularly important. This study simulates a patient search for online educational material about gender affirming surgery and evaluates the accessibility, readability, and quality of the information. An Internet search for the term "transgender surgery" was performed, and the first 10 relevant hits were identified. Readability was assessed using 10 established tests: Coleman-Liau, Flesch-Kincaid, FORCAST, Fry, Gunning Fog, New Dale-Chall, New Fog Count, Raygor Estimate, Simple Measure of Gobbledygook, and Flesch Reading Ease. Quality was assessed using Journal of the American Medical Association criteria and the DISCERN instrument. Review of 69 results was required to identify 10 sites with relevant patient information. There were 97 articles collected; overall mean reading level was 14.7. Individual Web site reading levels ranged from 12.0 to 17.5. All articles and Web sites exceeded the recommended sixth grade level. Quality ranged from 0 to 4 (Journal of the American Medical Association) and 35 to 79 (DISCERN) across Web sites. Web sites with relevant patient information about gender affirming surgery were difficult to identify from search results. The content of these sites universally exceeded the recommended reading level. A wide range of Web site quality was noted, and this may further complicate successful navigation. Barriers in access to appropriately written patient information on the Internet may contribute to disparities in referral, involvement, satisfaction, and outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.
Doran, Tim; Maurer, Kristin A; Ryan, Andrew M
The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital Value-Based Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success.
Chauhan, Muhammad Aufeef; Ali Babar, Muhammad
Cloud computing is being increasingly adopted in various domains for providing on-demand infrastructure and Software as a service (SaaS) by leveraging the utility computing model and virtualization technologies. One of the domains, where cloud computing is expected to gain huge traction is Global...... projects. Through an extensive review of the relevant literature on GSD and Cloud Computing, we have identified a set of quality attributes and potential architectural solutions for a cloud-based infrastructure that can provide TaaS to GSD teams. This paper outlines the promised benefits of TaaS to GSD...... efficiently and cost-effectively. Moreover, variations in tools available/used by different GSD team members can also pose challenges. We assert that providing Tools as a Service (TaaS) to GSD teams through a cloud-based infrastructure can be a promising solution to address the tools related challenges in GSD...
Beverley G. Hope
Full Text Available There has been a proliferation of online newspapers over recent years. Despite this, or perhaps because of it, factors affecting the quality of online newspapers remain only partially understood. Based on a two-factor model of hygiene and motivator factors, this paper examines quality for online newspapers giving attention to differences across culture, sex, and age. Hygiene factors are essential requirements whose absence causes dissatisfaction, while motivators are desirable elements that add value and increase user satisfaction. The paper presents findings from an empirical study of eighty-four Web users. Results show that hygiene factors for our respondents were: Timeliness, Content attractiveness, Content coverage, Usefulness, and Navigation, while motivators were: Writing style, Layout, Archives, Services, Interactivity, and Multimedia presentation. Four factors were borderline: Journalism ethics, Ease of use, Front page and headlines, and Locating information. However, the research reveals some differences in classification of factors across culture, sex, and age.
Jennifer M. Weiss
Full Text Available Aims. Colorectal cancer (CRC screening is underutilized. Increasing CRC screening rates requires interventions targeting multiple barriers at each level of the healthcare organization (patient, provider, and system. We examined groups of primary care providers (PCPs based on perceptions of screening barriers and the relationship to CRC screening rates to inform approaches for conducting barrier assessments prior to designing and implementing quality improvement interventions. Methods. We conducted a retrospective cohort study linking EHR and survey data. PCPs with complete survey responses for questions addressing CRC screening barriers were included (N=166 PCPs; 39,430 patients eligible for CRC screening. Cluster analysis identified groups of PCPs. Multivariate logistic regression estimated odds ratios and 95% confidence intervals for predictors of membership in one of the PCP groups. Results. We found two distinct groups: (1 PCPs identifying multiple barriers to CRC screening at patient, provider, and system levels (N=75 and (2 PCPs identifying no major barriers to screening (N=91. PCPs in the top half of CRC screening performance were more likely to identify multiple barriers than the bottom performers (OR, 4.14; 95% CI, 2.43–7.08. Conclusions. High-performing PCPs can more effectively identify CRC screening barriers. Targeting high-performers when conducting a barrier assessment is a novel approach to assist in designing quality improvement interventions for CRC screening.
D'Ambruoso, Lucia; Achadi, Endang; Adisasmita, Asri; Izati, Yulia; Makowiecka, Krystyna; Hussein, Julia
to conduct a confidential enquiry to assess the quality of care provided by Indonesian village midwives and to identify opportunities for improvement. local health-care practitioners assessed village-based care in obstetric emergencies in 13 cases of maternal death and near-miss from rural villages in West Java. The study focused on clinical quality of care, but also investigated the influence of the health system and social factors. The reviews were based on transcripts of interviews with health-care providers, family and community members involved in the cases. Both favourable and adverse factors were identified in order to recognise positive contributions, where they occurred. At the end of a series of case reviews, recommendations for practice were generated and disseminated. in the cases reviewed, midwives facilitated referral effectively, reducing delays in reaching health facilities. Midwives' emergency diagnostic skills were accurate but they were less capable in the clinical management of complications. Coverage was poor; in some locations, midwives were responsible for up to five villages. Village midwives were also perceived as unacceptable to women and their families. Families and communities did not prepare for emergencies with finances or transport, partly due to a poorly understood health insurance system. The enquiry had learning effects for those involved. village midwives should: receive appropriate support for the management of obstetric emergencies; engage with communities to promote birth preparedness; and work in partnership with formal and informal providers in the community. The enquiry was a diagnostic tool to identify opportunities for improving care. Practitioners had a unique insight into factors that contribute to quality care and how feasible interventions might be made.
Balfour, Margaret E; Zinn, Tylar E; Cason, Karena; Fox, Jerimya; Morales, Myra; Berdeja, Cesar; Gray, Jay
The authors describe a quality improvement approach in which a crisis center and a payer collaborate to improve care. Each crisis visit is considered as a potentially missed opportunity for community stabilization. Daily data on crisis visits are sent to the payer for a more up-to-date analysis of trends than is possible with financial claims data, which may lag behind services provided by up to 90 days. Using these trend data, the two organizations collaborate to identify patterns that lead to opportunities for improvement and develop multiple rapid-cycle projects for better management of services, resulting in significant decreases in readmissions and in the number of high utilizers.
Simpson, Andrea; Baldwin, Elizabeth Margaret
This study sought to analyze and evaluate the accessibility, availability and quality of online information regarding the National Disability Insurance Scheme (NDIS) and hearing loss. The most common search engine keyword terms a caregiver may enter when conducting a web search was determined using a keyword search tool. The top websites linked…
van der Wurff, R.; Schönbach, K.
A three-wave Delphi study in the Netherlands invited 60 experts to assess the quality of online and traditional journalism and to propose measures for improvement. Although from very different backgrounds and representing a wide range of opinions, the experts agree on a focused set of core standards
Kovach, Jamison V.; Miley, Michelle; Ramos, Miguel A.
Communication skills are a significant contributor to an individual's success in the workplace. Unfortunately, students often have trouble expressing their ideas in written form and the poor quality of students' written work often impedes the learning process. This pilot study investigates the use of online writing studios within a quality…
Rieder, J.; Prazeller, P.; Boehler, M.; Lirk, P.; Lindinger, W.; Amann, A.
The subthreshold exposure to trace anesthetic gases is not associated with considerable risk of adverse health effects. Online control of ambient air exchange at the postoperative workplace may help in supervising air quality and lead to cost reduction. A proton-transfer-reaction mass spectrometer
Full Text Available The aim of this action research project was to improve student learning by encouraging more “time on task” and to improve self-assessment and feedback through the introduction of weekly online tests in a Year 2 lecture module in biological sciences. Initially voluntary online tests were offered to students and those who participated achieved higher exam marks than those who did not, but completion rate was low. Making the tests compulsory led to high completion rates, but class performance decreased, indicating that using the same assessment for formative and for summative purposes is not always beneficial for learning. Finally, these problems were resolved by introducing a two-stage approach: the first stage of each test was formative and provided prompt feedback. However, students had to achieve 80% to progress to the second summative stage of the test. The two-stage online tests led to significantly improved class performance. This novel test design ensures that students go through at least two attempts and therefore fully benefit from the learning opportunities presented by the formative stage. Two-stage online tests present the opportunity to provide regular feedback in large classes and to improve performance not only of good but also of “weak” students.
van Engen-Verheul, Mariëtte M.; van der Veer, Sabine N.; de Keizer, Nicolette F.; Tjon Sjoe Sjoe, Winston; van der Zwan, Eric P. A.; Peek, Niels
Continuous monitoring and systematic improvement of quality have become increasingly common in healthcare. To support multidisciplinary care teams in improving their clinical performance using feedback on quality indicators, we developed the CARDSS Online system. This system supports (i) monitoring
Woods, Dexter R., Jr.
Online classes, hybrid or blended classes, and web-facilitated classes all employ online materials, which instructors and students are using at ever-increasing rates. Accordingly, instructors should continuously evaluate the effectiveness of such online materials. This paper sets forth the author's initial attempts to analyze a business course…
Nong, Truong Duy
Online learning, or e-learning, has become popular and grown rapidly in the past few decades, especially in higher education. In 2007, 66% of postsecondary degree-granting institutions in the United States reported offering online education. With advances in technology and the Internet, online education has the potential to reach a diverse group…
Besson, Marie; Samer, Caroline; Rollason, Victoria; Dayer, Pierre; Desmeules, Jules
Quality therapeutics play an important role in Switzerland's health care and economy. Switzerland holds a key position in the world of research and development, as well as in drug production. Recently, new emphasis has been placed on promoting clinical research and maintaining Switzerland's position as a center of excellence in the field. Recent revisions to the law regarding medical trials in human research allow for better allocation of regulatory resources and simplified procedures for drugs already authorized in Switzerland. The country has its own regulatory agency, the Swiss Agency for Therapeutic Products (Swissmedic), which is a public institution of the Swiss government. Swissmedic is responsible for ensuring safety in medicines, particularly regarding authorizations and market surveillance in the sector of medicinal products and medical devices. Although the centralized authorization procedure of the European Union for medicines does not apply to Switzerland, there are mutual recognition mechanisms between the Swiss medicine regulatory authority and the European Medicines Agency. Swissmedic is also in charge of postmarketing safety and oversees the national pharmacovigilance center, which collaborates closely with the World Health Organization center in Uppsala. In addition, university hospital-based clinical pharmacologists, who are involved in basic science and clinical research, regulatory affairs, ethics committees, and pharmacovigilance, promote quality therapeutics. This article discusses the role of the various stakeholders and the recent efforts made to provide a better allocation of resources aimed at further improving quality therapeutics in Switzerland. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.
Borges, Juliana Bassalobre Carvalho; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes
To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4 +/- 13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (PSERVQUAL scale.
Mizuno, Maki; Kinefuchi, Emiko; Kimura, Rumiko; Tsuda, Akiko
This study explored the relationship between professional quality of life and emotion work and the major stress factors related to abortion care in Japanese obstetric and gynecological nurses and midwives. Between October 2011 and January 2012, questionnaires that included questions concerning eight stress factors, the Professional Quality of Life Scale, and the Japanese version of the Frankfurt Emotional Work Scale, were answered by 255 nurses and midwives working in abortion and childbirth services. Professional Quality of Life scores (compassion fatigue, compassion satisfaction, burnout) were significantly associated with stress factors and emotion work. Multiple regression analysis revealed that of all the evaluated variables, the Japanese version of the Frankfurt Emotional Work Scale score for negative emotions display was the most significant positive predictor of compassion fatigue and burnout. The stress factors "thinking that the aborted fetus deserved to live" and "difficulty in controlling emotions during abortion care" were associated with compassion fatigue. These findings indicate that providing abortion services is a highly distressing experience for nurses and midwives.
Soler, C; Kekäläinen, J; Núñez, M; Sancho, M; Álvarez, J G; Núñez, J; Yaber, I; Gutiérrez, R
Phenotype-linked fertility hypothesis (PLFH) predicts that male secondary sexual traits reveal honest information about male fertilization ability. However, PLFH has rarely been studied in humans. The aim of the present study was to test PLFH in humans and to investigate whether potential ability to select fertile partners is independent of sex or cultural background. We found that on the contrary to the hypothesis, facial masculinity was negatively associated with semen quality. As increased levels of testosterone have been demonstrated to impair sperm production, this finding may indicate a trade-off between investments in secondary sexual signalling (i.e. facial masculinity) and fertility or status-dependent differences in investments in semen quality. In both sexes and nationalities (Spanish and Colombian), ranked male facial attractiveness predicted male semen quality. However, Spanish males and females estimated facial images generally more attractive (gave higher ranks) than Colombian raters, and in both nationalities, males gave higher ranks than females. This suggests that male facial cues may provide culture- and sex-independent information about male fertility. However, our results also indicate that humans may be more sensitive to facial attractiveness cues within their own populations and also that males may generally overestimate the attractiveness of other men to females. © 2014 The Authors. Journal of Evolutionary Biology © 2014 European Society For Evolutionary Biology.
Macario, Everly; Schneider, Yukari T; Campbell, Susan M; Volgman, Annabelle Santos
Although atrial fibrillation (AF) is the most common abnormal heart rhythm in men and women, there are gender differences. Mortality for women with AF can be 2.5 times greater than for men. AF risk among women is also greater than in men when patients have additional conditions. Women are more likely to experience longer symptomatic episodes, more recurrences, and higher ventricular rates during AF. We sought to explore presentation, comorbidities, treatment, and quality-of-life issues among women with AF. A convenience sample of 332 women with AF completed a 58-item online survey fielded for 2 weeks in April 2015. Of the respondents, 94% were Caucasian; 76% consumed four or fewer servings of fruits or vegetables per day; 43% engaged in moderate physical activity for 10 minutes 3 or fewer days per week; 41% had a body mass index (BMI) of greater than 30 kg/m(2); and 85% had never attended an AF support group. Women with AF often juggle many health conditions. Almost none had participated in an AF clinical trial. The ability to complete activities of daily living was associated significantly and positively with fruit/vegetable consumption and physical activity and significantly and negatively associated with BMI. Self-efficacy was associated significantly with physical activity and support group attendance. Open-ended comments showed many women patients have outstanding questions about their AF. AF education resources should underscore the positive physical and mental health effects of increasing fruit/vegetable consumption and physical activity. Caregivers, clinicians, and women with AF need to be made aware of the benefits of support groups, whether in-person or online, and clinical trials. Future research should engage in effective recruitment of non-White women with AF. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Han, Bong-Gyoon [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Watson, Zoe [Univ. of California, Berkeley, CA (United States); Cate, Jamie H. D. [Univ. of California, Berkeley, CA (United States); Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Glaeser, Robert M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
Analysis of images of biotinylated Escherichia coli 70S ribosome particles, bound to streptavidin affinity grids, demonstrates that the image-quality of particles can be predicted by the image-quality of the monolayer crystalline support film. Also, the quality of the Thon rings is a good predictor of the image-quality of particles, but only when images of the streptavidin crystals extend to relatively high resolution. When the estimated resolution of streptavidin was 5 Å or worse, for example, the ribosomal density map obtained from 22,697 particles went to only 9.5 Å, while the resolution of the map reached 4.0 Å for the same number of particles, when the estimated resolution of streptavidin crystal was 4 Å or better. It thus is easy to tell which images in a data set ought to be retained for further work, based on the highest resolution seen for Bragg peaks in the computed Fourier transforms of the streptavidin component. The refined density map obtained from 57,826 particles obtained in this way extended to 3.6 Å, a marked improvement over the value of 3.9 Å obtained previously from a subset of 52,433 particles obtained from the same initial data set of 101,213 particles after 3-D classification. These results are consistent with the hypothesis that interaction with the air-water interface can damage particles when the sample becomes too thin. Finally, streptavidin monolayer crystals appear to provide a good indication of when that is the case.
Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris
The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome
Full Text Available OBJECTIVE: To compare caretakers' perceived quality of care (PQC for under-fives treated for malaria, pneumonia and diarrhoea by community health workers (CHWs and primary health facility workers (PHFWs. METHODS: Caretaker rated PQC for children aged (2-59 months treated by either CHWs or PHFWs for a bought of malaria, pneumonia or diarrhoea was cross-sectionally compared in quality domains of accessibility, continuity, comprehensiveness, integration, clinical interaction, interpersonal treatment and trust. Child samples were randomly drawn from CHW (419 and clinic (399 records from eight Midwestern Uganda districts. An overall PQC score was predicted through factor analysis. PQC scores were compared for CHWs and PHFWs using Wilcoxon rank-sum test. Multinomial logistic regression models were used to specify the association between categorized PQC and service providers for each quality domain. Finally, overall PQC was dichotomized into "high" and "low" based on median score and relative risks (RR for PQC-service provider association were modeled in a "modified" Poisson regression model. RESULTS: Mean (SD overall PQC was significantly higher for CHWs 0.58 (0 .66 compared to PHFWs -0.58 (0.94, p<0.0001. In "modified" Poisson regression, the proportion of caretakers reporting high PQC was higher for CHWS compared to PHFWs, RR=3.1, 95%CI(2.5-3.8. In multinomial models PQC was significantly higher for CHWs compared to PHFWs in all domains except for continuity. CONCLUSION: PQC was significantly higher for CHWs compared to PHFWs in this resource constrained setting. CHWs should be tapped human resources for universal health coverage while scaling up basic child intervention as PQC might improve intervention utilization.
Yu. A. Rolik
Full Text Available The problem of providing electric power quality in the electric power systems (EPS that are equipped with sufficiently long air or cable transmission lines is under consideration. This problem proved to be of particular relevance to the EPS in which a source of electrical energy is the generator of wind turbines since the wind itself is an instable primary energy source. Determination of the degree of automation of voltage regulation in the EPS is reduced to the choice of methods and means of regulation of power quality parameters. The concept of a voltage loss and the causes of the latter are explained by the simplest power system that is presented by a single-line diagram. It is suggested to regulate voltage by means of changing parameters of the network with the use of the method of reducing loss of line voltage by reducing its reactance. The latter is achieved by longitudinal capacitive compensation of the inductive reactance of the line. The effect is illustrated by vector diagrams of currents and voltages in the equivalent circuits of transmission lines with and without the use of longitudinal capacitive compensation. The analysis of adduced formulas demonstrated that the use of this method of regulation is useful only in the systems of power supply with a relatively low power factor (cosφ < 0.7 to 0.9. This power factor is typical for the situation of inclusion the wind turbine with asynchronous generator in the network since the speed of wind is instable. The voltage regulation fulfilled with the aid of the proposed method will make it possible to provide the required quality of the consumers’ busbars voltage in this situation. In is turn, it will make possible to create the necessary conditions for the economical transmission of electric power with the lowest outlay of reactive power and the lowest outlay of active power losses.
It is appropriate that after almost half a century of Science and Mathematics education reform we take a look back and a peek forward to understand the present state of this wonderfully complex system. Each of the components of this system including teaching, professional development, assessment, content and the district K-12 curriculum all need to work together if we hope to provide quality science, mathematics and technology education for ALL students. How do the state and national standards drive the system? How do state policies on student testing and teacher licensure come into play? How do we improve the preparation, retention and job satisfaction of our K-12 teachers? What initiatives have made or are making a difference? What else needs to be done? What can the physics community do to support local efforts? This job is too big for any single organization or individual but we each can contribute to the effort. Our Center at Northeastern University, with support from the National Science Foundation, has a sharply defined focus: to get high quality, research-based instructional materials into the hands of K-12 classroom teachers and provide the support they need to use the materials effectively in their classrooms.
Ditzler, Nicholas; Greenhawt, Matthew
Health literacy among caregivers of food allergic individuals (FAIs) is poorly described, as are the information sources sought regarding food allergy. To assess the association among health literacy, trust in online sources of information, and food allergy quality of life (QoL) and self-efficacy. An online survey was administered to caregivers of FAIs assessing health literacy (Newest Vital Sign [NVS] and the eHeals Internet health literacy index), trust in online information (Hargittai Internet credibility index and Annenberg National Health Communication Survey [ANHCS]), QoL (Food Allergy Quality of Life Parental Burden), and self-efficacy (Food Allergy Self-Efficacy Questionnaire [FASEQ]). Among 1562 respondents, 94.6% (NVS) and 61.1% (eHeals) had good health literacy, and 58% had high levels of trust in online information (both indexes). The NVS correlated poorly with the eHeals and Hargittai indexes. Hargittai and eHeals scores were moderately correlated (r = 0.37, P < .001). A high NVS score was significantly associated with reported anaphylaxis and high eHeals and Hargittai scores with advocacy group membership. In unadjusted analyses, FAQL-PB scores were worse with high Hargiatti scores (P = .05) and ANHCS scores (P < .001). The FASEQ scores were better with high ANHCS scores (P = .02) and eHeals scores (P < .001). In an adjusted regression, high trust in online information (both indexes), worsening FASEQ score, blog readership, advocacy group membership, caring for multiple FAIs, and having milk or egg allergy were associated with worse FAQL-PB scores. In this sample, health literacy and trust in online information sources were high, with high trust in online information sources negatively associated with QoL. Advocacy group membership had an independent negative association with QoL. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Lynch, Noel P; Lang, Bronagh; Angelov, Sophia; McGarrigle, Sarah A; Boyle, Terence J; Al-Azawi, Dhafir; Connolly, Elizabeth M
This study evaluated the readability, accessibility and quality of information pertaining to breast reconstruction post mastectomy on the Internet in the English language. Using the Google © search engine the keywords "Breast reconstruction post mastectomy" were searched for. We analyzed the top 75 sites. The Flesch Reading Ease Score and Gunning Fog Index were calculated to assess readability. Web site quality was assessed objectively using the University of Michigan Consumer Health Web site Evaluation Checklist. Accessibility was determined using an automated accessibility tool. In addition, the country of origin, type of organisation producing the site and presence of Health on the Net (HoN) Certification status was recorded. The Web sites were difficult to read and comprehend. The mean Flesch Reading Ease scores were 55.5. The mean Gunning Fog Index scores was 8.6. The mean Michigan score was 34.8 indicating weak quality of websites. Websites with HoN certification ranked higher in the search results (p = 0.007). Website quality was influenced by organisation type (p information on breast reconstruction post mastectomy and procedures is poorly written and we suggest that Webpages providing information must be made more readable and accessible. We suggest that health professionals should recommend Web sites that are easy to read and contain high-quality surgical information. Medical information on the Internet should be readable, accessible, reliable and of a consistent quality. Copyright © 2017 Elsevier Ltd. All rights reserved.
Ludmila Mourão Xavier Gomes
Full Text Available OBJECTIVE: To evaluate the quality of healthcare provided to sickle cell disease children by primary healthcare services in a region of high prevalence. METHODS: A cross-sectional, descriptive study was performed by interviewing members of families with sickle cell disease children. The children had been identified from the Neonatal Screening Program in Minas Gerais state over the last 12 years in towns of the Montes Claros-Bocaiuva microregion. A structured questionnaire specially developed for this study and based on three axes was used: indicators of the child's health (immunization, growth and development, prophylaxis antibiotic therapy, perception of care by the family (health education and accessibility and knowledge of the family about the disease. RESULTS: Sixty-three of 71 families with children identified as having sickle cell disease were interviewed. The predominant genotypes were Hb SS (44.4% and Hb SC (41.2%. Adequate monitoring of growth and development was recorded for the first year of life in 23 children (36.6% and for the second year of life in 18 children (28.6%. The basic vaccination schedule was completed by 44 children (69.8% but 62 vaccination record cards (98.4% identified delays of special vaccines. Regular use of prophylactic penicillin was reported by 55 caregivers (87.3%. The family's perception of the care provided suggests poor accessibility to health services and lack of opportunities to answer doubts. The average performance of families in knowledge testing was 59.8%. CONCLUSION: The quality of healthcare is unsatisfactory. The care provided to children with sickle cell disease in primary healthcare services needs improvements.
