Contact Information for EPA's Office of Transportation and Air Quality

EPA Pesticide Factsheets

You will find an EPA employee by name or by topic of interest, also, you will know who to contact if you want to find a specific transportation and air quality document, importing a vehicle to the US, and other frequently asked questions.

2014 Proposed Revision to 2008 Ozone National Ambient Air Quality Standards (NAAQS) Supporting Documents

EPA Pesticide Factsheets

Find information on the 2014 proposed ozone NAAQS revision, and find tools for background ozone, maps of nonattainment areas, an overview of the proposal, and information on designations, monitoring and permitting requirements

Ranking sources of hospital quality information for orthopedic surgery patients: consequences for the system of managed competition.

PubMed

Bes, Romy Evelien; van den Berg, Bernard

2013-01-01

Healthcare quality information is crucial for the system of managed competition. Within a system of managed competition, health insurers can selectively contract care providers and are allowed to channel patients towards contracted providers. The idea is that insurers have a stronger bargaining position compared to care providers when they are able to channel patients. In the Dutch system of managed competition that was implemented in 2006, channelling patients to preferred providers has not yet been very successful. Empirical knowledge of which sources of hospital quality information they find important may help us to understand how to channel patients to preferred providers. The objective of this survey was to measure how patients rank various sources of information when they compare hospital quality in a system of managed competition. A written survey was conducted among clients of a large Dutch health insurance company. These clients underwent orthopedic surgery on the hip or knee no longer than 12 months ago. Two major players within a system of managed competition-health insurers and the government-were not seen as important sources of hospital quality information. In contrast, own experience and general practitioners (GPs) were seen as the most important sources of hospital quality information within the Dutch system of managed competition. Health insurers should take the main finding-that GPs are the most important source of hospital quality information-into account when they contract care providers and develop strategies for channeling patients towards preferred providers. A well-functioning system of managed competition will benefit patients, as it involves incentives for care providers to increase healthcare quality and to produce at the lowest cost per unit of quality.

Baselining current road weather information : results of the 2010 quality and importance survey final report.

DOT National Transportation Integrated Search

2011-01-30

This final report contains research findings on the characterization of the quality and value of road weather information resources used by members of the surface transportation community in their decision-making process. This report focuses on the r...

Evaluation of a Quality Improvement Resource for Public Health Practitioners

PubMed Central

Marcial, Laura H.; Brown, Stephen; Throop, Cynthia; Pina, Jamie

2017-01-01

Objectives: Quality improvement is a critical mechanism to manage public health agency performance and to strengthen accountability for public funds. The objective of this study was to evaluate a relatively new quality improvement resource, the Public Health Quality Improvement Exchange (PHQIX), a free online communication platform dedicated to making public health quality improvement information accessible to practitioners. Methods: We conducted an internet-based survey of registered PHQIX users (n = 536 respondents) in 2013 and key informant interviews with PHQIX frequent users (n = 21) in 2014, in the United States. We assessed use of the PHQIX website, user engagement and satisfaction, communication and knowledge exchange, use of information, and impact on quality improvement capacity and accreditation readiness. Results: Of 462 respondents, 369 (79.9%) browsed quality improvement initiatives, making it the most commonly used site feature, and respondents described PHQIX as a near-unique source for real-world quality improvement examples. Respondents were satisfied with the quality and breadth of topics and relevance to their settings (average satisfaction scores, 3.9-4.1 [where 5 was the most satisfied]). Of 407 respondents, 237 (58.2%) said that they had put into practice information learned on PHQIX, and 209 of 405 (51.6%) said that PHQIX had helped to improve quality improvement capacity. Fewer than half of respondents used the commenting function, the Community Forum, and the Ask an Expert feature. Conclusions: Findings suggest that PHQIX, particularly descriptions of the quality improvement initiatives, is a valued resource for public health practitioners. Users reported sharing information with colleagues and applying what they learned to their own work. These findings may relate to other efforts to disseminate quality improvement knowledge. PMID:28135430

Evaluation of a Quality Improvement Resource for Public Health Practitioners.

PubMed

Porterfield, Deborah S; Marcial, Laura H; Brown, Stephen; Throop, Cynthia; Pina, Jamie

Quality improvement is a critical mechanism to manage public health agency performance and to strengthen accountability for public funds. The objective of this study was to evaluate a relatively new quality improvement resource, the Public Health Quality Improvement Exchange (PHQIX), a free online communication platform dedicated to making public health quality improvement information accessible to practitioners. We conducted an internet-based survey of registered PHQIX users (n = 536 respondents) in 2013 and key informant interviews with PHQIX frequent users (n = 21) in 2014, in the United States. We assessed use of the PHQIX website, user engagement and satisfaction, communication and knowledge exchange, use of information, and impact on quality improvement capacity and accreditation readiness. Of 462 respondents, 369 (79.9%) browsed quality improvement initiatives, making it the most commonly used site feature, and respondents described PHQIX as a near-unique source for real-world quality improvement examples. Respondents were satisfied with the quality and breadth of topics and relevance to their settings (average satisfaction scores, 3.9-4.1 [where 5 was the most satisfied]). Of 407 respondents, 237 (58.2%) said that they had put into practice information learned on PHQIX, and 209 of 405 (51.6%) said that PHQIX had helped to improve quality improvement capacity. Fewer than half of respondents used the commenting function, the Community Forum, and the Ask an Expert feature. Findings suggest that PHQIX, particularly descriptions of the quality improvement initiatives, is a valued resource for public health practitioners. Users reported sharing information with colleagues and applying what they learned to their own work. These findings may relate to other efforts to disseminate quality improvement knowledge.

Water quality in the central Nebraska basins, Nebraska, 1992-95

USGS Publications Warehouse

Frenzel, S.A.; Swanson, R.B.; Huntzinger, T.L.; Stamer, J.K.; Emmons, P.J.; Zelt, R.B.

1998-01-01

This report is intended to summarize major findings that emerged between 1992 and 1995 from the water-quality assessment of the Central Nebraska Basins Study Unit and to relate these findings to water-quality issues of regional and national concern. The information is primarily intended for those who are involved in waterresource management. Indeed, this report addresses many of the concerns raised by regulators, water-utility managers, industry representatives, and other scientists, engineers, public officials, and members of stakeholder groups who provided advice and input to the USGS during this NAWQA Study-Unit investigation. Yet, the information contained here may also interest those who simply wish to know more about the quality of water in the rivers and aquifers in the area where they live.

Evaluation of the visual performance of image processing pipes: information value of subjective image attributes

NASA Astrophysics Data System (ADS)

Nyman, G.; Häkkinen, J.; Koivisto, E.-M.; Leisti, T.; Lindroos, P.; Orenius, O.; Virtanen, T.; Vuori, T.

2010-01-01

Subjective image quality data for 9 image processing pipes and 8 image contents (taken with mobile phone camera, 72 natural scene test images altogether) from 14 test subjects were collected. A triplet comparison setup and a hybrid qualitative/quantitative methodology were applied. MOS data and spontaneous, subjective image quality attributes to each test image were recorded. The use of positive and negative image quality attributes by the experimental subjects suggested a significant difference between the subjective spaces of low and high image quality. The robustness of the attribute data was shown by correlating DMOS data of the test images against their corresponding, average subjective attribute vector length data. The findings demonstrate the information value of spontaneous, subjective image quality attributes in evaluating image quality at variable quality levels. We discuss the implications of these findings for the development of sensitive performance measures and methods in profiling image processing systems and their components, especially at high image quality levels.

Internet Use Habits of Students of the Department of Information Management, Hacettepe University, Ankara

ERIC Educational Resources Information Center

Ucak, Nazan Ozenc

2007-01-01

The frequency and other characteristics of Internet use of students studying at the Department of Information Management at Hacettep University in Ankara, Turkey, are examined. According to the findings, students prefer electronic media to printed media, they find the easy accessibility of the information more important than the other qualities,…

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

PubMed

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

2016-02-01

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

Nursing Home Price and Quality Responses to Publicly Reported Quality Information

PubMed Central

Clement, Jan P; Bazzoli, Gloria J; Zhao, Mei

2012-01-01

Objective To assess whether the release of Nursing Home Compare (NHC) data affected self-pay per diem prices and quality of care. Data Sources Primary data sources are the Annual Survey of Wisconsin Nursing Homes for 2001–2003, Online Survey and Certification Reporting System, NHC, and Area Resource File. Study Design We estimated fixed effects models with robust standard errors of per diem self-pay charge and quality before and after NHC. Principal Findings After NHC, low-quality nursing homes raised their prices by a small but significant amount and decreased their use of restraints but did not reduce pressure sores. Mid-level and high-quality nursing homes did not significantly increase self-pay prices after NHC nor consistently change quality. Conclusions Our findings suggest that the release of quality information affected nursing home behavior, especially pricing and quality decisions among low-quality facilities. Policy makers should continue to monitor quality and prices for self-pay residents and scrutinize low-quality homes over time to see whether they are on a pathway to improve quality. In addition, policy makers should not expect public reporting to result in quick fixes to nursing home quality problems. PMID:22092366

Motivating medical information system performance by system quality, service quality, and job satisfaction for evidence-based practice.

PubMed

Chang, Ching-Sheng; Chen, Su-Yueh; Lan, Yi-Ting

2012-11-21

No previous studies have addressed the integrated relationships among system quality, service quality, job satisfaction, and system performance; this study attempts to bridge such a gap with evidence-based practice study. The convenience sampling method was applied to the information system users of three hospitals in southern Taiwan. A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid, suggesting a valid response rate of 56.6%. SPSS 17.0 and AMOS 17.0 (structural equation modeling) statistical software packages were used for data analysis and processing. The findings are as follows: System quality has a positive influence on service quality (γ11= 0.55), job satisfaction (γ21= 0.32), and system performance (γ31= 0.47). Service quality (β31= 0.38) and job satisfaction (β32= 0.46) will positively influence system performance. It is thus recommended that the information office of hospitals and developers take enhancement of service quality and user satisfaction into consideration in addition to placing b on system quality and information quality when designing, developing, or purchasing an information system, in order to improve benefits and gain more achievements generated by hospital information systems.

Factors of quality of financial report of local government in Indonesia

NASA Astrophysics Data System (ADS)

Muda, Iskandar; Haris Harahap, Abdul; Erlina; Ginting, Syafruddin; Maksum, Azhar; Abubakar, Erwin

2018-03-01

The purpose of this research is to find out whether the Accounting Information System and Internal Control in Local Revenue Office to the affect the Quality of Financial Report of Local Government. The sampling was conducted by using simple random sampling method in which the sample was determined without considering strata. The data research was conducted by distributing the questionnaires. The results showed that the degree of Accounting Information System and Internal Control simultaneously affect the Quality of Financial Report of Local Government. However, partially, Partially, accounting information system influence to the quality of financial report of local government and the internal control does not affect the quality of financial report.

Assessing Metadata Quality of a Federally Sponsored Health Data Repository.

PubMed

Marc, David T; Beattie, James; Herasevich, Vitaly; Gatewood, Laël; Zhang, Rui

2016-01-01

The U.S. Federal Government developed HealthData.gov to disseminate healthcare datasets to the public. Metadata is provided for each datasets and is the sole source of information to find and retrieve data. This study employed automated quality assessments of the HealthData.gov metadata published from 2012 to 2014 to measure completeness, accuracy, and consistency of applying standards. The results demonstrated that metadata published in earlier years had lower completeness, accuracy, and consistency. Also, metadata that underwent modifications following their original creation were of higher quality. HealthData.gov did not uniformly apply Dublin Core Metadata Initiative to the metadata, which is a widely accepted metadata standard. These findings suggested that the HealthData.gov metadata suffered from quality issues, particularly related to information that wasn't frequently updated. The results supported the need for policies to standardize metadata and contributed to the development of automated measures of metadata quality.

Assessing Metadata Quality of a Federally Sponsored Health Data Repository

PubMed Central

Marc, David T.; Beattie, James; Herasevich, Vitaly; Gatewood, Laël; Zhang, Rui

2016-01-01

The U.S. Federal Government developed HealthData.gov to disseminate healthcare datasets to the public. Metadata is provided for each datasets and is the sole source of information to find and retrieve data. This study employed automated quality assessments of the HealthData.gov metadata published from 2012 to 2014 to measure completeness, accuracy, and consistency of applying standards. The results demonstrated that metadata published in earlier years had lower completeness, accuracy, and consistency. Also, metadata that underwent modifications following their original creation were of higher quality. HealthData.gov did not uniformly apply Dublin Core Metadata Initiative to the metadata, which is a widely accepted metadata standard. These findings suggested that the HealthData.gov metadata suffered from quality issues, particularly related to information that wasn’t frequently updated. The results supported the need for policies to standardize metadata and contributed to the development of automated measures of metadata quality. PMID:28269883

Water Quality in the Nation's Streams and Aquifers Overview of Selected Findings, 1991-2001

USGS Publications Warehouse

Hamilton, Pixie A.; Miller, Timothy L.; Myers, Donna N.

2004-01-01

This report accompanies the publication of the last 15 of 51 river basin and aquifer assessments by the USGS National Water-Quality Assessment (NAWQA) Program during 1991?2001. It highlights selected water-quality findings of regional and national interest through examples from river basins and aquifer systems across the Nation. Forthcoming reports in the USGS series ?The Quality of Our Nation?s Waters? will present comprehensive national syntheses of information collected in the 51 study units on pesticides in water, sediment, and fish; volatile organic compounds in major aquifers used for domestic and public supply; nutrients and trace elements in streams and ground water; and aquatic ecology. This report, summaries of the 51 water-quality assessments, and a 1999 national synthesis of information on nutrients and pesticides, are available free of charge as USGS Circulars and on the World Wide Web at http://water.usgs.gov/nawqa/nawqa_sumr.html.

[Quality management is associated with high quality services in health care].

PubMed

Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

2013-12-09

In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

Investigating Criteria That Seventh Graders Use to Evaluate the Quality of Online Information

ERIC Educational Resources Information Center

Coiro, Julie; Coscarelli, Carla; Maykel, Cheryl; Forzani, Elena

2015-01-01

This article presents qualitative findings from a study that examined the types of criteria that middle school students use to evaluate the quality of online information and sources for a Web-based research assignment. Open-constructed responses from four critical evaluation items were compiled from diverse seventh graders in a representative,…

Switching health insurers: the role of price, quality and consumer information search.

PubMed

Boonen, Lieke H H M; Laske-Aldershof, Trea; Schut, Frederik T

2016-04-01

We examine the impact of price, service quality and information search on people's propensity to switch health insurers in the competitive Dutch health insurance market. Using panel data from annual household surveys and data on health insurers' premiums and quality ratings over the period 2006-2012, we estimate a random effects logit model of people's switching decisions. We find that switching propensities depend on health plan price and quality, and on people's age, health, education and having supplementary or group insurance. Young people (18-35 years) are more sensitive to price, whereas older people are more sensitive to quality. Searching for health plan information has a much stronger impact on peoples' sensitivity to price than to service quality. In addition, searching for health plan information has a stronger impact on the switching propensity of higher than lower educated people, suggesting that higher educated people make better use of available health plan information. Finally, having supplementary insurance significantly reduces older people's switching propensity.

Motivating medical information system performance by system quality, service quality, and job satisfaction for evidence-based practice

PubMed Central

2012-01-01

Background No previous studies have addressed the integrated relationships among system quality, service quality, job satisfaction, and system performance; this study attempts to bridge such a gap with evidence-based practice study. Methods The convenience sampling method was applied to the information system users of three hospitals in southern Taiwan. A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid, suggesting a valid response rate of 56.6%. SPSS 17.0 and AMOS 17.0 (structural equation modeling) statistical software packages were used for data analysis and processing. Results The findings are as follows: System quality has a positive influence on service quality (γ11= 0.55), job satisfaction (γ21= 0.32), and system performance (γ31= 0.47). Service quality (β31= 0.38) and job satisfaction (β32= 0.46) will positively influence system performance. Conclusions It is thus recommended that the information office of hospitals and developers take enhancement of service quality and user satisfaction into consideration in addition to placing b on system quality and information quality when designing, developing, or purchasing an information system, in order to improve benefits and gain more achievements generated by hospital information systems. PMID:23171394

Emerging markets for imported beef in China: Results from a consumer choice experiment in Beijing.

PubMed

Ortega, David L; Hong, Soo Jeong; Wang, H Holly; Wu, Laping

2016-11-01

The purpose of this study is to explore emerging markets for imported beef in China by assessing Beijing consumer demand for quality attributes. This study utilizes data from an in-store choice experiment to evaluate consumer willingness-to-pay for select food quality attributes (food safety, animal welfare, Green Food and Organic certification) taking into account country-of-origin information. Our results show that Beijing consumers value food safety information the most, and are willing to pay more for Australian beef products than for US or domestic (Chinese) beef. We explore the various relationships between the quality attributes, find evidence of preference heterogeneity and discuss agribusiness and marketing implications of our findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Continuous Professional Development and ECEC Quality: Findings from a European Systematic Literature Review

ERIC Educational Resources Information Center

Peleman, Brecht; Lazzari, Arianna; Budginaite, Irma; Siarova, Hanna; Hauari, Hanan; Peeters, Jan; Cameron, Claire

2018-01-01

This article presents the findings of an analysis of the effects of CPD initiatives on the quality of the pedagogical practices of ECEC practitioners. It is part of a larger study commissioned by Eurofound and jointly conducted by VBJK, IOE and PPMI (Eurofound, 2015). In order to draw policy-relevant information that might support decision makers…

Report: Procedural Review of EPA’s Greenhouse Gases Endangerment Finding Data Quality Processes

EPA Pesticide Factsheets

Report #11-P-0702, September 26, 2011. EPA met statutory requirements for rulemaking and generally followed requirements and guidance related to ensuring the quality of the supporting technical information.

Quality of Web-based information on obsessive compulsive disorder.

PubMed

Klila, Hedi; Chatton, Anne; Zermatten, Ariane; Khan, Riaz; Preisig, Martin; Khazaal, Yasser

2013-01-01

The Internet is increasingly used as a source of information for mental health issues. The burden of obsessive compulsive disorder (OCD) may lead persons with diagnosed or undiagnosed OCD, and their relatives, to search for good quality information on the Web. This study aimed to evaluate the quality of Web-based information on English-language sites dealing with OCD and to compare the quality of websites found through a general and a medically specialized search engine. Keywords related to OCD were entered into Google and OmniMedicalSearch. Websites were assessed on the basis of accountability, interactivity, readability, and content quality. The "Health on the Net" (HON) quality label and the Brief DISCERN scale score were used as possible content quality indicators. Of the 235 links identified, 53 websites were analyzed. The content quality of the OCD websites examined was relatively good. The use of a specialized search engine did not offer an advantage in finding websites with better content quality. A score ≥16 on the Brief DISCERN scale is associated with better content quality. This study shows the acceptability of the content quality of OCD websites. There is no advantage in searching for information with a specialized search engine rather than a general one. The Internet offers a number of high quality OCD websites. It remains critical, however, to have a provider-patient talk about the information found on the Web.

Quality Education for Social Development and Human Well-Being

ERIC Educational Resources Information Center

Moradi Sheykhjan, Tohid

2015-01-01

Education as a phenomenon is rather complex which makes it difficult to define its quality. Definitions of quality must be open to change and evolution based on information, changing contexts, and new understandings of the nature of education's challenges. The main objective of the paper is to find out the significance of quality education for…

Employers, Quality and Standards in Higher Education: Shared Values and Vocabularies or Elitism and Inequalities?

ERIC Educational Resources Information Center

Morley, Louise; Aynsley, Sarah

2007-01-01

This paper is based on a research project funded by the Higher Education Funding Council for England which investigated employers' needs for information on higher education quality and standards. A key issue was identifying the type of knowledge that employers utilise in graduate recruitment. A finding of the study was that information on quality…

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases

PubMed Central

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

2016-01-01

Background 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. Objective The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. Methods 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. Results 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. Conclusions 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. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality. PMID:27562540

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases.

PubMed

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

2016-08-25

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. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality.

Information from Pharmaceutical Companies and the Quality, Quantity, and Cost of Physicians' Prescribing: A Systematic Review

PubMed Central

Spurling, Geoffrey K.; Mansfield, Peter R.; Montgomery, Brett D.; Lexchin, Joel; Doust, Jenny; Othman, Noordin; Vitry, Agnes I.

2010-01-01

Background Pharmaceutical companies spent $57.5 billion on pharmaceutical promotion in the United States in 2004. The industry claims that promotion provides scientific and educational information to physicians. While some evidence indicates that promotion may adversely influence prescribing, physicians hold a wide range of views about pharmaceutical promotion. The objective of this review is to examine the relationship between exposure to information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing. Methods and Findings We searched for studies of physicians with prescribing rights who were exposed to information from pharmaceutical companies (promotional or otherwise). Exposures included pharmaceutical sales representative visits, journal advertisements, attendance at pharmaceutical sponsored meetings, mailed information, prescribing software, and participation in sponsored clinical trials. The outcomes measured were quality, quantity, and cost of physicians' prescribing. We searched Medline (1966 to February 2008), International Pharmaceutical Abstracts (1970 to February 2008), Embase (1997 to February 2008), Current Contents (2001 to 2008), and Central (The Cochrane Library Issue 3, 2007) using the search terms developed with an expert librarian. Additionally, we reviewed reference lists and contacted experts and pharmaceutical companies for information. Randomized and observational studies evaluating information from pharmaceutical companies and measures of physicians' prescribing were independently appraised for methodological quality by two authors. Studies were excluded where insufficient study information precluded appraisal. The full text of 255 articles was retrieved from electronic databases (7,185 studies) and other sources (138 studies). Articles were then excluded because they did not fulfil inclusion criteria (179) or quality appraisal criteria (18), leaving 58 included studies with 87 distinct analyses. Data were extracted independently by two authors and a narrative synthesis performed following the MOOSE guidelines. Of the set of studies examining prescribing quality outcomes, five found associations between exposure to pharmaceutical company information and lower quality prescribing, four did not detect an association, and one found associations with lower and higher quality prescribing. 38 included studies found associations between exposure and higher frequency of prescribing and 13 did not detect an association. Five included studies found evidence for association with higher costs, four found no association, and one found an association with lower costs. The narrative synthesis finding of variable results was supported by a meta-analysis of studies of prescribing frequency that found significant heterogeneity. The observational nature of most included studies is the main limitation of this review. Conclusions With rare exceptions, studies of exposure to information provided directly by pharmaceutical companies have found associations with higher prescribing frequency, higher costs, or lower prescribing quality or have not found significant associations. We did not find evidence of net improvements in prescribing, but the available literature does not exclude the possibility that prescribing may sometimes be improved. Still, we recommend that practitioners follow the precautionary principle and thus avoid exposure to information from pharmaceutical companies. Please see later in the article for the Editors' Summary PMID:20976098

The Effect of Publicized Quality Information on Home Health Agency Choice

PubMed Central

Jung, Jeah Kyoungrae; Wu, Bingxiao; Kim, Hyunjee; Polsky, Daniel

2016-01-01

We examine consumers’ use of publicized quality information in Medicare home health care markets, where consumer cost sharing and travel costs are absent. We report two findings. First, agencies with high quality scores are more likely to be preferred by consumers after the introduction of a public reporting program than before. Second, consumers’ use of publicized quality information differs by patient group. Community-based patients have slightly larger responses to public reporting than hospital-discharged patients. Patients with functional limitations at the start of their care, at least among hospital-discharged patients, have a larger response to the reported functional outcome measure than those without functional limitations. In all cases of significant marginal effects, magnitudes are small. We conclude that the current public reporting approach is unlikely to have critical impacts on home health agency choice. Identifying and releasing quality information that is meaningful to consumers may help increase consumers’ use of public reports. PMID:26719047

Public library computer training for older adults to access high-quality Internet health information

PubMed Central

Xie, Bo; Bugg, Julie M.

2010-01-01

An innovative experiment to develop and evaluate a public library computer training program to teach older adults to access and use high-quality Internet health information involved a productive collaboration among public libraries, the National Institute on Aging and the National Library of Medicine of the National Institutes of Health (NIH), and a Library and Information Science (LIS) academic program at a state university. One hundred and thirty-one older adults aged 54–89 participated in the study between September 2007 and July 2008. Key findings include: a) participants had overwhelmingly positive perceptions of the training program; b) after learning about two NIH websites (http://nihseniorhealth.gov and http://medlineplus.gov) from the training, many participants started using these online resources to find high quality health and medical information and, further, to guide their decision-making regarding a health- or medically-related matter; and c) computer anxiety significantly decreased (p < .001) while computer interest and efficacy significantly increased (p = .001 and p < .001, respectively) from pre- to post-training, suggesting statistically significant improvements in computer attitudes between pre- and post-training. The findings have implications for public libraries, LIS academic programs, and other organizations interested in providing similar programs in their communities. PMID:20161649

Information quantity and quality affect the realistic accuracy of personality judgment.

PubMed

Letzring, Tera D; Wells, Shannon M; Funder, David C

2006-07-01

Triads of unacquainted college students interacted in 1 of 5 experimental conditions that manipulated information quantity (amount of information) and information quality (relevance of information to personality), and they then made judgments of each others' personalities. To determine accuracy, the authors compared the ratings of each judge to a broad-based accuracy criterion composed of personality ratings from 3 types of knowledgeable informants (the self, real-life acquaintances, and clinician-interviewers). Results supported the hypothesis that information quantity and quality would be positively related to objective knowledge about the targets and realistic accuracy. Interjudge consensus and self-other agreement followed a similar pattern. These findings are consistent with expectations based on models of the process of accurate judgment (D. C. Funder, 1995, 1999) and consensus (D. A. Kenny, 1994). Copyright 2006 APA, all rights reserved.

Is the Moderating Effect of Social Support on New Korean Mothers' Psychological Distress Contingent on Levels of Marital Quality?

PubMed

Park, Ki Tae

2018-03-01

This study examines how levels of marital quality change the effect of social support on postpartum psychological distress among new Korean mothers using the Panel Study on Korean Children (N = 1585). In accord with findings from previous studies, this study shows that low marital quality negatively affects new mothers' mental health, but that social support alleviates psychological distress independent of marital quality. The main finding of this research is that the moderating effect of social support is contingent on levels of marital quality. Aggregated social support moderates the effects of marital quality on new mothers' mental health only when the level of marital quality is low. Furthermore, each dimension of social support (emotional, informational, and instrumental) only has a moderating effect when marital quality is low. The findings highlight the fact that the moderating effect of social support varies with the individual context and so customized social support that fits individual needs matters for the mental health of new mothers.

Corporate Use of Information regarding Natural Resources and Environmental Quality.

ERIC Educational Resources Information Center

Train, Russell E.

This report presents findings and recommendations from a 1-year study which identified corporate needs for resource information (particularly statistical information) and assessed the extent to which these needs are being met by various resource-information services, including those of the federal government. Chapter I discusses 11 types of…

State-Sponsored Public Reporting Programs of Hospital Quality in the United States

PubMed Central

Ross, Joseph S.; Sheth, Sameer D.; Krumholz, Harlan M.

2011-01-01

The prevalence of state public reporting initiatives focused on hospital quality is not known. We systematically reviewed state-sponsored publicly reporting programs focused on clinical aspects of hospital quality and performance for adults, surveying the 50 U.S. states and the District of Columbia. We found that while identifying information about programs was frequently a challenge, programs were present in 25 states (49%) and provided hospital quality information that varied considerably from state to state both by condition and by process and outcome measures reported. We examine the implications of these findings for future state initiatives. PMID:21134936

English and Spanish oral cancer information on the internet: a pilot surface quality and content evaluation of oral cancer web sites.

PubMed

Irwin, Jeannie Y; Thyvalikakath, Thankam; Spallek, Heiko; Wali, Teena; Kerr, Alexander Ross; Schleyer, Titus

2011-01-01

Oral and pharyngeal cancers are responsible for over 7600 deaths each year in the United States. Given the significance of the disease and the fact that many individuals increasingly rely on health information on the Internet, it is important that patients and others can access clear and accurate oral cancer information on the Web. The objective of this study was threefold: (a) develop an initial method to evaluate surface and content quality of selected English- and Spanish-language oral cancer Web sites; (b) conduct a pilot evaluation; and (c) discuss implications of our findings for dental public health. We developed a search strategy to find oral cancer sites frequented by the public using Medline Plus, Google, and Yahoo in English and Spanish. We adapted the Information Quality Tool (IQT) to perform a surface evaluation and developed a novel tool to evaluate site content for 24 sites each in English and Spanish. English-language sites had an average IQT score of 76.6 (out of 100) and an average content score of 52.1 (out of 100). Spanish-language sites had an average IQT score of 50.3 and an average content score of 25.6. The study produced a quality assessment of oral cancer Web sites useful for clinicians and patients. Sites provided more information on clinical presentation, and etiology, and risk factors, than other aspects of oral cancer. The surface and quality of Spanish-language sites was low, possibly putting Hispanic populations at a disadvantage regarding oral cancer information on the Web.

Sources of information used to support quality use of medicines: findings from a national survey of nurse practitioners in Australia.

PubMed

Buckley, Thomas; Stasa, Helen; Cashin, Andrew; Stuart, Meg; Dunn, Sandra V

2015-02-01

The purpose of this study was to investigate the sources, both print and electronic formats, which Australian nurse practitioners (NPs) currently use to obtain information regarding quality use of medicines (QUM). An additional aim was to document NPs' preferences for continuing education in relation to QUM. A national electronic survey of Australian NPs was conducted in 2007 and again in 2010. Eighty percent of respondents accessed information on QUM from professional literature, which may include scholarly journal articles, reports, and independent publications. There was a decrease in the percentage of respondents who obtained information from drug industry representatives. NPs prefer to receive medicines information in an electronic form, rather than a paper-based version, and over the time period more NPs are utilizing electronic sources rather than paper. These findings provide important insights into medical information products for the developers who may be able to use these results to ensure that their products meet the needs of NP clinicians. Additionally, the finding that NPs prefer to receive their continuing information related to medicines in electronic format, but also highly value conference proceedings, may help to inform future planning of NP education needs in relation to QUM. ©2014 American Association of Nurse Practitioners.

Characteristics and Quality of Autism Websites

ERIC Educational Resources Information Center

Reichow, Brian; Halpern, Jason I.; Steinhoff, Timothy B.; Letsinger, Nicole; Naples, Adam; Volkmar, Fred R.

2012-01-01

The World Wide Web is a common method for obtaining information on autism spectrum disorders, however, there are no guidelines for finding websites with high quality. We conducted two studies examining the characteristics and/or quality of autism websites in 2009 and 2010. We found websites with a .gov top-level domain had a statistically…

The Land of Confusion? High School Students and Their Use of the World Wide Web for Research.

ERIC Educational Resources Information Center

Lorenzen, Michael

2002-01-01

Examines high school students' use of the World Wide Web to complete assignments. Findings showed the students used a good variety of resources, including libraries and the World Wide Web, to find information for assignments. However, students were weak at determining the quality of the information found on web sites. Students did poorly at…

The Neuropeptide Oxytocin Enhances Information Sharing and Group Decision Making Quality.

PubMed

De Wilde, Tim R W; Ten Velden, Femke S; De Dreu, Carsten K W

2017-01-11

Groups can make better decisions than individuals when members cooperatively exchange and integrate their uniquely held information and insights. However, under conformity pressures group members are biased towards exchanging commonly known information, and away from exchanging unique information, thus undermining group decision-making quality. At the neurobiological level, conformity associates with the neuropeptide oxytocin. A double-blind placebo controlled study found no evidence for oxytocin induced conformity. Compared to placebo groups, three-person groups whose members received intranasal oxytocin, focused more on unique information (i) and repeated this information more often (ii). These findings reveal oxytocin as a neurobiological driver of group decision-making processes.

The Neuropeptide Oxytocin Enhances Information Sharing and Group Decision Making Quality

PubMed Central

De Wilde, Tim R. W.; Ten Velden, Femke S.; De Dreu, Carsten K. W.

2017-01-01

Groups can make better decisions than individuals when members cooperatively exchange and integrate their uniquely held information and insights. However, under conformity pressures group members are biased towards exchanging commonly known information, and away from exchanging unique information, thus undermining group decision-making quality. At the neurobiological level, conformity associates with the neuropeptide oxytocin. A double-blind placebo controlled study found no evidence for oxytocin induced conformity. Compared to placebo groups, three-person groups whose members received intranasal oxytocin, focused more on unique information (i) and repeated this information more often (ii). These findings reveal oxytocin as a neurobiological driver of group decision-making processes. PMID:28074896

Burn Wise - What You Can Do

EPA Pesticide Factsheets

Within this site you will find information for consumers to make informed decisions about what it means to burn wise. State & local agencies learn to improve air quality in their communities through changeout programs and education.

Competition and disclosure incentives: an empirical study of HMOs.

PubMed

Jin, Ginger Zhe

2005-01-01

I examine Health Maintenance Organizations' (HMOs) voluntary disclosure of product quality, which is not as complete as unraveling theories predict. After controlling for cost and demand factors, I find that HMOs use voluntary disclosure to differentiate from competitors, with lower disclosure rates in highly competitive markets. These findings are consistent with product differentiation, but challenge the intuition that competition should lead to more provision of quality information.

Water quality in the Albemarle-Pamlico drainage basin, North Carolina and Virginia, 1992-95

USGS Publications Warehouse

Spruill, Timothy B.; Harned, Douglas A.; Ruhl, Peter M.; Eimers, Jo Leslie; McMahon, Gerard; Smith, Kelly E.; Galeone, David R.; Woodside, Michael D.

1998-01-01

The NAWQA Program is assessing the water-quality conditions of more than 50 of the Nation's largest river basins and aquifers, known as Study Units. Collectively, these Study Units cover about one-half of the United States and include sources of drinking water used by about 70 percent of the U.S. population. Comprehensive assessments of about one-third of the Study Units are ongoing at a given time. Each Study Unit is scheduled to be revisited every decade to evaluate changes in water-quality conditions. NAWQA assessments rely heavily on existing information collected by the USGS and many other agencies as well as the use of nationally consistent study designs and methods of sampling and analysis. Such consistency simultaneously provides information about the status and trends in water-quality conditions in a particular stream or aquifer and, more importantly, provides the basis to make comparisons among watersheds and improve our understanding of the factors that affect water-quality conditions regionally and nationally. This report is intended to summarize major findings that emerged between 1992 and 1995 from the water-quality assessment of the Albemarle-Pamlico Drainage Study Unit and to relate these findings to water-quality issues of regional and national concern. The information is primarily intended for those who are involved in water-resource management. Indeed, this report addresses many of the concerns raised by regulators, water-utility managers, industry representatives, and other scientists, engineers, public officials, and members of stakeholder groups who provided advice and input to the USGS during this NAWQA Study-Unit investigation. Yet, the information contained here may also interest those who simply wish to know more about the quality of water in the rivers and aquifers in the area where they live.

A primer on evaluation and use of natural resource information for corporate data bases

Treesearch

H. Gyde Lund; Charles E. Thomas; Robert G. Bailey; James E. Brickell; William H. Clerke; Robert S. Cunningham; Raymond L. Czaplewski; Susan J. DeLost; Fran Evanisko; Harold R. Greenlee; Paul Howard; Randy Moore; Jerry F. Ragus; Brian M. Spears; Wayne Valentine

1995-01-01

This primer provides resource inventory specialists with information on how to evaluate existing natural resource information and how to use it in preparing new resource inventortes. Subjects covered indude determining information needs, finding existing lnformation, determining its utility, evaluating Its suitability and quality, and incorporating It into new...

Top management leadership style and quality of care in nursing homes.

PubMed

Castle, Nicholas G; Decker, Frederic H

2011-10-01

The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style assessment came from primary data collected from approximately 4,000 NHAs and DONs that was linked to quality information (i.e., Nursing Home Compare Quality Measures and 5-Star rating scores) and nursing home information (i.e., Online Survey, Certification, And Reporting data). A consensus manager leadership style has a strong association with better quality. Top managers using this style solicit and act upon input from their employees. For NHAs exhibiting this leadership style, the coefficients on 5 of the 7 quality indicators are statistically significant, and all 7 are significant when the DON exhibits this style. When the NHA and DON both have a consensus manager leadership style, 6 of the 7 quality indicator coefficients are significantly associated with better quality. The findings indicate that NHA and DON leadership style is associated with quality of care. Leadership strategies are amenable to change; thus, the findings of this study may be used to develop policies for promoting more effective leadership in nursing homes.

Baselining current road weather information : final report

DOT National Transportation Integrated Search

2009-06-10

This final report contains research findings on the characterization of the quality and value of road weather information resources used by members of the surface transportation community in their decision-making process. The objectives of the projec...

Information presentation features and comprehensibility of hospital report cards: design analysis and online survey among users.

PubMed

Sander, Uwe; Emmert, Martin; Dickel, Jochen; Meszmer, Nina; Kolb, Benjamin

2015-03-16

Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented. We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature. The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents' hospital choices were associated with particular information design elements. Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data ("N/A" as a value). When investigating the RAMR in a sample of 10 hospitals' report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature. To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a "good quality" range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.

An evaluation of the content and quality of tinnitus information on websites preferred by General Practitioners

PubMed Central

2012-01-01

Background Tinnitus is a prevalent and complex medical complaint often co-morbid with stress, anxiety, insomnia, depression, and cognitive or communication difficulties. Its chronicity places a major burden on primary and secondary healthcare services. In our recent national survey of General Practitioners (GPs) from across England, many reported that their awareness of tinnitus was limited and as a result were dissatisfied with the service they currently provide. GPs identified 10 online sources of information they currently use in clinical practice, but welcomed further concise and accurate information on tinnitus assessment and management. The purpose of this study was to assess the content, reliability, and quality of the information related to primary care tinnitus assessment and management on these 10 websites. Methods Tinnitus related content on each website was assessed using a summative content analysis approach. Reliability and quality of the information was assessed using the DISCERN questionnaire. Results Quality of information was rated using the validated DISCERN questionnaire. Significant inter-rater reliability was confirmed by Kendall’s coefficient of concordance (Wt) which ranged from 0.48 to 0.92 across websites. The website Map of Medicine achieved the highest overall DISCERN score. However, for information on treatment choice, the British Tinnitus Association was rated best. Content analysis revealed that all websites lacked a number of details relating to either tinnitus assessment or management options. Conclusions No single website provides comprehensive information for GPs on tinnitus assessment and management and so GPs may need to refer to more than one if they want to maximise their coverage of the topic. From those preferred by GPs we recommend several specific websites as the current ‘best’ sources. Our findings should guide healthcare website providers to improve the quality and inclusiveness of the information they publish on tinnitus. In the case of one website, our preliminary findings are already doing so. Such developments will in turn help facilitate best practice in primary care. PMID:22788751

An evaluation of the content and quality of tinnitus information on websites preferred by General Practitioners.

PubMed

Fackrell, Kathryn; Hoare, Derek J; Smith, Sandra; McCormack, Abby; Hall, Deborah A

2012-07-12

Tinnitus is a prevalent and complex medical complaint often co-morbid with stress, anxiety, insomnia, depression, and cognitive or communication difficulties. Its chronicity places a major burden on primary and secondary healthcare services. In our recent national survey of General Practitioners (GPs) from across England, many reported that their awareness of tinnitus was limited and as a result were dissatisfied with the service they currently provide. GPs identified 10 online sources of information they currently use in clinical practice, but welcomed further concise and accurate information on tinnitus assessment and management. The purpose of this study was to assess the content, reliability, and quality of the information related to primary care tinnitus assessment and management on these 10 websites. Tinnitus related content on each website was assessed using a summative content analysis approach. Reliability and quality of the information was assessed using the DISCERN questionnaire. Quality of information was rated using the validated DISCERN questionnaire. Significant inter-rater reliability was confirmed by Kendall's coefficient of concordance (Wt) which ranged from 0.48 to 0.92 across websites. The website Map of Medicine achieved the highest overall DISCERN score. However, for information on treatment choice, the British Tinnitus Association was rated best. Content analysis revealed that all websites lacked a number of details relating to either tinnitus assessment or management options. No single website provides comprehensive information for GPs on tinnitus assessment and management and so GPs may need to refer to more than one if they want to maximise their coverage of the topic. From those preferred by GPs we recommend several specific websites as the current 'best' sources. Our findings should guide healthcare website providers to improve the quality and inclusiveness of the information they publish on tinnitus. In the case of one website, our preliminary findings are already doing so. Such developments will in turn help facilitate best practice in primary care.

Quality of online information on type 2 diabetes: a cross-sectional study.

PubMed

Weymann, Nina; Härter, Martin; Dirmaier, Jörg

2015-12-01

Evidence-based health information is a prerequisite for patients with type 2 diabetes to engage in self-management and to make informed medical decisions. The Internet is an important source of health information. In the present study, we systematically assessed formal quality, quality of decision support and usability of German and English language websites on type 2 diabetes. The search term 'type 2 diabetes' was entered in the two most popular search engines. Descriptive data on website quality are presented. Additionally, associations between website quality and affiliation (commercial vs. non-commercial), presence of the HON code quality seal and website traffic were explored. Forty-six websites were included. Most websites provided basic information necessary for decision-making, while only one website also provided decision support. Websites with a HON code had significantly better formal quality than websites without HON code. We found a highly significant correlation between usability and website traffic and a significant correlation between formal quality and website traffic. Most websites do not provide sufficient information to support patients in medical decision-making. Our finding that usability and website traffic are tightly associated is consistent with previous research indicating that design is the most important cue for users assessing website credibility. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Effect of Publicized Quality Information on Home Health Agency Choice.

PubMed

Jung, Jeah Kyoungrae; Wu, Bingxiao; Kim, Hyunjee; Polsky, Daniel

2016-12-01

We examine consumers' use of publicized quality information in Medicare home health care markets, where consumer cost sharing and travel costs are absent. We report two findings. First, agencies with high quality scores are more likely to be preferred by consumers after the introduction of a public reporting program than before. Second, consumers' use of publicized quality information differs by patient group. Community-based patients have slightly larger responses to public reporting than hospital-discharged patients. Patients with functional limitations at the start of their care, at least among hospital-discharged patients, have a larger response to the reported functional outcome measure than those without functional limitations. In all cases of significant marginal effects, magnitudes are small. We conclude that the current public reporting approach is unlikely to have critical impacts on home health agency choice. Identifying and releasing quality information that is meaningful to consumers may help increase consumers' use of public reports. © The Author(s) 2015.

Assuring Integrity of Information Utility in Cyber-Learning Formats.

ERIC Educational Resources Information Center

Morrison, James L.; Stein, Linda L.

1999-01-01

Describes a cyber-learning project for the World Wide Web developed by faculty and librarians at the University of Delaware that combined discovery learning with problem-based learning to develop critical thinking and quality management for information. Undergraduates were to find, evaluate, and use information to generate an Internet marketing…

Water Quality in the Great Salt Lake Basins, Utah, Idaho, and Wyoming, 1998-2001

USGS Publications Warehouse

Waddell, Kidd M.; Gerner, Steven J.; Thiros, Susan A.; Giddings, Elise M.; Baskin, Robert L.; Cederberg, Jay R.; Albano, Christine M.

2004-01-01

This report contains the major findings of a 1998-2001 assessment of water quality in the Great Salt Lake Basins. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to water quality in other areas across the Nation. The water-quality conditions in the Great Salt Lake Basins summarized in this report are discussed in detail in other reports that can be accessed at http://ut.water.usgs.gov. Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to reports in this series from other basins can be accessed at the national NAWQA Web site http://water.usgs.gov/nawqa.

Water Quality in the Cook Inlet Basin Alaska, 1998-2001

USGS Publications Warehouse

Glass, Roy L.; Brabets, Timothy P.; Frenzel, Steven A.; Whitman, Matthew S.; Ourso, Robert T.

2004-01-01

This report contains the major findings of a 1998?2001 assessment of water quality in the Cook Inlet Basin. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies; universities; public interest groups; or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the Cook Inlet Basin summarized in this report are discussed in detail in other reports that can be accessed at http://ak.water.usgs.gov. Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report, in addition to reports in this series from other basins, can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water Quality on the Island of Oahu, Hawaii, 1999-2001

USGS Publications Warehouse

Anthony, Stephen S.; Hunt, Charles D.; Brasher, Anne M.D.; Miller, Lisa D.; Tomlinson, Michael S.

2004-01-01

This report contains the major findings of a 1999-2001 assessment of water quality on the island of Oahu, Hawaii. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions on Oahu summarized in this report are discussed in detail in other reports that can be accessed from (http://hi.water.usgs.gov/nawqa). Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to reports in this series from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water Quality in the Upper Illinois River Basin Illinois, Indiana, and Wisconsin, 1999-2001

USGS Publications Warehouse

Groschen, George E.; Arnold, Terri L.; Harris, Mitchell A.; Dupre, David H.; Fitzpatrick, Faith A.; Scudder, Barbara C.; Morrow, William S.; Terrio, Paul J.; Warner, Kelly L.; Murphy, Elizabeth A.

2004-01-01

This report contains the major findings of a 1999?2001 assessment of water quality in the upper Illinois River Basin. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public-interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report also is for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the upper Illinois River Basin summarized in this report are discussed in detail in other reports that can be accessed from (http://il.water.usgs.gov/nawqa/uirb). Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to reports in this series from other basins can be accessed from the national NAWQA Web site at (http://water.usgs.gov/nawqa).

Water Quality in the Delmarva Peninsula, Delaware, Maryland, and Virginia, 1999-2001

USGS Publications Warehouse

Denver, Judith M.; Ator, Scott W.; Debrewer, Linda M.; Ferrari, Matthew J.; Barbaro, Jeffrey R.; Hancock, Tracy C.; Brayton, Michael J.; Nardi, Mark R.

2004-01-01

This report contains the major findings of a 1999-2001 assessment of water quality in the Delmarva Peninsula. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is assessed at many scales?from local ground-water flow paths to regional ground-water networks and in surface water?and is discussed in terms of local, State, and regional issues. Conditions in the Delmarva Peninsula are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies; universities; public interest groups; or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to the quality of water in other areas across the Nation. Other products describing water-quality conditions in the Delmarva Peninsula are available. Detailed technical information, data and analyses, methodology, models, graphs, and maps that support the findings presented in this report can be accessed from http://md.water.usgs.gov/delmarva. Other reports in this series and data collected from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water quality in the Northern Rockies Intermontane basins, Idaho, Montana, and Washington, 1999-2001

USGS Publications Warehouse

Clark, Gregory M.; Caldwell, Rodney R.; Maret, Terry R.; Bowers, Craig L.; Dutton, DeAnn M.; Becksmith, Michael A.

2003-01-01

This report contains the major findings of a 1999–2001 assessment of water quality in the Northern Rockies Intermontane Basins. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the Northern Rockies Intermontane Basins summarized in this report are discussed in detail in other reports that can be accessed from (http://id.water.usgs.gov/nrok/index.html). Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to reports in this series from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water Quality in the Delaware River Basin, Pennsylvania, New Jersey, New York, and Delaware, 1998-2001

USGS Publications Warehouse

Fischer, Jeffrey M.; Riva-Murray, Karen; Hickman, R. Edward; Chichester, Douglas C.; Brightbill, Robin A.; Romanok, Kristin M.; Bilger, Michael D.

2004-01-01

This report contains the major findings of a 1998-2001 assessment of water quality in the Delaware River Basin. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the Delaware River Basin summarized in this report are discussed in detail in other reports that can be accessed from http://nj.water.usgs.gov/nawqa/delr/. Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report, in addition to reports in this series from other basins, can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water quality in the Yellowstone River Basin, Wyoming, Montana, and North Dakota, 1999-2001

USGS Publications Warehouse

Peterson, David A.; Bartos, Timothy T.; Clark, Melanie L.; Miller, Kirk A.; Porter, Stephen D.; Quinn, Thomas L.

2004-01-01

This report contains the major findings of a 1999?2001 assessment of water quality in the Yellowstone River Basin. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report also is for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the Yellowstone River Basin summarized in this report are discussed in detail in other reports that can be accessed from http://wy.water.usgs.gov/YELL/index.htm. Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report, in addition to reports in this series from other basins, can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Rare Diseases on the Internet: An Assessment of the Quality of Online Information.

PubMed

Pauer, Frédéric; Litzkendorf, Svenja; Göbel, Jens; Storf, Holger; Zeidler, Jan; Graf von der Schulenburg, Johann-Matthias

2017-01-18

The importance of the Internet as a medium for publishing and sharing health and medical information has increased considerably during the last decade. Nonetheless, comprehensive knowledge and information are scarce and difficult to find, especially for rare diseases. Additionally, the quality of health or medical information about rare diseases is frequently difficult to assess for the patients and their family members. The aim of this study is to assess the quality of information on the Internet about rare diseases. Additionally, the study aims to evaluate if the quality of information on rare diseases varies between different information supplier categories. A total of 13 quality criteria for websites providing medical information about rare diseases were transferred to a self-disclosure questionnaire. Identified providers of information on the Internet about rare diseases were invited to fill out the questionnaire. The questionnaire contained questions about the information provider in general (eg, supplier category, information category, language, use of quality certificates, and target group) and about quality aspects that reflect the 13 quality criteria. Differences in subgroup analyses were performed using t tests. We identified 693 websites containing information about rare diseases. A total of 123 questionnaires (17.7%) were completely filled out by the information suppliers. For the remaining identified suppliers (570/693, 82.3%), the questionnaires were filled out by the authors based on the information available on their website. In many cases, the quality of websites was proportionally low. Furthermore, subgroup analysis showed no statistically significant differences between the quality of information provided by support group/patient organization compared to medical institution (P=.19). The quality of information by individuals (patient/relative) was significantly lower compared to information provided by support group/patient organization (P=.001), medical institution (P=.009), and other associations and sponsoring bodies (P=.001) as well. Overall, the quality of information on the Internet about rare diseases is low. Quality certificates are rarely used and important quality criteria are often not fulfilled completely. Additionally, some information categories are underrepresented (eg, information about psychosocial counseling, social-legal advice, and family planning). Nevertheless, due to the high amount of information provided by support groups, this study shows that these are extremely valuable sources of information for patients suffering from a rare disease and their relatives. ©Frédéric Pauer, Svenja Litzkendorf, Jens Göbel, Holger Storf, Jan Zeidler, Johann-Matthias Graf von der Schulenburg. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.01.2017.

A COMPARISON OF PATIENT AND HEALTHCARE PROFESSIONAL VIEWS WHEN ASSESSING QUALITY OF INFORMATION ON PITUITARY ADENOMA AVAILABLE ON THE INTERNET.

PubMed

Druce, Irena; Williams, Chantal; Baggoo, Carolyn; Keely, Erin; Malcolm, Janine

2017-10-01

Patients are increasingly turning to the internet to seek reliable sources of health information and desire guidance in assessing the quality of information as healthcare becomes progressively more complex. Pituitary adenomas are a rare, diverse group of tumors associated with increased mortality and morbidity whose management requires a multidisciplinary approach. As such, patients with this disorder are often searching for additional sources of healthcare information. We undertook a study to assess the quality of information available on the internet for patients with pituitary adenoma. After exclusion, 42 websites were identified based on a search engine query with various search terms. Each website was assessed in triplicate: once by a health professional, once by a simulated patient, and once by a patient who had a pituitary adenoma and underwent medical and surgical treatment. The assessment tools included a content-specific questionnaire, the DISCERN tool, and the Ensuring Quality Information for Patients tool. The readability of the information was assessed with the Flesch-Kincaid grade level. We found that the overall quality of information on pituitary adenoma on the internet was variable and written at a high grade level. Correlation between the different assessors was poor, indicating that there may be differences in how healthcare professionals and patients view healthcare information. Our findings highlight the importance of assessment of the health information by groups of the intended user to ensure the needs of that population are met. Abbreviation: EQIP = Ensuring Quality Information for Patients.

An Exploration of Search Patterns and Credibility Issues among Older Adults Seeking Online Health Information

ERIC Educational Resources Information Center

Robertson-Lang, Laura; Major, Sonya; Hemming, Heather

2011-01-01

The Internet is an important resource for health information, among younger and older people alike. Unfortunately, there are limitations associated with online health information. Research is needed on the quality of information found online and on whether users are being critical consumers of the information they find. Also, there is a need for…

What do Canadian seniors say supports their quality of life? Findings from a national participatory research study.

PubMed

Bryant, Toba; Brown, Ivan; Cogan, Tara; Dallaire, Clemence; Laforest, Sophie; McGowan, Patrick; Raphael, Dennis; Richard, Lucie; Thompson, Loraine; Young, Joyce

2004-01-01

A national project investigated seniors' perceptions of the influences upon their quality of life. The seven participating cities were Montreal, Quebec City, Ottawa, Toronto, Regina, Vancouver and Whitehorse. The project focussed on policy decisions affecting the quality of life of seniors. It was a participatory study in which seniors controlled the direction and shape of the project in each city. Focus groups and individual interviews with seniors and stakeholders. Data analysis used qualitative methods to see the world through the eyes of participants. Each project was committed to hearing the voices of seniors and their views on which issues were affecting the quality of their lives. Across the seven cities, seniors highlighted access to information, health care, housing, income security, safety and security, social contacts and networks, and transportation as key issues that affect the quality of life of seniors in Canada. The findings affirm the value of participatory activities that involve seniors working with other sectors as a productive policy-informing approach. The Seniors' Quality of Life projects demonstrate the conceptual power of the determinants of health perspective to understand seniors' quality of life issues. While seniors considered health care to be a continuing concern, they also recognized socio-economic issues as significantly affecting the quality of their lives.

How consumers evaluate health care quality: Part II.

PubMed

Moore, S T; Bopp, K D

1999-01-01

This article is the second in a series which examines the way in which consumers assess information regarding the quality of health care services. In the previous article it was demonstrated that, in the view of health care consumers, three major perceptions held by health care consumers, are: (1) substantial differences in quality exist among health care providers, (2) little information is available that allows for the comparison of health care providers on issues related to quality, and (3) when such information is available it is found to be useful and often serves as the basis for decision regarding the choice of health care providers. We further discussed the short coming of marketing strategies based on complex quality indicators and the difficulties of image advertising in an age of institutional mistrust. The reader is reminded that these findings relate to the subjective assessments of consumers, not to objective facts concerning health care delivery.

An Evaluation Quality Framework for Analysing School-Based Learning (SBL) to Work-Based Learning (WBL) Transition Module

NASA Astrophysics Data System (ADS)

Alseddiqi, M.; Mishra, R.; Pislaru, C.

2012-05-01

The paper presents the results from a quality framework to measure the effectiveness of a new engineering course entitled 'school-based learning (SBL) to work-based learning (WBL) transition module' in the Technical and Vocational Education (TVE) system in Bahrain. The framework is an extended version of existing information quality frameworks with respect to pedagogical and technological contexts. It incorporates specific pedagogical and technological dimensions as per the Bahrain modern industry requirements. Users' views questionnaire on the effectiveness of the new transition module was distributed to various stakeholders including TVE teachers and students. The aim was to receive critical information in diagnosing, monitoring and evaluating different views and perceptions about the effectiveness of the new module. The analysis categorised the quality dimensions by their relative importance. This was carried out using the principal component analysis available in SPSS. The analysis clearly identified the most important quality dimensions integrated in the new module for SBL-to-WBL transition. It was also apparent that the new module contains workplace proficiencies, prepares TVE students for work placement, provides effective teaching and learning methodologies, integrates innovative technology in the process of learning, meets modern industrial needs, and presents a cooperative learning environment for TVE students. From the principal component analysis finding, to calculate the percentage of relative importance of each factor and its quality dimensions, was significant. The percentage comparison would justify the most important factor as well as the most important quality dimensions. Also, the new, re-arranged quality dimensions from the finding with an extended number of factors tended to improve the extended version of the quality information framework to a revised quality framework.

YouTube provides irrelevant information for the diagnosis and treatment of hip arthritis.

PubMed

Koller, Ulrich; Waldstein, Wenzel; Schatz, Klaus-Dieter; Windhager, Reinhard

2016-10-01

YouTube is increasingly becoming a key source for people to satisfy the need for additional information concerning their medical condition. This study analyses the completeness of accurate information found on YouTube pertaining to hip arthritis. The present study analyzed 133 YouTube videos using the search terms: hip arthritis, hip arthritis symptoms, hip arthritis diagnosis, hip arthritis treatment and hip replacement. Two quality assessment checklists with a scale of 0 to 12 points were developed to evaluate available video content for the diagnosis and the treatment of hip arthritis. Videos were grouped into poor quality (grade 0-3), moderate quality (grade 4-7) and excellent quality (grade 8-12), respectively. Three independent observers assessed all videos using the new grading system and independently scored all videos. Discrepancies regarding the categories were clarified by consensus discussion. For intra-observer reliabilities, grading was performed at two occasions separated by four weeks. Eighty-four percent (n = 112) had a poor diagnostic information quality, 14% (n = 19) a moderate quality and only 2% (n = 2) an excellent quality, respectively. In 86% (n = 114), videos provided poor treatment information quality. Eleven percent (n = 15) of videos had a moderate quality and only 3% (n = 4) an excellent quality, respectively. The present study demonstrates that YouTube is a poor source for accurate information pertaining to the diagnosis and treatment of hip arthritis. These finding are of high relevance for clinicians as videos are going to become the primary source of information for patients. Therefore, high quality educational videos are needed to further guide patients on the way from the diagnosis of hip arthritis to its proper treatment.

Improving the Quality of University Libraries through Citation Mining and Analysis Using Two New Dissertation Bibliometric Assessment Tools

ERIC Educational Resources Information Center

Tunon, Johanna; Brydges, Bruce

2005-01-01

University libraries are becoming increasingly aware of the need to assess the quality of students' information literacy and library research skills and to use this assessment data to effectively improve the quality of university library services to graduate programs. However, libraries have had difficulties finding ways to accomplish this both…

The impact of child's severity on quality-of-life among parents of children with autism spectrum disorder: the mediating role of optimism.

PubMed

Wisessathorn, Manika; Chanuantong, Tanasugarn; Fisher, Edwin B

2013-10-01

Investigate the impact of child severity and optimism on quality-of-life in parents of children with Autism Spectrum Disorder (ASD). Additionally, the role of optimism as mediator between child's severity and parental quality-of-life was also evaluated Three hundred three parents of children with ASD were recruited from the local autistic centers and schools in Bangkok, Thailand. A set of demographic information sheet, the Childhood Autism Rating Scale (CARS), the Life Oriented Test-Revised (LOT-R), and the WHOQOL-BREF test were submitted for collecting parental information. Using Pearson Correlation, a significant negative association was found between child's severity and parental quality-of-life while optimism was found to correlate positively with parental outcomes. The finding from path-analysis confirmed that impairment of language and repetitive behavior of an ASD child associated with optimism that, in turn, predicted level of parental quality-of-life in all domains. The current findings assured a role of optimism as mediator between child's severity and parental quality-of-life. Implications for the development of intervention focused on enhancing parent's optimism were recommended.

Replicating a survey of pressure ulcer content in nursing textbooks.

PubMed

Ayello, Elizabeth A; Meaney, Geraldine

2003-09-01

Nurses enter the profession with knowledge about pressure ulcer prevention and care and acquired from their basic educational programs. A prior review of nursing textbooks regarding pressure ulcer content published almost a decade ago revealed that incomplete, inaccurate, and at times limited information (as few as 200 lines of text) was contained in 10 commonly used textbooks. A review of the updated editions of the textbooks revealed a wide variation in the number of lines of text devoted to pressure ulcers, depth and quality of information, and the number of illustrations and tables. New findings were the inclusion of cultural concepts and research studies. These findings suggest an improvement in the amount and quality of pressure ulcer information in the majority of nursing textbooks surveyed. Recommendations for future textbook chapters on pressure ulcers are provided.

Fact Sheets and Additional information Regarding the 2012 Particulate Matter (PM) National Ambient Air Quality Standards (NAAQS)

EPA Pesticide Factsheets

Find tools for particulate matter, maps of nonattainment areas, an overview of the proposal, and information on designations, monitoring and permitting requirements and a presentation on the 2012 PM NAAQS revision.

Water Quality in the Yakima River Basin, Washington, 1999-2000

USGS Publications Warehouse

Fuhrer, Gregory J.; Morace, Jennifer L.; Johnson, Henry M.; Rinella, Joseph F.; Ebbert, James C.; Embrey, Sandra S.; Waite, Ian R.; Carpenter, Kurt D.; Wise, Daniel R.; Hughes, Curt A.

2004-01-01

This report contains the major findings of a 1999?2000 assessment of water quality in streams and drains in the Yakima River Basin. It is one of a series of reports by the NAWQA Program that present major findings on water resources in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is assessed at many scales?from large rivers that drain lands having many uses to small agricultural watersheds?and is discussed in terms of local, State, and regional issues. Conditions in the Yakima River Basin are compared to those found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, Tribal, State, or local agencies; universities; public interest groups; or the private sector. The information will be useful in addressing a number of current issues, such as source-water protection, pesticide registration, human health, drinking water, hypoxia and excessive growth of algae and plants, the effects of agricultural land use on water quality, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of water resources in areas near where they live, and how that water quality compares to the quality of water in other areas across the Nation. Other products describing water-quality conditions in the Yakima River Basin are available. Detailed technical information, data and analyses, methodology, and maps that support the findings presented in this report can be accessed from http://or.water.usgs.gov/yakima. Other reports in this series and data collected from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water Quality in the Santa Ana Basin, California, 1999-2001

USGS Publications Warehouse

Belitz, Kenneth; Hamlin, Scott N.; Burton, Carmen A.; Kent, Robert; Fay, Ronald G.; Johnson, Tyler D.

2004-01-01

This report contains the major findings of a 1999-2001 assessment of water quality in the Santa Ana River Basin. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live and how that water quality compares to other areas across the Nation. The water-quality conditions in the Santa Ana River Basin summarized in this report are discussed in detail in other reports that can be accessed from http://ca.water.usgs.gov/ sana_nawqa/. Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to other reports in this series from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water Quality in the Acadian-Pontchartrain Drainages; Louisiana and Mississippi, 1999-2001

USGS Publications Warehouse

Demcheck, Dennis K.; Tollett, Roland W.; Mize, Scott V.; Skrobialowski, Stanley C.; Fendick, Robert B.; Swarzenski, Christopher M.; Porter, Stephen

2004-01-01

This report contains the major findings of a 1999?2001 assessment of water quality in the Acadian-Pontchartrain Drainages Study Unit. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report also is for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to other areas across the Nation. The water-quality conditions in the Acadian-Pontchartrain Drainages Study Unit summarized in this report are discussed in detail in other reports that can be accessed from (http://la.water.usgs.gov/nawqa/default.htm). Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to other reports in this series from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Most Americans Do Not Believe That There Is An Association Between Health Care Prices And Quality Of Care.

PubMed

Phillips, Kathryn A; Schleifer, David; Hagelskamp, Carolin

2016-04-01

Many organizations are developing health care price information tools for consumers. However, consumers may avoid low-price care if they perceive price to be associated with quality. We conducted a nationally representative survey to examine whether consumers perceive that price and quality are associated and whether the way in which questions are framed affects consumers' responses. Most Americans (58-71 percent, depending on question framing) did not think that price and quality are associated, but a substantial minority did perceive an association (21-24 percent) or were unsure whether there was one (8-16 percent). Responses to questions framed in terms of high price and high quality differed from responses to questions framed in terms of low price and low quality. People who had compared prices were more likely than those who had not compared prices to perceive that price and quality were associated. We explore implications of these findings, including how behavioral economics can inform approaches to helping consumers use price and quality information. Project HOPE—The People-to-People Health Foundation, Inc.

