Patients' perspectives and experiences concerning barriers to accessing information about bilateral prophylactic mastectomy.

PubMed

Glassey, Rachael; O'Connor, Moira; Ives, Angela; Saunders, Christobel; kConFab Investigators; O'Sullivan, Sarah; Hardcastle, Sarah J

2018-05-11

To explore the barriers and experiences of accessing information for women who have received genetic risk assessment/testing results for breast cancer (BC) and are considering a bilateral prophylactic mastectomy (BPM) and, exploring participants' preferences concerning information and support needs. A qualitative retrospective study guided by interpretative phenomenological analysis was utilised. Semi-structured interviews were conducted with forty-six women who were either considering BPM or had already undergone the surgery. Three themes identified barriers to accessing information; difficulties accessing information, inconsistent information and clinical focus/medicalized information. A fourth theme - preferences of information and support needs, identified three subthemes; these were, psychological support, clearly defined processes and photos of mastectomies/reconstruction surgeries. Barriers to accessing information appeared to be widespread. A lack of integrated services contributed to inconsistent information, and medicalized terminology/clinical focus of consultations further complicated understanding. Preferences for information include clearly defined processes, so women know the pathways after confirmation of familial BC risk. Clinical implications include a multidisciplinary team approach, and a protocol that reflects current practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

From Digital Divide to Digital Democracy.

ERIC Educational Resources Information Center

de los Santos, Gerardo E., Ed.; de los Santos, Alfredo G., Jr., Ed.; Milliron, Mark David, Ed.

This publication is one of many efforts of the League for Innovation in the Community College to address the issue of societal technology access and learning needs. This work addresses the issue of the digital divide, which includes the often conflicting perspectives of information technology (IT) access and literacy needs held by government…

Differing perspectives on parent access to their child's electronic medical record during neonatal intensive care hospitalization: a pilot study.

PubMed

Chung, Rebecca K; Kim, Una Olivia; Basir, Mir Abdul

2018-04-01

To improve informed medical decision-making, principles for family-centered neonatal care recommend that parents have access to their child's medical record on an ongoing basis during neonatal intensive unit care (NICU) hospitalization. Currently, many NICUs do not allow independent parent access to their child's electronic medical record (EMR) during hospitalization. We undertook a cross-sectional survey pilot study of medical professionals and parents to explore opinions regarding this practice. Inclusion criteria: 18-years old, English-literate, legal guardian of patients admitted to the NICU for 14 days. NICU medical professionals included physicians, nurse practitioners, nurses, and respiratory therapists. Medical professionals believed parent access would make their work more difficult, increase time documenting and updating families, making them more liable to litigation and hesitant to chart sensitive information. However, parents felt that they lacked control over their child's care and desired direct access to the EMR. Parents believed this would improve accuracy of their child's medical chart, and increase advocacy and understanding of their child's illness. NICU parents and medical professionals have differing perspectives on independent parental access to their child's EMR. More research is needed to explore the potential of independent parental EMR access to further improve family-centered neonatal care.

Consultation with Aboriginal and Torres Strait Islander People in Early Childhood Education: The Impact of Colonial Discourses

ERIC Educational Resources Information Center

Miller, Melinda G.

2015-01-01

In Australian early years education, consultation and partnerships with Aboriginal and Torres Strait Islander people are central to embedding Indigenous perspectives. Building sustained and reciprocal partnerships with Aboriginal and Torres Strait Islander people supports access to local knowledges and perspectives to inform curriculum planning,…

International Perspectives in LIS Education: Global Education, Research, and Collaboration at the SJSU School of Information

ERIC Educational Resources Information Center

Hirsh, Sandra; Simmons, Michelle Holschuh; Christensen, Paul; Sellar, Melanie; Stenström, Cheryl; Hagar, Christine; Bernier, Anthony; Faires, Debbie; Fisher, Jane; Alman, Susan

2015-01-01

The IFLA Trend Report identified five trends that will impact the information environment (IFLA, 2015), such as access to information with new technologies, online education for global learning, hyper-connected communities, and the global information environment. The faculty at San José State University (SJSU) School of Information (iSchool) is…

Perspectives of People Living with HIV on Access to Health Care: Protocol for a Scoping Review

PubMed Central

Maybank, Allison; Hurley, Oliver; Modir, Hilary; Farrell, Alison; Marshall, Zack; Kendall, Claire; Johnston, Sharon; Hogel, Matthew; Rourke, Sean B; Liddy, Clare

2016-01-01

Background Strategies to improve access to health care for people living with human immunodeficiency virus (PLHIV) have demonstrated limited success. Whereas previous approaches have been informed by the views of health providers and decision-makers, it is believed that incorporating patient perspectives into the design and evaluations of health care programs will lead to improved access to health care services. Objective We aim to map the literature on the perspectives of PLHIV concerning access to health care services, to identify gaps in evidence, and to produce an evidence-informed research action plan to guide the Living with HIV program of research. Methods This scoping review includes peer-reviewed and grey literature from 1946 to May 2014 using double data extraction. Variations of the search terms “HIV”, “patient satisfaction”, and “health services accessibility” are used to identify relevant literature. The search strategy is being developed in consultation with content experts, review methodologists, and a librarian, and validated using gold standard studies identified by those stakeholders. The inclusion criteria are (1) the study includes the perspectives of PLHIV, (2) study design includes qualitative, quantitative, or mixed methods, and (3) outcome measures are limited to patient satisfaction, their implied needs, beliefs, and desires in relation to access to health care. The papers are extracted by two independent reviewers, including quality assessment. Data is then collated, summarized, and thematically analyzed. Results A total of 12,857 references were retrieved, of which 326 documents were identified as eligible in pre-screening, and 64 articles met the inclusion criteria (56% qualitative studies, 38% quantitative studies and 6% mixed-method studies). Only four studies were conducted in Canada. Data synthesis is in progress and full results are expected in June, 2016. Conclusions This scoping review will record and characterize the extensive body of literature on perspectives of PLHIV regarding access to health care. A literature repository will be developed to assist stakeholders, decision-makers, and PLHIV in developing and implementing patient-oriented health care programs. PMID:27193076

Therapists' Perspectives: Supporting Children to Use Switches and Technology for Accessing Their Environment, Leisure, and Communication

ERIC Educational Resources Information Center

Beauchamp, Fiona; Bourke-Taylor, Helen; Brown, Ted

2018-01-01

Background: Many children with cerebral palsy learn to use technology to access their environments and communicate; however, minimal research informs practice. Methods: A descriptive qualitative study with purposive sampling recruited 10 therapists (occupational, speech, and physiotherapists) from one early intervention service. Data were…

Designing Hypercontextualized Games: A Case Study with LieksaMyst

ERIC Educational Resources Information Center

Sedano, Carolina Islas; Sutinen, Erkki; Vinni, Mikko; Laine, Teemu H.