Makhni, Eric C; Crump, Erica K; Steinhaus, Michael E; Verma, Nikhil N; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R
To assess the quality and variability found across anterior cruciate ligament (ACL) rehabilitation protocols published online by academic orthopaedic programs. Web-based ACL physical therapy protocols from United States academic orthopaedic programs available online were included for review. Main exclusion criteria included concomitant meniscus repair, protocols aimed at pediatric patients, and failure to provide time points for the commencement or recommended completion of any protocol components. A comprehensive, custom scoring rubric was created that was used to assess each protocol for the presence or absence of various rehabilitation components, as well as when those activities were allowed to be initiated in each protocol. Forty-two protocols were included for review from 155 U.S. academic orthopaedic programs. Only 13 protocols (31%) recommended a prehabilitation program. Five protocols (12%) recommended continuous passive motion postoperatively. Eleven protocols (26%) recommended routine partial or non-weight bearing immediately postoperatively. Ten protocols (24%) mentioned utilization of a secondary/functional brace. There was considerable variation in range of desired full-weight-bearing initiation (9 weeks), as well as in the types of strength and proprioception exercises specifically recommended. Only 8 different protocols (19%) recommended return to sport after achieving certain strength and activity criteria. Many ACL rehabilitation protocols recommend treatment modalities not supported by current reports. Moreover, high variability in the composition and time ranges of rehabilitation components may lead to confusion among patients and therapists. Level II. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Mugambwa, Joshua; Mugerwa, George William; Mutumba, Wilson Williams; Muganzi, Claire; Namubiru, Bridget; Waswa, Yusuf; Kayongo, Isaac Newton
.... This research took a case study of Nsamizi Training Institute of Social Development (NTISD) to determine the relationship between privately provided accommodation service quality and customer satisfaction...
Luo, Hua-ping; Lu, Qi-peng; Ding, Hai-quan; Gao, Hong-zhi; Guo, Ling
To establish the on-line near infrared spectral correction model for the jujube quality of Southern Xinjiang, the main influence factors of online testing results were analyzed, and the corresponding parameters were studied. First of all, the collecting conditions of different jujube were set, such as measurement condition, spectral region, and the parameters of the apparatus. With near infrared spectrometer and self-designed jujube batch collecting attachment, the quality spectrum of jujube was obtained, and combining spectral preprocessing and detection precision, condition parameters were selected. Secondly, through PLS spectrum correction with different modeling parameters and two-dimensional correlation spectroscopy analysis, Brix characteristic spectral parameters were selected. The results showed that with sugar degree central wavelength 9116, 9 418 and 10,500 cm(-1), acquisition resolution 16 cm(-1), and scan number 8, the sugar degree relative error was 8%-10%, the size of single grain jujube spectra was reduced to 1/10 of the original, and the time was reduced to 3 seconds. It was concluded that with the experimental parameters, the spectra were compressed, a primary online correction model was established, and the jujube quality online detection with near infrared spectroscopy was basically realized.
Mohd Salleh, Mohd Idzwan; Zakaria, Nasriah; Abdullah, Rosni
The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
Lin, Jin; Xie, Zhi-jiang; Wang, Xue; Sun, Nan-Nan
Defects on the surface of hot rolled steel strips are main factors to evaluate quality of steel strips, an improved image recognition algorithm are used to extract the feature of Defects on the surface of steel strips. Base on the Machine vision and Artificial Neural Networks, establish a defect recognition method to select defect on the surface of steel strips. Base on these research. A surface inspection system and advanced algorithms for image processing to hot rolled strips is developed. Preparing two different fashion to lighting, adopting line blast vidicon of CCD on the surface steel strips on-line. Opening up capacity-diagnose-system with level the surface of steel strips on line, toward the above and undersurface of steel strips with ferric oxide, injure, stamp etc of defects on the surface to analyze and estimate. Miscarriage of justice and alternate of justice rate not preponderate over 5%.Geting hold of applications on some big enterprises of steel at home. Experiment proved that this measure is feasible and effective.
Li, Xing-Qiang; Wang, Zhong; Fu, Lu-Hua
For online quality control of car engine production, pneumatic measurement instrument plays an unshakeable role in measuring diameters inside engine block because of its portability and high-accuracy. To the limitation of its measuring principle, however, the working space between the pneumatic device and measured surface is too small to require manual operation. This lowers the measuring efficiency and becomes an obstacle to perform automatic measurement. In this article, a high-speed, automatic measuring system is proposed to take the place of pneumatic devices by using a laser-based measuring unit. The measuring unit is considered as a set of several measuring modules, where each of them acts like a single bore gauge and is made of four laser triangulation sensors (LTSs), which are installed on different positions and in opposite directions. The spatial relationship among these LTSs was calibrated before measurements. Sampling points from measured shaft holes can be collected by the measuring unit. A unified mathematical model was established for both calibration and measurement. Based on the established model, the relative pose between the measuring unit and measured workpiece does not impact the measuring accuracy. This frees the measuring unit from accurate positioning or adjustment, and makes it possible to realize fast and automatic measurement. The proposed system and method were finally validated by experiments.
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.
Ameh, Soter; Klipstein-Grobusch, Kerstin; D'ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier
The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while
Caradot, Nicolas; Sonnenberg, Hauke; Rouault, Pascale; Gruber, Günter; Hofer, Thomas; Torres, Andres; Pesci, Maria; Bertrand-Krajewski, Jean-Luc
This paper reports about experiences gathered from five online monitoring campaigns in the sewer systems of Berlin (Germany), Graz (Austria), Lyon (France) and Bogota (Colombia) using ultraviolet-visible (UV-VIS) spectrometers and turbidimeters. Online probes are useful for the measurement of highly dynamic processes, e.g. combined sewer overflows (CSO), storm events, and river impacts. The influence of local calibration on the quality of online chemical oxygen demand (COD) measurements of wet weather discharges has been assessed. Results underline the need to establish local calibration functions for both UV-VIS spectrometers and turbidimeters. It is suggested that practitioners calibrate locally their probes using at least 15-20 samples. However, these samples should be collected over several events and cover most of the natural variability of the measured concentration. For this reason, the use of automatic peristaltic samplers in parallel to online monitoring is recommended with short representative sampling campaigns during wet weather discharges. Using reliable calibration functions, COD loads of CSO and storm events can be estimated with a relative uncertainty of approximately 20%. If no local calibration is established, concentrations and loads are estimated with a high error rate, questioning the reliability and meaning of the online measurement. Similar results have been obtained for total suspended solids measurements.
Federici, Stefano; Borsci, Simone
The study brings together three aspects rarely observed at once in assistive technology (AT) surveys: (i) the assessment of user interaction/satisfaction with AT and service delivery, (ii) the motivational analysis of AT abandonment, and (iii) the management/design evaluation of AT delivery services. 15 health professionals and 4 AT experts were involved in modelling and assessing four AT Local Health Delivery Service (Centres) in Italy through a SWOT analysis and a Cognitive Walkthrough. In addition 558 users of the same Centres were interviewed in a telephone survey to rate their satisfaction and AT use. The overall AT abandonment was equal to 19.09%. Different Centres' management strategies resulted in different percentages of AT disuse, with a range from 12.61% to 24.26%. A significant difference between the declared abandonment and the Centres' management strategies (p = 0.012) was identified. A strong effect on abandonment was also found due to professionals' procedures (p = 0.005) and follow-up systems (p = 0.002). The user experience of an AT is affected not only by the quality of the interaction with the AT, but also by the perceived quality of the Centres in support and follow-up. Implications for Rehabilitation AT abandonment surveys provide useful information for modelling AT assessment and delivery process. SWOT and Cognitive Walkthrough analyses have shown suitable methods for exploring limits and advantages in AT service delivery systems. The study confirms the relevance of person centredness for a successful AT assessment and delivery process.
Full Text Available A sensitive on-line DPPH-CE-DAD method was developed and validated for both screening and determining the concentration of seven antioxidants of Reduning injection. The pH and concentrations of buffer solution, SDS, β-CD and organic modifier were studied for the detection of DPPH and seven antioxidants. By on-line mixing DPPH and sample solution, a DPPH-CE method for testing the antioxidant activity of the complex matrix was successfully established and used to screen the antioxidant components of Reduning injection. Then, antioxidant components including caffeic acid, isochlorogenic acid A, isochlorogenic acid B, isochlorogenic acid C, chlorogenic acid, neochlorogenic acid and cryptochlorogenic acid were quantified by the newly established CE-DAD method. Finally, the total antioxidant activity and the multiple active components were selected as markers to evaluate the quality of Reduning injection. The results demonstrated that the on-line DPPH-CE-DAD method was reagent-saving, rapid and feasible for on-line simultaneous determination of total pharmacological activity and contents of multi-components samples. It was also a powerful method for evaluating the quality control and mechanism of action of TCM injection.
Schoenfeld, Adam J; Davies, Jason M; Marafino, Ben J; Dean, Mitzi; DeJong, Colette; Bardach, Naomi S; Kazi, Dhruv S; Boscardin, W John; Lin, Grace A; Duseja, Reena; Mei, Y John; Mehrotra, Ateev; Dudley, R Adams
.4%). No statistically significant variation in guideline adherence by mode of communication (videoconference vs telephone vs webchat) was found. Significant variation in quality was found among companies providing virtual visits for management of common acute illnesses. More variation was found in performance for some conditions than for others, but no variation by mode of communication.
Wilcox, Brian Riley
The recent rapid proliferation of distance education necessitates the need for strong levels of academic accountability. An important factor found to influence and predict student success is students' perceptions of their online courses. Understanding how learners perceive their online learning environment is paramount to effective course design…
Dorcely, Brenda; Agarwal, Nitin; Raghuwanshi, Maya
Objective: The purpose of this study was to assess and compare the readability of type 2 diabetes online patient education materials from academic institutions in the northeast USA and the American Diabetes Association. Many US residents utilise the Internet to obtain health information. Studies have shown that online patient education materials…
Struminskaya, B.; Methodology and statistics for the behavioural and social sciences
Online panels – surveys administered over the Internet in which persons are asked to complete surveys regularly – offer cost reductions compared to surveys that use more traditional modes of data collection (face-to-face, telephone, and mail). However, some characteristics of online panels may cause
while the online section did not. Students in the online section interacted using the eCollege course delivery platform and email, while students...International Journal on ELearning 5, no. 2: 265-274. 77 Welsh, Elizabeth T., Connie R. Wanberg, Kenneth G. Brown, and Marcia J. Simmering. 2003. E
Beckett, Kate; Earthy, Sarah; Sleney, Jude; Barnes, Jo; Kellezi, Blerina; Barker, Marcus; Clarkson, Julie; Coffey, Frank; Elder, Georgina; Kendrick, Denise
To explore views of service providers caring for injured people on: the extent to which services meet patients' needs and their perspectives on factors contributing to any identified gaps in service provision. Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers' views were elicited through semistructured interviews. Data were analysed using thematic analysis. Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas. 40 service providers from a range of disciplines. Service providers described two distinct models of trauma care: an 'ideal' model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a 'real' model based on the realities of National Health Service (NHS) practice. Participants' 'ideal' model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, 'real' care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients' needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice. Service providers envisage an 'ideal' model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between 'real' and 'ideal' care. Using service provider views to inform service design
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.
Battaglia, Jessica N; Kieser, Mara A; Bruskiewitz, Ruth H; Pitterle, Michael E; Thorpe, Joshua M
To develop, implement, and assess the effectiveness of an online medication therapy management (MTM) program to train pharmacists and pharmacy students in providing MTM services for patients with diabetes and to increase their intent to perform these services. An online program was created using an Internet-based learning platform to simulate 4 MTM meetings between a pharmacist and a virtual patient diagnosed with diabetes. Eighty students and 42 pharmacists completed the program. After completing the program, scores on post-intervention assessments showed significant improvement in 2 areas: control over performing MTM, and knowledge of how to perform MTM. Students had a significantly less-positive attitude about MTM and a decline in their perception of the social expectation that MTM is part of the practice of pharmacy, while pharmacists' attitudes did not change significantly in these areas. This online program using a virtual patient improved both participants' belief that they have control over performing MTM, and their knowledge of how to perform MTM for diabetic patients, which may increase the likelihood that pharmacists and pharmacy students will perform MTM in the future.
Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A
This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation. © The Author(s) 2014.
Classen, Alice; Peters, Marcell K; Ferger, Stefan W; Helbig-Bonitz, Maria; Schmack, Julia M; Maassen, Genevieve; Schleuning, Matthias; Kalko, Elisabeth K V; Böhning-Gaese, Katrin; Steffan-Dewenter, Ingolf
Wild animals substantially support crop production by providing ecosystem services, such as pollination and natural pest control. However, the strengths of synergies between ecosystem services and their dependencies on land-use management are largely unknown. Here, we took an experimental approach to test the impact of land-use intensification on both individual and combined pollination and pest control services in coffee production systems at Mount Kilimanjaro. We established a full-factorial pollinator and vertebrate exclosure experiment along a land-use gradient from traditional homegardens (agroforestry systems), shaded coffee plantations to sun coffee plantations (total sample size = 180 coffee bushes). The exclusion of vertebrates led to a reduction in fruit set of ca 9%. Pollinators did not affect fruit set, but significantly increased fruit weight of coffee by an average of 7.4%. We found no significant decline of these ecosystem services along the land-use gradient. Pest control and pollination service were thus complementary, contributing to coffee production by affecting the quantity and quality of a major tropical cash crop across different coffee production systems at Mount Kilimanjaro.
Steven R. Carter
Full Text Available The current work investigates the effects of a broadly adopted online matchmaking site on the nature and quality of married couples formed. Measures of personality, emotion, interests, values and marital adjustment were collected from a sample of married couples who had been introduced by an online matchmaking service, and from a sample of married couples who had met through unfettered choice. Results showed that couples introduced by the online matchmaking site were more similar, and that such similarity in general using the current measures was a strong predictor of marital adjustment in both online matched and comparison couples. Marriages resulting from the online matchmaking service were observed to have significantly higher scores for marital adjustment. We conclude that online matchmaking services based on predictive inference and proscribed selection can be observed to have a significant and meaningful impact on marital quality.
Nicolaidis, Christina; Raymaker, Dora; McDonald, Katherine; Kapp, Steven; Weiner, Michael; Ashkenazy, Elesia; Gerrity, Martha; Kripke, Clarissa; Platt, Laura; Baggs, Amelia
The healthcare system is ill-equipped to meet the needs of adults on the autism spectrum. Our goal was to use a community-based participatory research (CBPR) approach to develop and evaluate tools to facilitate the primary healthcare of autistic adults. Toolkit development included cognitive interviewing and test-retest reliability studies. Evaluation consisted of a mixed-methods, single-arm pre/post-intervention comparison. A total of 259 autistic adults and 51 primary care providers (PCPs) residing in the United States. The AASPIRE Healthcare toolkit includes the Autism Healthcare Accommodations Tool (AHAT)-a tool that allows patients to create a personalized accommodations report for their PCP-and general healthcare- and autism-related information, worksheets, checklists, and resources for patients and healthcare providers. Satisfaction with patient-provider communication, healthcare self-efficacy, barriers to healthcare, and satisfaction with the toolkit's usability and utility; responses to open-ended questions. Preliminary testing of the AHAT demonstrated strong content validity and adequate test-retest stability. Almost all patient participants (>94 %) felt that the AHAT and the toolkit were easy to use, important, and useful. In pre/post-intervention comparisons, the mean number of barriers decreased (from 4.07 to 2.82, p communication improved (from 30.9 to 32.6, p = 0.03). Patients stated that the toolkit helped clarify their needs, enabled them to self-advocate and prepare for visits more effectively, and positively influenced provider behavior. Most of the PCPs surveyed read the AHAT (97 %), rated it as moderately or very useful (82 %), and would recommend it to other patients (87 %). The CBPR process resulted in a reliable healthcare accommodation tool and a highly accessible healthcare toolkit. Patients and providers indicated that the tools positively impacted healthcare interactions. The toolkit has the potential to reduce barriers to
van der Vaart, Rosalie; Drossaert, Constance H C; Taal, Erik; van de Laar, Mart A F J
Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted. First, interviews were performed with nurses/nurse practitioners (n = 9) and rheumatologists (n = 13). Subsequently, collected responses were quantified, using a questionnaire among the interviewees. The following advantages of patient home access to the EMR were reported: (1) enhancement of patient participation in treatment, (2) increased knowledge and self-management, (3) improved patient-provider interaction, (4) increased patient safety, and (5) better communication with others. Foreseen disadvantages of the service included: (1) problems with interpretation of data, (2) extra workload, (3) a change in consultation content, and (4) disturbing the patient-provider interaction. Also, the following preconditions emerged from the data: (1) optimal security, (2) no extra record, but a patient-accessible section, (3) no access to clinical notes, and (4) a lag time on the release of lab data. Most respondents reported that data on diagnosis, medication, treatment plan and consultations could be released to patients. On releasing more complex data, such as bodily examinations, lab results and radiological images the opinions differed considerably. Providing patients home access to their medical record might be a valuable next step into patient empowerment and in service towards the patient, provided that security is optimal and content and presentation of data are carefully considered.
Gressel, Gregory M; Lundsberg, Lisbet S; Illuzzi, Jessica L; Danton, Cheryl M; Sheth, Sangini S; Xu, Xiao; Gariepy, Aileen
To explore patient and provider perspectives regarding a new Web-based contraceptive support tool. We conducted a qualitative study at an urban Medicaid-based clinic among sexually active women interested in starting a new contraceptive method, clinic providers and staff. All participants were given the opportunity to explore Bedsider, an online contraceptive support tool developed for sexually active women ages 18-29 by the National Campaign to Prevent Teen and Unplanned Pregnancy and endorsed by the American Congress of Obstetricians and Gynecologists. Focus groups were conducted separately among patient participants and clinic providers/staff using open-ended structured interview guides to identify specific themes and key concepts related to use of this tool in an urban clinic setting. Patient participants were very receptive to this online contraceptive support tool, describing it as trustworthy, accessible and empowering. In contrast, clinic providers and staff had concerns regarding the Website's legitimacy, accessibility, ability to empower patients and applicability, which limited their willingness to recommend its use to patients. Contrasting opinions regarding Bedsider may point to a potential disconnect between how providers and patients view contraception information tools. Further qualitative and quantitative studies are needed to explore women's perspectives on contraceptive education and counseling and providers' understanding of these perspectives. This study identifies a contrast between how patients and providers in an urban clinic setting perceive a Web-based contraceptive tool. Given a potential patient-provider discrepancy in preferred methods and approaches to contraceptive counseling, additional research is needed to enhance this important arena of women's health care. Copyright © 2014 Elsevier Inc. All rights reserved.
Nalwadda, Gorrette; Tumwesigye, Nazarius M.; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence
Background Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15–24 in two rural districts in Uganda. Methods Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Results Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. Conclusions The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed. PMID:22132168
Poad, Berwyck L. J. [Central; Zheng, Xueyun [Biological; Mitchell, Todd W. [School; Smith, Richard D. [Biological; Baker, Erin S. [Biological; Blanksby, Stephen J. [Central
One of the most significant challenges in contemporary lipidomics lies in the separation and identification of lipid isomers that differ only in site(s) of unsaturation or geometric configuration of the carbon-carbon double bonds. While analytical separation techniques including ion mobility spectrometry (IMS) and liquid chromatography (LC) can separate isomeric lipids under appropriate conditions, conventional tandem mass spectrometry cannot provide unequivocal identification. To address this challenge, we have implemented ozone-induced dissociation (OzID) in-line with LC, IMS and high resolution mass spectrometry. Modification of an IMS- capable quadrupole time-of-flight mass spectrometer was undertaken to allow the introduction of ozone into the high-pressure trapping ion funnel region preceding the IMS cell. This enabled the novel LC-OzID-IMS-MS configuration where ozonolysis of ionized lipids occurred rapidly (10 ms) without prior mass-selection. LC-elution time alignment combined with accurate mass and arrival time extraction of ozonolysis products facilitated correlation of precursor and product ions without mass-selection (and associated reductions in duty cycle). Unsaturated lipids across 11 classes were examined using this workflow in both positive and negative ion modalities and in all cases the positions of carbon-carbon double bonds were unequivocally assigned based on predictable OzID transitions. Under these conditions geometric isomers exhibited different IMS arrival time distributions and distinct OzID product ion ratios providing a means for discrimination of cis/trans double bonds in complex lipids. The combination of OzID with multidimensional separations shows significant promise for facile profiling of unsaturation patterns within complex lipidomes.
van Veen, Merel Rebecca; Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen
Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors' questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. The website provides access to evidence- and eminence-based information on nutrition and cancer. As can be
Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen
Background Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. Objective The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. Methods To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors’ questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Results Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. Conclusions The website provides access to evidence- and eminence
Reschovsky, J; Reed, M; Blumenthal, D; Landon, B
With the growth of managed care, there are increasing concerns but inconclusive evidence regarding deterioration in the quality of medical care. To assess physicians' perceptions of their ability to provide high-quality care and explore what factors, including managed care, affect these perceptions. Bivariate and multivariate analyses of the Community Tracking Study Physician Survey, a cross-sectional, nationally representative telephone survey of 12,385 patient-care physicians conducted in 1996/1997. The response rate was 65%. Physicians who provide direct patient care for > or =20 h/wk, excluding federal employees and those in selected specialties. Level of agreement with 4 statements: 1 regarding overall ability to provide high-quality care and 3 regarding aspects of care delivery associated with quality. Between 21% and 31% of physicians disagreed with the quality statements. Specialists were generally 50% more likely than primary care physicians to express concerns about their ability to provide quality care. Generally, the number of managed care contracts, but not the percent of practice revenue from managed care, was negatively associated with perceived quality. Market-level managed care penetration independently affected physicians' perceptions. Practice setting affected perceptions of quality, with physicians in group settings less likely to express concerns than physicians in solo and 2-physician practices. Specific financial incentives and care management tools had limited positive or negative associations with perceived quality. Managed care involvement is only modestly associated with reduced perceptions of quality among physicians, with some specific tools enhancing perceived quality. Physicians may be able to moderate some negative effects of managed care by altering their practice arrangements.
Veenema, Tener Goodwin; Rains, Adam B; Casey-Lockyer, Mary; Springer, Janice; Kowal, Mary
Globally, shelters are a resource to promote critical health and safety in disasters, particularly for vulnerable populations (e.g., children, elderly, chronically ill). This study examines the nature and quality of healthcare services rendered in disaster and emergency shelters. To determine based upon systematic and accurate measurement the scope and quality of health care services rendered in disaster shelters and to describe the health outcomes experienced by shelter residents. An integrative review of English-language literature pertaining to the assessment, evaluation, and systematic measurement of healthcare quality and client outcomes in disaster and emergency shelters was undertaken. Articles were identified using a structured search strategy of six databases and indexing services (PubMed, CINAHL, EMBase, Scopus, Web of Science, and Google Scholar). Limited literature exists pertaining specifically to metrics for quality of health care in acute disaster and emergency shelters, and the literature that does exist is predominately U.S. based. Analysis of the existing evidence suggests that nurse staffing levels and staff preparedness, access to medications/medication management, infection control, referrals, communication, and mental health may be important concepts related to quality of disaster health care services. A small number of population-based and smaller, ad hoc outcomes-based evaluation efforts exist; however the existing literature regarding systematic outcomes-based quality assessment of disaster sheltering healthcare services is notably sparse. Copyright © 2015 Elsevier Ltd. All rights reserved.