Most Americans Do Not Believe That There Is An Association Between Health Care Prices And Quality Of Care

PubMed Central

Phillips, Kathryn A; Schleifer, David; Hagelskamp, Carolin

2016-01-01

Many organizations are developing health care price information tools for consumers. However, consumers may avoid low-price care if they perceive price to be associated with quality. We conducted a nationally representative survey to examine whether consumers perceive that price and quality are associated and whether the way in which questions are framed affects consumers’ responses. Most Americans (58–71 percent, depending on question framing) did not think that price and quality are associated, but a substantial minority did perceive an association (21–24 percent) or were unsure if there was one (8–16 percent). Responses to questions framed in terms of high price and high quality differed from responses to questions framed in terms of low price and low quality. People who had compared prices were more likely than those who have not compared prices to perceive that price and quality were associated. We explore implications of these findings, including how behavioral economics can inform approaches to helping consumers use price and quality information. PMID:27044965

Water Quality in the High Plains Aquifer, Colorado, Kansas, Nebraska, New Mexico, Oklahoma, South Dakota, Texas, and Wyoming, 1999-2004

USGS Publications Warehouse

Gurdak, Jason J.; McMahon, Peter B.; Dennehy, Kevin; Qi, Sharon L.

2009-01-01

This report contains the major findings of a 1999-2004 assessment of water quality in the High Plains aquifer. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings for principal and other aquifers and major river basins across the Nation. In these reports, water quality is discussed in terms of local, regional, State, and national issues. Conditions in the aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or the private sector. The information will be useful in addressing a number of current issues, such as drinking-water quality, the effects of agricultural practices on water quality, source-water protection, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of ground water in areas near where they live and how that water quality compares to the quality of water in other areas across the region and the Nation. The water-quality conditions in the High Plains aquifer summarized in this report are discussed in greater detail in other reports that can be accessed in Appendix 1 of http://pubs.usgs.gov/pp/1749/. Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to reports in this series from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa). This report accompanies the detailed and technical report of water-quality conditions in the High Plains aquifer 'Water-quality assessment of the High Plains aquifer, 1999-2004' (http://pubs.usgs.gov/pp/1749/)

76 FR 43143 - Approval and Promulgation of Air Quality Implementation Plan; Kansas; Final Disapproval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

..., some information is not publicly available, i.e., Confidential Business Information (CBI) or other... business are Monday through Friday, 8 to 4:30, excluding Federal holidays. FOR FURTHER INFORMATION CONTACT... unfair disadvantage by not finding the submittal incomplete instead of issuing a proposed disapproval is...

Tourism guide cloud service quality: What actually delights customers?

PubMed

Lin, Shu-Ping; Yang, Chen-Lung; Pi, Han-Chung; Ho, Thao-Minh

2016-01-01

The emergence of advanced IT and cloud services has beneficially supported the information-intensive tourism industry, simultaneously caused extreme competitions in attracting customers through building efficient service platforms. On response, numerous nations have implemented cloud platforms to provide value-added sightseeing information and personal intelligent service experiences. Despite these efforts, customers' actual perspectives have yet been sufficiently understood. To bridge the gap, this study attempts to investigate what aspects of tourism cloud services actually delight customers' satisfaction and loyalty. 336 valid survey questionnaire answers were analyzed using structural equation modeling method. The results prove positive impacts of function quality, enjoyment, multiple visual aids, and information quality on customers' satisfaction as well as of enjoyment and satisfaction on use loyalty. The findings hope to provide helpful references of customer use behaviors for enhancing cloud service quality in order to achieve better organizational competitiveness.

Information transfer in auditoria and room-acoustical quality.

PubMed

Summers, Jason E

2013-04-01

It is hypothesized that room-acoustical quality correlates with the information-transfer rate. Auditoria are considered as multiple-input multiple-output communication channels and a theory of information-transfer is outlined that accounts for time-variant multipath, spatial hearing, and distributed directional sources. Source diversity and spatial hearing are shown to be the mechanisms through which multipath increases the information-transfer rate by overcoming finite spatial resolution. In addition to predictions that are confirmed by recent and historical findings, the theory provides explanations for the influence of factors such as musical repertoire and ensemble size on subjective preference and the influence of multisource, multichannel auralization on perceived realism.

Advances in Collaborative Evaluation

ERIC Educational Resources Information Center

Rodriguez-Campos, Liliana

2012-01-01

Collaborative evaluation is an approach that offers, among others, many advantages in terms of access to information, quality of information gathered, opportunities for creative problem-solving, and receptivity to findings. In the last decade, collaborative evaluation has grown in popularity along with similar participatory, empowerment, and…

A diagnostic expert system for structured reports, quality assessment, and training of residents in sonography.

PubMed

Huettig, Matthias; Buscher, Georg; Menzel, Thomas; Scheppach, Wolfgang; Puppe, Frank; Buscher, Hans-Peter

2004-03-15

The quality of medical reports on diagnostic procedures has a considerable impact on the quality of medical care. Handwritten or otherwise unstructured reports tend to be incomplete, whereas structured questionnaires are of limited flexibility and not considered case-adequate. Thus, medical reports of this kind may promote an incomplete and misleading documentation and, therefore, be problematic with respect to their reliability. SonoConsult (SC), an expert system for structured and case-adequate documentation of sonographic findings with an additional diagnostic component, was evaluated with respect to user acceptance and suitability for enhancing the quality of reports and supporting sonographic beginners. The expectations and the attitudes of the users toward the program were evaluated by anonymous questionnaires. The documentation of findings and the diagnostic conclusions in 103 free text reports made by experienced examiners were evaluated by subjecting their information to a subsequent input into SC. Free text reports were checked for information that was asked by SC but not mentioned in the reports. In a series of 150 cases, the system diagnoses were blinded during input of findings into SC-questionnaires and the examiners' diagnostic conclusions were compared with the uncovered SC-diagnoses with respect to forgotten diagnoses. The structured and data-driven acquisition of information by the program was well accepted by the users. However, only a medium interest in the system-delivered diagnoses was noted. The program-generated reports were characterized by a more detailed description of the findings and a higher number of diagnoses in comparison to the unstructured reports before introduction of SC as the only documentation system. When unaware of the system diagnoses, information was entered into the questionnaires, and SC generated some diagnoses which were not mentioned by the examiners in their conclusions. The possibility to inspect the system diagnoses led to an enhancement of the number of diagnoses the examiners mentioned in their conclusions. By contrast, the examiners meant that the influence of the program on their conclusions was minimal or dispensable. Beginners in sonography acknowledged that the program led them to perform a complete examination in an adequate sequence. An expert system for the data-driven, case-adequate information acquisition of abdominal ultrasound examinations may enhance the quality of the reports and, potentially, of the examinations at the same time. In addition, it may help beginners to learn a structured problem- and finding-adequate examination sequence.

Measuring the Quality of the Website User Experience

ERIC Educational Resources Information Center

Sauro, Jeff

2016-01-01

Consumers spend an increasing amount of time and money online finding information, completing tasks, or making purchases. The quality of the website experience has become a key differentiator for organizations--affecting whether they purchase and their likelihood to return and recommend a website to friends. Two instruments were created to more…

Business Professionals Workplace Message Quality Perceptions

ERIC Educational Resources Information Center

Roach, Joy L.; Anderson, Marcia A.

2007-01-01

In light of today's large amount of written workplace communication, this study attempted to reveal information regarding the quality in which business messages are encoded on the job. Data were gathered through a questionnaire administered to a sample of 1994-2004 MBA graduates of three AACSB-accredited programs. Findings suggest that business…

Using Web sites on quality health care for teaching consumers in public libraries.

PubMed

Oermann, Marilyn H; Lesley, Marsha L; VanderWal, Jillon S

2005-01-01

More and more consumers are searching the Internet for health information. Health Web sites vary in quality, though, and not all consumers are aware of the need to evaluate the information they find on the Web. Nurses and other health providers involved in patient education can evaluate Web sites and suggest quality sites for patients to use. This article describes a project we implemented in 2 public libraries to educate consumers about quality health care and patient safety using Web sites that we had evaluated earlier. Participants (n = 103) completed resources on health care quality, questions patients should ask about their diagnoses and treatment options, changes in Medicare and Medicare options or ways to make their health benefits work for them, and tips to help prevent medical errors. Most consumers were highly satisfied with the Web sites and the information they learned on quality care from these resources. Many participants did not have Internet access at home or work and instead used the library to search the Web. Information about the Web sites used in this project and other sites on quality care can be made available in libraries and community settings and as part of patient education resources in hospitals. The Web provides easy access for consumers to information about patient safety initiatives and health care quality in general.

Annual reports in the Pacific: transforming data into information and knowledge.

PubMed

Hodge, Nicola

2012-04-01

Annual Reports provide a wealth of raw data. However, they are often comprised of pages of complex tables with little interpretation or descriptive analysis provided, thus limiting their usefulness in monitoring and evaluating health patterns. This article provides an overview of research carried out as part of a Masters Dissertation, which was concerned with what Annual Reports from Pacific Island Countries can tell us about the quality of data being produced from Health Information Systems (HIS). Five dimensions of quality were selected for assessment (comparability, disaggregation, interpretability, presentation and timeliness), and methods of measurement developed accordingly. Findings from the research are two-fold. Firstly, reports are often excessively long, with a wide range of information on the entire Health System and include pages of dense tables with little critical analysis on implications for policy or decision-making. The second main finding relates to the concept of quality. Overall, the research found that the quality of data produced from HIS, as presented in Annual Reports, is poor. The wealth of data contained within Annual Reports deserve wider dissemination and use, and could play a crucial role in evidence-based decision making and the monitoring and evaluation of health systems and health outcomes. As such, four key recommendations are proposed: (1) comprehensive review of reporting practices; (2) development of quality assessment tools; (3) development of regional reporting templates; and (4) development of a minimum data set.

Importance-performance analysis as a guide for hospitals in improving their provision of services.

PubMed

Whynes, D K; Reed, G

1995-11-01

As a result of the 1990 National Health Services Act, hospitals now compete with one another to win service contracts. A high level of service quality represents an important ingredient of a successful competitive strategy, yet, in general, hospitals have little external information on which to base quality decisions. Specifically, in their efforts to win contracts from fundholding general practitioners, hospitals require information on that which these purchasers deem important with respect to quality, and on how these purchasers assess the quality of their current service performance. The problem is complicated by the fact that hospital service quality, in itself, is multi-dimensional. In other areas of economic activity, the information problem has been resolved by importance-performance analysis and this paper reports the findings of such an analysis conducted for hosptials in the Trent region. The importance and performance service quality ratings of fundholders were obtained from a questionnaire survey and used in a particular variant of importance-performance analysis, which possesses certain advantages over more conventional approaches. In addition to providing empirical data on the determinants of service quality, as perceived by the purchasers of hospital services, this paper demonstrates how such information can be successfully employed in a quality enhancement strategy.

Quality of Informal Care Is Multidimensional

PubMed Central

Christie, Juliette; Smith, G. Rush; Williamson, Gail M.; Lance, Charles. E.; Shovali, Tamar E.; Silva, Luciana

2010-01-01

Purpose To demonstrate that assessing quality of informal care involves more than merely determining whether care recipient needs for assistance with activities of daily living (ADLs) are satisfied on a routine basis. Potentially harmful behavior (PHB), adequate care, and exemplary care (EC) are conceptually distinct dimensions of quality of care. We investigated the extent to which these three dimensions also are empirically distinguishable. Design 237 care recipients completed the quality of care measures, and their caregivers completed psychosocial measures of depressed affect, life events, cognitive status, and perceived pre-illness relationship quality. Results Confirmatory factor analyses indicated that PHB, adequate care, and EC are empirically distinct factors. Although PHB was moderately related to EC, adequate care was not associated with PHB and was only slightly related to EC. Psychosocial variables were not related to adequate care but were differentially associated with PHB and EC, providing further evidence for the distinction between the measures of quality of care used in this study. Conclusions Assessing quality of informal care is a complex endeavor. ADL assistance can be adequate in the presence of PHB and/or the absence of EC. Declines in EC may signal increases in PHB, independent of adequacy of care. These findings produce a brief, portable, and more comprehensive instrument for assessing quality of informal care. PMID:19469607

Web page quality: can we measure it and what do we find? A report of exploratory findings.

PubMed

Abbott, V P

2000-06-01

The aim of this study was to report exploratory findings from an attempt to quantify the quality of a sample of World Wide Web (WWW) pages relating to MMR vaccine that a typical user might locate. Forty pages obtained from a search of the WWW using two search engines and the search expression 'mmr vaccine' were analysed using a standard proforma. The proforma looked at the information the pages contained in terms of three categories: content, authorship and aesthetics. The information from each category was then quantified into a summary statistic, and receiver operating characteristic (ROC) curves were generated using a 'gold standard' of quality derived from the published literature. Optimal cut-off points for each of the three sections were calculated that best discriminated 'good' from 'bad' pages. Pages were also assessed as to whether they were pro- or anti-vaccination. For this sample, the combined contents and authorship score, with a cut-off of five, was a good discriminator, having 88 per cent sensitivity and 92 per cent specificity. Aesthetics was not a good discriminator. In the sample, 32.5 per cent of pages were pro-vaccination; 42.5 per cent were anti-vaccination and 25 per cent were neutral. The relative risk of being of poor quality if anti-vaccination was 3.3 (95 per cent confidence interval 1.8, 6.1). The sample of Web pages did contain some quality information on MMR vaccine. It also contained a great deal of misleading, inaccurate data. The proforma, combined with a knowledge of the literature, may help to distinguish between the two.

Turning Data Into Information: Opportunities to Advance Rehabilitation Quality, Research, and Policy.

PubMed

Bettger, Janet Prvu; Nguyen, Vu Q C; Thomas, J George; Guerrier, Tami; Yang, Qing; Hirsch, Mark A; Pugh, Terrence; Harris, Gabrielle; Eller, Mary Ann; Pereira, Carol; Hamm, Deanna; Rinehardt, Eric A; Shall, Matthew; Niemeier, Janet P

2018-06-01

Attention to health care quality and safety has increased dramatically. The internal focus of an organization is not without influence from external policy and research findings. Compared with other specialties, efforts to align and advance rehabilitation research, practice, and policy using electronic health record data are in the early stages. This special communication defines quality, applies the dimensions of quality to rehabilitation, and illustrates the feasibility and utility of electronic health record data for research on rehabilitation care quality and outcomes. Using data generated at the point of care provides the greatest opportunity for improving the quality of health care, producing generalizable evidence to inform policy and practice, and ultimately benefiting the health of the populations served. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Autonomy and Privacy in Clinical Laboratory Science Policy and Practice.

PubMed

Leibach, Elizabeth Kenimer

2014-01-01

Rapid advancements in diagnostic technologies coupled with growth in testing options and choices mandate the development of evidence-based testing algorithms linked to the care paths of the major chronic diseases and health challenges encountered most frequently. As care paths are evaluated, patient/consumers become partners in healthcare delivery. Clinical laboratory scientists find themselves firmly embedded in both quality improvement and clinical research with an urgent need to translate clinical laboratory information into knowledge required by practitioners and patient/consumers alike. To implement this patient-centered care approach in clinical laboratory science, practitioners must understand their roles in (1) protecting patient/consumer autonomy in the healthcare informed consent process and (2) assuring patient/consumer privacy and confidentiality while blending quality improvement study findings with protected health information. A literature review, describing the current ethical environment, supports a consultative role for clinical laboratory scientists in the clinical decision-making process and suggests guidance for policy and practice regarding the principle of autonomy and its associated operational characteristics: informed consent and privacy.

Process quality of decision-making in multidisciplinary cancer team meetings: a structured observational study.

PubMed

Hahlweg, Pola; Didi, Sarah; Kriston, Levente; Härter, Martin; Nestoriuc, Yvonne; Scholl, Isabelle

2017-11-17

The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation. An adaptation of the observer rating scale Multidisciplinary Tumor Board Metric for the Observation of Decision-Making (MDT-MODe) was used to assess the quality of the presented information and team processes in MDTMs. Data was analyzed using descriptive statistics and mixed logistic regression analysis. N = 249 cases were observed in N = 29 MDTMs. While cancer-specific medical information was judged to be of high quality, psychosocial information and information regarding patient views were considered to be of low quality. In 25% of the cases no, in 64% one, and in 10% more than one treatment recommendations were given (1% missing data). Giving no treatment recommendation was associated with duration of case discussion, duration of the MDTM session, quality of case history, quality of radiological information, and specialization of the MDTM. Higher levels of medical and treatment uncertainty during discussions were found to be associated with a higher probability for more than one treatment recommendation. The quality of different aspects of information was observed to differ greatly. In general, we did not find MDTMs to be in line with the principles of patient-centered care. Recommendation outcome varied substantially between different specializations of MDTMs. The quality of certain information was associated with the recommendation outcome. Uncertainty during discussions was related to more than one recommendation being considered. Time constraints were found to play an important role. Some of those aspects seem modifiable, which offers possibilities for the reorganization of MDTMs.

Understanding and using quality information for quality improvement: The effect of information presentation.

PubMed

Zwijnenberg, Nicolien C; Hendriks, Michelle; Delnoij, Diana M J; de Veer, Anke J E; Spreeuwenberg, Peter; Wagner, Cordula

2016-12-01

To examine how information presentation affects the understanding and use of information for quality improvement. An experimental design, testing 22 formats, and showing information on patient safety culture. Formats differed in visualization, outcomes and benchmark information. Respondents viewed three randomly selected presentation formats in an online survey, completing several tasks per format. The hospital sector in the Netherlands. A volunteer sample of healthcare professionals, mainly nurses, working in hospitals. Main Outcome Measure(s): The degree to which information is understandable and usable (accurate choice for quality improvement, sense of urgency to change and appraisal of one's own performance). About 115 healthcare professionals participated (response rate 25%), resulting in 345 reviews. Information in tables (P = 0.007) and bar charts (P < 0.0001) was better understood than radars. Presenting outcomes on a 5-point scale (P < 0.001) or as '% positive responders' (P < 0.001) was better understood than '% negative responders'. Formats without benchmarks were better understood than formats with benchmarks. Use: Bar charts resulted in more accurate choices than tables (P = 0.003) and radars (P < 0.001). Outcomes on a 5-point scale resulted in more accurate choices than '% negative responders' (P = 0.007). Presenting '% positive responders' resulted in a higher sense of urgency to change than outcomes on a 5-point scale (P = 0.002). Benchmark information had inconsistent effects on the appraisal of one's own performances. Information presentation affects healthcare professionals' understanding and use of quality information. Our findings supplement the further understanding on how quality information can be best communicated to healthcare professionals for realizing quality improvements. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

A Survey of Information Source Preferences of Parents of Individuals with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Gibson, Amelia N.; Kaplan, Samantha; Vardell, Emily

2017-01-01

For parents of children with an Autism spectrum disorder (ASD), high quality, easily accessible information and a strong peer network can be the key to raising a happy, healthy child, and maintaining family well-being and emotional resilience. This article reports the findings of an anonymous survey examining the information source preferences for…

Preference vs. Authority: A Comparison of Student Searching in a Subject-Specific Indexing and Abstracting Database and a Customized Discovery Layer

ERIC Educational Resources Information Center

Dahlen, Sarah P. C.; Hanson, Kathlene

2017-01-01

Discovery layers provide a simplified interface for searching library resources. Libraries with limited finances make decisions about retaining indexing and abstracting databases when similar information is available in discovery layers. These decisions should be informed by student success at finding quality information as well as satisfaction…

Health Information Retrieval Tool (HIRT)

PubMed Central

Nyun, Mra Thinzar; Ogunyemi, Omolola; Zeng, Qing

2002-01-01

The World Wide Web (WWW) is a powerful way to deliver on-line health information, but one major problem limits its value to consumers: content is highly distributed, while relevant and high quality information is often difficult to find. To address this issue, we experimented with an approach that utilizes three-dimensional anatomic models in conjunction with free-text search.

Access for all? A survey of health librarians in the north-west of England on provision of information to patients.

PubMed

King, Colette; Hornby, Susan

2003-12-01

This study examined the role that health librarians could play in helping patients to find information. A questionnaire survey was sent out to 50 health librarians in the north-west of England. It examined the following: the type of library and users, access to information for patients, librarians' attitudes to provision of information to patients and their knowledge of other sources available to their users. Ninety-seven per cent of librarians said that they could recommend quality information sources to patients, but many suggested that there were practical problems in allowing patients to use health libraries due to lack of appropriate resources, facilities and funding. Advantages of health library involvement in patient information include having a local point of contact for patients and the ability of librarians to find, evaluate and organize good-quality resources. However, health library staff may not have enough time to answer enquiries from the public and may lack training in dealing with patients. Innovation, especially in developing on-line services, could offer a way to provide a service without overloading the physical requirements of a library. Librarians could also collaborate with other staff to improve patient information.

Implementation of emergency department transfer communication measures in Minnesota critical access hospitals.

PubMed

Klingner, Jill; Moscovice, Ira; Casey, Michelle; McEllistrem Evenson, Alex

2015-01-01

Previously published findings based on field tests indicated that emergency department patient transfer communication measures are feasible and worthwhile to implement in rural hospitals. This study aims to expand those findings by focusing on the wide-scale implementation of these measures in the 79 Critical Access Hospitals (CAHs) in Minnesota from 2011 to 2013. Information was obtained from interviews with key informants involved in implementing the emergency department patient transfer communication measures in Minnesota as part of required statewide quality reporting. The first set of interviews targeted state-level organizations regarding their experiences working with providers. A second set of interviews targeted quality and administrative staff from CAHs regarding their experiences implementing measures. Implementing the measures in Minnesota CAHs proved to be successful in a number of respects, but informants also faced new challenges. Our recommendations, addressed to those seeking to successfully implement these measures in other states, take these challenges into account. Field-testing new quality measure implementations with volunteers may not be indicative of a full-scale implementation that requires facilities to participate. The implementation team's composition, communication efforts, prior relationships with facilities and providers, and experience with data collection and abstraction tools are critical factors in successfully implementing required reporting of quality measures on a wide scale. © 2014 National Rural Health Association.

Pesticides in the Nation's Streams and Ground Water, 1992-2001

USGS Publications Warehouse

Gilliom, Robert J.; Barbash, Jack E.; Crawford, Charles G.; Hamilton, Pixie A.; Martin, Jeffrey D.; Nakagaki, Naomi; Nowell, Lisa H.; Scott, Jonathan C.; Stackelberg, Paul E.; Thelin, Gail P.; Wolock, David M.

2006-01-01

This report is one of a series of publications, The Quality of Our Nation's Waters, that describe major findings of the NAWQA Program on water-quality issues of regional and national concern. This report presents evaluations of pesticides in streams and ground water based on findings for the first decadal cycle of NAWQA. 'Pesticides in the Nation's Streams and Ground Water, 1992-2001' greatly expands the analysis of pesticides presented in 'Nutrients and Pesticides,' which was the first report in the series and was based on early results from 1992 to 1995. Other reports in this series cover additional water-quality constituents of concern, such as volatile organic compounds and trace elements, as well as physical and chemical effects on aquatic ecosystems. Each report builds toward a more comprehensive understanding of regional and national water resources. The information in this series is intended primarily for those interested or involved in resource management, conservation, regulation, and policymaking at regional and national levels. In addition, the information might interest those at a local level who wish to know more about the general quality of streams and ground water in areas near where they live and how that quality compares with other areas across the Nation.

Parents' and Providers' Views of Important Aspects of Child Care Quality. Publication #2015-13

ERIC Educational Resources Information Center

Sosinsky, Laura; Halle, Tamara; Susman-Stillman, Amy; Cleveland, Jennifer; Li, Weilin

2015-01-01

The Maryland-Minnesota Child Care Research Partnership brought together two states committed to examining critical issues in early care and education and using research findings to inform policy with an interdisciplinary team of researchers experienced in conducting studies on (1) subsidy policy; (2) quality improvement strategies; and (3)…

Is the Use of Information and Communication Technology Associated With Aspects of Women's Primary Health Care in Brazil?

PubMed

Matta-Machado, Antônio Thomaz Gonzaga; de Lima, Ângela Maria L Dayrell; de Abreu, Daisy Maria Xavier; Araújo, Lucas Lobato; Sobrinho, Délcio Fonseca; Silva Lopes, Érica Araújo; Teixeira, Gabriel Henrique Silva; Dos Santos, Alaneir de Fátima

The use of information and communication technology (ICT) is on the increase in the health systems, representing a means of improving the quality of health care. This study analyzed the ICT incorporation in primary care in Brazil and identified the different aspects that may be associated with better quality in the care provided, in relation to certain aspects of women's care. We noted an unevenness regarding ICT incorporation in Brazil. However, the findings indicate an association between ICT and certain aspects of the quality provided in women's health care, which reinforces the need for further studies on this type of evaluation.

An importance-performance analysis of hospital information system attributes: A nurses' perspective.

PubMed

Cohen, Jason F; Coleman, Emma; Kangethe, Matheri J

2016-02-01

Health workers have numerous concerns about hospital IS (HIS) usage. Addressing these concerns requires understanding the system attributes most important to their satisfaction and productivity. Following a recent HIS implementation, our objective was to identify priorities for managerial intervention based on user evaluations of the performance of the HIS attributes as well as the relative importance of these attributes to user satisfaction and productivity outcomes. We collected data along a set of attributes representing system quality, data quality, information quality, and service quality from 154 nurse users. Their quantitative responses were analysed using the partial least squares approach followed by an importance-performance analysis. Qualitative responses were analysed using thematic analysis to triangulate and supplement the quantitative findings. Two system quality attributes (responsiveness and ease of learning), one information quality attribute (detail), one service quality attribute (sufficient support), and three data quality attributes (records complete, accurate and never missing) were identified as high priorities for intervention. Our application of importance-performance analysis is unique in HIS evaluation and we have illustrated its utility for identifying those system attributes for which underperformance is not acceptable to users and therefore should be high priorities for intervention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

User testing and performance evaluation of the Electronic Quality Improvement Platform for Plans and Pharmacies.

PubMed

Pringle, Janice L; Kearney, Shannon M; Grasso, Kim; Boyer, Annette D; Conklin, Mark H; Szymanski, Keith A

2015-01-01

To user-test and evaluate a performance information management platform that makes standardized, benchmarked medication use quality data available to both health plans and community pharmacy organizations. Multiple health/drug plans and multiple chain and independent pharmacies across the United States. During the first phase of the study, user experience was measured via user satisfaction surveys and interviews with key personnel (pharmacists, pharmacy leaders, and health plan leadership). Improvements were subsequently made to the platform based on these findings. During the second phase of the study, the platform was implemented in a greater number of pharmacies and by a greater number of payers. User experience was then reevaluated to gather information for further improvements. The surveys and interviews revealed that users found the Web-based platform easy to use and beneficial in terms of understanding and comparing performance metrics. Primary concerns included lack of access to real-time data and patient-specific data. Many users also expressed uncertainty as to how they could use the information and data provided by the platform. The study findings indicate that while information management platforms can be used effectively in both pharmacy and health plan settings, future development is needed to ensure that the provided data can be transferred to pharmacy best practices and improved quality care.

The Impact of Internet Health Information on Patient Compliance: A Research Model and an Empirical Study.

PubMed

Laugesen, John; Hassanein, Khaled; Yuan, Yufei

2015-06-11

Patients have been increasingly seeking and using Internet health information to become more active in managing their own health in a partnership with their physicians. This trend has both positive and negative effects on the interactions between patients and their physicians. Therefore, it is important to understand the impact that the increasing use of Internet health information has on the patient-physician relationship and patients' compliance with their treatment regimens. This study examines the impact of patients' use of Internet health information on various elements that characterize the interactions between a patient and her/his physician through a theoretical model based on principal-agent theory and the information asymmetry perspective. A survey-based study consisting of 225 participants was used to validate a model through various statistical techniques. A full assessment of the measurement model and structural model was completed in addition to relevant post hoc analyses. This research revealed that both patient-physician concordance and perceived information asymmetry have significant effects on patient compliance, with patient-physician concordance exhibiting a considerably stronger relationship. Additionally, both physician quality and Internet health information quality have significant effects on patient-physician concordance, with physician quality exhibiting a much stronger relationship. Finally, only physician quality was found to have a significant impact on perceived information asymmetry, whereas Internet health information quality had no impact on perceived information asymmetry. Overall, this study found that physicians can relax regarding their fears concerning patient use of Internet health information because physician quality has the greatest impact on patients and their physician coming to an agreement on their medical situation and recommended treatment regimen as well as patient's compliance with their physician's advice when compared to the impact that Internet health information quality has on these same variables. The findings also indicate that agreement between the patient and physician on the medical situation and treatment is much more important to compliance than the perceived information gap between the patient and physician (ie, the physician having a higher level of information in comparison to the patient). In addition, the level of agreement between a patient and their physician regarding the medical situation is more reliant on the perceived quality of their physician than on the perceived quality of Internet health information used. This research found that only the perceived quality of the physician has a significant relationship with the perceived information gap between the patient and their physician and the quality of the Internet health information has no relationship with this perceived information gap.

Water quality in the Mobile River Basin, Alabama, Georgia, and Mississippi, and Tennessee, 1999-2001

USGS Publications Warehouse

Atkins, J. Brian; Zappia, Humbert; Robinson, James L.; McPherson, Ann K.; Moreland, Richard S.; Harned, Douglas A.; Johnston, Brett F.; Harvill, John S.

2004-01-01

This report contains the major findings of a 1999?2001 assessment of water quality in the Mobile River Basin. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live, and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the Mobile River Basin summarized in this report are discussed in detail in other reports that can be accessed from the Mobile River Basin Web site (http://al.water.usgs.gov/pubs/mobl/mobl.html). Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to reports in this series from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water quality in the lower Tennessee River Basin, Tennessee, Alabama, Kentucky, Mississippi, and Georgia, 1999-2001

USGS Publications Warehouse

Woodside, Michael D.; Hoos, Anne B.; Kingsbury, James A.; Powell, Jeffrey R.; Knight, Rodney R.; Garrett, Jerry W.; Mitchell, Reavis L.; Robinson, John A.

2004-01-01

This report contains the major findings of a 1999?2001 assessment of water quality in the Lower Tennessee River Basin. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas where they live, and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the Lower Tennessee River Basin summarized in this report are discussed in detail in other reports that can be accessed from the Lower Tennessee River Basin Web site (http://tn.water.usgs.gov/lten/lten.html). Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to reports in this series from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water quality in the Great and Little Miami River Basins, Ohio and Indiana, 1999-2001

USGS Publications Warehouse

Rowe, Gary L.; Reutter, David C.; Runkle, Donna L.; Hambrook, Julie A.; Janosy, Stephanie D.; Hwang, Lee H.

2004-01-01

This report contains the major findings of a 1999?2001 assessment of water quality in the Great and Little Miami River Basins. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the Great and Little Miami River Basins summarized in this report are discussed in detail in other reports that can be accessed from (http://oh.water.usgs.gov/miam/intro.html). Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report, in addition to reports in this series from other basins, can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Water Quality in the New England Coastal Basins, Maine, New Hampshire, Massachusetts, and Rhode Island 1999-2001

USGS Publications Warehouse

Robinson, Keith W.; Flanagan, Sarah M.; Ayotte, Joseph D.; Campo, Kimberly W.; Chalmers, Ann; Coles, James F.; Cuffney, Thomas F.

2004-01-01

This report contains the major findings of a 1999?2001 assessment of water quality in the New England Coastal Basins. It is one of a series of reports by the National Water-Quality Assessment (NAWQA) Program that present major findings in 51 major river basins and aquifer systems across the Nation. In these reports, water quality is discussed in terms of local, State, and regional issues. Conditions in a particular basin or aquifer system are compared to conditions found elsewhere and to selected national benchmarks, such as those for drinking-water quality and the protection of aquatic organisms. This report is intended for individuals working with water-resource issues in Federal, State, or local agencies, universities, public interest groups, or in the private sector. The information will be useful in addressing a number of current issues, such as the effects of agricultural and urban land use on water quality, human health, drinking water, source-water protection, hypoxia and excessive growth of algae and plants, pesticide registration, and monitoring and sampling strategies. This report is also for individuals who wish to know more about the quality of streams and ground water in areas near where they live and how that water quality compares to the quality of water in other areas across the Nation. The water-quality conditions in the New England Coastal Basins summarized in this report are discussed in detail in other reports that can be accessed from http://nh.water.usgs.gov/CurrentProjects/nawqa/nawqaweb.htm. Detailed technical information, data and analyses, collection and analytical methodology, models, graphs, and maps that support the findings presented in this report in addition to reports in this series from other basins can be accessed from the national NAWQA Web site (http://water.usgs.gov/nawqa).

Information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing: a systematic review.

PubMed

Spurling, Geoffrey K; Mansfield, Peter R; Montgomery, Brett D; Lexchin, Joel; Doust, Jenny; Othman, Noordin; Vitry, Agnes I

2010-10-19

Pharmaceutical companies spent $57.5 billion on pharmaceutical promotion in the United States in 2004. The industry claims that promotion provides scientific and educational information to physicians. While some evidence indicates that promotion may adversely influence prescribing, physicians hold a wide range of views about pharmaceutical promotion. The objective of this review is to examine the relationship between exposure to information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing. We searched for studies of physicians with prescribing rights who were exposed to information from pharmaceutical companies (promotional or otherwise). Exposures included pharmaceutical sales representative visits, journal advertisements, attendance at pharmaceutical sponsored meetings, mailed information, prescribing software, and participation in sponsored clinical trials. The outcomes measured were quality, quantity, and cost of physicians' prescribing. We searched Medline (1966 to February 2008), International Pharmaceutical Abstracts (1970 to February 2008), Embase (1997 to February 2008), Current Contents (2001 to 2008), and Central (The Cochrane Library Issue 3, 2007) using the search terms developed with an expert librarian. Additionally, we reviewed reference lists and contacted experts and pharmaceutical companies for information. Randomized and observational studies evaluating information from pharmaceutical companies and measures of physicians' prescribing were independently appraised for methodological quality by two authors. Studies were excluded where insufficient study information precluded appraisal. The full text of 255 articles was retrieved from electronic databases (7,185 studies) and other sources (138 studies). Articles were then excluded because they did not fulfil inclusion criteria (179) or quality appraisal criteria (18), leaving 58 included studies with 87 distinct analyses. Data were extracted independently by two authors and a narrative synthesis performed following the MOOSE guidelines. Of the set of studies examining prescribing quality outcomes, five found associations between exposure to pharmaceutical company information and lower quality prescribing, four did not detect an association, and one found associations with lower and higher quality prescribing. 38 included studies found associations between exposure and higher frequency of prescribing and 13 did not detect an association. Five included studies found evidence for association with higher costs, four found no association, and one found an association with lower costs. The narrative synthesis finding of variable results was supported by a meta-analysis of studies of prescribing frequency that found significant heterogeneity. The observational nature of most included studies is the main limitation of this review. With rare exceptions, studies of exposure to information provided directly by pharmaceutical companies have found associations with higher prescribing frequency, higher costs, or lower prescribing quality or have not found significant associations. We did not find evidence of net improvements in prescribing, but the available literature does not exclude the possibility that prescribing may sometimes be improved. Still, we recommend that practitioners follow the precautionary principle and thus avoid exposure to information from pharmaceutical companies. Please see later in the article for the Editors' Summary.

Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy.

PubMed

Hollingsworth, Jessa; Baliko, Beverly; McKinney, Selina; Rosenquist, Peter

2018-04-17

The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care; however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed utilizing quality criteria derived from a systematic review of ECT practice guidelines, peer review, and facility policy. All ECT procedures occurring over a 2-month period of May to June 2017 were retrospectively audited and compared against target compliance rates set for the facility's ECT program. Facility policy was adapted to reflect quality standards, and audit findings were used to inform possible practice change initiatives, were used to create benchmarks for continuous quality monitoring, and were integrated into regular hospital quality meetings. Clarification on standards of care and the use of clinical auditing in ECT was an effective starting point in the development of a quality assurance strategy. Audit findings were successfully integrated into the hospital's overall quality program, and recognition of practice compliance informed areas for future quality development and policy revision in this small community-based hospital in the southeastern United States. This project sets the foundation for a quality assurance strategy that can be used to help monitor procedural safety and guide future improvement efforts in delivering ECT. Although it is just the first step in creating meaningful quality improvement, setting clear standards and identifying areas of greatest clinical need were crucial beginning for this hospital's growing program.

What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey.

PubMed

van Leeuwen, K M; Malley, J; Bosmans, J E; Jansen, A P D; Ostelo, R W; van der Horst, H E; Netten, A

2014-09-01

Local authorities spend considerable resources on social care at home for older adults. Given the expected growth in the population of older adults and budget cuts on local government, it is important to find efficient ways of maintaining and improving the quality of life of older adults. The ageing in place literature suggests that policies in other functions of local authorities may have a significant role to play. This study aims to examine the associations between social care-related quality of life (SCRQoL) in older adults and three potential policy targets for local authorities: (i) accessibility of information and advice, (ii) design of the home and (iii) accessibility of the local area. We used cross-sectional data from the English national Adult Social Care Survey (ASCS) 2010/2011 on service users aged 65 years and older and living at home (N=29,935). To examine the association between SCRQoL, as measured by the ASCOT, and three single-item questions about accessibility of information, design of the home and accessibility of the local area, we estimate linear and quantile regression models. After adjusting for physical and mental health factors and other confounders our findings indicate that SCRQoL is significantly lower for older adults who find it more difficult to find information and advice, for those who report that their home design is inappropriate for their needs and for those who find it more difficult to get around their local area. In addition, these three variables are as strongly associated with SCRQoL as physical and mental health factors. We conclude that in seeking to find ways to maintain and improve the quality of life of social care users living at home, local authorities could look more broadly across their responsibilities. Further research is required to explore the cost-effectiveness of these options compared to standard social care services. Copyright © 2014 Elsevier Ltd. All rights reserved.

Wolves in sheep's clothing: Is non-profit status used to signal quality?

PubMed

Jones, Daniel B; Propper, Carol; Smith, Sarah

2017-09-01

Why do many firms in the healthcare sector adopt non-profit status? One argument is that non-profit status serves as a signal of quality when consumers are not well informed. A testable implication is that an increase in consumer information may lead to a reduction in the number of non-profits in a market. We test this idea empirically by exploiting an exogenous increase in consumer information in the US nursing home industry. We find that the information shock led to a reduction in the share of non-profit homes, driven by a combination of home closure and sector switching. The lowest quality non-profits were the most likely to exit. Our results have important implications for the effects of reforms to increase consumer provision in a number of public services. Copyright © 2017. Published by Elsevier B.V.

Factors affecting success of an integrated community-based telehealth system.

PubMed

Hsieh, Hui-Lung; Tsai, Chung-Hung; Chih, Wen-Hai; Lin, Huei-Hsieh

2015-01-01

The rise of chronic and degenerative diseases in developed countries has become one critical epidemiologic issue. Telehealth can provide one viable way to enhance health care, public health, and health education delivery and support. The study aims to empirically examine and evaluate the success factors of community-based telehealth system adoption. The valid 336 respondents are the residents of a rural community in Taiwan. The structural equation modeling (SEM) was used to assess the proposed model applied to telehealth. The findings showed the research model had good explanatory power and fitness. Also, the findings indicated that system quality exerted the strongest overall effect on intention to use. Furthermore, service quality exerted the strongest overall effect on user satisfaction. The findings also illustrated that the joint effects of three intrinsic qualities (system quality, information quality, and service quality) on use were mediated by user satisfaction and intention to use. The study implies that community-based telehealth service providers should improve three intrinsic qualities to enhance user satisfaction and intention to use, which in turn can lead to increase the usage of the telehealth equipment. The integrated community-based telehealth system may become an innovative and suitable way to deliver better care to the residents of communities.

How Do I Find the Evidence? Find Your Librarian-Stat!

PubMed

Eresuma, Emily; Lake, Erica

Clinical nurses often struggle with a lack of time and proficiency when it comes to finding and reviewing research. Knowing where to start, and discerning which search terms will retrieve the best results, can be arduous. As expert searchers, medical librarians have the skills and knowledge to make significant contributions to the clinical team, helping nurses navigate information resources and research from start to finish. When there is not direct access to a librarian, the toolbox of resources outlined in the article can save nurses' time and effort when they require quality, evidence-based information.

Reporting quality of music intervention research in healthcare: A systematic review.

PubMed

Robb, Sheri L; Hanson-Abromeit, Deanna; May, Lindsey; Hernandez-Ruiz, Eugenia; Allison, Megan; Beloat, Alyssa; Daugherty, Sarah; Kurtz, Rebecca; Ott, Alyssa; Oyedele, Oladele Oladimeji; Polasik, Shelbi; Rager, Allison; Rifkin, Jamie; Wolf, Emily

2018-06-01

Concomitant with the growth of music intervention research, are concerns about inadequate intervention reporting and inconsistent terminology, which limits validity, replicability, and clinical application of findings. Examine reporting quality of music intervention research, in chronic and acute medical settings, using the Checklist for Reporting Music-based Interventions. In addition, describe patient populations and primary outcomes, intervention content and corresponding interventionist qualifications, and terminology. Searching MEDLINE, PubMed, CINAHL, HealthSTAR, and PsycINFO we identified articles meeting inclusion/exclusion criteria for a five-year period (2010-2015) and extracted relevant data. Coded material included reporting quality across seven areas (theory, content, delivery schedule, interventionist qualifications, treatment fidelity, setting, unit of delivery), author/journal information, patient population/outcomes, and terminology. Of 860 articles, 187 met review criteria (128 experimental; 59 quasi-experimental), with 121 publishing journals, and authors from 31 countries. Overall reporting quality was poor with <50% providing information for four of the seven checklist components (theory, interventionist qualifications, treatment fidelity, setting). Intervention content reporting was also poor with <50% providing information about the music used, decibel levels/volume controls, or materials. Credentialed music therapists and registered nurses delivered most interventions, with clear differences in content and delivery. Terminology was varied and inconsistent. Problems with reporting quality impedes meaningful interpretation and cross-study comparisons. Inconsistent and misapplied terminology also create barriers to interprofessional communication and translation of findings to patient care. Improved reporting quality and creation of shared language will advance scientific rigor and clinical relevance of music intervention research. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Defining 'quality' from the patient's perspective: findings from focus groups with Medicaid beneficiaries and implications for public reporting.

PubMed

Theis, Ryan P; Stanford, Jevetta C; Goodman, J Robyn; Duke, Lisa L; Shenkman, Elizabeth A

2017-06-01

With an increased emphasis on patient-centred outcomes and research, investigators seek to understand aspects of health care that are most important to patients. Such information is essential for developing report cards that present health-care quality information for consumers, which many states are adopting as a strategy to promote consumer choice. This study examined the processes that women in Medicaid follow for selecting health plans and explored their definitions of 'good' and 'poor' quality health care. We conducted focus groups with Medicaid beneficiaries in four Texas communities, using quota sampling to ensure representation of different racial/ethnic, eligibility and geographic groups. We conducted 22 focus groups with 102 participants between October 2012 and January 2013. In a free-list exercise, 'doctors' represented the most important aspect of health care to participants, followed by cost, attention, coverage and respect. Discussions of health-care quality revealed an even mix of structural factors (e.g. timeliness) and interpersonal factors (e.g. communication), although few differences were observed by beneficiary characteristics. Participants linked themes in their overall framing of 'quality' - revealing processes of care that affect health outcomes (e.g. discontinuity of care resulting from poor communication with providers) and which were often mediated by advocate providers who assisted patients experiencing barriers to services. Findings support other studies that highlight the importance of the patient-provider relationship. Patient-centred definitions of health-care quality can complement predominant provider-centred conceptual frameworks and better inform initiatives for public reporting of quality measures in these populations. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Design of Cycle 3 of the National Water-Quality Assessment Program, 2013-2022: Part 1: Framework of Water-Quality Issues and Potential Approaches

USGS Publications Warehouse

Rowe, Gary L.; Belitz, Kenneth; Essaid, Hedeff I.; Gilliom, Robert J.; Hamilton, Pixie A.; Hoos, Anne B.; Lynch, Dennis D.; Munn, Mark D.; Wolock, David W.

2010-01-01

In 1991, the U.S. Congress established the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) Program to develop long-term, nationally consistent information on the quality of the Nation's streams and groundwater. Congress recognized the critical need for this information to support scientifically sound management, regulatory, and policy decisions concerning the increasingly stressed water resources of the Nation. The long-term goals of NAWQA are to: (1) assess the status of water-quality conditions in the United States, (2) evaluate long-term trends in water-quality conditions, and (3) link status and trends with an understanding of the natural and human factors that affect water quality. These goals are national in scale, include both surface water and groundwater, and include consideration of water quality in relation to both human uses and aquatic ecosystems. Since 1991, NAWQA assessments and findings have fostered and supported major improvements in the availability and use of unbiased scientific information for decisionmaking, resource management, and planning at all levels of government. These improvements have enabled agencies and stakeholders to cost-effectively address a wide range of water-quality issues related to natural and human influences on the quality of water and potential effects on aquatic ecosystems and human health (http://water.usgs.gov/nawqa/xrel.pdf). NAWQA, like all USGS programs, provides policy relevant information that serves as a scientific basis for decisionmaking related to resource management, protection, and restoration. The information is freely available to all levels of government, nongovernmental organizations, industry, academia, and the public, and is readily accessible on the NAWQA Web site and other diverse formats to serve the needs of the water-resource community at different technical levels. Water-quality conditions in streams and groundwater are described in more than 1,700 publications (available online at http://water.usgs.gov/nawqa/bib/), and are documented by more than 14 million data records representing about 7,600 stream sites, 8,100 wells, and 2,000 water-quality and ecological constituents that are available from the NAWQA data warehouse (http://infotrek.er.usgs.gov/traverse/f?p=NAWQA:HOME:0). The Program promotes collaboration and liaison with government officials, resource managers, industry representatives, and other stakeholders to increase the utility and relevance of NAWQA science to decisionmakers. As part of this effort, NAWQA supports integration of data from other organizations into NAWQA assessments, where appropriate and cost-effective, so that more comprehensive findings are available across geographic and temporal scales.

Why Do So Few Consumers Use Health Care Quality Report Cards? A Framework for Understanding the Limited Consumer Impact of Comparative Quality Information.

PubMed

Bhandari, Neeraj; Scanlon, Dennis P; Shi, Yunfeng; Smith, Rachel A

2018-05-01

Despite growing investment in producing and releasing comparative provider quality information (CQI), consumer use of CQI has remained poor. We offer a framework to interpret and synthesize the existing literature's diverse approaches to explaining the CQI's low appeal for consumers. Our framework cautions CQI stakeholders against forming unrealistic expectations of pervasive consumer use and suggests that they focus their efforts more narrowly on consumers who may find CQI more salient for choosing providers. We review the consumer impact of stakeholder efforts to apply the burgeoning knowledge of consumers' cognitive limitations to the design and dissemination of the new generation of report cards; we conclude that while it is too limited to draw firm conclusions, early evidence suggests consumers are responding to the novel design and dissemination strategies. We find that consumers continue to have difficulty accessing reliable report cards, while the media remains underused in the dissemination of report cards.

The influence of enterprise resource planning (ERP) systems' performance on earnings management

NASA Astrophysics Data System (ADS)

Tsai, Wen-Hsien; Lee, Kuen-Chang; Liu, Jau-Yang; Lin, Sin-Jin; Chou, Yu-Wei

2012-11-01

We analyse whether there is a linkage between performance measures of enterprise resource planning (ERP) systems and earnings management. We find that earnings management decreases with the higher performance of ERP systems. The empirical result is as expected. We further analyse how the dimension of the DeLone and McLean model of information systems success affects earnings management. We find that the relationship between the performance of ERP systems and earnings management depends on System Quality after ERP implementation. The more System Quality improves, the more earnings management is reduced.

Maternal Communicative Behaviours and Interaction Quality as Predictors of Language Development: Findings from a Community-Based Study of Slow-to-Talk Toddlers

ERIC Educational Resources Information Center

Conway, Laura J.; Levickis, Penny A.; Smith, Jodie; Mensah, Fiona; Wake, Melissa; Reilly, Sheena

2018-01-01

Background: Identifying risk and protective factors for language development informs interventions for children with developmental language disorder (DLD). Maternal responsive and intrusive communicative behaviours are associated with language development. Mother-child interaction quality may influence how children use these behaviours in language…

An audit of the quality of online immunisation information available to Australian parents.

PubMed

Wiley, K E; Steffens, M; Berry, N; Leask, J

2017-01-13

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, transparently authored, well-referenced, and written in a way that is easily understood.

Cortical reinstatement and the confidence and accuracy of source memory.

PubMed

Thakral, Preston P; Wang, Tracy H; Rugg, Michael D

2015-04-01

Cortical reinstatement refers to the overlap between neural activity elicited during the encoding and the subsequent retrieval of an episode, and is held to reflect retrieved mnemonic content. Previous findings have demonstrated that reinstatement effects reflect the quality of retrieved episodic information as this is operationalized by the accuracy of source memory judgments. The present functional magnetic resonance imaging (fMRI) study investigated whether reinstatement-related activity also co-varies with the confidence of accurate source judgments. Participants studied pictures of objects along with their visual or spoken names. At test, they first discriminated between studied and unstudied pictures and then, for each picture judged as studied, they also judged whether it had been paired with a visual or auditory name, using a three-point confidence scale. Accuracy of source memory judgments- and hence the quality of the source-specifying information--was greater for high than for low confidence judgments. Modality-selective retrieval-related activity (reinstatement effects) also co-varied with the confidence of the corresponding source memory judgment. The findings indicate that the quality of the information supporting accurate judgments of source memory is indexed by the relative magnitude of content-selective, retrieval-related neural activity. Copyright © 2015 Elsevier Inc. All rights reserved.

Can High Quality Overcome Consumer Resistance to Restricted Provider Access? Evidence from a Health Plan Choice Experiment

PubMed Central

Harris, Katherine M

2002-01-01

Objective To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. Data Sources and Setting A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. Study Design An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. Principal Findings The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents “extremely satisfied with results of care” had the greatest impact on plan choice while the proportion of network doctors “affiliated with university medical centers” had the least. Other consumer and expert assessed measures had more comparable effects. Conclusions Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high quality. However, the results of this study suggest that in many cases, the level of quality required for consumers to accept access restrictions may be so high as to be unattainable. The results provide empirical support for the current focus of decision support efforts on consumer assessed quality measures. At the same time, however, the results suggest that consumers would also value quality measures based on expert assessments. This finding is relevant given the lack of comparative quality information based on expert judgment and research suggesting that consumers have apprehensions about their ability to meaningfully interpret performance-based quality measures. PMID:12132595

Hospital Board Oversight of Quality and Patient Safety: A Narrative Review and Synthesis of Recent Empirical Research

PubMed Central

Millar, Ross; Mannion, Russell; Freeman, Tim; Davies, Huw TO

2013-01-01

Context Recurring problems with patient safety have led to a growing interest in helping hospitals’ governing bodies provide more effective oversight of the quality and safety of their services. National directives and initiatives emphasize the importance of action by boards, but the empirical basis for informing effective hospital board oversight has yet to receive full and careful review. Methods This article presents a narrative review of empirical research to inform the debate about hospital boards’ oversight of quality and patient safety. A systematic and comprehensive search identified 122 papers for detailed review. Much of the empirical work appeared in the last ten years, is from the United States, and employs cross-sectional survey methods. Findings Recent empirical studies linking board composition and processes with patient outcomes have found clear differences between high- and low-performing hospitals, highlighting the importance of strong and committed leadership that prioritizes quality and safety and sets clear and measurable goals for improvement. Effective oversight is also associated with well-informed and skilled board members. External factors (such as regulatory regimes and the publication of performance data) might also have a role in influencing boards, but detailed empirical work on these is scant. Conclusions Health policy debates recognize the important role of hospital boards in overseeing patient quality and safety, and a growing body of empirical research has sought to elucidate that role. This review finds a number of areas of guidance that have some empirical support, but it also exposes the relatively inchoate nature of the field. Greater theoretical and methodological development is required if we are to secure more evidence-informed governance systems and practices that can contribute to safer care. PMID:24320168

[Health information on the Internet and trust marks as quality indicators: vaccines case study].

PubMed

Mayer, Miguel Angel; Leis, Angela; Sanz, Ferran

2009-10-01

To find out the prevalence of quality trust marks present in websites and to analyse the quality of these websites displaying trust marks compared with those that do not display them, in order to put forward these trust marks as a quality indicator. Cross-sectional study. Internet. Websites on vaccines. Using "vacunas OR vaccines" as key words, the features of 40 web pages were analysed. These web pages were selected from the page results of two search engines, Google and Yahoo! Based on a total of 9 criteria, the average score of criteria fulfilled was 7 (95% CI 3.96-10.04) points for the web pages offered by Yahoo! and 7.3 (95% CI 3.86-10.74) offered by Google. Amongst web pages offered by Yahoo!, there were three with clearly inaccurate information, while there were four in the pages offered by Google. Trust marks were displayed in 20% and 30% medical web pages, respectively, and their presence reached statistical significance (P=0.033) when fulfilling the quality criteria compared with web pages where trust marks were not displayed. A wide variety of web pages was obtained by search engines and a large number of them with useless information. Although the websites analysed had a good quality, between 15% and 20% showed inaccurate information. Websites where trust marks were displayed had more quality than those that did not display one and none of them were included amongst those where inaccurate information was found.

Quality assurance of nursing web sites: development and implications of the ALEU method.

PubMed

Cambil-Martín, Jacobo; Flynn, Maria; Villaverde-Gutiérrez, Carmen

2011-09-01

This article presents a study that evaluated the physical accessibility, readability, and usability of Spanish nursing Web sites and discusses the quality assurance issues raised, which are relevant to the wider nursing community. The Internet is recognized as an important source of health information for both nurses and the general public. Although it makes health-related information universally available, the wide variation in the overall quality of health Web sites is problematic. This raises many questions for the nursing profession: about what constitutes a good-quality Web site, about the nature of the information that nurses are finding and using to support their professional education, research, and clinical practice, and about the impact that Internet information ultimately has on health interactions and nursing care. The process of completing this small study showed that it is possible to usefully assess dimensions of Web site quality and suggested that it may be feasible to develop tools to help nurses evaluate national and international nursing Web sites. More research is needed to understand how nurses use the Internet to support their everyday professional practices, but the development and application of international Web site quality assurance tools may be important for maintaining professional nursing standards in the Internet age.

Consumerization of Information Technology: An Exploratory Qualitative Inquiry of Michigan Community Colleges

ERIC Educational Resources Information Center

Skallos, Maryly K.

2014-01-01

With funding cuts, reduced enrollments, and meeting a presidential initiative, Michigan community colleges need to find ways in which they can continue to provide quality education at an affordable price. Consumerization of information technology (IT) has been proposed to meet the technological needs of the community college. There is little…

The ARL Scholars Portal Initiative.

ERIC Educational Resources Information Center

Jackson, Mary E.

2002-01-01

Describes an initiative of the Association of Research Libraries (ARL), the Scholars Portal Initiative, a three-year collaborative effort which seeks to provide tools for an academic community to have a single point of access on the Web to find high-quality information resources and to deliver the information and related services directly to the…

Finding Quality Information on Internet for Educational Use

ERIC Educational Resources Information Center

Khine, Myint Swe

2006-01-01

One of the major shifts in education today under the influence of information and communication technologies is that there is an increased tendency toward the use of computers and Internet. The process of ICT integration in schools reaches a considerable level of maturity and teachers and students are optimizing the learning opportunities with the…

Environmental Scanning: Preliminary Findings of a Survey of CEO Information Seeking Behaviour in Two Canadian Industries.

ERIC Educational Resources Information Center

Auster, Ethel; Choo, Chun Wei

1992-01-01

Reports the preliminary results of a survey of the environmental scanning behavior of 207 chief executive officers (CEOs) in the Canadian publishing and telecommunications industries. Topics addressed include information sources, perceived source accessibility, perceived source quality, and frequency of source use. (16 references) (LRW)

Where to find information about drugs

PubMed Central

Day, Richard O; Snowden, Leone

2016-01-01

SUMMARY Good medicines information is critical to medical practice. Choose high-quality, pre-appraised sources first and make sure they are current. Select the information that is most relevant to the needs of your particular patient. Take the time to become familiar with the features of the resources you use. Australian Medicines Handbook, Therapeutic Guidelines, Australian Prescriber and NPS MedicineWise cover most routine clinical practice needs. PMID:27346917

Real People Don't Do Boolean: How To Teach End Users To Find High-Quality Information on the Internet.

ERIC Educational Resources Information Center

Vine, Rita

2001-01-01

Explains how to train users in effective Web searching. Discusses challenges of teaching Web information retrieval; a framework for information searching; choosing the right search tools for users; the seven-step lesson planning process; tips for delivering group Internet training; and things that help people work faster and smarter on the Web.…

Hospital Quality And Intensity Of Spending: Is There An Association?

PubMed Central

Yasaitis, Laura; Fisher, Elliott S.; Skinner, Jonathan S.

2009-01-01

Numerous studies in the United States have examined the association between quality and spending at the regional level. In this paper we evaluate this relationship at the level of individual hospitals, which are a more natural unit of analysis for reporting on and improving accountability. For all of the quality indicators studied, the association with spending is either nil or negative. The absence of positive correlations suggests that some institutions achieve exemplary performance on quality measures in settings that feature lower intensity of care. This finding highlights the need for reporting information on both quality and spending. PMID:19460774

Cluster randomized trial assessing the effects of rapid ethical assessment on informed consent comprehension in a low-resource setting.

PubMed

Addissie, Adamu; Abay, Serebe; Feleke, Yeweyenhareg; Newport, Melanie; Farsides, Bobbie; Davey, Gail

2016-07-12

Maximizing comprehension is a major challenge for informed consent processes in low-literacy and resource-limited settings. Application of rapid qualitative assessments to improve the informed consent process is increasingly considered useful. This study assessed the effects of Rapid Ethical Assessment (REA) on comprehension, retention and quality of the informed consent process. A cluster randomized trial was conducted among participants of HPV sero-prevalence study in two districts of Northern Ethiopia, in 2013. A total of 300 study participants, 150 in the intervention and 150 in the control group, were included in the study. For the intervention group, the informed consent process was designed with further revisions based on REA findings. Informed consent comprehension levels and quality of the consent process were measured using the Modular Informed Consent Comprehension Assessment (MICCA) and Quality of Informed Consent (QuIC) process assessment tools, respectively. Study recruitment rates were 88.7 % and 80.7 % (p = 0.05), while study retention rates were 85.7 % and 70.3 % (p < 0.005) for the intervention and control groups respectively. Overall, the mean informed consent comprehension scores for the intervention and control groups were 73.1 % and 45.2 %, respectively, with a mean difference in comprehension score of 27.9 % (95 % CI 24.0 % - 33.4 %; p < 0.001,). Mean scores for quality of informed consent for the intervention and control groups were 89.1 % and 78.5 %, respectively, with a mean difference of 10.5 % (95 % CI 6.8 -14.2 %; p < 0.001). Levels of informed consent comprehension, quality of the consent process, study recruitment and retention rates were significantly improved in the intervention group. We recommend REA as a potential modality to improve informed consent comprehension and quality of informed consent process in low resource settings.

Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals.

PubMed

Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz

2018-03-01

The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

Quality nursing care: a qualitative enquiry.

PubMed

Hogston, R

1995-01-01

In spite of the wealth of literature on quality nursing care, a disparity exists in defining quality. The purpose of this study was an attempt to seek out practising nurses' perceptions of quality nursing care and to present a definition of quality as described by nurses. Eighteen nurses from a large hospital in the south of England were interviewed. Qualitative analysis based on a modified grounded theory approach revealed three categories described as 'structure', 'process' and 'outcome'. This supports previous work on evaluating quality care but postulates that structure, process and outcome could also be used as a mechanism for defining quality. The categories are defined by using the words of the informants in order to explain the essential attributes of quality nursing care. The findings demonstrate how more informants cited quality in terms of process and outcome than structure. It is speculated that the significance of this rests with the fact that nurses have direct control over process and outcome whereas the political and economic climate in which nurses work is beyond their control and decisions over structure lie with their managers.

The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website.

PubMed

Barbara, Angela M; Dobbins, Maureen; Haynes, R Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder; Levinson, Anthony J

2016-05-11

Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal's strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be applied by designers of health-related websites.

The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website

PubMed Central

Dobbins, Maureen; Haynes, R. Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder

2016-01-01

Background Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Objective Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Methods Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. Results A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal’s strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. Conclusions The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be applied by designers of health-related websites. PMID:27170443

The ends of uncertainty: Air quality science and planning in Central California

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fine, James

Air quality planning in Central California is complicated and controversial despite millions of dollars invested to improve scientific understanding. This research describes and critiques the use of photochemical air quality simulation modeling studies in planning to attain standards for ground-level ozone in the San Francisco Bay Area and the San Joaquin Valley during the 1990's. Data are gathered through documents and interviews with planners, modelers, and policy-makers at public agencies and with representatives from the regulated and environmental communities. Interactions amongst organizations are diagramed to identify significant nodes of interaction. Dominant policy coalitions are described through narratives distinguished by theirmore » uses of and responses to uncertainty, their exposures to risks, and their responses to the principles of conservatism, civil duty, and caution. Policy narratives are delineated using aggregated respondent statements to describe and understand advocacy coalitions. I found that models impacted the planning process significantly, but were used not purely for their scientific capabilities. Modeling results provided justification for decisions based on other constraints and political considerations. Uncertainties were utilized opportunistically by stakeholders instead of managed explicitly. Ultimately, the process supported the partisan views of those in control of the modeling. Based on these findings, as well as a review of model uncertainty analysis capabilities, I recommend modifying the planning process to allow for the development and incorporation of uncertainty information, while addressing the need for inclusive and meaningful public participation. By documenting an actual air quality planning process these findings provide insights about the potential for using new scientific information and understanding to achieve environmental goals, most notably the analysis of uncertainties in modeling applications. Concurrently, needed uncertainty information is identified and capabilities to produce it are assessed. Practices to facilitate incorporation of uncertainty information are suggested based on research findings, as well as theory from the literatures of the policy sciences, decision sciences, science and technology studies, consensus-based and communicative planning, and modeling.« less

The Impact of Internet Health Information on Patient Compliance: A Research Model and an Empirical Study

PubMed Central

Hassanein, Khaled; Yuan, Yufei

2015-01-01

Background Patients have been increasingly seeking and using Internet health information to become more active in managing their own health in a partnership with their physicians. This trend has both positive and negative effects on the interactions between patients and their physicians. Therefore, it is important to understand the impact that the increasing use of Internet health information has on the patient-physician relationship and patients’ compliance with their treatment regimens. Objective This study examines the impact of patients’ use of Internet health information on various elements that characterize the interactions between a patient and her/his physician through a theoretical model based on principal-agent theory and the information asymmetry perspective. Methods A survey-based study consisting of 225 participants was used to validate a model through various statistical techniques. A full assessment of the measurement model and structural model was completed in addition to relevant post hoc analyses. Results This research revealed that both patient-physician concordance and perceived information asymmetry have significant effects on patient compliance, with patient-physician concordance exhibiting a considerably stronger relationship. Additionally, both physician quality and Internet health information quality have significant effects on patient-physician concordance, with physician quality exhibiting a much stronger relationship. Finally, only physician quality was found to have a significant impact on perceived information asymmetry, whereas Internet health information quality had no impact on perceived information asymmetry. Conclusions Overall, this study found that physicians can relax regarding their fears concerning patient use of Internet health information because physician quality has the greatest impact on patients and their physician coming to an agreement on their medical situation and recommended treatment regimen as well as patient’s compliance with their physician’s advice when compared to the impact that Internet health information quality has on these same variables. The findings also indicate that agreement between the patient and physician on the medical situation and treatment is much more important to compliance than the perceived information gap between the patient and physician (ie, the physician having a higher level of information in comparison to the patient). In addition, the level of agreement between a patient and their physician regarding the medical situation is more reliant on the perceived quality of their physician than on the perceived quality of Internet health information used. This research found that only the perceived quality of the physician has a significant relationship with the perceived information gap between the patient and their physician and the quality of the Internet health information has no relationship with this perceived information gap. PMID:26068214

Air pollution and public health: a guidance document for risk managers.