2012-01-01

Digital technology empowers one to access vast amounts of on-line data. From a learning perspective, however, it is difficult to access meaningful on-site information within a given context. The Hypercontextualized Game (HCG) design model interweaves on-site resources, translated as content, and the digital game. As a local game design process,…

The Effectiveness of Commercial Internet Web Sites: A User's Perspective.

ERIC Educational Resources Information Center

Bell, Hudson; Tang, Nelson K. H.

1998-01-01

A user survey of 60 company Web sites (electronic commerce, entertainment and leisure, financial and banking services, information services, retailing and travel, and tourism) determined that 30% had facilities for conducting online transactions and only 7% charged for site access. Overall, Web sites were rated high in ease of access, content, and…

An Ecological Perspective on U.S. Latinos' Health Communication Behaviors, Access, and Outcomes

ERIC Educational Resources Information Center

Katz, Vikki S.; Ang, Alfonso; Suro, Roberto

2012-01-01

U.S. Latinos experience constrained access to formal health care resources, contributing to higher incidence of preventable diseases and chronic health conditions than the general population. The authors explore whether a rich set of informal health communication connections--to friends, family, radio, television, Internet, newspapers, magazines,…

Exploring access to care among older people in the last phase of life using the behavioural model of health services use: a qualitative study from the perspective of the next of kin of older persons who had died in a nursing home.

PubMed

Condelius, Anna; Andersson, Magdalena

2015-10-26

There is little investigation into what care older people access during the last phase of their life and what factors enable access to care in this group. Illuminating this from the perspective of the next of kin may provide valuable insights into how the health and social care system operates with reference to providing care for this vulnerable group. The behavioural model of health services use has a wide field of application but has not been tested conceptually regarding access to care from the perspective of the next of kin. The aim of this study was to explore the care accessed by older people during the last phase of their life from the perspective of the next of kin and to conceptually test the behavioural model of health services use. The data collection took place in 2011 by means of qualitative interviews with 14 next of kin of older people who had died in a nursing home. The interviews were analysed using directed content analysis. The behavioural model of health services use was used in deriving the initial coding scheme, including the categories: utilization of health services, consumer satisfaction and characteristics of the population at risk. Utilization of health services in the last phase of life was described in five subcategories named after the type of care accessed i.e. admission to a nursing home, primary healthcare, hospital care, dental care and informal care. The needs were illuminated in the subcategories: general deterioration, medical conditions and acute illness and deterioration when death approaches. Factors that enabled access to care were described in three subcategories: the organisation of care, next of kin and the older person. These factors could also constitute barriers to accessing care. Next of kin's satisfaction with care was illuminated in the subcategories: satisfaction, dissatisfaction and factors influencing satisfaction. One new category was constructed inductively: the situation of the next of kin. A bed in a nursing home was often accessed during what the next of kin regarded as the last phase of life. The needs among older people in the last phase of life can be regarded as complex and worsening over time. Most enabling factors lied within the organisation of care but the next of kin enabled access to care and contributed significantly to care quality. More research is needed regarding ageism and stigmatic attitudes among professionals and informal caregivers acting as a barrier to accessing care for older people in the last phase of their life. The behavioural model of health services use was extended with a new category showing that the situation of the next of kin must be taken into consideration when investigating access to care from their perspective. It may also be appropriate to include informal care as part of the concept of access when investigating access to care among older people in the last phase of their life. The results may not be transferable to older people who have not gained access to a bed in a nursing home or to countries where the healthcare system differs largely from the Swedish.

Health websites: accessibility and usability for American sign language users.

PubMed

Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

2015-01-01

To date, there have been efforts toward creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our article focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users' perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (n = 32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to (a) navigation to find the task, (b) website usability, and (c) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This article also describes the participants' preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users.

An intermediary's perspective of online databases for local governments

NASA Technical Reports Server (NTRS)

Jack, R. F.

1984-01-01

Numerous public administration studies have indicated that local government agencies for a variety of reasons lack access to comprehensive information resources; furthermore, such entities are often unwilling or unable to share information regarding their own problem-solving innovations. The NASA/University of Kentucky Technology Applications Program devotes a considerable effort to providing scientific and technical information and assistance to local agencies, relying on its access to over 500 distinct online databases offered by 20 hosts. The author presents a subjective assessment, based on his own experiences, of several databases which may prove useful in obtaining information for this particular end-user community.

Manifestations of Metadata: From Alexandria to the Web--Old is New Again

ERIC Educational Resources Information Center

Kennedy, Patricia

2008-01-01

This paper is a discussion of the use of metadata, in its various manifestations, to access information. Information management standards are discussed. The connection between the ancient world and the modern world is highlighted. Individual perspectives are paramount in fulfilling information seeking. Metadata is interpreted and reflected upon in…

The Virtual School Library: Gateway to the Information Superhighway.

ERIC Educational Resources Information Center

Kuhlthau, Carol Collier, Ed.; And Others

This book is a compilation of 14 articles that present a wide range of perspectives on providing access to vast networks of information resources and enabling students to learn in an information-rich environment. The articles, arranged in four parts--overview of important technologies comprising the virtual library, learning in the electronic…

Perspectives of Family Members on Using Technology in Youth Mental Health Care: A Qualitative Study.

PubMed

Lal, Shalini; Daniel, Winnie; Rivard, Lysanne

2017-06-23

Information and communication technologies (ICTs) are increasingly recognized as having an important role in the delivery of mental health services for youth. Recent studies have evaluated young people's access and use of technology, as well as their perspectives on using technology to receive mental health information, services, and support; however, limited attention has been given to the perspectives of family members in this regard. The aim of this study was to explore the perspectives of family members on the use of ICTs to deliver mental health services to youth within the context of specialized early intervention for a first-episode psychosis (FEP). Six focus groups were conducted with family members recruited from an early intervention program for psychosis. Twelve family members participated in the study (target sample was 12-18, and recruitment efforts took place over the duration of 1 year). A 12-item semistructured focus group guide was developed to explore past experiences of technology and recommendations for the use of technology in youth mental health service delivery. A qualitative thematic analysis guided the identification and organization of common themes and patterns identified across the dataset. Findings were organized by the following themes: access and use of technology, potential negative impacts of technology on youth in recovery, potential benefits of using technology to deliver mental health services to youth, and recommendations to use technology for (1) providing quality information in a manner that is accessible to individuals of diverse socioeconomic backgrounds, (2) facilitating communication with health care professionals and services, and (3) increasing access to peer support. To our knowledge, this is among the first (or the first) to explore the perspectives of family members of youth being treated for FEP on the use of technology for mental health care. Our results highlight the importance of considering diverse experiences and attitudes toward the role of technology in youth mental health, digital literacy skills, phases of recovery, and sociodemographic factors when engaging family members in technology-enabled youth mental health care research and practice. Innovative methods to recruit and elicit the perspectives of family members on this topic are warranted. It is also important to consider educational strategies to inform and empower family members on the role, benefits, and use of ICTs in relation to mental health care for FEP. ©Shalini Lal, Winnie Daniel, Lysanne Rivard. Originally published in JMIR Mental Health (http://mental.jmir.org), 23.06.2017.