Fabricant, Peter D; Dy, Christopher J; Patel, Ronak M; Blanco, John S; Doyle, Shevaun M
The recent emphasis on shared decision-making has increased the role of the Internet as a readily accessible medical reference source for patients and families. However, the lack of professional review creates concern over the quality, accuracy, and readability of medical information available to patients on the Internet. Three Internet search engines (Google, Yahoo, and Bing) were evaluated prospectively using 3 difference search terms of varying sophistication ("congenital hip dislocation," "developmental dysplasia of the hip," and "hip dysplasia in children"). Sixty-three unique Web sites were evaluated by each of 3 surgeons (2 fellowship-trained pediatric orthopaedic attendings and 1 orthopaedic chief resident) for quality and accuracy using a set of scoring criteria based on the AAOS/POSNA patient education Web site. The readability (literacy grade level) of each Web site was assessed using the Fleisch-Kincaid score. There were significant differences noted in quality, accuracy, and readability of information depending on the search term used. The search term "developmental dysplasia of the hip" provided higher quality and accuracy compared with the search term "congenital hip dislocation." Of the 63 total Web sites, 1 (1.6%) was below the sixth grade reading level recommended by the NIH for health education materials and 8 (12.7%) Web sites were below the average American reading level (eighth grade). The quality and accuracy of information available on the Internet regarding developmental hip dysplasia significantly varied with the search term used. Patients seeking information about DDH on the Internet may not understand the materials found because nearly all of the Web sites are written at a level above that recommended for publically distributed health information. Physicians should advise their patients to search for information using the term "developmental dysplasia of the hip" or, better yet, should refer patients to Web sites that they have
Fast, Angela M; Deibert, Christopher M; Boyer, Celia; Hruby, Gregory W; McKiernan, James M
What's known on the subject? and What does the study add? Patients are highly likely to access the Internet for health information, and studies have reported that inaccurate or low-quality information may alter patients' expectations and negatively impact informed decision-making. In a unique collaboration with the Health On the Internet (HON) Foundation, we evaluated the top 20 search results for the urology search term 'partial nephrectomy,' and identified the highest and lowest scoring criteria to increase awareness of areas of concern and improvement. To further evaluate the quality of information available on the Internet with regard to the management of localized renal cancer, we evaluated websites providing information on 'partial nephrectomy' in conjunction with the Health On the Internet (HON) Foundation. Many patients now utilize the Internet as a resource to provide further information on disease, treatments and outcomes, and health information on the Internet is largely unregulated. Inaccurate information may contribute to unrealistic expectations and dissatisfied patients. A google.com search identified the top 30 websites for the search term 'partial nephrectomy'. The HON Foundation evaluated each website according to the eight principles for Health on the Internet code of conduct (HONcode) certification and reported the overall frequency of certification, as well as individual website compliance with each of the principles. Overall, seven (23.3%) of 30 websites met the requirements of HONcode certification and an additional two (6.7%) websites were under review to maintain their certification based on updating their resources. The remaining 21 (70%) websites did not meet the standards for certification. The lowest performing criteria included proper citation of medical information and a clear distinction of advertising from editorial content. The low rate of HONcode compliance for these websites illustrates the poor quality of information that
Shi, Bin; Wang, Peng; Jiang, Jiping; Liu, Rentao
It is critical for surface water management systems to provide early warnings of abrupt, large variations in water quality, which likely indicate the occurrence of spill incidents. In this study, a combined approach integrating a wavelet artificial neural network (wavelet-ANN) model and high-frequency surrogate measurements is proposed as a method of water quality anomaly detection and warning provision. High-frequency time series of major water quality indexes (TN, TP, COD, etc.) were produced via a regression-based surrogate model. After wavelet decomposition and denoising, a low-frequency signal was imported into a back-propagation neural network for one-step prediction to identify the major features of water quality variations. The precisely trained site-specific wavelet-ANN outputs the time series of residual errors. A warning is triggered when the actual residual error exceeds a given threshold, i.e., baseline pattern, estimated based on long-term water quality variations. A case study based on the monitoring program applied to the Potomac River Basin in Virginia, USA, was conducted. The integrated approach successfully identified two anomaly events of TP variations at a 15-minute scale from high-frequency online sensors. A storm event and point source inputs likely accounted for these events. The results show that the wavelet-ANN model is slightly more accurate than the ANN for high-frequency surface water quality prediction, and it meets the requirements of anomaly detection. Analyses of the performance at different stations and over different periods illustrated the stability of the proposed method. By combining monitoring instruments and surrogate measures, the presented approach can support timely anomaly identification and be applied to urban aquatic environments for watershed management. Copyright © 2017 Elsevier B.V. All rights reserved.
Frijters, Paul; Velamuri, Malathi
We review and model the impact of the internet on the production and uptake of high- quality news. Our review of trends in the market for news suggests 3 stylized facts: i) particular quality news markets are dominated by merely a few providers, ii) demand for quality news appears stable, but provision of news has become specialized; mainstream news is decoupled from quality news, and iii) the dominant business model of internet news mirrors that of radio, television, and newsp...
Cristian Valentin HAPENCIUC
Full Text Available Taking into account its pragmatic meaning, the success of a travel agency frequently relies on the activity of travel agents. In the process of promoting and selling flat voyages, customer service can be directly influenced by the interaction of factors such as: offer accuracy, sales representatives quality, employee timeliness, politeness of the travel agent, maintaining eye contact etc., all of which are components of the offered product. Thereby, we conducted, within the period 5 - 15 March 2015, a research based on interviews with 26 travel agents from 20 different units, in order to determine their awareness about potential factors that may have an influence on the quality of offered services. By the instrumentality of a questionnaire, we attempted to assess the integrity and loyalty of employees, their attitude regarding the activities they carry, their dissatisfaction, negative and positive factors influencing service quality, and their positioning to the organization and brand.
Vestergård, Lone Due; Løfgren, Bo; Krarup, Niels Henrik Vinther; Holm, Tina; Andersen, Lone Kærslund
International guidelines recommend monitoring the outcome following in-hospital cardiac arrest. Using data from automatic external defibrillators (AED) prospectively collected during a three-year period in a regional hospital, we evaluated the treatment quality of resuscitation. Time to defibrillation was acceptable, but quality of chest compressions did not comply with current international recommendations. AED use led to a high fraction of time with no chest compressions. Survival to discharge was 11%. Consequently, training in basic and advanced life support of hospital staff has been modified.
Adelstein, David; Barbour, Michael K.
Within the K-12 online learning environment there are a variety of standards that designers can utilize when creating online courses. To date, the only research-based standards available are proprietary in manner. As such, many jurisdictions have begun adopting online course design standards from the leading advocacy organization, which that have…
Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric
Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.
Rørtveit, Kristine; Severinsson, Elisabeth
The aim of this study was to reflect on aspects of mental health nursing leadership qualities with special focus on the therapeutic process for women who suffer from eating difficulties (ED). Therapy for patients with ED involves motivating them to make meaningful changes. Leadership qualities in MHN should focus on the relationship with the patient and positive empowerment processes. In-depth interviews were conducted with six women suffering from ED who had participated in art therapy. The interviews were analysed by means of an interpretative hermeneutic approach. A main theme 'The mental health nurse as a formative and mindful leader in a group therapeutic relationship' and two themes 'Leading sensitively towards awakening the patients' awareness of their pre-understanding' and 'Leading dialectically towards solving patients' existential dilemmas' were developed and comprised two aspects of leadership. The nurse-patient relationship is influenced by the patients' pre-understanding and existential dilemmas. Leadership qualities associated with being formative and mindful represent important aspects of this relationship and should be investigated and thematically described in greater detail in future research. The nurse-patient relationship should focus on clinical supervision, in order to strengthen the nurses' leadership qualities in terms of being aware and dialectical. © 2011 Blackwell Publishing Ltd.
Flu, Hans Christiaan
The aim of this thesis was to evaluate the quality of care in vascular surgery in end-stage renal disease (ESRD) and peripheral arterial occlusive disease (PAOD): intermittent claudication (IC) and critical lower limb ischaemia (CLI) patients. Therefore firstly it focused on the improvement of the
A substantial proportion of American, Canadian and English preschoolers regularly participate in family child care making its quality of vital importance for the children concerned, their parents, the school system and the society in which they live. This article discusses the seven key caregiver behaviors and physical space characteristics…
Doru Alexandru Pleşea
Full Text Available The mobile services are distinguished through their quality, either we speak about the way the client is approached and placed in the centre of the operator's actions, or about the services the client benefits in his capacity as a client. The Romanian mobile operators’ services have greatly evolved from their launch in 1997. Along these times, the mobile operators brought more value to these services, due to their need to meet the consumers' expectations with services of high quality and competitiveness. Usually the Romanian consumers place the price in the forefront of their service/mobile phone services acquisition, but an objective analyze of the quality of the mobile phone services has to take into account both technical aspects of the services and the interfacing services too. Therefore, this paper takes into account technical characteristics of the services such as national telephony coverage, data transmission services coverage, the signal quality, maximum speed of data transfer as well as related services such as distribution network, sales and support sales services, after-sales services, and range of available terminals. Based on mobile services comprehensive analysis made available to consumers by the major players on the Romanian market, this paper aims to highlight the main reasons of the consumers’ satisfaction and dissatisfaction.
Full Text Available Abstrak Latar belakang: Hipertensi merupakan faktor risiko utama penyakit kardiovaskular yang berpengaruh penting terhadap beberapa organ (jantung, otak, ginjal dan pembuluh darah. Penelitian ini bertujuan untuk untuk mengidentifikasi faktor dominan yang berhubungan dengan kualitas hidup penderita hipertensi. Metode: Disain penelitian ini adalah cross-sectional. Data berasal dari catatan medis pasien hipertensi yang diberikan pengobatan komplementer di fasilitas kesehatan di provinsi: DKI Jakarta, Jawa Tengah, Jawa Barat, Jawa Timur, Bali, Banten, dan Sumatera. Wawancara dan pencatatan catatan medis pasien dilakukan oleh 77 dokter praktek jamu. Pengukuran kualitas hidup pada pasien hipertensi dengan menggunakan kuesioner Short Form 36 WHO. Faktor risiko yang berhubungan dengan kualitas hidup pada pasien hipertensi dianalisis menggunakan regresi Cox. Hasil: Sebanyak 189 subjek pada penelitian ini. Proporsi subjek yang memiliki kualitas hidup yang baik adalah 51,9% (97/187. Faktor risiko dominan yang berhubungan dengan kualitas hidup pada pasien hipertensi adalah tingkat pendidikan dan jenis pengobatan. Dibandingkan dengan subjek yang memiliki tingkat pendidikan rendah, subjek yang tingkat pendidikan menengah dan tinggi memiliki risiko 83% lebih tinggi mempunyai kualitas hidup yang baik. Subjek yang mendapatkan jenis pengobatan konvensional dan herbal/tradisional berisiko 29% lebih tinggi mempunyai kualitas hidup yang baik. Kesimpulan: Subjek yang memiliki tingkat pendidikan yang lebih tinggi dan mendapatkan pengobatan konvensional dan herbal/tradisional berisiko mempunyai kualitas hidup yang baik.Kata kunci: kualitas hidup, pasien hipertensi Abstract Background: Hypertension is a major cardiovascular risk factor that had serious consequences to some organs (heart, brain, kidneys and blood vessels. This study aimed to investigate the dominant risk factors that related to quality of life in hypertension subjects. Methods: This cross
The author aimed to evaluate the quality of life and the factors affecting the caregivers of cancer patients receiving home care. This cross-sectional descriptive study was performed in 48 cancer patients who were served from home care unit and 48 caregivers between 01 and 28 February 2014. Patients' functional status was evaluated with Katz Index for Activities of Daily Living and the Lawton Scale for Instrumental Activities of Daily Living. The levels of quality of life of caregivers of patients with cancer were determined with Caregiver Quality of Life Index-Cancer (CQOLC). The mean age of forty-eight patients was 69.79 ± 16.09 years; 62.5% of them were female. The mean duration of home care was 5.99 ± 5.26 years; 25% of patients were fully dependent on the bed. 83.3% of caregivers were female, mean age of caregivers was 50.75 ± 14.89 years, and 77.1% of them were family members. The mean CQOLC score was 74.43 ± 24.45. The highest score was detected in the financial distress and the lowest score was detected in the positive adaptation. The quality of life is increasing as the length of care is reduced and income status increased. The quality of life of caregivers is very low. Each characteristic of the caregiver will affect the care he/she gives. From this point of view, it is important to consider the characteristics of caregivers in improving the care given to cancer patients. In this respect, there is a need to support caregivers both materially and spiritually.
Sneeuw, Kommer C. A.; Sprangers, Mirjam A. G.; Aaronson, Neil K.
Health-related quality of life (HRQL) studies sometimes rely, in part, on proxy information obtained from patients' significant others (spouse or close companion) or health care providers. This review: (1) provides a quantitative analysis of the results that have been reported in recent studies
Ngo-Metzger, Quyen; Sorkin, Dara H; Phillips, Russell S; Greenfield, Sheldon; Massagli, Michael P; Clarridge, Brian; Kaplan, Sherrie H
Provider-patient language discordance is related to worse quality care for limited English proficient (LEP) patients who speak Spanish. However, little is known about language barriers among LEP Asian-American patients. We examined the effects of language discordance on the degree of health education and the quality of interpersonal care that patients received, and examined its effect on patient satisfaction. We also evaluated how the presence/absence of a clinic interpreter affected these outcomes. Cross-sectional survey, response rate 74%. A total of 2,746 Chinese and Vietnamese patients receiving care at 11 health centers in 8 cities. Provider-patient language concordance, health education received, quality of interpersonal care, patient ratings of providers, and the presence/absence of a clinic interpreter. Regression analyses were used to adjust for potential confounding. Patients with language-discordant providers reported receiving less health education (beta = 0.17, p interpreter. Patients with language-discordant providers also reported worse interpersonal care (beta = 0.28, p interpreter did not mitigate these effects and in fact exacerbated disparities in patients' perceptions of their providers. Language barriers are associated with less health education, worse interpersonal care, and lower patient satisfaction. Having access to a clinic interpreter can facilitate the transmission of health education. However, in terms of patients' ratings of their providers and the quality of interpersonal care, having an interpreter present does not serve as a substitute for language concordance between patient and provider.
Weng, Cathy; Weng, Apollo; Tsai, Kevin
The primary purpose of this study was to uncover determines of students' intention to adopt online teaching evaluation at the end of semester by proposing a research model based on the Theory of Planned Behavior (TPB). The second purpose was to investigate the efficacy of the theory for predicting such intention. Besides users' attitude and…
Meacock, R.; Kristensen, Søren Rud; Sutton, M.
, and whether performance improvement is a transitory or investment activity. Our application to the Advancing Quality initiative demonstrates that the incentive payments represented less than half of the 13m pound total programme costs. By generating approximately 5200 quality-adjusted life years and 4.4m......Despite growing adoption of pay-for-performance (P4P) programmes in health care, there is remarkably little evidence on the cost-effectiveness of such schemes. We review the limited number of previous studies and critique the frameworks adopted and the narrow range of costs and outcomes considered......, before proposing a new more comprehensive framework, which we apply to the first P4P scheme introduced for hospitals in England. We emphasise that evaluations of cost-effectiveness need to consider who the residual claimant is on any cost savings, the possibility of positive and negative spillovers...
Wang, Jing; Han, Weiwei
Consumer neuroscience can provide useful insights into the neural foundations of consumer decisions, such as perceived quality. One of the applications is to guide attribute configuration of products to fit consumers' expectations on the basis of individual preferences. In this study, we required 20 participants to decide whether to buy the product provided in the stimuli and to respond as soon as possible. According to their reports of expectations after the experiment, we subdivided the stimuli into two conditions. Condition 1 contained the stimuli that fit individual preferences, whereas Condition 2 contained the other stimuli. An essential component of event-related potentials (ERPs), the P300, was elicited in the two conditions and distributed over almost all parietal and occipital regions. Products in Condition 1 induced a higher P300 amplitude than those in Condition 2. The results show that evaluating product attributes is a cognitive process that modulates attention in the aforementioned regions. When participants evaluate the alternatives, categorical processing occurred on the basis of similarity judgment. The situation in Condition 1 produced a similarity overlap between the product and the expectation and resulted in a higher P300. Otherwise, there was no overlap, leading to a smaller P300. Hence, the P300 may be a useful neural endogenous indicator for measuring consumers' evaluations of products in marketing research.
in males less that 20 years old and abdominal aortic aneurysms are to be contemplated if the patient is older than 50 years old. If any critical...resources limited by cost. Bergman (1995) discussed how financial objectives can be achieved without compromising the quality of care in the pediatric arena...Although his article focused on the pediatric population, the issues discussed apply to medical practice in general. The author stated how the
Ueda, Kayo; Ohtera, Shosuke; Kaso, Misato; Nakayama, Takeo
In childbirth, most deliveries are low-risk, defined as spontaneous labor at full term without special high-risk facts or complications, especially in high-resource countries where maternal and perinatal mortality rates are very low. Indeed, the majority of mothers and infants have no serious conditions during labor. However, the quality of care provided is not assured, and performance may vary by birthing facility and provider. The overuse of technology in childbirth in some parts of the world is almost certainly based on assumptions like, "something can go wrong at any minute." There is a need to assess the quality of care provided for mothers and infants in low-risk labor. We aimed to develop specific quality indicators for low-risk labor care provided primarily by midwives in Japan. We used a RAND-modified Delphi method, which integrates evidence review with expert consensus development. The procedure comprises five steps: (1) literature review, including clinical practice guidelines, to extract and develop quality indicator candidates; (2) formation of a multidisciplinary panel; (3) independent panel ratings (Round 1); (4) panel meeting and independent panel ratings (Round 2); and (5) independent panel ratings (Round 3). The three independent panel ratings (Rounds 1-3) were held between July and December 2012. The assembled multidisciplinary panel comprised eight clinicians (two pediatricians, three obstetricians, and three midwives) and three mothers who were nonclinicians. Evidentiary review extracted 166 key recommendations from 32 clinical practice guidelines, and 31 existing quality indicators were added. After excluding duplicate recommendations and quality indicators, the panel discussed 25 candidate indicators. Of these, 18 were adopted, one was modified, six were not adopted, and four were added during the meeting, respectively. We established 23 quality indicators for low-risk labor care provided by midwives in labor units in Japan.
Rao, Nisha; Kemper, Kathi J
Mind-body practices that intentionally generate positive emotion could improve health professionals' well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: (a) Gratitude, (b) Positive Word, and (c) Loving-kindness/Compassion meditation. Pairedttests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff's Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in providing compassionate care (73.3 ± 16.4 to 80.9 ± 13.8;Pgratitude, well-being, self-compassion, and confidence in providing compassionate care. © The Author(s) 2016.
Conclusion: Medical centers should guide interns in clinical cases and provide structured training. These measures could enhance the public's confidence in interns and improve patient satisfaction with interns through improved clinical skills, and provide an excellent work force for the dental field.
Wargocki, Pawel; Wyon, David Peter
codes stipulate that they should be. This is sometimes because financial resources for the maintenance and upgrade of school buildings are inadequate, but it is also because schools are increasingly allowing classroom temperatures to drift above the recommended range of 20–22 °C in warm weather......This paper is an overall summary of research by the authors on how classroom conditions affect the performance of schoolwork by children, motivated by the fact that the thermal and air quality conditions in school classrooms are now almost universally worse than the relevant standards and building...
of raw materials from aquaculture and from traditional fisheries. The aquaculture component will study the effects of dietary modulation, husbandry, fish physiology, genetics and pre-slaughter conditions. Validated traceability systems are assessed to make it possible to apply a total chain approach from......, by identifying risk factors and avoiding risks caused by viral and bacterial contamination and biogenic amines in seafood. The total value chain is addressed by developing consumer driven tailor-made, functional seafood products to improve health and to ensure nutritional quality and safety by full utilisation...
Full Text Available Quality of care is essential for further progress in reducing maternal and newborn deaths. The integration of educated, trained, regulated and licensed midwives into the health system is associated with improved quality of care and sustained decreases in maternal and newborn mortality. To date, research on barriers to quality of care for women and newborns has not given due attention to the care provider's perspective. This paper addresses this gap by presenting the findings of a systematic mapping of the literature of the social, economic and professional barriers preventing midwifery personnel in low and middle income countries (LMICs from providing quality of care.A systematic search of five electronic databases for literature published between January 1990 and August 2013. Eligible items included published and unpublished items in all languages. Items were screened against inclusion and exclusion criteria, yielding 82 items from 34 countries. 44% discussed countries or regions in Africa, 38% in Asia, and 5% in the Americas. Nearly half the articles were published since 2011. Data was extracted and presented in a narrative synthesis and tables. Items were organized into three categories; social; economic and professional barriers, based on an analytical framework. Barriers connected to the socially and culturally constructed context of childbirth, although least reported, appear instrumental in preventing quality midwifery care.Significant social and cultural, economic and professional barriers can prevent the provision of quality midwifery care in LMICs. An analytical framework is proposed to show how the overlaps between the barriers reinforce each other, and that they arise from gender inequality. Links are made between burn out and moral distress, caused by the barriers, and poor quality care. Ongoing mechanisms to improve quality care will need to address the barriers from the midwifery provider perspective, as well as the underlying
Luck, J; Peabody, J W; DeMaria, L M; Alvarado, C S; Menon, R
Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies
Decadt, Ine; Costermans, Els; Van de Poel, Maai; Kesteloot, Katrien; Devos, Timothy
Haemovigilance is the process of surveillance of blood transfusion procedures including unexpected hazards and reactions during the transfusion pathway in both donors and recipients. The haemovigilance team aims to increase blood transfusion safety and to decrease both morbidity and mortality in donors and recipients. The team collects data about transfusion reactions and incidents, instructs the involved health workers and assures the tracing of blood components. The haemovigilance team at the University Hospitals Leuven has played a pioneering role in the development of haemovigilance in Belgium Although the literature about safety and quality improvements by haemovigilance systems is abundant, there are no published data available measuring their financial impact in a hospital. Therefore, we studied the costs and returns of the haemovigilance team at the University Hospitals Leuven. This study has a descriptive explorative design. Research of the current costs and returns of the haemovigilance team were based upon data from the Medical Administration of the hospital. Data were analyzed descriptively. The haemovigilance team of the University Hospitals Leuven is financially viable: the direct costs are covered by the annual financial support of the National Public Health Service. The indirect returns come from two important tasks of the haemovigilance team itself: correction of the electronic registration of administered blood component and improvement of the return of conform preserved blood components to the blood bank. Besides safety and quality improvement, which are obviously their main goals, the haemovigilance team also implies a financial benefit for the hospital. Copyright © 2016 Elsevier Ltd. All rights reserved.
Thuneke, Klaus; Schreiber, Katja [Technologie- und Foerderzentrum, Straubing (Germany)
It was the goal of the work to investigate interactions between motor oils and rapeseed oil fuel and to test oil sensors for monitoring the quality of aged mixtures of motor oil and rapeseed oil. At first oil samples were aged in the laboratory, whereby motor oil type, share of rapeseed oil and aeration was varied. Depending on type of engine oil different ageing effects were noticed. Higher shares of rapeseed and aeration stimulate increase of viscosity and acid value. In a further step online oil sensors were tested in both, a model of a lubrication system and a test engine. The signals of the sensors plausibly described the oil ageing process by the indicators dynamic or acoustic viscosity, permittivity number, specific electric conductivity. In particular viscosity and permittivity are suitable for showing changes in different motor oil rapeseed oil mixtures during oil ageing. However, for a reliable control system detecting critical rapeseed oil enrichment in the motor oil onboard, further work has to be done. (orig.)