PubMed

Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin

2008-01-01

This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.

75 FR 24892 - Certain Coated Paper Suitable for High-Quality Print Graphics Using Sheet-Fed Presses From the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-06

... Industry Support Calculation Coated Paper Suitable For High-Quality Print Graphics Using Sheet-Fed Presses... employs an industry-wide test to determine whether, under section 773(c)(1)(B), available information in... sections 771(33)(E) and (F) of the Act. In addition, we find that Shandong Sun Paper Industry Joint Stock...

Creating quality improvement culture in public health agencies.

PubMed

Davis, Mary V; Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

2014-01-01

We conducted case studies of 10 agencies that participated in early quality improvement efforts. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.

Indoor Air Quality Tools for Tribal Communities

EPA Pesticide Factsheets

This Website can help you improve IAQ in your tribal community. You can find information to educate your community about the simple actions they can take to improve their IAQ and protect their health.

Indoor Air Quality in Tribal Communities

EPA Pesticide Factsheets

This Website can help you improve IAQ in your tribal community. You can find information to educate your community about the simple actions they can take to improve their IAQ and protect their health.

Is a public reporting approach appropriate for nursing home care?

PubMed

Stevenson, David G

2006-08-01

Publicizing quality information has been used as a quality improvement strategy in the acute care sector for more than a decade. Despite research showing mixed results of these efforts, publicly reporting quality measures is currently being pursued as a quality improvement strategy for nursing homes. Designed to empower consumers to make informed choices and to stimulate provider competition on quality, nursing home public reporting began in 1998 with the Nursing Home Compare Web site and has received greater emphasis in the 2002 Nursing Home Quality Initiative, both directed by the federal government. Focusing on the response of three key stakeholder groups across settings of care-consumers, providers, and purchasers-I identify several challenges that nursing home reporting must overcome to be successful. I conclude that publicly reporting quality measures for nursing homes will have a harder time promoting quality improvement than for acute care settings, where results have been disappointing thus far. In addition to the conceptual analysis, I evaluate whether the quality information reported on Nursing Home Compare had any impact on nursing home occupancy rates following its release. Using a pre/post-release design, I find that the effect of public reporting on nursing home occupancy rates has been minimal thus far. Although some estimates of effect are statistically significant and in the hypothesized direction, they all suggest very small effect sizes. It is unclear whether the absence of a larger reporting effect to date is specific to Nursing Home Compare or whether it inheres to the broader task of using quality information to promote change in the nursing home care sector.

Where Would You Go for Your Next Hospitalization?

PubMed Central

Jung, Kyoungrae; Feldman, Roger; Scanlon, Dennis

2014-01-01

We examine the effects of diverse dimensions of hospital quality – including consumers’ perceptions of unobserved attributes – on future hospital choice. We utilize consumers’ stated preference weights to obtain hospital-specific estimates of perceptions about unmeasured attributes such as reputation. We report three findings. First, consumers’ perceptions of reputation and medical services contribute substantially to utility for a hospital choice. Second, consumers tend to select hospitals with high clinical quality scores even before the scores are publicized. However, the effect of clinical quality on hospital choice is relatively small. Third, satisfaction with a prior hospital admission has a large impact on future hospital choice. Our findings suggest that including measures of consumers’ experience in report cards may increase their responsiveness to publicized information, but other strategies are needed to overcome the large effects of consumers’ beliefs about other quality attributes. PMID:21665300

Interventions to Improve the Quality of Outpatient Specialty Referral Requests: A Systematic Review.

PubMed

Hendrickson, Chase D; Lacourciere, Stacy L; Zanetti, Cole A; Donaldson, Patrick C; Larson, Robin J

2016-09-01

Requests for outpatient specialty consultations occur frequently but often are of poor quality because of incompleteness. The authors searched bibliographic databases, trial registries, and references during October 2014 for studies evaluating interventions to improve the quality of outpatient specialty referral requests compared to usual practice. Two reviewers independently extracted data and assessed quality. Findings were qualitatively summarized for completeness of information relayed in a referral request within naturally emerging intervention categories. Of 3495 articles screened, 11 were eligible. All 3 studies evaluating software-based interventions found statistically significant improvements. Among 4 studies evaluating template/pro forma interventions, completeness was uniformly improved but with variable or unreported statistical significance. Of 4 studies evaluating educational interventions, 2 favored the intervention and 2 found no difference. One study evaluating referral management was negative. Current evidence for improving referral request quality is strongest for software-based interventions and templates, although methodological quality varied and findings may be setting specific. © The Author(s) 2015.

Primary health-care nurses and Internet health information-seeking: Access, barriers and quality checks.

PubMed

Gilmour, Jean; Strong, Alison; Chan, Helen; Hanna, Sue; Huntington, Annette

2016-02-01

Online information is a critical resource for evidence-based practice and patient education. This study aimed to establish New Zealand nurses' access and evaluation of online health information in the primary care context using a postal questionnaire survey; there were 630 respondents from a random sample of 931 nurses. The majority of respondents were satisfied with work access to online information (84.5%, n = 501) and searched for online information at least several times a week (57.5%, n = 343). The major barrier to online information seeking was insufficient time, but 68 respondents had no work online information access. The level of nursing qualification was significantly correlated with computer confidence and information quality checking. A range of information evaluation approaches was used. Most nurses in study accessed and evaluated Internet information in contrast to the findings of earlier studies, but there were barriers preventing universal integration into practice. © 2014 Wiley Publishing Asia Pty Ltd.

Barriers to data quality resulting from the process of coding health information to administrative data: a qualitative study.

PubMed

Lucyk, Kelsey; Tang, Karen; Quan, Hude

2017-11-22

Administrative health data are increasingly used for research and surveillance to inform decision-making because of its large sample sizes, geographic coverage, comprehensivity, and possibility for longitudinal follow-up. Within Canadian provinces, individuals are assigned unique personal health numbers that allow for linkage of administrative health records in that jurisdiction. It is therefore necessary to ensure that these data are of high quality, and that chart information is accurately coded to meet this end. Our objective is to explore the potential barriers that exist for high quality data coding through qualitative inquiry into the roles and responsibilities of medical chart coders. We conducted semi-structured interviews with 28 medical chart coders from Alberta, Canada. We used thematic analysis and open-coded each transcript to understand the process of administrative health data generation and identify barriers to its quality. The process of generating administrative health data is highly complex and involves a diverse workforce. As such, there are multiple points in this process that introduce challenges for high quality data. For coders, the main barriers to data quality occurred around chart documentation, variability in the interpretation of chart information, and high quota expectations. This study illustrates the complex nature of barriers to high quality coding, in the context of administrative data generation. The findings from this study may be of use to data users, researchers, and decision-makers who wish to better understand the limitations of their data or pursue interventions to improve data quality.

How Adolescents Use Technology for Health Information: Implications for Health Professionals from Focus Group Studies

PubMed Central

Biscope, Sherry; Poland, Blake; Goldberg, Eudice

2003-01-01

Background Adolescents present many challenges in providing them effective preventive services and health care. Yet, they are typically the early adopters of new technology (eg, the Internet). This creates important opportunities for engaging youths via eHealth. Objective To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents. Methods Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 participants (55% female, 45% male; median age 16 years) were selected to reflect diversity in age, sex, geographic location, cultural identity, and risk. An 8-person team analyzed and coded the data according to major themes. Results Study participants most-frequently sought or distributed information related to school (89%), interacting with friends (85%), social concerns (85%), specific medical conditions (67%), body image and nutrition (63%), violence and personal safety (59%), and sexual health (56%). Finding personally-relevant, high-quality information was a pivotal challenge that has ramifications on the depth and types of information that adolescents can find to answer their health questions. Privacy in accessing information technology was a second key challenge. Participants reported using technologies that clustered into 4 domains along a continuum from highly-interactive to fixed information sources: (1) personal communication: telephone, cell phone, and pager; (2) social communication: e-mail, instant messaging, chat, and bulletin boards; (3) interactive environments: Web sites, search engines, and computers; and (4) unidirectional sources: television, radio, and print. Three emerging roles for health professionals in eHealth include: (1) providing an interface for adolescents with technology and assisting them in finding pertinent information sources; (2) enhancing connection to youths by extending ways and times when practitioners are available; and (3) fostering critical appraisal skills among youths for evaluating the quality of health information. Conclusions This study helps illuminate adolescent health-information needs, their use of information technologies, and emerging roles for health professionals. The findings can inform the design and more-effective use of eHealth applications for adolescent populations. PMID:14713660

How adolescents use technology for health information: implications for health professionals from focus group studies.

PubMed

Skinner, Harvey; Biscope, Sherry; Poland, Blake; Goldberg, Eudice

2003-12-18

Adolescents present many challenges in providing them effective preventive services and health care. Yet, they are typically the early adopters of new technology (eg, the Internet). This creates important opportunities for engaging youths via eHealth. To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents. Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 participants (55% female, 45% male; median age 16 years) were selected to reflect diversity in age, sex, geographic location, cultural identity, and risk. An 8-person team analyzed and coded the data according to major themes. Study participants most-frequently sought or distributed information related to school (89%), interacting with friends (85%), social concerns (85%), specific medical conditions (67%), body image and nutrition (63%), violence and personal safety (59%), and sexual health (56%). Finding personally-relevant, high-quality information was a pivotal challenge that has ramifications on the depth and types of information that adolescents can find to answer their health questions. Privacy in accessing information technology was a second key challenge. Participants reported using technologies that clustered into 4 domains along a continuum from highly-interactive to fixed information sources: (1) personal communication: telephone, cell phone, and pager; (2) social communication: e-mail, instant messaging, chat, and bulletin boards; (3) interactive environments: Web sites, search engines, and computers; and (4) unidirectional sources: television, radio, and print. Three emerging roles for health professionals in eHealth include: (1) providing an interface for adolescents with technology and assisting them in finding pertinent information sources; (2) enhancing connection to youths by extending ways and times when practitioners are available; and (3) fostering critical appraisal skills among youths for evaluating the quality of health information. This study helps illuminate adolescent health-information needs, their use of information technologies, and emerging roles for health professionals. The findings can inform the design and more-effective use of eHealth applications for adolescent populations.

Examining the accessibility of high-quality physical activity behaviour change support freely available online for men with prostate cancer.

PubMed

Short, Camille E; Gelder, Charlotte; Binnewerg, Lena; McIntosh, Megan; Turnbull, Deborah

2018-02-01

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.

Web-based Health Information Seeking and eHealth Literacy among Patients Living with Chronic Obstructive Pulmonary Disease (COPD).

PubMed

Stellefson, Michael L; Shuster, Jonathan J; Chaney, Beth H; Paige, Samantha R; Alber, Julia M; Chaney, J Don; Sriram, P S

2017-09-05

Many people living with Chronic Obstructive Pulmonary Disease (COPD) have low general health literacy; however, there is little information available on these patients' eHealth literacy, or their ability to seek, find, understand, and appraise online health information and apply this knowledge to address or solve disease-related health concerns. A nationally representative sample of patients registered in the COPD Foundation's National Research Registry (N = 1,270) was invited to complete a web-based survey to assess socio-demographic (age, gender, marital status, education), health status (generic and lung-specific health-related quality of life), and socio-cognitive (social support, self-efficacy, COPD knowledge) predictors of eHealth literacy, measured using the 8-item eHealth literacy scale (eHEALS). Over 50% of the respondents (n = 176) were female (n = 89), with a mean age of 66.19 (SD = 9.47). Overall, participants reported moderate levels of eHealth literacy, with more than 70% feeling confident in their ability to find helpful health resources on the Internet. However, respondents were much less confident in their ability to distinguish between high- and low-quality sources of web-based health information. Very severe versus less severe COPD (β = 4.15), lower lung-specific health-related quality of life (β = -0.19), and greater COPD knowledge (β = 0.62) were significantly associated with higher eHealth literacy. Higher COPD knowledge was also significantly associated with greater knowledge (ρ = 0.24, p = .001) and use (ρ = 0.24, p = .001) of web-based health resources. Findings emphasize the importance of integrating skill-building activities into comprehensive patient education programs that enable patients with severe cases of COPD to identify high-quality sources of web-based health information. Additional research is needed to understand how new social technologies can be used to help medically underserved COPD patients benefit from web-based self-management support resources.

Are Health Videos from Hospitals, Health Organizations, and Active Users Available to Health Consumers? An Analysis of Diabetes Health Video Ranking in YouTube

PubMed Central

Borras-Morell, Jose-Enrique; Martinez-Millana, Antonio; Karlsen, Randi

2017-01-01

Health consumers are increasingly using the Internet to search for health information. The existence of overloaded, inaccurate, obsolete, or simply incorrect health information available on the Internet is a serious obstacle for finding relevant and good-quality data that actually helps patients. Search engines of multimedia Internet platforms are thought to help users to find relevant information according to their search. But, is the information recovered by those search engines from quality sources? Is the health information uploaded from reliable sources, such as hospitals and health organizations, easily available to patients? The availability of videos is directly related to the ranking position in YouTube search. The higher the ranking of the information is, the more accessible it is. The aim of this study is to analyze the ranking evolution of diabetes health videos on YouTube in order to discover how videos from reliable channels, such as hospitals and health organizations, are evolving in the ranking. The analysis was done by tracking the ranking of 2372 videos on a daily basis during a 30-day period using 20 diabetes-related queries. Our conclusions are that the current YouTube algorithm favors the presence of reliable videos in upper rank positions in diabetes-related searches. PMID:28243314

Are Health Videos from Hospitals, Health Organizations, and Active Users Available to Health Consumers? An Analysis of Diabetes Health Video Ranking in YouTube.

PubMed

Fernandez-Llatas, Carlos; Traver, Vicente; Borras-Morell, Jose-Enrique; Martinez-Millana, Antonio; Karlsen, Randi

2017-01-01

Health consumers are increasingly using the Internet to search for health information. The existence of overloaded, inaccurate, obsolete, or simply incorrect health information available on the Internet is a serious obstacle for finding relevant and good-quality data that actually helps patients. Search engines of multimedia Internet platforms are thought to help users to find relevant information according to their search. But, is the information recovered by those search engines from quality sources? Is the health information uploaded from reliable sources, such as hospitals and health organizations, easily available to patients? The availability of videos is directly related to the ranking position in YouTube search. The higher the ranking of the information is, the more accessible it is. The aim of this study is to analyze the ranking evolution of diabetes health videos on YouTube in order to discover how videos from reliable channels, such as hospitals and health organizations, are evolving in the ranking. The analysis was done by tracking the ranking of 2372 videos on a daily basis during a 30-day period using 20 diabetes-related queries. Our conclusions are that the current YouTube algorithm favors the presence of reliable videos in upper rank positions in diabetes-related searches.

A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan.

PubMed

El-Jardali, Fadi; Fadlallah, Racha

2017-08-16

Improving quality of care and patient safety practices can strengthen health care delivery systems, improve health sector performance, and accelerate attainment of health-related Sustainability Development Goals. Although quality improvement is now prominent on the health policy agendas of governments in low- and middle-income countries (LMICs), including countries of the Eastern Mediterranean Region (EMR), progress to date has not been optimal. The objective of this study is to comprehensively review existing quality improvement and patient safety policies and strategies in two selected countries of the EMR (Lebanon and Jordan) to determine the extent to which these have been institutionalized within existing health systems. We used a mixed methods approach that combined documentation review, stakeholder surveys and key informant interviews. Existing quality improvement and patient safety initiatives were assessed across five components of an analytical framework for assessing health care quality and patient safety: health systems context; national policies and legislation; organizations and institutions; methods, techniques and tools; and health care infrastructure and resources. Both Lebanon and Jordan have made important progress in terms of increased attention to quality and accreditation in national health plans and strategies, licensing requirements for health care professionals and organizations (albeit to varying extents), and investments in health information systems. A key deficiency in both countries is the absence of an explicit national policy for quality improvement and patient safety across the health system. Instead, there is a spread of several (disjointed) pieces of legal measures and national plans leading to fragmentation and lack of clear articulation of responsibilities across the entire continuum of care. Moreover, both countries lack national sets of standardized and applicable quality indicators for performance measurement and benchmarking. Importantly, incentive systems that link contractual agreement, regulations, accreditation, and performance indicators are underutilized in Lebanon and absent in Jordan. At the healthcare organizational level, there is a need to instill a culture of continuous quality improvement and promote professional training in quality improvement and patient safety. Study findings highlight the importance of aligning policies, organizations, methods, capacities and resources in order to institutionalize quality improvement and patient safety practices in health systems. Gaps and dysfunctions identified can help inform national deliberations and dialogues among key stakeholders in each study country. Findings can also inform future quality improvement efforts in the EMR and beyond, with a particular emphasis on LMICs.

Access to timely formal dementia care in Europe: protocol of the Actifcare (ACcess to Timely Formal Care) study.

PubMed

Kerpershoek, Liselot; de Vugt, Marjolein; Wolfs, Claire; Jelley, Hannah; Orrell, Martin; Woods, Bob; Stephan, Astrid; Bieber, Anja; Meyer, Gabriele; Engedal, Knut; Selbaek, Geir; Handels, Ron; Wimo, Anders; Hopper, Louise; Irving, Kate; Marques, Maria; Gonçalves-Pereira, Manuel; Portolani, Elisa; Zanetti, Orazio; Verhey, Frans

2016-08-23

Previous findings indicate that people with dementia and their informal carers experience difficulties accessing and using formal care services due to a mismatch between needs and service use. This mismatch causes overall dissatisfaction and is a waste of the scarce financial care resources. This article presents the background and methods of the Actifcare (ACcess to Timely Formal Care) project. This is a European study aiming at best-practice development in finding timely access to formal care for community-dwelling people with dementia and their informal carers. There are five main objectives: 1) Explore predisposing and enabling factors associated with the use of formal care, 2) Explore the association between the use of formal care, needs and quality of life and 3) Compare these across European countries, 4) Understand the costs and consequences of formal care services utilization in people with unmet needs, 5) Determine the major costs and quality of life drivers and their relationship with formal care services across European countries. In a longitudinal cohort study conducted in eight European countries approximately 450 people with dementia and informal carers will be assessed three times in 1 year (baseline, 6 and 12 months). In this year we will closely monitor the process of finding access to formal care. Data on service use, quality of life and needs will be collected. The results of Actifcare are expected to reveal best-practices in organizing formal care. Knowledge about enabling and predisposing factors regarding access to care services, as well as its costs and consequences, can advance the state of the art in health systems research into pathways to dementia care, in order to benefit people with dementia and their informal carers.

Public reporting and the quality of care of German nursing homes.

PubMed

Herr, Annika; Nguyen, Thu-Van; Schmitz, Hendrik

2016-10-01

Since 2009, German nursing homes have been evaluated regularly by an external institution with quality report cards published online. We follow recent debates and argue that most of the information in the report cards does not reliably measure quality of care. However, a subset of up to seven measures does. Do these measures that reflect "risk factors" improve over time? Using a sample of more than 3000 German nursing homes with information on two waves, we assume that the introduction of public reporting is an exogenous institutional change and apply before-after-estimations to obtain estimates for the relation between public reporting and quality. We find a significant improvement of the identified risk factors. Also, the two employed outcome quality indicators improve significantly. The improvements are driven by nursing homes with low quality in the first evaluation. To the extent that this can be interpreted as evidence that public reporting positively affects the (reported) quality in nursing homes, policy makers should carefully choose indicators reflecting care-sensitive quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Learning about Teaching: Initial Findings from the Measures of Effective Teaching Project. Research Paper. MET Project

ERIC Educational Resources Information Center

Bill & Melinda Gates Foundation, 2010

2010-01-01

In fall 2009, the Bill & Melinda Gates Foundation launched the Measures of Effective Teaching (MET) project to test new approaches to measuring effective teaching. The goal of the MET project is to improve the quality of information about teaching effectiveness available to education professionals within states and districts--information that…

Predictive modelling: parents’ decision making to use online child health information to increase their understanding and/or diagnose or treat their child’s health

PubMed Central

2012-01-01

Background The quantum increases in home Internet access and available online health information with limited control over information quality highlight the necessity of exploring decision making processes in accessing and using online information, specifically in relation to children who do not make their health decisions. The aim of this study was to understand the processes explaining parents’ decisions to use online health information for child health care. Methods Parents (N = 391) completed an initial questionnaire assessing the theory of planned behaviour constructs of attitude, subjective norm, and perceived behavioural control, as well as perceived risk, group norm, and additional demographic factors. Two months later, 187 parents completed a follow-up questionnaire assessing their decisions to use online information for their child’s health care, specifically to 1) diagnose and/or treat their child’s suspected medical condition/illness and 2) increase understanding about a diagnosis or treatment recommended by a health professional. Results Hierarchical multiple regression showed that, for both behaviours, attitude, subjective norm, perceived behavioural control, (less) perceived risk, group norm, and (non) medical background were the significant predictors of intention. For parents’ use of online child health information, for both behaviours, intention was the sole significant predictor of behaviour. The findings explain 77% of the variance in parents’ intention to treat/diagnose a child health problem and 74% of the variance in their intentions to increase their understanding about child health concerns. Conclusions Understanding parents’ socio-cognitive processes that guide their use of online information for child health care is important given the increase in Internet usage and the sometimes-questionable quality of health information provided online. Findings highlight parents’ thirst for information; there is an urgent need for health professionals to provide parents with evidence-based child health websites in addition to general population education on how to evaluate the quality of online health information. PMID:23228171

Information sharing model in supporting implementation of e-procurement service: Case of Bandung city

NASA Astrophysics Data System (ADS)

Ramantoko, Gadang; Irawan, Herry

2017-10-01

This research examines the factors influencing the Information Sharing Model in Supporting Implementation of e-Procurement Services: Case of Bandung City in its early maturity stage. The early maturity of information sharing stage was determined using e-Government Maturity Stage Conceptual Framework from Estevez. Bandung City e-Procurement Information Sharing system was categorized at stage 1 in Estevez' model where the concern was mainly on assessing the benefit and risk of implementing the system. The Authors were using DeLone & McLean (D&M) Information System Success model to study benefit and risk of implementing the system in Bandung city. The model was then empirically tested by employing survey data that was collected from the available 40 listed supplier firms. D&M's model adjusted by Klischewski's description was introducing Information Quality, System Quality, and Service Quality as independent variable; Usability and User Satisfaction as intermediate dependent variable; and Perceived Net Benefit as final dependent variable. The findings suggested that, all of the predictors in D&M's model significantly influenced the net perceived benefit of implementing the e-Procurement system in the early maturity stage. The theoretical contribution of this research suggested that D&M's model might find useful in modeling complex information technology successfulness such as the one used in e-Procurement service. This research could also have implications for policy makers (LPSE) and system providers (LKPP) following the introduction of the service. However, the small number of respondent might be considered limitation of the study. The model needs to be further tested using larger number of respondents by involving the population of the firms in extended boundary/municipality area around Bandung.

Informing women about hormone replacement therapy: the consensus conference statement

PubMed Central

Mosconi, Paola; Donati, Serena; Colombo, Cinzia; Mele, Alfonso; Liberati, Alessandro; Satolli, Roberto

2009-01-01

Background The risks/benefits balance of hormone replacement therapy is controversial. Information can influence consumers' knowledge and behavior; research findings about hormone replacement therapy are uncertain and the messages provided by the media are of poor quality and incomplete, preventing a fully informed decision making process. We therefore felt that an explicit, rigorous and structured assessment of the information needs on this issue was urgent and we opted for the organisation of a national consensus conference (CC) to assess the current status of the quality of information on hormone replacement therapy (HRT) and re-visit recent research findings on its risks/benefits. Methods We chose a structured approach based on the traditional CC method combined with a structured preparatory work supervised by an organising committee (OC) and a scientific board (SB). The OC and SB chose the members of the CC's jury and appointed three multidisciplinary working groups (MWG) which were asked to review clinical issues and different aspects of the quality of information. Before the CC, the three MWGs carried out: a literature review on the risk/benefit profile of HRT and two surveys on the quality of information on lay press and booklets targeted to women. A population survey on women's knowledge, attitude and practice was also carried out. The jury received the documents in advance, listened the presentations during the two-day meeting of the CCs, met immediately after in a closed-door meeting and prepared the final document. Participants were researchers, clinicians, journalists as well as consumers' representatives. Results Key messages in the CC's deliberation were: a) women need to be fully informed about the transient nature of menopausal symptoms, about HRT risks and benefits and about the availability of non-pharmacological interventions; b) HRT is not recommended to prevent menopausal symptoms; c) the term "HRT" is misleading and "post menopausal hormone therapy" should be the preferred definition. Conclusion This CC led to the identification of specific information drawbacks. Women are exposed to messages that are often partial, non evidence-based nor transparently developed. The structured and participative methodology of this CC allowed a multidisciplinary perspective and a substantial lay people input. PMID:19480688

Evaluation of the quality of patient information to support informed shared decision-making.

PubMed

Godolphin, W; Towle, A; McKendry, R

2001-12-01

(a) To find out how much patient information material on display in family physicians' offices refers to management choices, and hence may be useful to support informed and shared decision-making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians. All print information available for patients and exchanged between physicians and patients was collected in a single complete day of the office practices of 21 family physicians. A published and validated instrument (DISCERN) was used to assess quality. Community office practices in the greater Vancouver area, British Columbia, Canada. The physicians were purposefully recruited by their association with the medical school Department of Family Practice, their interest in providing patients with print information and their representation of a range of practice types and location. The source of the pamphlets and these categories: available in the physicians' offices; exchanged between physician and patient; and produced with the explicit or apparent intent to support evidence-based patient choice. The quality of the print information to support ISDM, as measured by DISCERN and the ease of use and reliability of the DISCERN tool. Fewer than 50% of pamphlets available in these offices fulfilled our minimum criteria for ISDM (mentioned more than one management option). Offices varied widely in the proportion of pamphlets on display that supported ISDM and how particular the physician was in selecting materials. The DISCERN tool is quick, valid and reliable for the evaluation of patient information. The quality of patient information materials used in the consultation and available in these offices was below midpoint on the DISCERN score. Major deficiencies were with respect to the mention of choices, risks, effect of no treatment or uncertainty and reliability (source, evidence-base). Good quality information can be produced; some is available locally.

Evaluation of the quality of patient information to support informed shared decision‐making

PubMed Central

Godolphin, William; Towle, Angela; McKendry, Rachael

2008-01-01

Objectives (a) To find out how much patient information material on display in family physicians’ offices refers to management choices, and hence may be useful to support informed and shared decision‐making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians. Design All print information available for patients and exchanged between physicians and patients was collected in a single complete day of the office practices of 21 family physicians. A published and validated instrument (DISCERN) was used to assess quality. Setting and participants Community office practices in the greater Vancouver area, British Columbia, Canada. The physicians were purposefully recruited by their association with the medical school Department of Family Practice, their interest in providing patients with print information and their representation of a range of practice types and location. Main variables studied The source of the pamphlets and these categories: available in the physicians’ offices; exchanged between physician and patient; and produced with the explicit or apparent intent to support evidence‐based patient choice. Main outcome measures The quality of the print information to support ISDM, as measured by DISCERN and the ease of use and reliability of the DISCERN tool. Results and conclusions Fewer than 50% of pamphlets available in these offices fulfilled our minimum criteria for ISDM (mentioned more than one management option). Offices varied widely in the proportion of pamphlets on display that supported ISDM and how particular the physician was in selecting materials. The DISCERN tool is quick, valid and reliable for the evaluation of patient information. The quality of patient information materials used in the consultation and available in these offices was below midpoint on the DISCERN score. Major deficiencies were with respect to the mention of choices, risks, effect of no treatment or uncertainty and reliability (source, evidence‐base). Good quality information can be produced; some is available locally. PMID:11703497

Social media for patients: benefits and drawbacks.

PubMed

De Martino, Ivan; D'Apolito, Rocco; McLawhorn, Alexander S; Fehring, Keith A; Sculco, Peter K; Gasparini, Giorgio

2017-03-01

Social media is increasingly utilized by patients to educate themselves on a disease process and to find hospital, physicians, and physician networks most capable of treating their condition. However, little is known about quality of the content of the multiple online platforms patients have to communicate with other potential patients and their potential benefits and drawbacks. Patients are not passive consumers of health information anymore but are playing an active role in the delivery of health services through an online environment. The control and the regulation of the sources of information are very difficult. The overall quality of the information was poor. Bad or misleading information can be detrimental for patients as well as influence their confidence on physicians and their mutual relationship. Orthopedic surgeons and hospital networks must be aware of these online patient portals as they provide important feedback on the patient opinion and experience that can have a major impact on future patient volume, patient opinion, and perceived quality of care.

Assessing the quality of the nation's water resources

USGS Publications Warehouse

Hamilton, Pixie A.

2002-01-01

This issue of IMPACT highlights findings from the first decade of studies (1991 to 2001) by the National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey (USGS). The articles also discuss the Program’s approaches and models designed to help understand and estimate the fate and transport of contaminants in different geographic areas and environmental settings and over different time frames. NAWQA was established by Congress in 1991 with a goal of developing long-term, consistent, and comparable science-based information on nationwide water-quality conditions. This information is used to support sound management and policy decisions by decision makers at all levels – local, state, and national – who, every day, face complex regulations and management issues related to water resources.

Gaps, disconnections, and discontinuities--the role of information exchange in the delivery of quality long-term care.

PubMed

Georgiou, Andrew; Marks, Anne; Braithwaite, Jeffrey; Westbrook, Johanna Irene

2013-10-01

The smart use of information and communication technologies (ICT) is widely seen as a means of enhancing the quality of aged care services. One of the barriers to ICT diffusion in aged care is the failure to cater for the complex and interdisciplinary requirements of the aged care environment. The aim of this qualitative study was to identify the layers of information exchange and communication and produce a conceptual model that can help to inform decisions related to the design, implementation, and sustainability of ICT. A qualitative study conducted in 2010 within seven Australian residential aged care facilities. It included 11 focus groups involving 47 staff and 54 individual interviews and observation sessions. The analysis of work processes identified key information exchange components related to the type of information (residential, clinical, and administrative) that is collected, stored, and communicated. This information relies on a diverse number of internal and external communication channels that are important for the organization of care. The findings highlight potential areas of communication dysfunction as a consequence of structural holes, fragmentation, or disconnections that can adversely affect the continuity and coordination of care, its safety, and quality.

Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary of findings tables with a new format.

PubMed

Carrasco-Labra, Alonso; Brignardello-Petersen, Romina; Santesso, Nancy; Neumann, Ignacio; Mustafa, Reem A; Mbuagbaw, Lawrence; Etxeandia Ikobaltzeta, Itziar; De Stio, Catherine; McCullagh, Lauren J; Alonso-Coello, Pablo; Meerpohl, Joerg J; Vandvik, Per Olav; Brozek, Jan L; Akl, Elie A; Bossuyt, Patrick; Churchill, Rachel; Glenton, Claire; Rosenbaum, Sarah; Tugwell, Peter; Welch, Vivian; Garner, Paul; Guyatt, Gordon; Schünemann, Holger J

2016-06-01

The current format of summary of findings (SoFs) tables for presenting effect estimates and associated quality of evidence improve understanding and assist users finding key information in systematic reviews. Users of SoF tables have demanded alternative formats to express findings from systematic reviews. We conducted a randomized controlled trial among systematic review users to compare the relative merits of a new format with the current formats of SoF tables regarding understanding, accessibility of information, satisfaction, and preference. Our primary goal was to show that the new format is not inferior to the current format. Of 390 potentially eligible subjects, 290 were randomized. Of seven items testing understanding, three showed similar results, two showed small differences favoring the new format, and two (understanding risk difference and quality of the evidence associated with a treatment effect) showed large differences favoring the new format [63% (95% confidence interval {CI}: 55, 71) and 62% (95% CI: 52, 71) more correct answers, respectively]. Respondents rated information in the alternative format as more accessible overall and preferred the new format over the current format. While providing at least similar levels of understanding for some items and increased understanding for others, users prefer the new format of SoF tables. Copyright © 2016 Elsevier Inc. All rights reserved.

Are informal carers and community care workers effective in managing malnutrition in the older adult community? A systematic review of current evidence.

PubMed

Marshall, S; Bauer, J; Capra, S; Isenring, E

2013-01-01

Enhancing the effectiveness of the community and aged care workforce to prevent malnutrition and functional decline is important in reducing hospital and aged care facility demand. To investigate the impact of nutrition-related interventions delivered to or by informal carers and non-clinical community care workers on malnutrition-related health outcomes of community-dwelling older adults (≥65 years). Intervention studies were searched for using six electronic databases for English-language publications from January 1980 to 30 May 2012. Nine studies were eligible for inclusion. The strength and quality of the evidence was moderate (six studies with level II intervention evidence, five with positive quality). Types of interventions used were highly varied. The majority of interventions were delivered to informal carers (6 studies), with three of these studies also involving older adult care recipients. Five interventions were targeted at identifying, preventing and/or treating malnutrition specifically (two positive quality, three neutral quality, n=2368). As a result of these interventions, nutritional status improved or stabilized (two positive quality, two neutral quality, n=2333). No study reported an improvement in functional status but two successfully prevented further decline in their participants (two neutral quality, n=1097). Interventions targeted at identifying, preventing and/or treating malnutrition were able to improve or prevent decline in nutritional and functional status, without increasing informal carer burden. The findings of this review support the involvement of non-clinical community care workers and informal carers as part of the nutritional care team for community-dwelling older adults.

Surfing for back pain patients: the nature and quality of back pain information on the Internet.

PubMed

Li, L; Irvin, E; Guzmán, J; Bombardier , C

2001-03-01

A prospective, systematic review of web sites related to back pain. To assess the nature and quality of back pain-related information on the World Wide Web during a 2-year period. The Internet has become a rich source of medical information. Limited knowledge is available, however, about the quality of online resources. Although previous systematic reviews on medical-related web sites found problems in varying degrees with the credibility of information, no such review was conducted to assess the back pain-related sites. A search of web sites was conducted in November 1996 using five search engines (AltaVista, Infoseek, Lycos, Yahoo, and Magellan) and two key terms ("back pain" and "back problems"). A sample of sites was evaluated by two independent reviewers. Each site was described by the type and nature of the sponsor, target audience, and content. Overall quality was assessed in terms of evidence-based information available. Seventy-four web sites were reviewed in 1996, and nine of them (12.2%) were identified as high-quality sites. Advertising was the focus of 80.8% of the sites. Eleven sites (14.9%) were found to be discontinued 1 year later, and 20 (27.0%) were not accessible by the reviewers at the 2-year follow-up evaluation. Of the remaining 54 sites, 44.4% were produced by for-profit companies, and most sites targeted people with back pain (63.0%). Only seven out of the nine high-quality sites held their ratings at the 2-year follow-up evaluation. Most back pain-related web sites can be classified as advertising. The quality varied considerably, resulting in difficulties for patients to find useful information in this field. The increasing number of people seeking medical information on the Web creates a need for more high quality sites. Further, systematic review of web sites should be encouraged to monitor the accuracy of Internet publication.

Bioterrorism web site resources for infectious disease clinicians and epidemiologists.

PubMed

Ferguson, Natalie E; Steele, Lynn; Crawford, Carol Y; Huebner, Nathan L; Fonseka, Jamila C; Bonander, Jason C; Kuehnert, Matthew J

2003-06-01

Finding bioterrorism-related information on the World Wide Web can be laborious. We hope to help readers find such information more easily by summarizing essential information in a consistent framework. A panel of 7 Centers for Disease Control and Prevention reviewers identified Web sites and evaluated them for sponsorship, mission, content usefulness, online ease of use, and adherence to commonly accepted quality criteria. Of >100 potential sites identified, 81 were chosen for target content of interest, and 43 were selected for inclusion. The results were classified into general purpose/portal sites; biological agent information; laboratory, infection control, epidemiology, and mental health information; and emergency contact sources, news and updates, event preparedness resources, information for first-responder settings, clinical and public education materials, and research resources. Agents covered included anthrax, smallpox, plague, botulism, tularemia, and viral hemorrhagic fever.

Medical information on the internet: a tool for measuring consumer perception of quality aspects.

PubMed

Dubowicz, Arthur; Schulz, Peter J

2015-03-30

Most of adult Internet users have searched for health information on the Internet. The Internet has become one of the most important sources for health information and treatment advice. In most cases, the information found is not verified with a medical doctor, but judged by the "online-diagnosers" independently. Facing this situation, public health authorities raise concern over the quality of medical information laypersons can find on the Internet. The objective of the study was aimed at developing a measure to evaluate the credibility of websites that offer medical advice and information. The measure was tested in a quasi-experimental study on two sleeping-disorder websites of different quality. There were 45 survey items for rating the credibility of websites that were tested in a quasi-experimental study with a random assignment of 454 participants to either a high- or a low-quality website exposure. Using principal component analysis, the original items were reduced to 13 and sorted into the factors: trustworthiness, textual deficits of the content, interferences (external links on the Web site), and advertisements. The first two factors focus more on the provided content itself, while the other two describe the embedding of the content into the website. The 45 survey items had been designed previously using exploratory observations and literature research. The final scale showed adequate power and reliability for all factors. The loadings of the principal component analysis ranged satisfactorily (.644 to .854). Significant differences at P<.001 were found between the low- and high-quality groups. Advertisements on the website were rated as disturbing in both experimental conditions, meaning that they do not differentiate between good and bad information. The scale reliably distinguished high- and low-quality of medical advice given on websites.

Trust Me, I’m a Doctor: Examining Changes in How Privacy Concerns Affect Patient Withholding Behavior

PubMed Central

Johnson, Tyler; Ford, Eric W; Huerta, Timothy R

2017-01-01

Background As electronic health records (EHRs) become ubiquitous in the health care industry, privacy breaches are increasing and being made public. These breaches may make consumers wary of the technology, undermining its potential to improve care coordination and research. Objective Given the developing concerns around privacy of personal health information stored in digital format, it is important for providers to understand how views on privacy and security may be associated with patient disclosure of health information. This study aimed to understand how privacy concerns may be shifting patient behavior. Methods Using a pooled cross-section of data from the 2011 and 2014 cycles of the Health Information and National Trends Survey (HINTS), we tested whether privacy and security concerns, as well as quality perceptions, are associated with the likelihood of withholding personal health information from a provider. A fully interacted multivariate model was used to compare associations between the 2 years, and interaction terms were used to evaluate trends in the factors that are associated with withholding behavior. Results No difference was found regarding the effect of privacy and security concerns on withholding behavior between 2011 and 2014. Similarly, whereas perceived high quality of care was found to reduce the likelihood of withholding information from a provider in both 2011 (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.56-0.94) and 2014 (OR 0.61, 95% CI 0.48-0.76), no difference was observed between years. Conclusions These findings suggest that consumers’ beliefs about EHR privacy and security, the relationship between technology use and quality, and intentions to share information with their health care provider have not changed. These findings are counter to the ongoing discussions about the implications of security failures in other domains. Our results suggest that providers could ameliorate privacy and security by focusing on the care quality benefits EHRs provide. PMID:28052843

Self and friend's differing views of social anxiety disorder's effects on friendships.

PubMed

Rodebaugh, Thomas L; Lim, Michelle H; Fernandez, Katya C; Langer, Julia K; Weisman, Jaclyn S; Tonge, Natasha; Levinson, Cheri A; Shumaker, Erik A

2014-11-01

Social anxiety disorder is known to be associated with self-report of global friendship quality. However, information about specific friendships, as well as information beyond self-report, is lacking. Such information is crucial, because known biases in information processing related to social anxiety disorder render global self-ratings particularly difficult to interpret. We examined these issues focusing on diagnosed participants (n = 77) compared with community control participants (n = 63). We examined self-report regarding global (i.e., overall) friendship quality and a specific friendship's quality; in addition, we examined friend-report of that friendship's quality. Results suggested that social anxiety disorder has a negative impact on self-perception of friendship quality for a specific friendship, but that this effect is less evident as reported by the friends. Specifically, social anxiety disorder was associated with a tendency to report worse friendship quality in comparison to friend-report, particularly in participants who were younger or had less long-lasting friendships. However, friend-report did show clear differences based on diagnostic group, with friends reporting participants with social anxiety disorder to be less dominant in the friendship and less well-adjusted. Overall, the findings are consistent with results of other studies indicating that social anxiety disorder has a strong association with self-ratings of impairment, but that these ratings appear out of proportion with the report of observers (in this case, friends).

Self and Friend’s Differing Views of Social Anxiety Disorder’s Effects on Friendships

PubMed Central

Rodebaugh, Thomas L.; Lim, Michelle H.; Fernandez, Katya C.; Langer, Julia K.; Weisman, Jaclyn S.; Tonge, Natasha; Levinson, Cheri A.; Shumaker, Erik A.

2014-01-01

Social anxiety disorder is known to be associated with self-report of global friendship quality. However, information about specific friendships, as well as information beyond self-report, is lacking. Such information is crucial, because known biases in information processing related to social anxiety disorder render global self-ratings particularly difficult to interpret. We examined these issues focusing on diagnosed participants (n = 77) compared with community control participants (n = 63). We examined self-report regarding global (i.e., overall) friendship quality and a specific friendship’s quality; in addition, we examined friend-report of that friendship’s quality. Results suggested that social anxiety disorder has a negative impact on self-perception of friendship quality for a specific friendship, but that this effect is less evident as reported by the friends. Specifically, social anxiety disorder was associated with a tendency to report worse friendship quality in comparison to friend-report, particularly in participants who were younger or had less long-lasting friendships. However, friend-report did show clear differences based on diagnostic group, with friends reporting participants with social anxiety disorder to be less dominant in the friendship and less well-adjusted. Overall, the findings are consistent with results of other studies indicating that social anxiety disorder has a strong association with self-ratings of impairment, but that these ratings appear out of proportion with the report of observers (in this case, friends). PMID:25314261

The California stream quality assessment

USGS Publications Warehouse

Van Metre, Peter C.; Egler, Amanda L.; May, Jason T.

2017-03-06

In 2017, the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) project is assessing stream quality in coastal California, United States. The USGS California Stream Quality Assessment (CSQA) will sample streams over most of the Central California Foothills and Coastal Mountains ecoregion (modified from Griffith and others, 2016), where rapid urban growth and intensive agriculture in the larger river valleys are raising concerns that stream health is being degraded. Findings will provide the public and policy-makers with information regarding which human and natural factors are the most critical in affecting stream quality and, thus, provide insights about possible approaches to protect the health of streams in the region.

The Communication Accretion Spiral: A Communication Process for Promoting and Sustaining Meaningful Partnerships between Families and Early Childhood Service Staff

ERIC Educational Resources Information Center

Elliott, Roslyn

2005-01-01

Findings of an investigation of parents' perceptions of early childhood service quality identified limitations in staff-parent communication which inhibit the development of a shared parent and staff approach to children's care and education. These findings have informed the development of an accretion model of communication for crossing the…

Evaluating the Quality and Readability of Internet Information on Meningiomas.

PubMed

Saeed, Fozia; Anderson, Ian

2017-01-01

The Internet is a highly powerful resource for patients and provides an extensive amount of information on medical conditions. It is therefore important that the information accessible is accurate, up to date, and at an appropriate comprehensive level for the general public. This article aims to evaluate the quality of patient information on meningiomas. The term meningioma was searched using the following search engines: Google, Bing, Yahoo, Ask, and AOL. The top 100 meningioma Web sites were analyzed for readability using the Flesch Reading Ease score and the Flesch-Kincaid grade level. The quality of each Web page was assessed with the DISCERN instrument and the Centers for Disease Control and Prevention (CDC) Clear Communication Index (CCI). The quality of information on the Internet on meningiomas is highly variable. The overall mean Flesch Reading Ease score was 43.1 (standard deviation = 13.3) and the mean Flesch-Kincaid grade of all the Web sites was 11.2 (standard deviation = 2.3). This finding suggests that the information is on average difficult to read. Only one Web site was at the recommended seventh-grade level and the remainder were above this grade. Only one third of the Web pages had Health On the Net Code of Conduct or The Information Standard certification and were found to be significantly of higher quality: DISCERN (P = 0.022) and CDC CCI (P = 0.027). More than 50% of the Web sites had significantly poor or average DISCERN scores and only 2 Web sites fulfilled the CDC CCI criteria. It is recommended that clinicians personally research material for their patients to be able to guide them to reliable and accurate Web sites. It is also encouraged to become Health On the Net Code of Conduct/The Information Standard certified because this may indicate information of high quality. In addition, it is also recommended that authors of existing information assess the quality of their online health information against the CDC CCI criteria. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

The quality march. National survey profiles quality improvement activities.

PubMed

1993-12-05

This nationwide profile of CQI/TQM adopters and non-adopters provides important baseline information with which to chart the growing involvement of hospitals with formal quality improvement efforts. Using a stringent definition, the findings suggest rather widespread adoption of CQI/TQM, although most of it has been very recent. Further, there are systematic differences by bed size, teaching orientation, and system membership. Though the Deming method is the most popular approach to CQI/TQM, nearly as many hospitals report using a combination of approaches, and approximately 22 percent report that they have not selected any specific approach. Of particular note is the finding that those involved with CQI/TQM activities perceive fewer barriers to their quality improvement efforts than those not involved. The impact of these differences on perceived costs and outcomes will be addressed in the next issue of Hospitals & Health Networks.

2015 Revision to 2008 Ozone National Ambient Air Quality Standards (NAAQS) Related Documents

EPA Pesticide Factsheets

Find tools for background ozone, maps of nonattainment areas, an overview of the proposal, and information on designations, monitoring and permitting requirements and a presentation on the 2015 ozone NAAQS revision.

Benchmarking and Its Relevance to the Library and Information Sector. Interim Findings of "Best Practice Benchmarking in the Library and Information Sector," a British Library Research and Development Department Project.

ERIC Educational Resources Information Center

Kinnell, Margaret; Garrod, Penny

This British Library Research and Development Department study assesses current activities and attitudes toward quality management in library and information services (LIS) in the academic sector as well as the commercial/industrial sector. Definitions and types of benchmarking are described, and the relevance of benchmarking to LIS is evaluated.…

Creating Quality Improvement Culture in Public Health Agencies

PubMed Central

Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

2014-01-01

Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680

The determinants of physician attitudes and subjective norms toward drug information sources: modification and test of the theory of reasoned action.

PubMed

Gaither, C A; Bagozzi, R P; Ascione, F J; Kirking, D M

1997-10-01

To improve upon the theory of reasoned action and apply it to pharmaceutical research, we investigated the effects of relevant appraisals attributes, and past behavior of physicians on the use of drug information sources. We also examined the moderating effects of practice characteristics. A mail questionnaire asked HMO physicians to evaluate seven common sources of drug information on general appraisals (degree of usefulness and ease of use), specific attributes (availability, quality of information on harmful effects and on drug efficacy), and past behavior when searching for information on a new, simulated H2 antagonist agent. Semantic differential scales were used to measure each appraisal, attribute and past behavior. Information was also collected on practice characteristics. Findings from 108/200 respondents indicated that appraisals and attributes were useful determinants of attitudes and subjective norms toward use. Degree of usefulness and quality of information on harmful effects were important predictors of attitudes toward use for several sources of information. Ease of use and degree of usefulness were important predictors of subjective norms toward use. In many cases, moderating effects of practice characteristics were in opposing directions. Past behavior had significant direct effects on attitudes toward the PDR. The findings suggest ways to improve the usefulness of the theory of reasoned action as a model of decision-making. We also propose practical guidelines that can be used to improve the types of drug information sources used by physicians.

Service quality and asymmetric information in the regulation of monopolies: The Chilean electricity distribution industry

NASA Astrophysics Data System (ADS)

Melo, Oscar Alfredo

This study is an enquiry about the role that service quality, asymmetric information, scope of regulation and regulator's preferences play in the regulation of monopolies, with an application to the case of the Chilean electricity distribution industry. In Chapter 1, I present the problem of regulating a monopolist and introduce the special conditions that the electricity sector has. Later I discuss the main characteristics of the electricity system that operates in Chile. The literature on regulation is reviewed in Chapter 2. A special emphasis is given to the problems of quality and information, and the lack of its proper joint treatment. In Chapter 3, I develop four theoretical models of regulation that explicitly consider the regulation of price and quality versus price-only regulation, and a symmetric versus asymmetric information structure where only the regulator knows its true costs. In these models, I also consider the effect of a regulator that may have a preference between consumers and the regulated monopolistic firms. I conclude that with symmetric information and independent of the scope of regulation, having a regulator that prefers consumers or producers does not affect the efficiency of the outcome. I also show that the regulator's inability to set quality, thus regulating only price, leads to an inefficient outcome, away from the first best solution that can be achieved by regulating both price and quality, even with asymmetric information, as long as the regulator does not have a "biased" preference for consumers or the monopolistic producers. If the regulator has a "bias," then the equilibrium will be inefficient with asymmetric information. But the effect on equilibrium price and quality depends on the direction of the effect of quality on the marginal effect of price in demand. More importantly, no closed-form solution can be derived unless drastic simplifications are made. To further investigate the outcome of the models, I use numerical simulation in Chapter 4, assuming flexible functional forms and alternative sets of parameters that represent the scenarios of interest. The results show that when the regulator is biased toward consumers (producers), symmetric information models yield higher (lower) quality except for the most efficient firm. Chapter 5 uses data from the electricity sector in Chile and estimates the price and quality elasticity of demand and finds a positive effect of quality on the price elasticity of demand.

Service quality in healthcare institutions: establishing the gaps for policy action.

PubMed

Abuosi, Aaron A; Atinga, Roger A

2013-01-01

The authors seek to examine two key issues: to assess patients' hospital service quality perceptions and expectation using SERVQUAL; and to outline the distinct concepts used to assess patient perceptions. Questionnaires were administered to 250 patients on admission and follow-up visits. The 22 paired SERVQUAL expectation and perception items were adopted. Repeated t-measures and factor analysis with Varimax rotation were used to analyse data. Results showed that patient expectations were not being met during medical treatment. Perceived service quality was rated lower than expectations for all variables. The mean difference between perceptions and expectations was statistically significant. Contrary to the SERVQUAL five-factor model, four service-quality factors were identified in the study. Findings have practical implications for hospital managers who should consider stepping up staffing levels backed by client-centred training programmes to help clinicians deliver care to patients' expectations. Limited studies are tailored towards patients' service-quality perception and expectation in Ghanaian hospitals. The findings therefore provide valuable information for policy and practice.

UrQt: an efficient software for the Unsupervised Quality trimming of NGS data.

PubMed

Modolo, Laurent; Lerat, Emmanuelle

2015-04-29

Quality control is a necessary step of any Next Generation Sequencing analysis. Although customary, this step still requires manual interventions to empirically choose tuning parameters according to various quality statistics. Moreover, current quality control procedures that provide a "good quality" data set, are not optimal and discard many informative nucleotides. To address these drawbacks, we present a new quality control method, implemented in UrQt software, for Unsupervised Quality trimming of Next Generation Sequencing reads. Our trimming procedure relies on a well-defined probabilistic framework to detect the best segmentation between two segments of unreliable nucleotides, framing a segment of informative nucleotides. Our software only requires one user-friendly parameter to define the minimal quality threshold (phred score) to consider a nucleotide to be informative, which is independent of both the experiment and the quality of the data. This procedure is implemented in C++ in an efficient and parallelized software with a low memory footprint. We tested the performances of UrQt compared to the best-known trimming programs, on seven RNA and DNA sequencing experiments and demonstrated its optimality in the resulting tradeoff between the number of trimmed nucleotides and the quality objective. By finding the best segmentation to delimit a segment of good quality nucleotides, UrQt greatly increases the number of reads and of nucleotides that can be retained for a given quality objective. UrQt source files, binary executables for different operating systems and documentation are freely available (under the GPLv3) at the following address: https://lbbe.univ-lyon1.fr/-UrQt-.html .

Sharing resources: opportunities for smaller primary care practices to increase their capacity for patient care. Findings from the 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

PubMed

Fryer, Ashley-Kay; Doty, Michelle M; Audet, Anne-Marie J

2011-03-01

Most Americans get their health care in small physician practices. Yet, small practice settings are often unable to provide the same range of services or partici­pate in quality improvement initiatives as large practices because they lack the staff, infor­mation technology, and office systems. One promising strategy is to share clinical sup­port services and information systems with other practices. New findings from the 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians suggest smaller practices that share resources are more likely than those without shared resources to have advanced electronic medical records and health information technology, routinely track and manage patient information, have after-hours care arrangements, and engage in quality monitoring and benchmarking. This issue brief highlights strategies that can increase resources among small- and medium-sized practices and efforts supported by states, the private sector, and the Affordable Care Act that encourage the expansion of shared-resource models.

Quality assurance of medicines supplied to low-income and middle-income countries: poor products in shiny boxes?

PubMed Central

Schiavetti, B; Meessen, B; Pouget, C; Caudron, J M; Marchal, B; Massat, P; Thys, S; Ravinetto, R

2017-01-01

Objective In today's context of globalisation of pharmaceutical production and distribution, international and national procurement agencies play a de facto key role in defining the quality of medicines available in sub-Saharan Africa. We evaluated the compliance of a sample of pharmaceutical distributors active in sub-Saharan Africa with the standards of the WHO guideline ‘Model Quality Assurance System (WHO MQAS) for procurement agencies’, and we investigated factors favouring or hindering the adequate implementation of the guideline. Methods We used mixed-methods methodology to analyse quantitative and qualitative data. The quantitative study consisted of a retrospective secondary analysis of data collected by QUAMED (Quality Medicines for all), a partnership that pleads for universal access to quality-assured medicines. The qualitative survey consisted of formal and informal interviews with key informants. We adopted an embedded multiple-case study design. Findings Our analysis suggests that international distributors based in Europe perform, on average, better than sub-Saharan African distributors. However, some weaknesses are ubiquitous and concern critical processes, such as the initial selection of the products and the ongoing reassessment of their quality. This is due to several different factors: weak regulatory oversight, insufficient human/financial resources, weak negotiating power, limited judicial autonomy and/or lack of institutional commitment to quality. Conclusions Our findings suggest that pharmaceutical distributors active in sub-Saharan Africa generally do not apply stringent criteria for selecting products and suppliers. Therefore, product quality is not consistently assured but depends on the requirements of purchasers. While long-term solutions are awaited, the WHO MQAS guideline should be used as an evaluation and training tool to upgrade current standards. PMID:28589013

A pilot qualitative study to explore stakeholder opinions regarding prescribing quality indicators

PubMed Central

2012-01-01

Background Information on prescribing quality of diabetes care is required by health care providers, insurance companies, policy makers, and the public. Knowledge regarding the opinions and preferences of all involved parties regarding prescribing quality information is important for effective use of prescribing quality indicators. Methods Between June and December 2009 we conducted semi structured interviews with 16 key-informants representing eight different organizations in the Netherlands involved in healthcare quality measurement and improvement. The interview guide included topics on participants’ opinions and preferences regarding existing types of prescribing quality indicators in relation to their aim of using quality information. Content analysis methods were used to process the resulting transcripts following the framework of predetermined themes. Results Findings from this qualitative study of stakeholder preferences showed that indicators focusing on undertreatment are found important by all participants. Furthermore, health care providers and policy makers valued prescribing safety indicators, insurance companies prioritized indicators focusing on prescribing costs, and patients’ organization representatives valued indicators focusing on interpersonal side of prescribing. Representatives of all stakeholders preferred positive formulation of the indicators to motivate health care providers to participate in health improvement programs. A composite score was found to be most useful by all participants as a starting point of prescribing quality assessment. Lack of information on reasons for deviating from guidelines recommendations appeared to be the most important barrier for using prescribing quality indicators. According to the health care providers, there are many legitimate reasons for not prescribing the recommended treatment and these reasons are not always taken into account by external evaluators. The latter may cause mistrust of health care providers towards external stakeholders and limit the use of PQI in external quality improvement programs. Conclusion Prescribing quality indicators are considered to be an important tool for assessing quality of provided diabetes care by all participants, although the preferences for specific types of indicators may differ by stakeholder depending on their user aim. Introduction of information systems to register the reasons for deviating from the recommended drug treatment may contribute to a more widespread use of PQI for assessment of provided health care quality to diabetic patents. This study identified the potential preferences regarding quality indicators for diabetes care, and this could be used for development of questionnaires to conduct a survey among a larger group of participants. PMID:22769967

Looking Upstream: Findings from Focus Groups on Public Perceptions of Source Water Quality in British Columbia, Canada

PubMed Central

Henrich, Natalie; Holmes, Bev; Prystajecky, Natalie

2015-01-01

In association with the development of new microbial tests for source water quality (SWQ), focus groups with members of the public were conducted to gain insight into their perceptions of SWQ, behaviours and contaminants they think pose the greatest threat to its quality, and what/how they want to know about SWQ. Discussions revealed a low concern about SWQ in general, and in particular about microbial contamination. Participants identified behaviours that threaten SWQ, barriers to changing behaviour and suggestions for inducing change. A strong desire was expressed for water quality information to be interpreted and communicated in terms of how SWQ may impact human health and how their actions should be altered in response to test results. The information can be used to inform communication strategies and possibly impact policies associated with water quality testing and implementation of new tests. More broadly, awareness of the public’s understanding and beliefs about source water can be used in working with the public to adopt water-friendly behaviours, influence the content and methods of communicating with the public about water issues and water quality, and could contribute to the direction of future research and investment into water technologies to align with the public’s priorities. PMID:26540561

Looking Upstream: Findings from Focus Groups on Public Perceptions of Source Water Quality in British Columbia, Canada.

PubMed

Henrich, Natalie; Holmes, Bev; Prystajecky, Natalie

2015-01-01

In association with the development of new microbial tests for source water quality (SWQ), focus groups with members of the public were conducted to gain insight into their perceptions of SWQ, behaviours and contaminants they think pose the greatest threat to its quality, and what/how they want to know about SWQ. Discussions revealed a low concern about SWQ in general, and in particular about microbial contamination. Participants identified behaviours that threaten SWQ, barriers to changing behaviour and suggestions for inducing change. A strong desire was expressed for water quality information to be interpreted and communicated in terms of how SWQ may impact human health and how their actions should be altered in response to test results. The information can be used to inform communication strategies and possibly impact policies associated with water quality testing and implementation of new tests. More broadly, awareness of the public's understanding and beliefs about source water can be used in working with the public to adopt water-friendly behaviours, influence the content and methods of communicating with the public about water issues and water quality, and could contribute to the direction of future research and investment into water technologies to align with the public's priorities.

The "Consumer Report" version of Earth Science Data Quality description

NASA Astrophysics Data System (ADS)

Vicente, G. A.

2014-12-01

The generation, delivery and access of Earth Observation (EO) data quality information is a difficult problem because it is not uniquely defined, user dependent, difficult to be quantified, handled differently by different teams and perceived differently by data providers and data users. Initiatives such as the International Organization for Standards (ISO) 19115 and 19157 are important steps forward but difficult to implement, too complex and out of reach for the majority of data producers and users. This is because most users only want a quick and intelligible way to compare data sets from different providers to find the ones that best fit their interest. Therefore we need to simplify the problem by focusing on a few relevant quality parameters and develop a common framework to deliver them. This work is intended to tap into the data producers and user's knowledge and expertise on data quality for the development and adoption of a "Consumer Report" version of a "Data Quality Matrix". The goal is to find the most efficient and friendly approach to displays a selected number of quality parameters rated to each product and to target group of users.

Health Information Exchange Readiness for Demonstrating Return on Investment and Quality of Care.

PubMed

Khurshid, Anjum; Diana, Mark L; Jain, Rahul

2015-01-01

To study the extent to which community health information exchanges (HIEs) deliver and measure return on investment (ROI) and improvements in the quality of care. We surveyed operational HIEs for their characteristics, information domains, impact on quality of care, and ROI. A 60 percent response rate was achieved. Two-thirds of respondents agreed that community HIEs demonstrated a positive ROI, while one-third had no opinion or disagreed. One-fourth or fewer respondents reported using various metrics to calculate ROI. Most respondents agreed that HIEs improve the quality of care, though several were not sure and were awaiting further evidence. Most respondents indicated that they did not deliver reports on quality measures (76 percent) and that data were not being used to measure quality performance of participating providers (73 percent). Respondents from most HIEs believe that the HIEs are demonstrating a positive ROI; however, a minority of them indicated they had used or will use specific metrics to calculate ROI. HIE representatives overwhelmingly reported that they believe the HIE activities improve the quality of healthcare delivered, but only a few are using data to evaluate provider performance or generate reports on quality measures. This study demonstrates the challenge faced by policy makers and healthcare organizations that are investing millions of dollars in HIEs that are believed to improve health outcomes and increase efficiency, but still need more time to develop the evidence to confirm that belief. Our study shows that calculating ROI for HIEs or their impact on quality of care remains a secondary priority for most HIEs. This finding raises serious questions for the sustained support of HIEs, both financially and as a policy lever, given the end of Health Information Technology for Economic and Clinical Health (HITECH) Act funding.

Effects of fire, insect, and pathogen damage on wood quality of dead and dying western conifers

Treesearch

Eini C. Lowell; Valerie A. Rapp; Richard W. Haynes; Caitlin Cray

2010-01-01

We update and expand the 1992 survey of research findings by Lowell and colleagues, providing an ecological context for the findings, using a more reader-friendly format, and including extensive citations so readers can get indepth information on particular topics. Our intent is that managers will use this report as a desktop reference and field guide. The worksheet...

Service quality of Early Childhood Education web portals in Finnish municipalities

NASA Astrophysics Data System (ADS)

Koskivaara, Eija; Pihlaja, Päivi

Increasing number of governmental organizations have transformed material on their web sites as a way of providing users with information about their products and services. In this paper, we apply Yang et al (2005) instrument for analyzing municipal early childhood education (ECE) web sites in Finland. The objective of the study was to find out the quality of ECE web portals as well as to give hints to improve their value from users' point of view. In general the five dimensions, usability, usefulness of content, adequacy of information, accessibility, and interaction, of the Yang et al model seems to be applicable also in the early childhood education environment.