Information as a Primary Good from a Rawlsian Perspective.

ERIC Educational Resources Information Center

Cizmar, Francis J.

This paper seeks to establish a philosophical foundation and a conceptual framework for a belief in the right to free information access. According to an overview of the professional literature, and to the moral philosophy of Immanuel Kant as operationalized in the theories of John Rawls, information can be seen as a primary good and as a…

Educating for Social Justice: Perspectives from Library and Information Science and Collaboration with K-12 Social Studies Educators

ERIC Educational Resources Information Center

Naidoo, Jamie Campbell; Sweeney, Miriam E.

2015-01-01

Library and Information Science (LIS) as a discipline is guided by core values that emphasize equal access to information, freedom of expression, democracy, and education. Importantly, diversity and social responsibility are specifically called out as foundations of the profession (American Library Association, 2004). Following from this, there…

Chinese-American Parents' Perspectives about Using the Internet to Access Information for Children with Special Needs

ERIC Educational Resources Information Center

Zeng, Songtian; Cheatham, Gregory A.

2017-01-01

As the Internet contains large amounts of health- and education-related information, it provides a potentially efficient and affordable format for directly reaching a large number of families with evidence-based health- and education-related information for their children with disabilities. Little is known, however, about Internet…

Enhancing News Literacy

ERIC Educational Resources Information Center

Quinn, Lena Consolini

2009-01-01

A revolution in media has sparked an explosion of information, thanks largely to the Internet. Despite the apparent gains in diversity of perspective and ease of access to information, the concern over the reliability of sources extends particularly to youth consumers and their ability to decipher the truth amidst this vast array of media…

Health Websites: Accessibility and Usability for American Sign Language Users

PubMed Central

Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R.; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

2015-01-01

To date, there have been efforts towards creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our paper focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users’ perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (N=32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to: 1) navigation to find the task, 2) website usability, and 3) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This paper also describes the participants’ preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users. PMID:24901350

Perspectives of rural carers on benefits and barriers of receiving occupational therapy via Information and Communication Technologies.

PubMed

Gardner, Kate; Bundy, Anita; Dew, Angela

2016-04-01

People with a disability living in rural areas commonly experience difficulty in accessing therapy services. Information and Communication Technologies (ICT) may have the potential to provide occupational therapy services remotely through two-way visual interactions. The aim of this qualitative study was to understand the perspectives of carers of a person with a disability living in rural New South Wales (NSW) on the use of ICT for occupational therapy service delivery. Individual semi-structured telephone interviews were conducted with 11 carers of persons with a disability living in rural NSW. Participants were asked about their use of technology, therapy experiences and their attitudes towards using ICT to receive occupational therapy for their son/daughter. Data were analysed via constant comparison and thematic analysis. Participants were willing to use ICT to enhance their current access to therapy based on their in-depth knowledge of their son or daughter and their prior experiences with therapy and technology. For ICT to work for occupational therapy, participants identified the need for support and access prior to, during and between ICT sessions. From the carers' perspectives, ICT has the potential to increase access to occupational therapy services for people with a disability who live in rural NSW. Occupational therapists could benefit from eliciting the experiences, knowledge and willingness of rural carers to deliver therapy via ICT, thereby supplementing and enhancing in-person service delivery. © 2016 Occupational Therapy Australia.

Access Scheme for Controlling Mobile Agents and its Application to Share Medical Information.

PubMed

Liao, Yu-Ting; Chen, Tzer-Shyong; Chen, Tzer-Long; Chung, Yu-Fang; Chen, Yu- Xin; Hwang, Jen-Hung; Wang, Huihui; Wei, Wei

2016-05-01

This study is showing the advantage of mobile agents to conquer heterogeneous system environments and contribute to a virtual integrated sharing system. Mobile agents will collect medical information from each medical institution as a method to achieve the medical purpose of data sharing. Besides, this research also provides an access control and key management mechanism by adopting Public key cryptography and Lagrange interpolation. The safety analysis of the system is based on a network attacker's perspective. The achievement of this study tries to improve the medical quality, prevent wasting medical resources and make medical resources access to appropriate configuration.

Accessing Parental Perspectives to Inform the Development of Parent Training in Autism in South-Eastern Europe

ERIC Educational Resources Information Center

Preece, David; Symeou, Loizos; Stošic, Jasmina; Troshanska, Jasmina; Mavrou, Katerina; Theodorou, Eleni; Frey Škrinjar, Jasmina

2017-01-01

Parent training has been shown to be an important means of supporting families living with autism--but such services are not universally accessible. A multinational project funded by the European Commission has been developed in order to establish such parent training in three south-eastern European countries. To ensure that the training was…

Secondary Students' Attitudes to Animal Research: Examining the Potential of a Resource to Communicate the Scientist's Perspective

ERIC Educational Resources Information Center

France, Bev; Birdsall, Sally

2015-01-01

A DVD resource that provided a scientist's perspective on the use of animals in research and teaching was evaluated with a questionnaire that asked students' views pre and post their access to the resource. Thirty-nine secondary students (Y10-Y13) took part in three different teaching programmes that provided information about animal research and…

77 FR 36606 - Pipeline Safety: Government/Industry Pipeline Research and Development Forum, Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... the best available knowledge and expertise, and considers stakeholder perspectives. Specifically the... rooms. All public spaces are ADA accessible. Contact the Westin for more information. Refer to the...

'Maybe it was her fate and maybe she ran out of blood': final caregivers' perspectives on access to care in obstetric emergencies in rural Indonesia.