Kaicker, Jatin; Wu Ke; Athreya, Sriharsha, E-mail: firstname.lastname@example.org [Michael G. Degroote School of Medicine, Department of Medical Imaging (Canada)
This study was designed to examine the best internet resources about uterine fibroid embolization (UFE) pertinent to medical trainees, radiologists, gynecologists, family physicians, and patients. The terms 'uterine fibroid embolization,' 'uterine fibroid embolization,' and 'uterine artery embolization' were entered into Google, Yahoo, and Bing search engines; the top 20 hits were assessed. The hits were categorized as organizational or nonorganizational. Additionally, 23 radiological and obstetrical organizations were assessed. The DISCERN instrument and Journal of the American Medical Association (JAMA) benchmarks (authorship, attribution, currency, disclosure) were used to assess the information critically. The scope, strength, weaknesses, and unique features were highlighted for the top five organizational and nonorganizational websites. A total of 203 websites were reviewed; 23 were removed in accordance with the exclusion criteria and 146 were duplicate websites, for a total of 34 unique sites. It was found that 35 % (12/34 websites) were organizational (family medicine, radiology, obstetrics/gynecology) and 65 % (22/34 websites) were nonorganizational (teaching or patient resources). The overall mean DISCERN score was 49.6 (10.7). Two-tailed, unpaired t test demonstrated no statistically significant difference between organizational and nonorganizational websites (p = 0.101). JAMA benchmarks revealed 44 % (15/34 websites) with authorship, 71 % (24/34 websites) with attribution, 68 % (23/34 websites) with disclosure, and 47 % (16/34 websites) with currency. The overall quality of websites for UFE is moderate, with important but not serious shortcomings. The best websites provided relevant information about the procedure, benefits/risks, and were interactive. DISCERN scores were compromised by sites failing to provide resources for shared decision-making, additional support, and discussing consequence of no treatment. JAMA
Contacos-Sawyer, Jonna; Revels, Mark; Ciampa, Mark
The purpose of this paper is to identify the key elements of a High Performance Work System (HPWS) and explore the possibility of implementation in an online institution of higher learning. With the projected rapid growth of the demand for online education and its importance in post-secondary education, providing high quality curriculum, excellent…
Waheed, M.; Kaur, K.; Kumar, S.
Quality knowledge has an impact on online students learning outcomes and loyalty. A framework that delineates the perceived eLearning knowledge quality (KQ) and its relationship with learning outcomes and loyalty is currently absent. Grounded in the KQ and information system success framework--this study presents the indicators of perceived…
Im, U.; Bianconi, R.; Solazzo, E.; Kioutsioukis, I.; Badia, A.; Balzarini, A.; Baro, R.; Bellasio, R.; Brunner, D.; Chemel, C.; Curci, G.; Denier van der Gon, H.A.C.; Flemming, J.; Forkel, R.; Giordano, L.; Jimenez-Guerrero, P.; Hirtl, M.; Hodzic, A.; Honzak, L.; Jorba, O.; Knote, C.; Makar, P.A.; Manders-Groot, A.M.M.; Neal, L.; Perez, J.L.; Pirovano, G.; Pouliot, G.; San Jose, R.; Savage, N.; Schroder, W.; Sokhi, R.S.; Syrakov, D.; Torian, A.; Tucella, P.; Wang, K.; Werhahn, J.; Wolke, R.; Zabkar, R.; Zhang, Y.; Zhang, J.; Hogrefe, C.; Galmarini, S.
The second phase of the Air Quality Model Evaluation International Initiative (AQMEII) brought together seventeen modeling groups from Europe and North America, running eight operational online-coupled air quality models over Europe and North America using common emissions and boundary conditions.
John R. Grandzol and Christian J. Grandzol
Full Text Available This integrative review of literature on online educational best practices is intended to provide a quick reference for those interested in designing online business courses and programs. Primarily American in its perspective, this review may be helpful for business schools seeking optimal online course designs that foster quality learning experiences comparable in outcomes to traditional methods. Paramount in this review are the emphases on consistency, cohesiveness, and assessment.
Cheng, Adam; Overly, Frank; Kessler, David; Nadkarni, Vinay M; Lin, Yiqun; Doan, Quynh; Duff, Jonathan P; Tofil, Nancy M; Bhanji, Farhan; Adler, Mark; Charnovich, Alex; Hunt, Elizabeth A; Brown, Linda L
Many healthcare providers rely on visual perception to guide cardiopulmonary resuscitation (CPR), but little is known about the accuracy of provider perceptions of CPR quality. We aimed to describe the difference between perceived versus measured CPR quality, and to determine the impact of provider role, real-time visual CPR feedback and Just-in-Time (JIT) CPR training on provider perceptions. We conducted secondary analyses of data collected from a prospective, multicenter, randomized trial of 324 healthcare providers who participated in a simulated cardiac arrest scenario between July 2012 and April 2014. Participants were randomized to one of four permutations of: JIT CPR training and real-time visual CPR feedback. We calculated the difference between perceived and measured quality of CPR and reported the proportion of subjects accurately estimating the quality of CPR within each study arm. Participants overestimated achieving adequate chest compression depth (mean difference range: 16.1-60.6%) and rate (range: 0.2-51%), and underestimated chest compression fraction (0.2-2.9%) across all arms. Compared to no intervention, the use of real-time feedback and JIT CPR training (alone or in combination) improved perception of depth (pPerception of depth is more accurate in CPR providers versus team leaders (27.8% vs. 7.4%; p=0.043) when using real-time feedback. Healthcare providers' visual perception of CPR quality is poor. Perceptions of CPR depth are improved by using real-time visual feedback and with prior JIT CPR training. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Available With Slovenia joining the EU the need for higher quality and faster transit transport of goods through customs procedures has increased. This paper presents the recent logistics approach, which allows a better link between transportation and freight forwarding. Modern computer programs used by forwarding companies have contributed to this. Forwarder companies may have a role of organizer or a place using the transport services of customs clearance of goods at the entry / exit to / from the European Union. Each type of transport has a role to play, but gets even stronger when combined under one category. This is a multimodal transport. As an example we use logistic work in a logistic company. Here the work is divided in to transit of goods, customs clearance of goods, but also touching the law and the ranking of goods by tariff codes.
Jackson, Sarah C; Murff, Elizabeth J Tipton
Literature on self-assessment presents substantial evidence regarding the impact of self-assessment on dental practitioners and quality of care. Related dental hygiene research documents a need to enhance self-assessment curricula; however, no published curriculum module exists to effectively teach self-assessment. The purpose of this study was to explore the impact of a self-assessment educational module for dental hygiene curricula designed using adult learning principles. This module was implemented with thirty-three dental hygiene students in their junior year using a one-group, pretest-posttest design. Results analyzed using matched pairs Wilcoxon signed-rank test indicated the self-assessment module was effective (pforms was also enhanced after module implementation (peffective. Findings indicate a self-assessment educational module enhanced these dental hygiene students' self-assessment perceptions and skills.
Full Text Available Objective To investigate the relationship between macronutrient intake adequacy and the national diet quality index score. Methods The study analyzed a representative sample of 1,662 individuals from the municipality of São Paulo who participated in a cross-sectional study called Health Survey-Capital (2008/2009. Two 24-hour recalls were collected. Habitual intake was determined by the Multiple Source Method. The Brazilian index was calculated as suggested, and macronutrient adequacy was given by the World Health Organization and Food and Agriculture Organization recommendations. A generalized linear model verified the relationship between the Brazilian index and macronutrient adequacy. All analyses with a descriptive level below 0.05 were considered significant. The analyses were performed by the software Stata 12.0, survey mode. Results The vast majority (91% of the population had inappropriate macronutrient intakes, and the total median Brazilian index score was 61.3 points (interquartile range=10.1. The total Brazilian index score of individuals with high lipid intake was worse than that of individuals with proper lipid intake (β=0,96; p=0,004, while those with high protein intake had a better score (β=1,10; p=0,003 than those with proper protein intake. Conclusion The revised Brazilian Healthy Eating Index assesses diet quality properly regarding high lipid intake, but it has some limitations regarding high protein intake according to the World Health Organization and Food and Agriculture Organization recommendations. New studies should investigate the possibility of adapting this index to the World Health Organization and Food and Agriculture Organization recommendations.
Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane
Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.
McConville, Fran; Portela, Anayda
Background Quality of care is essential for further progress in reducing maternal and newborn deaths. The integration of educated, trained, regulated and licensed midwives into the health system is associated with improved quality of care and sustained decreases in maternal and newborn mortality. To date, research on barriers to quality of care for women and newborns has not given due attention to the care provider’s perspective. This paper addresses this gap by presenting the findings of a systematic mapping of the literature of the social, economic and professional barriers preventing midwifery personnel in low and middle income countries (LMICs) from providing quality of care. Methods and Findings A systematic search of five electronic databases for literature published between January 1990 and August 2013. Eligible items included published and unpublished items in all languages. Items were screened against inclusion and exclusion criteria, yielding 82 items from 34 countries. 44% discussed countries or regions in Africa, 38% in Asia, and 5% in the Americas. Nearly half the articles were published since 2011. Data was extracted and presented in a narrative synthesis and tables. Items were organized into three categories; social; economic and professional barriers, based on an analytical framework. Barriers connected to the socially and culturally constructed context of childbirth, although least reported, appear instrumental in preventing quality midwifery care. Conclusions Significant social and cultural, economic and professional barriers can prevent the provision of quality midwifery care in LMICs. An analytical framework is proposed to show how the overlaps between the barriers reinforce each other, and that they arise from gender inequality. Links are made between burn out and moral distress, caused by the barriers, and poor quality care. Ongoing mechanisms to improve quality care will need to address the barriers from the midwifery provider perspective
Vargas Bustamante, Arturo; Chen, Jie
We surveyed physicians about their ability to provide high-quality care to patients from diverse ethnic backgrounds. Primarily, we wanted to explore the challenges faced by physicians treating Latino patients compared to physicians whose patients were primarily white and non-Latino. We found that physicians treating Latinos, particularly those who worked in primary care in comparison to specialists, were less likely than physicians treating primarily white patients to believe in their ability to provide high-quality care. They cited problems of inadequate time with patients, patients' ability to pay, patients' nonadherence to recommended treatment, difficulties communicating with patients, relative lack of specialist availability, and lack of timely transmission of reports among physicians. Insurance expansions and complementary reforms mandated by the Affordable Care Act of 2010 and other recent legislation should aid physicians in closing some of these gaps in quality.
Ghostwriting is difficult to detect, it has the potential to be high quality, and universities do not currently have adequate policies in place to police it. Determining the quality of the ghostwriting services available to tertiary students is of vital importance because underestimating the potential for students to use these services to pass…
Desimone, Laura; Porter, Andrew C.; Birman, Beatrice F.; Garet, Michael S.; Yoon, Kwang Suk
Examined policy mechanisms and processes that districts used to provide high quality inservice professional development to teachers. Data from a national probability sample of professional development coordinators in districts that received federal funding for professional development highlighted specific management and implementation strategies…
Renting, Nienke; Gans, Rijk O. B.; Borleffs, Jan C. C.; Van Der Wal, Martha A.; Jaarsma, A. Debbie C.; Cohen-Schotanus, Janke
Introduction: Residents benefit from regular, high quality feedback on all CanMEDS roles during their training. However, feedback mostly concerns Medical Expert, leaving the other roles behind. A feedback system was developed to guide supervisors in providing feedback on CanMEDS roles. We analyzed
Rosemann, T.J.; Wensing, M.J.P.; Szecsenyi, J.; Grol, R.P.T.M.
BACKGROUND: Osteoarthritis (OA) has a high prevalence in primary care. Patient satisfaction is an important indicator for the quality of care provided to OA patients. Little is known about satisfaction of patients with this condition in a primary care setting in Germany. The aim of the study was to
To examine the relationships of providing compassion at work with job performance and mental health, as well as to identify the role of interpersonal relationship quality in moderating these relationships. This study adopted a two-stage survey completed by 235 registered nurses employed by hospitals in Taiwan. All hypotheses were tested using hierarchical regression analyses. The results show that providing compassion is an effective predictor of job performance and mental health, whereas interpersonal relationship quality can moderate the relationships of providing compassion with job performance and mental health. When nurses are frequently willing to listen, understand, and help their suffering colleagues, the enhancement engendered by providing compassion can improve the provider's job performance and mental health. Creating high-quality relationships in the workplace can strengthen the positive benefits of providing compassion. Motivating employees to spontaneously exhibit compassion is crucial to an organization. Hospitals can establish value systems, belief systems, and cultural systems that support a compassionate response to suffering. In addition, nurses can internalize altruistic belief systems into their own personal value systems through a long process of socialization in the workplace. © 2017 Sigma Theta Tau International.
Hanley, Terry; Ersahin, Zehra; Sefi, Aaron; Hebron, Judith
Online counselling is increasingly being used as an alternative to face-to-face student counselling. Using an exploratory mixed methods design, this project investigated the practice by examining the types of therapeutic goals that 11- to 25-year-olds identify online in routine practice. These goals were then compared to goals identified in…
The aim of this action research project was to improve student learning by encouraging more "time on task" and to improve self-assessment and feedback through the introduction of weekly online tests in a Year 2 lecture module in biological sciences. Initially voluntary online tests were offered to students and those who participated…
Englot, Dario J; Hassnain, Kevin H; Rolston, John D; Harward, Stephen C; Sinha, Saurabh R; Haglund, Michael M
Drug-resistant epilepsy is a devastating disorder associated with diminished quality of life (QOL). Surgical resection leads to seizure freedom and improved QOL in many epilepsy patients, but not all individuals are candidates for resection. In these cases, neuromodulation-based therapies such as vagus nerve stimulation (VNS) are often used, but most VNS studies focus exclusively on reduction of seizure frequency. QOL changes and predictors with VNS remain poorly understood. Using the VNS Therapy Patient Outcome Registry, we examined 7 metrics related to QOL after VNS for epilepsy in over 5000 patients (including over 3000 with ≥12months follow-up), as subjectively assessed by treating physicians. Trends and predictors of QOL changes were examined and related to post-operative seizure outcome and likelihood of VNS generator replacement. After VNS therapy, physicians reported patient improvement in alertness (58-63%, range over follow-up period), post-ictal state (55-62%), cluster seizures (48-56%), mood change (43-49%), verbal communication (38-45%), school/professional achievements (29-39%), and memory (29-38%). Predictors of net QOL improvement included shorter time to implant (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.1-1.6), generalized seizure type (OR, 1.2; 95% CI, 1.0-1.4), female gender (OR, 1.2; 95% CI, 1.0-1.4), and Caucasian ethnicity (OR, 1.3; 95% CI, 1.0-1.5). No significant trends were observed over time. Patients with net QOL improvement were more likely to have favorable seizure outcomes (chi square [χ 2 ]=148.1, pmetrics subjectively rated by physicians. QOL improvement is associated with favorable seizure outcome and a higher likelihood of generator replacement, suggesting satisfaction with therapy. It is important to consider QOL metrics in neuromodulation for epilepsy, given the deleterious effects of seizures on patient QOL. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Thompson, Joyce E; Land, Sandra; Camacho-Hubner, Alma Virginia; Fullerton, Judith T
To obtain a snapshot of the maternal and newborn care provided by different types of maternal and child health providers in Latin America and the Caribbean (LAC) to 1) better inform advocacy and programmatic strategies and interventions to improve the quality of those services in the region, and 2) determine the need for more rigorous study of the issues. A rapid assessment of 83 health workers providing antepartum, intrapartum, and immediate postpartum and newborn care (within two hours of birth) in eight LAC countries was conducted in November and December of 2011. Health workers were observed by two-person expert maternal/newborn clinician teams using pretested forms based on international quality-of-care standards. A total of 105 care encounters were observed, primarily in urban, public, referral-level settings. Providers of care included obstetricians, midwives, generalist physicians, medical residents, registered nurses, auxiliary nurses, and students of medicine, midwifery, and nursing. Hand washing, as an indicator of quality of antepartum care, was observed in only 41% of the observed encounters. Labor management often lacked certain elements of respectful maternity care across all provider groups. Several clinical tasks of high importance in the identification and prevention of common complications of antepartum, intrapartum, and immediate postpartum/newborn care were not documented as performed during the observation periods. Providers self-reported limited competence (ability to perform to a defined level of proficiency) in manual removal of the placenta, bimanual compression of the uterus, and newborn resuscitation. The findings suggest that 1) the quality of maternal and newborn care and 2) the competence of maternal and child health providers in the diverse selection of LAC countries that were studied require substantial attention.
Locatelli, Sara M; LaVela, Sherri L
Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress.
Florentine Renaissance Resources. Online Tratte of Office Holders 1282-1532, Ed. by D. Herlihy, R. Burr Litchfield, A. Molho, R. Barducci, 2000. Online Catasto of 1427, Ed. by D. Herlihy, C. Klapisch-Zuber, Vers. 1.2., Brown University, Providence, R.I.
Full Text Available Florentine Renaissance Resources. - Online Tratte of Office Holders 1282-1532, Edited by David Herlihy, R. Burr Litchfield, Anthony Molho and Roberto Barducci , 2000 - Online Catasto of 1427, Edited by David Herlihy, Christiane Klapisch-Zuber, Version 1.2., Brown University, Providence, R.I. , 1996
Leung, Sau F; Ma, Joyce Lc; Russell, Janice
Eating disorders are serious mental illnesses that have a significant effect on afflicted individuals' quality of life. Evidence has shown that they can be improved with treatment. Internet-based interventions are useful in engaging individuals with eating disorders in self-management and treatment. This study aimed primarily to identify the change in quality of life of individuals with disordered eating after participating in an open trial of an Internet-based self-help programme, and compared their quality of life at assessment with that of healthy controls. Factors affecting their quality of life were examined. Secondary outcomes related to symptom improvement were also reported. This study included 194 individuals with disordered eating and 50 healthy controls. The former group was recruited from eating disorder outpatient clinics and treatment units, as well as via information disseminated through various Internet websites, while the healthy controls were recruited from university student newspapers and university campuses. The Medical Outcomes Study Short Form Survey (SF-36v2) was used to assess participants' quality of life. Other measures were used to assess their symptoms and motivational stages of change to recover from an eating disorder. The Wilcoxon signed ranks test and one-way repeated measures ANOVA were used to identify the change in quality of life of individuals with disordered eating from baseline to 1-, 3- and 6-month follow-ups. The Mann-Whitney U test was employed to compare the difference in quality of life between participants with disordered eating and the healthy controls. Spearman rank order correlations were performed to examine the factors associated with quality of life. The participants with disordered eating had significantly poorer quality of life than the healthy controls in both physical and psychological domains. The factors associated with their poor quality of life included dieting behaviour, use of laxatives, severe eating
Software projects are often late and over-budget and this leads to major problems for software customers. Clearly, there is a serious issue in estimating a realistic, software project budget. Furthermore, generic estimation models cannot be trusted to provide credible estimates for projects as complex as software projects. This book presents a number of examples using data collected over the years from various organizations building software. It also presents an overview of the non-for-profit organization, which collects data on software projects, the International Software Benchmarking Stan
Rodrigues, Alexandre M; Ferreira, Pedro L; Ferré-Grau, Carmen
To evaluate the quality of life of informal caregivers of patients with pressure ulcer; to assess their levels of burden; to analyse the variables influencing both their quality of life and burden. Informal caregivers of pressure ulcer patients, besides coping with the natural dependency of these patients, deal with the specificity of caring these types of wounds. This situation has an impact on not only the quality of life and burden felt by informal caregivers but also on individual and familiar dynamics. Descriptive and correlational study. This study focused on 145 informal caregivers providing home care. Measurement instruments were: SF-36v2 and the Burden Interview Scale. Descriptive analysis of the quantitative variables was carried out according to measures of central tendency, and the qualitative variables were described using absolute and relative frequencies. The relationships or associations between variables were explored through correlational analysis and, whenever the data allowed, multivariate techniques were used. Informal caregivers showed low levels of quality of life and, most of them, significant burden. Quality of life decreased with overload, with the increasing number of pressure ulcer and with less experience of informal caregivers, with lack of financial remuneration, with unemployment, with patient positioning and with the direct care of the wound. The burden increased with the number of pressure ulcer in each patient and with the lack of financial remuneration. These informal caregivers have low quality of life and are overburdened. Both situations are positively and negatively influenced by factors related to the pressure ulcer and to the patients' sociodemographic data. The results of this study allow more effective monitoring by health professionals of levels of burden and quality of life encountered in pressure ulcer informal caregivers, as well as direct interventions to inhibit the factors inducing burden and enhance those that
Leung, Sau F; Ma, Joyce LC; Russell, Janice
Background Eating disorders are serious mental illnesses that have a significant effect on afflicted individuals’ quality of life. Evidence has shown that they can be improved with treatment. Internet-based interventions are useful in engaging individuals with eating disorders in self-management and treatment. This study aimed primarily to identify the change in quality of life of individuals with disordered eating after participating in an open trial of an Internet-based self-help programme,...
Ting, Ong Soo; Ariff, Mohd Shoki Md; Zakuan, Norhayati; Sulaiman, Zuraidah; Zameri Mat Saman, Muhamad
The growing usage of internet and online shopping in Malaysia presents a huge prospect in e-commerce market, specifically for B2C segment. As a result, electronic service quality (e-SQ), electronic satisfaction (e-Satisfaction) and electronic loyalty (e-Loyalty) become vital for online retailers to attract and retain online shoppers in this virtual environment. The association between e-SQ, e-Satisfaction and e-Loyalty should be continuously examined to cope with the advancement in information and communication technology, and the changing expectation of online shoppers. However, construct of e-SQ for online retailers in B2C market is still debatable. In this research, E-SERVQUAL was integrated with the other e-SQ scales to measure e-SQ of a prominent online retailer in Malaysia. Specifically, the e-SQ constructs are Efficiency, Privacy and Trust, Fulfilment, Responsiveness, Contact and Website Design. 390 sets of completed and usable questionnaires were gathered using online questionnaire and convenience sampling procedure. The result indicated that the five proposed dimensions of e-SQ constitute e-SQ of online retailer in B2C market. All the dimensions of e-SQ were found to have positive and significant effect on e-Satisfaction of online shoppers. Responsiveness of e-SQ had the strongest impact on e-satisfaction of online shoppers. The shoppers e-Satisfaction was positively and significantly affected their e-Loyalty towards continuous usage of online retailer's website. Managerial and theoretical implications are discussed based on the results of the study.
Quartly, G. D.; Nencioli, F.; Labroue, S.; Femenias, P.; Scharroo, R.; Abdalla, S.; Bonnefond, P.; Cancet, M.; Frery, M.-L.; Raynal, M.; Baker, S.; Muir, A.; Brockley, D.; Shepherd, A.; Garcia, P.; Roca, M.; Calmant, S.; Cretaux, J.-F.
Sentinel-3A, launched in February 2016, is part of ESA's long-term commitment to climate monitoring from space. Its suite of instruments for measuring surface topography includes a Microwave Radiometer (MWR) and SRAL, the first delay-Doppler instrument to provide global coverage. SRAL promises fine spatial resolution and reduced noise levels that should together lead to improved performance over all Earth surfaces. The Sentinel-3 Mission Performance Centre (S3MPC) has been developing the methodology to evaluate the accuracy of retrievals, monitor any changes and develop solutions to known problems. The S3MPC monitors internal temperatures, path delays and the shape of the generated pulses to assess the instruments health. The MWR records over known reference surfaces are compared with those from other spaceborne instruments. Over the ocean the SRAL's return pulses are analysed to give range to the sea surface, wave height and signal strength (which can be interpreted as wind speed). The metocean data are regularly contrasted with records from in situ measurements and the output from meteorological models, which rapidly highlights the effects of any changes in processing. Range information is used to give surface elevation, which is assessed in three ways. First, flights over a dedicated radar transponder provide an estimate of path delay to within 10 mm (r.m.s.). Second, measurements are compared to GPS-levelled surfaces near Corsica and over Lake Issyk-kul. Third, there are consistency checks between ascending and descending passes and with other missions. Further waveform analysis techniques are being developed to improve the retrieval of information over sea-ice, land-ice and inland waters.
Yagur-Kroll, Sharon; Schreuder, Erik; Ingham, Colin J; Heideman, René; Rosen, Rachel; Belkin, Shimshon
The use of live bacterial reporters as sensing entities in whole-cell biosensors allows the investigation of the biological effects of a tested sample, as well as the bioavailability of its components. Here we present a proof of concept for a new design for online continuous water monitoring flow-cell biosensor, incorporating recombinant reporter bacteria, engineered to generate an optical signal (fluorescent or bioluminescent) in the presence of the target compound(s). At the heart of the flow-cell is a disposable chip made of porous aluminum oxide (PAO), which retains the sensor microorganisms on its rigid planar surface, while its high porosity allows an undisturbed access both to the sample and to essential nutrients. The ability of the bacterial reporters to detect model toxic chemicals was first demonstrated using a "naked" PAO chip placed on solid agar, and later in a chip encased in a specially designed flow-through configuration which enables continuous on-line monitoring. The applicability of the PAO chip to simultaneous online detection of diverse groups of chemicals was demonstrated by the incorporation of a 6-member sensor array into the flow-through chip. The selective response of the array was also confirmed in spiked municipal wastewater effluents. Sensing activity was retained by the bacteria after 12-weeks storage of freeze-dried biochips, demonstrating the biochip potential as a simple minimal maintenance "plug-in" cartridge. This low-cost and easy to handle PAO-based flow-cell biosensor may serve as a basis for a future platform for water quality monitoring. Copyright © 2014 Elsevier B.V. All rights reserved.