Factors associated with the quality of life of nursing home residents in Hong Kong.

PubMed

Lai, C K Y; Leung, D D M; Kwong, E W Y; Lee, R L P

2015-03-01

The quality of life of nursing home residents has increasingly become an important dimension when evaluating care in a nursing home. Not a lot is known about the quality of life of nursing home residents in Hong Kong. To investigate factors associated with the quality of life of nursing home residents to inform care management policies and service delivery. This study reports data from 125 nursing home residents. The Hong Kong Chinese version of the World Health Organization's Quality of Life-Brief version was used. Other measures used include the Mini-Mental State Examination, the Mini-Nutritional Assessment, the Geriatric Depression Scale, the Modified STRATIFY Falls Prediction Tool and the Modified Barthel Index. A univariate analysis and a multiple regression analysis were then performed to identify the influencing factors. The participants reported a moderate level of quality of life, with the exception in the domain of social relationships. A univariate analysis found some associations between demographic and clinical characteristics and quality of life. A multiple regression analysis indicated that pain, being younger (65-74 years), having son(s) or daughter(s), and cognitive impairment were negatively associated factors. The smallness of the sample from a single study site limits the generalizability of the findings. This study provides information that has hitherto been lacking on the quality of life and associated factors among local nursing home residents in Hong Kong. The preliminary findings can help healthcare staff to identify those at risk of suffering from a low quality of life and to design appropriate care interventions to improve the quality of life of such residents. Adequate pain relief, family connectedness and special attention to the needs of those with cognitive impairment are important considerations in ensuring a better quality of life for older people in long-term residential care. © 2014 International Council of Nurses.

How could health information be improved? Recommended actions from the Victorian Consultation on Health Literacy.

PubMed

Hill, Sophie J; Sofra, Tanya A

2017-03-07

Objective Health literacy is on the policy agenda. Accessible, high-quality health information is a major component of health literacy. Health information materials include print, electronic or other media-based information enabling people to understand health and make health-related decisions. The aim of the present study was to present the findings and recommended actions as they relate to health information of the Victorian Consultation on Health Literacy. Methods Notes and submissions from the 2014 Victorian Consultation workshops and submissions were analysed thematically and a report prepared with input from an advisory committee. Results Health information needs to improve and recommendations are grouped into two overarching themes. First, the quality of information needs to be increased and this can be done by developing a principle-based framework to inform updating guidance for information production, formulating standards to raise quality and improving the systems for delivering information to people. Second, there needs to be a focus on users of health information. Recommendation actions were for information that promoted active participation in health encounters, resources to encourage critical users of health information and increased availability of information tailored to population diversity. Conclusion A framework to improve health information would underpin the efforts to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management. What is known about the topic? Health information is a critical component of the concept of health literacy. Poorer health literacy is associated with poorer health outcomes across a range of measures. Improving access to and the use of quality sources of health information is an important strategy for meeting the health literacy needs of the population. In recent years, health services and governments have taken a critical interest in improving health literacy. What does this paper add? This article presents the findings of the Victorian Consultation on Health Literacy as they relate to needs, priorities and potential actions for improving health information. In the context of the National Statement for Health Literacy, health information should be a priority, given its centrality to the public's management of its own health and effective, standards-based, patient-centred clinical care. A framework to improve health information would underpin the efforts of government, services and consumer organisations to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management. What are the implications for practitioners? The development and provision of health information materials needs to be systematised and supported by infrastructure, requiring leadership, cultural change, standards and skills development.

Testing a Nursing-Specific Model of Electronic Patient Record documentation with regard to information completeness, comprehensiveness and consistency.

PubMed

von Krogh, Gunn; Nåden, Dagfinn; Aasland, Olaf Gjerløw

2012-10-01

To present the results from the test site application of the documentation model KPO (quality assurance, problem solving and caring) designed to impact the quality of nursing information in electronic patient record (EPR). The KPO model was developed by means of consensus group and clinical testing. Four documentation arenas and eight content categories, nursing terminologies and a decision-support system were designed to impact the completeness, comprehensiveness and consistency of nursing information. The testing was performed in a pre-test/post-test time series design, three times at a one-year interval. Content analysis of nursing documentation was accomplished through the identification, interpretation and coding of information units. Data from the pre-test and post-test 2 were subjected to statistical analyses. To estimate the differences, paired t-tests were used. At post-test 2, the information is found to be more complete, comprehensive and consistent than at pre-test. The findings indicate that documentation arenas combining work flow and content categories deduced from theories on nursing practice can influence the quality of nursing information. The KPO model can be used as guide when shifting from paper-based to electronic-based nursing documentation with the aim of obtaining complete, comprehensive and consistent nursing information. © 2012 Blackwell Publishing Ltd.

Finding Good Child Care: The Essential Questions To Ask When Seeking Quality Care for Your Child. CCAC Information Guide 19.

ERIC Educational Resources Information Center

Child Care Action Campaign, New York, NY.

This Child Care Action Campaign (CCAC) Information Guide focuses on questions for parents to ask when looking for the right childcare program. The guide provides a checklist for parents to use when evaluating potential or currently used childcare programs. By sharing and discussing the checklist with caregivers, parents and caregivers can work…

The public gets what the public wants: experiences of public reporting in long-term care in Europe.

PubMed

Rodrigues, Ricardo; Trigg, Lisa; Schmidt, Andrea E; Leichsenring, Kai

2014-05-01

Public reporting of quality in long-term care is advocated on the basis of allowing providers to improve their performance by benchmarking and supporting users to choose the best providers. Both mechanisms are intended to drive improvements in quality. However, there is relatively scarce comparative research on the experiences and impact of public reporting on quality in long-term care in Europe. Using information gathered from key informants by means of a structured questionnaire and country profiles, this paper discusses experiences with public reporting mechanisms in seven European countries and available information on their impact on quality in long-term care. Countries surveyed included a variety of public reporting schemes, ranging from pilot programmes to statutory mechanisms. Public reporting mechanisms more often focus on institutional care. Inspections carried out as part of a legal quality assurance framework are the main source of information gathering, supplemented by provider self-assessments in the context of internal quality management and user satisfaction surveys. Information on quality goes well beyond structural indicators to also include indicators on quality of life of users. Information is displayed using numerical scores (percentages), but also measures such as ratings (similar to school grades) and ticks and crosses. Only one country corrects for case-mix. The internet is the preferred medium of displaying information. There was little evidence to show whether public reporting has a significant impact on driving users' choices of provider. Studies reported low awareness of quality indicators among potential end users and information was not always displayed in a convenient format, e.g. through complicated numerical scores. There is scarce evidence of public reporting directly causing improved quality, although the relative youth and the pilot characteristics of some of the schemes covered here could also have contributed to downplay their impact. The establishment of public reporting mechanisms did however contribute to shaping the discussion on quality measurement in several of the countries surveyed. The findings presented in this paper highlight the need to consider some factors in the discussion of the impact of public reporting in long-term care, namely, the organisation of care markets, frequently characterised by limited competition; the circumstances under which user choice takes place, often made under conditions of duress; and the leadership conditions needed to bring about improvements in quality in different care settings. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Assessing the Value of Enhancing AirNow Data with NASA Satellite Data

NASA Astrophysics Data System (ADS)

Pasch, A. N.; Burke, B.; Huang, S.; Dye, T.; Dawes, S. S.; DeWinter, J. L.; Zahn, P. H.; Haderman, M.; Szykman, J.; White, J. E.; Dickerson, P.; van Donkelaar, A.; Martin, R.

2013-12-01

We will describe the methodology and findings from a study that addressed how satellite-enhanced air quality information provided through the U.S. Environmental Protection Agency's (EPA) AirNow Satellite Data Processor (ASDP) program could contribute to greater socioeconomic benefits. This study was funded by the National Aeronautics and Space Administration (NASA) and conducted, in partnership with the EPA, by the Center for Technology in Government at the University at Albany (CTG) and Sonoma Technology, Inc. (STI). AirNow is the national repository of real-time air quality data and forecasts for the United States. While mainly a public outreach and awareness tool, AirNow relies on the same network of ground-based air quality monitors that is used by federal, state, local, and tribal governments throughout the United States. Extensive as the monitoring network is, considerable gaps exist in certain parts of the United States. Even areas with monitors considered adequate for regulatory purposes can lack information needed to resolve localized air quality issues or give forecasters sufficient confidence about the potential air quality impact of specific events. Monitors are expensive to deploy and maintain; thus, EPA is seeking other ways to improve coverage and detail. Satellite-estimated data can provide information for many places where ground monitors do not exist, and supplement ground monitors, providing additional information for use in analysis and forecasting. ASDP uses satellite-derived estimates for fine-particle pollution (PM2.5) and provides coverage for a small window of time during the day. As satellite capabilities improve in terms of different types of sensors and increased coverage throughout the day, the ASDP program is prepared to extend its scope to additional pollutants and provide greater enhancements to the ground-based networks. In this study, CTG assessed the socioeconomic benefits of air quality data at a community level through three case studies in the Denver, Atlanta, and Kansas City regions by interviewing people at EPA regional offices, state environmental and public health agencies, local public health authorities, regional planning and non-profit outreach organizations, and universities. The interviews focused on the existing uses of air quality information and the potential value of incorporating NASA satellite-enhanced AirNow data to support and enhance the missions of the organizations interviewed. STI analyzed the economic benefit of using satellite data to fill in gaps in the current air quality monitoring network used to provide information to the public. This presentation will discuss how the findings can be used to improve estimation of the socioeconomic benefits derived from Earth observation science in policy and management decisions.

Electronic health records implementation: an evaluation of information system impact and contingency factors.

PubMed

Nguyen, Lemai; Bellucci, Emilia; Nguyen, Linh Thuy

2014-11-01

This paper provides a review of EHR (electronic health record) implementations around the world and reports on findings including benefits and issues associated with EHR implementation. A systematic literature review was conducted from peer-reviewed scholarly journal publications from the last 10 years (2001-2011). The search was conducted using various publication collections including: Scopus, Embase, Informit, Medline, Proquest Health and Medical Complete. This paper reports on our analysis of previous empirical studies of EHR implementations. We analysed data based on an extension of DeLone and McLean's information system (IS) evaluation framework. The extended framework integrates DeLone and McLean's dimensions, including information quality, system quality, service quality, intention of use and usage, user satisfaction and net benefits, together with contingent dimensions, including systems development, implementation attributes and organisational aspects, as identified by Van der Meijden and colleagues. A mix of evidence-based positive and negative impacts of EHR was found across different evaluation dimensions. In addition, a number of contingent factors were found to contribute to successful implementation of EHR. This review does not include white papers or industry surveys, non-English papers, or those published outside the review time period. This review confirms the potential of this technology to aid patient care and clinical documentation; for example, in improved documentation quality, increased administration efficiency, as well as better quality, safety and coordination of care. Common negative impacts include changes to workflow and work disruption. Mixed observations were found on EHR quality, adoption and satisfaction. The review warns future implementers of EHR to carefully undertake the technology implementation exercise. The review also informs healthcare providers of contingent factors that potentially affect EHR development and implementation in an organisational setting. Our findings suggest a lack of socio-technical connectives between the clinician, the patient and the technology in developing and implementing EHR and future developments in patient-accessible EHR. In addition, a synthesis of DeLone and McLean's framework and Van der Meijden and colleagues' contingent factors has been found useful in comprehensively understanding and evaluating EHR implementations. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

Developing Methodologies to Find Abbreviated Laboratory Test Names in Narrative Clinical Documents by Generating High Quality Q-Grams.

PubMed

Kim, Kyungmo; Choi, Jinwook

2017-01-01

Laboratory test names are used as basic information to diagnose diseases. However, this kind of medical information is usually written in a natural language. To find this information, lexicon based methods have been good solutions but they cannot find terms that do not have abbreviated expressions, such as "neuts" that means "neutrophils". To address this issue, similar word matching can be used; however, it can be disadvantageous because of significant false positives. Moreover, processing time is longer as the size of terms is bigger. Therefore, we suggest a novel q-gram based algorithm, named modified triangular area filtering, to find abbreviated laboratory test terms in clinical documents, minimizing the possibility to impair the lexicons' precision. In addition, we found the terms using the methodology with reasonable processing time. The results show that this method can achieve 92.54 precision, 87.72 recall, 90.06 f1-score in test sets when edit distance threshold(τ) = 3.

Synonym-Based Word Frequency Analysis to Support the Development and Presentation of a Public Health Quality Improvement Taxonomy.

PubMed

Pina, Jamie; Massoudi, Barbara L; Chester, Kelley; Koyanagi, Mark

2018-06-07

Researchers and analysts have not completely examined word frequency analysis as an approach to creating a public health quality improvement taxonomy. To develop a taxonomy of public health quality improvement concepts for an online exchange of quality improvement work. We analyzed documents, conducted an expert review, and employed a user-centered design along with a faceted search approach to make online entries searchable for users. To provide the most targeted facets to users, we used word frequency to analyze 334 published public health quality improvement documents to find the most common clusters of word meanings. We then reviewed the highest-weighted concepts and categorized their relationships to quality improvement details in our taxonomy. Next, we mapped meanings to items in our taxonomy and presented them in order of their weighted percentages in the data. Using these methods, we developed and sorted concepts in the faceted search presentation so that online exchange users could access relevant search criteria. We reviewed 50 of the top synonym clusters and identified 12 categories for our taxonomy data. The final categories were as follows: Summary; Planning and Execution Details; Health Impact; Training and Preparation; Information About the Community; Information About the Health Department; Results; Quality Improvement (QI) Staff; Information; Accreditation Details; Collaborations; and Contact Information of the Submitter. Feedback about the elements in the taxonomy and presentation of elements in our search environment from users has been positive. When relevant data are available, the word frequency analysis method may be useful in other taxonomy development efforts for public health.

Do economic evaluation studies inform effective healthcare resource allocation in Iran? A critical review of the literature.

PubMed

Haghparast-Bidgoli, Hassan; Kiadaliri, Aliasghar Ahmad; Skordis-Worrall, Jolene

2014-01-01

To aid informed health sector decision-making, data from sufficient high quality economic evaluations must be available to policy makers. To date, no known study has analysed the quantity and quality of available Iranian economic evaluation studies. This study aimed to assess the quantity, quality and targeting of economic evaluation studies conducted in the Iranian context. The study systematically reviewed full economic evaluation studies (n = 30) published between 1999 and 2012 in international and local journals. The findings of the review indicate that although the literature on economic evaluation in Iran is growing, these evaluations were of poor quality and suffer from several major methodological flaws. Furthermore, the review reveals that economic evaluation studies have not addressed the major health problems in Iran. While the availability of evidence is no guarantee that it will be used to aid decision-making, the absence of evidence will certainly preclude its use. Considering the deficiencies in the data identified by this review, current economic evaluations cannot be a useful source of information for decision makers in Iran. To improve the quality and overall usefulness of economic evaluations we would recommend; 1) developing clear national guidelines for the conduct of economic evaluations, 2) highlighting priority areas where information from such studies would be most useful and 3) training researchers and policy makers in the calculation and use of economic evaluation data.

Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

Do economic evaluation studies inform effective healthcare resource allocation in Iran? A critical review of the literature

PubMed Central

2014-01-01

To aid informed health sector decision-making, data from sufficient high quality economic evaluations must be available to policy makers. To date, no known study has analysed the quantity and quality of available Iranian economic evaluation studies. This study aimed to assess the quantity, quality and targeting of economic evaluation studies conducted in the Iranian context. The study systematically reviewed full economic evaluation studies (n = 30) published between 1999 and 2012 in international and local journals. The findings of the review indicate that although the literature on economic evaluation in Iran is growing, these evaluations were of poor quality and suffer from several major methodological flaws. Furthermore, the review reveals that economic evaluation studies have not addressed the major health problems in Iran. While the availability of evidence is no guarantee that it will be used to aid decision-making, the absence of evidence will certainly preclude its use. Considering the deficiencies in the data identified by this review, current economic evaluations cannot be a useful source of information for decision makers in Iran. To improve the quality and overall usefulness of economic evaluations we would recommend; 1) developing clear national guidelines for the conduct of economic evaluations, 2) highlighting priority areas where information from such studies would be most useful and 3) training researchers and policy makers in the calculation and use of economic evaluation data. PMID:25050084

Analysis of German nutrition brochures for pregnant women with evidence-based patient information criteria.

PubMed

Küllenberg de Gaudry, Daniela; Grede, Nina; Motschall, Edith; Lins, Sabine

2015-02-01

To evaluate nutrition brochures for pregnant women in Germany based on evidence-based patient information (EBPI) criteria. Nutrition brochures for pregnant women in Germany were collected. Brochures addressing the risk of salmonellosis, toxoplasmosis or listeriosis were analyzed by two researchers independently. Fifty brochures reporting any information on the risk of infection were analyzed. Most brochures did not include literature citations and only few brochures gave a risk description, predominantly verbally, which usually leads to an overestimation of the actual risk. Advertisement was present in 22% of the brochures. German nutrition brochures for pregnant women should be adapted to comply with evidence-based patient information (EBPI) criteria for achieving a better quality of the disseminated information. The findings highlight the need of high quality nutrition brochures for pregnant women, which are relevant not only for pregnant women, but also to those responsible for creating brochures, and to physicians in charge of patient information. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2016-06-01

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

The role of histopathology in forensic practice: an overview.

PubMed

Dettmeyer, R B

2014-09-01

The role of forensic histopathology in routine practice is to establish the cause of death in particular cases. This is achieved on the basis of microscopic analysis of representative cell and tissue samples taken from the major internal organs and from abnormal findings made at autopsy. A prerequisite of this is adherence to the quality standards set out for conventional histological/cytological staining and enzyme histochemical and immunohistochemical methods. The interpretation of histological findings is performed by taking into account macroscopic autopsy findings and information on previous history. Histological analysis may prompt postmortem biochemical and chemical-toxicological investigations. The results of histological analysis need to be classified by experts in the context of the available information and the need to withstand the scrutiny of other experts.

Health Advice from Internet Discussion Forums: How Bad Is Dangerous?

PubMed

Cole, Jennifer; Watkins, Chris; Kleine, Dorothea

2016-01-06

Concerns over online health information-seeking behavior point to the potential harm incorrect, incomplete, or biased information may cause. However, systematic reviews of health information have found few examples of documented harm that can be directly attributed to poor quality information found online. The aim of this study was to improve our understanding of the quality and quality characteristics of information found in online discussion forum websites so that their likely value as a peer-to-peer health information-sharing platform could be assessed. A total of 25 health discussion threads were selected across 3 websites (Reddit, Mumsnet, and Patient) covering 3 health conditions (human immunodeficiency virus [HIV], diabetes, and chickenpox). Assessors were asked to rate information found in the discussion threads according to 5 criteria: accuracy, completeness, how sensible the replies were, how they thought the questioner would act, and how useful they thought the questioner would find the replies. In all, 78 fully completed assessments were returned by 17 individuals (8 were qualified medical doctors, 9 were not). When the ratings awarded in the assessments were analyzed, 25 of the assessments placed the discussion threads in the highest possible score band rating them between 5 and 10 overall, 38 rated them between 11 and 15, 12 rated them between 16 and 20, and 3 placed the discussion thread they assessed in the lowest rating band (21-25). This suggests that health threads on Internet discussion forum websites are more likely than not (by a factor of 4:1) to contain information of high or reasonably high quality. Extremely poor information is rare; the lowest available assessment rating was awarded only 11 times out of a possible 353, whereas the highest was awarded 54 times. Only 3 of 78 fully completed assessments rated a discussion thread in the lowest possible overall band of 21 to 25, whereas 25 of 78 rated it in the highest of 5 to 10. Quality assessments differed depending on the health condition (chickenpox appeared 17 times in the 20 lowest-rated threads, HIV twice, and diabetes once). Although assessors tended to agree on which discussion threads contained good quality information, what constituted poor quality information appeared to be more subjective. Most of the information assessed in this study was considered by qualified medical doctors and nonmedically qualified respondents to be of reasonably good quality. Although a small amount of information was assessed as poor, not all respondents agreed that the original questioner would have been led to act inappropriately based on the information presented. This suggests that discussion forum websites may be a useful platform through which people can ask health-related questions and receive answers of acceptable quality.

Smart use of data, information and communication: the INFORM-ed Best Local Practice Project--Grafton Base Hospital.

PubMed

Lloyd, Sheree; Collie, Jean; McInnes, Alastair; King, Kevin; Lollback, Alison; Garland, Angie

This paper describes current progress for an information management project in a medium-sized rural hospital after the first four months of the one-year project. In particular, the article examines some of the project outcomes to date as these relate to the National Hospitals and Health Reform recommendations for the smart use of data, information and communication. The paper identifies a number of important challenges and issues that have been addressed by the project and proposes that the project findings may be used to inform similar projects in other settings. These findings relate to clinician requirements for reports, investment in human resources, development, and time for information management activities. An understanding of data collected, information systems, and presentation of clinician data are also important. The benefits of information sharing in assisting quality improvement activities are particularly relevant but, more importantly, they can engage and involve clinicians in the use of information. The importance of local data, information, and knowledge is described. Finally, issues for the health information management profession, such as working collegially and sharing knowledge and expertise, are outlined.

Hippocampal activity during recognition memory co-varies with the accuracy and confidence of source memory judgments.

PubMed

Yu, Sarah S; Johnson, Jeffrey D; Rugg, Michael D

2012-06-01

It has been proposed that the hippocampus selectively supports retrieval of contextual associations, but an alternative view holds that the hippocampus supports strong memories regardless of whether they contain contextual information. We employed a memory test that combined the 'Remember/Know' and source memory procedures, which allowed test items to be segregated both by memory strength (recognition accuracy) and, separately, by the quality of the contextual information that could be retrieved (indexed by the accuracy/confidence of a source memory judgment). As measured by fMRI, retrieval-related hippocampal activity tracked the quality of retrieved contextual information and not memory strength. These findings are consistent with the proposal that the hippocampus supports contextual recollection rather than recognition memory more generally. Copyright © 2011 Wiley Periodicals, Inc.

Visual Working Memory Cannot Trade Quantity for Quality.

PubMed

Ramaty, Ayelet; Luria, Roy

2018-01-01

Two main models have been proposed to describe how visual working memory (WM) allocates its capacity: the slot-model and the continuous resource-model. The purpose of the current study was to test a direct prediction of the resource model suggesting that WM can trade-off between the quantity and quality of the encoded information. Previous research reported equivocal results, with studies that failed to find such a trade-off and other studies that reported a trade-off. Following the design of previous studies, in Experiment 1 we replicated this trade-off, by presenting the memory array for 1200 ms. Experiment 2 failed to observe a trade-off between quantity and quality using a memory array interval of 300 ms (a standard interval for visual WM). Experiment 3 again failed to find this trade-off, when reinstating the 1200 ms memory array interval but adding an articulatory suppression manipulation. We argue that while participants can trade quantity for quality, this pattern depends on verbal encoding and transfer to long-term memory processes that were possible to perform only during the long retention interval. When these processes were eliminated, the trade-off disappeared. Thus, we didn't find any evidence that the trade-off between quantity for quality can occur within visual WM.

Quality of physician communication about human papillomavirus vaccine: findings from a national survey.

PubMed

Gilkey, Melissa B; Malo, Teri L; Shah, Parth D; Hall, Megan E; Brewer, Noel T

2015-11-01

Improving the quality of physicians' recommendations for human papillomavirus (HPV) vaccination is critical to addressing low coverage. Thus, we sought to describe HPV vaccine communication practices among primary care physicians. Pediatricians and family physicians (n = 776) completed our national online survey in 2014. We assessed the quality of their HPV vaccine recommendations on strength of endorsement (i.e., saying the vaccine is important), timeliness (recommending it by ages 11-12), consistency (recommending it routinely vs. using a risk-based approach), and urgency (recommending same-day vaccination). A sizeable minority of physicians reported that they do not strongly endorse HPV vaccine (27%) or deliver timely recommendations for girls (26%) or boys (39%). Many physicians (59%) used a risk-based approach to recommending HPV vaccine, and only half (51%) usually recommended same-day vaccination. Overall recommendation quality was lower among physicians who were uncomfortable talking about HPV vaccine or who believed parents did not value it. Quality was higher among physicians who began discussions by saying the child was due for HPV vaccine versus giving information or eliciting questions. Many physicians in our national sample reported recommending HPV vaccine inconsistently, behind schedule, or without urgency. These practices likely contribute to under-immunization among adolescents, and may convey ambivalence to parents. As one of the first studies to assess multiple aspects of recommendation quality, these findings can inform the many state and national initiatives that aim to improve communication about HPV vaccine so as to address the persistent underuse of a powerful tool for cancer prevention. ©2015 American Association for Cancer Research.

A Global Assessment on Climate Research Engaging Indigenous Knowledge Systems and Recommendations for Quality Standards of Research Practice in Indigenous Communities

NASA Astrophysics Data System (ADS)

Davíd-Chavez, D. M.; Gavin, M. C.

2017-12-01

Indigenous communities worldwide have maintained their own knowledge systems for millennia informed through careful observation of dynamics of environmental changes. Withstanding centuries of challenges to their rights to maintain and practice these knowledge systems, Indigenous peoples continually speak to a need for quality standards for research in their communities. Although, international and Indigenous peoples' working groups emphasize Indigenous knowledge systems and the communities who hold them as critical resources for understanding and adapting to climate change, there has yet to be a comprehensive, evidence based analysis into how diverse knowledge systems are integrated in scientific studies. Do current research practices challenge or support Indigenous communities in their efforts to maintain and appropriately apply their knowledge systems? This study addresses this question using a systematic literature review and meta-analysis assessing levels of Indigenous community participation and decision-making in all stages of the research process (initiation, design, implementation, analysis, dissemination). Assessment is based on reported quality indicators such as: outputs that serve the community, ethical guidelines in practice (free, prior, and informed consent and intellectual property rights), and community access to findings. These indicators serve to identify patterns between levels of community participation and quality standards in practice. Meta-analysis indicates most climate studies practice an extractive model in which Indigenous knowledge systems are co-opted with minimal participation or decision-making authority from communities who hold them. Few studies report outputs that directly serve Indigenous communities, ethical guidelines in practice, or community access to findings. Studies reporting the most quality indicators were initiated in mutual agreement between Indigenous communities and outside researchers or by communities themselves. This study also draws from the researcher's experiences as an Indigenous scientist and includes recommendations for quality research practice. This global assessment provides an evidence base to inform our understanding of broader impacts related to research design.

Is Anyone Paying Attention to Physician Report Cards? The Impact of Increased Availability on Consumers' Awareness and Use of Physician Quality Information.

PubMed

Shi, Yunfeng; Scanlon, Dennis P; Bhandari, Neeraj; Christianson, Jon B

2017-08-01

To determine if the release of health care report cards focused on physician practice quality measures leads to changes in consumers' awareness and use of this information. Data from two rounds of a survey of the chronically ill adult population conducted in 14 regions across the United States, combined with longitudinal information from a public reporting tracking database. Both data were collected as part of the evaluation for Aligning Forces for Quality, a nationwide quality improvement initiative funded by the Robert Wood Johnson Foundation. Using a longitudinal design and an individual-level fixed effects modeling approach, we estimated the impact of community public reporting efforts, measured by the availability and applicability of physician quality reports, on consumers' awareness and use of physician quality information (PQI). The baseline level of awareness was 12.6 percent in our study sample, drawn from the general population of chronically ill adults. Among those who were not aware of PQI at the baseline, when PQI became available in their communities for the first time, along with quality measures that are applicable to their specific chronic conditions, the likelihood of PQI awareness increased by 3.8 percentage points. For the same group, we also find similar increases in the uses of PQI linked to newly available physician report cards, although the magnitudes are smaller, between 2 and 3 percentage points. Specific contents of physician report cards can be an important factor in consumers' awareness and use of PQI. Policies to improve awareness and use of PQI may consider how to customize quality report cards and target specific groups of consumers in dissemination. © Health Research and Educational Trust.

Finding meaning in art: Preferred levels of ambiguity in art appreciation

PubMed Central

Jakesch, Martina; Leder, Helmut

2011-01-01

Uncertainty is typically not desirable in everyday experiences, but uncertainty in the form of ambiguity may be a defining feature of aesthetic experiences of modern art. In this study, we examined different hypotheses concerning the quantity and quality of information appreciated in art. Artworks were shown together with auditorily presented statements. We tested whether the amount of information, the amount of matching information, or the proportion of matching to nonmatching statements apparent in a picture (levels of ambiguity) affect liking and interestingness. Only the levels of ambiguity predicted differences in the two dependent variables. These findings reveal that ambiguity is an important determinant of aesthetic appreciation and that a certain level of ambiguity is appreciable. PMID:19565431

The Web: Can We Make It Easier To Find Information?

ERIC Educational Resources Information Center

Maddux, Cleborne D.

1999-01-01

Reviews problems with the World Wide Web that can be attributed to human error or ineptitude, and provides suggestions for improvement. Discusses poor Web design, poor use of search engines, and poor quality control by search engines and directories. (AEF)

Fact Sheets and Additional Information Regarding the Primary National Ambient Air Quality Standard (NAAQS) for Sulfur Dioxide

EPA Pesticide Factsheets

Find tools for primary standards for Sulfur Dioxide, maps of nonattainment areas, an overview of the proposal, projected nonattainment areas for 2020, and a presentation on the 2011 SO2 primary NAAQS revision.

Introducing modern technology to promote transparency in health services.

PubMed

Islam, Mohammad Shafiqul

2015-01-01

Quantitative indicators show that Bangladeshi maternal and child healthcare is progressing satisfactorily. However, healthcare quality is still inadequate. It is hypothesised that modern technology enhances healthcare quality. Therefore, the purpose of this paper is to investigate how modern technology such as electronic record keeping and the internet can contribute to enhancing Bangladeshi healthcare quality. This study also explores how socio-economic and political factors affect the healthcare quality. This paper is based on a qualitative case study involving 68 in-depth interviews with healthcare professionals, elected representatives, local informants and five focus group discussions with healthcare service users to understand technology's effect on health service quality. The study has been conducted in one rural and one urban service organisations to understand how various factors contribute differently to healthcare quality. The findings show that modern technology, such as the internet and electronic devices for record keeping, contribute significantly to enhancing health service transparency, which in turn leads to quality health and family planning services. The findings also show that information and communication technology (ICT) is an effective mechanism for reducing corruption and promoting transparency. However, resource constraints impact adversely on the introduction of technology, which leads to less transparent healthcare. Progress in education and general socio-economic conditions makes it suitable to enhance ICT usage, which could lead to healthcare transparency, but political and bureaucratic factors pose a major challenge to ensure transparency. This paper can be a useful guide for promoting governance and healthcare quality in developing countries including Bangladesh. It analyses the ICT challenges that healthcare staff face when promoting transparent healthcare. This paper provides a deeper understanding of transparency and healthcare quality in an ICT context using empirical data, which has not been explored in Bangladesh. This critical thinking is useful for policy makers and healthcare practitioners for promoting health service quality.

An open-source, mobile-friendly search engine for public medical knowledge.

PubMed

Samwald, Matthias; Hanbury, Allan

2014-01-01

The World Wide Web has become an important source of information for medical practitioners. To complement the capabilities of currently available web search engines we developed FindMeEvidence, an open-source, mobile-friendly medical search engine. In a preliminary evaluation, the quality of results from FindMeEvidence proved to be competitive with those from TRIP Database, an established, closed-source search engine for evidence-based medicine.

Finding "hard to find" literature on hard to find groups: A novel technique to search grey literature on refugees and asylum seekers.

PubMed

Enticott, Joanne; Buck, Kimberly; Shawyer, Frances

2018-03-01

There is a lack of information on how to execute effective searches of the grey literature on refugee and asylum seeker groups for inclusion in systematic reviews. High-quality government reports and other grey literature relevant to refugees may not always be identified in conventional literature searches. During the process of conducting a recent systematic review, we developed a novel strategy for systematically searching international refugee and asylum seeker-related grey literature. The approach targets governmental health departments and statistical agencies, who have considerable access to refugee and asylum seeker populations for research purposes but typically do not publish findings in academic forums. Compared to a conventional grey literature search strategy, our novel technique yielded an eightfold increase in relevant high-quality grey sources that provided valuable content in informing our review. Incorporating a search of the grey literature into systematic reviews of refugee and asylum seeker research is essential to providing a more complete view of the evidence. Our novel strategy offers a practical and feasible method of conducting systematic grey literature searches that may be adaptable to a range of research questions, contexts, and resource constraints. Copyright © 2017 John Wiley & Sons, Ltd.

The double-edged sword of electronic health records: implications for patient disclosure.

PubMed

Campos-Castillo, Celeste; Anthony, Denise L

2015-04-01

Electronic health record (EHR) systems are linked to improvements in quality of care, yet also privacy and security risks. Results from research studies are mixed about whether patients withhold personal information from their providers to protect against the perceived EHR privacy and security risks. This study seeks to reconcile the mixed findings by focusing on whether accounting for patients' global ratings of care reveals a relationship between EHR provider-use and patient non-disclosure. A nationally representative sample from the 2012 Health Information National Trends Survey was analyzed using bivariate and multivariable logit regressions to examine whether global ratings of care suppress the relationship between EHR provider-use and patient non-disclosure. 13% of respondents reported having ever withheld information from a provider because of privacy/security concerns. Bivariate analysis showed that withholding information was unrelated to whether respondents' providers used an EHR. Multivariable analysis showed that accounting for respondents' global ratings of care revealed a positive relationship between having a provider who uses an EHR and withholding information. After accounting for global ratings of care, findings suggest that patients may non-disclose to providers to protect against the perceived EHR privacy and security risks. Despite evidence that EHRs inhibit patient disclosure, their advantages for promoting quality of care may outweigh the drawbacks. Clinicians should leverage the EHR's value in quality of care and discuss patients' privacy concerns during clinic visits, while policy makers should consider how to address the real and perceived privacy and security risks of EHRs. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Public information officers' and journalists' perceived barriers to providing quality health information.

PubMed

Avery, Elizabeth Johnson; Lariscy, Ruthann Weaver; Sohn, Youngju

2009-06-01

Given the increase in the volume of health and medical news over the past few years, the expanding population of journalists committed to feeding the public's voracious appetite for such information, and the important role of government public health organizations in producing and disseminating public health information, it is surprising that little research exists that explores the relationships among public health entities and health journalists. This article describes and analyzes similarities and differences in perceptions between journalists and information officers in public health agencies on a number of issues to reveal how public information officers and health journalists can work to build a local public health agenda free from the burden of unnecessary or inconsistent barriers. This study reports findings from a study with a 3-stage pretest and 90 interviews with state and local public health information officers and the health journalists who cover public health beats across the United States. Despite some agreement, results indicate wide disparities between these populations' identification of what the barriers to high-quality health care and information are, and a generalized absence of a "shared vision."

Health information technology capacity at federally qualified health centers: a mechanism for improving quality of care

PubMed Central

2013-01-01

Background The adoption of health information technology has been recommended as a viable mechanism for improving quality of care and patient health outcomes. However, the capacity of health information technology (i.e., availability and use of multiple and advanced functionalities), particularly in federally qualified health centers (FQHCs) on improving quality of care is not well understood. We examined associations between health information technology (HIT) capacity at FQHCs and quality of care, measured by the receipt of discharge summary, frequency of patients receiving reminders/notifications for preventive care/follow-up care, and timely appointment for specialty care. Methods The analyses used 2009 data from the National Survey of Federally Qualified Health Centers. The study included 776 of the FQHCs that participated in the survey. We examined the extent of HIT use and tested the hypothesis that level of HIT capacity is associated with quality of care. Multivariable logistic regressions, reporting unadjusted and adjusted odds ratios, were used to examine whether ‘FQHCs’ HIT capacity’ is associated with the outcome measures. Results The results showed a positive association between health information technology capacity and quality of care. FQHCs with higher HIT capacity were significantly more likely to have improved quality of care, measured by the receipt of discharge summaries (OR=1.43; CI=1.01, 2.40), the use of a patient notification system for preventive and follow-up care (OR=1.74; CI=1.23, 2.45), and timely appointment for specialty care (OR=1.77; CI=1.24, 2.53). Conclusions Our findings highlight the promise of HIT in improving quality of care, particularly for vulnerable populations who seek care at FQHCs. The results also show that FQHCs may not be maximizing the benefits of HIT. Efforts to implement HIT must include strategies that facilitate the implementation of comprehensive and advanced functionalities, as well as promote meaningful use of these systems. Further examination of the role of health information systems in clinical decision-making and improvements in patient outcomes are needed to better understand the benefits of HIT in improving overall quality of care. PMID:23363660

Health information technology capacity at federally qualified health centers: a mechanism for improving quality of care.

PubMed

Frimpong, Jemima A; Jackson, Bradford E; Stewart, LaShonda M; Singh, Karan P; Rivers, Patrick A; Bae, Sejong

2013-01-31

The adoption of health information technology has been recommended as a viable mechanism for improving quality of care and patient health outcomes. However, the capacity of health information technology (i.e., availability and use of multiple and advanced functionalities), particularly in federally qualified health centers (FQHCs) on improving quality of care is not well understood. We examined associations between health information technology (HIT) capacity at FQHCs and quality of care, measured by the receipt of discharge summary, frequency of patients receiving reminders/notifications for preventive care/follow-up care, and timely appointment for specialty care. The analyses used 2009 data from the National Survey of Federally Qualified Health Centers. The study included 776 of the FQHCs that participated in the survey. We examined the extent of HIT use and tested the hypothesis that level of HIT capacity is associated with quality of care. Multivariable logistic regressions, reporting unadjusted and adjusted odds ratios, were used to examine whether 'FQHCs' HIT capacity' is associated with the outcome measures. The results showed a positive association between health information technology capacity and quality of care. FQHCs with higher HIT capacity were significantly more likely to have improved quality of care, measured by the receipt of discharge summaries (OR=1.43; CI=1.01, 2.40), the use of a patient notification system for preventive and follow-up care (OR=1.74; CI=1.23, 2.45), and timely appointment for specialty care (OR=1.77; CI=1.24, 2.53). Our findings highlight the promise of HIT in improving quality of care, particularly for vulnerable populations who seek care at FQHCs. The results also show that FQHCs may not be maximizing the benefits of HIT. Efforts to implement HIT must include strategies that facilitate the implementation of comprehensive and advanced functionalities, as well as promote meaningful use of these systems. Further examination of the role of health information systems in clinical decision-making and improvements in patient outcomes are needed to better understand the benefits of HIT in improving overall quality of care.

Whatever? The effect of social exclusion on adopting persuasive messages.

PubMed

Pfundmair, Michaela; Aydin, Nilüfer; Frey, Dieter

2017-01-01

The aversive state of social exclusion can result in a broad range of cognitive deficits. Being unable or unmotivated to process relevant information, we assumed that social exclusion would also affect the success of persuasive attempts. We hypothesized that socially excluded people would adopt attitudes regardless of persuasion quality. In three studies using different manipulations of social exclusion and persuasion, we showed that participants who were socially excluded adopted persuasive messages regardless of argument quality. In contrast, this undifferentiated response was not shown by socially included participants who were more persuaded by high- compared to low-quality arguments. In Study 3, we moreover revealed that this pattern could only be replicated in reliable situations-that is, when the communicator appeared credible. These findings support the assumption that social exclusion can lead to reduced processing of information.

Judging nursing information on the world wide web.

PubMed

Cader, Raffik

2013-02-01

The World Wide Web is increasingly becoming an important source of information for healthcare professionals. However, finding reliable information from unauthoritative Web sites to inform healthcare can pose a challenge to nurses. A study, using grounded theory, was undertaken in two phases to understand how qualified nurses judge the quality of Web nursing information. Data were collected using semistructured interviews and focus groups. An explanatory framework that emerged from the data showed that the judgment process involved the application of forms of knowing and modes of cognition to a range of evaluative tasks and depended on the nurses' critical skills, the time available, and the level of Web information cues. This article mainly focuses on the six evaluative tasks relating to assessing user-friendliness, outlook and authority of Web pages, and relationship to nursing practice; appraising the nature of evidence; and applying cross-checking strategies. The implications of these findings to nurse practitioners and publishers of nursing information are significant.

Health Information Technology in Healthcare Quality and Patient Safety: Literature Review.

PubMed

Feldman, Sue S; Buchalter, Scott; Hayes, Leslie W

2018-06-04

The area of healthcare quality and patient safety is starting to use health information technology to prevent reportable events, identify them before they become issues, and act on events that are thought to be unavoidable. As healthcare organizations begin to explore the use of health information technology in this realm, it is often unclear where fiscal and human efforts should be focused. The purpose of this study was to provide a foundation for understanding where to focus health information technology fiscal and human resources as well as expectations for the use of health information technology in healthcare quality and patient safety. A literature review was conducted to identify peer-reviewed publications reporting on the actual use of health information technology in healthcare quality and patient safety. Inductive thematic analysis with open coding was used to categorize a total of 41 studies. Three pre-set categories were used: prevention, identification, and action. Three additional categories were formed through coding: challenges, outcomes, and location. This study identifies five main categories across seven study settings. A majority of the studies used health IT for identification and prevention of healthcare quality and patient safety issues. In this realm, alerts, clinical decision support, and customized health IT solutions were most often implemented. Implementation, interface design, and culture were most often noted as challenges. This study provides valuable information as organizations determine where they stand to get the most "bang for their buck" relative to health IT for quality and patient safety. Knowing what implementations are being effectivity used by other organizations helps with fiscal and human resource planning as well as managing expectations relative to cost, scope, and outcomes. The findings from this scan of the literature suggest that having organizational champion leaders that can shepherd implementation, impact culture, and bridge knowledge with developers would be a valuable resource allocation to consider. ©Sue S Feldman, Scott Buchalter, Leslie W. Hayes. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 04.06.2018.

What information is used in treatment decision aids? A systematic review of the types of evidence populating health decision aids.

PubMed

Clifford, Amanda M; Ryan, Jean; Walsh, Cathal; McCurtin, Arlene

2017-02-23

Patient decision aids (DAs) are support tools designed to provide patients with relevant information to help them make informed decisions about their healthcare. While DAs can be effective in improving patient knowledge and decision quality, it is unknown what types of information and evidence are used to populate such decision tools. Systematic methods were used to identify and appraise the relevant literature and patient DAs published between 2006 and 2015. Six databases (Academic Search Complete, AMED, CINAHL, Biomedical Reference Collection, General Sciences and MEDLINE) and reference list searching were used. Articles evaluating the effectiveness of the DAs were appraised using the Cochrane Risk of Bias tool. The content, quality and sources of evidence in the decision aids were evaluated using the IPDASi-SF and a novel classification system. Findings were synthesised and a narrative analysis was performed on the results. Thirteen studies representing ten DAs met the inclusion criteria. The IPDASI-SF score ranged from 9 to 16 indicating many of the studies met the majority of quality criteria. Sources of evidence were described but reports were sometimes generic or missing important information. The majority of DAs incorporated high quality research evidence including systematic reviews and meta-analyses. Patient and practice evidence was less commonly employed, with only a third of included DAs using these to populate decision aid content. The quality of practice and patient evidence ranged from high to low. Contextual factors were addressed across all DAs to varying degrees and covered a range of factors. This is an initial study examining the information and evidence used to populate DAs. While research evidence and contextual factors are well represented in included DAs, consideration should be given to incorporating high quality information representing all four pillars of evidence based practice when developing DAs. Further, patient and expert practice evidence should be acquired rigorously and DAs should report the means by which such evidence is obtained with citations clearly provided.

Evaluation of websites that contain information relating to malaria in pregnancy.

PubMed

Hamwela, V; Ahmed, W; Bath, P A

2018-04-01

The study identified available websites on malaria in pregnancy on the World Wide Web and sought to evaluate their readability and information quality. A purposeful sample of websites were selected which provided information on Malaria in pregnancy. A total of 31 websites were identified from searches using Google, Yahoo and Bing search engines. Two generic tools (Discern and HON), one specific tool designed to assess information quality of malaria in pregnancy and readability tests (Flesch Reading Ease and Flesh-Kincaid Grade level) were used to evaluate the websites. Most of the websites scored below 50% with the HON Code tool, with most lacking information on the symptoms. One website scored over 70 with the reading ease with two (2) achieving a score of 7 for the reading level test. The readability of the websites was too advanced for an ordinary consumer. The results of this study indicated that the information quality of malaria in pregnancy websites varied from fair to medium. It was also found that the readability of the websites was too advanced for an ordinary consumer. These findings suggest that most websites are not comprehensive in addressing all the relevant aspects of malaria in pregnancy. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Training and quality assurance with the Structured Clinical Interview for DSM-IV (SCID-I/P).

PubMed

Ventura, J; Liberman, R P; Green, M F; Shaner, A; Mintz, J

1998-06-15

Accuracy in psychiatric diagnosis is critical for evaluating the suitability of the subjects for entry into research protocols and for establishing comparability of findings across study sites. However, training programs in the use of diagnostic instruments for research projects are not well systematized. Furthermore, little information has been published on the maintenance of interrater reliability of diagnostic assessments. At the UCLA Research Center for Major Mental Illnesses, a Training and Quality Assurance Program for SCID interviewers was used to evaluate interrater reliability and diagnostic accuracy. Although clinically experienced interviewers achieved better interrater reliability and overall diagnostic accuracy than neophyte interviewers, both groups were able to achieve and maintain high levels of interrater reliability, diagnostic accuracy, and interviewer skill. At the first quality assurance check after training, there were no significant differences between experienced and neophyte interviewers in interrater reliability or diagnostic accuracy. Standardization of training and quality assurance procedures within and across research projects may make research findings from study sites more comparable.

Just ask Siri? A pilot study comparing smartphone digital assistants and laptop Google searches for smoking cessation advice.

PubMed

Boyd, Matt; Wilson, Nick

2018-01-01

To compare voice-activated internet searches by smartphone (two digital assistants) with laptop ones for information and advice related to smoking cessation. Responses to 80 questions on a range of topics related to smoking cessation (including the FAQ from a NHS website), compared for quality. Smartphone and internet searches as performed in New Zealand. Ranked responses to the questions. Google laptop internet searches came first (or first equal) for best quality smoking cessation advice for 83% (66/80) of the responses. Voiced questions to Google Assistant ("OK Google") came first/first equal 76% of the time vs Siri (Apple) at 28%. Google and Google Assistant were statistically significantly better than Siri searches (odds ratio 12.4 and 8.5 respectively, p<0.0001 in each comparison). When asked FAQs from the National Health Service website, or to find information the Centers for Disease Control has made videos on, the best search results used expert sources 59% (31/52) of the time, "some expertise" (eg, Wikipedia) 18% of the time, but also magazines and other low quality sources 19% of the time. Using all three methods failed to find relevant information 8% (6/80) of the time, with Siri having the most failed responses (53% of the time). Google internet searches and Google Assistant were found to be significantly superior to the Siri digital assistant for smoking cessation information. While expert content was returned over half the time, there is still substantial room for improvement in how these software systems deliver smoking cessation advice.

What Makes a Good Summary?

NASA Astrophysics Data System (ADS)

Zhao, Qunhua; Santos, Eugene; Nguyen, Hien; Mohamed, Ahmed

One of the biggest challenges for intelligence analysts who participate in prevention or response to a terrorism act is to quickly find relevant information from massive amounts of data. Along with research on information retrieval and filtering, text summarization is an effective technique to help intelligence analysts shorten their time to find critical information and make timely decisions. Multi-document summarization is particularly useful as it serves to quickly describe a collection of information. The obvious shortcoming lies in what it cannot capture especially in more diverse collections. Thus, the question lies in the adequacy and/or usefulness of such summarizations to the target analyst. In this chapter, we report our experimental study on the sensitivity of users to the quality and content of multi-document summarization. We used the DUC 2002 collection for multi-document summarization as our testbed. Two groups of document sets were considered: (I) the sets consisting of closely correlated documents with highly overlapped content; and (II) the sets consisting of diverse documents covering a wide scope of topics. Intuitively, this suggests that creating a quality summary would be more difficult for the latter case. However, human evaluators were discovered to be fairly insensitive to this difference. This occurred when they were asked to rank the performance of various automated summarizers. In this chapter, we examine and analyze our experiments in order to better understand this phenomenon and how we might address it to improve summarization quality. In particular, we present a new metric based on document graphs that can distinguish between the two types of document sets.

Social Informatics: Natural Tools for Students' Information Training in the Conditions of Embodied and Mental Approaches Being Employed

ERIC Educational Resources Information Center

Barkhatova, Daria; Nigmatulina, Elmira; Stepanova, Tatyana

2017-01-01

The relevance of the problem under study is due to the society's requirements for the quality information training of a personality which is oriented to forming the solid fundamental knowledge as well as to developing the cognitive capacities that are needed for solving mental tasks. With regard to this, the paper is aimed at finding out the…

Data Quality in Institutional Arthroplasty Registries: Description of a Model of Validation and Report of Preliminary Results.

PubMed

Bautista, Maria P; Bonilla, Guillermo A; Mieth, Klaus W; Llinás, Adolfo M; Rodríguez, Fernanda; Cárdenas, Laura L

2017-07-01

Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains. Adherence is defined as the proportion of patients included in the registry, completeness is defined as the proportion of data effectively recorded, and accuracy is defined as the proportion of data consistent with medical records. A random sample of 53 patients (25.4%) was selected to assess the latest 2 domains. A direct comparison between the registry's database and medical records was performed. In total, 324 variables containing information on demographic data, surgical procedure, clinical outcomes, and key performance indicators were analyzed. Two hundred nine of 212 patients who underwent surgery during the study period were included in the registry, accounting for an adherence of 98.6%. Completeness was 91.7% and accuracy was 85.8%. Most errors were found in the preoperative range of motion and timely administration of prophylactic antibiotics and thromboprophylaxis. This model provides useful information regarding the quality of the recorded data since it identified deficient areas within the IAR. We recommend that institutional arthroplasty registries be constantly monitored for data quality before using their information for research or quality improvement purposes. Copyright © 2017 Elsevier Inc. All rights reserved.

Factors influencing psychosocial adjustment and quality of life in Parkinson patients and informal caregivers.

PubMed

Navarta-Sánchez, María Victoria; Senosiain García, Juana M; Riverol, Mario; Ursúa Sesma, María Eugenia; Díaz de Cerio Ayesa, Sara; Anaut Bravo, Sagrario; Caparrós Civera, Neus; Portillo, Mari Carmen

2016-08-01

The influence that social conditions and personal attitudes may have on the quality of life (QoL) of Parkinson's disease (PD) patients and informal caregivers does not receive enough attention in health care, as a result of it not being clearly identified, especially in informal caregivers. The aim of this study was to provide a comprehensive analysis of psychosocial adjustment and QoL determinants in PD patients and informal caregivers. Ninety-one PD patients and 83 caregivers participated in the study. Multiple regression analyses were performed including benefit finding, coping, disease severity and socio-demographic factors, in order to determine how these aspects influence the psychosocial adjustment and QoL in PD patients and caregivers. Regression models showed that severity of PD was the main predictor of psychosocial adjustment and QoL in patients. Nevertheless, multiple regression analyses also revealed that coping was a significant predictor of psychosocial adjustment in patients and caregivers. Furthermore, psychosocial adjustment was significantly related to QoL in patients and caregivers. Also, coping and benefit finding were predictors of QoL in caregivers but not in patients. Multidisciplinary interventions aimed at improving PD patients' QoL may have more effective outcomes if education about coping skills, and how these can help towards a positive psychosocial adjustment to illness, were included, and targeted not only at patients, but also at informal caregivers.

The role of the physical environment in crossing the quality chasm.

PubMed

Henriksen, Kerm; Isaacson, Sandi; Sadler, Blair L; Zimring, Craig M

2007-11-01

Evidence-based design findings are available to help inform hospital decision makers of opportunities for ensuring that quality and safety are designed into new and refurbished facilities. The Institute of Medicine's six quality aims of patient centeredness, safety, effectiveness, efficiency, timeliness, and equity provide an organizing framework for introducing a representative portion of the evidence. Design improvements include single-bed and variable-acuity rooms; electronic access to medical records; greater accommodation for families and visitors; handrails to prevent patient falls; standardization (room layout, equipment, and supplies for improved efficiencies); improved work process flow to reduce delays and wait times; and better assessment of changing demographics, disease conditions, and community needs for appropriately targeted health care services. A recent analysis of the business case suggests that a slight, one-time incremental cost for ensuring safety and quality would be paid back in two to three years in the form of operational savings and increased revenues. Hospitals leaders anticipating new construction projects should take advantage of evidence-based design findings that have the potential of raising the quality of acute care for decades to come.

Hospital quality of care: does information technology matter? The relationship between information technology adoption and quality of care.

PubMed

Menachemi, Nir; Chukmaitov, Askar; Saunders, Charles; Brooks, Robert G

2008-01-01

Hospitals have been slow to adopt information technology (IT) largely because of a lack of generalizable evidence of the value associated with such adoption. To explore the relationship between IT adoption and quality of care in acute-care hospitals. Primary data on hospital IT adoption were combined with secondary hospital discharge data. Regression analyses were used to examine the relationship between various measures of IT adoption and several quality indicators after controlling for confounders. Adoption of IT was measured using a previously validated method that considers clinical, administrative, and strategic IT capabilities of acute-care hospitals. Quality measures included the Inpatient Quality Indicators developed by the Agency for Healthcare Research and Quality. Data from 98 hospitals were available for analyses. Hospitals adopted an average of 11.3 (45.2%) clinical IT applications, 15.7 (74.8%) administrative IT applications, and 5 (50%) strategic IT applications. In multivariate regression analyses, hospitals that adopted a greater number of IT applications were significantly more likely to have desirable quality outcomes on seven Inpatient Quality Indicator measures, including risk-adjusted mortality from percutaneous transluminal coronary angioplasty, gastrointestinal hemorrhage, and acute myocardial infarction. An increase in clinical IT applications was also inversely correlated with utilization of incidental appendectomy, and an increase in the adoption of strategic IT applications was inversely correlated with risk-adjusted mortality from craniotomy and laparoscopic cholecystectomy. Hospital adoption of IT is associated with desirable quality outcomes across hospitals in Florida. These findings will assist hospital leaders interested in understanding better the effect of costly IT adoption on quality of care in their institutions.

FindZebra: a search engine for rare diseases.

PubMed

Dragusin, Radu; Petcu, Paula; Lioma, Christina; Larsen, Birger; Jørgensen, Henrik L; Cox, Ingemar J; Hansen, Lars Kai; Ingwersen, Peter; Winther, Ole

2013-06-01

The web has become a primary information resource about illnesses and treatments for both medical and non-medical users. Standard web search is by far the most common interface to this information. It is therefore of interest to find out how well web search engines work for diagnostic queries and what factors contribute to successes and failures. Among diseases, rare (or orphan) diseases represent an especially challenging and thus interesting class to diagnose as each is rare, diverse in symptoms and usually has scattered resources associated with it. We design an evaluation approach for web search engines for rare disease diagnosis which includes 56 real life diagnostic cases, performance measures, information resources and guidelines for customising Google Search to this task. In addition, we introduce FindZebra, a specialized (vertical) rare disease search engine. FindZebra is powered by open source search technology and uses curated freely available online medical information. FindZebra outperforms Google Search in both default set-up and customised to the resources used by FindZebra. We extend FindZebra with specialized functionalities exploiting medical ontological information and UMLS medical concepts to demonstrate different ways of displaying the retrieved results to medical experts. Our results indicate that a specialized search engine can improve the diagnostic quality without compromising the ease of use of the currently widely popular standard web search. The proposed evaluation approach can be valuable for future development and benchmarking. The FindZebra search engine is available at http://www.findzebra.com/. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Nonprice Competition and Quality of Care in Managed Care: The New York SCHIP Market

PubMed Central

Liu, Hangsheng; Phelps, Charles E

2008-01-01

Objective To examine the effect of nonprice competition among managed care plans on the quality of care in the New York SCHIP market. Data Sources U.S. Census 2000; 2002 New York State Managed Care Plan Performance Report; and 2001 New York State Managed Care Annual Enrollment Report. Study Design Each market is defined as a county, and competition is measured as the number of plans in a market. Quality of care is measured in percentages using three Consumer Assessment of Health Plans Survey and three Health Plan Employer Data and Information Set scores. Two-stage least squares is applied to address the endogeneity between competition and the quality of care, using population as an instrument. Principle Findings We find a negative association between competition and quality of care. An additional managed care plan is significantly associated with a decrease of 0.40–2.31 percentage points in four out of six quality measures. After adjusting for production cost, a positive correlation is observed between price and quality measures across different pricing regions. Conclusions It seems likely that pricing policy is a constraint on quality production, although it may not be interpreted as a causal relationship and further study is needed. PMID:18454776

Effects of regulated competition on key outcomes of care: cataract surgeries in the Netherlands.

PubMed

Heijink, Richard; Mosca, Ilaria; Westert, Gert

2013-11-01

Similar to several other countries, the Netherlands implemented market-oriented health care reforms in recent years. Previous studies raised questions on the effects of these reforms on key outcomes such as quality, costs, and prices. The empirical evidence is up to now mixed. This study looked at the variation in prices, volume, and quality of cataract surgeries since the introduction of price competition in 2006. We found no price convergence over time and constant price differences between hospitals. Quality indicators generally showed positive results in cataract care, though the quality and scope of the indicators was suboptimal at this stage. Furthermore, we found limited between-hospital variation in quality and there was no clear-cut relation between prices and quality. Volume of cataract care strongly increased in the period studied. These findings indicate that health insurers may not have been able to drive prices down, make trade-offs between price and quality, and selectively contract health care without usable quality information. Positive results coming out from the 2006 reform should not be taken for granted. Looking forward, future research on similar topics and with newer data should clarify the extent to which these findings can be generalized. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Trust Me, I'm a Doctor: Examining Changes in How Privacy Concerns Affect Patient Withholding Behavior.

PubMed

Walker, Daniel M; Johnson, Tyler; Ford, Eric W; Huerta, Timothy R

2017-01-04

As electronic health records (EHRs) become ubiquitous in the health care industry, privacy breaches are increasing and being made public. These breaches may make consumers wary of the technology, undermining its potential to improve care coordination and research. Given the developing concerns around privacy of personal health information stored in digital format, it is important for providers to understand how views on privacy and security may be associated with patient disclosure of health information. This study aimed to understand how privacy concerns may be shifting patient behavior. Using a pooled cross-section of data from the 2011 and 2014 cycles of the Health Information and National Trends Survey (HINTS), we tested whether privacy and security concerns, as well as quality perceptions, are associated with the likelihood of withholding personal health information from a provider. A fully interacted multivariate model was used to compare associations between the 2 years, and interaction terms were used to evaluate trends in the factors that are associated with withholding behavior. No difference was found regarding the effect of privacy and security concerns on withholding behavior between 2011 and 2014. Similarly, whereas perceived high quality of care was found to reduce the likelihood of withholding information from a provider in both 2011 (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.56-0.94) and 2014 (OR 0.61, 95% CI 0.48-0.76), no difference was observed between years. These findings suggest that consumers' beliefs about EHR privacy and security, the relationship between technology use and quality, and intentions to share information with their health care provider have not changed. These findings are counter to the ongoing discussions about the implications of security failures in other domains. Our results suggest that providers could ameliorate privacy and security by focusing on the care quality benefits EHRs provide. ©Daniel M Walker, Tyler Johnson, Eric W Ford, Timothy R Huerta. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.01.2017.

Fact Sheets and Additional Information Regarding the Primary National Ambient Air Quality Standards (NAAQS) for Nitrogen Dioxide (NO2)

EPA Pesticide Factsheets

Find tools for primary standards for Nitrogen Dioxide, maps of monitoring areas, an overview of the proposal, monitor requirements, design values for counties, and a presentation on the 2010 NO2 primary NAAQS revision.

National Nutrient Database for Standard Reference - Find Nutrient Value of Common Foods by Nutrient

MedlinePlus

... grams Household * required field ​ USDA Food Composition Databases Software developed by the National Agricultural Library v.3.9.4.1 2018-06-11 NAL Home | USDA.gov | Agricultural Research Service | Plain Language | FOIA | Accessibility Statement | Information Quality | Privacy ...

Redefining Professional Development. Newsletter

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2006

2006-01-01

The research on effective professional development is consistent across many studies. Researchers Willis Hawley and Linda Valli (Westchester Institute for Human Services Research, n.d.), in their synthesis of the professional development literature, find that high-quality teacher development is as follows: (1) Informed by research on teaching and…

Health Advice from Internet Discussion Forums: How Bad Is Dangerous?

PubMed Central

Watkins, Chris; Kleine, Dorothea

2016-01-01

Background Concerns over online health information–seeking behavior point to the potential harm incorrect, incomplete, or biased information may cause. However, systematic reviews of health information have found few examples of documented harm that can be directly attributed to poor quality information found online. Objective The aim of this study was to improve our understanding of the quality and quality characteristics of information found in online discussion forum websites so that their likely value as a peer-to-peer health information–sharing platform could be assessed. Methods A total of 25 health discussion threads were selected across 3 websites (Reddit, Mumsnet, and Patient) covering 3 health conditions (human immunodeficiency virus [HIV], diabetes, and chickenpox). Assessors were asked to rate information found in the discussion threads according to 5 criteria: accuracy, completeness, how sensible the replies were, how they thought the questioner would act, and how useful they thought the questioner would find the replies. Results In all, 78 fully completed assessments were returned by 17 individuals (8 were qualified medical doctors, 9 were not). When the ratings awarded in the assessments were analyzed, 25 of the assessments placed the discussion threads in the highest possible score band rating them between 5 and 10 overall, 38 rated them between 11 and 15, 12 rated them between 16 and 20, and 3 placed the discussion thread they assessed in the lowest rating band (21-25). This suggests that health threads on Internet discussion forum websites are more likely than not (by a factor of 4:1) to contain information of high or reasonably high quality. Extremely poor information is rare; the lowest available assessment rating was awarded only 11 times out of a possible 353, whereas the highest was awarded 54 times. Only 3 of 78 fully completed assessments rated a discussion thread in the lowest possible overall band of 21 to 25, whereas 25 of 78 rated it in the highest of 5 to 10. Quality assessments differed depending on the health condition (chickenpox appeared 17 times in the 20 lowest-rated threads, HIV twice, and diabetes once). Although assessors tended to agree on which discussion threads contained good quality information, what constituted poor quality information appeared to be more subjective. Conclusions Most of the information assessed in this study was considered by qualified medical doctors and nonmedically qualified respondents to be of reasonably good quality. Although a small amount of information was assessed as poor, not all respondents agreed that the original questioner would have been led to act inappropriately based on the information presented. This suggests that discussion forum websites may be a useful platform through which people can ask health-related questions and receive answers of acceptable quality. PMID:26740148

Evaluation of Dengue-Related Health Information on the Internet

PubMed Central

Rao, Navya R.; Mohapatra, Manaswini; Mishra, Swayamprabha; Joshi, Ashish

2012-01-01

The objective of this study was to examine the quality of dengue-related health information on the Internet. Three raters used the keyword dengue to search the Google, Yahoo!, and Bing search engines during August 2011. The first 20 websites from each search engine were examined for a total of 60 sites. Duplicate, nonfunctional, non-English, and nonoperational websites were excluded from the study, resulting in 36 sites for final analysis. The 16-item DISCERN tool was used to evaluate the quality of dengue-related health information on the Internet. Chi-square analysis and analysis of variance were performed to compare the DISCERN scores. Inter-rater reliability analysis showed significant differences in the level of agreement among the three raters. The 36 unique websites were categorized into .com, .edu, .gov, .org, and other sites. The .com sites had the lowest DISCERN scores. Educating consumers on how to find and recognize valid health information on the Internet may lead to better informed decision making. PMID:22783151

[Reliable health information for patients with rare diseases : Quality demands defined by the National Action Plan and how they are put into practice].