PubMed

D'Ambruoso, Lucia; Byass, Peter; Qomariyah, Siti Nurul

2010-03-01

Maternal mortality persists in low-income settings despite preventability with skilled birth attendance and emergency obstetric care. Poor access limits the effectiveness of life-saving interventions and is typical of maternal health care in low-income settings. This paper examines access to care in obstetric emergencies from the perspectives of service users, using established and contemporary theoretical frameworks of access and a routine health surveillance method. The implications for health planning are also considered. The final caregivers of 104 women who died during pregnancy or childbirth were interviewed in two rural districts in Indonesia using an adapted verbal autopsy. Qualitative analysis revealed social and economic barriers to access and barriers that arose from the health system itself. Health insurance for the poor was highly problematic. For providers, incomplete reimbursements, and low public pay, acted as disincentives to treat the poor. For users, the schemes were poorly socialized and understood, complicated to use and led to lower quality care. Services, staff, transport, equipment and supplies were also generally unavailable or unaffordable. The multiple barriers to access conferred a cumulative disadvantage that culminated in exclusion. This was reflected in expressions of powerlessness and fatalism regarding the deaths. The analysis suggests that conceiving of access as a structurally determined, complex and dynamic process, and as a reciprocally maintained phenomenon of disadvantaged groups, may provide useful explanatory concepts for health planning. Health planning from this perspective may help to avoid perpetuating exclusion on social and economic grounds, by health systems and services, and help foster a sense of control at the micro-level, among peoples' feelings and behaviours regarding their health. Verbal autopsy surveys provide an opportunity to routinely collect information on the exclusory mechanisms of health systems, important information for equitable health planning.

Networked Mediated Influence 2.0

DTIC Science & Technology

2014-12-12

but they communicate the information through different frames of reference. . . . Frames work by accessing a particular perspective on an issue...nature yet attention grabbers.214 Framing. A form of communications where information is presented in a unique slant, focal point, or frame of reference...mental frameworks differ in their implications for decision making, the results can be dramatic.215 Information Communication Technologies (ICTs). A term

Open Geosciences Knowledge: foster Information Preparedness in a Disaster Resilience Perspective

NASA Astrophysics Data System (ADS)

Rapisardi, Elena; Di Franco, Sabina

2014-05-01

Information in science communication is the ability and the capacity to transfer scientific knowledge to enable the understanding of communication content. Particularly, as stated in many documents and programs (e.g. UNISDR, a clear and correct information on hazards and emergency matters is crucial,either for practitioners or population,to cope with disaster and to allow collaboration to take the best decision. The Open Knowledge is defined as a set of criteria and conditions related to production, use and distribution, that include principles for better access to knowledge. However,knowledge is a pillar to understand the world in itself and to guide human actions and interactions with the environment. A free and open access to knowledge in a wider perspective includes also an ethical topic that is strictly connected to the acting in terms of interactions and responsibilities, in other words with the purpose of knowledge. Focusing on "data" as a technical issue, could displace ethics and responsibility as external issues, enhancing the technical value of data. In this perspective "opening" to an open knowledge perspective could not only solve problems related to the téchne, such as functionalities and efficiency, but it should foster sharing and collaboration expressed through ethics (praxis). The web era frees the information, hence the internet "information deluge" brings to the idea of "encyclopedia" (and of Wikipedia) as a tool to "organize, control and filter" knowledge, to allow communication, knowledge transfer, education, and sense-making. Social media and crowdsourcing have considerable promise for supporting collaborative and innovative ways that reshape the information production and distribution. However, the debate is now facing an important concern related to true/false issues, focusing on validation, and liability. Without any doubt the massive use of Social Media during recent major and minor disasters highlighted a huge need of clear, correct, free and trustworthy information. The challenge is to find models and tools to build an open and structured knowledge to sustain a common understanding in Disaster Resilience [DR] in order to cope with risks and reduce the impact of disaster: to observe natural phenomena, to understand natural hazards dynamics and local risks, to improve and facilitate the access to validated and reliable information.

“It’s Like a Phantom Disease”: Patient Perspectives on Access to Treatment for Chagas Disease in the United States

PubMed Central

Forsyth, Colin J.; Hernandez, Salvador; Flores, Carmen A.; Roman, Mario F.; Nieto, J. Maribel; Marquez, Grecia; Sequeira, Juan; Sequeira, Harry; Meymandi, Sheba K.

2018-01-01

Abstract. Chagas disease (CD) affects > 6 million people globally, including > 300,000 in the United States. Although early detection and etiological treatment prevents chronic complications from CD, < 1% of U.S. cases have been diagnosed and treated. This study explores access to etiological treatment from the perspective of patients with CD. In semi-structured interviews with 50 Latin American–born patients of the Center of Excellence for Chagas Disease at the Olive View–UCLA Medical Center, we collected demographic information and asked patients about their experiences managing the disease and accessing treatment. Patients were highly marginalized, with 63.4% living below the U.S. poverty line, 60% lacking a high school education, and only 12% with private insurance coverage. The main barriers to accessing health care for CD were lack of providers, precarious insurance coverage, low provider awareness, transportation difficulties, and limited time off. Increasing access to diagnosis and treatment will not only require a dramatic increase in provider and public education, but also development of programs which are financially, linguistically, politically, and geographically accessible to patients. PMID:29380723

Applying a health system perspective to the evolving Farmácia Popular medicines access programme in Brazil

PubMed Central

Chaves, Luisa A; Campos, Monica R; Bertoldi, Andrea D; Silva, Rondineli M; Bigdeli, Maryam; Ross-Degnan, Dennis; Emmerick, Isabel C M

2017-01-01

The Farmácia Popular Program (FPP) launched a subsidy system in Brazil, but in coexistence with the ongoing regular governmental access to medicines (Unified Health System (SUS) dispensings) mechanisms, causing overlaps in terms of financing and target population. This characteristic is quite different from most countries with medicines cost-sharing schemes. This paper aims to analyse the FPP under a health systems perspective considering the different health system levels. We analysed the findings from the study ‘Impact of consecutive subsidies policies on access to and use of medicines in Brazil – ISAUM-Br’, designed with the objective of describing and evaluating the impact of the government medicines subsidy policies implemented between 2004 and 2011. Patient share of copayment increased with the implementation of the intervention, which decreased the reference price and decreased with SNP (Saúde Não Tem Preço; zero copayment for patients). There was an increased number of FPP dispensations over time, but SUS dispensings remained the most important source for medicines, especially for hypertension and diabetes. FPP allowed the establishment of a well-designed pharmaceutical information system in the country. Despite the improvement on control mechanism, fraud remained a problem. There were important effects on the pharmaceutical market and sales of generic medicines. FPP has proven to be a very important policy for promoting access to medicines for hypertension and diabetes in Brazil. Examining this policy with a health system perspective has allowed us to highlight many of its important consequences, including for the first time a broad and consistent information system on access to medicines in the country. PMID:29527335

Information Literacy Training in Canada's Public Libraries

ERIC Educational Resources Information Center

Julien, Heidi; Hoffman, Cameron

2008-01-01

The purposes of the study were to explore the role of Canada's public libraries in developing the public's information literacy (IL) skills, to explore current IL training practices, and to explore the perspectives and IL experiences of individuals who visit public libraries to access the Internet. This article documents the second phase of a…

The patient perspective on the effects of medical record accessibility: a systematic review.