Full Text Available Information technology can increase the quality of medical care and is a target for many of the pioneers in the development of clinical or medical information. Electronic medical record (EMR, one of such technologies, is a well-known and valuable system to access patient information in hospitals. Electronic medical records which are used for the purpose of providing basic health care are available through a network of computers. All units of the hospital such as examination room, conference room, emergency, patient care units, nursing stations, operating rooms, recovery units, laboratory, radiology, pharmacy and medical records should have access to it. Among its advantages are improved quality of care provided to patients, better organized information, improvement in the timeliness of the process, accuracy and completeness of documentation, patient access to electronic copies of records, prevention of medication errors and allergies, reduced medical errors, immediate access to information in different places, decision support technology and improvement in the process of doing . S urely the use of electronic medical records has created a new dimension to patient care and clinical practice and will provide a comprehensive system to support people in the community and enhance the quality of services provided to them.
Simmet, Anja; Depa, Julia; Tinnemann, Peter; Stroebele-Benschop, Nanette
In many affluent countries, food-insecure households use food pantries to keep their family fed. The long-term dependence of many users on these programs calls for a systematic review of studies on the nutritional quality of food provided by food pantries. The purpose of this systematic review was to summarize the current scientific evidence about the nutritional quality of food bags distributed by food pantries. A systematic literature search was conducted in the electronic databases PubMed, PsycINFO, PsycARTICLES, and Psychology Behavioral Sciences Collection to identify cross-sectional, cohort, and intervention studies reporting baseline data conducted in high-income countries and published between 1980 and 2015, which reported the nutritional quality of food bags distributed by food pantries. Identified citations were screened in two stages and data were independently extracted by two authors using a predefined data sheet. The quality of included studies was evaluated using criteria of an adapted Ottawa Scale. The systematic review was reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Applying the two-stage screening, 9 of 1,546 articles were identified for inclusion. Nutritional quality of food bags varied widely between and within studies. Milk products, vitamins A and C, and calcium were provided in particularly low amounts. None of the studies were nationally representative and only a few studies controlled for the household composition of the recipients of food bags. Food pantries likely have a strong influence on users' diets, but the food pantries examined in the selected studies were largely unable to support healthy diets. The distribution of more perishable foods would increase users' diet quality and may have an immense potential to address malnutrition in vulnerable population groups. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Reddy, Ashok; Pollack, Craig E; Asch, David A; Canamucio, Anne; Werner, Rachel M
Primary care provider (PCP) turnover is common and can disrupt patient continuity of care. Little is known about the effect of PCP turnover on patient care experience and quality of care. To measure the effect of PCP turnover on patient experiences of care and ambulatory care quality. Observational, retrospective cohort study of a nationwide sample of primary care patients in the Veterans Health Administration (VHA). We included all patients enrolled in primary care at the VHA between 2010 and 2012 included in 1 of 2 national data sets used to measure our outcome variables: 326,374 patients in the Survey of Healthcare Experiences of Patients (SHEP; used to measure patient experience of care) associated with 8441 PCPs and 184,501 patients in the External Peer Review Program (EPRP; used to measure ambulatory care quality) associated with 6973 PCPs. Whether a patient experienced PCP turnover, defined as a patient whose provider (physician, nurse practitioner, or physician assistant) had left the VHA (ie, had no patient encounters for 12 months). Five patient care experience measures (from SHEP) and 11 measures of quality of ambulatory care (from EPRP). Nine percent of patients experienced a PCP turnover in our study sample. Primary care provider turnover was associated with a worse rating in each domain of patient care experience. Turnover was associated with a reduced likelihood of having a positive rating of their personal physician of 68.2% vs 74.6% (adjusted percentage point difference, -5.3; 95% CI, -6.0 to -4.7) and a reduced likelihood of getting care quickly of 36.5% vs 38.5% (adjusted percentage point difference, -1.1; 95% CI, -2.1 to -0.1). In contrast, PCP turnover was not associated with lower quality of ambulatory care except for a lower likelihood of controlling blood pressure of 78.7% vs 80.4% (adjusted percentage point difference, -1.44; 95% CI, -2.2 to -0.7). In 9 measures of ambulatory care quality, the difference between patients who experienced no
Hammarberg, Karin; Prentice, Tess; Purcell, Isabelle; Johnson, Louise
Many factors influence the chance of having a baby with assisted reproductive technologies (ART). A 2016 Australian Competition and Consumer Commission (ACCC) investigation concluded that ART clinics needed to improve the quality of information they provide about chance of ART success. To evaluate changes in the quality of information about success rates provided on the websites of ART clinics in Australia and New Zealand before and after the ACCC investigation. Desktop audits of websites of ART clinics in Australia and New Zealand were conducted in 2016 and 2017 and available information about success rates was scored using a matrix with eight variables and a possible range of scores of 0-9. Of the 54 clinic websites identified in 2016, 32 had unique information and were eligible to be audited. Of these, 29 were also eligible to be audited in 2017. While there was a slight improvement in the mean score from 2016 to 2017 (4.93-5.28), this was not statistically significantly different. Of the 29 clinics, 14 had the same score on both occasions, 10 had a higher and five a lower information quality score in 2017. To allow people who consider ART to make informed decisions about treatment they need comprehensive and accurate information about what treatment entails and what the likely outcomes are. As measured by a scoring matrix, most ART clinics had not improved the quality of the information about success rates following the ACCC investigation. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Lange, Elizabeth M S; Shah, Anuj M; Braithwaite, Brian A; You, Whitney B; Wong, Cynthia A; Grobman, William A; Toledo, Paloma
The objective of this study was to evaluate the readability, content, and quality of patient education materials addressing preeclampsia. Websites of U.S. obstetrics and gynecology residency programs were searched for patient education materials. Readability, content, and quality were assessed. A one-sample t-test was used to evaluate mean readability level compared with the recommended 6th grade reading level. Mean readability levels were higher using all indices (p Content was variable with good website understandability, but poor actionability. The mean readability was above the recommended 6th grade reading level. The content, readability, and actionability of preeclampsia patient education materials should be improved.
Natan, Merav Ben; Beyil, Valery; Neta, Okev
A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.
The aim of this action research project was to improve student learning by encouraging more "time on task" and to improve self-assessment and feedback through the introduction of weekly online tests...
The aim of this action research project was to improve student learning by encouraging more "time on task" and to improve self-assessment and feedback through the introduction of weekly online tests...
Zhang, Y.; Meratnia, Nirvana; Havinga, Paul J.M.
Data collected by Wireless Sensor Networks (WSNs) are inherently unreliable. Therefore, to ensure high data quality, secure monitoring, and reliable detection of interesting and critical events, outlier detection mechanisms are needed to be in place. The constraint nature of resources available in
Stenlaaaas, Ola; Roedjegaard, Henrik
Swedish automotive gas has until now been a very uniform, high quality automotive fuel. Elsewhere in Europe the quality of automotive gas varies significantly. Gas from different sources with different flammability require engine settings adjusted to the chosen gas' unique composition. The prospects for a vehicle-mounted sensor based on infrared technology for gas quality measurement has been studied and solutions are presented with questions that must be answered in a possible future work. The proposed vehicle mounted sensor is based on two channels, one of which measures the partial pressure of methane and the other measures the partial pressure of heavier hydrocarbons in 'equivalents of butane'. Ethane produces a signal of about 0.6 equivalents of butane and propane about 0.8 equivalents. The sensor can be accommodated in a cube with 5 cm side and should be equipped with nipple connections to the existing system. The sensor is expected to work throughout their entire lifetime without manual calibration, through continuous automatic calibration, so-called ABC (Automatic Baseline Compensation). The sensor will have to meet tough quality and environmental standards in which primarily contact ring, vibration and prevention of leakage are identified as extra difficult. Working temperatures and the electrical conditions of power supply and communication interface is considered less challenging. In one million volumes, the cost per sensor could be 200 to 300 SEK.
Full Text Available Medical information system (MIS is at the heart of information technology (IT implementation policies in healthcare systems around the world. Different architecture and application models of MIS are developed. Despite of obvious advantages and benefits, application of MIS in everyday practice is slow. On the background of analysis of the existing models of MIS in Georgia has been created a multi-user web-based approach. This article will present the architecture of the system and its application for cytology quality assurance programs. Five hundred Georgian language electronic medical records from the cervical screening activity illustrated by images were selected for quality assurance program. The primary goal of the MIS is patient management. However, the system can be used for quality assurance programs. The ideal of healthcare in the information age must be to create a situation where healthcare professionals spend more time creating knowledge from medical information and less time managing medical information. The application of easily available and adaptable technology and improvement of the infrastructure conditions is the basis for eHealth applications. The MIS is perspective and actual technology solution. It can be used for cytology quality assurance programs.
The lab developed a push-broom, line-scan imaging system capable of simultaneous measurements of reflectance and fluorescence. The system allows multitasking inspections for quality and safety attributes of apples due to its dynamic capabilities in simultaneously capturing fluorescence and reflectan...
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
Wu, Qilong; Zhang, Zhenghua; Cao, Guodong; Zhang, Xihui
Polymeric membrane has been widely used for the treatment of drinking water in China, and the total treating capacity has reached up to 3.8 million m 3 /d. However, the membrane breakage found in the membrane modules in many water treatment plants resulted in an increase in turbidity and bacterial amount in the membrane permeate. In this study, a membrane module running for 3 years in a full-scale application was examined in terms of the breaking positions and the numbers of the broken fibers. It was found that most of the breaking positions were mainly on the outlet side of the module and that the distance from these points to the outlet was about 1/10-2/10 length of the membrane module. The lab-scale tests showed that the increase of the numbers of the breaking fibers in the membrane module (the breaking fibers were from 1 to 4 of 75 fibers) resulted in the increase in turbidity, particle count and the amount of total bacteria and coliform bacteria. Meanwhile, the water quality after the filtration with broken membrane fibers was similar to the quality of the raw water, which indicated that once the membrane fiber breakage occurred in the membrane module, the quality of drinking water after membrane filtration was significantly affected. Furthermore, the breaking position closer to the outlet side of the membrane module exposed much higher microbiological risk than those in the middle or near the bottom side. A pilot scale test was conducted by using a membrane module with 6600 fibers, and the effect of the membrane breakage (1-4 broken fibers) on water quality was also investigated. The results indicated that periodical backwashing caused drastic fluctuation of turbidity, particle count and the bacterial amount in the permeate water, which might be due to the washing force and self-blocking action inside the hollow fibers. Moreover, there is a good quantitative relationship (R 2 = 0.945) between particle count and the bacterial amount, which indicated that an
Mehta, Neil; Atreja, Ashish
Peer support groups have a long history and have been shown to improve health outcomes. With the increasing familiarity with online social networks like Facebook and ubiquitous access to the Internet, online social support networks are becoming popular. While studies have shown the benefit of these networks in providing emotional support or meeting informational needs, robust data on improving outcomes such as a decrease in health services utilization or reduction in adverse outcomes is lacking. These networks also pose unique challenges in the areas of patient privacy, funding models, quality of content, and research agendas. Addressing these concerns while creating patient-centred, patient-powered online support networks will help leverage these platforms to complement traditional healthcare delivery models in the current environment of value-based care.
Burns, Peter D.; Phillips, Jonathan B.; Williams, Don
In this paper we address the problem of Image Quality Assessment of no reference metrics, focusing on JPEG corrupted images. In general no reference metrics are not able to measure with the same performance the distortions within their possible range and with respect to different image contents. The crosstalk between content and distortion signals influences the human perception. We here propose two strategies to improve the correlation between subjective and objective quality data. The first strategy is based on grouping the images according to their spatial complexity. The second one is based on a frequency analysis. Both the strategies are tested on two databases available in the literature. The results show an improvement in the correlations between no reference metrics and psycho-visual data, evaluated in terms of the Pearson Correlation Coefficient.
Weitzman, Elissa R; Cole, Emily; Kaci, Liljana; Mandl, Kenneth D
To foster informed decision-making about health social networking (SN) by patients and clinicians, the authors evaluated the quality/safety of SN sites' policies and practices. Multisite structured observation of diabetes-focused SN sites. Measurements 28 indicators of quality and safety covering: (1) alignment of content with diabetes science and clinical practice recommendations; (2) safety practices for auditing content, supporting transparency and moderation; (3) accessibility of privacy policies and the communication and control of privacy risks; and (4) centralized sharing of member data and member control over sharing. Quality was variable across n=10 sites: 50% were aligned with diabetes science/clinical practice recommendations with gaps in medical disclaimer use (30% have) and specification of relevant glycosylated hemoglobin levels (0% have). Safety was mixed with gaps in external review approaches (20% used audits and association links) and internal review approaches (70% use moderation). Internal safety review offers limited protection: misinformation about a diabetes 'cure' was found on four moderated sites. Of nine sites with advertising, transparency was missing on five; ads for unfounded 'cures' were present on three. Technological safety was poor with almost no use of procedures for secure data storage and transmission; only three sites support member controls over personal information. Privacy policies' poor readability impedes risk communication. Only three sites (30%) demonstrated better practice. Limitations English-language diabetes sites only. The quality/safety of diabetes SN is variable. Observed better practice suggests improvement is feasible. Mechanisms for improvement are recommended that engage key stakeholders to balance autonomy, community ownership, conditions for innovation, and consumer protection.
pressure (and thus low RH) unless a failure occurs in the driers . However, in locations where suspect ambient air quality may exist, such as at...on a monitor’s readings should be minimal, as this air is expected to be very dry unless the drier system fails or another hardware problem occurs...correctly, perform limited laboratory testing of a significant fraction (e.g., -25%, up to a maximum of five units) of the initial batch of production
Gian Marco Revel
Full Text Available In this paper the problem of experimentally testing the mechanical reliability of electronic components for quality control is approached. In general, many tests are performed on electronic devices (personal computers, power supply units, lamps, etc., according to the relevant international standards (IEC, in order to verify their resistance to shock and vibrations, but these are mainly “go no-go” experiments, performed on few samples taken from the production batches.
Radiotherapy has existed as a clinical medical procedure since as early as 1900, and has become an essential component of modern hospitals. It is predicted that, sometime between the years 2010 and 2020, the number of patients receiving radiation therapy during their initial treatment is expected to rise by 22% from 470,000 per year to 575,000 per year Due to the potential for harm in radiotherapy, quality assurance is an essential element at every stage of modern clinical workflow. The quality and use of time in QA procedures and checks is an important issue that has significant impact on both practice and research in the field of radiotherapy. This thesis documents the results of development and results of tools addressing that question. While the motivation for radiotherapy QA is principally about improving quality of patient care, and developing radiotherapy research tools, we also discuss the relevance of QA to radiotherapy malpractice lawsuits and related financial costs. We show that in the treatment plan check performed by the medical physicist---also known as the second check or physics check---a substantial fraction (~33%) of the average time is spent on non-physics related analysis. We also demonstrate the development and implementation of a web-based system, referred to as PlanTracker within this thesis, to track the status of the plan. This thesis concludes with further developments being considered as an outgrowth of this system.
Farrell, Michael H; Christopher, Stephanie A
To examine the quality of communication likely to be experienced by parents when being first informed about how newborn screening identified heterozygous "carrier" status for cystic fibrosis or sickle cell disease. Primary care providers (PCPs) of infants found to have carrier status were telephoned over a 48-month period, and asked to rehearse with a standardized patient how they would inform the infants' parent(s). 214 rehearsal transcripts were abstracted using explicit criteria methods to measure the frequency of five categories of high-quality communication behaviors. Overall, PCPs used large amounts of jargon and failed to use high quality communication behaviors. On average, PCPs used 18.6 total jargon words (8.7 unique words), but explained 2.4 jargon words. The most frequent assessment of understanding was the close-ended version, although it was only seen in 129 of 214 transcripts. The most common organizing behavior was importance emphasis (121/214). Precautionary empathy was rare; the most frequent behavior was "instruction about emotion" (33/214). The limited use of high-quality communication behaviors in rehearsals raises concern about parental understanding, decision-making, and psychosocial outcomes after newborn screening. Measurement of specific behaviors may help PCPs to improve communication, and thereby improve the patient experience. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Aldrich, Heather Troxell; Salandanan, Karen; Kendall, Patricia; Bunning, Marisa; Stonaker, Frank; Külen, Oktay; Stushnoff, Cecil
Tomatoes (Solanum lycopersicum L.) are widely consumed and well known for their health benefits, many of which have been associated with the high levels of antioxidants present in tomatoes. With a growing interest in local and organic foods, it would be helpful to determine whether farmers could naturally improve the quality and antioxidant content of tomatoes for sale in local markets. This study evaluated antioxidant properties, quality attributes, and yield for 10 tomato cultivars grown for 2 years using certified organic and conventional practices. Cultivar and year effects impacted (P < 0.05) all tests conducted, while growing method influenced (P < 0.05) yield, soluble solids content, ascorbic acid, and antioxidant radical scavenging capacity. Even when accounting for year-to-year variability, cultivars in the highest groups had 1.35- to 1.67-fold higher antioxidant levels than cultivars in the lowest groups. 'New Girl', 'Jet Star', 'Fantastic', and 'First Lady' were always in the highest groups, while 'Roma' and 'Early Girl' consistently had the lowest antioxidant content. Compared to production practices and environmental effects of years that are generally beyond the control of small-scale producers, choice of cultivar provides the simplest and most effective means of increasing antioxidant properties. Knowledge of tomato cultivars with naturally higher antioxidant levels could assist smaller-scale producers to grow fruit that may provide a competitive advantage and the opportunity to capitalize on the increasing popularity of locally grown, high-quality fresh produce. Copyright © 2010 Society of Chemical Industry.
Full Text Available With the development and implementation of a multilingual interactive communication system the e-health project ENN-ICS, funded by the European Union, aims at the improvement of health care in Europe. The field of application is sleep physiology and sleep medicine. ENN-ICS Centre offers direct access to medical information for multiple users, i.e. health authorities, health care professionals, patients and citizen. Using XML technologies the new web based network integrates advanced e-learning and e-publishing methods for the training of healthcare professionals. Editorial and distributive processes are supported by customized central editorial, content management and learning management systems (CMS, LMS. ENN-ICS e-health services are evaluated by selected user groups in North, Middle and Southern Europe using reliable and scientifically accepted validation instruments. The compliance with essential quality requirements and criteria is tested and verified by using adapted online questionnaires based on the DISCERN questionnaire for evaluating patient information, on the HON principles for evaluating health-related websites and on the GMDS catalogue of quality criteria for electronic publications in medicine. The system architecture and its exemplary applications can be used as a model for future e-health services dealing with neurological and other medical topics.
Di Lorenzo, Mirella; Thomson, Alexander R; Schneider, Kenneth; Cameron, Petra J; Ieropoulos, Ioannis
The heavy use of chemicals for agricultural, industrial and domestic purposes has increased the risk of freshwater contamination worldwide. Consequently, the demand for efficient new analytical tools for on-line and on-site water quality monitoring has become particularly urgent. In this study, a small-scale single chamber air-cathode microbial fuel cell (SCMFC), fabricated by rapid prototyping layer-by-layer 3D printing, was tested as a biosensor for continuous water quality monitoring. When acetate was fed as the rate-limiting substrate, the SCMFC acted as a sensor for chemical oxygen demand (COD) in water. The linear detection range was 3-164 ppm, with a sensitivity of 0.05 μA mM(-1) cm(-2) with respect to the anode total surface area. The response time was as fast as 2.8 min. At saturating acetate concentrations (COD>164 ppm), the miniature SCMFC could rapidly detect the presence of cadmium in water with high sensitivity (0.2 μg l(-1) cm(-2)) and a lower detection limit of only 1 μg l(-1). The biosensor dynamic range was 1-25 μg l(-1). Within this range of concentrations, cadmium affected only temporarily the electroactive biofilm at the anode. When the SCMFCs were again fed with fresh wastewater and no pollutant, the initial steady-state current was recovered within 12 min. Copyright © 2014. Published by Elsevier B.V.
Luo, Tian; Ke, Jing; Xie, Yunfei; Dong, Yuming
Capillary electrophoresis (CE) with ultraviolet detection was applied to determine underivatized amino acids in beer, based on the coordination interaction of copper ions and amino acids. An online sweeping technique was combined with CE to improve detection sensitivity. Using the United Nations Food Agriculture Organization/World Health Organization model of essential amino acid pattern and flavor of amino acids, the quality and taste in three kinds of beer were evaluated. It was found that Beer2 had higher quality than the other two kinds and the content of phenylalanine, proline, serine, and isoleucine was relatively large in all three kinds of beers with a great influence on beer flavor. Optimal conditions for separation were as follows: 50mM CuSO 4 at pH 4.40 as buffer; total length of fused silica capillary, 73 cm; effective length, 65 cm; separation voltage, 22.5 kV; and optimized sweeping condition, 70 seconds. In the appropriate range, linearity (r 2 > 0.9989), precision with a relative standard deviation amino acids in beer and to perform quantitative analysis directly without derivatization for the first time. Copyright © 2017. Published by Elsevier B.V.
Patel, Urvi; Cobourne, Martyn T
The aim of this study was to evaluate the quality of information available on the Internet for a person interested in orthodontic extractions. The term "orthodontic extractions" was entered into the search engines of both Google and Yahoo, and the first 50 Web links for each were pooled and examined. Exclusion criteria consisted of repetitions, sites requiring registration or login, and those accessing scientific articles. Sites fulfilling the criteria for inclusion were examined by using the LIDA instrument, a validated method of evaluating health care Web sites, based on accessibility, usability, and reliability. The readability of each site was further assessed by using the Flesch reading ease score. Of the 100 Web sites identified, 21 were suitable for inclusion and scoring. Overall, the mean total LIDA score was 93 of a possible 144 (65%) (range, 71-116 or 49%-81%). No Web site scored above an arbitrary gold standard of 90%; however, most (20 of 21) scored above 50%. With the LIDA instrument, average accessibility was 70%, average usability was 72%, and average reliability was 41%. The average Flesch reading ease score was 58.3. Overall, the quality of information available on the Internet with regard to orthodontic extractions is variable. Although readability is generally good, reliability is a cause for concern, and patients should interpret many of these sites with caution. The top-rated Web sites in a search engine are not necessarily those of the highest quality. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Steele, Joseph R; Schomer, Don F
Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.