PubMed

Schaefer, Corinna; Brunsmann, Frank; Siegert, Svenja

2017-05-01

Information for patients with rare diseases has to adhere to strict quality criteria in order to support individual treatment decisions or coping strategies. However, developers are facing specific challenges: For example, the evidence is often insufficient or of very low quality. In the context of the National Action League for People with Rare Diseases (NAMSE), criteria have been developed that assure high-quality information on rare diseases. Core criteria comprise the involvement of patients or their advocates in all stages of the development process, the systematic search and assessment of the evidence, systematic collection of patient experience, transparency in terms of people involved and funding, and nondirective and neutral formulation of content and documentation of the process. In a joint project between the Alliance for Chronic Rare Diseases (ACHSE e. V.) and the German Agency for Quality in Medicine (ÄZQ), ten short information leaflets on different rare diseases have been developed in the past three years, conceived to show the applicability of these criteria. First experiences with this format show that the criteria are adaptive to a broad range of diverse rare diseases and settings. Involving patients and their advocates throughout the whole development process - from prioritization to development of methods and provision of patient experience and coping strategies - is crucial. Insufficient evidence remains a challenge. The examples show that in the absence of proven findings, information that matters to patients and reflects this uncertainty is feasible.

NIOSH testimony on indoor air quality: Selected references before the Subcommittee on Superfund, Ocean and Water Protection, Committee on Environment and Public Works, United States Senate by J. Donald Millar, May 26, 1989

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1989-09-01

The National Institute for Occupational Safety and Health (NIOSH) has compiled the document in response to an increasing number of requests for information about indoor air quality (IAQ), including sick building syndrome. Included in the publication are: NIOSH Congressional testimony that describes the NIOSH IAQ investigations program and summarizes the results of NIOSH research and findings on IAQ problems, NIOSH guidance for conducting indoor air quality investigations, NIOSH journal article on evaluating building ventilation systems, and list of non-NIOSH publications on indoor air quality. As the Federal agency responsible for conducting research and making recommendations for occupational safety and healthmore » standards, NIOSH limits its IAQ activities to the occupational environment. The U.S. Environmental Protection Agency (EPA) also conducts an IAQ program and can be contacted for information regarding both occupational and non-occupational settings.« less

Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians

PubMed Central

Perales, Francisco

2015-01-01

Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus . This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation. PMID:26091283

Nectar quality perception by honey bees (Apis mellifera ligustica).

PubMed

Sanderson, Charlotte E; Cook, Peyton; Hill, Peggy S M; Orozco, Benjamin S; Abramson, Charles I; Wells, Harrington

2013-11-01

In exploring how foragers perceive rewards, we often find that well-motivated individuals are not too choosy and unmotivated individuals are unreliable and inconsistent. Nevertheless, when given a choice we see that individuals can clearly distinguish between rewards. Here we develop the logic of using responses to two-choice problems as a derivative function of perceived reward, and utilize this model to examine honey bee perception of nectar quality. Measuring the derivative allows us to deduce the perceived reward function. The derivative function of the perceived reward equation gives the rate of change of the reward perceived for each reward value. This approach depends on presenting free-flying foragers with a series of two different rewards presented simultaneously (i.e., two-choice, binomial tests). We also examine how honey bees integrate information from a range of reward qualities to formulate a functional response. Results suggest that honey bees overestimate higher quality rewards and that direct comparison is an important step in the integration of information from a range of rewards.

College quality and hourly wages: evidence from the self-revelation model, sibling models and instrumental variables.

PubMed

Borgen, Nicolai T

2014-11-01

This paper addresses the recent discussion on confounding in the returns to college quality literature using the Norwegian case. The main advantage of studying Norway is the quality of the data. Norwegian administrative data provide information on college applications, family relations and a rich set of control variables for all Norwegian citizens applying to college between 1997 and 2004 (N = 141,319) and their succeeding wages between 2003 and 2010 (676,079 person-year observations). With these data, this paper uses a subset of the models that have rendered mixed findings in the literature in order to investigate to what extent confounding biases the returns to college quality. I compare estimates obtained using standard regression models to estimates obtained using the self-revelation model of Dale and Krueger (2002), a sibling fixed effects model and the instrumental variable model used by Long (2008). Using these methods, I consistently find increasing returns to college quality over the course of students' work careers, with positive returns only later in students' work careers. I conclude that the standard regression estimate provides a reasonable estimate of the returns to college quality. Copyright © 2014 Elsevier Inc. All rights reserved.

Usability Testing and Redesign of Library Web Pages at Lund University, Faculty of Engineering: A Case Study Applying a Two-Phase, Systematic Quality Approach

ERIC Educational Resources Information Center

Persson, Ann-Christin; Langh, Maria; Nilsson, Jessica

2010-01-01

Introduction: The Lund University Faculty of Engineering's LibQual+[R] survey 2007 showed that students and faculty had difficulties finding the information they needed at the libraries' Websites. To be able to improve the Websites, we needed to find out how the users navigated the Websites, as well as what content they needed. Method: Twenty-four…

Robust Sensor Placements at Informative and Communication-efficient Locations

DTIC Science & Technology

2010-08-01

tree T ∗ with cost `∗, spanning a setA∗. Then PSPIEL can find a tree T with costO (r dim(V,E))×`∗, spanning a setAwith expected sensing quality F (A...V, E), s, t ∈ V and an (r, γ)-local monotone submodular function F , PSPIEL will find an s− t path P with costO (r dim(V,E))× `∗, spanning a setA with

YouTube as a source of chronic obstructive pulmonary disease patient education: a social media content analysis.

PubMed

Stellefson, Michael; Chaney, Beth; Ochipa, Kathleen; Chaney, Don; Haider, Zeerak; Hanik, Bruce; Chavarria, Enmanuel; Bernhardt, Jay M

2014-05-01

The aim of the present study is to conduct a social media content analysis of chronic obstructive pulmonary disease (COPD) patient education videos on YouTube. A systematic search protocol was used to locate 223 videos. Two independent coders evaluated each video to determine topics covered, media source(s) of posted videos, information quality as measured by HONcode guidelines for posting trustworthy health information on the Internet, and viewer exposure/engagement metrics. Over half the videos (n = 113, 50.7%) included information on medication management, with far fewer videos on smoking cessation (n = 40, 17.9%). Most videos were posted by a health agency or organization (n = 128, 57.4%), and the majority of videos were rated as high quality (n = 154, 69.1%). HONcode adherence differed by media source (Fisher's exact test = 20.52, p = 0.01), however with user-generated content receiving the lowest quality scores. Overall level of user engagement as measured by number of "likes," "favorites," "dislikes," and user comments was low (median range = 0-3, interquartile range = 0-16) across all sources of media. Study findings suggest that COPD education via YouTube has the potential to reach and inform patients; however, existing video content and quality varies significantly. Future interventions should help direct individuals with COPD to engage with high-quality patient education videos on YouTube that are posted by reputable health organizations and qualified medical professionals. Patients should be educated to avoid and/or critically view low-quality videos posted by individual YouTube users who are not health professionals.

YouTube as a source of COPD patient education: A social media content analysis

PubMed Central

Stellefson, Michael; Chaney, Beth; Ochipa, Kathleen; Chaney, Don; Haider, Zeerak; Hanik, Bruce; Chavarria, Enmanuel; Bernhardt, Jay M.

2014-01-01

Objective Conduct a social media content analysis of COPD patient education videos on YouTube. Methods A systematic search protocol was used to locate 223 videos. Two independent coders evaluated each video to determine topics covered, media source(s) of posted videos, information quality as measured by HONcode guidelines for posting trustworthy health information on the Internet, and viewer exposure/engagement metrics. Results Over half the videos (n=113, 50.7%) included information on medication management, with far fewer videos on smoking cessation (n=40, 17.9%). Most videos were posted by a health agency or organization (n=128, 57.4%), and the majority of videos were rated as high quality (n=154, 69.1%). HONcode adherence differed by media source (Fisher’s Exact Test=20.52, p=.01), with user-generated content (UGC) receiving the lowest quality scores. Overall level of user engagement as measured by number of “likes,” “favorites,” “dislikes,” and user comments was low (mdn range = 0–3, interquartile (IQR) range = 0–16) across all sources of media. Conclusion Study findings suggest that COPD education via YouTube has the potential to reach and inform patients, however, existing video content and quality varies significantly. Future interventions should help direct individuals with COPD to increase their engagement with high-quality patient education videos on YouTube that are posted by reputable health organizations and qualified medical professionals. Patients should be educated to avoid and/or critically view low-quality videos posted by individual YouTube users who are not health professionals. PMID:24659212

Principal agent relationships and the efficiency of hospitals.

PubMed

Ludwig, Martijn; Van Merode, Frits; Groot, Wim

2010-06-01

The efficiency of hospitals is an important political issue and has been the subject of a number of studies. Most studies find evidence for inefficiency but provide no theoretical explanations for differences in efficiency. This study used principal agent theory to explain differences in efficiency between hospitals. Two agency issues are examined: (1) quality of care in the relationship between hospital and patient, and (2) internal organisation, i.e. the relationship between the hospital and its main departments. It was found that efficiency and quality go together. This implies that the potential harmful information asymmetry between hospitals and patients does not appear to be a major problem, because increasing efficiency does not seem to reduce quality. Further, we find no relationship between the efficiency of departments and the efficiency of the entire hospital. The interest of hospital departments is currently not in line with the interests of the entire hospital.

Principal agent relationships and the efficiency of hospitals

PubMed Central

Ludwig, Martijn; Van Merode, Frits

2009-01-01

The efficiency of hospitals is an important political issue and has been the subject of a number of studies. Most studies find evidence for inefficiency but provide no theoretical explanations for differences in efficiency. This study used principal agent theory to explain differences in efficiency between hospitals. Two agency issues are examined: (1) quality of care in the relationship between hospital and patient, and (2) internal organisation, i.e. the relationship between the hospital and its main departments. It was found that efficiency and quality go together. This implies that the potential harmful information asymmetry between hospitals and patients does not appear to be a major problem, because increasing efficiency does not seem to reduce quality. Further, we find no relationship between the efficiency of departments and the efficiency of the entire hospital. The interest of hospital departments is currently not in line with the interests of the entire hospital. PMID:19655184

The history of quality measurement in home health care.

PubMed

Rosati, Robert J

2009-02-01

Quality improvement is as central to home health care as to any other field of health care. With the mandated addition in 2000 of Outcome Assessment and Information Set (OASIS) and outcome-based quality improvement (OBQI), Medicare home health agencies entered a new era of documenting, tracking, and systematically improving quality. OBQI is augmented by the Medicare Quality Improvement Organization (QIO) program, which is now entering the ninth in a series of work assignments, with the tenth scope in the planning stages. Evidence has shown that applied quality improvement methods can drive better outcomes using important metrics, such as acute care hospitalization. This article reviews key findings from the past 2 decades of home care quality improvement research and public policy advances, describes specific examples of local and regional programmatic approaches to quality improvement, and forecasts near-future trends in this vital arena of home health care.

The effect of providing climate and health information on support for alternative electricity portfolios

NASA Astrophysics Data System (ADS)

Sergi, Brian; Davis, Alex; Azevedo, Inês

2018-02-01

Support for addressing climate change and air pollution may depend on the type of information provided to the public. We conduct a discrete choice survey assessing preferences for combinations of electricity generation portfolios, electricity bills, and emissions reductions. We test how participants’ preferences change when emissions information is explicitly provided to them. We find that support for climate mitigation increases when mitigation is accompanied by improvements to air quality and human health. We estimate that an average respondent would accept an increase of 19%-27% in their electricity bill if shown information stating that either CO2 or SO2 emissions are reduced by 30%. Furthermore, an average respondent is willing to pay an increase of 30%-40% in electricity bills when shown information stating that both pollutants are reduced by 30% simultaneously. Our findings suggest that the type of emissions information provided to the public will affect their support for different electricity portfolios.

Fact Sheets and Additional Information Regarding the 2010 Revision to the Primary National Ambient Air Quality Standards (NAAQS) for Sulfur Dioxide

EPA Pesticide Factsheets

Find tools for primary standards for Sulfur Dioxide, maps of nonattainment areas, an overview of the proposal, projected nonattainment areas for 2020, and a presentation on the 2011 SO2 primary NAAQS revision.

Media reporting, carbon information disclosure, and the cost of equity financing: evidence from China.

PubMed

Li, Li; Liu, Quanqi; Tang, Dengli; Xiong, Jucheng

2017-04-01

By using Shanghai and Shenzhen A-share listed companies in heavy polluting industry as research object from 2009 to 2014, this paper examines the relationship between media reporting, carbon information disclosure, and the cost of equity financing. The results show that media reporting can improve the quality of carbon information disclosure, and carbon information disclosure level is negatively associated with the cost of equity financing. This study also finds that financial carbon information disclosure and non-financial carbon information disclosure have significant negative relationship with the cost of equity financing respectively. Moreover, this paper shows that media reporting can strengthen the relationship between carbon information disclosure and the cost of equity financing.

CONTRIBUTION OF STAKEHOLDER ENGAGEMENT TO THE IMPACT OF A HEALTH TECHNOLOGY ASSESSMENT: AN IRISH CASE STUDY.

PubMed

Ryan, Máirín; Moran, Patrick S; Harrington, Patricia; Murphy, Linda; O'Neill, Michelle; Whelan, Marty; Teljeur, Conor

2017-01-01

The aim of this study was to illustrate the contribution of stakeholder engagement to the impact of health technology assessment (HTA) using an Irish HTA of a national public access defibrillation (PAD) program. In response to draft legislation that proposed a PAD program, the Minister for Health requested that Health Information and Quality Authority undertake an HTA to inform the design and implementation of a national PAD program and the necessary underpinning legislation. The draft legislation outlined a program requiring widespread installation and maintenance of automatic external defibrillators in specified premises. Stakeholder engagement to optimize the impact of the HTA included one-to-one interviews with politicians, engagement with an Expert Advisory Group, public and targeted consultation, and positive media management. The HTA quantified the clinical benefits of the proposed PAD program as modest, identified that substantial costs would fall on small/medium businesses at a time of economic recession, and that none of the programs modeled were cost-effective. The Senator who proposed the Bill actively publicized the HTA process and its findings and encouraged participation in the public consultation. Participation of key stakeholders was important for the quality and acceptability of the HTA findings and advice. Media management promoted public engagement and understanding. The Bill did not progress. The HTA informed the decision not to progress with legislation for a national PAD program. Engagement was tailored to ensure that key stakeholders including politicians and the public were informed of the HTA process, the findings, and the advice, thereby maximizing acceptance. Appropriate stakeholder engagement optimizes the impact of HTA.

QUOTEchemo: a patient-centred instrument to measure quality of communication preceding chemotherapy treatment through the patient's eyes.

PubMed

van Weert, Julia C M; Jansen, Jesse; de Bruijn, Gert-Jan; Noordman, Janneke; van Dulmen, Sandra; Bensing, Jozien M

2009-11-01

Knowing patients' needs is a prerequisite to ensure high quality cancer care. This study describes the development and psychometric properties of a patient-centred instrument to measure needs and actual experiences with communication preceding chemotherapy treatment: QUOTE(chemo). QUOTE-questionnaires (Quality Of care Through the patients' Eyes) are widely used to gain insight into unmet needs, but no validated, standardised questionnaire combining patients' needs and experiences surrounding chemotherapy treatment is available yet. To evaluate the psychometric properties of the QUOTE(chemo), content validity, internal structure and convergent validity were investigated amongst 345 cancer patients, new to chemotherapy, from 10 different hospitals. Literature study, focus group discussions and a categorisation procedure of 67 relevant topics revealed seven main themes: Treatment-related information, Prognosis information, Rehabilitation information, Coping information, Interpersonal communication, Tailored communication and Affective communication. Confirmatory factor analysis using structural equation modelling indicated that the measurement model provided good fit to the data with factor loadings ranging from .43 to .77. The seven QUOTE(chemo) dimensions captured relevant issues of concern with good internal consistency (alpha .72-.92), satisfactory item-total correlations (.35-.79) and satisfactory convergent validity. Affective communication, Treatment-related information and Rehabilitation information were perceived most important by patients. The instrument also appeared to be able to determine which aspects need improvement to ensure high quality care. The highest need for improvement was found for communicating Prognosis information and Rehabilitation information and for Interpersonal communication. These findings provide preliminary evidence of the reliability and validity of the QUOTE(chemo) for use in cancer care surrounding chemotherapy treatment. Researchers and health care providers can use the instrument to measure patients' needs and experiences with communication to identify aspects that need improvement.

Conceptualization and Implementation of the Central Information Portal on Rare Diseases: Protocol for a Qualitative Study

PubMed Central

Hartz, Tobias; Göbel, Jens; Storf, Holger; Pauer, Frédéric; Babac, Ana; Lührs, Verena; Bruckner-Tuderman, Leena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, TOF; Graf von der Schulenburg, J-Matthias; Frank, Martin

2018-01-01

Background Recently, public and political interest has focused on people living with rare diseases and their health concerns. Due to the large number of different types of rare diseases and the sizable number of patients, taking action to improve the life of those affected is gaining importance. In 2013, the federal government of Germany adopted a national action plan for rare diseases, including the call to establish a central information portal on rare diseases (Zentrales Informationsportal über seltene Erkrankungen, ZIPSE). Objective The objective of this study, therefore, was to conduct scientific research on how such a portal must be designed to meet the needs of patients, their families, and medical professionals, and to provide high-quality information for information seekers. Methods We chose a 3-step procedure to develop a needs-based prototype of a central information portal. In the first step, we determined the information needs of patients with rare diseases, their relatives, and health care professionals by means of qualitative interviews and their content-analytical evaluation. On the basis of this, we developed the basic structure of the portal. In the second step, we identified quality criteria for websites on rare diseases to ensure that the information linked with ZIPSE meets the quality demands. Therefore, we gathered existing criteria catalogs and discussed them in an expert workshop. In the third step, we implemented and tested the developed prototypical information portal. Results A portal page was configured and made accessible on the Web. The structure of ZIPSE was based on the findings from 108 qualitative interviews with patients, their relatives, and health care professionals, through which numerous information needs were identified. We placed particularly important areas of information, such as symptoms, therapy, research, and advisory services, on the start page. Moreover, we defined 13 quality criteria, referring to factors such as author information, creation date, and privacy, enabling links with high-quality information. Moreover, 19 users tested all the developed routines based on usability and comprehensibility. Subsequently, we improved the visual presentation of search results and other important search functions. Conclusions The implemented information portal, ZIPSE, provides high-quality information on rare diseases from a central point of access. By integrating the targeted groups as well as different experts on medical information during the construction, the website can assure an improved search for information for users. ZIPSE can also serve as a model for other Web-based information systems in the field of rare diseases. Registered Report Identifier RR1-10.2196/7425 PMID:29752252

Effects of health information technology on patient outcomes: a systematic review.

PubMed

Brenner, Samantha K; Kaushal, Rainu; Grinspan, Zachary; Joyce, Christine; Kim, Inho; Allard, Rhonda J; Delgado, Diana; Abramson, Erika L

2016-09-01

To systematically review studies assessing the effects of health information technology (health IT) on patient safety outcomes. The authors employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement methods. MEDLINE, Cumulative Index to Nursing Allied Health (CINAHL), EMBASE, and Cochrane Library databases, from 2001 to June 2012, were searched. Descriptive and comparative studies were included that involved use of health IT in a clinical setting and measured effects on patient safety outcomes. Data on setting, subjects, information technology implemented, and type of patient safety outcomes were all abstracted. The quality of the studies was evaluated by 2 independent reviewers (scored from 0 to 10). A total of 69 studies met inclusion criteria. Quality scores ranged from 1 to 9. There were 25 (36%) studies that found benefit of health IT on direct patient safety outcomes for the primary outcome measured, 43 (62%) studies that either had non-significant or mixed findings, and 1 (1%) study for which health IT had a detrimental effect. Neither the quality of the studies nor the rate of randomized control trials performed changed over time. Most studies that demonstrated a positive benefit of health IT on direct patient safety outcomes were inpatient, single-center, and either cohort or observational trials studying clinical decision support or computerized provider order entry. Many areas of health IT application remain understudied and the majority of studies have non-significant or mixed findings. Our study suggests that larger, higher quality studies need to be conducted, particularly in the long-term care and ambulatory care settings. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Self-organized flexible leadership promotes collective intelligence in human groups

PubMed Central

Kurvers, Ralf H. J. M.; Wolf, Max; Naguib, Marc; Krause, Jens

2015-01-01

Collective intelligence refers to the ability of groups to outperform individual decision-makers. At present, relatively little is known about the mechanisms promoting collective intelligence in natural systems. We here test a novel mechanism generating collective intelligence: self-organization according to information quality. We tested this mechanism by performing simulated predator detection experiments using human groups. By continuously tracking the personal information of all members prior to collective decisions, we found that individuals adjusted their response time during collective decisions to the accuracy of their personal information. When individuals possessed accurate personal information, they decided quickly during collective decisions providing accurate information to the other group members. By contrast, when individuals had inaccurate personal information, they waited longer, allowing them to use social information before making a decision. Individuals deciding late during collective decisions had an increased probability of changing their decision leading to increased collective accuracy. Our results thus show that groups can self-organize according to the information accuracy of their members, thereby promoting collective intelligence. Interestingly, we find that individuals flexibly acted both as leader and as follower depending on the quality of their personal information at any particular point in time. PMID:27019718

Nursing home administrators' opinions of pay for performance.

PubMed

Castle, Nicholas G; Engberg, John; Ferguson-Rome, Jamie C; Sonon, Kristen

2014-01-01

The research presented here provides some descriptive information of nursing home pay for performance (P4P) initiatives and an examination of the opinions of nursing home administrators (NHAs) about P4P. Opinions on three common elements of P4P were examined: the incentive format, program format, and quality format. Information came from a mail survey of 2,426 NHAs. Most of the summary scores show that few NHAs gave positive responses to P4P. Very few NHAs believed that P4P would increase their revenues. NHAs were skeptical that P4P systems were for quality improvement and instead believed they were developed for purposes of cost reduction. Relatively few NHAs believed that P4P would improve quality of care. Given that we have limited experience with setting performance goals and incentive formats for NHAs, the findings presented may prove useful in modeling future P4P systems.

Benchmarking study of corporate research management and planning practices

NASA Astrophysics Data System (ADS)

McIrvine, Edward C.

1992-05-01

During 1983-84, Xerox Corporation was undergoing a change in corporate style through a process of training and altered behavior known as Leadership Through Quality. One tenet of Leadership Through Quality was benchmarking, a procedure whereby all units of the corporation were asked to compare their operation with the outside world. As a part of the first wave of benchmark studies, Xerox Corporate Research Group studied the processes of research management, technology transfer, and research planning in twelve American and Japanese companies. The approach taken was to separate `research yield' and `research productivity' (as defined by Richard Foster) and to seek information about how these companies sought to achieve high- quality results in these two parameters. The most significant findings include the influence of company culture, two different possible research missions (an innovation resource and an information resource), and the importance of systematic personal interaction between sources and targets of technology transfer.

Audit and Feedback: A Quality Improvement Study to Increase Pneumococcal Vaccination Rates.

PubMed

Clark, Rebecca Culver; Carter, Kimberly Ferren; Jackson, Julie; Hodges, Deborah

The purpose of this quality improvement study was to explore the impact of audit and feedback on the pneumococcal immunization rate for at-risk adults in ambulatory settings. Study findings support the hypothesis that timely, individualized audit and feedback can have a positive impact on immunization rate; generalized feedback that did not provide actionable information did not have the same impact. The difference between the interventions was significant, χ (1, N = 1993) = 124.7, P <.001.

An evaluation of the readability of drinking water quality reports: a national assessment.

PubMed

Roy, Siddhartha; Phetxumphou, Katherine; Dietrich, Andrea M; Estabrooks, Paul A; You, Wen; Davy, Brenda M

2015-09-01

The United States Environmental Protection Agency mandates that community water systems (or water utilities) provide annual consumer confidence reports (CCRs)--water quality reports--to their consumers. These reports encapsulate information regarding sources of water, detected contaminants, regulatory compliance, and educational material. These reports have excellent potential for providing the public with accurate information on the safety of tap water, but there is a lack of research on the degree to which the information can be understood by a large proportion of the population. This study evaluated the readability of a nationally representative sample of 30 CCRs, released between 2011 and 2013. Readability (or 'comprehension difficulty') was evaluated using Flesch-Kincaid readability tests. The analysis revealed that CCRs were written at the 11th-14th grade level, which is well above the recommended 6th-7th grade level for public health communications. The CCR readability ease was found to be equivalent to that of the Harvard Law Review journal. These findings expose a wide chasm that exists between current water quality reports and their effectiveness toward being understandable to US residents. Suggestions for reorienting language and scientific information in CCRs to be easily comprehensible to the public are offered.

A rapid review of consumer health information needs and preferences.

PubMed

Ramsey, Imogen; Corsini, Nadia; Peters, Micah D J; Eckert, Marion

2017-09-01

This rapid review summarizes best available evidence on consumers' needs and preferences for information about healthcare, with a focus on the Australian context. Three questions are addressed: 1) Where do consumers find and what platform do they use to access information about healthcare? 2) How do consumers use the healthcare information that they find? 3) About which topics or subjects do consumers need healthcare information? A hierarchical approach was adopted with evidence first sought from reviews then high quality studies using Medline (via PubMed), CINAHL, Embase, the JBI Database of Systematic Reviews and Implementation Reports, the Campbell Collaboration Library of Systematic Reviews, EPPI-Centre, and Epistemonikos. Twenty-eight articles were included; four systematic reviews, three literature reviews, thirteen quantitative studies, six qualitative studies, and two mixed methods studies. Consumers seek health information at varying times along the healthcare journey and through various modes of delivery. Complacency with historical health information modes is no longer appropriate and flexibility is essential to suit growing consumer demands. Health information should be readily available in different formats and not exclusive to any single medium. Copyright © 2017. Published by Elsevier B.V.

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda

PubMed Central

2014-01-01

Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. Discussion EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. Trial registration PACTR201311000681314 PMID:24690284

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda.

PubMed

Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan

2014-04-02

Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. PACTR201311000681314.

Leveraging electronic health record documentation for Failure Mode and Effects Analysis team identification

PubMed Central

Carson, Matthew B; Lee, Young Ji; Benacka, Corrine; Mutharasan, R. Kannan; Ahmad, Faraz S; Kansal, Preeti; Yancy, Clyde W; Anderson, Allen S; Soulakis, Nicholas D

2017-01-01

Objective: Using Failure Mode and Effects Analysis (FMEA) as an example quality improvement approach, our objective was to evaluate whether secondary use of orders, forms, and notes recorded by the electronic health record (EHR) during daily practice can enhance the accuracy of process maps used to guide improvement. We examined discrepancies between expected and observed activities and individuals involved in a high-risk process and devised diagnostic measures for understanding discrepancies that may be used to inform quality improvement planning. Methods: Inpatient cardiology unit staff developed a process map of discharge from the unit. We matched activities and providers identified on the process map to EHR data. Using four diagnostic measures, we analyzed discrepancies between expectation and observation. Results: EHR data showed that 35% of activities were completed by unexpected providers, including providers from 12 categories not identified as part of the discharge workflow. The EHR also revealed sub-components of process activities not identified on the process map. Additional information from the EHR was used to revise the process map and show differences between expectation and observation. Conclusion: Findings suggest EHR data may reveal gaps in process maps used for quality improvement and identify characteristics about workflow activities that can identify perspectives for inclusion in an FMEA. Organizations with access to EHR data may be able to leverage clinical documentation to enhance process maps used for quality improvement. While focused on FMEA protocols, findings from this study may be applicable to other quality activities that require process maps. PMID:27589944

Coping with Inflammatory Bowel Disease: Engaging with Information to Inform Health-Related Decision Making in Daily Life.

PubMed

Restall, Gayle J; Simms, Alexandria M; Walker, John R; Haviva, Clove; Graff, Lesley A; Sexton, Kathryn A; Miller, Norine; Targownik, Laura E; Bernstein, Charles N

2017-08-01

People with inflammatory bowel disease (IBD) require disease and lifestyle information to make health-related decisions in their daily lives. Derived from a larger qualitative study of the lived experiences of people with IBD, we report on findings that explored how people with IBD engage with health-related information in their daily lives. Participants were recruited primarily from the Manitoba IBD Cohort Study. We used purposive sampling to select people with a breadth of characteristics and experiences. Individual interviews were audio-recorded and transcribed verbatim. Data were analyzed using inductive qualitative methods consistent with a phenomenological approach. Forty-five people with IBD participated; 51% were women. Findings highlighted the temporal and contextual influences on engagement with health-related information. Temporal influences were described as the changing need for health-related information over time. Participants identified 6 contextual factors influencing engagement with information to make health decisions: (1) emotional and attitudinal responses, (2) perceived benefits and risks, (3) trust in the source of the information, (4) knowledge and skills to access and use information, (5) availability of evidence to support decisions, and (6) social and economic environments. Findings illustrate the changing needs for health-related information over the course of IBD, and with evolving health and life circumstances. Practitioners can be responsive to information needs of people with IBD by having high-quality information available at the right time in a variety of formats and by supporting the incorporation of information in daily life.

Comparing and using assessments of the value of information to clinical decision-making.

PubMed Central

Urquhart, C J; Hepworth, J B

1996-01-01

This paper discusses the Value project, which assessed the value to clinical decision-making of information supplied by National Health Service (NHS) library and information services. The project not only showed how health libraries in the United Kingdom help clinicians in decision-making but also provided quality assurance guidelines for these libraries to help make their information services more effective. The paper reviews methods and results used in previous studies of the value of health libraries, noting that methodological differences appear to affect the results. The paper also discusses aspects of user involvement, categories of clinical decision-making, the value of information to present and future clinical decisions, and the combination of quantitative and qualitative assessments of value, as applied to the Value project and the studies reviewed. The Value project also demonstrated that the value placed on information depends in part on the career stage of the physician. The paper outlines the structure of the quality assurance tool kit, which is based on the findings and methods used in the Value project. PMID:8913550

Do School Report Cards Produce Accountability through the Ballot Box?

ERIC Educational Resources Information Center

Kogan, Vladimir; Lavertu, Stéphane; Peskowitz, Zachary

2016-01-01

Public education has been transformed by the widespread adoption of accountability systems that involve the dissemination of school district performance information. Using data from Ohio, we examine if elections serve as one channel through which these accountability systems might lead to improvements in educational quality. We find little…

Wireless tracking of cotton modules Part II: automatic machine identification and system testing

USDA-ARS?s Scientific Manuscript database

Mapping the harvest location of cotton modules is essential to practical understanding and utilization of spatial-variability information in fiber quality. A wireless module-tracking system was recently developed, but automation of the system is required before it will find practical use on the far...

Evaluator Training: Content and Topic Valuation in University Evaluation Courses

ERIC Educational Resources Information Center

Davies, Randall; MacKay, Kathryn

2014-01-01

Quality training opportunities for evaluators will always be important to the evaluation profession. While studies have documented the number of university programs providing evaluation training, additional information is needed concerning what content is being taught in current evaluation courses. This article summarizes the findings of a survey…

Borrowing and Repaying Student Loans

ERIC Educational Resources Information Center

Hillman, Nicholas W.

2015-01-01

This essay synthesizes the most recent and rigorous research on student loan debt. It focuses on basic questions about who borrows, how much, and whether debt affects behaviors. Answers to these questions are necessary for informing federal student loan policymaking, yet the research findings are surprisingly mixed because of poor data quality,…

Microcomputer Usage in Schools, 1984-1985.

ERIC Educational Resources Information Center

Quality Education Data, Inc., Denver, CO.

Results are presented for the fourth annual survey of all U.S. school districts by Quality Educational Data, Inc. Findings are displayed in tabular form and include information on the following: market penetration by major brands of microcomputers in school districts and buildings; school districts that use microcomputers and the brand or…

Research Libraries' Costs of Doing Business (and Strategies for Avoiding Them)

ERIC Educational Resources Information Center

Greenstein, Daniel

2004-01-01

With today's relatively flat budgets, research libraries are finding their buying power further diminished by the hyperinflationary costs of library materials. Yet technology innovation, coupled with organizational restructuring, is enabling libraries not only to provide more high-quality information services but also to achieve unparalleled…

Solutions that work for finding and keeping top staff.

PubMed

Maun, C; Lind, D L

1990-08-01

"It is important for providers to celebrate their quality employees and give them actual data as to what makes them good employees. Not subjective opinions, but actual, real-world information about why they are good and why they have been chosen to be part of this celebration."

Economic Analysis of Children’s Surgical Care in Low- and Middle-Income Countries: A Systematic Review and Analysis

PubMed Central

Poenaru, Dan; Ozgediz, Doruk; Ameh, Emmanuel A.; Farmer, Diana; Smith, Emily R.; Rice, Henry E.

2016-01-01

Background Understanding the economic value of health interventions is essential for policy makers to make informed resource allocation decisions. The objective of this systematic review was to summarize available information on the economic impact of children’s surgical care in low- and middle-income countries (LMICs). Methods We searched MEDLINE (Pubmed), Embase, and Web of Science for relevant articles published between Jan. 1996 and Jan. 2015. We summarized reported cost information for individual interventions by country, including all costs, disability weights, health outcome measurements (most commonly disability-adjusted life years [DALYs] averted) and cost-effectiveness ratios (CERs). We calculated median CER as well as societal economic benefits (using a human capital approach) by procedure group across all studies. The methodological quality of each article was assessed using the Drummond checklist and the overall quality of evidence was summarized using a scale adapted from the Agency for Healthcare Research and Quality. Findings We identified 86 articles that met inclusion criteria, spanning 36 groups of surgical interventions. The procedure group with the lowest median CER was inguinal hernia repair ($15/DALY). The procedure group with the highest median societal economic benefit was neurosurgical procedures ($58,977). We found a wide range of study quality, with only 35% of studies having a Drummond score ≥ 7. Interpretation Our findings show that many areas of children’s surgical care are extremely cost-effective in LMICs, provide substantial societal benefits, and are an appropriate target for enhanced investment. Several areas, including inguinal hernia repair, trichiasis surgery, cleft lip and palate repair, circumcision, congenital heart surgery and orthopedic procedures, should be considered “Essential Pediatric Surgical Procedures” as they offer considerable economic value. However, there are major gaps in existing research quality and methodology which limit our current understanding of the economic value of surgical care. PMID:27792792

It is time to improve the quality of medical information distributed to students across social media.

PubMed

Zucker, Benjamin E; Kontovounisios, Christos

2018-01-01

The ubiquitous nature of social media has meant that its effects on fields outside of social communication have begun to be felt. The generation undergoing medical education are of the generation referred to as "digital natives", and as such routinely incorporate social media into their education. Social media's incorporation into medical education includes its use as a platform to distribute information to the public ("distributive education") and as a platform to provide information to a specific audience ("push education"). These functions have proved beneficial in many regards, such as enabling constant access to the subject matter, other learners, and educators. However, the usefulness of using social media as part of medical education is limited by the vast quantities of poor quality information and the time required to find information of sufficient quality and relevance, a problem confounded by many student's preoccupation with "efficient" learning. In this Perspective, the authors discuss whether social media has proved useful as a tool for medical education. The current growth in the use of social media as a tool for medical education seems to be principally supported by students' desire for efficient learning rather than by the efficacy of social media as a resource for medical education. Therefore, improvements in the quality of information required to maximize the impact of social media as a tool for medical education are required. Suggested improvements include an increase in the amount of educational content distributed on social media produced by academic institutions, such as universities and journals.

Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

PubMed

Mohammed, Siti Asma; Yusof, Maryati Mohd

2013-04-01

Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.

Evaluating Written Patient Information for Eczema in German: Comparing the Reliability of Two Instruments, DISCERN and EQIP

PubMed Central

McCool, Megan E.; Wahl, Josepha; Schlecht, Inga; Apfelbacher, Christian

2015-01-01

Patients actively seek information about how to cope with their health problems, but the quality of the information available varies. A number of instruments have been developed to assess the quality of patient information, primarily though in English. Little is known about the reliability of these instruments when applied to patient information in German. The objective of our study was to investigate and compare the reliability of two validated instruments, DISCERN and EQIP, in order to determine which of these instruments is better suited for a further study pertaining to the quality of information available to German patients with eczema. Two independent raters evaluated a random sample of 20 informational brochures in German. All the brochures addressed eczema as a disorder and/or therapy options and care. Intra-rater and inter-rater reliability were assessed by calculating intra-class correlation coefficients, agreement was tested with weighted kappas, and the correlation of the raters’ scores for each instrument was measured with Pearson’s correlation coefficient. DISCERN demonstrated substantial intra- and inter-rater reliability. It also showed slightly better agreement than EQIP. There was a strong correlation of the raters’ scores for both instruments. The findings of this study support the reliability of both DISCERN and EQIP. However, based on the results of the inter-rater reliability, agreement and correlation analyses, we consider DISCERN to be the more precise tool for our project on patient information concerning the treatment and care of eczema. PMID:26440612

Evaluating Written Patient Information for Eczema in German: Comparing the Reliability of Two Instruments, DISCERN and EQIP.

PubMed

McCool, Megan E; Wahl, Josepha; Schlecht, Inga; Apfelbacher, Christian

2015-01-01

Patients actively seek information about how to cope with their health problems, but the quality of the information available varies. A number of instruments have been developed to assess the quality of patient information, primarily though in English. Little is known about the reliability of these instruments when applied to patient information in German. The objective of our study was to investigate and compare the reliability of two validated instruments, DISCERN and EQIP, in order to determine which of these instruments is better suited for a further study pertaining to the quality of information available to German patients with eczema. Two independent raters evaluated a random sample of 20 informational brochures in German. All the brochures addressed eczema as a disorder and/or therapy options and care. Intra-rater and inter-rater reliability were assessed by calculating intra-class correlation coefficients, agreement was tested with weighted kappas, and the correlation of the raters' scores for each instrument was measured with Pearson's correlation coefficient. DISCERN demonstrated substantial intra- and inter-rater reliability. It also showed slightly better agreement than EQIP. There was a strong correlation of the raters' scores for both instruments. The findings of this study support the reliability of both DISCERN and EQIP. However, based on the results of the inter-rater reliability, agreement and correlation analyses, we consider DISCERN to be the more precise tool for our project on patient information concerning the treatment and care of eczema.

Patient-reported outcomes in randomised controlled trials of colorectal cancer: an analysis determining the availability of robust data to inform clinical decision-making

PubMed Central

Whale, Katie; Fish, Daniel; Fayers, Peter; Cafaro, Valentina; Pusic, Andrea; Blazeby, Jane M.; Efficace, Fabio

2016-01-01

Purpose Randomised controlled trials (RCTs) are the most robust study design measuring outcomes of colorectal cancer (CRC) treatments, but to influence clinical practice trial design and reporting of patient-reported outcomes (PROs) must be of high quality. Objectives of this study were as follows: to examine the quality of PRO reporting in RCTs of CRC treatment; to assess the availability of robust data to inform clinical decision-making; and to investigate whether quality of reporting improved over time. Methods A systematic review from January 2004–February 2012 identified RCTs of CRC treatment describing PROs. Relevant abstracts were screened and manuscripts obtained. Methodological quality was assessed using International Society for Quality of Life Research—patient-reported outcome reporting standards. Changes in reporting quality over time were established by comparison with previous data, and risk of bias was assessed with the Cochrane risk of bias tool. Results Sixty-six RCTs were identified, seven studies (10 %) reported survival benefit favouring the experimental treatment, 35 trials (53 %) identified differences in PROs between treatment groups, and the clinical significance of these differences was discussed in 19 studies (29 %). The most commonly reported treatment type was chemotherapy (n = 45; 68 %). Improvements over time in key methodological issues including the documentation of missing data and the discussion of the clinical significance of PROs were found. Thirteen trials (20 %) had high-quality reporting. Conclusions Whilst improvements in PRO quality reporting over time were found, several recent studies still fail to robustly inform clinical practice. Quality of PRO reporting must continue to improve to maximise the clinical impact of PRO findings. PMID:25910987

A scope classification of data quality requirements for food composition data.

PubMed

Presser, Karl; Hinterberger, Hans; Weber, David; Norrie, Moira

2016-02-15

Data quality is an important issue when managing food composition data since the usage of the data can have a significant influence on policy making and further research. Although several frameworks for data quality have been proposed, general tools and measures are still lacking. As a first step in this direction, we investigated data quality requirements for an information system to manage food composition data, called FoodCASE. The objective of our investigation was to find out if different requirements have different impacts on the intrinsic data quality that must be regarded during data quality assessment and how these impacts can be described. We refer to the resulting classification with its categories as the scope classification of data quality requirements. As proof of feasibility, the scope classification has been implemented in the FoodCASE system. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Survey of Information Source Preferences of Parents of Individuals with Autism Spectrum Disorder.

PubMed

Gibson, Amelia N; Kaplan, Samantha; Vardell, Emily

2017-07-01

For parents of children with an Autism spectrum disorder (ASD), high quality, easily accessible information and a strong peer network can be the key to raising a happy, healthy child, and maintaining family well-being and emotional resilience. This article reports the findings of an anonymous survey examining the information source preferences for 935 parents of individuals with ASDs in North Carolina. Data indicates that parents show similar information seeking patterns across the age spectrum, that availability of information (as indicated by overall information source selection) decrease as children age. It also shows that parents rely heavily on local sources of information, preferring them to nonlocal sources (such as the internet) for many types of information.

[Access to health information sources in Spain. how to combat "infoxication"].

PubMed

Navas-Martin, Miguel Ángel; Albornos-Muñoz, Laura; Escandell-García, Cintia

2012-01-01

Internet has become a priceless source for finding health information for both patients and healthcare professionals. However, the universality and the abundance of information can lead to unfounded conclusions about health issues that can confuse further than clarify the health information. This aspect causes intoxication of information: infoxication. The question lies in knowing how to filter the information that is useful, accurate and relevant for our purposes. In this regard, integrative portals, such as the Biblioteca Virtual de Salud, compile information at different levels (international, national and regional), different types of resources (databases, repositories, bibliographic sources, etc.), becoming a starting point for obtaining quality information. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Analysis of chemistry textbook content and national science education standards in terms of air quality-related learning goals

NASA Astrophysics Data System (ADS)

Naughton, Wendy

In this study's Phase One, representatives of nine municipal agencies involved in air quality education were interviewed and interview transcripts were analyzed for themes related to what citizens need to know or be able to do regarding air quality concerns. Based on these themes, eight air quality Learning Goal Sets were generated and validated via peer and member checks. In Phase Two, six college-level, liberal-arts chemistry textbooks and the National Science Education Standards (NSES) were analyzed for congruence with Phase One learning goals. Major categories of desired citizen understandings highlighted in agency interviews concerned air pollution sources, impact, detection, and transport. Identified cognitive skills focused on information-gathering and -evaluating skills, enabling informed decision-making. A content match was found between textbooks and air quality learning goals, but most textbooks fail to address learning goals that remediate citizen misconceptions and inabilities---particularly those with a "personal experience" focus. A partial match between NSES and air quality learning goals was attributed to differing foci: Researcher-derived learning goals deal specifically with air quality, while NSES focus is on "fundamental science concepts," not "many science topics." Analysis of findings within a situated cognition framework suggests implications for instruction and NSES revision.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Janka, R., E-mail: rolf.janka@idr.imed.uni-erlangen.de; Wenkel, E.; Fellner, C.

The purpose of this work was to find out how often the clinician asks for a conventional angiography (CA) in patients with peripheral arterial occlusive disease (PAOD) after a magnetic resonance angiography (MRA) has been performed and how often the CA reveals additional information for therapy planning. Quality criteria for the MRA were defined and tested to see whether they can predict the need for an additional CA. In this prospective study, 81 patients suffering from PAOD (Fontaine classification IIa, n = 13; IIb, n = 33; III, n = 10; IV, n = 25) were examined with a 1.5-Tmore » MR-scanner with dedicated coils using a step-by-step technique. The vascular surgeon decided whether he could plan the therapy on the basis of the MRA or if he needed an additional CA. The MRA was assessed in terms of the image quality of the MRA and regarding therapeutic management of the patient in a two-grade scale: sufficient and insufficient. In 27/81 (33%) patients, the clinician asked for a CA, which revealed new information in only 11 patients. The relative number of MRAs with insufficient image quality was significantly higher (p < 0.01) in the group with additional information on CA (8/11) compared to the group without additional information (0/16). The assessment of an MRA based on image quality and regarding therapeutic management of the patient might reduce the number of CAs for therapy planning in patients with PAOD.« less

Can high quality overcome consumer resistance to restricted provider access? Evidence from a health plan choice experiment.

PubMed

Harris, Katherine M

2002-06-01

To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents "extremely satisfied with results of care" had the greatest impact on plan choice while the proportion of network doctors "affiliated with university medical centers" had the least. Other consumer and expert assessed measures had more comparable effects. Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high quality. However, the results of this study suggest that in many cases, the level of quality required for consumers to accept access restrictions may be so high as to be unattainable. The results provide empirical support for the current focus of decision support efforts on consumer assessed quality measures. At the same time, however, the results suggest that consumers would also value quality measures based on expert assessments. This finding is relevant given the lack of comparative quality information based on expert judgment and research suggesting that consumers have apprehensions about their ability to meaningfully interpret performance-based quality measures.

What results when firms implement practices: the differential relationship between specific practices, firm financial performance, customer service, and quality.

PubMed

Gibson, Cristina B; Porath, Christine L; Benson, George S; Lawler, Edward E

2007-11-01

Previous research on organizational practices is replete with contradictory evidence regarding their effects. Here, the authors argue that these contradictory findings may have occurred because researchers have often examined complex practice combinations and have failed to investigate a broad variety of firm-level outcomes. Thus, past research may obscure important differential effects of specific practices on specific firm-level outcomes. Extending this research, the authors develop hypotheses about the effects of practices that (a) enable information sharing, (b) set boundaries, and (c) enable teams on 3 different firm-level outcomes: financial performance, customer service, and quality. Relationships are tested in a sample of observations from over 200 Fortune 1000 firms. Results indicate that information-sharing practices were positively related to financial performance 1 year following implementation of the practices, boundary-setting practices were positively related to firm-level customer service, and team-enabling practices were related to firm-level quality. No single set of practices predicted all 3 firm-level outcomes, indicating practice-specific effects. These findings help resolve the theoretical tension in the literature regarding the effects of organizational practices and offer guidance as to how to best target practices to increase specific work-related outcomes. Implications for theory, research, and practice are discussed. (c) 2007 APA

Childhood socioeconomic status and risk in early family environments: predictors of global sleep quality in college students.

PubMed

Counts, Cory J; Grubin, Fiona C; John-Henderson, Neha A

2018-06-01

Low socioeconomic status (SES) in childhood associates with poor sleep quality in adulthood. Separately, childhood family environments shape health into adulthood. Here, we investigated whether these early life factors independently or interactively inform global sleep quality in college students. Cross-sectional. College students at a state university (N = 391). As a measure of childhood SES, we asked participants to consider their families' socioeconomic standing relative to the rest of the society during their childhood. We used the Risky Family questionnaire to measure adversity and the presence of warmth and affection in the family environment during childhood, and the Pittsburgh Sleep Quality Index as a measure of current global sleep quality. We used linear regressions adjusting for age and sex to examine relationships between childhood SES, risk in childhood family environments, and global sleep quality. Lower childhood SES and greater risk in childhood family environments independently predicted poor sleep quality. Importantly, in low-risk family environments, there was no significant difference in sleep quality as a function of childhood SES. However, students who were from low childhood SES backgrounds who also reported high levels of risk in their early family environments had the worst sleep quality. Findings highlight the importance of considering socioeconomic and family environments in childhood as informants of sleep quality across the lifespan. Compromised sleep quality in college students could affect academic performance and health over time. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Infant Gastroesophageal Reflux Information on the World Wide Web.

PubMed

Balgowan, Regina; Greer, Leah C; D'Auria, Jennifer P

2016-01-01

The purpose of this study was to describe the type and quality of health information about infant gastroesophageal reflux (GER) that a parent may find on the World Wide Web. The data collection tool included evaluation of Web site quality and infant GER-specific content on the 30 sites that met the inclusion criteria. The most commonly found content categories in order of frequency were management strategies, when to call a primary care provider, definition, and clinical features. The most frequently mentioned strategies included feeding changes, infant positioning, and medications. Thirteen of the 30 Web sites included information on both GER and gastroesophageal reflux disease. Mention of the use of medication to lessen infant symptoms was found on 15 of the 30 sites. Only 10 of the 30 sites included information about parent support and coping strategies. Pediatric nurse practitioners (PNPs) should utilize well-child visits to address the normalcy of physiologic infant GER and clarify any misperceptions parents may have about diagnosis and the role of medication from information they may have found on the Internet. It is critical for PNPs to assist in the development of Web sites with accurate content, advise parents on how to identify safe and reliable information, and provide examples of high-quality Web sites about child health topics such as infant GER. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Evidence-based ethics – What it should be and what it shouldn't

PubMed Central

Strech, Daniel

2008-01-01

Background The concept of evidence-based medicine has strongly influenced the appraisal and application of empirical information in health care decision-making. One principal characteristic of this concept is the distinction between "evidence" in the sense of high-quality empirical information on the one hand and rather low-quality empirical information on the other hand. In the last 5 to 10 years an increasing number of articles published in international journals have made use of the term "evidence-based ethics", making a systematic analysis and explication of the term and its applicability in ethics important. Discussion In this article four descriptive and two normative characteristics of the general concept "evidence-based" are presented and explained systematically. These characteristics are to then serve as a framework for assessing the methodological and practical challenges of evidence-based ethics as a developing methodology. The superiority of evidence in contrast to other empirical information has several normative implications such as the legitimization of decisions in medicine and ethics. This implicit normativity poses ethical concerns if there is no formal consent on which sort of empirical information deserves the label "evidence" and which does not. In empirical ethics, which relies primarily on interview research and other methods from the social sciences, we still lack gold standards for assessing the quality of study designs and appraising their findings. Conclusion The use of the term "evidence-based ethics" should be discouraged, unless there is enough consensus on how to differentiate between high- and low-quality information produced by empirical ethics. In the meantime, whenever empirical information plays a role, the process of ethical decision-making should make use of systematic reviews of empirical studies that involve a critical appraisal and comparative discussion of data. PMID:18937838

[Quality of life in dysphonia].

PubMed

Rosanowski, F; Grässel, E; Hoppe, U; Köllner, V

2009-09-01

Quality of life is multidimensional and comprises physical, emotional, and social aspects. It has always been the implicit focus of medical work. However, since the 1980s it has been possible to measure it explicitly. Quality of life is impaired in dysphonic patients; this finding is supported by specific studies on self-reported physical, emotional, and social well-being. For practical application of these data, it is recommended to measure all three domains. From a therapeutic point of view, verbal intervention following the PLISSIT model (permission, limited information, special suggestions, intensive therapy) has been proven to enhance patient satisfaction. Therefore, this clinical procedure is recommended for routine application in dysphonic patients.

Perceived Quality of Informed Refusal Process: A Cross-Sectional Study from Iranian Patients' Perspectives.

PubMed

Farzandipour, Mehrdad; Sheikhtaheri, Abbas; Sadeqi Jabali, Monireh

2015-12-01

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider-patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. © 2014 John Wiley & Sons Ltd.

The persuasion context and results in online opinion seeking: effects of message and source-the moderating role of network managers.

PubMed

Cabezudo, Rebeca San José; Izquierdo, Carmen Camarero; Pinto, Javier Rodríguez

2013-11-01

Online opinion networks are areas for social exchange, or conversational networks, made up of individuals actively involved in sharing experiences and opinions concerning matters of mutual interest between consumers or concerning their experience with a given product or service. We pinpoint a gap in the literature regarding how the persuasion process occurs when individuals seek opinions online, including the results process. In an attempt to find an answer, we draw on traditional theories related to information processing. These are mostly taken from the field of psychology and enable us to identify which signals or aspects of communication or opinions the individuals focus their attention on (message and source) and the value attached to such communications as well as how much they impact individuals' purchase decisions, bearing in mind the medium (or online opinion network) in which the opinions are located. Findings from those interviewed support the idea that the quality of information on the Internet, as well as trust in the source of said information, or in the opinion of network users, have an impact on the informational value obtained from involvement in this online opinion seeking and on purchasing decisions. Moreover, depending on the kind of network (firm or brand controlled, review Web sites, and user-controlled nonofficial opinion networks), the quality of the information or trust in the users will have a different bearing in the persuasion process.

Functionality of hospital information systems: results from a survey of quality directors at Turkish hospitals.

PubMed

Saluvan, Mehmet; Ozonoff, Al

2018-01-12

We aimed to determine availability of core Hospital Information Systems (HIS) functions implemented in Turkish hospitals and the perceived importance of these functions on quality and patient safety. We surveyed quality directors (QDs) at civilian hospitals in the nation of Turkey. Data were collected via web survey using an instrument with 50 items describing core functionality of HIS. We calculated mean availability of each function, mean and median values of perceived impact on quality, and we investigated the relationship between availability and perceived importance. We received responses from 31% of eligible institutions, representing all major geographic regions of Turkey. Mean availability of 50 HIS functions was 65.6%, ranging from 19.6% to 97.4%. Mean importance score was 7.87 (on a 9-point scale) ranging from 7.13 to 8.41. Functions related to result management (89.3%) and decision support systems (52.2%) had the highest and lowest reported availability respectively. Availability and perceived importance were moderately correlated (r = 0.52). QDs report high importance of the HIS functions surveyed as they relate to quality and patient safety. Availability and perceived importance of HIS functions are generally correlated, with some interesting exceptions. These findings may inform future investments and guide policy changes within the Turkish healthcare system. Financial incentives, regulations around certified HIS, revisions to accreditation manuals, and training interventions are all policies which will help integrate HIS functions to support quality and patient safety in Turkish hospitals.

The Experience of Persons With Multiple Sclerosis Using MS INFoRm: An Interactive Fatigue Management Resource.

PubMed

Pétrin, Julie; Akbar, Nadine; Turpin, Karen; Smyth, Penelope; Finlayson, Marcia

2018-04-01

We aimed to understand participants' experiences with a self-guided fatigue management resource, Multiple Sclerosis: An Interactive Fatigue Management Resource ( MS INFoRm), and the extent to which they found its contents relevant and useful to their daily lives. We recruited 35 persons with MS experiencing mild to moderate fatigue, provided them with MS INFoRm, and then conducted semistructured interviews 3 weeks and 3 months after they received the resource. Interpretive description guided the analysis process. Findings indicate that participants' experience of using MS INFoRm could be understood as a process of change, influenced by their initial reactions to the resource. They reported experiencing a shift in knowledge, expectations, and behaviors with respect to fatigue self-management. These shifts led to multiple positive outcomes, including increased levels of self-confidence and improved quality of life. These findings suggest that MS INFoRm may have a place in the continuum of fatigue management interventions for people with MS.

Do consumer reports of health plan quality affect health plan selection?

PubMed Central

Spranca, M; Kanouse, D E; Elliott, M; Short, P F; Farley, D O; Hays, R D

2000-01-01

OBJECTIVE: To learn whether consumer reports of health plan quality can affect health plan selection. DATA SOURCES: A sample of 311 privately insured adults from Los Angeles County. STUDY DESIGN: The design was a fractional factorial experiment. Consumers reviewed materials on four hypothetical health plans and selected one. The health plans varied as to cost, coverage, type of plan, ability to keep one's doctor, and quality, as measured by the Consumer Assessment of Health Plans Study (CAHPS) survey. DATA ANALYSIS: We used multinomial logistic regression to model each consumer's choice among health plans. PRINCIPAL FINDINGS: In the absence of CAHPS information, 86 percent of consumers preferred plans that covered more services, even though they cost more. When CAHPS information was provided, consumers shifted to less expensive plans covering fewer services if CAHPS ratings identified those plans as higher quality (59 percent of consumers preferred plans covering more services). Consumer choices were unaffected when CAHPS ratings identified the more expensive plans covering more services as higher quality (89 percent of consumers preferred plans covering more services). CONCLUSIONS: This study establishes that, under certain realistic conditions, CAHPS ratings could affect consumer selection of health plans and ultimately contain costs. Other studies are needed to learn how to enhance exposure and use of CAHPS information in the real world as well as to identify other conditions in which CAHPS ratings could make a difference. PMID:11130805

BRIEF REPORT: Nutrition and Weight Loss Information in a Popular Diet Book: Is It Fact, Fiction, or Something in Between?

PubMed Central

Goff, Sarah L; Foody, Joanne M; Inzucchi, Silvio; Katz, David; Mayne, Susan T; Krumholz, Harlan M

2006-01-01

BACKGROUND/OBJECTIVE Diet books dominate the New York Times Advice Best Seller list and consumers cite such books as an important source of nutrition information. However, the scientific support for nutrition claims presented as fact (nutrition facts) in diet books is not known. DESIGN/MEASUREMENTS We assessed the quality of nutrition facts in the best-selling South Beach Diet using support in peer-reviewed literature as a measure of quality. We performed structured literature searches on nutrition facts located in the books' text, and then assigned each fact to 1 of 4 categories (1) fact supported, (2) fact not supported, (3) fact both supported and not supported, and (4) no related papers. A panel of expert reviewers adjudicated the findings. RESULTS Forty-two nutrition facts were included. Fourteen (33%) facts were supported, 7 (17%) were not supported, 18 (43%) were both supported and not supported, and 3 (7%) had no related papers, including the fact that the diet had been “scientifically studied and proven effective.” CONCLUSIONS Consumers obtain nutrition information from diet books. We found that over 67% of nutrition facts in a best-seller diet book may not be supported in the peer-reviewed literature. These findings have important implications for educating consumers about nutrition information sources. PMID:16808780

Methodological variation in economic evaluations conducted in low- and middle-income countries: information for reference case development.

PubMed

Santatiwongchai, Benjarin; Chantarastapornchit, Varit; Wilkinson, Thomas; Thiboonboon, Kittiphong; Rattanavipapong, Waranya; Walker, Damian G; Chalkidou, Kalipso; Teerawattananon, Yot

2015-01-01

Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions.

Scaling up quality care for mothers and newborns around the time of birth: an overview of methods and analyses of intervention-specific bottlenecks and solutions.

PubMed

Dickson, Kim E; Kinney, Mary V; Moxon, Sarah G; Ashton, Joanne; Zaka, Nabila; Simen-Kapeu, Aline; Sharma, Gaurav; Kerber, Kate J; Daelmans, Bernadette; Gülmezoglu, A; Mathai, Matthews; Nyange, Christabel; Baye, Martina; Lawn, Joy E

2015-01-01

The Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortality targets cannot be achieved without high quality, equitable coverage of interventions at and around the time of birth. This paper provides an overview of the methodology and findings of a nine paper series of in-depth analyses which focus on the specific challenges to scaling up high-impact interventions and improving quality of care for mothers and newborns around the time of birth, including babies born small and sick. The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the ENAP process. Country workshops engaged technical experts to complete a tool designed to synthesise "bottlenecks" hindering the scale up of maternal-newborn intervention packages across seven health system building blocks. We used quantitative and qualitative methods and literature review to analyse the data and present priority actions relevant to different health system building blocks for skilled birth attendance, emergency obstetric care, antenatal corticosteroids (ACS), basic newborn care, kangaroo mother care (KMC), treatment of neonatal infections and inpatient care of small and sick newborns. The 12 countries included in our analysis account for the majority of global maternal (48%) and newborn (58%) deaths and stillbirths (57%). Our findings confirm previously published results that the interventions with the most perceived bottlenecks are facility-based where rapid emergency care is needed, notably inpatient care of small and sick newborns, ACS, treatment of neonatal infections and KMC. Health systems building blocks with the highest rated bottlenecks varied for different interventions. Attention needs to be paid to the context specific bottlenecks for each intervention to scale up quality care. Crosscutting findings on health information gaps inform two final papers on a roadmap for improvement of coverage data for newborns and indicate the need for leadership for effective audit systems. Achieving the Sustainable Development Goal targets for ending preventable mortality and provision of universal health coverage will require large-scale approaches to improving quality of care. These analyses inform the development of systematic, targeted approaches to strengthening of health systems, with a focus on overcoming specific bottlenecks for the highest impact interventions.

Scaling up quality care for mothers and newborns around the time of birth: an overview of methods and analyses of intervention-specific bottlenecks and solutions

PubMed Central

2015-01-01

Background The Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortality targets cannot be achieved without high quality, equitable coverage of interventions at and around the time of birth. This paper provides an overview of the methodology and findings of a nine paper series of in-depth analyses which focus on the specific challenges to scaling up high-impact interventions and improving quality of care for mothers and newborns around the time of birth, including babies born small and sick. Methods The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the ENAP process. Country workshops engaged technical experts to complete a tool designed to synthesise "bottlenecks" hindering the scale up of maternal-newborn intervention packages across seven health system building blocks. We used quantitative and qualitative methods and literature review to analyse the data and present priority actions relevant to different health system building blocks for skilled birth attendance, emergency obstetric care, antenatal corticosteroids (ACS), basic newborn care, kangaroo mother care (KMC), treatment of neonatal infections and inpatient care of small and sick newborns. Results The 12 countries included in our analysis account for the majority of global maternal (48%) and newborn (58%) deaths and stillbirths (57%). Our findings confirm previously published results that the interventions with the most perceived bottlenecks are facility-based where rapid emergency care is needed, notably inpatient care of small and sick newborns, ACS, treatment of neonatal infections and KMC. Health systems building blocks with the highest rated bottlenecks varied for different interventions. Attention needs to be paid to the context specific bottlenecks for each intervention to scale up quality care. Crosscutting findings on health information gaps inform two final papers on a roadmap for improvement of coverage data for newborns and indicate the need for leadership for effective audit systems. Conclusions Achieving the Sustainable Development Goal targets for ending preventable mortality and provision of universal health coverage will require large-scale approaches to improving quality of care. These analyses inform the development of systematic, targeted approaches to strengthening of health systems, with a focus on overcoming specific bottlenecks for the highest impact interventions. PMID:26390820

Nutritional supplement products: Does the label information influence purchasing decisions for the physically active?