PubMed

Vermeir, Peter; Degroote, Sophie; Vandijck, Dominique; Van Tiggelen, Hanne; Peleman, Renaat; Verhaeghe, Rik; Mariman, An; Vogelaers, Dirk

2017-06-01

Health care is shifting from a paternalistic to a participatory model, with increasing patient involvement. Medical record accessibility to patients may contribute significantly to patient comanagement. To systematically review the literature on the patient perspective of effects of personal medical record accessibility on the individual patient, patient-physician relationship and quality of medical care. Screening of PubMed, Web of Science, Cinahl, and Cochrane Library on the keywords 'medical record', 'patient record', 'communication', 'patient participation', 'doctor-patient relationship', 'physician-patient relationship' between 1 January 2002 and 31 January 2016; systematic review after assessment for methodological quality. Out of 557 papers screened, only 12 studies qualified for the systematic review. Only a minority of patients spontaneously request access to their medical file, in contrast to frequent awareness of this patient right and the fact that patients in general have a positive view on open visit notes. The majority of those who have actually consulted their file are positive about this experience. Access to personal files improves adequacy and efficiency of communication between physician and patient, in turn facilitating decision-making and self-management. Increased documentation through patient involvement and feedback on the medical file reduces medical errors, in turn increasing satisfaction and quality of care. Information improvement through personal medical file accessibility increased reassurance and a sense of involvement and responsibility. From the patient perspective medical record accessibility contributes to co-management of personal health care.

Words are not enough: how preschoolers' integration of perspective and emotion informs their referential understanding.

PubMed

Graham, Susan A; San Juan, Valerie; Khu, Melanie

2017-05-01

When linguistic information alone does not clarify a speaker's intended meaning, skilled communicators can draw on a variety of cues to infer communicative intent. In this paper, we review research examining the developmental emergence of preschoolers' sensitivity to a communicative partner's perspective. We focus particularly on preschoolers' tendency to use cues both within the communicative context (i.e. a speaker's visual access to information) and within the speech signal itself (i.e. emotional prosody) to make on-line inferences about communicative intent. Our review demonstrates that preschoolers' ability to use visual and emotional cues of perspective to guide language interpretation is not uniform across tasks, is sometimes related to theory of mind and executive function skills, and, at certain points of development, is only revealed by implicit measures of language processing.

Rural Veteran Access to Healthcare Services: Investigating the Role of Information and Communication Technologies in Overcoming Spatial Barriers

PubMed Central

Schooley, Benjamin L; Horan, Thomas A; Lee, Pamela W; West, Priscilla A

2010-01-01

This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented. Spatial distance is a significant factor for many rural veterans when seeking healthcare. For this sample of rural veterans, a range of telephone, computer, and Internet technologies may become more important for accessing care as Internet access becomes more ubiquitous and as younger veterans begin using the VA health system. The focus group highlighted the negative impact of distance, economic considerations, geographic barriers, and specific medical conditions on access to care. Lack of adequate technology infrastructure was seen as an obstacle to utilization. This study discusses the need to consider distance, travel modes, age, and information technology infrastructure and adoption when designing health information technology to care for rural patients. PMID:20697468

Pathway to Support the Sustainable National Health Information System

NASA Astrophysics Data System (ADS)

Sahavechaphan, Naiyana; Phengsuwan, Jedsada; U-Ruekolan, Suriya; Aroonrua, Kamron; Ponhan, Jukrapong; Harnsamut, Nattapon; Vannarat, Sornthep

Heath information across geographically distributed healthcare centers has been recognized as an essential resource that drives an efficient national health-care plan. There is thus a need for the National Health Information System (NHIS) that provides the transparent and secure access to health information from different healthcare centers both on demand and in a time efficient manner. As healthiness is the ultimate goal of people and nation, we believe that the NHIS should be sustainable by taking the healthcare center and information consumer perspectives into account. Several issues in particular must be resolved altogether: (i) the diversity of health information structures among healthcare centers; (ii) the availability of health information sharing from healthcare centers; (iii) the efficient information access to various healthcare centers; and (iv) the privacy and privilege of heath information. To achieve the sustainable NHIS, this paper details our work which is divided into 3 main phases. Essentially, the first phase focuses on the application of metadata standard to enable the interoperability and usability of health information across healthcare centers. The second phase moves forward to make information sharing possible and to provide an efficient information access to a large number of healthcare centers. Finally, in the third phase, the privacy and privilege of health information is promoted with respect to access rights of information consumers.

Medical abortion: understanding perspectives of rural and marginalized women from rural South India.

PubMed

Sri, B Subha; Ravindran, T K Sundari

2012-09-01

To understand how rural and other groups of marginalized women define safe abortion; their perspectives and concerns regarding medical abortion (MA); and what factors affect their access to safe abortion. Focus group discussions were held with various groups of rural and marginalized women in Tamil Nadu to understand their perspectives and concerns on abortion, especially MA. Nearly a decade after mifepristone was approved for abortion in India, most study participants had never heard of MA. When they learned of the method, most preferred it over other methods of abortion. The women also had questions and concerns about the method and recommendations on how services should be provided. Their definition of a "safe abortion" included criteria beyond medical safety. They placed a high priority on "social safety," including confidentiality and privacy. In their view, factors affecting access to safe abortion and choice of provider included cost, assurance of secrecy, promptness of service provision, and absence of provider gatekeeping and provider-imposed conditions for receiving services. Women's preference for MA shows the potential of this technology to address the problem of unsafe abortion in India. Women need better access to information and services to realize this potential, however. Women's preferences regarding information dissemination and service provision need to be taken into account if policies and programs are to be truly responsive to the needs of marginalized women. Copyright © 2012. Published by Elsevier Ireland Ltd.

Informatics Observed [and] Agenda: A Tool for Agenda Setting Research [and] Telos Language Partner: Multimedia Language Learning, Authoring and Customisation [and] Towards a Consumer Perspective on Information Behaviour Research [and] The Digital Library as Access Management Facilitator [and] Knowledge and Information Management (KIM'21) [and] Perspectives of ICT in Professional Development and Education.