Beehler, Gregory P; Lilienthal, Kaitlin R; Possemato, Kyle; Johnson, Emily M; King, Paul R; Shepardson, Robyn L; Vair, Christina L; Reyner, Jacqueline; Funderburk, Jennifer S; Maisto, Stephen A; Wray, Laura O
Primary care behavioral health (PCBH) is a population-based approach to delivering mental and behavioral health care in the primary care setting. Implementation of the PCBH model varies across practice settings, which can impact how PCBH providers deliver services to patients and in turn may predict a variety of important outcomes. This article aims to characterize PCBH provider engagement in key processes of integrated care as demonstrated in results from empirical studies of real-world clinical practice. For this narrative review of published studies on PCBH provider engagement in processes of care, PubMed and PsycINFO databases were searched from January 1990 through May 2016 to identify relevant articles. Provider adherence to the brief, time-limited treatment model appears suboptimal. Common mental health conditions, such as depression, were often the primary focus of provider attention, with less consistent emphasis on behavioral medicine concerns. Whereas providers regularly conducted qualitative functional assessments with patients, routine use of standardized measures was low. Engagement in interprofessional collaboration with the primary care team was also low, but engagement in behaviors that fostered therapeutic relationships was high. This review identified several strengths and weaknesses of typical PCBH provider practices. Results are discussed in relation to their value as areas for future quality improvement initiatives that can improve PCBH service delivery and, ultimately, patient outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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
Miller, Nathan P; Amouzou, Agbessi; Hazel, Elizabeth; Legesse, Hailemariam; Degefie, Tedbabe; Tafesse, Mengistu; Black, Robert E; Bryce, Jennifer
Ethiopia has scaled up integrated community case management of childhood illness (iCCM), including several interventions to improve the performance of Health Extension Workers (HEWs). We assessed associations between interventions to improve iCCM quality of care and the observed quality of care among HEWs. We assessed iCCM implementation strength and quality of care provided by HEWs in Ethiopia. Multivariate logistic regression analyses were performed to assess associations between interventions to improve iCCM quality of care and correct management of iCCM illnesses. Children who were managed by an HEW who had attended a performance review and clinical mentoring meeting (PRCMM) had 8.3 (95% confidence interval (CI) 2.34-29.51) times the odds of being correctly managed, compared to children managed by an HEW who did not attend a PRCMM. Management by an HEW who received follow-up training also significantly increased the odds of correct management (odds ratio (OR) = 2.09, 95% CI 1.05-4.18). Supervision on iCCM (OR = 0.63, 95% CI 0.23-1.72) did not significantly affect the odds of receiving correct care. These results suggest PRCMM and follow-up training were effective interventions, while implementation of supportive supervision needs to be reviewed to improve impact.
Forry, Nicole; Simkin, Shana; Wessel, Julia; Rodrigues, Katherine
Early life experiences are critical to a child's development. Research has shown that, for a variety of reasons, children born into low-income families are at a disadvantage when compared to their higher-income peers. Fortunately, research has also shown a positive association between high quality child care and the academic and social-emotional…
Desjarlais, Malinda; Joseph, Jessica J
Previous studies indicate that characteristics of social-based technologies (STs) stimulate the sharing of intimate information online, which in turn enhances the quality of friendships. In addition, intimate online self-disclosure has been positively associated with offline self-disclosure. One objective of the current study was to combine the literature and test a model which postulates that STs use stimulates online self-disclosure which facilitates offline self-disclosure and, thereby, enhances the quality of close friendships. A second objective of this study was to examine if the aforementioned model applies to two categories of STs, including socially interactive technologies (SITs; e.g., instant messaging) and socially passive technologies (SPTs; e.g., reading posts on social networking sites). An online survey was conducted with 212 young adults between 18 and 25 years of age. The proposed indirect positive effects of SITs and SPTs use on the quality of friendships were supported. The positive effect of SITs use on the quality of friendships was explained entirely by the young adults' disclosure of personal information when using SITs which facilitated intimate self-disclosure during face-to-face interactions. Although there was not a direct effect of SPTs use on the quality of friendships, SPTs use was positively related to SPTs self-disclosure, which had a positive effect on offline self-disclosure. The current study enhances our understanding regarding the positive effects associated with the use of STs among close friends and identifies the contribution of online self-disclosure for offline interactions.
Bruny, Jennifer; Ziegler, Moritz
Innovation is a crucial part of surgical history that has led to enhancements in the quality of surgical care. This comprises both changes which are incremental and those which are frankly disruptive in nature. There are situations where innovation is absolutely required in order to achieve quality improvement or process improvement. Alternatively, there are innovations that do not necessarily arise from some need, but simply are a new idea that might be better. All change must assure a significant commitment to patient safety and beneficence. Innovation would ideally enhance patient care quality and disease outcomes, as well stimulate and facilitate further innovation. The tensions between innovative advancement and patient safety, risk and reward, and demonstrated effectiveness versus speculative added value have created a contemporary "surgical conundrum" that must be resolved by a delicate balance assuring optimal patient/provider outcomes. This article will explore this delicate balance and the rules that govern it. Recommendations are made to facilitate surgical innovation through clinical research. In addition, we propose options that investigators and institutions may use to address competing priorities. Copyright © 2015 Elsevier Inc. All rights reserved.
Edmonds, Leslie; And Others
This study evaluated the use of an online catalog by 33 children in the fourth, sixth, and eighth grades. As a basis of comparison, the children's ability to use the card catalog was also evaluated. Touch screen terminals were used to access a CLSI catalog. A specific set of tests was developed to determine if children have the necessary…
Full Text Available Kjell G Gundersen,1 Rick Potvin2 1IFocus Øyeklinikk AS, Haugesund, Norway; 2Science in Vision, Akron, NY, USA Purpose: To compare two different diffractive trifocal intraocular lens (IOL designs, evaluating longer-term refractive outcomes, visual acuity (VA at various distances, low contrast VA and quality of vision.Patients and methods: Patients with binocularly implanted trifocal IOLs of two different designs (FineVision [FV] and Panoptix [PX] were evaluated 6 months to 2 years after surgery. Best distance-corrected and uncorrected VA were tested at distance (4 m, intermediate (80 and 60 cm and near (40 cm. A binocular defocus curve was collected with the subject’s best distance correction in place. The preferred reading distance was determined along with the VA at that distance. Low contrast VA at distance was also measured. Quality of vision was measured with the National Eye Institute Visual Function Questionnaire near subset and the Quality of Vision questionnaire.Results: Thirty subjects in each group were successfully recruited. The binocular defocus curves differed only at vergences of −1.0 D (FV better, P=0.02, −1.5 and −2.00 D (PX better, P<0.01 for both. Best distance-corrected and uncorrected binocular vision were significantly better for the PX lens at 60 cm (P<0.01 with no significant differences at other distances. The preferred reading distance was between 42 and 43 cm for both lenses, with the VA at the preferred reading distance slightly better with the PX lens (P=0.04. There were no statistically significant differences by lens for low contrast VA (P=0.1 or for quality of vision measures (P>0.3.Conclusion: Both trifocal lenses provided excellent distance, intermediate and near vision, but several measures indicated that the PX lens provided better intermediate vision at 60 cm. This may be important to users of tablets and other handheld devices. Quality of vision appeared similar between the two lens designs
Guada, Joseph; Venable, Victoria
Social workers are major mental health providers and, thus, can be key players in guiding consumers and their families to accurate information regarding schizophrenia. The present study, using the WebMedQual scale, is a comprehensive analysis across a one-year period at two different time points of the top for-profit and nonprofit sites that…
Webb, Katie; Bullock, Alison; Dimond, Rebecca; Stacey, Mark
To explore how a medical textbook app ('iDoc') supports newly qualified doctors in providing high-quality patient care. The iDoc project, funded by the Wales Deanery, provides new doctors with an app which gives access to key medical textbooks. Participants' submitted case reports describing self-reported accounts of specific instances of app use. The size of the data set enabled analysis of a subsample of 'complex' case reports. Of the 568 case reports submitted by Foundation Year 1s (F1s)/Year 2s (F2s), 142 (25%) detailed instances of diagnostic decision-making and were identified as 'complex'. We analysed these data against the Quality Improvement (QI) Framework using thematic content analysis. Clinical settings across Wales, UK. Newly qualified doctors (2012-2014; n=114), F1 and F2. The iDoc app, powered by Dr Companion software, provided newly qualified doctors in Wales with a selection of key medical textbooks via individuals' personal smartphone. Doctors' use of the iDoc app supported 5 of the 6 QI elements: efficiency, timeliness, effectiveness, safety and patient-centredness. None of the case reports were coded to the equity element. Efficiency was the element which attracted the highest number of case report references. We propose that the QI Framework should be expanding to include 'learning' as a 7th element. Access to key medical textbooks via an app provides trusted and valuable support to newly qualified doctors during a period of transition. On the basis of these doctors' self-reported accounts, our evidence indicates that the use of the app enhances efficiency, effectiveness and timeliness of patient-care in addition consolidating a safe, patient-centred approach. We propose that there is scope to extend the QI Framework by incorporating 'learning' as a 7th element in recognition of the relationship between providing high-quality care through educational engagement. Published by the BMJ Publishing Group Limited. For permission to use (where not
Full Text Available Monopoly market conditions, in which public companies used to operate ten to twenty years ago, substantially dictated the way of considering and creating business of public companies in Serbia. However, introduction of changes to the environment, such as more intensive competition and changes of needs and demands of the customers requires abandoning old orientations to business. Public companies are in position to create and offer a higher level of service quality, based on better and more intensified communication with their customers. Public enterprises are monitored by public authorities, especially in the areas of restrictions on the choice of business strategies, pricing and price restrictions, selection of suppliers and the like. On the other hand, there is a branch competition occurring, on which public companies must count. In such an environment, creating effective services should be the key strategic objective for the development of public utility companies of the city of Belgrade. Service companies should be modern service companies, able to actively participate in the market, looking upon customers - citizens as users of their services. The aim of the research is to determine the perception of value and customer satisfaction with the services provided by the public utilities of Belgrade. The results of the study indicate that respondents are not satisfied with provided services and do not have clearly defined attitudes towards key aspects of public enterprises, which are supposed to be important for positioning and improving the quality of services in the market.
Cardarelli, Roberto; Workman, Charlotte Sue; Weatherford, Sarah; Whanger, Stacey; King, Dana E
Practice-based research networks (PBRNs) have been described as new clinical laboratories for primary care research and dissemination. PBRNs, however, have struggled to disseminate research results in a meaningful way to participating providers and clinics. The Central Appalachia Inter-Professional Pain Education Collaborative was developed to work with PBRN clinics using quality improvement methods, deliver statewide continuing education activities to address the issue of opioid use in patients with chronic pain, and develop a multimodal mechanism to disseminate project results to clinics and participating providers. Successful change in the delivery of chronic pain care was dependent on the clinic's commitment to a team-based, patient-centered approach. Statistically significant improvements were shown in 10 of 16 process measures, and 80% of the participants agreed that the quality improvement process activity increased their knowledge and would improve their performance in managing patients with chronic pain, as well as patient outcomes in their practice. The Central Appalachia Inter-Professional Pain Education Collaborative project used an extensive and innovative dissemination plan under the rubric of "continual dissemination." Unlike traditional dissemination efforts that focus on summary presentations, this initiative used a continual dissemination approach that updated participants quarterly through multiple means throughout the project, which improved engagement in the project.
Online Toxicity Monitors have been developed to provide continuous, time-relevant information regarding water quality. These systems measure a physiological or behavioral response of a sentinel organism to changes water quality. One such system, the Microlan Toxcontrol, is base...
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
Full Text Available To improve the learning of basic concepts in molecular biology of an undergraduate science class, a pedagogical tool was developed, consisting of learning objectives listed at the end of each lecture and answers to those objectives made available as videos online. The aim of this study was to determine if the pedagogical tool was used by students as instructed, and to explore students’ perception of its usefulness. A combination of quantitative survey data and measures of online viewing was used to evaluate the usage of the pedagogical practice. A total of 77 short videos linked to 11 lectures were made available to 71 students, and 64 completed the survey. Using online tracking tools, a total of 7046 views were recorded. Survey data indicated that most students (73.4% accessed all videos, and the majority (98.4% found the videos to be useful in assisting their learning. Interestingly, approximately half of the students (53.1% always or most of the time used the pedagogical tool as recommended, and consistently answered the learning objectives before watching the videos. While the proposed pedagogical tool was used by the majority of students outside the classroom, only half used it as recommended limiting the impact on students’ involvement in the learning of the material presented in class.
Owen, Susanne; Ryan, Greg; Woulfe, Jim; McKauge, Leigh; Stupans, Ieva
Academics preparing students for experiential placements within professional programs require considerable curriculum planning and pedagogical expertise. Communities of practice involving workshops and online processes provide opportunities for collaborative work in developing quality curriculum materials and also in supporting widespread…
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Huntington, Dale; Zaky, Hassan H M; Shawky, Sherine; Fattah, Faten Abdel; El-Hadary, Eman
A case-control, quasi-experimental study was designed (post-test only) to investigate the effect of a performance-based incentive payment scheme on behaviours of public-sector service providers in delivering a basic package of maternal and child-health services in Egyptian primary healthcare units. The results showed significant improvements in the quality of family-planning, antenatal care, and child-care services as reported by women seen in clinics where the incentive payment scheme was in operation as measured by various indicators, including both technical and inter-personal communication content. An analysis of characteristics of the service providers and clients found no significant or meaningful differences between the study groups, and the facilities of both the study groups were essentially the same. Some findings are suggestive of other influences on behaviours of the service providers not captured by the data-collection instruments of the study. Subsequent to this study, the payment scheme has been rolled out to other districts in Egypt.
Funk, Laura; Stajduhar, Kelli
Relationships between families and home health nurses promote effective care and service access for those at end of life, positive caregiver experiences, and satisfaction with care. This study explores family caregivers' accounts of relationships with home care nurses; findings inform a model of relationships and satisfaction with home health services. Ethnographic, qualitative interviews were conducted with 26 bereaved caregivers in one Western Canadian regional health agency. Data analysis was informed by symbolic interactionism. Participants described their relationships with home care nurses and spoke about their assessments of the care provided. Findings highlighted the importance of the length, frequency, and continuity of contact, conversation, socializing, and sharing information. Participants were cognizant of their own and care recipients' roles in building relationship. Nurse behaviors demonstrating affection, acknowledgment, commitment, and understanding were appreciated. A model links relationship preconditions, relational demonstrations, and perceived care quality and may be used to identify points of intervention.
Johansen, Monika Alise; Berntsen, Gro K Rosvold; Schuster, Tibor; Henriksen, Eva; Horsch, Alexander
We conducted in two parts a systematic review of randomized controlled trials (RCTs) on electronic symptom reporting between patients and providers to improve health care service quality. Part 1 reviewed the typology of patient groups, health service innovations, and research targets. Four innovation categories were identified: consultation support, monitoring with clinician support, self-management with clinician support, and therapy. To assess the methodological quality of the RCTs, and summarize effects and benefits from the methodologically best studies. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles between 1990 and November 2011. Risk of bias and feasibility were judged according to the Cochrane recommendation, and theoretical evidence and preclinical testing were evaluated according to the Framework for Design and Evaluation of Complex Interventions to Improve Health. Three authors assessed the risk of bias and two authors extracted the effect data independently. Disagreement regarding bias assessment, extraction, and interpretation of results were resolved by consensus discussions. Of 642 records identified, we included 32 articles representing 29 studies. No articles fulfilled all quality requirements. All interventions were feasible to implement in a real-life setting, and theoretical evidence was provided for almost all studies. However, preclinical testing was reported in only a third of the articles. We judged three-quarters of the articles to have low risk for random sequence allocation and approximately half of the articles to have low risk for the following biases: allocation concealment, incomplete outcome data, and selective reporting. Slightly more than one fifth of the articles were judged as low risk for blinding of outcome assessment. Only 1 article had low risk of bias for blinding of participants and personnel. We excluded 12
Chiu, Yen-Lin; Liang, Jyh-Chong; Mao, Pili Chih-Min; Tsai, Chin-Chung
Although Internet-based learning is widely used to improve health professionals' knowledge and skills, the self-regulated learning (SRL) activities of online continuing education in pharmacy are seldom discussed. The main purpose of this study was to explore the relationships between pharmacists' Internet self-efficacy (ISE) and their SRL in online continuing education. A total of 164 in-service pharmacists in Taiwan were surveyed with the Internet Self-Efficacy Survey, including basic ISE (B-ISE), advanced ISE (A-ISE) and professional ISE (P-ISE), as well as the Self-Regulated Learning Questionnaire consisting of preparatory SRL (P-SRL) and enactment SRL (E-SRL). Results of a 1-by-3 (educational levels: junior college versus bachelor versus master) analysis of variance and a 1-by-4 (institutions: community-based versus hospital versus clinic versus company) analysis of variance revealed that there were differences in ISE and SRL among different education levels and working institutions. The hierarchical regression analyses indicated that B-ISE and P-ISE were significant predictors of P-SRL, whereas P-ISE was a critical predictor of E-SRL. Moreover, the interaction of P-ISE × age was linked to E-SRL, implying that P-ISE has a stronger influence on E-SRL for older pharmacists than for younger pharmacists. However, the interactions between age and ISE (A-ISE, B-ISE, and P-ISE) were not related to P-SRL. This study highlighted the importance of ISE and age for increasing pharmacists' SRL in online continuing education.
Xie, Yingke; Wen, Zhiyu; Mo, Zhihong; Yu, Zhiqiang; Wei, Kanglin
An automatic, miniature and multi-parameter on-line water quality monitoring system based on a micro-spectrometer is designed and implemented. The system is integrated with the flow-batch analysis and spectrophotometric detection method. The effectiveness of the system is tested by measuring chemical oxygen demand (COD) and ammonia-nitrogen in water. The results show that the modified system provides a cost-effective, sensitive, reproducible and reliable way to measure COD and ammonia-nitrogen in water samples with automatic operation and low toxic chemical consumption. In addition, the experiment results show that the relative error of the system is less than 10%, the limit of detection is 2 mg/L COD and 0.032 mg/L ammonia-nitrogen, respectively, and the relative standard deviation was 6.6% at 15.0 mg/L COD (n = 7) and 5.0% at 0.300 mg/L ammonia-nitrogen (n = 7). Results from the newly designed system are consistent with the data collected through the Chinese national standard analysis methods.
van de Ven, Katinka; Koenraadt, Rosa
Online drug markets are expanding the boundaries of drug supply including the sale and purchase of image and performance enhancing drugs (IPEDs). However, the role of the internet in IPED markets, and in particular the ways in which these substances are supplied via the surface web, has rarely been considered. This article examines the online IPED market in order to inform drug policy and to provide a nuanced understanding of retailers involved, particularly exploring the relationship between buyers and sellers. This paper is based on two extensive research projects conducted in the Netherlands and Belgium. The first project focuses on muscle drugs and is based on 64 IPED dealing cases, semi-structured interviews with authorities (N=32), and dealers (N=15), along with an analysis of 10 steroid-selling websites. The second research project primarily focuses on weight loss drugs and sexual enhancers in the Netherlands, and relies on interviews with authorities (N=38), suppliers (N=30), and consumers (N=10), analysis of 69 criminal case files, and an online analysis. In the literature, the illicit online sale of IPEDs is generally associated with illegal online pharmacies that try to mislead buyers. While confirmed in our research, we also illustrate that there are online suppliers who invest in customer relationships and services, and that users are aware of the illegal nature of their business. These e-vendors incorporate a 'social supply business model' by providing the best possible service to their customers and attempting to minimise risks in order to attract, satisfy and maintain customers. As it is likely that users will continue to make use of the internet to order IPEDs, regardless of closing down selling websites, it is first of all important to counteract these online sources by educating all types of consumers and providing harm reduction services. Copyright © 2017 Elsevier B.V. All rights reserved.
Lundin, Mona; Lundin, Johan
Purpose: In this study, online in-service training for people employed in the food production industry is scrutinized. The purpose of this study is to analyse how the participants adapt to such online environments in terms of the kind of discussions they establish. The more specific interest relates to how the participants discuss current work…
Richards, Kelly; Bell, Tamara; Dwyer, Angela
The quality of feedback provided to university students has long been recognised as the most important predictor of student learning and satisfaction. However, providing quality feedback to students is challenging in the current context, in which universities increasingly rely on casualised and inexperienced academic staff to assess undergraduate…
Dalaryd, Mårten; Knöös, Tommy; Ceberg, Crister
mean square deviation (RMSD) of 0.0028 with a maximum deviation of 0.0043 (0.39%) from Monte Carlo calculated values. For all beams in this study, the RMSD between the proposed model and the Monte Carlo calculated values was 0.0006 with a maximum deviation of 0.0013 (0.1%). Using an earlier proposed relationship [Xiong and Rogers, Med. Phys. 35, 2104-2109 (2008)] between %dd(10)x and L̄/ρair (water) gave a RMSD of 0.0018 with a maximum deviation of 0.0029 (0.26%) for all beams in this study (compared to RMSD 0.0015 and a maximum deviation of 0.0048 (0.47%) for the relationship used in AAPM TG-51 published by Almond et al. [Med. Phys. 26, 1847-1870 (1999)]). Using TPR20,10 as a beam-quality specifier, for the flattening filter free beams used in this study, gave a maximum difference of 0.39% between L̄/ρair (water) predicted using IAEA TRS-398 and Monte Carlo calculations. An additional parameter for determining L̄/ρair (water) has been presented. This parameter is easy to measure; it requires only an additional dose measurement at 5 cm depth with SSD 95 cm, and provides information for accurate determination of the L̄/ρair (water) ratio for beams both with and without a flattening filter at the investigated energies.
Khader, A. I.; Rosenberg, D. E.; McKee, M.
Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i) ignore the health risk of nitrate-contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome) is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs
A. I. Khader
Full Text Available Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i ignore the health risk of nitrate-contaminated water, (ii switch to alternative water sources such as bottled water, or (iii implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012. The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water
Ibrahim, Luka Mangveep; Oleribe, Obinna O; Nguku, Patrick; Tongwong, Gabriel Chukwak; Mato, Lakda Gonen; Longkyer, Musa Istifanus; Ogiri, Samuel; Nsubuga, Peter
Tuberculosis (TB) is public health concern in Nigeria. The country uses the Directly Observed Treatment Short course (DOTS) strategy for its control. Plateau state started using the DOTS strategy in 2001 and had the Private health facilities (PHF) as an important stakeholder. We evaluated their contributions to case finding and quality of the services to identify gaps in monitoring and evaluation in the TB control services within the PHF to plan for intervention so as to meet the set target for TB control in the state. We used the logical framework approach to identify and analyze the problem. We drew up an objective tree and from the objective tree developed a logical framework matrix including evaluation plan. We also conducted desk review to extract data on case findings, case management and outcomes of the treatment. We interviewed TB focal persons and laboratory personnel using structured questionnaire. The data was analyzed using excel spread sheet. Of the 127 health facilities with TB patients on treatment 27 (21.3%) were PHF. The PHF reported 54.6% (1494) of TB cases in 2011. The sputum conversion rates, cured rate, treatment success rate, and default rates were 85%, 73%, 81.4% and 6.6% respectively. The discordant rates were 3.1% and 1.2% for the state and private health facilities respectively. Log frame approach is a useful tool for evaluation of TB control services and helps provide evidence for decision making to improve quality of the TB services in the public and private health facilities in the state.
Lehmberg, S; Soyka, M
The online study presented surveyed occasional users, high-risk users and non-consumers of psychotropic substances for relationships between consumer type and emotion regulation (ER), health-related quality of life (HRQOL) and coping strategies. A total of 199 people participated in the survey. The sample was split into three groups depending on a substance list and a detailed questionnaire regarding the consumption habits: 28 individuals had no illicit drug experience, 127 were occasional users and 44 frequent (high-risk) users. The sample set was tested using the (1) emotion regulation inventory, (2) the coping inventory for stressful situations and (3) the medical outcomes study (MOS) 36-item short-form health survey. Regarding ER the occasional users showed no significant differences to the two reference groups, except for the scale of re-evaluation where the high-risk consumers scored higher than the occasional users. Regarding HRQOL no significant differences were observed between the three groups; however, significant differences were observed between persons with strong and weak physical and mental HRQOL scores and satisfaction with own emotion regulation. The search for predictors showed a significant predictive value for gender, the number of inhabitants at the place of residence and the ER strategy of re-evaluation in negative emotions for the allocation to a consumer type. Neither substance consumption as an ER strategy nor a relationship between consumer type and coping strategy and/or HRQOL could be observed. With respect to ER the only significant difference observed was that of high-risk users employing the strategy of re-evaluation more often than occasional users. A possible explanation is reality embellishment and a down-playing function of this strategy associated with drug consumption. Therefore, the assumed relationship between affective dysfunction and drug addiction could not be observed.