PubMed

Gabriels, Gary; Lambert, Mike

2013-10-02

The increase in sales of nutritional supplement globally can be attributed, in part, to aggressive marketing by manufacturers, rather than because the nutritional supplements have become more effective. Furthermore, the accuracy of the labelling often goes unchallenged. Therefore, any effects of the supplement, may be due to contaminants or adulterants in these products not reflected on the label. A self-administered questionnaire was used to determine how consumers of nutritional supplements acquired information to assist their decision-making processes, when purchasing a product. The study was approved by the University of Cape Town, Faculty of Health Sciences Human Research Ethics Committee. The questionnaire consisted of seven, closed and open-ended questions. The participants were asked to respond to the questions according to a defined list of statements. A total of 259 participants completed and returned questionnaires. The data and processing of the returned questionnaires was captured using Windows-based Microsoft® Office Excel 2003 SP 1 (Excel © 1985-2003 Microsoft Corporation). Statistica Version 10 (copyright © Stat Soft, Inc. 1984-2011) was used to calculate the descriptive statistics. The main finding of the study was that nearly 70% of the respondents who purchased supplements were strongly influenced by container label information that stipulated that the nutritional supplement product is free of banned substances. The second finding was that just over 50% of the respondents attached importance to the quality of the nutritional supplement product information on the container label. The third finding was that about 40% of the respondents were strongly influenced by the ingredients on the labels when they purchased nutritional supplements. This study, (i) identifies short-comings in current labelling information practices, (ii) provides opportunities to improve label and non-label information and communication, and, (iii) presents the case for quality assurance laboratory "screening testing" of declared and undeclared contaminants and/or adulterants, that could have negative consequences to the consumer.

Nutritional supplement products: does the label information influence purchasing decisions for the physically active?

PubMed Central

2013-01-01

Background The increase in sales of nutritional supplement globally can be attributed, in part, to aggressive marketing by manufacturers, rather than because the nutritional supplements have become more effective. Furthermore, the accuracy of the labelling often goes unchallenged. Therefore, any effects of the supplement, may be due to contaminants or adulterants in these products not reflected on the label. Methods A self-administered questionnaire was used to determine how consumers of nutritional supplements acquired information to assist their decision-making processes, when purchasing a product. The study was approved by the University of Cape Town, Faculty of Health Sciences Human Research Ethics Committee. The questionnaire consisted of seven, closed and open-ended questions. The participants were asked to respond to the questions according to a defined list of statements. A total of 259 participants completed and returned questionnaires. The data and processing of the returned questionnaires was captured using Windows-based Microsoft® Office Excel 2003 SP 1 (Excel © 1985–2003 Microsoft Corporation). Statistica Version 10 (copyright © Stat Soft, Inc. 1984–2011) was used to calculate the descriptive statistics. Results The main finding of the study was that nearly 70% of the respondents who purchased supplements were strongly influenced by container label information that stipulated that the nutritional supplement product is free of banned substances. The second finding was that just over 50% of the respondents attached importance to the quality of the nutritional supplement product information on the container label. The third finding was that about 40% of the respondents were strongly influenced by the ingredients on the labels when they purchased nutritional supplements. Conclusion This study, (i) identifies short-comings in current labelling information practices, (ii) provides opportunities to improve label and non-label information and communication, and, (iii) presents the case for quality assurance laboratory “screening testing” of declared and undeclared contaminants and/or adulterants, that could have negative consequences to the consumer. PMID:24088193

Health on the Net Foundation: assessing the quality of health web pages all over the world.

PubMed

Boyer, Célia; Gaudinat, Arnaud; Baujard, Vincent; Geissbühler, Antoine

2007-01-01

The Internet provides a great amount of information and has become one of the communication media which is most widely used [1]. However, the problem is no longer finding information but assessing the credibility of the publishers as well as the relevance and accuracy of the documents retrieved from the web. This problem is particularly relevant in the medical area which has a direct impact on the well-being of citizens. In this paper, we assume that the quality of web pages can be controlled, even when a huge amount of documents has to be reviewed. But this must be supported by both specific automatic tools and human expertise. In this context, we present various initiatives of the Health on the Net Foundation informing the citizens about the reliability of the medical content on the web.

Report explores Congress' science policy

NASA Astrophysics Data System (ADS)

Jones, Richard

Scientists interested in understanding how Congress develops science policy would find it useful to read a recent report by the Carnegie Commission on Science, Technology, and Government. “Science, Technology and Congress: Analysis and Advice from the Congressional Support Agencies” contains revealing insights about the often hard-pressed system that Congress uses to analyze science and technology issues.“Congress is on the front line of many battles over the directions of science and technology,” says the 70-page report. “The quality of congressional decisions on these issues often depends on the quality and usefulness of information and analysis made available to Congress.” The report describes the overwhelming amount of information received by members of Congress, few of whom have “substantial training or experience” in science and technology. Making this information understandable and useful is the role of the Office of Technology Assessment, the Congressional Research Service, the General Accounting Office, and the Congressional Budget Office.

Looking inward and back: Real-time monitoring of visual working memories.

PubMed

Suchow, Jordan W; Fougnie, Daryl; Alvarez, George A

2017-04-01

Confidence in our memories is influenced by many factors, including beliefs about the perceptibility or memorability of certain kinds of objects and events, as well as knowledge about our skill sets, habits, and experiences. Notoriously, our knowledge and beliefs about memory can lead us astray, causing us to be overly confident in eyewitness testimony or to overestimate the frequency of recent experiences. Here, using visual working memory as a case study, we stripped away all these potentially misleading cues, requiring observers to make confidence judgments by directly assessing the quality of their memory representations. We show that individuals can monitor the status of information in working memory as it degrades over time. Our findings suggest that people have access to information reflecting the existence and quality of their working memories, and furthermore, that they can use this information to guide their behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries

PubMed Central

Burnett, Susan; Renz, Anna; Wiig, Siri; Fernandes, Alexandra; Weggelaar, Anne Marie; Calltorp, Johan; Anderson, Janet E.; Robert, Glenn; Vincent, Charles; Fulop, Naomi

2013-01-01

Purpose Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients' rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway). Main Challenges Identified The cross-country comparison identified the following seven challenges with respect to comparing the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of public access to data exist; and finally, hospital accreditation and licensing systems differ in each country. Conclusion Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make informed choices about where they receive their health care in different countries, and some governments will remain in the dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries. PMID:23292003

Enabling the Usability of Earth Science Data Products and Services by Evaluating, Describing, and Improving Data Quality throughout the Data Lifecycle

NASA Astrophysics Data System (ADS)

Downs, R. R.; Peng, G.; Wei, Y.; Ramapriyan, H.; Moroni, D. F.

2015-12-01

Earth science data products and services are being used by representatives of various science and social science disciplines, by planning and decision-making professionals, by educators and learners ranging from primary through graduate and informal education, and by the general public. The diversity of users and uses of Earth science data is gratifying and offers new challenges for enabling the usability of these data by audiences with various purposes and levels of expertise. Users and other stakeholders need capabilities to efficiently find, explore, select, and determine the applicability and suitability of data products and services to meet their objectives and information needs. Similarly, they need to be able to understand the limitations of Earth science data, which can be complex, especially when considering combined or simultaneous use of multiple data products and services. Quality control efforts of stakeholders, throughout the data lifecycle, can contribute to the usability of Earth science data to meet the needs of diverse users. Such stakeholders include study design teams, data producers, data managers and curators, archives, systems professionals, data distributors, end-users, intermediaries, sponsoring organizations, hosting institutions, and others. Opportunities for engaging stakeholders to review, describe, and improve the quality of Earth science data products and services throughout the data lifecycle are identified and discussed. Insight is shared from the development of guidelines for implementing the Group on Earth Observations (GEO) Data Management Principles, the recommendations from the Earth Science Data System Working Group (ESDSWG) on Data Quality, and the efforts of the Information Quality Cluster of the Federation of Earth Science Information Partners (ESIP). Examples and outcomes from quality control efforts of data facilities, such as scientific data centers, that contribute to the usability of Earth science data also are offered.

Quality of nursing care perceived by patients and their nurses: an application of the critical incident technique. Part 2.

PubMed

Redfern, S; Norman, I

1999-07-01

The aims of the study were to identify indicators of quality of nursing care from the perceptions of patients and nurses, and to determine the congruence between patients' and nurses' perceptions. The paper is presented in two parts. Part 1 included the background and methods to the study and the findings from the comparison of patients' and nurses' perceptions. Part 2 describes the perceptions of patients and nurses, and draws conclusions drawn from the study as a whole. Patients and nurses in hospital wards were interviewed using the critical incident technique. We grouped 4546 indicators of high and low quality nursing care generated from the interview transcripts into 316 subcategories, 68 categories and 31 themes. The themes were grouped into eight clusters: therapeutic context for care, attitudes and sensitivity, teaching and leadership, motivation to nurse, monitoring and informing, high-dependency care, efficiency and thoroughness, reflection and anticipation. As shown in Part 1 of the paper, congruence between patients' and nurses' perceptions of quality was high and significant, although there was some difference of emphasis. The findings support an emerging theory of interpersonal competence and quality in nursing care.

Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking.

PubMed

El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

2015-01-01

Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts' opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can contribute to redefining the role of media in strengthening health systems.

Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking

PubMed Central

El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

2015-01-01

Background Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Methods Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Results Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts’ opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Conclusion Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can contribute to redefining the role of media in strengthening health systems. PMID:26308077

Using Third Party Data to Update a Reference Dataset in a Quality Evaluation Service

NASA Astrophysics Data System (ADS)

Xavier, E. M. A.; Ariza-López, F. J.; Ureña-Cámara, M. A.

2016-06-01

Nowadays it is easy to find many data sources for various regions around the globe. In this 'data overload' scenario there are few, if any, information available about the quality of these data sources. In order to easily provide these data quality information we presented the architecture of a web service for the automation of quality control of spatial datasets running over a Web Processing Service (WPS). For quality procedures that require an external reference dataset, like positional accuracy or completeness, the architecture permits using a reference dataset. However, this reference dataset is not ageless, since it suffers the natural time degradation inherent to geospatial features. In order to mitigate this problem we propose the Time Degradation & Updating Module which intends to apply assessed data as a tool to maintain the reference database updated. The main idea is to utilize datasets sent to the quality evaluation service as a source of 'candidate data elements' for the updating of the reference database. After the evaluation, if some elements of a candidate dataset reach a determined quality level, they can be used as input data to improve the current reference database. In this work we present the first design of the Time Degradation & Updating Module. We believe that the outcomes can be applied in the search of a full-automatic on-line quality evaluation platform.

Parental Mindfulness and Dyadic Relationship Quality in Low-income Cohabiting Black Stepfamilies: Associations with Parenting Experienced by Adolescents

PubMed Central

Parent, Justin; Clifton, Jessica; Forehand, Rex; Golub, Andrew; Reid, Megan; Pichler, Emily R.

2014-01-01

Cohabitation is a family structure experienced by many Black children; yet, we have limited understanding of how personal and interpersonal processes operate within these families to influence the parenting provided to these children. Informed by both family systems theory and the spillover hypothesis and utilizing a model to account for the interdependence of the mother and her partner, the current study sought to understand the direct and indirect associations among parental mindfulness, the mother-partner relationship quality, and firm parenting practices in a sample of 121 Black cohabiting low-income stepfamilies. Assessment consisted of standardized measurements of maternal and male cohabiting partner reports on mindfulness (i.e., acting with awareness) and relationship quality (i.e., relationship satisfaction, ability to resolve conflict, and coparenting conflict) as well as adolescent report on parenting (i.e., parent’s firm control). Mindfulness was directly related to each individual’s own perceptions of relationship quality and some support emerged for a cross-informant link (e.g., mother’s mindfulness related to partner report of relationship quality). Furthermore, maternal perceptions of relationship quality, as well as mindfulness operating through relationship quality, were related to youth reports of maternal firm parenting. The results suggest that both mindfulness and the relationship quality of adults are variables deserving attention when studying the parenting received by children in cohabiting stepfamilies. Clinical implications of the findings are considered. PMID:25544936

Cost and results of information systems for health and poverty indicators in the United Republic of Tanzania.

PubMed Central

Rommelmann, Vanessa; Setel, Philip W.; Hemed, Yusuf; Angeles, Gustavo; Mponezya, Hamisi; Whiting, David; Boerma, Ties

2005-01-01

OBJECTIVE: To examine the costs of complementary information generation activities in a resource-constrained setting and compare the costs and outputs of information subsystems that generate the statistics on poverty, health and survival required for monitoring, evaluation and reporting on health programmes in the United Republic of Tanzania. METHODS: Nine systems used by four government agencies or ministries were assessed. Costs were calculated from budgets and expenditure data made available by information system managers. System coverage, quality assurance and information production were reviewed using questionnaires and interviews. Information production was characterized in terms of 38 key sociodemographic indicators required for national programme monitoring. FINDINGS: In 2002-03 approximately US$ 0.53 was spent per Tanzanian citizen on the nine information subsystems that generated information on 37 of the 38 selected indicators. The census and reporting system for routine health service statistics had the largest participating populations and highest total costs. Nationally representative household surveys and demographic surveillance systems (which are not based on nationally representative samples) produced more than half the indicators and used the most rigorous quality assurance. Five systems produced fewer than 13 indicators and had comparatively high costs per participant. CONCLUSION: Policy-makers and programme planners should be aware of the many trade-offs with respect to system costs, coverage, production, representativeness and quality control when making investment choices for monitoring and evaluation. In future, formal cost-effectiveness studies of complementary information systems would help guide investments in the monitoring, evaluation and planning needed to demonstrate the impact of poverty-reduction and health programmes. PMID:16184275

Use of quality measures for Medicaid behavioral health services by state agencies: implications for health care reform.

PubMed

Seibert, Julie; Fields, Suzanne; Fullerton, Catherine Anne; Mark, Tami L; Malkani, Sabrina; Walsh, Christine; Ehrlich, Emily; Imshaug, Melina; Tabrizi, Maryam

2015-06-01

The structure-process-outcome quality framework espoused by Donabedian provides a conceptual way to examine and prioritize behavioral health quality measures used by states. This report presents an environmental scan of the quality measures and satisfaction surveys that state Medicaid managed care and behavioral health agencies used prior to Medicaid expansion in 2014. Data were collected by reviewing online documents related to Medicaid managed care contracts for behavioral health, quality strategies, quality improvement plans, quality and performance indicators data, annual outcomes reports, performance measure specification manuals, legislative reports, and Medicaid waiver requests for proposals. Information was publicly available for 29 states. Most states relied on process measures, along with some structure and outcome measures. Although all states reported on at least one process measure of behavioral health quality, 52% of states did not use any outcomes measures and 48% of states had no structure measures. A majority of the states (69%) used behavioral health measures from the National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set, and all but one state in the sample (97%) used consumer experience-of-care surveys. Many states supplemented these data with locally developed behavioral health indicators that rely on administrative and nonadministrative data. State Medicaid agencies are using nationally recognized as well as local measures to assess quality of behavioral health care. Findings indicate a need for additional nationally endorsed measures in the area of substance use disorders and treatment outcomes.

Quality of YouTube TM videos on dental implants.

PubMed

Abukaraky, A; Hamdan, A-A; Ameera, M-N; Nasief, M; Hassona, Y

2018-07-01

Patients search YouTube for health-care information. To examine what YouTube offers patients seeking information on dental implants, and to evaluate the quality of provided information. A systematic search of YouTube for videos containing information on dental implants was performed using the key words Dental implant and Tooth replacement. Videos were examined by two senior Oral and Maxillofacial Surgery residents who were trained and calibrated to perform the search. Initial assessment was performed to exclude non- English language videos, duplicate videos, conference lectures, and irrelevant videos. Included videos were analyzed with regard to demographics and content's usefulness. Information for patients available from the American Academy of Implant Dentistry, European Association of Osseointegration, and British Society of Restorative Dentistry were used for benchmarking. A total of 117 videos were analyzed. The most commonly discussed topics were related to procedures involved in dental implantology (76.1%, n=89), and to the indications for dental implants (58.1%, n=78). The mean usefulness score of videos was poor (6.02 ±4.7 [range 0-21]), and misleading content was common (30.1% of videos); mainly in topics related to prognosis and maintenance of dental implants. Most videos (83.1%, n=97) failed to mention the source of information presented in the video or where to find more about dental implants. Information about dental implants on YouTube is limited in quality and quantity. YouTube videos can have a potentially important role in modulating patients attitude and treatment decision regarding dental implants.

[Biomedical information on the internet using search engines. A one-year trial].

PubMed

Corrao, Salvatore; Leone, Francesco; Arnone, Sabrina

2004-01-01

The internet is a communication medium and content distributor that provide information in the general sense but it could be of great utility regarding as the search and retrieval of biomedical information. Search engines represent a great deal to rapidly find information on the net. However, we do not know whether general search engines and meta-search ones are reliable in order to find useful and validated biomedical information. The aim of our study was to verify the reproducibility of a search by key-words (pediatric or evidence) using 9 international search engines and 1 meta-search engine at the baseline and after a one year period. We analysed the first 20 citations as output of each searching. We evaluated the formal quality of Web-sites and their domain extensions. Moreover, we compared the output of each search at the start of this study and after a one year period and we considered as a criterion of reliability the number of Web-sites cited again. We found some interesting results that are reported throughout the text. Our findings point out an extreme dynamicity of the information on the Web and, for this reason, we advice a great caution when someone want to use search and meta-search engines as a tool for searching and retrieve reliable biomedical information. On the other hand, some search and meta-search engines could be very useful as a first step searching for defining better a search and, moreover, for finding institutional Web-sites too. This paper allows to know a more conscious approach to the internet biomedical information universe.

Quality of anti-malarials collected in the private and informal sectors in Guyana and Suriname

PubMed Central

2012-01-01

Background Despite a significant reduction in the number of malaria cases in Guyana and Suriname, this disease remains a major problem in the interior of both countries, especially in areas with gold mining and logging operations, where malaria is endemic. National malaria control programmes in these countries provide treatment to patients with medicines that are procured and distributed through regulated processes in the public sector. However, availability to medicines in licensed facilities (private sector) and unlicensed facilities (informal sector) is common, posing the risk of access to and use of non-recommended treatments and/or poor quality products. Methods To assess the quality of circulating anti-malarial medicines, samples were purchased in the private and informal sectors of Guyana and Suriname in 2009. The sampling sites were selected based on epidemiological data and/or distance from health facilities. Samples were analysed for identity, content, dissolution or disintegration, impurities, and uniformity of dosage units or weight variation according to manufacturer, pharmacopeial, or other validated method. Results Quality issues were observed in 45 of 77 (58%) anti-malarial medicines sampled in Guyana of which 30 failed visual & physical inspection and 18 failed quality control tests. The proportion of monotherapy and ACT medicines failing quality control tests was 43% (13/30) and 11% (5/47) respectively. A higher proportion of medicines sampled from the private sector 34% (11/32) failed quality control tests versus 16% (7/45) in the informal sector. In Suriname, 58 medicines were sampled, of which 50 (86%) were Artecom®, the fixed-dose combination of piperaquine-dihydroartemisinin-trimethoprim co-blistered with a primaquine phosphate tablet. All Artecom samples were found to lack a label claim for primaquine, thus failing visual and physical inspection. Conclusions The findings of the studies in both countries point to significant problems with the quality of anti-malarial medicines available in private and informal sector facilities as well as the availability of therapy not compliant with national treatment guidelines. They also stress the need to strengthen regulatory control efforts on the availability of anti-malarial medicines in these sectors and in endemic areas. PMID:22704709

An information based approach to improving overhead imagery collection

NASA Astrophysics Data System (ADS)

Sourwine, Matthew J.; Hintz, Kenneth J.

2011-06-01

Recent growth in commercial imaging satellite development has resulted in a complex and diverse set of systems. To simplify this environment for both customer and vendor, an information based sensor management model was built to integrate tasking and scheduling systems. By establishing a relationship between image quality and information, tasking by NIIRS can be utilized to measure the customer's required information content. Focused on a reduction in uncertainty about a target of interest, the sensor manager finds the best sensors to complete the task given the active suite of imaging sensors' functions. This is done through determination of which satellite will meet customer information and timeliness requirements with low likelihood of interference at the highest rate of return.

Using Mobile Phones to Improve Educational Outcomes: An Analysis of Evidence from Asia

ERIC Educational Resources Information Center

Valk, John-Harmen; Rashid, Ahmed T.; Elder, Laurent

2010-01-01

Despite improvements in educational indicators, such as enrolment, significant challenges remain with regard to the delivery of quality education in developing countries, particularly in rural and remote regions. In the attempt to find viable solutions to these challenges, much hope has been placed in new information and communication technologies…

The Health Care Dilemma. Second Edition.

ERIC Educational Resources Information Center

McTaggart, Aubrey C.; McTaggart, Lorna, M.

The purpose of this book is to provide useful information about the components of quality health care and to suggest ways for the consumer to find and avail himself of the best care possible. The following subjects are covered, including brief histories of sociological background and suggestions on how to judge competency: (1) physicians,…

Principals' Approaches to Hiring, Assigning, Evaluating, and Developing Teachers

ERIC Educational Resources Information Center

Donaldson, Morgaen L.

2011-01-01

This article provides key findings from a study of 30 principals working in charter and conventional schools in two northeastern states. It aims to inform policy makers regarding how principals could more positively influence teacher quality. It focuses on the following questions: (1) What influenced how principals hired, assigned, evaluated, and…

Effectiveness of an Adaptation of the Project Connect Health Systems Intervention: Youth and Clinic-Level Findings

ERIC Educational Resources Information Center

Loosier, Penny S.; Doll, Shelli; Lepar, Danielle; Ward, Kristin; Gamble, Ginger; Dittus, Patricia J.

2016-01-01

Background: The Project Connect Health Systems Intervention (Project Connect) uses a systematic process of collecting community and healthcare infrastructure information to craft a referral guide highlighting local healthcare providers who provide high quality sexual and reproductive healthcare. Previous self-report data on healthcare usage…

Microcomputer Usage in Schools, 1983-84.

ERIC Educational Resources Information Center

Quality Education Data, Inc., Denver, CO.

Results are presented for the third annual survey of all United States school districts by Quality Education Data, Inc. Findings are displayed in tabular form, and include information on the following: size of the microcomputer marketplace and the kinds of people involved; availability of software by brand for home, business, and education use;…

Task-Technology Fit Assessment of an Expertise Transfer System

DTIC Science & Technology

2009-03-01

Air Education and Training Command In Partial Fulfillment of the Requirements for the Degree of Master of Science in Information Resource Management...Transfer Forum (ETF) developed by the Oklahoma State University for the Defense Ammunition Center’s quality assurance personnel. The preliminary findings...Technology-to-Performance Chain (TPC) ....................................................................13 Expertise Transfer Forum (ETF

The Law School Years: Probing Questions, Actionable Data. Annual Survey Results, 2005

ERIC Educational Resources Information Center

Law School Survey of Student Engagement, 2005

2005-01-01

The Law School Survey of Student Engagement (LSSSE) documents dimensions of quality in legal education and provides information about law student participation in effective educational activities that law schools and other organizations can use to improve student learning. This paper presents findings from the second LSSSE. Promising findings…

Improving Survey Methods with Cognitive Interviews in Small- and Medium-Scale Evaluations

ERIC Educational Resources Information Center

Ryan, Katherine; Gannon-Slater, Nora; Culbertson, Michael J.

2012-01-01

Findings derived from self-reported, structured survey questionnaires are commonly used in evaluation and applied research to inform policy-making and program decisions. Although there are a variety of issues related to the quality of survey evidence (e.g., sampling precision), the validity of response processes--how respondents process thoughts…

Optimizing Mothers' Social Networks: Information-Sharing Strategies

ERIC Educational Resources Information Center

Lashley, Cynthia O'Nell

2010-01-01

Finding high-quality infant care continues to be challenging for many families. Such challenges are even greater for single mothers with limited resources and English language skills. Several years ago, this challenge formed the basis for an urban, center-based program called the Pregnant-Mothers Support Group (PSG). The PSG served single,…

Benefits and Challenges of Dual-Earning: Perspectives of Successful Couples.

ERIC Educational Resources Information Center

Haddock, Shelley A.; Rattenborg, Karen

2003-01-01

Examines the benefits and challenges derived from the dual-earner lifestyle for couples who successfully balance family and work. Many therapists harbor negative and stereotypical assumptions of the quality of dual-earner family life, but the findings of this study are helpful in providing a more balanced, informed view of the possibilities of…

Critical to quality in telemedicine service management: application of DFSS (Design for Six Sigma) and SERVQUAL).

PubMed

Yun, Eun Kyoung; Chun, Kee Moon

2008-01-01

Telemedicine generally refers to the use of communications and information technologies for the delivery of health care. owever, telemedicine is not merely a simple combination of health care and technology. The researchers propose a systematic approach for assessing needs of telemedicine customers, called critical-to-quality (CTQ) in Six Sigma, with a purpose of continuous quality improvement. The combination approach using DFSS (Design for Six Sigma) and SERVQUAL (Service Quality Framework) was applied to define the critical quality attributes of telemedicine service management and to match them with the current telemedicine process. With a step-by-step procedure, telemedicine service process was reviewed and all the important CTQ candidates identified via a case study. The findings suggest that nurses need further understanding and research methods that will improve and manage the quality of health care service in various medical fields.

Public Reporting of Nursing Home Quality of Care: Lessons from the United States Experience for Canadian Policy Discussion

PubMed Central

Hutchinson, Alison M.; Draper, Kellie; Sales, Anne E.

2009-01-01

While the demand for continuing care services in Canada grows, the quality of such services has come under increasing scrutiny. Consideration has been given to the use of public reporting of quality data as a mechanism to stimulate quality improvement and promote public accountability for and transparency in service quality. The recent adoption of the Resident Assessment Instrument (RAI) throughout a number of Canadian jurisdictions means that standardized quality data are available for comparisons among facilities across regions, provinces and nationally. In this paper, we explore current knowledge on public reporting in nursing homes in the United States to identify what lessons may inform policy discussion regarding potential use of public reporting in Canada. Based on these findings, we make recommendations regarding how public reporting should be progressed and managed if Canadian jurisdictions were to implement this strategy. PMID:21037828

Components of quality of life for persons with a quadriplegic and paraplegic spinal cord injury.

PubMed

Manns, P J; Chad, K E

2001-11-01

This investigation determined the themes that represented quality of life for persons with a spinal cord injury. Fifteen people (6 females, 9 males; 7 persons with quadriplegia, 8 with paraplegia) participated in this study, which used naturalistic inquiry methodologies. Results showed that quality of life for this population, regardless of severity of impairment, consisted of nine themes: (a) physical function and independence, (b) accessibility, (c) emotional well-being, (d) stigma, (e) spontaneity, (f) relationships and social function, (g) occupation, (h) finances, and (i) physical well-being. The themes of life quality were similar for quadriplegics and paraplegics; however, physical function and independence and physical well-being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life.

Improving the Quality of Informed Consent in Clinical Research with Information Technology.

PubMed

Taber, Celia; Warren, Jim; Day, Karen

2016-01-01

The clinical research industry has yet to fully embrace information technology (IT) for informed consent purposes, even though it is used indispensably in our everyday lives and in other areas of clinical research and healthcare. This paper presents findings of a meta-narrative literature review to discuss the potential for IT to improve the quality of clinical research informed consent. The review reveals three main rationales for including IT in research consent. First, in the current context consent documents frequently fail to be effective decision aids for patients, and the lack of patient centricity in the process. Second, social media provides opportunities for patients to consult with a broader community during research consent to seek broader support, and potential to participate in creating a more patient centric process. Third, multimedia tools provide opportunities for improved patient education, engagement and decision making during research consent. IT offers opportunities to achieve more meaningful research consent, but more research is needed to create an evidence base, policies and economic analyses on the return on investment of using IT in the process.

The quality of life of medical students studying in New Zealand: a comparison with nonmedical students and a general population reference group.

PubMed

Henning, Marcus A; Krägeloh, Christian U; Hawken, Susan J; Zhao, Yipin; Doherty, Iain

2012-01-01

Quality of life is an essential component of learning and has strong links with the practice and study of medicine. There is burgeoning evidence in the research literature to suggest that medical students are experiencing health-related problems such as anxiety, depression, and burnout. The aim of the study was to investigate medical students' perceptions concerning their quality of life. Two hundred seventy-four medical students studying in their early clinical years (response rate = 80%) participated in the present study. Medical students were asked to fill in the abbreviated version of the World Health Organization Quality of Life questionnaire to elicit information about their quality of life perceptions in relation to their physical health, psychological health, social relationships, and environment. Subsequently, their responses were compared with two nonmedical students groups studying at a different university in the same city and an Australian general population norm. The findings were compared using independent group's t tests, confidence intervals, and Cohen's d. The main finding of the study indicated that medical students had similar quality of life perceptions to nonmedical students except in relation to the environment domain. Furthermore, the medical student group scored lower than the general population reference group on the physical health, psychological health, and environment quality of life domains. The results suggest that all university students are expressing concerns related to quality of life, and thus their health might be at risk. The findings in this study provided no evidence to support the notion that medical students experience lower levels of quality of life compared to other university students. When compared to the general population, all student groups examined in this study appeared to be experiencing lower levels of quality of life. This has implications for pastoral support, educationalists, student support personnel, and the university system.

Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains.

PubMed

Harrington, Charlene; Jacobsen, Frode F; Panos, Justin; Pollock, Allyson; Sutaria, Shailen; Szebehely, Marta

2017-01-01

This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.

Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains

PubMed Central

Harrington, Charlene; Jacobsen, Frode F; Panos, Justin; Pollock, Allyson; Sutaria, Shailen; Szebehely, Marta

2017-01-01

This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability. PMID:28634428

Public Attitudes about Health Information Technology, and Its Relationship to Health Care Quality, Costs, and Privacy

PubMed Central

Gaylin, Daniel S; Moiduddin, Adil; Mohamoud, Shamis; Lundeen, Katie; Kelly, Jennifer A

2011-01-01

Objective To understand Americans' attitudes concerning health information technology's (IT's) potential to improve health care and differences in those attitudes based on demographics and technological affinity. Data Sources/Study Setting A random-digit-dial sample with known probability of selection for every household in the United States with a telephone, plus a supplemental sample of cell phone users. Telephone interviews were conducted from August 2009 through November 2009. Study Design Data were analyzed to present univariate estimates of Americans' opinions of health IT, as well as multivariate logistic regressions to assess hypotheses relating individuals' characteristics to their opinions. Characteristics used in our model include age, race, ethnicity, gender, income, and affinity to technology. Findings A large majority (78 percent) favor use of electronic medical records (EMRs); believe EMRs could improve care and reduce costs (78 percent and 59 percent, respectively); believe benefits of EMR use outweigh privacy risks (64 percent); and support health care information sharing among providers (72 percent). Regression analyses show more positive attitudes among those with higher incomes and greater comfort using electronic technologies. Conclusion The findings suggest that American's believe that health IT adoption is an effective means to improve the quality and safety of health care. PMID:21275986

Using implementation science to improve urologic oncology care.

PubMed

Skolarus, Ted A; Sales, Anne E

2016-09-01

There are many gaps between recommended urologic cancer care and real-world practice. Although we increasingly define these quality gaps because of our growing health services research capacity in urologic oncology, we often fall short in translating these findings into effective interventions and strategies to reduce gaps in care. In this article, we highlight implementation research as a logical next step for translating our health services research findings into effective individual and organizational behavior change strategies to improve quality of care. We explain how implementation research focuses on different, upstream outcomes from our clinical outcomes to get the right care to the right patient at the right time. Lastly, we share information about resources and training for those interested in learning more about this emerging, transdisciplinary field. Published by Elsevier Inc.

THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN

PubMed Central

Pouragha, Behrouz; Zarei, Ehsan

2016-01-01

Aim: The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. Methods: this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson’s correlation, and multivariate regression methods with the SPSS.18 software. Results: According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. Conclusion: The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction. PMID:27047262

Designing a Score-Based Method for the Evaluation of the Nutritional Quality of the Gluten-Free Bakery Products and their Gluten-Containing Counterparts.

PubMed

Morreale, Federico; Angelino, Donato; Pellegrini, Nicoletta

2018-04-25

Gluten-free (GF) products are consumed both by individuals with celiac disease and by an increasing number of people with no specific medical needs. Although the technological quality of GF products has been recently improved, their nutritional quality is still scarcely addressed. Moreover, the few published studies report conflicting results, mostly because the information from product nutrition facts is the only considered factor. The aim of the present study was to develop a score-based method for the nutritional evaluation of 134 packaged Italian GF bakery products and to compare it with that of 162 matched gluten-containing (GC) food items. The score included the information from the nutrition facts and the presence/absence of some nutritionally relevant components in the ingredients list. Results indicated an overall low nutritional quality of the considered GF bakery products. Additionally, with the sole exception of GF bread substitutes, there was no difference in nutritional quality between GF and equivalent GC bakery products. Future research and development of GF bakery products may take advantage of this scoring method, as it may represent an easy approach to evaluate their nutritional quality. The present findings do not justify the consumption of packaged GF bakery products by people without any specific medical needs.

THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN.

PubMed

Pouragha, Behrouz; Zarei, Ehsan

2016-02-01

The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson's correlation, and multivariate regression methods with the SPSS.18 software. According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction.

Domain differentiated disclosure to mothers and siblings and associations with sibling relationship quality and youth emotional adjustment.

PubMed

Campione-Barr, Nicole; Lindell, Anna K; Giron, Sonia E; Killoren, Sarah E; Greer, Kelly Bassett

2015-09-01

Disclosure, or revealing personal information to others, is important for the development and maintenance of close relationships (Jourard, 1971; Rotenberg, 1995). More recently within developmental psychology, however, the focus has been the study of adolescent disclosure to parents as a means of information management regarding their daily activities. This research assumes that a) disclosure between multiple adolescents and parents within the same family are similar, and b) only information transmitted from adolescents to parents is important for adolescent well-being. Thus, this article presents the findings of 2 within-family studies to investigate differences in the amount and social domain (Smetana, 2006; Turiel, 2002) of youth disclosure to mothers versus siblings, and the influence of disclosure to siblings on relationship quality and youth emotional adjustment. Study 1 utilized 101 sibling dyads with youth ranging in age from 11-21 years, but all siblings living together. Study 2 investigated a sample of 58 sibling dyads in which all first-borns were first-year college students and all second-borns were in high school. All participants completed questionnaire measures to assess study variables. Findings revealed that while youth disclosed more to mothers than siblings, this difference disappears by emerging adulthood, particularly depending on the domain of the issue. Additionally, while greater disclosure among siblings was positive for the quality of the relationship, sibling disclosure was differentially associated with emotional adjustment depending on whether youth were the disclosers or being disclosed to, the domain of the issues disclosed, and the gender composition of the dyad. (c) 2015 APA, all rights reserved).

Effects of Contributor Experience on the Quality of Health-Related Wikipedia Articles

PubMed Central

Fetahu, Besnik; Kimmerle, Joachim

2018-01-01

Background Consulting the Internet for health-related information is a common and widespread phenomenon, and Wikipedia is arguably one of the most important resources for health-related information. Therefore, it is relevant to identify factors that have an impact on the quality of health-related Wikipedia articles. Objective In our study we have hypothesized a positive effect of contributor experience on the quality of health-related Wikipedia articles. Methods We mined the edit history of all (as of February 2017) 18,805 articles that were listed in the categories on the portal health & fitness in the English language version of Wikipedia. We identified tags within the articles’ edit histories, which indicated potential issues with regard to the respective article’s quality or neutrality. Of all of the sampled articles, 99 (99/18,805, 0.53%) articles had at some point received at least one such tag. In our analysis we only considered those articles with a minimum of 10 edits (10,265 articles in total; 96 tagged articles, 0.94%). Additionally, to test our hypothesis, we constructed contributor profiles, where a profile consisted of all the articles edited by a contributor and the corresponding number of edits contributed. We did not differentiate between rollbacks and edits with novel content. Results Nonparametric Mann-Whitney U-tests indicated a higher number of previously edited articles for editors of the nontagged articles (mean rank tagged 2348.23, mean rank nontagged 5159.29; U=9.25, P<.001). However, we did not find a significant difference for the contributors’ total number of edits (mean rank tagged 4872.85, mean rank nontagged 5135.48; U=0.87, P=.39). Using logistic regression analysis with the respective article’s number of edits and number of editors as covariates, only the number of edited articles yielded a significant effect on the article’s status as tagged versus nontagged (dummy-coded; Nagelkerke R2 for the full model=.17; B [SE B]=-0.001 [0.00]; Wald c2 [1]=19.70; P<.001), whereas we again found no significant effect for the mere number of edits (Nagelkerke R2 for the full model=.15; B [SE B]=0.000 [0.01]; Wald c2 [1]=0.01; P=.94). Conclusions Our findings indicate an effect of contributor experience on the quality of health-related Wikipedia articles. However, only the number of previously edited articles was a predictor of the articles’ quality but not the mere volume of edits. More research is needed to disentangle the different aspects of contributor experience. We have discussed the implications of our findings with respect to ensuring the quality of health-related information in collaborative knowledge-building platforms. PMID:29748161

Conscious and unconscious thought in risky choice: testing the capacity principle and the appropriate weighting principle of unconscious thought theory.

PubMed

Ashby, Nathaniel J S; Glöckner, Andreas; Dickert, Stephan

2011-01-01

Daily we make decisions ranging from the mundane to the seemingly pivotal that shape our lives. Assuming rationality, all relevant information about one's options should be thoroughly examined in order to make the best choice. However, some findings suggest that under specific circumstances thinking too much has disadvantageous effects on decision quality and that it might be best to let the unconscious do the busy work. In three studies we test the capacity assumption and the appropriate weighting principle of Unconscious Thought Theory using a classic risky choice paradigm and including a "deliberation with information" condition. Although we replicate an advantage for unconscious thought (UT) over "deliberation without information," we find that "deliberation with information" equals or outperforms UT in risky choices. These results speak against the generality of the assumption that UT has a higher capacity for information integration and show that this capacity assumption does not hold in all domains. Furthermore, we show that "deliberate thought with information" leads to more differentiated knowledge compared to UT which speaks against the generality of the appropriate weighting assumption.

Looking beyond the Internet: examining socioeconomic inequalities in cancer information seeking among cancer patients.

PubMed

Lee, Chul-Joo; Ramírez, A Susana; Lewis, Nehama; Gray, Stacy W; Hornik, Robert C

2012-01-01

The gap in cancer information seeking between high-socioeconomic-status (high-SES) cancer patients and low-SES cancer patients deserves serious attention, considering the importance of information and knowledge in cancer control. We thus explored the association of SES, as measured by education, with cancer patients' overall cancer information seeking, and with seeking from each source (i.e., the Internet, mass media, medical sources, and nonmedical interpersonal sources) and across two topic categories (i.e., treatment, quality of life). We then asked whether the effect of education on treatment information seeking is reduced among those who are particularly motivated to control treatment choices. We conducted a survey with breast, prostate, and colon cancer patients diagnosed in 2005 (n = 2,013), who were randomly drawn from the Pennsylvania Cancer Registry in the fall of 2006. We found that education was more strongly associated with Internet use than with the use of other sources regardless of topics. Also, when information was sought from mass media, education had a greater association with treatment information seeking than with quality-of-life information seeking. Preference for active participation in treatment decision making, however, did not moderate the effect of education on treatment information seeking. The implications of these findings for public health research and cancer patient education were discussed.

Looking beyond the Internet: Examining Socioeconomic Inequalities in Cancer Information Seeking among Cancer Patients

PubMed Central

Lee, Chul-joo; Ramirez, Susana; Lewis, Nehama; Gray, Stacy W.; Hornik, Robert C.

2014-01-01

The gap in cancer information seeking between high-socioeconomic status (SES) cancer patients and low-SES cancer patients deserves serious attention considering the importance of information and knowledge in cancer control. We thus explored the association of SES, as measured by education, with cancer patients’ overall cancer information seeking, and with seeking from each source (i.e., the Internet, mass media, medical sources, and non-medical interpersonal sources) and across two topic categories (i.e., treatment, quality of life). We then asked whether the effect of education on treatment information seeking is reduced among those who are particularly motivated to control treatment choices. We conducted a survey with breast, prostate, and colon cancer patients diagnosed in 2005 (N = 2,013), who were randomly drawn from the Pennsylvania Cancer Registry in the fall of 2006. We found that education was more strongly associated with Internet use than with the use of other sources regardless of topics. Also, when information was sought from mass media, education had a greater association with treatment information seeking than with quality-of-life information seeking. Preference for active participation in treatment decision making, however, did not moderate the effect of education on treatment information seeking. The implications of these findings for public health research and cancer patient education were discussed. PMID:22356137

The extent, quality and impact of patient and public involvement in primary care research: a mixed methods study.

PubMed

Blackburn, Steven; McLachlan, Sarah; Jowett, Sue; Kinghorn, Philip; Gill, Paramjit; Higginbottom, Adele; Rhodes, Carol; Stevenson, Fiona; Jinks, Clare

2018-01-01

In the UK, more patients go to primary care than other parts of the health service. Therefore it is important for research into primary care to include the insights and views of people who receive these services. To explore the extent, quality and impact of patient and public involvement (PPI) in primary care research, we examined documents of 200 projects and surveyed 191 researchers.We found that about half of studies included PPI to develop research ideas and during the study itself. Common activities included designing study materials, advising on methods, and managing the research. Some studies did not undertake the PPI activities initially planned and funded for. PPI varied by study design, health condition and study population. We found pockets of good practice: having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However, good practice was lacking in other areas. Few projects offered PPI contributors training, used PPI to develop information for participants about study progress and included PPI to advise on publishing findings.Researchers reported beneficial impacts of PPI. Most impact was reported when the approach to PPI included more indicators of good practice. The main cost of PPI for researchers was their time. Many reported difficulties providing information about PPI.In partnership with PPI contributors, we have used these findings to develop:a new Cost and Consequences Framework for PPI highlighting financial and non-financial costs, benefits and harms of PPIFifteen co-produced recommendations to improve the practice and delivery of PPI. Background: To improve the lives of patients in primary care requires the involvement of service users in primary care research. We aimed to explore the extent, quality and impact of patient and public involvement (PPI) in primary care research. Methods: We extracted information about PPI from grant applications, reports and an electronic survey of researchers of studies funded by the NIHR School for Primary Care Research (SPCR). We applied recognised quality indicators to assess the quality of PPI and assessed its impact on research. Results: We examined 200 grant applications and reports of 181 projects. PPI was evident in the development of 47 (24%) grant applications. 113 (57%) grant applications included plans for PPI during the study, mostly in study design, oversight, and dissemination. PPI during projects was reported for 83 (46%) projects, including designing study materials and managing the research. We identified inconsistencies between planned and reported PPI. PPI varied by study design, health condition and study population.Of 46 (24%) of 191 questionnaires completed, 15 reported PPI activity. Several projects showed best practice according to guidelines, in terms of having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However few projects offered PPI contributors training, used PPI to develop information for participants about study progress, and had PPI in advising on dissemination.Beneficial impacts of PPI in designing studies and writing participant information was frequently reported. Less impact was reported on developing funding applications, managing or carrying out the research. The main cost of PPI for researchers was their time. Many researchers found it difficult to provide information about PPI activities.Our findings informed:a new Cost and Consequences Framework for PPI in primary care research highlighting financial and non-financial costs, plus the benefits and harms of PPIFifteen co-produced recommendations to improve PPI in research and within the SPCR. Conclusions: The extent, quality and impact of PPI in primary care research is inconsistent across research design and topics. Pockets of good practice were identified making a positive impact on research. The new Cost and Consequences Framework may help others assess the impact of PPI.

Relationship among family environment, self-control, friendship quality, and adolescents’ smartphone addiction in South Korea: Findings from nationwide data

PubMed Central

Kim, Hye-Jin; Min, Jin-Young; Lee, Tae-Jin; Yoo, Seunghyun

2018-01-01

Background Many studies have examined the negative impact on smartphone addiction in adolescents. Recent concerns have focused on predictors of smartphone addiction. This study aimed to investigate the association of adolescents’ smartphone addiction with family environment (specifically, domestic violence and parental addiction). We further investigated whether self-control and friendship quality, as predictors of smartphone addiction, may reduce the observed risk. Methods We used the 2013 national survey on internet usage and utilization data from the National Information Agency of Korea. Information on exposure and covariates included self-reported experience of domestic violence and parental addiction, sociodemographic variables, and other variables potentially related to smartphone addiction. Smartphone addiction was estimated using a smartphone addiction proneness scale, a standardized measure developed by national institutions in Korea. Results Adolescents who had experienced domestic violence (OR = 1.74; 95% CI: 1.23–2.45) and parental addiction (OR = 2.01; 95% CI: 1.24–3.27) were found to be at an increased risk for smartphone addiction after controlling for all potential variables. Furthermore, on classifying adolescents according to their level of self-control and friendship quality the association between domestic violence and parental addiction, and smartphone addiction was found to be significant in the group with adolescents with lower levels of self-control (OR = 2.87; 95% CI: 1.68–4.90 and OR = 1.95; 95% CI: 1.34–2.83) and friendship quality (OR = 2.33; 95% CI: 1.41–3.85 and OR = 1.83; 95% CI: 1.26–2.64). Conclusion Our findings suggest that family dysfunction was significantly associated with smartphone addiction. We also observed that self-control and friendship quality act as protective factors against adolescents’ smartphone addiction. PMID:29401496

Relationship among family environment, self-control, friendship quality, and adolescents' smartphone addiction in South Korea: Findings from nationwide data.

PubMed

Kim, Hye-Jin; Min, Jin-Young; Min, Kyoung-Bok; Lee, Tae-Jin; Yoo, Seunghyun

2018-01-01

Many studies have examined the negative impact on smartphone addiction in adolescents. Recent concerns have focused on predictors of smartphone addiction. This study aimed to investigate the association of adolescents' smartphone addiction with family environment (specifically, domestic violence and parental addiction). We further investigated whether self-control and friendship quality, as predictors of smartphone addiction, may reduce the observed risk. We used the 2013 national survey on internet usage and utilization data from the National Information Agency of Korea. Information on exposure and covariates included self-reported experience of domestic violence and parental addiction, sociodemographic variables, and other variables potentially related to smartphone addiction. Smartphone addiction was estimated using a smartphone addiction proneness scale, a standardized measure developed by national institutions in Korea. Adolescents who had experienced domestic violence (OR = 1.74; 95% CI: 1.23-2.45) and parental addiction (OR = 2.01; 95% CI: 1.24-3.27) were found to be at an increased risk for smartphone addiction after controlling for all potential variables. Furthermore, on classifying adolescents according to their level of self-control and friendship quality the association between domestic violence and parental addiction, and smartphone addiction was found to be significant in the group with adolescents with lower levels of self-control (OR = 2.87; 95% CI: 1.68-4.90 and OR = 1.95; 95% CI: 1.34-2.83) and friendship quality (OR = 2.33; 95% CI: 1.41-3.85 and OR = 1.83; 95% CI: 1.26-2.64). Our findings suggest that family dysfunction was significantly associated with smartphone addiction. We also observed that self-control and friendship quality act as protective factors against adolescents' smartphone addiction.

Measuring the Process and Quality of Informed Consent for Clinical Research: Development and Testing

PubMed Central

Cohn, Elizabeth Gross; Jia, Haomiao; Smith, Winifred Chapman; Erwin, Katherine; Larson, Elaine L.

2013-01-01

Purpose/Objectives To develop and assess the reliability and validity of an observational instrument, the Process and Quality of Informed Consent (P-QIC). Design A pilot study of the psychometrics of a tool designed to measure the quality and process of the informed consent encounter in clinical research. The study used professionally filmed, simulated consent encounters designed to vary in process and quality. Setting A major urban teaching hospital in the northeastern region of the United States. Sample 63 students enrolled in health-related programs participated in psychometric testing, 16 students participated in test-retest reliability, and 5 investigator-participant dyads were observed for the actual consent encounters. Methods For reliability and validity testing, students watched and rated videotaped simulations of four consent encounters intentionally varied in process and content and rated them with the proposed instrument. Test-retest reliability was established by raters watching the videotaped simulations twice. Inter-rater reliability was demonstrated by two simultaneous but independent raters observing an actual consent encounter. Main Research Variables The essential elements of information and communication for informed consent. Findings The initial testing of the P-QIC demonstrated reliable and valid psychometric properties in both the simulated standardized consent encounters and actual consent encounters in the hospital setting. Conclusions The P-QIC is an easy-to-use observational tool that provides a quick assessment of the areas of strength and areas that need improvement in a consent encounter. It can be used in the initial trainings of new investigators or consent administrators and in ongoing programs of improvement for informed consent. Implications for Nursing The development of a validated observational instrument will allow investigators to assess the consent process more accurately and evaluate strategies designed to improve it. PMID:21708532

The effect of normative social forces on managed care organizations: implications for strategic management.

PubMed

Kirby, E G; Sebastian, J G

1998-01-01

Drawing on institutional theory, this study examines how adherence to a number of "institutional" and "technical" environmental forces can influence the business success of managed care organizations (MCOs). The standards studied include: (1) institutional forces: socially accepted procedures for delivering care (access to quality care, availability of information, and delivery of care in a personal manner); and (2) technical forces: industry standards for cost control and efficient use of financial and medical resources. The most significant finding is that successful MCOs must conform to both institutional and technical forces to be successful. MCOs that conform to either one or the other type of standard were no more successful than those that conformed to neither. These findings have several important implications for MCO strategy. First, to be successful, MCO executives must understand the external environment in which they operate. They must anticipate and respond to shifts in that environment. Second, this understanding of the external environment must place equal emphasis on societal demands (e.g., for accessible care and information) and on technical demands (e.g., for cost-efficient care). These findings may well reflect that once managed care penetration reaches relatively high levels, marketshare can no longer be gained through cost-efficiency alone; rather, enrollee satisfaction based on societal demands becomes a key factor in maintaining and gaining marketshare. Institutional theory provides' some strategies for accomplishing these goals. Cost-containment strategies include implementing policies for cutting costs in areas that do not affect the quality of care, such as using generic drugs and reducing administrative excesses and redundancies. At the same time, MCOs must implement strategies aimed at improving conformity to prevailing societal perceptions of appropriate care, including providing patients more freedom to choose their physicians and encouraging and rewarding care providers for being friendly and personable. An MCO should work to inform the public of the organization's efforts to provide high-quality, low-cost medical care in a friendly, convenient manner.

Measuring up: Implementing a dental quality measure in the electronic health record context.

PubMed

Bhardwaj, Aarti; Ramoni, Rachel; Kalenderian, Elsbeth; Neumann, Ana; Hebballi, Nutan B; White, Joel M; McClellan, Lyle; Walji, Muhammad F

2016-01-01

Quality improvement requires using quality measures that can be implemented in a valid manner. Using guidelines set forth by the Meaningful Use portion of the Health Information Technology for Economic and Clinical Health Act, the authors assessed the feasibility and performance of an automated electronic Meaningful Use dental clinical quality measure to determine the percentage of children who received fluoride varnish. The authors defined how to implement the automated measure queries in a dental electronic health record. Within records identified through automated query, the authors manually reviewed a subsample to assess the performance of the query. The automated query results revealed that 71.0% of patients had fluoride varnish compared with the manual chart review results that indicated 77.6% of patients had fluoride varnish. The automated quality measure performance results indicated 90.5% sensitivity, 90.8% specificity, 96.9% positive predictive value, and 75.2% negative predictive value. The authors' findings support the feasibility of using automated dental quality measure queries in the context of sufficient structured data. Information noted only in free text rather than in structured data would require using natural language processing approaches to effectively query electronic health records. To participate in self-directed quality improvement, dental clinicians must embrace the accountability era. Commitment to quality will require enhanced documentation to support near-term automated calculation of quality measures. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

The 2010 California Research at the Nexus of Air Quality and Climate Change (CalNex) field study

NASA Astrophysics Data System (ADS)

Ryerson, T. B.; Andrews, A. E.; Angevine, W. M.; Bates, T. S.; Brock, C. A.; Cairns, B.; Cohen, R. C.; Cooper, O. R.; de Gouw, J. A.; Fehsenfeld, F. C.; Ferrare, R. A.; Fischer, M. L.; Flagan, R. C.; Goldstein, A. H.; Hair, J. W.; Hardesty, R. M.; Hostetler, C. A.; Jimenez, J. L.; Langford, A. O.; McCauley, E.; McKeen, S. A.; Molina, L. T.; Nenes, A.; Oltmans, S. J.; Parrish, D. D.; Pederson, J. R.; Pierce, R. B.; Prather, K.; Quinn, P. K.; Seinfeld, J. H.; Senff, C. J.; Sorooshian, A.; Stutz, J.; Surratt, J. D.; Trainer, M.; Volkamer, R.; Williams, E. J.; Wofsy, S. C.

2013-06-01

The California Research at the Nexus of Air Quality and Climate Change (CalNex) field study was conducted throughout California in May, June, and July of 2010. The study was organized to address issues simultaneously relevant to atmospheric pollution and climate change, including (1) emission inventory assessment, (2) atmospheric transport and dispersion, (3) atmospheric chemical processing, and (4) cloud-aerosol interactions and aerosol radiative effects. Measurements from networks of ground sites, a research ship, tall towers, balloon-borne ozonesondes, multiple aircraft, and satellites provided in situ and remotely sensed data on trace pollutant and greenhouse gas concentrations, aerosol chemical composition and microphysical properties, cloud microphysics, and meteorological parameters. This overview report provides operational information for the variety of sites, platforms, and measurements, their joint deployment strategy, and summarizes findings that have resulted from the collaborative analyses of the CalNex field study. Climate-relevant findings from CalNex include that leakage from natural gas infrastructure may account for the excess of observed methane over emission estimates in Los Angeles. Air-quality relevant findings include the following: mobile fleet VOC significantly declines, and NOx emissions continue to have an impact on ozone in the Los Angeles basin; the relative contributions of diesel and gasoline emission to secondary organic aerosol are not fully understood; and nighttime NO3 chemistry contributes significantly to secondary organic aerosol mass in the San Joaquin Valley. Findings simultaneously relevant to climate and air quality include the following: marine vessel emissions changes due to fuel sulfur and speed controls result in a net warming effect but have substantial positive impacts on local air quality.

Quality improvement in physiotherapy services.

PubMed

Boak, George; Sephton, Ruth; Hough, Elaine; Ten Hove, Ruth

2017-06-12

Purpose The purpose of this paper is to evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes. Design/methodology/approach This is a multiple case study and information was gathered from eight physiotherapy teams over 24 months. Findings The process change was successfully implemented in six teams. It had a clear, positive effect on service quality provided to patients in three teams. Whilst quality also improved in three other teams, other issues make changes difficult to assess. Factors that enabled process change to be effective are suggested. Research limitations/implications The findings are based on results achieved by only eight English teams. Practical implications This process change may be appropriate for other teams providing therapy services if attention is paid to potential enabling factors, and a learning approach is adopted to designing and introducing the change. Originality/value To the best of the authors' knowledge, no other longitudinal process change study in therapy services has been published.

Searching the web: a survey on the quality of advice on postnatal sequelae of intrauterine growth restriction and the implication of developmental origins of health and disease.

PubMed

Perzel, S; Huebner, H; Rascher, W; Menendez-Castro, C; Hartner, A; Fahlbusch, F B

2017-10-01

Intrauterine growth restriction (IUGR) and fetal growth restriction (FGR) are pregnancy complications associated with morbidity in later life. Despite a growing body of evidence from current research on developmental origins of health and disease (DOHaD), little information is currently provided to parents on long-term metabolic, cardiovascular and neurologic consequences. As parents strongly rely on internet-based health-related information, we examined the quality of information on IUGR/FGR sequelae and DOHaD in webpages used by laypersons. Simulating non-clinicians experience, we entered the terms 'IUGR consequences' and 'FGR consequences' into Google and Yahoo search engines. The quality of the top search-hits was analyzed with regard to the certification through the Health On the Net Foundation (HON), currentness of cited references, while reliability of information and DOHaD-related consequences were assessed via the DISCERN Plus score (DPS). Overall the citation status was not up-to-date and only a few websites were HON-certified. The results of our analysis showed a dichotomy between the growing body of evidence regarding IUGR/FGR-related sequelae and lack of current guidelines, leaving parents without clear directions. Furthermore, detailed information on the concept of DOHaD is not provided. These findings emphasize the responsibility of the individual physician for providing advice on IUGR/FGR-related sequelae, monitoring and follow-up.

Following your heart or your head: focusing on emotions versus information differentially influences the decisions of younger and older adults.

PubMed

Mikels, Joseph A; Löckenhoff, Corinna E; Maglio, Sam J; Goldstein, Mary K; Garber, Alan; Carstensen, Laura L

2010-03-01

Research on aging has indicated that whereas deliberative cognitive processes decline with age, emotional processes are relatively spared. To examine the implications of these divergent trajectories in the context of health care choices, we investigated whether instructional manipulations emphasizing a focus on feelings or details would have differential effects on decision quality among younger and older adults. We presented 60 younger and 60 older adults with health care choices that required them to hold in mind and consider multiple pieces of information. Instructional manipulations in the emotion-focus condition asked participants to focus on their emotional reactions to the options, report their feelings about the options, and then make a choice. In the information-focus condition, participants were instructed to focus on the specific attributes, report the details about the options, and then make a choice. In a control condition, no directives were given. Manipulation checks indicated that the instructions were successful in eliciting different modes of processing. Decision quality data indicate that younger adults performed better in the information-focus than in the control condition whereas older adults performed better in the emotion-focus and control conditions than in the information-focus condition. Findings support and extend extant theorizing on aging and decision making as well as suggest that interventions to improve decision-making quality should take the age of the decision maker into account.

Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.

PubMed

Jones, Emily; Wittie, Michael

2015-01-01

To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.

Short and long term improvements in quality of chronic care delivery predict program sustainability.

PubMed

Cramm, Jane Murray; Nieboer, Anna Petra

2014-01-01

Empirical evidence on sustainability of programs that improve the quality of care delivery over time is lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in quality of chronic care delivery on program sustainability. In this longitudinal study, professionals [2010 (T0): n=218, 55% response rate; 2011 (T1): n=300, 68% response rate; 2012 (T2): n=265, 63% response rate] from 22 Dutch disease-management programs completed surveys assessing quality of care and program sustainability. Our study findings indicated that quality of chronic care delivery improved significantly in the first 2 years after implementation of the disease-management programs. At T1, overall quality, self-management support, delivery system design, and integration of chronic care components, as well as health care delivery and clinical information systems and decision support, had improved. At T2, overall quality again improved significantly, as did community linkages, delivery system design, clinical information systems, decision support and integration of chronic care components, and self-management support. Multilevel regression analysis revealed that quality of chronic care delivery at T0 (p<0.001) and quality changes in the first (p<0.001) and second (p<0.01) years predicted program sustainability. In conclusion this study showed that disease-management programs based on the chronic care model improved the quality of chronic care delivery over time and that short and long term changes in the quality of chronic care delivery predicted the sustainability of the projects. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Informal worker phenomenon in housing construction project

NASA Astrophysics Data System (ADS)

Wijayaningtyas, Maranatha; Sipan, Ibrahim; Lukiyanto, Kukuh

2017-11-01

The informal workers phenomenon on housing construction projects in Indonesia is different from workers in other sectors who would always request as permanent employees. Substantively, the informal workers are disinclined to be bound as permanent employees which different from the general labor paradigm. Hence, the objective of this study is to find out how the labour selection process, the factors that affected their performance, and the suitable wage system to achieve the target completion of housing construction project. The qualitative method is used to uncover and understand the meaning behind the phenomena (numina) of informal workers action and their influence on housing construction project which called phenomenological approach. Five informal workers and two project managers were selected as informants based on predetermined criteria with in-depth interviews. The results showed that the informal worker were more satisfied with the wage based on unit price while working in the housing construction project for the flexibility in working hours. In addition, the developer was also relieved because they only control the quality and the achievement of the project completion time which supported by informal worker leader. Therefore, these findings are beneficial for both of developer and government as policy maker to succeed the housing program in Indonesia.

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

PubMed

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

2016-12-01

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

Quality of life in dementia patients: nursing home versus home care.

PubMed

Nikmat, Azlina Wati; Hawthorne, Graeme; Al-Mashoor, S Hassan

2011-12-01

Care management providing a high quality of life (QoL) is a crucial issue in dealing with increasing numbers of dementia patients. Although the transition from informal (home-based) care to formal (institutional) care is often a function of dementia stage, for those with early dementia there is currently no definitive evidence showing that informal or formal care provides a higher QoL, particularly where informal care is favored for local cultural reasons. This paper outlines the research protocol for a study comparing formal and informal care in Malaysia. It seeks to provide evidence regarding which is more appropriate and results in higher QoL in early dementia. This is a quasi-experimental study design involving 224 early dementia patients from both nursing home and community settings. Participants will be assessed for cognitive severity, QoL, needs, activities of daily living, depression and social isolation/connectedness by using the Mini-Mental State Examination (MMSE), Cognitive Impairment Scale - 4 items (CIS-4), EUROPE Health Interview Survey-Quality of Life (WHO8), Assessment of Quality of Life (AQoL8), Camberwell Assessment of Need for the Elderly - Short Version (CANE-S), Barthel Index (BI), Cornell Scale for Depression (CSDD), Geriatric Depression Scale - 15 items (GDS-15), and Friendship Scale (FS) respectively. This study aims to provide a better understanding of care needs in early dementia. Given population aging, the study findings will provide evidence assisting decision-making for policies aimed at reducing the burden of caregiving and preserving the QoL of dementia patients.

Evolution of a CDC Public Health Research Agenda for Low-Risk Prostate Cancer

PubMed Central

Hall, Ingrid J.; Smith, Judith Lee

2016-01-01

Men with prostate cancer face difficult choices when selecting a therapy for localized prostate cancer. Comparative data from controlled studies are lacking and clinical opinions diverge about the benefits and harms of treatment options. Consequently, there is limited guidance for patients regarding the impact of treatment decisions on quality of life. There are opportunities for public health to intervene at several decision-making points. Information on typical quality of life outcomes associated with specific prostate cancer treatments could help patients select treatment options. From 2003 to present, the Division of Cancer Prevention and Control at CDC has supported projects to explore patient information-seeking behavior post-diagnosis, caregiver and provider involvement in treatment decision making, and patient quality of life following prostate cancer treatment. CDC's work also includes research that explores barriers and facilitators to the presentation of active surveillance as a viable treatment option and promotes equal access to information for men and their caregivers. This article provides an overview of the literature and considerations that initiated establishing a prospective public health research agenda around treatment decision making. Insights gathered from CDC-supported studies are poised to enhance understanding of the process of shared decision making and the influence of patient, caregiver, and provider preferences on the selection of treatment choices. These findings provide guidance about attributes that maximize patient experiences in survivorship, including optimal quality of life and patient and caregiver satisfaction with information, treatment decisions, and subsequent care. PMID:26590643

On pictures and stuff: image quality and material appearance

NASA Astrophysics Data System (ADS)

Ferwerda, James A.