ERIC Educational Resources Information Center

Cawkell, Tony; Kok, Yeong Haur; Goh, Angela; Holaday, Duncan; Hoffstaedter, Petra; Kohn, Kurt; Rowley, Jennifer; van Halm, Johan; Pye, Jo

1999-01-01

The following collection of articles reprinted from "CD ROM and Online Review" include "a new way of learning." Discuses research and development funding in educational technology and recommends to offer vast sums to investigate the best way of teaching a particular topic, and through that to fund the use of computers as an incidental part of the…

Perceptual judgments made better by indirect interactions: Evidence from a joint localization task

PubMed Central

Sebanz, Natalie; Knoblich, Günther

2017-01-01

Others’ perceptual judgments tend to have strong effects on our own, and can improve perceptual judgments when task partners engage in communication. The present study investigated whether individuals benefit from others’ perceptual judgments in indirect interactions, where outcomes of individual decisions can be observed in a shared environment. Participants located a target in a 2D projection of a 3D container either from two complementary viewpoints (Experiment 1), or from a single viewpoint (Experiment 2). Uncertainty about the target location was high on the front-back dimension and low on the left-right dimension. The results showed that pairs of participants benefitted from taking turns in providing judgments. When each member of the pair had access to one complementary perspective, the pair achieved the same level of accuracy as when the two individuals had access to both complimentary perspectives and better performance than when the two individuals had access to only one perspective. These findings demonstrate the important role of a shared environment for successful integration of perceptual information while highlighting limitations in assigning appropriate weights to others’ judgments. PMID:29095951

Preferred information sources for clinical decision making: critical care nurses' perceptions of information accessibility and usefulness.

PubMed

Marshall, Andrea P; West, Sandra H; Aitken, Leanne M

2011-12-01

Variability in clinical practice may result from the use of diverse information sources to guide clinical decisions. In routine clinical practice, nurses privilege information from colleagues over more formal information sources. It is not clear whether similar information-seeking behaviour is exhibited when critical care nurses make decisions about a specific clinical practice, where extensive practice variability exists alongside a developing research base. This study explored the preferred sources of information intensive care nurses used and their perceptions of the accessibility and usefulness of this information for making decisions in clinically uncertain situations specific to enteral feeding practice. An instrumental case study design, incorporating concurrent verbal protocols, Q methodology and focus groups, was used to determine intensive care nurses' perspectives of information use in the resolution of clinical uncertainty. A preference for information from colleagues to support clinical decisions was observed. People as information sources were considered most useful and most accessible in the clinical setting. Text and electronic information sources were seen as less accessible, mainly because of the time required to access the information within the documents. When faced with clinical uncertainty, obtaining information from colleagues allows information to be quickly accessed and applied within the context of a specific clinical presentation. Seeking information from others also provides opportunities for shared decision-making and potential validation of clinical judgment, although differing views may exacerbate clinical uncertainty. The social exchange of clinical information may meet the needs of nurses working in a complex, time-pressured environment but the extent of the evidence base for information passed through verbal communication is unclear. The perceived usefulness and accessibility of information is premised on the ease of use and access and thus the variability in information may be contributing to clinical uncertainty. Copyright ©2011 Sigma Theta Tau International.

Telephone helplines as a source of support for eating disorders: Service user, carer, and health professional perspectives.

PubMed

Prior, Amie-Louise; Woodward, Debbie; Hoefkens, Toni; Clayton, Debbie; Thirlaway, Katie; Limbert, Caroline

2018-01-01

Access to care for eating disorders can be problematic for numerous reasons including lack of understanding and delays with treatment referrals. Previous research has highlighted the benefits of telephone helplines as an accessible source of support for those who may not wish to access face-to-face support or to fill a gap for those waiting for treatment. This study aimed to gain an insight into the perspectives of those who may use or refer others to a telephone helpline in order to identify the requirements of such a service. Triangulation of service user, carer and health professionals' perspectives resulted in identification of themes relating to the type of support, delivery and practicalities of a helpline. The findings indicated that telephone helplines may offer numerous benefits for individuals with an eating disorder, whether accessed as a first step, alongside treatment or as an extension of this support when in recovery. Additionally helplines may provide an opportunity for carers to access information and discuss their own experiences, while supporting their loved one. Raising awareness of these services is important to encourage those affected by an eating disorder to access and make the most of this type of support. These findings offer an insight into the key requirements for new and existing service development with regard to both the type of support and the method of communication required by individuals with eating disorders.

Parent or Caregiver, Staff, and Dentist Perspectives on Access to Dental Care Issues for Head Start Children in Ohio

PubMed Central

Siegal, Mark D.; Marx, Mary L.; Cole, Shannon L.

2005-01-01

Objectives. We conducted 5 surveys on consumer and provider perspectives on access to dental care for Ohio Head Start children to assess the need and appropriate strategies for action. Methods. We collected information from Head Start children (open-mouth screenings), their parents or caregivers (questionnaire and telephone interviews), Head Start staff (interviews), and dentists (questionnaire). Geocoded addresses were also analyzed. Results. Twenty-eight percent of Head Start children had at least 1 decayed tooth. For the 11% of parents whose children could not get desired dental care, cost of care or lack of insurance (34%) and dental office factors (20%) were primary factors. Only 7% of general dentists and 29% of pediatric dentists reported accepting children aged 0 through 5 years of age as Medicaid recipients without limitation. Head Start staff and dentists felt that poor appointment attendance negatively affected children’s receiving care, but parents/caregivers said finding accessible dentists was the major problem. Conclusions. Many Ohio Head Start children do not receive dental care. Medicaid and patient age were primary dental office limitations that are partly offset by the role Head Start plays in ensuring dental care. Dentists, Head Start staff, and parents/caregivers have different perspectives on the problem of access to dental care. PMID:16006416

Developing a smartphone app to support the nursing community.

PubMed

Colton, Scott; Hunt, Louise

2016-02-01

Healthcare professionals are turning increasingly to the digital sector to access information they need for their work. Mobile technology, such as smartphones and tablets, provides a unique opportunity to place high-quality information directly into users' hands. This article describes the ongoing development of a smartphone app, Preparing for Caring, designed to prepare the future workforce by enabling mentors and nursing students to access supportive material during practice-based learning episodes. The article explores the rationale for designing the app and discusses the challenges and benefits of developing this resource from the perspectives of student, mentor and healthcare manager.

Improving College Choice: Helping Students and Parents Make Better Informed Decisions. Data for Action 2012

ERIC Educational Resources Information Center

Data Quality Campaign, 2012

2012-01-01

As the demand for college graduates increases, it is critical (from both supply and demand perspectives) that students choose the postsecondary option that best meets their needs. Improved college readiness is an important first step to better informed choices about college. Parents and students need access to easy-to-understand data to make the…

"Let the "Orientales" Be as Enlightened as They Are Brave": The Digital Divide in the Context of Uruguay's Public Schools

ERIC Educational Resources Information Center

Capurro, Rafael; Rodríguez Fleitas, Maximiliano

2017-01-01

In this paper we present two recent information literacy and access initiatives in Uruguay and their necessary historical antecedents, and analyze them from a phenomenological perspective to provide commentary on current philosophical discussions about information and the digital divide. To provide historical context we present a brief history of…

Primary care assessment from a male population perspective.