Giffen, Carol A; Wagner, Elizabeth L; Adams, John T; Hitchcock, Denise M; Welniak, Lisbeth A; Brennan, Sean P; Carroll, Leslie E
The National Heart, Lung, and Blood Institute (NHLBI), within the United States' National Institutes of Health (NIH), established the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) in 2008 to develop the infrastructure needed to link the contents of the NHLBI Biorepository and the NHLBI Data Repository, and to promote the utilization of these scientific resources by the broader research community. Program utilization metrics were developed to measure the impact of BioLINCC on Biorepository access by researchers, including visibility, program efficiency, user characteristics, scientific impact, and research types. Input data elements were defined and are continually populated as requests move through the process of initiation through fulfillment and publication. This paper reviews the elements of the tracking metrics which were developed for BioLINCC and reports the results for the first six on-line years of the program.
Computerized monitoring and online information system for energy and facility management service providers. Outsourcing of management and maintenance services; Informationssystem mit Online-Service fuer Dienstleistungsanbieter. Service und Wartung kostenguenstig gestalten
Niclas, C. [Segno Industrie Automation GmbH, Bremen (Germany)
The article addresses the emerging new business opportunities of service companies as contractors in the energy sector. Outsourcing and contracting models and in particular the computer architecture and the software and programming of available online systems are discussed. (orig./CB) [German] Regionale und kommunale Versorgungsunternehmen, Krankenhaeuser, Druckereien sowie produzierende Unternehmen koennen sich voll und ganz auf ihr Kerngeschaeft konzentrieren und einen Service- und Wartungsdienst kostenguenstig outsourcen. Serviceorientierte Dienstleister werden im gleichen Zuge durch Einsatz eines Service-Informationssystems in die Lage versetzt, Versorgungs- und Betreuungskonzepte optimal anzubieten. Langfristige Kundenbindungen sowie eine Verbesserung der Kundennaehe sind die Erfolge. Optimierung von Kunden-Anlagen und Einbindung in zukuenftige Investitionsmassnahmen seien an dieser Stelle nur als moegliche Zusatzgeschaefte zu erwaehnen. (orig.)
Mahrous, Mohamed Saad
This study aims to identify the satisfaction levels of the family members of patients in intensive care units. This is a cross-sectional analytical study. General intensive care units offer a variety of services to clinical and surgical patients. For the purpose of this study, a trained interviewer communicated with the families of patients, either before or after visiting hours. The study included 208 participants: 119 (57.2%) males and 89 (42.8%) females. Seventy-three (35.1%) of the patients attended a private hospital, and 135 (64.9%) attended a public hospital in the city of Al Madinah Al- Munawarah. All of the participants were either family members or friends of patients admitted to the intensive care units at the hospitals. The responses of both groups yielded low scores on the satisfaction index. However, a relatively high score was noted in response to questions 2, 6, and 10, which concerned the care that was extended by the hospital staff to their patients, the courteous attitude of intensive care unit staff members towards patients, and patients' satisfaction with the medical care provided, respectively. A very low score was obtained for item 11, which was related to the possibility for improvements to the medical care that the patients received. Overall, greater satisfaction with the services offered by the public intensive care units was reported compared to the satisfaction with the services offered by the private intensive care units. An overall low score on the satisfaction index was obtained, and further studies are recommended to assess the current situation and improve the satisfaction and quality of care provided by intensive care units.
Full Text Available With improved survival outcomes after pediatric liver transplantation (LT, health-related quality of life (HRQoL is an important outcome metric. Understanding the elements contributing to HRQoL after LT in children would enable more targeted strategies towards optimizing best outcomes. This qualitative study aimed to explore health care providers (HCP perceptions about HRQoL after pediatric LT. Thirteen experienced HCP participated in two focus group discussions. Data analysis via a thematic analysis approach revealed 4 major themes: “LT as a facilitator of better HRQoL,” “coping and adapting to LT,” “living with a transplanted liver,” and “the family context.” HCP identified elements that both enhance (improved physical health, peer relationship, and activities of daily living and challenge (need for immunosuppression, transplant follow-up, and restrictions the multidimensional domains of HRQoL. HCP perceived LT to be a stressful life-changing event for children and their families. Patients and their parents’ ability to cope and adjust positively to LT was perceived as a key contributor to better HRQoL. HCP perspective highlights the importance of promoting psychosocial support and a family-centered care delivery model towards the overarching goal of optimizing durable outcomes.
Brühlmann, David; Sokolov, Michael; Butté, Alessandro; Sauer, Markus; Hemberger, Jürgen; Souquet, Jonathan; Broly, Hervé; Jordan, Martin
Rational and high-throughput optimization of mammalian cell culture media has a great potential to modulate recombinant protein product quality. We present a process design method based on parallel design-of-experiment (DoE) of CHO fed-batch cultures in 96-deepwell plates to modulate monoclonal antibody (mAb) glycosylation using medium supplements. To reduce the risk of losing valuable information in an intricate joint screening, 17 compounds were separated into five different groups, considering their mode of biological action. The concentration ranges of the medium supplements were defined according to information encountered in the literature and in-house experience. The screening experiments produced wide glycosylation pattern ranges. Multivariate analysis including principal component analysis and decision trees was used to select the best performing glycosylation modulators. Subsequent D-optimal quadratic design with four factors (three promising compounds and temperature shift) in shake tubes confirmed the outcome of the selection process and provided a solid basis for sequential process development at a larger scale. The glycosylation profile with respect to the specifications for biosimilarity was greatly improved in shake tube experiments: 75% of the conditions were equally close or closer to the specifications for biosimilarity than the best 25% in 96-deepwell plates. Biotechnol. Bioeng. 2017;114: 1448-1458. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Ariff, Mohd Shoki Md; Sze Yan, Ng; Zakuan, Norhayati; Zaidi Bahari, Ahamad; Jusoh, Ahmad
The growing use of internet and online purchasing among young consumers in Malaysia provides a huge prospect in e-commerce market, specifically for B2C segment. In this market, if E-marketers know the web-based factors affecting online buyers' behaviour, and the effect of these factors on behaviour of online consumers, then they can develop their marketing strategies to convert potential customers into active one, while retaining existing online customers. Review of previous studies related to the online purchasing behaviour in B2C market has point out that the conceptualization and empirical validation of the online purchasing behaviour of Information and Communication Technology (ICT) literate users, or ICT professional, in Malaysia has not been clearly addressed. This paper focuses on (i) web-based factors which online buyers (ICT professional) keep in mind while shopping online; and (ii) the effect of web-based factors on online purchasing behaviour. Based on the extensive literature review, a conceptual framework of 24 items of five factors was constructed to determine web-based factors affecting online purchasing behaviour of ICT professional. Analysis of data was performed based on the 310 questionnaires, which were collected using a stratified random sampling method, from ICT undergraduate students in a public university in Malaysia. The Exploratory factor analysis performed showed that five factors affecting online purchase behaviour are Information Quality, Fulfilment/Reliability/Customer Service, Website Design, Quick and Details, and Privacy/Security. The result of Multiple Regression Analysis indicated that Information Quality, Quick and Details, and Privacy/Security affect positively online purchase behaviour. The results provide a usable model for measuring web-based factors affecting buyers' online purchase behaviour in B2C market, as well as for online shopping companies to focus on the factors that will increase customers' online purchase.
Talitha Rosa Matlin
Full Text Available Abstract Objective – This article aims to assess student achievement of higher-order information literacy learning outcomes from online tutorials as compared to in-person instruction in science and health science courses. Methods – Information literacy instruction via online tutorials or an in-person one-shot session was implemented in multiple sections of a biology (n=100 and a kinesiology course (n=54. After instruction, students in both instructional environments completed an identical library assignment to measure the achievement of higher-order learning outcomes and an anonymous student survey to measure the student experience of instruction. Results – The data collected from library assignments revealed no statistically significant differences between the two instructional groups in total assignment scores or scores on specific questions related to higher-order learning outcomes. Student survey results indicated the student experience is comparable between instruction groups in terms of clarity of instruction, student confidence in completing the course assignment after library instruction, and comfort in asking a librarian for help after instruction. Conclusions – This study demonstrates that it is possible to replace one-shot information literacy instruction sessions with asynchronous online tutorials with no significant reduction in student learning in undergraduate science and health science courses. Replacing in-person instruction with online tutorials will allow librarians at this university to reach a greater number of students and maintain contact with certain courses that are transitioning to completely online environments. While the creation of online tutorials is initially time-intensive, over time implementing online instruction could free up librarian time to allow for the strategic integration of information literacy instruction into other courses. Additional time savings could be realized by incorporating auto
Larisa N. Paskhalova
Full Text Available The aim of the investigation is to generalize the experience on implementation of the Program of development of educational institution that allows providing high quality of education in the conditions of introduction of Federal Educational Standards of New Generation. Methods. Traditional psychological and pedagogical methods involve: stating, developing and control. Analysis of the average data and dynamics of educational results, an expert estimation, interrogations and questioning are used. Results. Transition of a gymnasium to educational institution of new type has become result of introduction of the Program of development. The unique profile of establishment is created and priority positions are taken in the educational environment of the region; in response to an implementation of the program of the development focused on the social procurement. Efficiency of the Program is confirmed with intermediate results of monitoring concerning all subjects of educational space: trained, teachers and parents. The program allows all participants of educational process to be involved in process of introduction of new quality of education via the mechanism of realization of system. The program represents improvement of activity of structures of educational space of a gymnasium, development of resource base, and also a control system as a factor of ensuring stability of functioning and innovative development of a gymnasium. Scientific novelty. The possibility of implementation of the Program of development of educational institution through introduction of system-activity and project-based approach which connected nine sub-programmes in one complex (structured in three modules is shown. It includes introduction of Federal State Educational Standard (FSES, an international exam, development of a progymnasium, formation of the personality, ongoing support to gifted children, extension of innovative culture of teachers, efficiency of management and
mohammad javad tarrahi
Conclusion: Expectations of the clients in all aspects of offering services are beyond than their perceptions, and needed to improve the quality of offering services in these centers in all the dimensions especially empathy dimension. It is recommended that the quality of the offering services be assessed periodically in these centers and intervene to improve the delivering of health services.
Chretien, Katherine C; Tuck, Matthew G
The rise of social media has increased connectivity and blurred personal and professional boundaries, bringing new challenges for medical professionalism. Whether traditional professionalism principles apply to the online social media space remains unknown. The purpose of this synthetic literature review was to characterize the original peer-reviewed research studies published between 1 January 2000-1 November 2014 on online professionalism, to assess methodologies and approaches used, and to provide insights to guide future studies in this area. The investigators searched three databases and performed manual searches of bibliographies to identify the 32 studies included. Most studies originated in the USA. Cross-sectional surveys and analyses of publicly available online content were the most common methodologies employed. Studies covered the general areas of use and privacy, assessment of unprofessional online behaviours, consensus-gathering of what constitutes unprofessional or inappropriate online behaviours, and education and policies. Studies were of variable quality; only around half of survey studies had response rates of 50% or greater. Medical trainees were the most common population studied. Future directions for research include public perspectives of online professionalism, impact on patient trust, and how to use social media productively as medical professionals.
Hart, Tae L; Coon, David W; Kowalkowski, Marc A; Zhang, Karen; Hersom, Justin I; Goltz, Heather H; Wittmann, Daniela A; Latini, David M
Gay men with prostate cancer (GMPCa) may have differential health-related quality of life (HRQOL) and sexual health outcomes than heterosexual men with prostate cancer (PCa), but existing information is based on clinical experience and small studies. Our goals were to: (i) describe HRQOL and examine changes in sexual functioning and bother; (ii) explore the psychosocial aspects of sexual health after PCa; and (iii) examine whether there were significant differences on HRQOL and sexual behavior between GMPCa and published norms. A convenience sample of GMPCa completed validated disease-specific and general measures of HRQOL, ejaculatory function and bother, fear of cancer recurrence, and satisfaction with prostate cancer care. Measures of self-efficacy for PCa management, illness intrusiveness, and disclosure of sexual orientation were also completed. Where possible, scores were compared against published norms. Main outcome measures were self-reported sexual functioning and bother on the Expanded Prostate Cancer Index. Compared with norms, GMPCa reported significantly worse functioning and more severe bother scores on urinary, bowel, hormonal symptom scales (Ps sexual functioning scores (P sexual bother scores were similar to that of published samples. GMPCa tended to be more "out" about their sexual orientation than other samples of gay men. GMPCa reported substantial changes in sexual functioning after PCa treatment. They also reported significantly worse disease-specific and general HRQOL, fear of recurrence, and were less satisfied with their medical care than other published PCa samples. Sexual health providers must have an awareness of the unique functional and HRQOL differences between gay and heterosexual men with PCa. © 2014 International Society for Sexual Medicine.
van Engen-Verheul, Mariëtte M; van der Veer, Sabine N; de Keizer, Nicolette F; Tjon Sjoe Sjoe, Winston; van der Zwan, Eric P A; Peek, Niels
Continuous monitoring and systematic improvement of quality have become increasingly common in healthcare. To support multidisciplinary care teams in improving their clinical performance using feedback on quality indicators, we developed the CARDSS Online system. This system supports (i) monitoring of indicator-based performance, (ii) selecting aspects of care that need improvement, (iii) developing a quality improvement (QI) plan, and (iv) periodically adjusting the QI plan. During educational outreach visits, the system actively involves the team in the improvement effort, and guides them through the process of systematic QI without needing extensive knowledge of the underlying concepts. During the implementation of the system in the field of cardiac rehabilitation (CR) in the Netherlands, we have conducted the first outreach visits to four CR teams. During the visits, the teams formulated QI plans consisting of 4 to 7 improvement goals, each goal accompanied by 1 to 5 QI actions. Currently, we are evaluating the effect of CARDSS Online on the quality of CR in the Netherlands in a cluster randomized trial.
Décieux Jean Philippe
Full Text Available Online surveys have become a popular method for data gathering for many reasons, including low costs and the ability to collect data rapidly. However, online data collection is often conducted without adequate attention to implementation details. One example is the frequent use of the forced answering option, which forces the respondent to answer each question in order to proceed through the questionnaire. The avoidance of missing data is often the idea behind the use of the forced answering option. However, we suggest that the costs of a reactance effect in terms of quality reduction and unit nonresponse may be high because respondents typically have plausible reasons for not answering questions. The objective of the study reported in this paper was to test the influence of forced answering on dropout rates and data quality. The results show that requiring participants answer every question increases dropout rates and decreases quality of answers. Our findings suggest that the desire for a complete data set has to be balanced against the consequences of reduced data quality.
Fernandez, J. M.; Vano, E.; Ten, J. I.; Prieto, C.; Martinez, D.
The present work describes an online patient dosimetry and an image quality audit system in digital radiology. the system allows auditing of different parameters depending on contents of DICOM (Digital Imaging and Communication in Medicine) header. For the patient dosimetry audit, current mean values of entrance surface dose (ESD) were compared with local and national reference values (RVs) for the specific examination type evaluated. Mean values exceeding the RV trigger an alarm signal and then an evaluation of the technical parameters, operational practice and image quality starts, using data available in the DICOM header to derive any abnormal settings or performance to obtain the image. the X-ray tube output for different kVp values is measured periodically, allowing for the automatic calculation of the ESD. The system also allows for image quality audit linking it with the dose imparted and other technical parameters if the alarm condition if produced. Results and advantages derived from this online quality control are discussed. (Author) 5 refs.
Sobota, Amy E; Shah, Nishita; Mack, Jennifer W
Transition from pediatric to adult care is a vulnerable time for young adults with sickle cell disease (SCD); however, improvements in transition are limited by a lack of quality indicators. The purpose of this study was to establish quality indicators for transition in SCD and to determine the optimal timing between the final pediatric visit and the first adult provider visit. We conducted a modified Delphi survey to reach a consensus on which quality indicators are most important for a successful transition. Our expert panel consisted of members of the Sickle Cell Adult Provider Network. In the first round, the participants ranked a list of quality indicators by importance. In the second round, the participants chose their "top 5" quality indicators in terms of importance and also ranked them on feasibility. The response rates for the two rounds were 68 and 96%, respectively. Nine quality indicators were chosen as "top 5" by a majority of respondents, including communication between pediatric and adult providers, timing of first adult visit, patient self-efficacy, quality of life, and trust with their adult provider. Based on the comments from round 1, respondents were also asked for the optimal timing between leaving pediatric care and entering adult care. Most recommended a first adult visit within 2 months of the final pediatric visit. By using these quality indicators chosen by the majority of respondents, we can better develop and evaluate transition programs for young adults with SCD and improve health outcomes for these vulnerable patients. © 2016 Wiley Periodicals, Inc.
Resnick, Sheilagh M.; Griffiths, Mark D.
In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…
Full Text Available This study proposes a probabilistic principal component analysis- (PPCA- based method for online monitoring of water-quality contaminant events by UV-Vis (ultraviolet-visible spectroscopy. The purpose of this method is to achieve fast and sound protection against accidental and intentional contaminate injection into the water distribution system. The method is achieved first by properly imposing a sliding window onto simultaneously updated online monitoring data collected by the automated spectrometer. The PPCA algorithm is then executed to simplify the large amount of spectrum data while maintaining the necessary spectral information to the largest extent. Finally, a monitoring chart extensively employed in fault diagnosis field methods is used here to search for potential anomaly events and to determine whether the current water-quality is normal or abnormal. A small-scale water-pipe distribution network is tested to detect water contamination events. The tests demonstrate that the PPCA-based online monitoring model can achieve satisfactory results under the ROC curve, which denotes a low false alarm rate and high probability of detecting water contamination events.
Isman, Aytekin; Gazi, Zehra Altinay; Aksal, Fahriye Altinay
This article presents a study that examined students' perceptions toward online practice and their developing attitudes toward the online learning process. The results indicated that both cultural background and personal qualities affect students' perceptions.
Dolan, Brigid M; Yialamas, Maria A; McMahon, Graham T
There is limited research on whether online formative self-assessment and learning can change the behavior of medical professionals. We sought to determine if an adaptive longitudinal online curriculum in bone health would improve resident physicians' knowledge, and change their behavior regarding prevention of fragility fractures in women. We used a randomized control trial design in which 50 internal medicine resident physicians at a large academic practice were randomized to either receive a standard curriculum in bone health care alone, or to receive it augmented with an adaptive, longitudinal, online formative self-assessment curriculum delivered via multiple-choice questions. Outcomes were assessed 10 months after the start of the intervention. Knowledge outcomes were measured by a multiple-choice question examination. Clinical outcomes were measured by chart review, including bone density screening rate, calculation of the fracture risk assessment tool (FRAX) score, and rate of appropriate bisphosphonate prescription. Compared to the control group, residents participating in the intervention had higher scores on the knowledge test at the end of the study. Bone density screening rates and appropriate use of bisphosphonates were significantly higher in the intervention group compared with the control group. FRAX score reporting did not differ between the groups. Residents participating in a novel adaptive online curriculum outperformed peers in knowledge of fragility fracture prevention and care practices to prevent fracture. Online adaptive education can change behavior to improve patient care.
Reviewed by Cengiz Hakan AYDIN
Full Text Available The growth of online learning all over the world arise new challenges. One of the major challenges is the issue of quality. What should an online course look like? What kinds of instructional strategies should be provided? To what extent various kinds of interactions must be required? What are the effective learning activities? For what functions should different technologies be used? How can learning be assessed? And similar and more questions have yet no standardized answers although they have been around since early implementations of online learning. Each provider uses different standards developed by either themselves or some institutions or some researchers. Sloan-C: Pillars of Quality, Robley and Wince’s Rubric for Quality Interactions, Concord Model, Schrum’s Qualities of Successful Students, Quality Matters, and E-excellence: Quality Manual for E-learning in Higher Education are among many of these standards.The book, entitled as The Perfect Online Course: Best Practices for Designing and Teaching is also trying to establish a list of standards about how to design and implement an effective online course.The main goal of the book is to create a framework of quality educational guidelines that can be used to offer “perfect” online course.
Full Text Available Turbidity (T has been widely used to detect the occurrence of pollutants in surface water. Using data collected from January 2013 to June 2014 at eleven sites along two rivers feeding the Taihu Basin, China, the relationship between the concentration of five metals (aluminum (Al, titanium (Ti, nickel (Ni, vanadium (V, lead (Pb and turbidity was investigated. Metal concentration was determined using inductively coupled plasma mass spectrometry (ICP-MS. The linear regression of metal concentration and turbidity provided a good fit, with R(2 = 0.86-0.93 for 72 data sets collected in the industrial river and R(2 = 0.60-0.85 for 60 data sets collected in the cleaner river. All the regression presented good linear relationship, leading to the conclusion that the occurrence of the five metals are directly related to suspended solids, and these metal concentration could be approximated using these regression equations. Thus, the linear regression equations were applied to estimate the metal concentration using online turbidity data from January 1 to June 30 in 2014. In the prediction, the WASP 7.5.2 (Water Quality Analysis Simulation Program model was introduced to interpret the transport and fates of total suspended solids; in addition, metal concentration downstream of the two rivers was predicted. All the relative errors between the estimated and measured metal concentration were within 30%, and those between the predicted and measured values were within 40%. The estimation and prediction process of metals' concentration indicated that exploring the relationship between metals and turbidity values might be one effective technique for efficient estimation and prediction of metal concentration to facilitate better long-term monitoring with high temporal and spatial density.
Perloff, Jennifer; Clarke, Sean; DesRoches, Catherine M; O'Reilly-Jacob, Monica; Buerhaus, Peter
State scope of practice (SoP) laws impose significant restrictions on the services that a nurse practitioner (NP) may provide in some states, yet evidence about SoP limitations on the quality of primary care is very limited. This study uses six different classifications of state regulations and bivariate and multivariate analyses to compare beneficiaries attributed to primary care nurse practitioners and primary care physicians in 2013 testing two hypotheses: (1) chronic disease management, cancer screening, preventable hospitalizations, and adverse outcomes of care provided by primary care nurse practitioners are better in reduced and restricted practice states compared to states without restrictions and (2) by decreasing access to care, SoP restrictions negatively affect the quality of primary care. Results show a lack of consistent association between quality of primary care provided by NPs and state SoP restrictions. State regulations restricting NP SoP do not improve the quality of care.
... conditions. + Chronic health care. + Health services to ameliorate the effects of physical and mental... these factors affecting the quality of care given to children under titles XIX and XXI, the Secretary is... Doc No: 2010-18140] DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services...
This study examined the association between Computerized Physician Order Entry (CPOE) application and healthcare quality in pediatric patients at hospital level. This was a retrospective study among 1,428 hospitals with pediatric setting in Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) and Health Information and…
Bromer, Juliet; Korfmacher, Jon
Research Findings: Home-based child care accounts for a significant proportion of nonparental child care arrangements for young children in the United States. Yet the early care and education field lacks clear models or pathways for how to improve quality in these settings. The conceptual model presented here articulates the components of…
Parish, Susan; Magana, Sandra; Rose, Roderick; Timberlake, Maria; Swaine, Jamie G.
This study examines access to, utilization of, and quality of health care for Latino children with autism and other developmental disabilities. We analyze data from the National Survey of Children with Special Health Care Needs (N = 4,414 children with autism and other developmental disabilities). Compared with White children, Latino children with…
Patrinos, Harry Anthony; Fasih, Tazeen; Barrera, Felipe; Garcia-Moreno, Vicente A.; Bentaouet-Kattan, Raja; Baksh, Shaista; Wickramasekera, Inosha
School-based management (SBM) has become a very popular movement over the past decade. The World Bank Education Team's SBM work program emerged out of a need to define the concept more clearly, review the evidence, support impact assessments in various countries, and provide some initial feedback to teams preparing education projects. During the…
Pai, Hsiang-Chu; Tsai, Yi-Chen
Stroke is a major cause of long-term disability. Most stroke survivors return to their own home and need to be cared for by family members, most of whom are informal caregivers. The aim of this study was to identify whether cognitive appraisal influences health-related quality of life. A cross-sectional, descriptive, correlational design was used. Participants included 77 primary support persons, mean age = 59.47 years, who were younger than stroke survivors (mean age = 78.13 years). Data were collected between March-November 2012 and obtained through face-to-face interviews, using the Short-Form-36 Health Survey, Caregiver Burden Inventory, and five cognitive appraisal questions. In addition, the Barthel Index, Modified Rankin Scale, and Glasgow Coma Scale were used to assess patient disease severity. Hierarchical multiple regression analysis was used to identify predictors of health-related quality of life. The results indicated that 61% of participants rated their health as poor or fair. Patient severity, gender of primary support person, age, employment, burden, and cognitive appraisal impact accounted for 45.8% of the variance in primary support persons' physical component summary of health-related quality of life, with age, burden, and appraisal impact being the strongest of six predictors. In addition, burden and appraisal impact were the strongest of six predictors, explaining 18.1% of the variance in primary support persons' mental component summary of health-related quality of life. The results of the current study further highlight the importance of cognitive appraisal on the stroke survivor's primary support person's health-related quality of life.