2014-02-01

Realistic images are a puzzle because they serve as visual representations of objects while also being objects themselves. When we look at an image we are able to perceive both the properties of the image and the properties of the objects represented by the image. Research on image quality has typically focused improving image properties (resolution, dynamic range, frame rate, etc.) while ignoring the issue of whether images are serving their role as visual representations. In this paper we describe a series of experiments that investigate how well images of different quality convey information about the properties of the objects they represent. In the experiments we focus on the effects that two image properties (contrast and sharpness) have on the ability of images to represent the gloss of depicted objects. We found that different experimental methods produced differing results. Specifically, when the stimulus images were presented using simultaneous pair comparison, observers were influenced by the surface properties of the images and conflated changes in image contrast and sharpness with changes in object gloss. On the other hand, when the stimulus images were presented sequentially, observers were able to disregard the image plane properties and more accurately match the gloss of the objects represented by the different quality images. These findings suggest that in understanding image quality it is useful to distinguish between quality of the imaging medium and the quality of the visual information represented by that medium.

Anomaly Detection in Power Quality at Data Centers

NASA Technical Reports Server (NTRS)

Grichine, Art; Solano, Wanda M.

2015-01-01

The goal during my internship at the National Center for Critical Information Processing and Storage (NCCIPS) is to implement an anomaly detection method through the StruxureWare SCADA Power Monitoring system. The benefit of the anomaly detection mechanism is to provide the capability to detect and anticipate equipment degradation by monitoring power quality prior to equipment failure. First, a study is conducted that examines the existing techniques of power quality management. Based on these findings, and the capabilities of the existing SCADA resources, recommendations are presented for implementing effective anomaly detection. Since voltage, current, and total harmonic distortion demonstrate Gaussian distributions, effective set-points are computed using this model, while maintaining a low false positive count.

The relevance of context in understanding health literacy skills: Findings from a qualitative study.

PubMed

McKenna, Verna B; Sixsmith, Jane; Barry, Margaret M

2017-10-01

Conceptualizing health literacy as a relational concept, which involves how individuals interact with complex health and social systems, requires a greater understanding of the context of people's health experiences. To describe individuals' experiences of accessing, understanding, appraising and applying health information; explore the barriers and facilitators to using these skills; and to describe the experience of information exchange in health consultations. A longitudinal qualitative methodology with thematic analysis of interviews was used. Health literacy levels were assessed using the HLS-EU-47-Item Questionnaire. Findings are presented from the first round of data collection. Twenty-six participants purposefully selected from a CVD risk reduction programme at three separate time points. Four key themes identified: using health literacy capacities for managing health; psychological and structural factors that impact on these capacities; and the relationship quality with the health-care provider (HCP). Although limited health literacy was prevalent across the sample (65%), all individuals were very proactive in attempting to utilize health literacy skills. Findings emphasize the importance of contextual factors such as the quality of communication with the health-care provider, perceptions of control, attitudes to family medical history, navigating structural barriers and being supported in managing treatment and medication side-effects. Findings are relevant for health-care providers in order to enhance the patient-provider relationship and to ensure optimum health outcomes for all individuals regardless of health literacy levels. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

What constitutes evidence-based patient information? Overview of discussed criteria.

PubMed

Bunge, Martina; Mühlhauser, Ingrid; Steckelberg, Anke

2010-03-01

To survey quality criteria for evidence-based patient information (EBPI) and to compile the evidence for the identified criteria. Databases PubMed, Cochrane Library, PsycINFO, PSYNDEX and Education Research Information Center (ERIC) were searched to update the pool of criteria for EBPI. A subsequent search aimed to identify evidence for each criterion. Only studies on health issues with cognitive outcome measures were included. Evidence for each criterion is presented using descriptive methods. 3 systematic reviews, 24 randomized-controlled studies and 1 non-systematic review were included. Presentation of numerical data, verbal presentation of risks and diagrams, graphics and charts are based on good evidence. Content of information and meta-information, loss- and gain-framing and patient-oriented outcome measures are based on ethical guidelines. There is a lack of studies on quality of evidence, pictures and drawings, patient narratives, cultural aspects, layout, language and development process. The results of this review allow specification of EBPI and may help to advance the discourse among related disciplines. Research gaps are highlighted. Findings outline the type and extent of content of EBPI, guide the presentation of information and describe the development process. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Good-quality social care for people with Parkinson’s disease: a qualitative study

PubMed Central

Kennedy, Fiona; Stocks, Amanda-Jayne; McDonnell, Ann; Ramaswamy, Bhanu; Wood, Brendan; Whitfield, Malcolm

2016-01-01

Objectives The study examines the meaning of good-quality social care for people with Parkinson's disease and their carers. It identifies, from their perspective, the impact of good-quality social care on health and well-being. Design Qualitative case study methodology, interview and framework analysis techniques were used. Setting: community locations in the north and midlands of England. Participants Data were collected from 43 participants including individual interviews with people with Parkinson's disease (n=4), formal and informal social care providers (n=13), 2 focus groups, 1 with people with Parkinson's disease and their carers (n=17), and 1 with professionals (n=8), plus a telephone interview with a former commissioner. Findings Good-quality social care, delivered in a timely fashion, was reported to have a positive impact on health. Furthermore, there is an indication that good-quality social care can prevent untoward events, such as infections, symptom deterioration and deterioration in mental health. The concept of the ‘Impact Gap’ developed from the findings, illustrates how the costs of care may be reduced by delivering good-quality social care. Control, choice and maintaining independence emerged as indicators of good-quality social care, irrespective of clinical condition. Participants identified characteristics indicative of good-quality social care specific to Parkinson's disease, including understanding Parkinson's disease, appropriate administration of medication, timing of care and reassessment. ‘Parkinson's aware’ social care was seen to generate psychological, physical and social benefits that were inter-related. Conclusions The findings indicate how maximising quality in social care delivery for people with Parkinson's disease can impact on health and well-being. Long-term or short-term benefits may result in prevented events and reductions in health and social care resource. Health professionals can be instrumental in early detection of and signposting to social care. PMID:26883233

Positioning continuing education: boundaries and intersections between the domains continuing education, knowledge translation, patient safety and quality improvement.

PubMed

Kitto, Simon; Bell, Mary; Peller, Jennifer; Sargeant, Joan; Etchells, Edward; Reeves, Scott; Silver, Ivan

2013-03-01

Public and professional concern about health care quality, safety and efficiency is growing. Continuing education, knowledge translation, patient safety and quality improvement have made concerted efforts to address these issues. However, a coordinated and integrated effort across these domains is lacking. This article explores and discusses the similarities and differences amongst the four domains in relation to their missions, stakeholders, methods, and limitations. This paper highlights the potential for a more integrated and collaborative partnership to promote networking and information sharing amongst the four domains. This potential rests on the premise that an integrated approach may result in the development and implementation of more holistic and effective interdisciplinary interventions. In conclusion, an outline of current research that is informed by the preliminary findings in this paper is also briefly discussed. The research concerns a comprehensive mapping of the relationships between the domains to gain an understanding of potential dissonances between how the domains represent themselves, their work and the work of their 'partner' domains.

Instruments to assess the quality of health information on the World Wide Web: what can our patients actually use?

PubMed

Bernstam, Elmer V; Shelton, Dawn M; Walji, Muhammad; Meric-Bernstam, Funda

2005-01-01

To find and assess quality-rating instruments that can be used by health care consumers to assess websites displaying health information. Searches of PubMed, the World Wide Web (using five different search engines), reference tracing from identified articles, and a review of the of the American Medical Informatics Association's annual symposium proceedings. Sources were examined for availability, number of elements, objectivity, and readability. A total of 273 distinct instruments were found and analyzed. Of these, 80 (29%) made evaluation criteria publicly available and 24 (8.7%) had 10 or fewer elements (items that a user has to assess to evaluate a website). Seven instruments consisted of elements that could all be evaluated objectively. Of these seven, one instrument consisted entirely of criteria with acceptable interobserver reliability (kappa> or =0.6); another instrument met readability standards. There are many quality-rating instruments, but few are likely to be practically usable by the intended audience.

The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing.

PubMed

Hassmiller, Susan; Bilazarian, Ani

2018-04-01

The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement.

Why Latinas With Breast Cancer Select Specific Informal Caregivers to Participate With Them in Psychosocial Interventions.

PubMed

Badger, Terry; Segrin, Chris; Swiatkowski, Paulina; McNelis, Melissa; Weihs, Karen; Lopez, Ana Maria

2017-07-01

The purpose of this study is to describe the reasons 88 Latinas with breast cancer selected specific supportive others to participate in an 8-week psychosocial intervention. Participants were asked one open-ended question during the baseline assessment for a larger clinical trial: "Could you tell me more about why you selected [insert name] to participate in the study with you?" A content analysis of the responses found three thematic categories: source of informational or emotional support, concern for the informal caregiver's welfare, and special characteristics or qualities of the informal caregiver. These findings reflected both the cultural value of familism, the woman's role as caregiver to the family ( marianismo), and the man's role of provider ( machismo). Findings provide support for including the supportive person identified by the patient during a health crisis rather than the provider suggesting who that should be. Psychosocial services designed and implemented through such a cultural lens are more likely to be successful.

Quality of online health information about oral contraceptives from Hebrew-language websites.

PubMed

Neumark, Yehuda; Flum, Lior; Lopez-Quintero, Catalina; Shtarkshall, Ronny

2012-09-24

The Internet is a frequently used source of health information. Adolescents in particular seem to be receptive to online health information (OHI) and often incorporate such information in their decision-making processes. Yet, OHI is often incomplete, inaccurate, or unreliable. This study assessed the quality of Hebrew online (non-user-generated) content on oral contraceptives (OC), with regard to accuracy/completeness, credibility, and usability. Twenty-nine websites in Hebrew, including those of the four Israeli HMOs, were identified and evaluated. The websites were categorized as: HMO, health portal, contraception-specific, promotional-commercial, and life style and women's health. A set of established content parameters was selected by a family planning expert to assess accuracy/completeness. The Health on the Net Foundation Code of Conduct (HONcode) principles were used to assess the websites' reliability. Usability was assessed by applying items selected from the Minervation Validation and the University of Michigan's 'Website Evaluation checklist' scale. Mean scores, standard deviations (SD), and ranges were calculated for all websites and for category-specific websites. Correlation between dimensions and Inter-rater reliability were also examined. The mean score for accuracy/completeness was 50.9% for all websites (SD=30.1%, range 8-100%). Many websites failed to provide complete information, or provided inaccurate information regarding what to do when a pill is missed and when to use back-up methods. The average credibility score for all websites was 70.6% (SD=15.1, range=38=98%). The credibility parameters that were most commonly absent were funding source, authoring, date of content creation and last modification, explicit reference to evidence-based information, and references and citations. The average usability score for all websites was 94.5% (SD=6.9%, range 79-100%). A weak correlation was found between the three quality parameters assessed. Wide variation was noted in the quality of Hebrew-language OC websites. HMOs' websites scored highest on credibility and usability, and contraceptive-specific websites exhibited the greatest accuracy/completeness. The findings highlight the need to establish quality guidelines for health website content, train health care providers in assisting their patients to seek high quality OHI, and strengthen e-health literacy skills among online-information seekers, including perhaps health professionals.

Quality of online health information about oral contraceptives from Hebrew-language websites

PubMed Central

2012-01-01

Background The Internet is a frequently used source of health information. Adolescents in particular seem to be receptive to online health information (OHI) and often incorporate such information in their decision-making processes. Yet, OHI is often incomplete, inaccurate, or unreliable. This study assessed the quality of Hebrew online (non-user-generated) content on oral contraceptives (OC), with regard to accuracy/completeness, credibility, and usability. Methods Twenty-nine websites in Hebrew, including those of the four Israeli HMOs, were identified and evaluated. The websites were categorized as: HMO, health portal, contraception-specific, promotional-commercial, and life style and women’s health. A set of established content parameters was selected by a family planning expert to assess accuracy/completeness. The Health on the Net Foundation Code of Conduct (HONcode) principles were used to assess the websites’ reliability. Usability was assessed by applying items selected from the Minervation Validation and the University of Michigan’s ′Website Evaluation checklist′ scale. Mean scores, standard deviations (SD), and ranges were calculated for all websites and for category-specific websites. Correlation between dimensions and Inter-rater reliability were also examined. Results The mean score for accuracy/completeness was 50.9% for all websites (SD=30.1%, range 8–100%). Many websites failed to provide complete information, or provided inaccurate information regarding what to do when a pill is missed and when to use back–up methods. The average credibility score for all websites was 70.6% (SD=15.1, range=38=98%). The credibility parameters that were most commonly absent were funding source, authoring, date of content creation and last modification, explicit reference to evidence-based information, and references and citations. The average usability score for all websites was 94.5% (SD=6.9%, range 79–100%). A weak correlation was found between the three quality parameters assessed. Conclusions Wide variation was noted in the quality of Hebrew-language OC websites. HMOs’ websites scored highest on credibility and usability, and contraceptive-specific websites exhibited the greatest accuracy/completeness. The findings highlight the need to establish quality guidelines for health website content, train health care providers in assisting their patients to seek high quality OHI, and strengthen e-health literacy skills among online-information seekers, including perhaps health professionals. PMID:23006798

The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review

PubMed Central

Wichmann, Anne B; Adang, Eddy MM; Stalmeier, Peep FM; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra JFJ; Engels, Yvonne

2017-01-01

Background: In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. Aim: To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year’s value for palliative care. Design: The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. Data sources: A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Findings: Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. Conclusion: The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to—in addition to the EQ-5D— make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year. PMID:28190374

A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995.

PubMed

Dantas, F; Fisher, P; Walach, H; Wieland, F; Rastogi, D P; Teixeira, H; Koster, D; Jansen, J P; Eizayaga, J; Alvarez, M E P; Marim, M; Belon, P; Weckx, L L M

2007-01-01

The quality of information gathered from homeopathic pathogenetic trials (HPTs), also known as 'provings', is fundamental to homeopathy. We systematically reviewed HPTs published in six languages (English, German, Spanish, French, Portuguese and Dutch) from 1945 to 1995, to assess their quality in terms of the validity of the information they provide. The literature was comprehensively searched, only published reports of HPTs were included. Information was extracted by two reviewers per trial using a form with 87 items. Information on: medicines, volunteers, ethical aspects, blinding, randomization, use of placebo, adverse effects, assessments, presentation of data and number of claimed findings were recorded. Methodological quality was assessed by an index including indicators of internal and external validity, personal judgement and comments of reviewers for each study. 156 HPTs on 143 medicines, involving 2815 volunteers, produced 20,538 pathogenetic effects (median 6.5 per volunteer). There was wide variation in methods and results. Sample size (median 15, range 1-103) and trial duration (mean 34 days) were very variable. Most studies had design flaws, particularly absence of proper randomization, blinding, placebo control and criteria for analysis of outcomes. Mean methodological score was 5.6 (range 4-16). More symptoms were reported from HPTs of poor quality than from better ones. In 56% of trials volunteers took placebo. Pathogenetic effects were claimed in 98% of publications. On average about 84% of volunteers receiving active treatment developed symptoms. The quality of reports was in general poor, and much important information was not available. The HPTs were generally of low methodological quality. There is a high incidence of pathogenetic effects in publications and volunteers but this could be attributable to design flaws. Homeopathic medicines, tested in HPTs, appear safe. The central question of whether homeopathic medicines in high dilutions can provoke effects in healthy volunteers has not yet been definitively answered, because of methodological weaknesses of the reports. Improvement of the method and reporting of results of HPTs are required. References to all included RCTs are available on-line at.

The Role of the Principal's Leadership Style in the Implementation of ICT Policy

ERIC Educational Resources Information Center

Hadjithoma-Garstka, Christina

2011-01-01

This paper presents findings of a study in information communication technology (ICT) implementation, on the principal's leadership style in relation to other factors that influence implementation. The principal's leadership style is perceived--on the basis of the characteristics of the context where the study was conducted--as a personal quality,…

Quality of Care in Creches for Disadvantaged Children: A Brazilian Case Study.

ERIC Educational Resources Information Center

Ferreira, M. C. Rossetti; And Others

A study was conducted to critically assess the developmental conditions of 187 children (ages 1 month to 6 years) in eight creches (day nurseries) located in and around Ribeirao Preto, Brazil. Data were collected through informal interviews of day care staff and from 20 hours of direct observations of day care units. Findings indicated inadequate…

Does Parent Involvement and Neighborhood Quality Matter for African American Boys' Kindergarten Mathematics Achievement?

ERIC Educational Resources Information Center

Baker, Claire E.

2015-01-01

Research Findings: There is growing evidence that home learning stimulation that includes informal numeracy experiences can promote math-related learning in school. Furthermore, national studies suggest that children who start kindergarten with stronger math skills are more likely to succeed in high school. This study used a large sample of…

Social Indicators for Rural Development: Descriptive Social Reporting. Final Report, Sociology Report No. 141.

ERIC Educational Resources Information Center

Carter, Keith A.; And Others

Project 2142 was a multi-phase effort to discover and mobilize for dissemination to rural decision-makers various information and findings pertaining to the quality of life experienced by rural people. The initial research phases involved design of a conceptual framework that placed some parameters on the variety of social phenomena studied.…

A Query into the Quarter Century on the Interrelationships of Food, People, Environment, Land and Climate. Output Report.

ERIC Educational Resources Information Center

Ingraham, Elizabeth Wright

Scientists and educators examined long-term national and world trends related to the web of interrelationships involved in climate, food production, population, land use, and environmental quality. Current information and projections for the next quarter century were discussed. In reviewing scientific findings, it was noted that global weather…

?Cuan buenas son nuestras viviendas?: Los hispanos [How Good Is Our Housing? Hispanics].

ERIC Educational Resources Information Center

Yezer, Anthony; Limmer, Ruth

This report provides statistical information regarding the quality and cost of housing occupied by Hispanic Americans throughout the United States. Some of the findings include: (1) Hispanos occupy older and worse dwellings than the general U.S. population, with a significant number of dwellings lacking heat and adequate electricity and plumbing…

Comparison of Student Academic Achievement in an Information Technology Course across Modalities

ERIC Educational Resources Information Center

Susee, Dawn

2017-01-01

Online education continues to grow at a faster pace than traditional education. Even though students may prefer face-to-face education, they find the anywhere, anytime aspect of online education hard to resist. Universities are offering more courses in both a face-to-face and online option. For both accreditation and quality assurance purposes, it…

Quality Schooling in the Network Society: A Community Approach through the Everyday Use of the Internet

ERIC Educational Resources Information Center

Meneses, Julio; Momino, Josep Maria

2012-01-01

Beginning with a discussion of the latest findings in the information and communication technologies (ICT) and educational improvement field, this article develops a comprehensive strategy to analyse online community building. Far from offering a utopian or dystopian vision, we study the contribution of ICT appropriation as a tool for…

Low health literacy and evaluation of online health information: a systematic review of the literature.

PubMed

Diviani, Nicola; van den Putte, Bas; Giani, Stefano; van Weert, Julia Cm

2015-05-07

Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review, future research in this field should (1) specifically focus on health literacy, (2) devote more attention to the identification of the different criteria people use to evaluate online health information, (3) develop shared definitions and measures for the most commonly used outcomes in the field of evaluation of online health information, and (4) assess the relationship between the different evaluative dimensions and the role played by health literacy in shaping their interplay.

Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature

PubMed Central

van den Putte, Bas; Giani, Stefano; van Weert, Julia CM

2015-01-01

Background Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. Objective The main aim of this study was to review existing evidence on the association between low health literacy and (1) people’s ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Methods Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. Results After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. Conclusions The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review, future research in this field should (1) specifically focus on health literacy, (2) devote more attention to the identification of the different criteria people use to evaluate online health information, (3) develop shared definitions and measures for the most commonly used outcomes in the field of evaluation of online health information, and (4) assess the relationship between the different evaluative dimensions and the role played by health literacy in shaping their interplay. PMID:25953147

A Method for Finding Metabolic Pathways Using Atomic Group Tracking.

PubMed

Huang, Yiran; Zhong, Cheng; Lin, Hai Xiang; Wang, Jianyi

2017-01-01

A fundamental computational problem in metabolic engineering is to find pathways between compounds. Pathfinding methods using atom tracking have been widely used to find biochemically relevant pathways. However, these methods require the user to define the atoms to be tracked. This may lead to failing to predict the pathways that do not conserve the user-defined atoms. In this work, we propose a pathfinding method called AGPathFinder to find biochemically relevant metabolic pathways between two given compounds. In AGPathFinder, we find alternative pathways by tracking the movement of atomic groups through metabolic networks and use combined information of reaction thermodynamics and compound similarity to guide the search towards more feasible pathways and better performance. The experimental results show that atomic group tracking enables our method to find pathways without the need of defining the atoms to be tracked, avoid hub metabolites, and obtain biochemically meaningful pathways. Our results also demonstrate that atomic group tracking, when incorporated with combined information of reaction thermodynamics and compound similarity, improves the quality of the found pathways. In most cases, the average compound inclusion accuracy and reaction inclusion accuracy for the top resulting pathways of our method are around 0.90 and 0.70, respectively, which are better than those of the existing methods. Additionally, AGPathFinder provides the information of thermodynamic feasibility and compound similarity for the resulting pathways.

A Method for Finding Metabolic Pathways Using Atomic Group Tracking

PubMed Central

Zhong, Cheng; Lin, Hai Xiang; Wang, Jianyi

2017-01-01

A fundamental computational problem in metabolic engineering is to find pathways between compounds. Pathfinding methods using atom tracking have been widely used to find biochemically relevant pathways. However, these methods require the user to define the atoms to be tracked. This may lead to failing to predict the pathways that do not conserve the user-defined atoms. In this work, we propose a pathfinding method called AGPathFinder to find biochemically relevant metabolic pathways between two given compounds. In AGPathFinder, we find alternative pathways by tracking the movement of atomic groups through metabolic networks and use combined information of reaction thermodynamics and compound similarity to guide the search towards more feasible pathways and better performance. The experimental results show that atomic group tracking enables our method to find pathways without the need of defining the atoms to be tracked, avoid hub metabolites, and obtain biochemically meaningful pathways. Our results also demonstrate that atomic group tracking, when incorporated with combined information of reaction thermodynamics and compound similarity, improves the quality of the found pathways. In most cases, the average compound inclusion accuracy and reaction inclusion accuracy for the top resulting pathways of our method are around 0.90 and 0.70, respectively, which are better than those of the existing methods. Additionally, AGPathFinder provides the information of thermodynamic feasibility and compound similarity for the resulting pathways. PMID:28068354

Research gaps in routine health information system design barriers to data quality and use in low- and middle-income countries: A literature review.

PubMed

Kumar, Manish; Gotz, David; Nutley, Tara; Smith, Jason B

2018-01-01

Despite the potential impact of health information system (HIS) design barriers on health data quality and use and, ultimately, health outcomes in low- and middle-income countries (LMICs), no comprehensive literature review has been conducted to study them in this context. We therefore conducted a formal literature review to understand system design barriers to data quality and use in LMICs and to identify any major research gaps related understanding how system design affects data use. We conducted an electronic search across 4 scientific databases-PubMed, Web of Science, Embase, and Global Health-and consulted a data use expert. Following a systematic inclusion and exclusion process, 316 publications (316 abstracts and 18 full papers) were included in the review. We found a paucity of scientific publications that explicitly describe system design factors that hamper data quality or data use for decision making. Although user involvement, work flow, human-computer interactions, and user experience are critical aspects of system design, our findings suggest that these issues are not discussed or conceptualized in the literature. Findings also showed that individual training efforts focus primarily on imparting data analysis skills. The adverse impact of HIS design barriers on data integrity and health system performance may be even bigger in LMICs than elsewhere, leading to errors in population health management and clinical care. We argue for integrating systems thinking into HIS strengthening efforts to reduce the HIS design-user reality gap. Copyright © 2017 John Wiley & Sons, Ltd.

Surfing the Net for medical information about psychological trauma: An empirical study of the quality and accuracy of trauma-related websites

PubMed Central

BREMNER, J. DOUGLAS; QUINN, JOHN; QUINN, WILLIAM; VELEDAR, EMIR

2011-01-01

Psychological trauma is a major public-health problem, and trauma victims frequently turn to the Internet for medical information related to trauma. The Internet has many advantages for trauma victims, including low cost, privacy, use of access, and reduced direct social interactions. However, there are no regulations on what is posted on the Internet, or by whom, and little is known about the quality of information currently available related to the topic of psychological trauma. The purpose of this study was to evaluate the quality of Internet sites related to the topic of psychological trauma. The top 20 hits for searches on Google, AllTheWeb, and Yahoo were tabulated, using search words of ‘psychological trauma’, ‘stress’, ‘PTSD’, and ‘trauma’. From these searches, a list of 94 unique unsponsored hits that represented accessible websites was generated. Fourteen sites were unrelated or only peripherally related, and eight were related but were not comprehensively evaluated because they represented brochures, online book sales, etc. Seventy-two websites underwent evaluation of the content, design, disclosure, ease of use, and other factors based on published guidelines for medical information sites. Forty-two per cent of sites had inaccurate information, 82% did not provide a source of their information, and 41% did not use a mental-health professional in the development of the content. Ratings of content (e.g. accuracy, reliability, etc.) were 4 (2 SD) on a scale of 1 – 10, with 10 being the best. There were similar ratings for the other variables assessed. These findings suggest that although abundant, websites providing information about psychological trauma are often not useful, and can sometimes provide inaccurate and potentially harmful information to consumers of medical information. PMID:16954059

Surfing the net for medical information about psychological trauma: an empirical study of the quality and accuracy of trauma-related websites.

PubMed

Bremner, J Douglas; Quinn, John; Quinn, William; Veledar, Emir

2006-09-01

Psychological trauma is a major public-health problem, and trauma victims frequently turn to the Internet for medical information related to trauma. The Internet has many advantages for trauma victims, including low cost, privacy, use of access, and reduced direct social interactions. However, there are no regulations on what is posted on the Internet, or by whom, and little is known about the quality of information currently available related to the topic of psychological trauma. The purpose of this study was to evaluate the quality of Internet sites related to the topic of psychological trauma. The top 20 hits for searches on Google, AllTheWeb, and Yahoo were tabulated, using search words of 'psychological trauma', 'stress', 'PTSD', and 'trauma'. From these searches, a list of 94 unique unsponsored hits that represented accessible websites was generated. Fourteen sites were unrelated or only peripherally related, and eight were related but were not comprehensively evaluated because they represented brochures, online book sales, etc. Seventy-two websites underwent evaluation of the content, design, disclosure, ease of use, and other factors based on published guidelines for medical information sites. Forty-two per cent of sites had inaccurate information, 82% did not provide a source of their information, and 41% did not use a mental-health professional in the development of the content. Ratings of content (e.g. accuracy, reliability, etc.) were 4 (2 SD) on a scale of 1 - 10, with 10 being the best. There were similar ratings for the other variables assessed. These findings suggest that although abundant, websites providing information about psychological trauma are often not useful, and can sometimes provide inaccurate and potentially harmful information to consumers of medical information.

Assessment of Completeness and Positional Accuracy of Linear Features in Volunteered Geographic Information (vgi)

NASA Astrophysics Data System (ADS)

Eshghi, M.; Alesheikh, A. A.

2015-12-01

Recent advances in spatial data collection technologies and online services dramatically increase the contribution of ordinary people to produce, share, and use geographic information. Collecting spatial data as well as disseminating them on the internet by citizens has led to a huge source of spatial data termed as Volunteered Geographic Information (VGI) by Mike Goodchild. Although, VGI has produced previously unavailable data assets, and enriched existing ones. But its quality can be highly variable and challengeable. This presents several challenges to potential end users who are concerned about the validation and the quality assurance of the data which are collected. Almost, all the existing researches are based on how to find accurate VGI data from existing VGI data which consist of a) comparing the VGI data with the accurate official data, or b) in cases that there is no access to correct data; therefore, looking for an alternative way to determine the quality of VGI data is essential, and so forth. In this paper it has been attempt to develop a useful method to reach this goal. In this process, the positional accuracy of linear feature of Iran, Tehran OSM data have been analyzed.

‘You don't know which bits to believe’: qualitative study exploring carers’ experiences of seeking information on the internet about childhood eczema

PubMed Central

Santer, Miriam; Muller, Ingrid; Yardley, Lucy; Burgess, Hana; Ersser, Steven J; Lewis-Jones, Sue; Little, Paul

2015-01-01

Objective We sought to explore parents and carers’ experiences of searching for information about childhood eczema on the internet. Design A qualitative interview study was carried out among carers of children aged 5 years or less with a recorded diagnosis of eczema. The main focus of the study was to explore carers’ beliefs and understandings around eczema and its treatment. As part of this, we explored experiences of formal and informal information seeking about childhood eczema. Transcripts of interviews were analysed thematically. Setting Participants were recruited from six general practices in South West England. Participants Interviews were carried out with 31 parents from 28 families. Results Experiences of searching for eczema information on the internet varied widely. A few interviewees were able to navigate through the internet and find the specific information they were looking for (for instance about treatments their child had been prescribed), but more found searching for eczema information online to be a bewildering experience. Some could find no information of relevance to them, whereas others found the volume of different information sources overwhelming. Some said that they were unsure how to evaluate online information or that they were wary of commercial interests behind some information sources. Interviewees said that they would welcome more signposting towards high quality information from their healthcare providers. Conclusions We found very mixed experiences of seeking eczema information on the internet; but many participants in this study found this to be frustrating and confusing. Healthcare professionals and healthcare systems have a role to play in helping people with long-term health conditions and their carers find reliable online information to support them with self-care. PMID:25854963

Data quality assessment for comparative effectiveness research in distributed data networks

PubMed Central

Brown, Jeffrey; Kahn, Michael; Toh, Sengwee

2015-01-01

Background Electronic health information routinely collected during healthcare delivery and reimbursement can help address the need for evidence about the real-world effectiveness, safety, and quality of medical care. Often, distributed networks that combine information from multiple sources are needed to generate this real-world evidence. Objective We provide a set of field-tested best practices and a set of recommendations for data quality checking for comparative effectiveness research (CER) in distributed data networks. Methods Explore the requirements for data quality checking and describe data quality approaches undertaken by several existing multi-site networks. Results There are no established standards regarding how to evaluate the quality of electronic health data for CER within distributed networks. Data checks of increasing complexity are often employed, ranging from consistency with syntactic rules to evaluation of semantics and consistency within and across sites. Temporal trends within and across sites are widely used, as are checks of each data refresh or update. Rates of specific events and exposures by age group, sex, and month are also common. Discussion Secondary use of electronic health data for CER holds promise but is complex, especially in distributed data networks that incorporate periodic data refreshes. The viability of a learning health system is dependent on a robust understanding of the quality, validity, and optimal secondary uses of routinely collected electronic health data within distributed health data networks. Robust data quality checking can strengthen confidence in findings based on distributed data network. PMID:23793049

Towards a Quality Assessment Method for Learning Preference Profiles in Negotiation

NASA Astrophysics Data System (ADS)

Hindriks, Koen V.; Tykhonov, Dmytro

In automated negotiation, information gained about an opponent's preference profile by means of learning techniques may significantly improve an agent's negotiation performance. It therefore is useful to gain a better understanding of how various negotiation factors influence the quality of learning. The quality of learning techniques in negotiation are typically assessed indirectly by means of comparing the utility levels of agreed outcomes and other more global negotiation parameters. An evaluation of learning based on such general criteria, however, does not provide any insight into the influence of various aspects of negotiation on the quality of the learned model itself. The quality may depend on such aspects as the domain of negotiation, the structure of the preference profiles, the negotiation strategies used by the parties, and others. To gain a better understanding of the performance of proposed learning techniques in the context of negotiation and to be able to assess the potential to improve the performance of such techniques a more systematic assessment method is needed. In this paper we propose such a systematic method to analyse the quality of the information gained about opponent preferences by learning in single-instance negotiations. The method includes measures to assess the quality of a learned preference profile and proposes an experimental setup to analyse the influence of various negotiation aspects on the quality of learning. We apply the method to a Bayesian learning approach for learning an opponent's preference profile and discuss our findings.

Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research.

PubMed

Meißner, Anne; Schnepp, Wilfried

2014-06-20

Since the introduction of electronic nursing documentation systems, its implementation in recent years has increased rapidly in Germany. The objectives of such systems are to save time, to improve information handling and to improve quality. To integrate IT in the daily working processes, the employee is the pivotal element. Therefore it is important to understand nurses' experience with IT implementation. At present the literature shows a lack of understanding exploring staff experiences within the implementation process. A systematic review and meta-ethnographic synthesis of primary studies using qualitative methods was conducted in PubMed, CINAHL, and Cochrane. It adheres to the principles of the PRISMA statement. The studies were original, peer-reviewed articles from 2000 to 2013, focusing on computer-based nursing documentation in Residential Aged Care Facilities. The use of IT requires a different form of information processing. Some experience this new form of information processing as a benefit while others do not. The latter find it more difficult to enter data and this result in poor clinical documentation. Improvement in the quality of residents' records leads to an overall improvement in the quality of care. However, if the quality of those records is poor, some residents do not receive the necessary care. Furthermore, the length of time necessary to complete the documentation is a prominent theme within that process. Those who are more efficient with the electronic documentation demonstrate improved time management. For those who are less efficient with electronic documentation the information processing is perceived as time consuming. Normally, it is possible to experience benefits when using IT, but this depends on either promoting or hindering factors, e.g. ease of use and ability to use it, equipment availability and technical functionality, as well as attitude. In summary, the findings showed that members of staff experience IT as a benefit when it simplifies their daily working routines and as a burden when it complicates their working processes. Whether IT complicates or simplifies their routines depends on influencing factors. The line between benefit and burden is semipermeable. The experiences differ according to duties and responsibilities.

Evaluating the quality of Internet health resources in pediatric urology.

PubMed

Fast, Angela M; Deibert, Christopher M; Hruby, Gregory W; Glassberg, Kenneth I

2013-04-01

Many patients and their parents utilize the Internet for health-related information, but quality is largely uncontrolled and unregulated. The Health on the Net Foundation Code (HONcode) and DISCERN Plus were used to evaluate the pediatric urological search terms 'circumcision,' 'vesicoureteral reflux' and 'posterior urethral valves'. A google.com search was performed to identify the top 20 websites for each term. The HONcode toolbar was utilized to determine whether each website was HONcode accredited and report the overall frequency of accreditation for each term. The DISCERN Plus instrument was used to score each website in accordance with the DISCERN Handbook. High and low scoring criteria were then compared. A total of 60 websites were identified. For the search terms 'circumcision', 'posterior urethral valves' and 'vesicoureteral reflux', 25-30% of the websites were HONcode certified. Out of the maximum score of 80, the average DISCERN Plus score was 60 (SD = 12, range 38-78), 40 (SD = 12, range 22-69) and 45 (SD = 19, range 16-78), respectively. The lowest scoring DISCERN criteria included: 'Does it describe how the treatment choices affect overall quality of life?', 'Does it describe the risks of each treatment?' and 'Does it provide details of additional sources of support and information?' (1.35, 1.83 and 1.95 out of 5, respectively). These findings demonstrate the poor quality of information that patients and their parents may use in decision-making and treatment choices. The two lowest scoring DISCERN Plus criteria involved education on quality of life issues and risks of treatment. Physicians should know how to best use these tools to help guide patients and their parents to websites with valid information. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Factors of accepting pain management decision support systems by nurse anesthetists

PubMed Central

2013-01-01

Background Pain management is a critical but complex issue for the relief of acute pain, particularly for postoperative pain and severe pain in cancer patients. It also plays important roles in promoting quality of care. The introduction of pain management decision support systems (PM-DSS) is considered a potential solution for addressing the complex problems encountered in pain management. This study aims to investigate factors affecting acceptance of PM-DSS from a nurse anesthetist perspective. Methods A questionnaire survey was conducted to collect data from nurse anesthetists in a case hospital. A total of 113 questionnaires were distributed, and 101 complete copies were returned, indicating a valid response rate of 89.3%. Collected data were analyzed by structure equation modeling using the partial least square tool. Results The results show that perceived information quality (γ=.451, p<.001), computer self-efficacy (γ=.315, p<.01), and organizational structure (γ=.210, p<.05), both significantly impact nurse anesthetists’ perceived usefulness of PM-DSS. Information quality (γ=.267, p<.05) significantly impacts nurse anesthetists’ perceptions of PM-DSS ease of use. Furthermore, both perceived ease of use (β=.436, p<.001, R2=.487) and perceived usefulness (β=.443, p<.001, R2=.646) significantly affected nurse anesthetists’ PM-DSS acceptance (R2=.640). Thus, the critical role of information quality in the development of clinical decision support system is demonstrated. Conclusions The findings of this study enable hospital managers to understand the important considerations for nurse anesthetists in accepting PM-DSS, particularly for the issues related to the improvement of information quality, perceived usefulness and perceived ease of use of the system. In addition, the results also provide useful suggestions for designers and implementers of PM-DSS in improving system development. PMID:23360305

Informed consent in Malaysia: an overview.

PubMed

Che Ngah, Anisah

2005-01-01

The right of a person to control his body is a concept that has long been recognized in Malaysia under the law of torts. The purpose of requiring informed consent is to preserve that right in medical decision-making. Informed Consent is a relatively new concept in medical litigation cases. However in the late 1990's, it has become one of the important claims under negligence made against the doctor for failure to disclose relevant information to patients in respect of the treatment proposed. Whether Malaysia has begun to recognize patient's right to decision-making is yet to be seen. Furthermore the social-cultural relationship between doctors and patients had to be considered. In this respect, the researcher had conducted interviews with doctors and patients to gauge their reaction towards a shared process of decision-making, which is the central issue in the doctrine of informed consent. Findings suggest that in society where primary health care is the main thrust to achieve health for all, the possibility of recognition of the rights of patients to receive information before making decisions about treatment appears remote. The findings also underscore the importance of incorporating aspects of informed consent as part of providing quality service to patients.

Methodological Variation in Economic Evaluations Conducted in Low- and Middle-Income Countries: Information for Reference Case Development

PubMed Central

2015-01-01

Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions. PMID:25950443

Are results of randomized controlled trials useful to psychotherapists?

PubMed

Persons, J B; Silberschatz, G

1998-02-01

Two clinicians provided opposite answers to the title question: Persons argued that information from randomized controlled trials (RCTs) is vital to clinicians, and Silberschatz argued that information from RCTs is irrelevant to clinicians. Persons argued that clinicians cannot provide top quality care to their patients without attending to findings of RCTs and that clinicians have an ethical responsibility to inform patients about, recommend, and provide treatments supported by RCTs before informing patients about, recommending, and providing treatments shown to be inferior in RCTs or not evaluated in RCTs. Silberschatz argued that RCTs do not and cannot answer questions that concern practicing clinicians. He advocates alternative research approaches (effectiveness studies, quasi-experimental methods, case-specific research) for studying psychotherapy.

Study of relation of continuing medical education to quality of family physicians' care.

PubMed

Dunn, E V; Bass, M J; Williams, J I; Borgiel, A E; MacDonald, P; Spasoff, R A

1988-10-01

A random sample of 120 physicians in Ontario was studied to assess quality of care in primary care and test an hypothesis that quality of care was related to continuing medical education (CME) activities. The quality-of-care scores were obtained by an in-office audit of a random selection of charts. The scores were global scores for charting, prevention, the use of 13 classes of drugs, and care of a two-year period for 182 different diagnoses. There were no relationships between global quality-of-care scores based on these randomly chosen charts and either the type or quantity of the physicians' CME activities. These activities were reading journals, attending rounds, attending scientific conferences, having informal consultations, using audio and video cassettes, and engaging in self-assessment. The implications of these findings are significant for future research in CME and for planners of present CME programs.

Measuring patients' experiences with rheumatic care: the consumer quality index rheumatoid arthritis.

PubMed

Zuidgeest, Marloes; Sixma, Herman; Rademakers, Jany

2009-12-01

Rheumatologists and other caregivers can learn from patients’ experiences with the quality of care that can be measured with the CQ-index Rheumatoid Arthritis (CQ-index RA) survey. Patients with RA (n = 590) received this survey were they rated their actual experiences and what they find important in rheumatic healthcare. Descriptive analyses and psychometric methods were used to test the reliability. The response rate was 69%. The items in the pilot instrument could be grouped into 10 scales (α ranged from 0.77 to 0.94). The most important quality aspects according to patients concerned the alertness when prescribing medication. Providing patients with information on a special website of the hospital about RA was the highest quality improvement aspect. The results of this study show that the CQ-index RA is a reliable instrument for quality assessment from the patients’ perspective. The instrument provides rheumatologists and other caregivers with feedback for service improvement initiatives.

The quality of feeding assistance care practices for long-term care veterans: implications for quality improvement efforts.

PubMed

Simmons, Sandra F; Sims, Nichole; Durkin, Daniel W; Shotwell, Matthew S; Erwin, Scott; Schnelle, John F

2013-09-01

The primary purpose of this study was to determine the quality of feeding assistance care and identify areas in need of improvement for a sample of long-term care veterans. A secondary purpose was to compare these findings with the results of previous studies in community facilities to determine ways in which the VA sample might differ. A repeated measures observational study was conducted in two VA facilities with 200 long-stay residents. Research staff conducted standardized observations during and between meals for 3 months. There was a trend for better feeding assistance care quality during meals in the VA sample, but there were still multiple aspects of care in need of improvement both during and between meals. Higher licensed nurse staffing levels in the VA should enable effective supervision and management, but observation-based measures of care quality are necessary for accurate information about daily feeding assistance care provision.

Healthcare applications of knowledge discovery in databases.

PubMed

DeGruy, K B

2000-01-01

Many healthcare leaders find themselves overwhelmed with data, but lack the information they need to make informed decisions. Knowledge discovery in databases (KDD) can help organizations turn their data into information. KDD is the process of finding complex patterns and relationships in data. The tools and techniques of KDD have achieved impressive results in other industries, and healthcare needs to take advantage of advances in this exciting field. Recent advances in the KDD field have brought it from the realm of research institutions and large corporations to many smaller companies. Software and hardware advances enable small organizations to tap the power of KDD using desktop PCs. KDD has been used extensively for fraud detection and focused marketing. There is a wealth of data available within the healthcare industry that would benefit from the application of KDD tools and techniques. Providers and payers have a vast quantity of data (such as, charges and claims), but not effective way to analyze the data to accurately determine relationships and trends. Organizations that take advantage of KDD techniques will find that they offer valuable assistance in the quest to lower healthcare costs while improving healthcare quality.

A trait based approach to defining valued mentoring qualities

NASA Astrophysics Data System (ADS)

Pendall, E.

2012-12-01

Graduate training in the sciences requires strong personal interactions among faculty, senior lab members and more junior members. Within the lab-group setting we learn to frame problems, to conduct research and to communicate findings. The result is that individual scientists are partly shaped by a few influential mentors. We have all been influenced by special relationships with mentors, and on reflection we may find that certain qualities have been especially influential in our career choices. In this presentation I will discuss favorable mentoring traits as determined from an informal survey of scientists in varying stages of careers and from diverse backgrounds. Respondents addressed questions about traits they value in their mentors in several categories: 1) personal qualities such as approachability, humor and encouragement; background including gender, ethnicity, and family status; 2) scientific qualities including discipline or specialization, perceived stature in discipline, seniority, breadth of perspective, and level of expectations; and 3) community-oriented qualities promoted by mentors, such as encouraging service contributions and peer-mentoring within the lab group. The results will be compared among respondents by gender, ethnicity, stage of career, type of work, and subdiscipline within the broadly defined Biogeoscience community. We hope to contribute to the growing discussion on building a diverse and balanced scientific workforce.

Health information needs and health-related quality of life in a diverse population of long-term cancer survivors✩

PubMed Central

Kent, Erin E.; Arora, Neeraj K.; Rowland, Julia H.; Bellizzi, Keith M.; Forsythe, Laura P.; Hamilton, Ann S.; Oakley-Girvan, Ingrid; Beckjord, Ellen B.; Aziz, Noreen M.

2015-01-01

Objective To investigate health information needs and their association with health-related quality of life (HRQOL) in a diverse, population-based sample of long-term cancer survivors. Methods We analyzed health information needs from 1197 cancer survivors 4–14 years post-diagnosis drawn from two cancer registries in California. Multivariable regression models were used to identify factors associated with endorsement of total number and different categories of needs. The relationship between number of needs and HRQOL and effect modification by confidence for obtaining information was examined. Results Survivors reported a high prevalence of unmet information needs in the following categories: side effects & symptoms: 75.8%; tests & treatment: 71.5%; health promotion: 64.5%; interpersonal & emotional: 60.2%; insurance: 39.0%; and sexual functioning & fertility: 34.6%. Survivors who were younger, non-White, and did not receive but wanted a written treatment summary reported a higher number of needs. Number of information needs was inversely related to mental well-being, particularly for those with low confidence for obtaining information (P < 0.05). Conclusion These patterns suggest disparities in access to important health information in long-term survivors and that affect HRQOL. Practice Implications Findings suggest a need for tailored interventions to equip survivors with comprehensive health information and to bolster skills for obtaining information. PMID:23021856

Quality of reporting web-based and non-web-based survey studies: What authors, reviewers and consumers should consider.

PubMed

Turk, Tarek; Elhady, Mohamed Tamer; Rashed, Sherwet; Abdelkhalek, Mariam; Nasef, Somia Ahmed; Khallaf, Ashraf Mohamed; Mohammed, Abdelrahman Tarek; Attia, Andrew Wassef; Adhikari, Purushottam; Amin, Mohamed Alsabbahi; Hirayama, Kenji; Huy, Nguyen Tien

2018-01-01

Several influential aspects of survey research have been under-investigated and there is a lack of guidance on reporting survey studies, especially web-based projects. In this review, we aim to investigate the reporting practices and quality of both web- and non-web-based survey studies to enhance the quality of reporting medical evidence that is derived from survey studies and to maximize the efficiency of its consumption. Reporting practices and quality of 100 random web- and 100 random non-web-based articles published from 2004 to 2016 were assessed using the SUrvey Reporting GuidelinE (SURGE). The CHERRIES guideline was also used to assess the reporting quality of Web-based studies. Our results revealed a potential gap in the reporting of many necessary checklist items in both web-based and non-web-based survey studies including development, description and testing of the questionnaire, the advertisement and administration of the questionnaire, sample representativeness and response rates, incentives, informed consent, and methods of statistical analysis. Our findings confirm the presence of major discrepancies in reporting results of survey-based studies. This can be attributed to the lack of availability of updated universal checklists for quality of reporting standards. We have summarized our findings in a table that may serve as a roadmap for future guidelines and checklists, which will hopefully include all types and all aspects of survey research.

Procedural justice and quality of life in compensation processes.

PubMed

Elbers, Nieke A; Akkermans, Arno J; Cuijpers, Pim; Bruinvels, David J

2013-11-01

There is considerable evidence that being involved in compensation processes has a negative impact on claimants' health. Previous studies suggested that this negative effect is caused by a stressful compensation process: claimants suffered from a lack of communication, a lack of information, and feelings of distrust. However, these rather qualitative findings have not been quantitatively investigated yet. This observational study aimed to fill this gap of knowledge, investigating the claimants' perceived fairness of the compensation process, the provided information, and the interaction with lawyers and insurance companies, in relation to the claimants' quality of life. Participants were individuals injured in traffic accidents, older than 18 years, who were involved in a compensation process in the Netherlands. They were recruited by three claims settlement offices. Outcome measures were procedural, interactional, and informational justice, and quality of life. Participants (n=176) perceived the interaction with lawyers to be fairer than the interaction with insurance companies (p<.001). The length of hospital stay was positively associated with procedural justice (β=.31, p<.001). Having trunk/back injury was negatively related to procedural justice (β=-.25, p=.001). Whiplash injury and length of time involved in the claim process were not associated with any of the justice scales. Finally, procedural justice was found to be positively correlated with quality of life (rs=.22, p=.004). The finding that the interaction with insurance companies was considered less fair than the interaction with lawyers may imply that insurers could improve their interaction with claimants, e.g. by communicating more directly. The result that claimants with mild injuries and with trunk/back injuries considered the compensation process to be less fair than those with respectively severe injuries and injuries to other body parts suggests that especially the former two require an attentive treatment. Finally, the fact that procedural justice was positively correlated with quality of life could implicate that it is possible to improve claimants' health in compensation processes by enhancing procedural justice, e.g. by increasing the ability for claimants to express their views and feelings and by involving claimants in the decision-making process. Copyright © 2012 Elsevier Ltd. All rights reserved.

Access to New Zealand Sign Language interpreters and quality of life for the deaf: a pilot study.

PubMed

Henning, Marcus A; Krägeloh, Christian U; Sameshima, Shizue; Shepherd, Daniel; Shepherd, Gregory; Billington, Rex

2011-01-01

This paper aims to: (1) explore usage and accessibility of sign language interpreters, (2) appraise the levels of quality of life (QOL) of deaf adults residing in New Zealand, and (3) consider the impact of access to and usage of sign language interpreters on QOL. Sixty-eight deaf adults living in New Zealand participated in this study. Two questionnaires were employed: a 12-item instrument about access and use of New Zealand sign language interpreters and the abbreviated version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF). The results showed that 39% of this sample felt that they were unable to adequately access interpreting services. Moreover, this group scored significantly lower than a comparable hearing sample on all four WHOQOL-BREF domains. Finally, the findings revealed that access to good quality interpreters were associated with access to health services, transport issues, engagement in leisure activities, gaining more information, mobility and living in a healthy environment. These findings have consequences for policy makers and agencies interested in ensuring that there is an equitable distribution of essential services for all groups within New Zealand which inevitably has an impact on the health of the individual.

An analysis of methods used to synthesize evidence and grade recommendations in food-based dietary guidelines

PubMed Central

Blake, Phillipa; Durão, Solange; Naude, Celeste E; Bero, Lisa

2018-01-01

Abstract Evidence-informed guideline development methods underpinned by systematic reviews ensure that guidelines are transparently developed, free from overt bias, and based on the best available evidence. Only recently has the nutrition field begun using these methods to develop public health nutrition guidelines. Given the importance of following an evidence-informed approach and recent advances in related methods, this study sought to describe the methods used to synthesize evidence, rate evidence quality, grade recommendations, and manage conflicts of interest (COIs) in national food-based dietary guidelines (FBDGs). The Food and Agriculture Organization’s FBDGs database was searched to identify the latest versions of FBDGs published from 2010 onward. Relevant data from 32 FBDGs were extracted, and the findings are presented narratively. This study shows that despite advances in evidence-informed methods for developing dietary guidelines, there are variations and deficiencies in methods used to review evidence, rate evidence quality, and grade recommendations. Dietary guidelines should follow systematic and transparent methods and be informed by the best available evidence, while considering important contextual factors and managing conflicts of interest. PMID:29425371

Using indoor air quality monitoring in 6 counties to change policy in North Carolina.

PubMed

Proescholdbell, Scott; Steiner, Julea; Goldstein, Adam O; Malek, Sally Herndon

2009-07-01

Indoor air quality monitoring has become a valuable tool for states wanting to assess levels of particulate matter before and after smoke-free policies are implemented. However, many states face barriers in passing comprehensive smoke-free legislation, making such study comparisons unlikely. We used indoor air monitoring data to educate decision makers about the value of comprehensive smoke-free laws in a state with strong historical ties to tobacco. We trained teams in 6 counties in North Carolina to monitor air quality in hospitality venues with 1 of 3 possible smoking policy designations: 1) smoke-free, 2) separate smoking and nonsmoking sections (mixed), or 3) smoking allowed in all areas. Teams monitored 152 venues for respirable suspended particles that were less than 2.5 microm in diameter and collected information on venue characteristics. The data were combined and analyzed by venue policy and by county. Our findings were presented to key decision makers, and we then collected information on media publicity about these analyses. Overall, smoke-free venues had the lowest particulate matter levels (15 microg/m3), well below established Environmental Protection Agency standards. Venues with mixed policies and venues that permitted smoking in all areas had particulate matter levels that are considered unhealthy by Environmental Protection Agency standards. The media coverage of our findings included newspaper, radio, and television reports. Findings were also discussed with local health directors, state legislators, and public health advocates. Study data have been used to quantify particulate matter levels, raise awareness about the dangers of secondhand smoke, build support for evidence-based policies, and promote smoke-free policies among policy makers. The next task is to turn this effort into meaningful policy change that will protect everyone from the harms of secondhand smoke.

Conceptualization and Implementation of the Central Information Portal on Rare Diseases: Protocol for a Qualitative Study.

PubMed

Litzkendorf, Svenja; Hartz, Tobias; Göbel, Jens; Storf, Holger; Pauer, Frédéric; Babac, Ana; Lührs, Verena; Bruckner-Tuderman, Leena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Tof; Graf von der Schulenburg, J-Matthias; Frank, Martin

2018-05-11

Recently, public and political interest has focused on people living with rare diseases and their health concerns. Due to the large number of different types of rare diseases and the sizable number of patients, taking action to improve the life of those affected is gaining importance. In 2013, the federal government of Germany adopted a national action plan for rare diseases, including the call to establish a central information portal on rare diseases (Zentrales Informationsportal über seltene Erkrankungen, ZIPSE). The objective of this study, therefore, was to conduct scientific research on how such a portal must be designed to meet the needs of patients, their families, and medical professionals, and to provide high-quality information for information seekers. We chose a 3-step procedure to develop a needs-based prototype of a central information portal. In the first step, we determined the information needs of patients with rare diseases, their relatives, and health care professionals by means of qualitative interviews and their content-analytical evaluation. On the basis of this, we developed the basic structure of the portal. In the second step, we identified quality criteria for websites on rare diseases to ensure that the information linked with ZIPSE meets the quality demands. Therefore, we gathered existing criteria catalogs and discussed them in an expert workshop. In the third step, we implemented and tested the developed prototypical information portal. A portal page was configured and made accessible on the Web. The structure of ZIPSE was based on the findings from 108 qualitative interviews with patients, their relatives, and health care professionals, through which numerous information needs were identified. We placed particularly important areas of information, such as symptoms, therapy, research, and advisory services, on the start page. Moreover, we defined 13 quality criteria, referring to factors such as author information, creation date, and privacy, enabling links with high-quality information. Moreover, 19 users tested all the developed routines based on usability and comprehensibility. Subsequently, we improved the visual presentation of search results and other important search functions. The implemented information portal, ZIPSE, provides high-quality information on rare diseases from a central point of access. By integrating the targeted groups as well as different experts on medical information during the construction, the website can assure an improved search for information for users. ZIPSE can also serve as a model for other Web-based information systems in the field of rare diseases. RR1-10.2196/7425. ©Svenja Litzkendorf, Tobias Hartz, Jens Göbel, Holger Storf, Frédéric Pauer, Ana Babac, Verena Lührs, Leena Bruckner-Tuderman, Franziska Schauer, Jörg Schmidtke, Lisa Biehl, TOF Wagner, J-Matthias Graf von der Schulenburg, Martin Frank. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 11.05.2018.

Pharmaceutical drugs chatter on Online Social Networks.

PubMed

Wiley, Matthew T; Jin, Canghong; Hristidis, Vagelis; Esterling, Kevin M

2014-06-01

The ubiquity of Online Social Networks (OSNs) is creating new sources for healthcare information, particularly in the context of pharmaceutical drugs. We aimed to examine the impact of a given OSN's characteristics on the content of pharmaceutical drug discussions from that OSN. We compared the effect of four distinguishing characteristics from ten different OSNs on the content of their pharmaceutical drug discussions: (1) General versus Health OSN; (2) OSN moderation; (3) OSN registration requirements; and (4) OSNs with a question and answer format. The effects of these characteristics were measured both quantitatively and qualitatively. Our results show that an OSN's characteristics indeed affect the content of its discussions. Based on their information needs, healthcare providers may use our findings to pick the right OSNs or to advise patients regarding their needs. Our results may also guide the creation of new and more effective domain-specific health OSNs. Further, future researchers of online healthcare content in OSNs may find our results informative while choosing OSNs as data sources. We reported several findings about the impact of OSN characteristics on the content of pharmaceutical drug discussion, and synthesized these findings into actionable items for both healthcare providers and future researchers of healthcare discussions on OSNs. Future research on the impact of OSN characteristics could include user demographics, quality and safety of information, and efficacy of OSN usage. Copyright © 2014 Elsevier Inc. All rights reserved.

Applying user-generated quality criteria to develop an Internet intervention for patients with heart disease.

PubMed

Kerr, Cicely; Murray, Elizabeth; Burns, Jo; Turner, Indra; Westwood, Mark A; Macadam, Catherine; Nazareth, Irwin; Patterson, David

2008-01-01

Internet interventions can help people to self-manage chronic disease. However, they are only likely to be used if they meet patients' perceived needs. We have developed an Internet intervention in two stages to meet the needs of patients with coronary heart disease (CHD). First, user-generated criteria were applied to an existing US-based intervention called 'CHESS Living with Heart Disease' which provides information, emotional and social support, self-assessment and monitoring tools, and behavioural change support. This identified the development work required. Then we conducted a user evaluation with a panel of five patients with CHD. Overall, users generally made positive comments about the information content. However they were critical of presentation, ease of navigation through the content, understanding what was offered in the different services and finding the information they were after. Applying user-generated quality criteria proved useful in developing an intervention to meet the needs of UK patients with CHD.

Multisource data fusion for documenting archaeological sites

NASA Astrophysics Data System (ADS)

Knyaz, Vladimir; Chibunichev, Alexander; Zhuravlev, Denis

2017-10-01

The quality of archaeological sites documenting is of great importance for cultural heritage preserving and investigating. The progress in developing new techniques and systems for data acquisition and processing creates an excellent basis for achieving a new quality of archaeological sites documenting and visualization. archaeological data has some specific features which have to be taken into account when acquiring, processing and managing. First of all, it is a needed to gather as full as possible information about findings providing no loss of information and no damage to artifacts. Remote sensing technologies are the most adequate and powerful means which satisfy this requirement. An approach to archaeological data acquiring and fusion based on remote sensing is proposed. It combines a set of photogrammetric techniques for obtaining geometrical and visual information at different scales and detailing and a pipeline for archaeological data documenting, structuring, fusion, and analysis. The proposed approach is applied for documenting of Bosporus archaeological expedition of Russian State Historical Museum.

Extracting information from the text of electronic medical records to improve case detection: a systematic review

PubMed Central

Carroll, John A; Smith, Helen E; Scott, Donia; Cassell, Jackie A

2016-01-01

Background Electronic medical records (EMRs) are revolutionizing health-related research. One key issue for study quality is the accurate identification of patients with the condition of interest. Information in EMRs can be entered as structured codes or unstructured free text. The majority of research studies have used only coded parts of EMRs for case-detection, which may bias findings, miss cases, and reduce study quality. This review examines whether incorporating information from text into case-detection algorithms can improve research quality. Methods A systematic search returned 9659 papers, 67 of which reported on the extraction of information from free text of EMRs with the stated purpose of detecting cases of a named clinical condition. Methods for extracting information from text and the technical accuracy of case-detection algorithms were reviewed. Results Studies mainly used US hospital-based EMRs, and extracted information from text for 41 conditions using keyword searches, rule-based algorithms, and machine learning methods. There was no clear difference in case-detection algorithm accuracy between rule-based and machine learning methods of extraction. Inclusion of information from text resulted in a significant improvement in algorithm sensitivity and area under the receiver operating characteristic in comparison to codes alone (median sensitivity 78% (codes + text) vs 62% (codes), P = .03; median area under the receiver operating characteristic 95% (codes + text) vs 88% (codes), P = .025). Conclusions Text in EMRs is accessible, especially with open source information extraction algorithms, and significantly improves case detection when combined with codes. More harmonization of reporting within EMR studies is needed, particularly standardized reporting of algorithm accuracy metrics like positive predictive value (precision) and sensitivity (recall). PMID:26911811

How evidence-based is the information on the internet about nausea and vomiting of pregnancy?

PubMed

Sacks, Samantha; Abenhaim, Haim A

2013-08-01

The Internet has become an important source of information about pregnancy and about health related concerns in general. This study assessed the quality of information available on the Internet for the common problem of nausea and vomiting of pregnancy (NVP). We used three search terms, "nausea and vomiting in pregnancy," "morning sickness," and "hyperemesis gravidarum," to identify the most popular sites as rated by Google. With modifications of previously described tools, the quality of the websites was rated in three categories: accountability using the Silberg criteria, presentation using a modified Abbott's score, and readability using the Flesch-Kincaid grade level score. Subsequently the information on the websites was compared with the SOGC guideline on management of NVP. We identified 24 unique websites as most popular. The overall scores for accountability indicated poor quality, with only 25% of the websites meeting the required criteria and less than one half of the sites indicating authorship and credentials. Esthetic appeal criteria were met in over 75% of the websites. The readability score of the websites was significantly above the score recommended for the general population, with an average Flesch-Kincaid Grade level score of 10.7 (max = 12). Eighty-seven percent of the websites contained accurate, evidence-based recommendations according to the information provided in the SOGC clinical practice guideline on management of NVP. Overall, the majority of information available online is accurate; however, the web pages demonstrated poor accountability and targeted an audience with a higher reading ability than the general population. Consideration of these findings would help create easy to navigate, credible web pages containing information to help women make informed decisions during pregnancy.

What patients' complaints and praise tell the health practitioner: implications for health care quality. A qualitative research study.

PubMed

Mattarozzi, Katia; Sfrisi, Fiamma; Caniglia, Filippo; De Palma, Alessandra; Martoni, Monica

2017-02-01

In order to identify which health care aspects play a role in patient satisfaction and quality of health care, the present study analyses a large number of instances of complaint and praise. One thousand two hundred and thirty-five instances of complaint and one thousand five hundred thirty-six of praise submitted from patients or other souces (i.e. a patient's family member or a legal representative) to a northern-Italian hospital were analysed. We adopted Reader and colleagues' (2014) patients' complaint taxonomy, in conjunction with a detailed content analysis of relationship and communication of information aspects. The most frequent causes of complaint concerned care system management (68.1%), particularly the time taken to access treatment, and relationship aspects (52.8%). The importance of relationship aspects was confirmed by the expression of gratitude through praise (89%). The most critical factor of the relationship domain was effective communication of information to the patient (39.3%). Frequently patients complained of: (i) having received information that was inconsistent with the truth, (ii) having had difficulty in obtaining information, and (iii) untimely communication of information. Clinical aspects did not seem to be the main factors that triggered a complaint (36,8%), and, when indicated, they were almost always associated with relationship issues. This study indicates that not only complaints, but also instances of praise, are a potentially important source of information regarding health care aspects that play a role in patient satisfaction and quality of care. Our findings underline the relevance of relationship aspects in determining patients' satisfaction with the care received. In particular, health practitioners should focus their attention on how information is understood, translated and applied by patients. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Protocol-developing meta-ethnography reporting guidelines (eMERGe).