PubMed

Silva, Abiúde Nadabe E; Silva, Simone Albino da; Silva, Ana Roberta Vilarouca da; Araújo, Telma Maria Evangelista de; Rebouças, Cristiana Brasil Almeida; Nogueira, Lídya Tolstenko

2018-01-01

to evaluate the quality of primary health care from the perspective of the male population. a cross-sectional descriptive-evaluative study conducted at the family health units of Teresina, Piauí, Brazil, with the male population being interviewed through the Primary Care Assessment Tool (PCAT). 301 participants with mean age of 51.34 years, married, incomplete elementary school and monthly income between one and two minimum wages. The evaluation was positive for the following care domains: utilization, information system and longitudinality. The features access, comprehensiveness of care, service available and service provided, family centeredness and community orientation obtained a negative evaluation. the features of primary care are unsatisfactory, indicating the need to expand access to services offered and to qualify care for male users.

Invisible Light: a global infotainment community based on augmented reality technologies

NASA Astrophysics Data System (ADS)

Israel, Kai; Wozniak, Peter; Vauderwange, Oliver; Curticapean, Dan

2015-10-01

Theoretical details about optics and photonics are not common knowledge nowadays. Physicists are keen to scientifically explain `light,' which has a huge impact on our lives. It is necessary to examine it from multiple perspectives and to make the knowledge accessible to the public in an interdisciplinary, scientifically well-grounded and appealing medial way. To allow an information exchange on a global scale, our project "Invisible Light" establishes a worldwide accessible platform. Its contents will not be created by a single instance, but user-generated, with the help of the global community. The article describes the infotainment portal "Invisible Light," which stores scientific articles about light and photonics and makes them accessible worldwide. All articles are tagged with geo-coordinates, so they can be clearly identified and localized. A smartphone application is used for visualization, transmitting the information to users in real time by means of an augmented reality application. Scientific information is made accessible for a broad audience and in an attractive manner.

The international council of ophthalmology: vision for ophthalmic education in an interdependent world.

PubMed

Lee, Andrew G; Golnik, Karl C; Tso, Mark O M; Spivey, Bruce; Miller, Kathleen; Gauthier, Tina-Marie

2012-10-01

To describe the emerging strategic global perspective of the International Council of Ophthalmology (ICO) efforts in ophthalmic education. A global perspective describing how the development of sophisticated educational tools in tandem with information technology can revolutionize ophthalmic education worldwide. Review of ICO educational tools, resources, and programs that are available to ophthalmic educators across the globe. With the explosive growth of the Internet, the ability to access medical information in the most isolated of locations is now possible. Through specific ICO initiatives, including the ICO curricula, the "Teaching the Teachers" program, and the launching of the new ICO Center for Ophthalmic Educators, the ICO is providing ophthalmic educators across the globe with access to standardized but customizable educational programs and tools to better train ophthalmologists and allied eye care professionals throughout the world. Access to educational tools and strengthening of global learning will help providers meet the goals of VISION 2020 and beyond in eliminating avoidable blindness. It is the intent of the ICO that its programs for ophthalmic educators, including conferences, courses, curricula, and online resources, result in better-trained ophthalmologists and eye care professionals worldwide. Copyright © 2012 Elsevier Inc. All rights reserved.

Transformative Learning, Enactivism, and Affectivity

ERIC Educational Resources Information Center

Maiese, Michelle

2017-01-01

Education theorists have emphasized that transformative learning is not simply a matter of students gaining access to new knowledge and information, but instead centers upon personal transformation: it alters students' perspectives, interpretations, and responses. How should learning that brings about this sort of self-transformation be understood…

Challenges of user-centred assistive technology provision in Australia: shopping without a prescription.

PubMed

Steel, Emily J; Layton, Natasha Ann; Foster, Michele M; Bennett, Sally

2016-01-01

People with disability have a right to assistive technology devices and services, to support their inclusion and participation in society. User-centred approaches aim to address consumer dissatisfaction and sub-optimal outcomes from assistive technology (AT) provision, but make assumptions of consumer literacy and empowerment. Policy discourses about consumer choice prompt careful reflection, and this paper aims to provide a critical perspective on user involvement in assistive technology provision. User-centred approaches are considered, using literature to critically reflect on what user involvement means in AT provision. Challenges at the level of interactions between practitioners and consumers, and also the level of markets and policies are discussed, using examples from Australia. There is no unanimous conceptual framework for user-centred practice. Power imbalances and differing perspectives between practitioners and consumers make it difficult for consumers to feel empowered. Online access to information and international suppliers has not surmounted information asymmetries for consumers or lifted the regulation of publicly funded AT devices. Ensuring access and equity in the public provision of AT is challenging in an expanding market with diverse stakeholders. Consumers require personalised information and support to facilitate their involvement and choice in AT provision. Implications for Rehabilitation Variations in approaches informing AT provision practices have a profound impact on equity of access and outcomes for consumers. An internationalised and online market for AT devices is increasing the need for effective information provision strategies and services. Power imbalances between practitioners and consumers present barriers to the realisation of user-centred practice.

International perspectives on sharing clinical data with patients.

PubMed

Prey, Jennifer E; Polubriaginof, Fernanda; Kuperman, Gilad J; Tiase, Victoria; Collins, Sarah A; Vawdrey, David K

2016-02-01

Engaging patients in their care has become a topic of increasing importance, and enabling patients to have access to their clinical data is a key aspect of such engagement. We investigated, on an international scale, the current state of approaches for providing patients with access to their own clinical information. Individuals from 28 countries were invited to participate in a cross-sectional semi-structured interview. Interview questions focused on social and cultural influences that affected patient engagement activities, government support for current and planned initiatives, data ownership models, and technical issues. Interviews were conducted with individuals from 16 countries representing six continents. Respondents reported substantive initiatives for providing information to patients in the majority of countries interviewed. These initiatives were diverse in nature and stage of implementation. Enabling patient access to data is occurring on an international scale. There is considerable variability in the level of maturity, the degree of government involvement, the technical infrastructure, and the plans for future development across the world. As informaticians, we are still in the early stages of deploying patient engagement technologies and have yet to identify optimal strategies in this arena. Efforts to improve patient access to data are active on a global-scale. There are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Accessing sexual and reproductive health care and information: Perspectives and recommendations from young Asian American women.

PubMed

Frost, Madeline; Cares, Alexa; Gelman, Katie; Beam, Rita

2016-12-01

Understanding the influence of culture on how sexual and reproductive health is perceived and addressed in Asian American communities is important for the effective provision of care and health information. This study aimed to explore how and when sexual and reproductive health information is shared within Asian American families and communities, barriers and facilitators to accessing sexual and reproductive health care and information for young Asian American women, and their recommendations to improve access. Qualitative data were collected through six focus groups conducted with a total of 33 young Asian American women. The majority of participants reported that stigma created a barrier to discussing these topics within their families and communities, and discussed ways in which they confidentially seek out care and information. Responses varied with respect to participants' preferred means of increasing access to care and information; some recommended strategies that would increase communication about these issues in their families and communities, while others expressed a desire to maintain confidentiality. These findings suggest that diversified strategies are needed to connect Asian American women with sexual and reproductive health care and information in order to meet their varied preferences, including strategies that are community-driven and culturally appropriate. Copyright © 2016 Elsevier B.V. All rights reserved.