Wakefield, Claire E; Sansom-Daly, Ursula M; McGill, Brittany C; McCarthy, Maria; Girgis, Afaf; Grootenhuis, Martha; Barton, Belinda; Patterson, Pandora; Osborn, Michael; Lowe, Cherie; Anazodo, Antoinette; Miles, Gordon; Cohn, Richard J
Due to advances in multimodal therapies, most children survive cancer. In addition to the stresses of diagnosis and treatment, many families are now navigating the challenges of survivorship. Without sufficient support, the ongoing distress that parents experience after their child's cancer treatment can negatively impact the quality of life and psychological wellbeing of all family members. The 'Cascade' (Cope, Adapt, Survive: Life after C AncEr) study is a three-arm randomised controlled trial to evaluate the feasibility and efficacy of a new intervention to improve the quality of life of parents of young cancer survivors. Cascade will be compared to a peer-support group control and a 6-month waitlist control. Parents (n = 120) whose child (under 16 years of age) has completed cancer treatment in the past 1 to 12 months will be recruited from hospitals across Australia. Those randomised to receive Cascade will participate in four, weekly, 90-minute online group sessions led live by a psychologist. Cascade involves peer discussion on cognitive-behavioural coping skills, including behavioural activation, thought challenging, mindfulness and acceptance, communication and assertiveness skills training, problem-solving and goal-setting. Participants randomised to peer support will receive four, weekly, 90-minute, live, sessions of non-directive peer support. Participants will complete measures at baseline, directly post-intervention, one month post-intervention, and 6 months post-intervention. The primary outcome will be parents' quality of life. Secondary outcomes include parent depression, anxiety, parenting self-agency, and the quality of life of children in the family. The child cancer survivor and all siblings aged 7 to 15 years will be invited to complete self-report quality of life measures covering physical, emotional, social and school-related domains. This article reviews the empirical rationale for group-based, online cognitive-behavioural therapy in
Aung, Tin; Longfield, Kim; Aye, Nyo Me; San, Aung Kyaw; Sutton, Thea S; Montagu, Dominic
This study evaluates the effectiveness of a training programme for improving the diagnostic and treatment quality of the most complex service offered by Sun Primary Health (SPH) providers, paediatric malaria. The study further assesses whether any quality improvements were sustained over the following 12 months. The study took place in 13 townships in central Myanmar between January 2011 and October 2012. A total of 251 community health workers were recruited and trained in the provision of paediatric and adult malaria diagnosis and treatment; 197 were surveyed in all three rounds: baseline, 6 and 12 months. Townships were selected based on a lack of alterative sources of medical care, averaging 20 km from government or private professional health care treatment facilities. Seventy percent of recruits were assistant nurse midwives or had other basic health training; the rest had no health training experience. Recruits were evaluated on their ability to properly diagnosis and treat a simulated 5-year-old patient using a previously validated method known as Observed Simulated Patient. A trained observer scored SPH providers on a scale of 1-100, based on WHO and Myanmar MOH established best practices. During a pilot test, 20 established private physicians operating in malaria-endemic areas of Myanmar scored an average of 70/100. Average quality scores of newly recruited SPH providers prior to training (baseline) were 12/100. Six months after training, average quality scores were 48/100. This increase was statistically significant (p training, providers were retested and average quality scores were 45/100 (R3-R1, p training programme was able to improve the quality of paediatric malaria care significantly, and to maintain that improvement over time. Quality of care remains lower than that of trained physicians; however, SPH providers operate in rural areas where no trained physicians operate. More research is needed to establish acceptable and achievable levels of
McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk
Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (peducation. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.
Shaik, Naj; Lowe, Sue; Pinegar, Kem
Education is a service with multiplicity of student interactions over time and across multiple touch points. Quality teaching needs to be supplemented by consistent quality supporting services for programs to succeed under the competitive distance learning landscape. ServQual and e-SQ scales have been proposed for measuring quality of traditional…
Kowalczyk, Nina K
Radiologic science programs continue to adopt the use of blended online education in their curricula, with an increase in the use of online courses since 2009. However, perceived barriers to the use of online education formats persist in the radiologic science education community. An electronic survey was conducted to explore the current status of online education in the radiologic sciences and to identify barriers to providing online courses. A random sample of 373 educators from radiography, radiation therapy, and nuclear medicine technology educational programs accredited by the Joint Review Committee on Education in Radiologic Technology and Joint Review Committee on Educational Programs in Nuclear Medicine Technology was chosen to participate in this study. A qualitative analysis of self-identified barriers to online teaching was conducted. Three common themes emerged: information technology (IT) training and support barriers, student-related barriers, and institutional barriers. Online education is not prevalent in the radiologic sciences, in part because of the need for the clinical application of radiologic science course content, but online course activity has increased substantially in radiologic science education, and blended or hybrid course designs can effectively provide opportunities for student-centered learning. Further development is needed to increase faculty IT self-efficacy and to educate faculty regarding pedagogical methods appropriate for online course delivery. To create an excellent online learning environment, educators must move beyond technology issues and focus on providing quality educational experiences for students.
Carter, Christy S.; Solberg, Lauren B.; Solberg, Laurence M.
The Department of Aging and Geriatric Research at the University of Florida College of Medicine has established online education programs to provide healthcare professionals with advanced training in the field of gerontology to establish proficiency in providing quality care to older individuals. A major barrier to creating our online education…
Connor, Michael J; Karakala, Nithin
Continuous renal replacement therapy (CRRT) use continues to expand globally. Despite improving technology, CRRT remains a complex intervention. Delivery of high-quality CRRT requires close collaboration of a multidisciplinary team including members of the critical care medicine, nephrology, nursing, pharmacy, and nutrition support teams. While significant gaps in medical evidence regarding CRRT persist, the growing evidence base supports evolving best practice and consensus to define high-quality CRRT. Unfortunately, there is wide variability in CRRT operating characteristics and limited uptake of these best practices. This article will briefly review the current best practice on important aspects of CRRT delivery including CRRT dose, anticoagulation, dialysis vascular access, fluid management, and drug dosing in CRRT. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Full Text Available Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1 Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2 Whether online access to records improves patient safety and health outcomes; (3 Whether record access increases disparities across social classes and between genders; and (4 Improving efficiency. The challenges for practice are: (1 How to incorporate online access into clinical workflow; (2 The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.
Mold, Freda; de Lusignan, Simon
Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.
Mold, Freda; de Lusignan, Simon
Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225
Vieira, Fabiola Sulpino
To identify items on the agenda of Brazil's Unified Health System that are related to the quality of pharmaceutical services and have not yet been implemented. Data were collected from the inspection reports issued by the federal government's controllership office. Inspection reports completed from August 2004-July 2006, available on the Internet, were reviewed. The issues identified were classified into 15 categories. Of the 660 inspections that were carried out, 659 were analyzed (one was unavailable). In 62 cities pharmaceutical assistance services had not been audited, therefore, a the final sample of 597 cities was analyzed (10.7% of Brazil's municipalities). Of these, 90.3% had issues associated with the management of resources or services. In 71% of the municipalities, the reports indicated lack of or deficient inventory control, and in 39%, inadequate storage conditions. A shortage of drugs was observed in 24% of the municipalities. The goals of Brazil's national drug and pharmaceutical assistance policies are far from being met. Quality pharmaceutical services must again be included on the agenda at all three government levels since it is impossible to have effective health care without quality pharmaceutical services.
The use of microbead-based spoligotyping for Mycobacterium tuberculosis complex to evaluate the quality of the conventional method: providing guidelines for Quality Assurance when working on membranes.
Abadia, E.; Zhang, Jian; Ritacco, V.; Kremer, K.; Ruimy, R.; Rigouts, L.; Gomes, H.M.; Elias, A.R.; Fauville-Dufaux, M.; Stoffels, K.; Rasolofo-Razanamparany, V.; rcia de Viedma, D. Ga; Herranz, M.; Al-Hajoj, S.; Rastogi, N.; Garzelli, C.; Tortoli, E.; Suffys, P.N.; Soolingen, D. van; Refregier, G.; Sola, C.
BACKGROUND: The classical spoligotyping technique, relying on membrane reverse line-blot hybridization of the spacers of the Mycobacterium tuberculosis CRISPR locus, is used world-wide (598 references in Pubmed on April 8th, 2011). However, until now no inter-laboratory quality control study had
Julian D. Richards
almost all report low levels of usage. Digital technology now offers the means by which the crisis may at last be overcome. It provides an opportunity to provide unprecedented access to archaeological data through online digital archives and to integrate synthetic interpretation with recorded observations in a seamless fashion, in a way which has been pioneered by Internet Archaeology. It may even allow a virtual re-integration of the paper and artefactual archives, which in the British Isles have become physically separated. However, the growth of the World Wide Web brings with it its own problems of locating relevant resources of quality which need addressing by effective indexing and access. Such resources need not be brought together in a central place but can instead be searched across distributed sites. On the other hand, if we maintain archives at a local level we must be aware of problems of data integrity. The trend for archaeological data to be captured and held in digital format, and even to be born digital raises issues of data preservation. This article is based on the experiences gained and lessons learned during the development of the Archaeology Data Service over the last five years, presented here as a case study which links each of the above themes. It is clear that we need to plan for data re-use, and that archiving must be considered at the outset of a project, not just regarded as an afterthought once the final publication proofs have been checked, and that we must provide adequate documentation to allow re-users to understand the context of our recorded observations, rather than pretending that data can be divorced from the observer. This inevitably has a cost, but our profession has long played lip service to the importance of the structured and ordered archive, without necessarily doing anything about it. We must also train future generations of archaeologists to apply skills of source criticism in their use of archival sources and, as the
Hsu, Huei-Chen; Liu, Wen-Liang
This research aims to investigate decoy effects on online brand choices. To assess the influence of decoys, we test decoy effects on three constructs-product involvement, judgment conditions, and decoy conditions-within an online experiment. A survey of 635 Internet users and a 2 × 2 × 3 ANOVA between-subjects experimental design is used to guide the research design and the systematic analysis procedure. A major finding of this study is that a standard decoy seems to have a significant effect on an advertised (target) brand for high-involvement products; from the survey, it is also apparent that competitors can also use inferior decoys to increase brand preference for low-involvement products.
Desai, Karishma; Chewning, Betty; Mott, David
With increased use of the internet, more people access medications and health supplements online. However little is known about factors associated with using online buying. Given the variable quality of online pharmacies, an important question is whether online consumers also have health care providers with whom they discuss internet information and decisions. To help address these gaps this study used the Andersen Model to explore (1) the characteristics of internet buyers of medicines and/vitamins, (2) the association between health care use and buying medicines and/vitamins online drawing on the Andersen health care utilization framework, and (3) factors predicting discussion of internet information with health providers. The National Cancer Institute's Health Information National Trends Survey (HINTS) 2007 was analyzed to study online medication buying among a national sample of internet users (N = 5074). The Andersen Model of health care utilization guided the study's variable selection and analyses. Buying online and talking about online information are the two main outcome variables. Separate multivariate logistic regression analyses identified factors associated with online buying and factors predicting discussions with providers about online information. In 2007, 14.5% (n = 871) of internet users bought a medication or vitamin online. About 85% of online buyers had a regular provider, but only 39% talked to the provider about online information even though most (93.7%) visited the provider ≥1 times/year. Multivariate analyses found internet health product consumers were more likely to be over 50 years old, have insurance and discuss the internet with their provider than non-internet health product consumers. Moreover, discussion of internet information was more likely if consumers had a regular provider and perceived their communication to be at least fair or good in general. There is a clear association of online buying with age, frequency of visits and
Full Text Available The purpose of this study is to investigate the relationship among online retailing information quality, e-satisfaction, e-trust and young generation customer’s commitment in mainland China. The study variables have considerable importance in e-tailers performance. The data were collected based on a sample of 383 students from Chinese universities during the first quarter of 2014. We used confirmatory factor analysis (CFA and structural equation modeling (SEM to evaluate the hypotheses about the relationship among model constructs. Thus, all the hypotheses developed in the study were positively confirmed except one. Therefore, the investigated variables are reinforcing the theory and previous research in this field. This study reveals interesting implications of information quality, e-satisfaction, e-trust and customers commitment that are useful to both academicians and practitioners.
Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.
Huang, Pingjie; Wang, Ke; Hou, Dibo; Zhang, Jian; Yu, Jie; Zhang, Guangxin
The contaminant detection in water distribution systems is essential to protect public health from potentially harmful compounds resulting from accidental spills or intentional releases. As a noninvasive optical technique, ultraviolet-visible (UV-Vis) spectroscopy is investigated for detecting contamination events. However, current methods for event detection exhibit the shortcomings of noise susceptibility. In this paper, a new method that has less sensitivity to noise was proposed to detect water quality contamination events by analyzing the complexity of the UV-Vis spectrum series. The proposed method applied approximate entropy (ApEn) to measure spectrum signals' complexity, which made a distinction between normal and abnormal signals. The impact of noise was attenuated with the help of ApEn's insensitivity to signal disturbance. This method was tested on a real water distribution system data set with various concentration simulation events. Results from the experiment and analysis show that the proposed method has a good performance on noise tolerance and provides a better detection result compared with the autoregressive model and sequential probability ratio test.
Chen, Guang-Pei; Ahunbay, Ergun; Li, X Allen
To develop an integrated quality assurance (QA) software tool for online replanning capable of efficiently and automatically checking radiation treatment (RT) planning parameters and gross plan quality, verifying treatment plan data transfer from treatment planning system (TPS) to record and verify (R&V) system, performing a secondary monitor unit (MU) calculation with or without a presence of a magnetic field from MR-Linac, and validating the delivery record consistency with the plan. The software tool, named ArtQA, was developed to obtain and compare plan and treatment parameters from both the TPS and the R&V system database. The TPS data are accessed via direct file reading and the R&V data are retrieved via open database connectivity and structured query language. Plan quality is evaluated with both the logical consistency of planning parameters and the achieved dose-volume histograms. Beams in between the TPS and R&V system are matched based on geometry configurations. To consider the effect of a 1.5 T transverse magnetic field from MR-Linac in the secondary MU calculation, a method based on modified Clarkson integration algorithm was developed and tested for a series of clinical situations. ArtQA has been used in their clinic and can quickly detect inconsistencies and deviations in the entire RT planning process. With the use of the ArtQA tool, the efficiency for plan check including plan quality, data transfer, and delivery check can be improved by at least 60%. The newly developed independent MU calculation tool for MR-Linac reduces the difference between the plan and calculated MUs by 10%. The software tool ArtQA can be used to perform a comprehensive QA check from planning to delivery with conventional Linac or MR-Linac and is an essential tool for online replanning where the QA check needs to be performed rapidly.
Chen, Guang-Pei, E-mail: email@example.com; Ahunbay, Ergun; Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226 (United States)
Purpose: To develop an integrated quality assurance (QA) software tool for online replanning capable of efficiently and automatically checking radiation treatment (RT) planning parameters and gross plan quality, verifying treatment plan data transfer from treatment planning system (TPS) to record and verify (R&V) system, performing a secondary monitor unit (MU) calculation with or without a presence of a magnetic field from MR-Linac, and validating the delivery record consistency with the plan. Methods: The software tool, named ArtQA, was developed to obtain and compare plan and treatment parameters from both the TPS and the R&V system database. The TPS data are accessed via direct file reading and the R&V data are retrieved via open database connectivity and structured query language. Plan quality is evaluated with both the logical consistency of planning parameters and the achieved dose–volume histograms. Beams in between the TPS and R&V system are matched based on geometry configurations. To consider the effect of a 1.5 T transverse magnetic field from MR-Linac in the secondary MU calculation, a method based on modified Clarkson integration algorithm was developed and tested for a series of clinical situations. Results: ArtQA has been used in their clinic and can quickly detect inconsistencies and deviations in the entire RT planning process. With the use of the ArtQA tool, the efficiency for plan check including plan quality, data transfer, and delivery check can be improved by at least 60%. The newly developed independent MU calculation tool for MR-Linac reduces the difference between the plan and calculated MUs by 10%. Conclusions: The software tool ArtQA can be used to perform a comprehensive QA check from planning to delivery with conventional Linac or MR-Linac and is an essential tool for online replanning where the QA check needs to be performed rapidly.
Chandler, Jennifer A; Sun, Jeffrey A; Racine, Eric
Recently, the news media have reported on the discovery of covert awareness and the establishment of limited communication using a functional magnetic resonance imaging (fMRI) neuroimaging technique with several brain-injured patients thought to have been in a vegetative state. This discovery has raised many ethical, legal, and social questions related to quality of life, end-of-life decision making, diagnostic and prognostic accuracy in disorders of consciousness, resource allocation, and other issues. This project inquires into the public responses to these discoveries. We conducted a thematic analysis of online comments (n = 779) posted in response to 15 news articles and blog posts regarding the case of a Canadian patient diagnosed for 12 years as in a vegetative state, but who was reported in 2012 as having been able to communicate via fMRI. The online comments were coded using an iteratively refined codebook structured around 14 main themes. Among the most frequent public reactions revealed in the online comments were discussions of the quality of life of patients with disorders of consciousness, whether life-sustaining treatment should be withdrawn (and whether the fMRI communication technique should be used to ask patients about this), and misgivings about the accuracy of diagnosis in disorders of consciousness and brain death. These public perspectives are relevant to the obligations of clinicians, lawyers, and public policymakers to patients, families, and the public. Future work should consider how best to alleviate families' concerns as this type of research shakes their faith in diagnostic accuracy, to clarify the legal rules relating to advance directives in this context, and to address the manner in which public messaging might help to alleviate any indirect impact on confidence in the organ donation system.
Hesselink, G.J.; Schoonhoven, L.; Plas, M. van der; Wollersheim, H.C.H.; Vernooij-Dassen, M.J.F.J.
OBJECTIVE: To identify barriers experienced and perceived at discharge by physicians, nurses, patients and relatives. DESIGN: We developed questionnaires based on focus group interviews with hospital and community care providers, and individual interviews with patients and relatives. A survey was
Nørskov, Sladjana V.; Rask, Morten
This paper addresses the application of observation to online settings with a special focus on observer roles. It draws on a study of online observation of a virtual community, i.e. an open source software (OSS) community. The paper examines general and specific advantages and disadvantages...... of the observer roles in online settings by relating these roles to the same roles assumed in offline settings. The study suggests that under the right circumstances online and offline observation may benefit from being combined as they complement each other well. Quality issues and factors important to elicit...... trustworthy observational data from online study settings, such as OSS communities, are discussed. A proposition is made concerning how threats to credibility and transferability in relation to online observation (i.e. lack of richness and detail, risk of misunderstandings) can be diminished, while...
Ariff, Mohd Shoki Md; Sylvester, Michele; Zakuan, Norhayati; Ismail, Khalid; Mat Ali, Kamarudin
The development of e-commerce has increased the popularity of online shopping worldwide. In Malaysia, it was reported that online shopping market size was RM1.8 billion in 2013 and it is estimated to reach RM5 billion by 2015. However, online shopping was rated 11th out of 15 purposes of using internet in 2012. Consumers' perceived risks of online shopping becomes a hot topic to research as it will directly influence users' attitude towards online purchasing, and their attitude will have significant impact to the online purchasing behaviour. The conceptualization of consumers' perceived risk, attitude and online shopping behaviour of this study provides empirical evidence in the study of consumer online behaviour. Four types of risks - product risk, financial, convenience and non-delivery risks - were examined in term of their effect on consumers' online attitude. A web-based survey was employed, and a total of 300 online shoppers of a Malaysia largest online marketplace participated in this study. The findings indicated that product risk, financial and non-delivery risks are hazardous and negatively affect the attitude of online shoppers. Convenience risk was found to have positive effect on consumers' attitude, denoting that online buyers of this site trusted the online seller and they encountered less troublesome with the site. It also implies that consumers did not really concern on non-convenience aspect of online shopping, such as handling of returned products and examine the quality of products featured in the online seller website. The online buyers' attitude was significantly and positively affects their online purchasing behaviour. The findings provide useful model for measuring and managing consumers' perceived risk in internet-based transaction to increase their involvement in online shopping and to reduce their cognitive dissonance in the e-commerce setting.
Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Latson, Larry A; Bhatla, Puneet; Feng, Li; Axel, Leon
Object Residual respiratory motion degrades image quality in conventional cardiac cine MRI (CCMR). We evaluated whether a free-breathing (FB) radial imaging CCMR sequence with compressed sensing reconstruction (eXtra-Dimension (e.g. cardiac and respiratory phases) Golden-angle RAdial Sparse Parallel, or XD-GRASP) could provide better image quality than a conventional Cartesian breath-held (BH) sequence, in an unselected population of patients undergoing clinical CCMR. Material and Methods 101 patients who underwent BH and FB imaging in a mid-ventricular short-axis plane at a matching location were included. Visual and quantitative image analysis was performed by two blinded experienced readers, using a 5-point qualitative scale to score overall image quality and visual signal-to-noise ratio (SNR) grade, with measures of noise and sharpness. End-diastole (ED) and end-systole (ES) left-ventricular areas were also measured and compared for both BH and FB images. Results Image quality was generally better with the BH cines (overall quality grade BH vs FB: 4 vs 2.9, pcine in general, it provided improved image quality in the subgroup of patients presenting respiratory motion-induced artifacts on breath-held images. PMID:29067539
The purpose of this study is to determine the perceptions of final-year nursing students regarding the adequacy of education, resources and internships in preparation for graduation. The study design was a descriptive cross-sectional study of nursing students (n: 1804) in their final year of education and questionnaires were used to collect data. Information related to student-to-instructor ratios and internships was obtained from each institution. Most students reported receiving instruction or supervision by lecturers and clinicians who did not specialise in the field. Overall, students did not find the facilities, educational or technological resources and the quality of education offered by their respective schools adequate. The proportion of students who found the level of theoretical education, clinical practice and instructor support adequate was higher in state university colleges of nursing/faculties of health sciences than in state university schools of health sciences.
Iorizzo, Massimo; Ellison, Shelby; Senalik, Douglas; Zeng, Peng; Satapoomin, Pimchanok; Huang, Jiaying; Bowman, Megan; Iovene, Marina; Sanseverino, Walter; Cavagnaro, Pablo; Yildiz, Mehtap; Macko-Podgórni, Alicja; Moranska, Emilia; Grzebelus, Ewa; Grzebelus, Dariusz; Ashrafi, Hamid; Zheng, Zhijun; Cheng, Shifeng; Spooner, David; Van Deynze, Allen; Simon, Philipp
We report a high-quality chromosome-scale assembly and analysis of the carrot (Daucus carota) genome, the first sequenced genome to include a comparative evolutionary analysis among members of the euasterid II clade. We characterized two new polyploidization events, both occurring after the divergence of carrot from members of the Asterales order, clarifying the evolutionary scenario before and after radiation of the two main asterid clades. Large- and small-scale lineage-specific duplications have contributed to the expansion of gene families, including those with roles in flowering time, defense response, flavor, and pigment accumulation. We identified a candidate gene, DCAR_032551, that conditions carotenoid accumulation (Y) in carrot taproot and is coexpressed with several isoprenoid biosynthetic genes. The primary mechanism regulating carotenoid accumulation in carrot taproot is not at the biosynthetic level. We hypothesize that DCAR_032551 regulates upstream photosystem development and functional processes, including photomorphogenesis and root de-etiolation.