PubMed

France, E F; Ring, N; Noyes, J; Maxwell, M; Jepson, R; Duncan, E; Turley, R; Jones, D; Uny, I

2015-11-25

Designing and implementing high-quality health care services and interventions requires robustly synthesised evidence. Syntheses of qualitative research studies can provide evidence of patients' experiences of health conditions; intervention feasibility, appropriateness and acceptability to patients; and advance understanding of health care issues. The unique, interpretive, theory-based meta-ethnography synthesis approach is suited to conveying patients' views and developing theory to inform service design and delivery. However, meta-ethnography reporting is often poor quality, which discourages trust in, and use of, meta-ethnography findings. Users of evidence syntheses require reports that clearly articulate analytical processes and findings. Tailored research reporting guidelines can raise reporting standards but none exists for meta-ethnography. This study aims to create an evidence-based meta-ethnography reporting guideline articulating the methodological standards and depth of reporting required to improve reporting quality. The mixed-methods design of this National Institute of Health Research-funded study (http://www.stir.ac.uk/emerge/) follows good practice in research reporting guideline development comprising: (1) a methodological systematic review (PROSPERO registration: CRD42015024709) to identify recommendations and guidance in conducting/reporting meta-ethnography; (2) a review and audit of published meta-ethnographies to identify good practice principles and develop standards in conduct/reporting; (3) an online workshop and Delphi studies to agree guideline content with 45 international qualitative synthesis experts and 45 other stakeholders including patients; (4) development and wide dissemination of the guideline and its accompanying detailed explanatory document, a report template for National Institute of Health Research commissioned meta-ethnographies, and training materials on guideline use. Meta-ethnography, devised in the field of education, is now used widely in other disciplines. Methodological advances relevant to meta-ethnography conduct exist. The extent of discipline-specific adaptations of meta-ethnography and the fit of any adaptions with the underpinning philosophy of meta-ethnography require investigation. Well-reported meta-ethnography findings could inform clinical decision-making. A bespoke meta-ethnography reporting guideline is needed to improve reporting quality, but to be effective potential users must know it exists, trust it and use it. Therefore, a rigorous study has been designed to develop and promote a guideline. By raising reporting quality, the guideline will maximise the likelihood that high-quality meta-ethnographies will contribute robust evidence to improve health care and patient outcomes.

Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review

PubMed Central

2017-01-01

Background With online health information becoming increasingly popular among patients, concerns have been raised about the impact of patients’ Internet health information-seeking behavior on their relationship with physicians. Therefore, it is pertinent to understand the influence of online health information on the patient-physician relationship. Objective Our objective was to systematically review existing research on patients’ Internet health information seeking and its influence on the patient-physician relationship. Methods We systematically searched PubMed and key medical informatics, information systems, and communication science journals covering the period of 2000 to 2015. Empirical articles that were in English were included. We analyzed the content covering themes in 2 broad categories: factors affecting patients’ discussion of online findings during consultations and implications for the patient-physician relationship. Results We identified 18 articles that met the inclusion criteria and the quality requirement for the review. The articles revealed barriers, facilitators, and demographic factors that influence patients’ disclosure of online health information during consultations and the different mechanisms patients use to reveal these findings. Our review also showed the mechanisms in which online information could influence patients’ relationship with their physicians. Conclusions Results of this review contribute to the understanding of the patient-physician relationship of Internet-informed patients. Our main findings show that Internet health information seeking can improve the patient-physician relationship depending on whether the patient discusses the information with the physician and on their prior relationship. As patients have better access to health information through the Internet and expect to be more engaged in health decision making, traditional models of the patient-provider relationship and communication strategies must be revisited to adapt to this changing demographic. PMID:28104579

Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review.

PubMed

Tan, Sharon Swee-Lin; Goonawardene, Nadee

2017-01-19

With online health information becoming increasingly popular among patients, concerns have been raised about the impact of patients' Internet health information-seeking behavior on their relationship with physicians. Therefore, it is pertinent to understand the influence of online health information on the patient-physician relationship. Our objective was to systematically review existing research on patients' Internet health information seeking and its influence on the patient-physician relationship. We systematically searched PubMed and key medical informatics, information systems, and communication science journals covering the period of 2000 to 2015. Empirical articles that were in English were included. We analyzed the content covering themes in 2 broad categories: factors affecting patients' discussion of online findings during consultations and implications for the patient-physician relationship. We identified 18 articles that met the inclusion criteria and the quality requirement for the review. The articles revealed barriers, facilitators, and demographic factors that influence patients' disclosure of online health information during consultations and the different mechanisms patients use to reveal these findings. Our review also showed the mechanisms in which online information could influence patients' relationship with their physicians. Results of this review contribute to the understanding of the patient-physician relationship of Internet-informed patients. Our main findings show that Internet health information seeking can improve the patient-physician relationship depending on whether the patient discusses the information with the physician and on their prior relationship. As patients have better access to health information through the Internet and expect to be more engaged in health decision making, traditional models of the patient-provider relationship and communication strategies must be revisited to adapt to this changing demographic. ©Sharon Swee-Lin Tan, Nadee Goonawardene. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.01.2017.

Evidence based post graduate training. A systematic review of reviews based on the WFME quality framework

PubMed Central

2011-01-01

Background A framework for high quality in post graduate training has been defined by the World Federation of Medical Education (WFME). The objective of this paper is to perform a systematic review of reviews to find current evidence regarding aspects of quality of post graduate training and to organise the results following the 9 areas of the WFME framework. Methods The systematic literature review was conducted in 2009 in Medline Ovid, EMBASE, ERIC and RDRB databases from 1995 onward. The reviews were selected by two independent researchers and a quality appraisal was based on the SIGN tool. Results 31 reviews met inclusion criteria. The majority of the reviews provided information about the training process (WFME area 2), the assessment of trainees (WFME area 3) and the trainees (WFME area 4). One review covered the area 8 'governance and administration'. No review was found in relation to the mission and outcomes, the evaluation of the training process and the continuous renewal (respectively areas 1, 7 and 9 of the WFME framework). Conclusions The majority of the reviews provided information about the training process, the assessment of trainees and the trainees. Indicators used for quality assessment purposes of post graduate training should be based on this evidence but further research is needed for some areas in particular to assess the quality of the training process. PMID:21977898

Comparison of patients' assessments of the quality of stroke care with audit findings.

PubMed

Howell, Esther; Graham, Chris; Hoffman, A; Lowe, D; McKevitt, Christopher; Reeves, Rachel; Rudd, A G

2007-12-01

To determine the extent of correlation between stroke patients' experiences of hospital care with the quality of services assessed in a national audit. Patients' assessments of their care derived from survey data were linked to data obtained in the National Sentinel Stroke Audit 2004 for 670 patients in 51 English NHS trusts. A measure of patients' experience of hospital stroke care was derived by summing responses to 31 survey items and grouping these into three broad concept domains: quality of care; information; and relationships with staff. Audit data were extracted from hospital admissions data and management information to assess the organisation of services, and obtained retrospectively from patient records to evaluate the delivery of care. Patient survey responses were compared with audit measures of organisation of care and compliance with clinical process standards. Patient experience scores were positively correlated with clinicians' assessment of the organisational quality of stroke care, but were largely unrelated to clinical process standards. Responses to individual questions regarding communication about diagnosis revealed a discrepancy between clinicians' and patients' reports. Better organised stroke care is associated with more positive patient experiences. Examining areas of disparity between patients' and clinicians' reports is important for understanding the complex nature of healthcare and for identifying areas for quality improvement. Future evaluations of the quality of stroke services should include a validated patient experience survey in addition to audit of clinical records.

Medicare's Hospital Compare quality reports appear to have slowed price increases for two major procedures.

PubMed

Dor, Avi; Encinosa, William E; Carey, Kathleen

2015-01-01

Previous research has found that Hospital Compare, Medicare's public reporting initiative, has had little impact on patient outcomes. However, little is known about the initiative's impact on hospital prices, which may be significant because private insurers are generally well positioned to respond to quality information when negotiating prices with hospitals. We estimated difference-in-differences models of the effects of Hospital Compare quality reporting on transaction prices for two major cardiac procedures, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). States that had mandated their own public reporting systems before the implementation of Hospital Compare formed the control group. We found that prices for these procedures continued to increase overall after the initiation of Hospital Compare quality scores, but the rate of increase was significantly lower in states with no quality reporting metrics of their own before Hospital Compare, when compared to the control states (annual rates of increase of 4.4 percent versus 8.7 percent for PCI, and 3.9 percent versus 10.6 percent for CABG, adjusted for overall inflation). This finding implies that Hospital Compare provided leverage to purchasers in moderating price increases, while adding competitive pressures on hospitals. Providing accurate quality information on both hospitals and health plans could benefit consumers. Project HOPE—The People-to-People Health Foundation, Inc.

Identifying key hospital service quality factors in online health communities.

PubMed

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

2015-04-07

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

The importance of knowledge-based technology.

PubMed

Cipriano, Pamela F

2012-01-01

Nurse executives are responsible for a workforce that can provide safer and more efficient care in a complex sociotechnical environment. National quality priorities rely on technologies to provide data collection, share information, and leverage analytic capabilities to interpret findings and inform approaches to care that will achieve better outcomes. As a key steward for quality, the nurse executive exercises leadership to provide the infrastructure to build and manage nursing knowledge and instill accountability for following evidence-based practices. These actions contribute to a learning health system where new knowledge is captured as a by-product of care delivery enabled by knowledge-based electronic systems. The learning health system also relies on rigorous scientific evidence embedded into practice at the point of care. The nurse executive optimizes use of knowledge-based technologies, integrated throughout the organization, that have the capacity to help transform health care.

Quality of Pharmaceutical Advertisements in Medical Journals: A Systematic Review

PubMed Central

Othman, Noordin; Vitry, Agnes; Roughead, Elizabeth E.

2009-01-01

Background Journal advertising is one of the main sources of medicines information to doctors. Despite the availability of regulations and controls of drug promotion worldwide, information on medicines provided in journal advertising has been criticized in several studies for being of poor quality. However, no attempt has been made to systematically summarise this body of research. We designed this systematic review to assess all studies that have examined the quality of pharmaceutical advertisements for prescription products in medical and pharmacy journals. Methods and Findings Studies were identified via searching electronic databases, web library, search engine and reviewing citations (1950 – February 2006). Only articles published in English and examined the quality of information included in pharmaceutical advertisements for prescription products in medical or pharmacy journals were included. For each eligible article, a researcher independently extracted the data on the study methodology and outcomes. The data were then reviewed by a second researcher. Any disagreements were resolved by consensus. The data were analysed descriptively. The final analysis included 24 articles. The studies reviewed advertisements from 26 countries. The number of journals surveyed in each study ranged from four to 24 journals. Several outcome measures were examined including references and claims provided in advertisements, availability of product information, adherence to codes or guidelines and presentation of risk results. The majority of studies employed a convenience-sampling method. Brand name, generic name and indications were usually provided. Journal articles were commonly cited to support pharmaceutical claims. Less than 67% of the claims were supported by a systematic review, a meta-analysis or a randomised control trial. Studies that assessed misleading claims had at least one advertisement with a misleading claim. Two studies found that less than 28% of claims were unambiguous clinical claims. Most advertisements with quantitative information provided risk results as relative risk reduction. Studies were conducted in 26 countries only and then the generalizability of the results is limited. Conclusions Evidence from this review indicates that low quality of journal advertising is a global issue. As information provided in journal advertising has the potential to change doctors' prescribing behaviour, ongoing efforts to increase education about drug promotion are crucial. The results from our review suggest the need for a global pro-active and effective regulatory system to ensure that information provided in medical journal advertising is supporting the quality use of medicines. PMID:19623259

Gaining customer knowledge: obtaining and using customer judgments for hospitalwide quality improvement.

PubMed

Nelson, E C; Caldwell, C; Quinn, D; Rose, R

1991-03-01

Customer knowledge is an essential feature of hospitalwide quality improvement. All systems and processes have customers. The aim is to use customer knowledge and voice of the customer measurement to plan, design, improve, and monitor these systems and processes continuously. In this way, the hospital stands the best chance of meeting customers' needs and, hopefully, delivering services that are so outstanding that customers will be surprised and delighted. There are many methods, both soft and hard, that can be used to increase customer knowledge. One useful strategy is to use a family of quality measures that reflect the voice of the customer. These measures can generate practical and powerful customer knowledge information that is essential to performing strategic planning, deploying quality policy, designing new services, finding targets for improvements, and monitoring those continuous improvements based on customers' judgments.

Quality assessment of persian mental disorders websites using the webmedqual scale.

PubMed

Shahrzadi, Leila; Mojiri, Shahin; Janatian, Sima; Taheri, Behjat; Ashrafi-Rizi, Hasan; Shahrzadi, Zeinab; Zahedi, Razieh

2014-06-01

Nowadays, anyone with any level of Internet knowledge can act as producer and distributor of information. It differs from most traditional media of information transmission, lack of information control and lack of quality management to contents. This leads to quality of health information on the internet is doubtful. The object of this study is guidance patients to select valid mental disorders and determine the quality of Persian mental disorders websites. The sample of this study comprised 29 Persian mental disorders websites that were chosen by searching the Google, Yahoo and AltaVista search engines for the Persian equivalents of the three concepts "depression," "anxiety," and "obsession". website was created by individuals or organizations. Data collection was performed with the WebMedQual checklist. Websites was assessed based on indicators as content, authority of source, design, accessibility and availability, links, user support, and confidentiality and privacy (Maximum score for any website was 83, mean score 41.5 and minimum score was 0). Collected data analyzed by one sample T- test in SPSS 20. Findings presented by Mean score and optimal score. Based on the WebMedQual scale the mean score of Persian mental disorders websites in sex constructs including "content" (7.02±2.10), "authority of source" (4.71±1.96),"accessibility and availability" (2.19±0.47), "links" (1.45±0.97), "user support" (4.28±1.33), and"confidentiality and privacy" (2.81±2.81) are poor and below average, but the score for the "design" (9.17± 1.59) is above average. The best website of mental disorders was that of the "IranianPsychological Association". According to the results, only one website obtained the average score, so the quality of Persian mental disorders websites is low. Therefore, it is essential for users to criticize websites' content and not trust them before evaluating them. It is better to use the ranked list websites or search on the internet by help information experts.

DOE Advanced Scientific Computing Advisory Committee (ASCAC) Subcommittee Report on Scientific and Technical Information

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hey, Tony; Agarwal, Deborah; Borgman, Christine

The Advanced Scientific Computing Advisory Committee (ASCAC) was charged to form a standing subcommittee to review the Department of Energy’s Office of Scientific and Technical Information (OSTI) and to begin by assessing the quality and effectiveness of OSTI’s recent and current products and services and to comment on its mission and future directions in the rapidly changing environment for scientific publication and data. The Committee met with OSTI staff and reviewed available products, services and other materials. This report summaries their initial findings and recommendations.

Effective radiology dashboards: key research findings.

PubMed

Karami, Mahtab; Safdari, Reza; Rahimi, Azin

2013-01-01

Innovative organizations have access to information for business intelligence through the objectives displayed in dashboards. In healthcare organizations, where the goal is to improve quality of care along with reducing costs, the radiology department is important from both financial and clinical aspects. Therefore, how to manage this department has critical impact on the effectiveness and efficiency of the organization. Today, since the information in this department not only has different data structure but also is gathered from different data sources, a well defined, comprehensive dashboard can be an effective tool to enhance performance.

Hidden profiles and concealed information: strategic information sharing and use in group decision making.

PubMed

Toma, Claudia; Butera, Fabrizio

2009-06-01

Two experiments investigated the differential impact of cooperation and competition on strategic information sharing and use in a three-person group decision-making task. Information was distributed in order to create a hidden profile so that disconfirmation of group members' initial preferences was required to solve the task. Experiment 1 revealed that competition, compared to cooperation, led group members to withhold unshared information, a difference that was not significant for shared information. In competition, compared to cooperation, group members were also more reluctant to disconfirm their initial preferences. Decision quality was lower in competition than in cooperation, this effect being mediated by disconfirmation use and not by information sharing. Experiment 2 replicated these findings and revealed the role of mistrust in predicting strategic information sharing and use in competition. These results support a motivated information processing approach of group decision making.

Agriculture — A river runs through it — The connections between agriculture and water quality

USGS Publications Warehouse

Capel, Paul D.; McCarthy, Kathleen A.; Coupe, Richard H.; Grey, Katia M.; Amenumey, Sheila E.; Baker, Nancy T.; Johnson, Richard L.

2018-06-06

Sustaining the quality of the Nation’s water resources and the health of our diverse ecosystems depends on the availability of sound water-resources data and information to develop effective, science-based policies. Effective management of water resources also brings more certainty and efficiency to important economic sectors. Taken together, these actions lead to immediate and longterm economic, social, and environmental benefits that make a difference to the lives of the almost 400 million people projected to live in the United States by 2050.In 1991, Congress established the U.S. Geological Survey National Water-Quality Assessment (NAWQA) to address where, when, why, and how the Nation’s water quality has changed, or is likely to change in the future, in response to human activities and natural factors. Since then, NAWQA has been a leading source of scientific data and knowledge used by national, regional, state, and local agencies to develop science-based policies and management strategies to improve and protect water resources used for drinking water, recreation, irrigation, energy development, and ecosystem needs. Plans for the third decade of NAWQA (2013–23) address priority water-quality issues and science needs identified by NAWQA stakeholders, such as the Advisory Committee on Water Information and the National Research Council, and are designed to meet increasing challenges related to population growth, increasing needs for clean water, and changing land-use and weather patterns.This report is one of a series of publications, The Quality of Our Nation’s Waters, which describes major findings of the NAWQA Project on water-quality issues of regional and national concern and provides science-based information for assessing and managing the quality of our groundwater resources. Other reports in this series focus on occurrence and distribution of nutrients, pesticides, and volatile organic compounds in streams and groundwater, the effects of contaminants and stream-flow alteration on the condition of aquatic communities in streams, and on the quality of groundwater from private domestic and public supply wells. Each reports builds toward a more comprehensive understanding of the quality of regional and national water resources. All NAWQA reports are available online (https://water.usgs.gov/nawqa/bib/).We hope this publication will provide you with insights and information to meet your water-resource needs and will foster increased citizen awareness and involvement in the protection and restoration of our Nation’s waters. The information in this report is intended primarily for those interested or involved in resource management and protection, conservation, regulation, and policymaking at the regional and national levels.

Social support mediates the association between benefit finding and quality of life in caregivers.

PubMed

Brand, Charles; Barry, Lorna; Gallagher, Stephen

2016-06-01

The psychosocial pathways underlying associations between benefit finding and quality of life are poorly understood. Here, we examined associations between benefit finding, social support, optimism and quality of life in a sample of 84 caregivers. Results revealed that quality of life was predicted by benefit finding, optimism and social support. Moreover, the association between benefit finding and quality of life was explained by social support, but not optimism; caregivers who reported greater benefit finding perceived their social support be higher and this, in turn, had a positive effect on their overall quality of life. These results underscore the importance of harnessing benefit finding to enhance caregiver quality of life. © The Author(s) 2014.

Assessment of the iodine concentration in table salt at the production stage in South Africa.

PubMed Central

Jooste, Pieter L.

2003-01-01

OBJECTIVE: To determine the iodine content of iodized salt at the production stage, to assess the perceptions and knowledge of salt producers about the prevention and control of iodine deficiency, and to examine the internal quality control procedures used during iodization in South Africa. METHOD: Salt samples were collected for iodine analysis by titration from the 12 producers iodizing salt in South Africa. Information on the producers' knowledge of iodine deficiency disorders and on internal quality control was obtained by means of questionnaires. FINDINGS: The legal requirement of 40-60 ppm iodine was met in 30.9% of salt samples; 57.9% contained more than 30 ppm iodine; 34.8% contained under 20 ppm iodine. There were shortcomings in perceptions and knowledge about iodine deficiency disorders and in the internal quality control procedures of a substantial proportion of the producers. CONCLUSION: In order to encourage and support salt producers to achieve optimal iodization there should be an information, education and communication strategy aimed at improving knowledge of iodine deficiency disorders and at raising the standard of internal quality control procedures. External monitoring should continue. PMID:12973644

Sense of community, organizational commitment and quality of services.

PubMed

Lampinen, Mai-Stiina; Suutala, ElinaAnnikki; Konu, Anne Irmeli

2017-10-02

Purpose The purpose of this paper is to examine how factors associated with a sense of community in the workplace are connected with organizational commitment and the quality of services among frontline managers and middle managers in social and health care services in Finland. Design/methodology/approach A questionnaire designed specifically for this research was sent to 241 lower-level and middle-level managers in social and health care services in central Finland. A total of 136 managers completed the questionnaire (response rate 56 per cent). The results were analyzed using descriptive statistics, exploratory factor analysis, Spearman's rank-order correlation coefficient and multiple linear regression analyses. Findings The study showed that feeling a sense of belonging, mutual trust and appreciation, and open interaction among colleagues were connected to organizational commitment for frontline managers and middle managers in social and health care services in Finland. Correspondingly, an open flow of information in the organization, job meaningfulness and appreciation received from managers' superiors were connected to the quality of services. Originality/value This study provides information on the factors that influence social and health care managers' organizational commitment and on items connected to their experience of the quality of services.

Gap analysis: synergies and opportunities for effective nursing leadership.

PubMed

Davis-Ajami, Mary Lynn; Costa, Linda; Kulik, Susan

2014-01-01

Gap analysis encompasses a comprehensive process to identify, understand, address, and bridge gaps in service delivery and nursing practice. onducting gap analysis provides structure to information gathering and the process of finding sustainable solutions to important deficiencies. Nursing leaders need to recognize, measure, monitor, and execute on feasible actionable solutions to help organizations make adjustments to address gaps between what is desired and the actual real-world conditions contributing to the quality chasm in health care. Gap analysis represents a functional and comprehensive tool to address organizational deficiencies. Using gap analysis proactively helps organizations map out and sustain corrective efforts to close the quality chasm. Gaining facility in gap analysis should help the nursing profession's contribution to narrowing the quality chasm.

Epitaxial growth of single-orientation high-quality MoS2 monolayers

NASA Astrophysics Data System (ADS)

Bana, Harsh; Travaglia, Elisabetta; Bignardi, Luca; Lacovig, Paolo; Sanders, Charlotte E.; Dendzik, Maciej; Michiardi, Matteo; Bianchi, Marco; Lizzit, Daniel; Presel, Francesco; De Angelis, Dario; Apostol, Nicoleta; Das, Pranab Kumar; Fujii, Jun; Vobornik, Ivana; Larciprete, Rosanna; Baraldi, Alessandro; Hofmann, Philip; Lizzit, Silvano

2018-07-01

We present a study on the growth and characterization of high-quality single-layer MoS2 with a single orientation, i.e. without the presence of mirror domains. This single orientation of the MoS2 layer is established by means of x-ray photoelectron diffraction. The high quality is evidenced by combining scanning tunneling microscopy with x-ray photoelectron spectroscopy measurements. Spin- and angle-resolved photoemission experiments performed on the sample revealed complete spin-polarization of the valence band states near the K and -K points of the Brillouin zone. These findings open up the possibility to exploit the spin and valley degrees of freedom for encoding and processing information in devices that are based on epitaxially grown materials.

A Survey of Current Valued Academic Leadership Qualities in Nursing.

PubMed

Delgado, Cheryl; Mitchell, Maureen M

2016-01-01

An informal survey was used to identify nurse faculty leadership qualities currently valued and relevant. The accelerating retirement rate for seasoned leaders has created a need for nurse educators and academic leaders. Our school was concerned that we were not meeting students' needs for today's leadership challenges. We were also interested in the experiences of leadership preparation. This was a cross-sectional, online survey of faculty at top nursing schools as determined by US News & World Report. The top leadership qualities identified were integrity, communication clarity, and problem-solving ability. Current challenges for leaders were finding qualified faculty, obtaining resources, and team building. The results may guide curricular adjustments and the transition to a new generation of nurse academic leaders.

Recent research on the management of hemlock-spruce forests in southeast Alaska for multiple values.

Treesearch

Michael H. McClellan

2005-01-01

This is a review of research findings from silvicultural studies that addressed information needs identified during the revision of the Tongass National Forest land management plan. A central concern of resource managers is balancing tradeoffs among habitat concerns, wood production, wood-product quality, and operability on the Tongass. This paper provides a historical...

The development of guidelines for drug and alcohol dependence treatment: affecting policy and practice.

PubMed

Heather, N; Mattick, R P

1994-01-01

The rationale and methodology behind the Australian Quality Assurance Project is described. The Project aimed to develop guidelines for treatment content based on three sources of information: research findings, current practice and expert opinion. The issue of the gap between research and practice is discussed, as well as the role of dissemination in altering clinician behaviour.

Employee empowerment through team building and use of process control methods.

PubMed

Willems, S

1998-02-01

The article examines the use of statistical process control and performance improvement techniques in employee empowerment. The focus is how these techniques provide employees with information to improve their productivity and become involved in the decision-making process. Findings suggest that at one Mississippi hospital employee improvement has had a positive effect on employee productivity, morale, and quality of work.

Tapping the Principal Pipeline: Identifying Talent for Future School Leadership in the Absence of Formal Succession Management Programs

ERIC Educational Resources Information Center

Myung, Jeannie; Loeb, Susanna; Horng, Eileen

2011-01-01

Purpose: In light of the difficulty many districts face finding quality principal candidates, this article explores an informal recruitment mechanism of teachers to become principals, which the authors call tapping. The authors assess the extent to which current teachers are being approached by school leaders to consider leadership and whether…

Collaboration among Faculty Members and Community Partners: Increasing the Quality of Online Library and Information Science Graduate Programs through Academic Service-Learning

ERIC Educational Resources Information Center

Angel, Christine M.

2016-01-01

Finding innovative ways to deliver effective classroom instruction resulting in demonstration of student proficiency of the eight American Library Association core competencies within the online learning environment is challenging. While the use of technology is very important in the delivery of course content, focusing on the pedagogy of teaching…

Elucidating the Mechanisms of the Tomato ovate Mutation in Regulating Fruit Quality Using Proteomics Analysis.

PubMed

Liu, Juhua; Zhang, Jing; Miao, Hongxia; Jia, Caihong; Wang, Jingyi; Xu, Biyu; Jin, Zhiqiang

2017-11-22

The ovate mutation has frequently been used to study changes in fruit shape but not fruit quality. A deterioration in fruit quality associated with the ovate mutation was discovered in this study. To elucidate how ovate influences the quality of fruit, we performed a proteomics analysis of the fruits of the ovate mutant (LA3543) and wild-type ("Ailsa Craig", LA2838A) using tandem mass tag analysis. The results indicated that the ovate mutation significantly influences fruit quality in a number of ways, including by reducing the expression of 1-aminocyclopropane-1-carboxylic acid oxidase 3 (ACO3) in ethylene biosynthesis, improving firmness by reducing the amount of pectinesterase and polygalacturonase, reducing sugar accumulation by downregulating the abundance of mannan endo-1,4-β-mannosidase 4, β-galactosidase, and β-amylase, and reducing the malic acid content by downregulating the accumulation of malic enzymes and malate synthase. These findings could inform future improvements in fruit quality.

Quality of life, Risk Assessment, and Safety Research in Liver Transplantation: New Frontiers in Health Services and Outcomes Research

PubMed Central

Butt, Zeeshan; Parikh, Neehar D.; Skaro, Anton; Ladner, Daniela; Cella, David

2013-01-01

Purpose of review In this review, we briefly summarize three fruitful, emerging areas in liver transplantation research: quality of life; risk assessment; and patient safety. Our goal is to highlight recent findings in these areas, with a call for increased integration of social scientists and transplant clinicians to address how best to shape policy and improve outcomes. Recent findings After liver transplantation, recipients generally experience clinically significant, sustained improvement in their physical, social and emotional well-being. However, a sizeable minority of patients do experience excess morbidity that may benefit from ongoing surveillance and/or intervention. There is growing body of research that describes risks associated with liver transplantation, which can be useful aids to better inform decision making by patients, clinicians, payers, and policy makers. In contrast, there has been a relative lack of empirical data on transplant patient safety vulnerabilities, placing the field of surgery in stark contrast to other high risk industries, where such assessments inform continuous process improvement. Summary Health services and outcomes research has grown in importance in the liver transplantation literature, but several important questions remain unanswered that merit programmatic, interdisciplinary research. PMID:22476225

The Northeast Stream Quality Assessment

USGS Publications Warehouse

Van Metre, Peter C.; Riva-Murray, Karen; Coles, James F.

2016-04-22

In 2016, the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) is assessing stream quality in the northeastern United States. The goal of the Northeast Stream Quality Assessment (NESQA) is to assess the quality of streams in the region by characterizing multiple water-quality factors that are stressors to aquatic life and evaluating the relation between these stressors and biological communities. The focus of NESQA in 2016 will be on the effects of urbanization and agriculture on stream quality in all or parts of eight states: Connecticut, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont.Findings will provide the public and policymakers with information about the most critical factors affecting stream quality, thus providing insights about possible approaches to protect the health of streams in the region. The NESQA study will be the fourth regional study conducted as part of NAWQA and will be of similar design and scope to the first three, in the Midwest in 2013, the Southeast in 2014, and the Pacific Northwest in 2015 (http://txpub.usgs.gov/RSQA/).

How does the purchasing staff of an accident insurance organization seek information about treatment effectiveness?

PubMed Central

Dwairy, Mai N.; Kendall, Nicholas

2002-01-01

Objectives: The objective is to study how the staff who purchase health care services for a large national government accident-compensation system seek information on treatment effectiveness, how they assess the quality of that information, whether they question the information sources they choose, and how familiar they are with the key concepts of evidence-based health care (EBHC). Method: Staff (22 out of 34) of the health purchasing division of the New Zealand Accident Compensation Corporation (NZ ACC) were interviewed using eight preformatted questions to which they could provide open and multiple answers. Responses were subsequently codified into typologies for quantitative analysis. Results: Most respondents report that they assess the effectiveness of a treatment by accessing published information (nonhuman sources), by consulting others (human sources), or by both means. They assess the quality of information mostly by consulting others, and the second-highest proportion of responses state that they do not know how to evaluate the quality of information. No clear preference emerges with respect to the types of information needed to determine the effectiveness of treatments. The majority of the staff believes they can access information needed to determine treatment effectiveness through the Internet or information databases such as MEDLINE. Although most said they understand the key concepts of EBHC, only five out of twenty-two were able to accurately describe them. Conclusions: The findings suggest that there is a low level of awareness among the staff of the NZ ACC regarding the use of evidence and understanding of the key concepts of EBHC. Many surveyed staff members lack the skills or training to directly question information about effectiveness of a treatment. They have little idea of the information required to determine the effectiveness of a treatment, and the majority appears to lack the skills to evaluate the health care literature. PMID:11999181

Improving Physician Recommendations for Human Papillomavirus Vaccination: The Role of Professional Organizations.

PubMed

Hswen, Yulin; Gilkey, Melissa B; Rimer, Barbara K; Brewer, Noel T

2017-01-01

To address low human papillomavirus (HPV) vaccination coverage, the American Academy of Family Physicians (AAFP) and the American Academy of Pediatrics (AAP) have launched national campaigns encouraging physicians to deliver strong HPV vaccine recommendations. We surveyed family physicians and pediatricians to examine the impact of these efforts on physicians' recommendation practices. A national sample of family physicians and pediatricians (n = 776) completed our online survey in 2014. The survey assessed reach, content, and influence of AAFP and AAP communications about HPV vaccination. The survey also assessed quality of physicians' communication practices for recommending HPV vaccination. Forty-seven percent of family physicians reported receiving information on HPV vaccination from AAFP, whereas 62% of pediatricians reported receiving information from AAP. Among physicians reached by AAFP or AAP, most reported receiving the message to give strong recommendations to adolescent boys (71%) and girls (78%). Although receiving information was not associated with HPV vaccine recommendation quality, receiving the message to give strong recommendations correlated with delivering higher-quality recommendations for boys (odds ratio, 4.19, 95% confidence interval, 2.64-6.64) and girls (odds ratio, 3.15, 95% confidence interval, 1.91-5.18). Over half of physicians reported improving their HPV vaccine communication after receiving information from AAFP (69%) or AAP (53%). Our findings suggest that it is important for AAFP and AAP to communicate the need for strong HPV vaccine recommendations. Given that many physicians reported improving their recommendation practices, professional organizations stand to contribute to increasing HPV vaccination coverage, but they will likely need to increase the intensity of quality improvement efforts to do so.

Parents on the web: risks for quality management of cough in children.

PubMed

Pandolfini, C; Impicciatore, P; Bonati, M

2000-01-01

Health information on the Internet, with respect to common, self-limited childhood illnesses, has been found to be unreliable. Therefore, parents navigating on the Internet risk finding advice that is incomplete or, more importantly, not evidence-based. The importance that a resource such as the Internet as a source of quality health information for consumers should, however, be taken into consideration. For this reason, studies need to be performed regarding the quality of material provided. Various strategies have been proposed that would allow parents to distinguish trustworthy web documents from unreliable ones. One of these strategies is the use of a checklist for the appraisal of web pages based on their technical aspects. The purpose of this study was to assess the quality of information present on the Internet regarding the home management of cough in children and to examine the applicability of a checklist strategy that would allow consumers to select more trustworthy web pages. The Internet was searched for web pages regarding the home treatment of cough in children with the use of different search engines. Medline and the Cochrane database were searched for available evidence concerning the management of cough in children. Three checklists were created to assess different aspects of the web documents. The first checklist was designed to allow for a technical appraisal of the web pages and was based on components such as the name of the author and references used. The second was constructed to examine the completeness of the health information contained in the documents, such as causes and mechanism of cough, and pharmacological and nonpharmacological treatment. The third checklist assessed the quality of the information by measuring it against a gold standard document. This document was created by combining the policy statement issued by the American Academy of Pediatrics regarding the pharmacological treatment of cough in children with the guide of the World Health Organization on drugs for children. For each checklist, the web page contents were analyzed and quantitative measurements were assigned. Of the 19 web pages identified, 9 explained the purpose and/or mechanism of cough and 14 the causes. The most frequently mentioned pharmacological treatments were single-ingredient suppressant preparations, followed by single-ingredient expectorants. Dextromethorphan was the most commonly referred to suppressant and guaifenesin the most common expectorant. No documents discouraged the use of suppressants, although 4 of the 10 web documents that addressed expectorants discouraged their use. Sixteen web pages addressed nonpharmacological treatment, 14 of which suggested exposure to a humid environment and/or extra fluid. In most cases, the criteria in the technical appraisal checklist were not present in the web documents; moreover, 2 web pages did not provide any of the items. Regarding content completeness, 3 web pages satisfied all the requirements considered in the checklist and 2 documents did not meet any of the criteria. Of the 3 web pages that scored highest in technical aspect, 2 also supplied complete information. No relationship was found, however, between the technical aspect and the content completeness. Concerning the quality of the health information supplied, 10 pages received a negative score because they contained more incorrect than correct information, and 1 web page received a high score. This document was 1 of the 2 that also scored high in technical aspect and content completeness. No relationship was found, however, among quality of information, technical aspect, and content completeness. As the results of this study show, a parent navigating the Internet for information on the home management of cough in children will no doubt find incorrect advice among the search results. (ABSTRACT TRUNCATED)

Quality issues with malaria rapid diagnostic test accessories and buffer packaging: findings from a 5-country private sector project in Africa.

PubMed

Harvey, Steven A; Incardona, Sandra; Martin, Nina; Lussiana, Cristina; Streat, Elizabeth; Dolan, Stephanie; Champouillon, Nora; Kyabayinze, Daniel J; Mugerwa, Robert; Nakanwagi, Grace; Njoki, Nancy; Rova, Ratsimandisa; Cunningham, Jane

2017-04-20

Use of antigen-detecting malaria rapid diagnostic tests (RDTs) has increased exponentially over the last decade. WHO's Global Malaria Programme, FIND, and other collaborators have established a quality assurance scheme to guide product selection, lot verification, transport, storage, and training procedures. Recent concerns over the quality of buffer packaging and test accessories suggest a need to include these items in product assessments. This paper describes quality problems with buffer and accessories encountered in a project promoting private sector RDT use in five African countries and suggests steps to avoid or more rapidly identify and resolve such problems. Private provider complaints about RDT buffer vials and kit accessories were collected during supervisory visits, and a standard assessment process was developed. Using 100 tests drawn from six different lots produced by two manufacturers, lab technicians visually assessed alcohol swab packaging, blood transfer device (BTD) usability, and buffer appearance, then calculated mean blood volume from 10 BTD transfers and mean buffer volume from 10 individual buffer vials. WHO guided complaint reporting and follow-up with manufacturers. Supervisory visits confirmed user reports of dry alcohol swabs, poorly functioning BTDs, and non-uniform volumes of buffer. Lot testing revealed further evidence of quality problems, leading one manufacturer to replace buffer vials and accessories for 40,000 RDTs. In December 2014, WHO issued an Information Notice for Users regarding variable buffer volumes in single-use vials and recommended against procurement of these products until defects were addressed. Though not necessarily comprehensive or generalizable, the findings presented here highlight the need for extending quality assessment to all malaria RDT test kit contents. Defects such as those described in this paper could reduce test accuracy and increase probability of invalid, false positive, or false negative results. Such deficiencies could undermine provider confidence in RDTs, prompting a return to presumptive treatment or reliance on poor quality microscopy. In partial response to this experience, WHO, FIND, and other project partners have developed guidance on documenting, troubleshooting, reporting, and resolving such problems when they occur.

Big Data and Heath Impacts of Drinking Water Quality Violation

NASA Astrophysics Data System (ADS)

Allaire, M.; Zheng, S.; Lall, U.

2017-12-01

Health impacts of drinking water quality violations are only understood at a coarse level in the United States. This limits identification of threats to water security in communities across the country. Substantial under-reporting is suspected due to requirements at U.S. public health institutes that water borne illnesses be confirmed by health providers. In the era of `big data', emerging information sources could offer insight into waterborne disease trends. In this study, we explore the use of fine-resolution sales data for over-the-counter medicine to estimate the health impacts of drinking water quality violations. We also demonstrate how unreported water quality issues can be detected by observing market behavior. We match a panel of supermarket sales data for the U.S. at the weekly level with geocoded violations data from 2006-2015. We estimate the change in anti-diarrheal medicine sale due to drinking water violations using a fixed effects model. We find that water quality violations have considerable effects on medicine sales. Sales nearly double due to Tier 1 violations, which pose an immediate health risk, and sales increase 15.1 percent due to violations related to microorganisms. Furthermore, our estimate of diarrheal illness cases associated with water quality violations indicates that the Centers for Disease Control and Prevention (CDC) reporting system may only capture about one percent of diarrheal cases due to impaired water. Incorporating medicine sales data could offer national public health institutes a game-changing way to improve monitoring of disease outbreaks. Since many disease cases are not formally diagnosed by health providers, consumption information could provide additional information to remedy under-reporting issues and improve water security in communities across the United States.

Childhood abuse is associated with stress-related sleep disturbance and poor sleep quality in pregnancy

PubMed Central

Gelaye, Bizu; Kajeepeta, Sandhya; Zhong, Qiu-Yue; Borba, Christina P.C.; Rondon, Marta B.; Sánchez, Sixto E.; Henderson, David C.; Williams, Michelle A.

2015-01-01

Objectives Childhood abuse is associated with increased risks of adult psychiatric disorders and physical health conditions. Accumulating evidence documents associations of childhood abuse with sleep disturbances in adulthood. However, to date, no study has evaluated associations of childhood abuse and sleep disturbances among pregnant women. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding socio-demographic characteristics, history of childhood abuse, and complaints of sleep disturbances. Spanish language version of the Ford Insomnia Response to Stress Test (FIRST-S) and the Pittsburgh Sleep Quality Index (PSQI-S) were used to assess stress-related sleep disturbance and sleep quality, respectively. Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CIs). Results Women who experienced any childhood abuse had a 1.65-fold increased odds of stress-related sleep disturbance (aOR=1.65; 95% CI: 1.15–2.38) and 2.11-fold increased odds of poor sleep quality during early pregnancy (aOR=2.11; 95% CI: 1.35–3.30) as compared with women who reported no abuse. Compared with women who reported no childhood abuse, those who reported both physical and sexual abuse during childhood were more than twice as likely to suffer from stress-related sleep disturbance (aOR=2.26; 95% CI:1.44–3.53) and poor sleep quality (aOR=2.43; 95% CI:1.45–4.09). Conclusions A history of childhood abuse is associated with increased odds of stress-related sleep disturbance and poor sleep quality during pregnancy. These findings, if replicated, should be used to inform the development of trauma-informed care for such sleep disturbances induced by childhood trauma. PMID:26429757

Effects of Contributor Experience on the Quality of Health-Related Wikipedia Articles.

PubMed

Holtz, Peter; Fetahu, Besnik; Kimmerle, Joachim

2018-05-10

Consulting the Internet for health-related information is a common and widespread phenomenon, and Wikipedia is arguably one of the most important resources for health-related information. Therefore, it is relevant to identify factors that have an impact on the quality of health-related Wikipedia articles. In our study we have hypothesized a positive effect of contributor experience on the quality of health-related Wikipedia articles. We mined the edit history of all (as of February 2017) 18,805 articles that were listed in the categories on the portal health & fitness in the English language version of Wikipedia. We identified tags within the articles' edit histories, which indicated potential issues with regard to the respective article's quality or neutrality. Of all of the sampled articles, 99 (99/18,805, 0.53%) articles had at some point received at least one such tag. In our analysis we only considered those articles with a minimum of 10 edits (10,265 articles in total; 96 tagged articles, 0.94%). Additionally, to test our hypothesis, we constructed contributor profiles, where a profile consisted of all the articles edited by a contributor and the corresponding number of edits contributed. We did not differentiate between rollbacks and edits with novel content. Nonparametric Mann-Whitney U-tests indicated a higher number of previously edited articles for editors of the nontagged articles (mean rank tagged 2348.23, mean rank nontagged 5159.29; U=9.25, P<.001). However, we did not find a significant difference for the contributors' total number of edits (mean rank tagged 4872.85, mean rank nontagged 5135.48; U=0.87, P=.39). Using logistic regression analysis with the respective article's number of edits and number of editors as covariates, only the number of edited articles yielded a significant effect on the article's status as tagged versus nontagged (dummy-coded; Nagelkerke R 2 for the full model=.17; B [SE B]=-0.001 [0.00]; Wald c 2 [1]=19.70; P<.001), whereas we again found no significant effect for the mere number of edits (Nagelkerke R 2 for the full model=.15; B [SE B]=0.000 [0.01]; Wald c 2 [1]=0.01; P=.94). Our findings indicate an effect of contributor experience on the quality of health-related Wikipedia articles. However, only the number of previously edited articles was a predictor of the articles' quality but not the mere volume of edits. More research is needed to disentangle the different aspects of contributor experience. We have discussed the implications of our findings with respect to ensuring the quality of health-related information in collaborative knowledge-building platforms. ©Peter Holtz, Besnik Fetahu, Joachim Kimmerle. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 10.05.2018.

Improving data quality across 3 sub-Saharan African countries using the Consolidated Framework for Implementation Research (CFIR): results from the African Health Initiative.

PubMed

Gimbel, Sarah; Mwanza, Moses; Nisingizwe, Marie Paul; Michel, Cathy; Hirschhorn, Lisa

2017-12-21

High-quality data are critical to inform, monitor and manage health programs. Over the seven-year African Health Initiative of the Doris Duke Charitable Foundation, three of the five Population Health Implementation and Training (PHIT) partnership projects in Mozambique, Rwanda, and Zambia introduced strategies to improve the quality and evaluation of routinely-collected data at the primary health care level, and stimulate its use in evidence-based decision-making. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this paper: 1) describes and categorizes data quality assessment and improvement activities of the projects, and 2) identifies core intervention components and implementation strategy adaptations introduced to improve data quality in each setting. The CFIR was adapted through a qualitative theme reduction process involving discussions with key informants from each project, who identified two domains and ten constructs most relevant to the study aim of describing and comparing each country's data quality assessment approach and implementation process. Data were collected on each project's data quality improvement strategies, activities implemented, and results via a semi-structured questionnaire with closed and open-ended items administered to health management information systems leads in each country, with complementary data abstraction from project reports. Across the three projects, intervention components that aligned with user priorities and government systems were perceived to be relatively advantageous, and more readily adapted and adopted. Activities that both assessed and improved data quality (including data quality assessments, mentorship and supportive supervision, establishment and/or strengthening of electronic medical record systems), received higher ranking scores from respondents. Our findings suggest that, at a minimum, successful data quality improvement efforts should include routine audits linked to ongoing, on-the-job mentoring at the point of service. This pairing of interventions engages health workers in data collection, cleaning, and analysis of real-world data, and thus provides important skills building with on-site mentoring. The effect of these core components is strengthened by performance review meetings that unify multiple health system levels (provincial, district, facility, and community) to assess data quality, highlight areas of weakness, and plan improvements.

Ensuring and Improving Information Quality for Earth Science Data and Products Role of the ESIP Information Quality Cluster

NASA Technical Reports Server (NTRS)

Ramapriyan, H. K. (Rama); Peng, Ge; Moroni, David; Shie, Chung-Lin

2016-01-01

Quality of products is always of concern to users regardless of the type of products. The focus of this paper is on the quality of Earth science data products. There are four different aspects of quality scientific, product, stewardship and service. All these aspects taken together constitute Information Quality. With increasing requirement on ensuring and improving information quality, there has been considerable work related to information quality during the last several years. Given this rich background of prior work, the Information Quality Cluster (IQC), established within the Federation of Earth Science Information Partners (ESIP) has been active with membership from multiple organizations. Its objectives and activities, aimed at ensuring and improving information quality for Earth science data and products, are discussed briefly.

Ensuring and Improving Information Quality for Earth Science Data and Products: Role of the ESIP Information Quality Cluster

NASA Technical Reports Server (NTRS)

Ramapriyan, Hampapuram; Peng, Ge; Moroni, David; Shie, Chung-Lin

2016-01-01

Quality of products is always of concern to users regardless of the type of products. The focus of this paper is on the quality of Earth science data products. There are four different aspects of quality - scientific, product, stewardship and service. All these aspects taken together constitute Information Quality. With increasing requirement on ensuring and improving information quality, there has been considerable work related to information quality during the last several years. Given this rich background of prior work, the Information Quality Cluster (IQC), established within the Federation of Earth Science Information Partners (ESIP) has been active with membership from multiple organizations. Its objectives and activities, aimed at ensuring and improving information quality for Earth science data and products, are discussed briefly.

How do Consumers Search for and Appraise Information on Medicines on the Internet? A Qualitative Study Using Focus Groups

PubMed Central

Aslani, Parisa; Williams, Kylie A

2003-01-01

Background Many consumers use the Internet to find information about their medicines. It is widely acknowledged that health information on the Internet is of variable quality and therefore the search and appraisal skills of consumers are important for selecting and assessing this information. The way consumers choose and evaluate information on medicines on the Internet is important because it has been shown that written information on medicines can influence consumer attitudes to and use of medicines. Objective To explore consumer experiences in searching for and appraising Internet-based information on medicines. Methods Six focus groups (N = 46 participants) were conducted in metropolitan Sydney, Australia from March to May 2003 with consumers who had used the Internet for information on medicines. Verbatim transcripts of the group discussions were analyzed using a grounded theory approach. Results All participants reported using a search engine to find information on medicines. Choice of search engine was determined by factors such as the workplace or educational environments, or suggestions by family or friends. Some participants found information solely by typing the medicine name (drug or brand name) into the search engine, while others searched using broader terms. Search skills ranged widely from more-advanced (using quotation marks and phrases) to less-than-optimal (such as typing in questions and full sentences). Many participants selected information from the first page of search results by looking for keywords and descriptions in the search results, and by looking for the source of the information as apparent in the URL. Opinions on credible sources of information on medicines varied with some participants regarding information by pharmaceutical companies as the "official" information on a medicine, and others preferring what they considered to be impartial sources such as governments, organizations, and educational institutions. It was clear that although most participants were skeptical of trusting information on the Internet, they had not paid conscious attention to how they selected information on medicines. Despite this, it was evident that participants viewed the Internet as an important source for information on medicines. Conclusions The results showed that there was a range of search and appraisal skills among participants, with many reporting a limited awareness of how they found and evaluated Internet-based information on medicines. Poor interpretation of written information on medicines has been shown to lead to anxiety and poor compliance to therapy. This issue is more important for Internet-based information since it is not subject to quality control and standardization as is written information on medicines. Therefore, there is a need for promoting consumer search and appraisal skills when using this information. Educating consumers in how to find and interpret Internet-based information on medicines may help them use their medicines in a safer and more-effective way. PMID:14713661

Making health care quality reports easier to use.

PubMed

Hibbard, J H; Peters, E; Slovic, P; Finucane, M L; Tusler, M

2001-11-01

Although there is evidence that consumers want comparative quality information, most studies indicate that consumers make limited use of the data in decision making. The reasons for the limited use appear to be the complexity of the information and the difficulty of processing and using the amount of information in reports. The purpose of this investigation was to determine whether there are approaches to reporting comparative information that make it easier for consumers to comprehend the information. Further, the degree to which consumers who have a low level of skill can accurately use that information when it is presented in a format that is easier to use was examined. The study used an experimental design to examine how different presentation approaches affect the use of information. Participants were randomly assigned to different conditions and were asked to review information and complete a decision task related to using comparative information and making health plan selections. Two separate convenience samples were used in the study: an elderly Medicare sample (N = 253), and a nonelderly sample (N = 239). The findings indicate that there are data presentation approaches that help consumers who have lower skills use information more accurately. Some of these presentation strategies (for example, relative stars) improve comprehension among the lower skilled, and other strategies (for example, evaluative labels) appear to aid those in the midrange of comprehension skill. Using these approaches in reporting would likely increase the use of the comparative information and increase the efficacy of reporting efforts.

Acceptability of an Electronic Self Report Assessment Program for Patients with Cancer

PubMed Central

Wolpin, S.; Berry, D.; Austin-Seymour, M.; Bush, N.; Fann, J.R.; Halpenny, B.; Lober, W.; McCorkle, Ruth

2010-01-01

Background Eliciting symptom and quality of life information from patients is an important component of medical and nursing care processes. Traditionally, this information has been collected with paper and pencil. However, this approach presents several barriers, including delays in receiving information, difficulty integrating responses with electronic records and the time required to manual score questionnaires for measurement purposes. One solution that addresses many of these barriers is the adoption of computerized screening for symptom and quality of life information. Objective This research explored the acceptability of asking symptom and quality of life questions using the Electronic Self Report Assessment – Cancer program on wireless laptops equipped with touch screen format. Methods Acceptability data was explored with respect to whether any differences may be attributed to demographics, and symptom and quality of life levels such as depression, cognitive and emotional functioning. This evaluation utilized descriptive and univariate statistics to examine data from 342 participants from the ongoing ESRA-C randomized clinical trial. Research participants for the ESRA-C study were recruited from the Seattle Cancer Care Alliance (SCCA), a consortium between the University of Washington Medical Center, Fred Hutchinson Cancer Research Center, and Children’s Hospital and Regional Medical Center in Seattle, Washington. Results The sample consisted of 342 adult participants who completed both baseline and follow-up survey sessions. Medical Oncology represented the largest recruitment group (45.3%), followed by Stem Cell Transplant (34.5%) and Radiation Oncology (20.2%). The primary finding was that patients were generally able to utilize ESRA-C quickly and without difficulty in a real-world clinical setting and that they were overall quite satisfied with the ESRA-C program. Significant differences were found in several acceptability areas with respect to demographics and quality of life measures, such as age, gender, and severe distress. Conclusions This analysis confirms that the ESRA-C application for collecting symptom and quality of life information is easy for patients to use and acceptable across a range of user characteristics. We intend to build on our work by using the survey platform in other modalities while ensuring that the patient’s preferences are considered at all times. PMID:19047882

Acceptability of an Electronic Self-Report Assessment Program for patients with cancer.

PubMed

Wolpin, Seth; Berry, Donna; Austin-Seymour, Mary; Bush, Nigel; Fann, Jesse R; Halpenny, Barbara; Lober, William B; McCorkle, Ruth

2008-01-01

Eliciting symptom and quality of life information from patients is an important component of medical and nursing care processes. Traditionally, this information has been collected with paper and pencil. However, this approach presents several barriers, including delays in receiving information, difficulty in integrating responses with electronic records, and the time required to manually score questionnaires for measurement purposes. One solution that addresses many of these barriers is the adoption of computerized screening for symptom and quality-of-life information. This research explored the acceptability of asking symptom and quality-of-life questions using the Electronic Self Report Assessment-Cancer program on wireless laptops equipped with touch-screen format. Acceptability data were explored with respect to whether any differences may be attributed to demographics and symptom and quality-of-life levels, such as depression and cognitive and emotional functioning. This evaluation used descriptive and univariate statistics to examine data from 342 participants from the ongoing ESRA-C randomized clinical trial. Research participants for the ESRA-C study were recruited from the Seattle Cancer Care Alliance, a consortium among the University of Washington Medical Center, Fred Hutchinson Cancer Research Center, and Children's Hospital and Regional Medical Center in Seattle, WA. The sample consisted of 342 adult participants who completed both baseline and follow-up survey sessions. Medical oncology represented the largest recruitment group (45.3%), followed by stem cell transplant (34.5%) and radiation oncology (20.2%). The primary finding was that patients were generally able to use ESRA-C quickly and without difficulty in a real-world clinical setting and that they were overall quite satisfied with the ESRA-C program. Significant differences were found in several acceptability areas with respect to demographics and quality of life measures such as age, sex, and severe distress. This analysis confirms that the ESRA-C application for collecting symptom and quality of life information is easy for patients to use and acceptable across a range of user characteristics. We intend to build on our work by using the survey platform in other modalities while ensuring that the patient's preferences are considered at all times.

How Do Infant Feeding Apps in China Measure Up? A Content Quality Assessment

PubMed Central

Freeman, Becky; Li, Mu

2017-01-01

Background Globally, with the popularization of mobile phones, the number of health-related mobile phone apps has skyrocketed to 259,000 in 2016. In the digital era, people are accessing health information through their fingertips. In China, there are several apps that claim to provide infant feeding and nutrition guidance. However, the quality of information in those apps has not been extensively assessed. Objective We aimed to assess the quality of Chinese infant feeding apps using comprehensive quality assessment criteria and to explore Chinese mothers’ perceptions on apps’ quality and usability. Methods We searched for free-to-download Chinese infant feeding apps in the iTunes and Android App Stores. We conducted a comprehensive assessment of the accountability, scientific basis, accuracy of information relevant to infant feeding, advertising policy, and functionality and carried out a preliminary screening of infant formula advertisements in the apps. In addition, we also conducted exploratory qualitative research through semistructured interviews with Chinese mothers in Shanghai to elicit their views about the quality of apps. Results A total of 4925 apps were screened, and 26 apps that met the selection criteria were evaluated. All 26 apps were developed by commercial entities, and the majority of them were rated poorly. The highest total score was 62.2 (out of approximately 100) and the lowest was 16.7. In the four quality domains assessed, none of them fulfilled all the accountability criteria. Three out of 26 apps provided information covering the three practices from the World Health Organization’s infant feeding recommendations. Only one app described its advertising policy in its terms of usage. The most common app functionality was a built-in social forum (19/26). Provision of a website link was the least common functionality (2/26). A total of 20 out of 26 apps promoted infant formula banner advertisements on their homepages. In addition, 12 apps included both e-commerce stores and featured infant formula advertisements. In total, 21 mothers were interviewed face-to-face. Mothers highly valued immediate access to parenting information and multifunctionality provided by apps. However, concerns regarding incredible information and commercial activities in apps, as well as the desire for information and support offered by health care professionals were expressed. Conclusions The findings provide valuable information on Chinese infant feeding apps. The results are concerning, particularly with the relative absence of scientific basis and credibility and the large number of commercial advertisements that are displayed. Apps do seem to be able to provide an opportunity for mothers to access health information and support; it is time for tighter controls on content and advertisements. Ongoing app research and development should focus on implementation of a standard framework, which would drive the development of high-quality apps to support healthy infant feeding through cooperation among academics, health professionals, app users, app developers, and government bodies. PMID:29212627

How Do Infant Feeding Apps in China Measure Up? A Content Quality Assessment.

PubMed

Zhao, Jing; Freeman, Becky; Li, Mu

2017-12-06

Globally, with the popularization of mobile phones, the number of health-related mobile phone apps has skyrocketed to 259,000 in 2016. In the digital era, people are accessing health information through their fingertips. In China, there are several apps that claim to provide infant feeding and nutrition guidance. However, the quality of information in those apps has not been extensively assessed. We aimed to assess the quality of Chinese infant feeding apps using comprehensive quality assessment criteria and to explore Chinese mothers' perceptions on apps' quality and usability. We searched for free-to-download Chinese infant feeding apps in the iTunes and Android App Stores. We conducted a comprehensive assessment of the accountability, scientific basis, accuracy of information relevant to infant feeding, advertising policy, and functionality and carried out a preliminary screening of infant formula advertisements in the apps. In addition, we also conducted exploratory qualitative research through semistructured interviews with Chinese mothers in Shanghai to elicit their views about the quality of apps. A total of 4925 apps were screened, and 26 apps that met the selection criteria were evaluated. All 26 apps were developed by commercial entities, and the majority of them were rated poorly. The highest total score was 62.2 (out of approximately 100) and the lowest was 16.7. In the four quality domains assessed, none of them fulfilled all the accountability criteria. Three out of 26 apps provided information covering the three practices from the World Health Organization's infant feeding recommendations. Only one app described its advertising policy in its terms of usage. The most common app functionality was a built-in social forum (19/26). Provision of a website link was the least common functionality (2/26). A total of 20 out of 26 apps promoted infant formula banner advertisements on their homepages. In addition, 12 apps included both e-commerce stores and featured infant formula advertisements. In total, 21 mothers were interviewed face-to-face. Mothers highly valued immediate access to parenting information and multifunctionality provided by apps. However, concerns regarding incredible information and commercial activities in apps, as well as the desire for information and support offered by health care professionals were expressed. The findings provide valuable information on Chinese infant feeding apps. The results are concerning, particularly with the relative absence of scientific basis and credibility and the large number of commercial advertisements that are displayed. Apps do seem to be able to provide an opportunity for mothers to access health information and support; it is time for tighter controls on content and advertisements. Ongoing app research and development should focus on implementation of a standard framework, which would drive the development of high-quality apps to support healthy infant feeding through cooperation among academics, health professionals, app users, app developers, and government bodies. ©Jing Zhao, Becky Freeman, Mu Li. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 06.12.2017.

An Investigation of Factors Affecting How Engineers and Scientists Seek Information

NASA Technical Reports Server (NTRS)

Anderson, Claire J; Glassman, Myron; McAfee, R. Bruce; Pinelli, Thomas

2001-01-01

This study investigated how 872 US aerospace scientists and engineers select information carriers. When considering oral and written information carriers, the principle of least effort was supported with a strong preference for oral communication over written communication. In examining how the respondents select written carriers, the decision to use or not to use a written carrier was found to be primarily a function of the perceived importance of the carrier's information to a person's work. Task uncertainty and task complexity were found to be significant, but not the primary nor a totally consistent criteria. The perceived quality and accessibility of written carriers were not found significant. The findings reinforce the need for firms to hire knowledgeable employees, to provide them with comprehensive training programs, and to develop formal and informal communication networks.

Habits of Internet users and usefulness of websites in Spanish for health education.

PubMed

Mira, J J; Llinás, G; Pérez-Jover, V

2008-01-01

To analyse whether websites in Spanish are an adequate medium to be self-informed considering the surfing styles of Internet users. In a real context 225 subjects searched for information on the Net to answer a series of questions on two diseases and one therapeutic technique. Also, they informed their habits when using Internet. Slightly more than the half of the questions were correctly answered. To find information, they visited more than 70 different pages in all cases. A major number of websites visited was not related with a better knowledge of treatment or illness (p>0.05). When health professionals recommend a website to a patient (web prescription) they must consider both, the quality of the information, and the style for surfing on the Net.

An online expert network for high quality information on occupational safety and health: cross-sectional study of user satisfaction and impact

PubMed Central

2011-01-01

Background Many people have difficulties finding information on health questions, including occupational safety and health (OSH) issues. One solution to alleviate these difficulties could be to offer questioners free-of-charge, online access to a network of OSH experts who provide tailored, high-quality information. The aim of this study was to assess whether network quality, respectively information quality, as perceived by the questioners, is associated with questioners' overall satisfaction and to explore the impact of the information received on questioners' knowledge, work and work functioning. Methods We evaluated the experiences of OSH questioners with the online network ArboAntwoord.com over a two-year period. In this network, approximately 80 qualified experts are available to answer OSH questions. By means of a questionnaire, we assessed questioners' overall satisfaction with the network, whether the network was user-friendly, easily accessible and easy to handle and whether the information provided was complete, applicable and received in a timely manner. The impact of the information on questioners' knowledge, work or work functioning was explored with seven questions. In the study period, 460 unique OSH questioners asked 851 OSH questions. In total, 205 of the 460 questioners completed the questionnaire (response rate 45%). Results Of the responders, 71% were satisfied with the ArboAntwoord network. Multiple logistic regression analysis showed that the applicability of the information had a positive influence on the questioners' overall satisfaction (OR = 16.0, 95% CI: 7.0-36.4). Also, user friendliness of the network (OR = 3.3, 95% CI: 1.3-8.6) and completeness of the information provided (OR = 3.0, 95% CI: 1.3-6.8) were positively related to the questioners' satisfaction. For 74% of the questioners, the information helped to increase their knowledge and understanding. Overall, 25% of the questioners indicated that the received information improved their work, work functioning or health. Conclusions A free-of-charge, online expert network in the field of OSH can be a useful strategy to provide OSH questioners with applicable, complete and timely information that may help improve safety and health at work. This study provides more insight in how to satisfy network questioners and about the potential impact of provided information on OSH. PMID:22111587

An online expert network for high quality information on occupational safety and health: cross-sectional study of user satisfaction and impact.

PubMed

Rhebergen, Martijn D F; Lenderink, Annet F; van Dijk, Frank J H; Hulshof, Carel T J

2011-11-23

Many people have difficulties finding information on health questions, including occupational safety and health (OSH) issues. One solution to alleviate these difficulties could be to offer questioners free-of-charge, online access to a network of OSH experts who provide tailored, high-quality information. The aim of this study was to assess whether network quality, respectively information quality, as perceived by the questioners, is associated with questioners' overall satisfaction and to explore the impact of the information received on questioners' knowledge, work and work functioning. We evaluated the experiences of OSH questioners with the online network ArboAntwoord.com over a two-year period. In this network, approximately 80 qualified experts are available to answer OSH questions. By means of a questionnaire, we assessed questioners' overall satisfaction with the network, whether the network was user-friendly, easily accessible and easy to handle and whether the information provided was complete, applicable and received in a timely manner. The impact of the information on questioners' knowledge, work or work functioning was explored with seven questions. In the study period, 460 unique OSH questioners asked 851 OSH questions. In total, 205 of the 460 questioners completed the questionnaire (response rate 45%). Of the responders, 71% were satisfied with the ArboAntwoord network. Multiple logistic regression analysis showed that the applicability of the information had a positive influence on the questioners' overall satisfaction (OR = 16.0, 95% CI: 7.0-36.4). Also, user friendliness of the network (OR = 3.3, 95% CI: 1.3-8.6) and completeness of the information provided (OR = 3.0, 95% CI: 1.3-6.8) were positively related to the questioners' satisfaction. For 74% of the questioners, the information helped to increase their knowledge and understanding. Overall, 25% of the questioners indicated that the received information improved their work, work functioning or health. A free-of-charge, online expert network in the field of OSH can be a useful strategy to provide OSH questioners with applicable, complete and timely information that may help improve safety and health at work. This study provides more insight in how to satisfy network questioners and about the potential impact of provided information on OSH.