Preparing for Sudden Death: Social Work in the Emergency Room.

ERIC Educational Resources Information Center

Wells, Paula J.

1993-01-01

Provides guidelines from social work perspective on how social workers and health care professionals can provide bereavement counseling for families whose relatives have died in emergency room. Discusses providing family with privacy and accessibility; keeping family informed; using understandable terminology; speaking directly about death;…

The Charge of the Byte Brigade: Educators Lead the Fourth Revolution.

ERIC Educational Resources Information Center

Gardner, David Pierpont

1986-01-01

Opportunities provided by computer technologies are considered from two perspectives: what they are enabling teachers and researchers to do and implications for the future. Processing information, opening access to the library, and coordinating telecommunications are discussed, including the University of California MELVYL system. (MLW)

Merchants of Death: Media Violence and American Empire.

ERIC Educational Resources Information Center

Trend, David

2003-01-01

Research has done little to advance understanding of who accesses the violent imagery in popular culture. The narrow perspective provided by mass-produced media violence must be broadened by critical viewpoints that provide information people need to participate in the democratic process. (Contains 85 reference notes.) (SK)

Accessibility and content of individualized adult reconstructive hip and knee/musculoskeletal oncology fellowship web sites.

PubMed

Young, Bradley L; Cantrell, Colin K; Patt, Joshua C; Ponce, Brent A

2018-06-01

Accessible, adequate online information is important to fellowship applicants. Program web sites can affect which programs applicants apply to, subsequently altering interview costs incurred by both parties and ultimately impacting rank lists. Web site analyses have been performed for all orthopaedic subspecialties other than those involved in the combined adult reconstruction and musculoskeletal (MSK) oncology fellowship match. A complete list of active programs was obtained from the official adult reconstruction and MSK oncology society web sites. Web site accessibility was assessed using a structured Google search. Accessible web sites were evaluated based on 21 previously reported content criteria. Seventy-four adult reconstruction programs and 11 MSK oncology programs were listed on the official society web sites. Web sites were identified and accessible for 58 (78%) adult reconstruction and 9 (82%) MSK oncology fellowship programs. No web site contained all content criteria and more than half of both adult reconstruction and MSK oncology web sites failed to include 12 of the 21 criteria. Several programs participating in the combined Adult Reconstructive Hip and Knee/Musculoskeletal Oncology Fellowship Match did not have accessible web sites. Of the web sites that were accessible, none contained comprehensive information and the majority lacked information that has been previously identified as being important to perspective applicants.

Consideration of techniques to mitigate the unauthorized 3D printing production of keys

NASA Astrophysics Data System (ADS)

Straub, Jeremy; Kerlin, Scott

2016-05-01

The illicit production of 3D printed keys based on remote-sensed imagery is problematic as it allows a would-be intruder to access a secured facility without the attack attempt being as obviously detectable as conventional techniques. This paper considers the problem from multiple perspectives. First, it looks at different attack types and considers the prospective attack from a digital information perspective. Second, based on this, techniques for securing keys are considered. Third, the design of keys is considered from the perspective of making them more difficult to duplicate using visible light sensing and 3D printing. Policy and legal considerations are discussed.

Academic Research Library as Broker in Addressing Interoperability Challenges for the Geosciences

NASA Astrophysics Data System (ADS)

Smith, P., II

2015-12-01

Data capture is an important process in the research lifecycle. Complete descriptive and representative information of the data or database is necessary during data collection whether in the field or in the research lab. The National Science Foundation's (NSF) Public Access Plan (2015) mandates the need for federally funded projects to make their research data more openly available. Developing, implementing, and integrating metadata workflows into to the research process of the data lifecycle facilitates improved data access while also addressing interoperability challenges for the geosciences such as data description and representation. Lack of metadata or data curation can contribute to (1) semantic, (2) ontology, and (3) data integration issues within and across disciplinary domains and projects. Some researchers of EarthCube funded projects have identified these issues as gaps. These gaps can contribute to interoperability data access, discovery, and integration issues between domain-specific and general data repositories. Academic Research Libraries have expertise in providing long-term discovery and access through the use of metadata standards and provision of access to research data, datasets, and publications via institutional repositories. Metadata crosswalks, open archival information systems (OAIS), trusted-repositories, data seal of approval, persistent URL, linking data, objects, resources, and publications in institutional repositories and digital content management systems are common components in the library discipline. These components contribute to a library perspective on data access and discovery that can benefit the geosciences. The USGS Community for Data Integration (CDI) has developed the Science Support Framework (SSF) for data management and integration within its community of practice for contribution to improved understanding of the Earth's physical and biological systems. The USGS CDI SSF can be used as a reference model to map to EarthCube Funded projects with academic research libraries facilitating the data and information assets components of the USGS CDI SSF via institutional repositories and/or digital content management. This session will explore the USGS CDI SSF for cross-discipline collaboration considerations from a library perspective.

ADHD in Indian Elementary Classrooms: Understanding Teacher Perspectives

ERIC Educational Resources Information Center

David, Neena

2013-01-01

ADHD in India is culturally viewed as a school specific condition. Parents perceive accessing child psychiatric services as stigmatizing and prefer educational interventions for ADHD. There is a crucial need for research that restructures information and intervention paradigms about ADHD within a school context. The objectives of the present study…

The Internet, Political Participation, and E-Government in Comparative Perspective

ERIC Educational Resources Information Center

Sharma, Mukul

2010-01-01

This dissertation addresses three important questions, together with optimistic and pessimistic views, about people's access/use of the Internet, its ability to promote their participation in politics, and its role in government provision of information and public services. Chapter Two addresses the question of the determinants of people's access…

The Japanese Mind: Understanding Contemporary Japanese Culture.

ERIC Educational Resources Information Center

Davies, Roger J., Ed.; Ikeno, Osamu, Ed.

This collection of essays offers an overview of contemporary Japanese culture, and can serve as a resource for classes studying Japan. The 28 essays offer an informative, accessible look at the values, attitudes, behavior patterns, and communication styles of modern Japan from the unique perspective of the Japanese people. Filled with examples…

Perspectives or Telemedicine Development in Ukraine

DTIC Science & Technology

2001-05-01

National Register of the individuals who are suffering from consequences of the Chernobyl disaster. This Register monitors the health of more than 700,000...integrate the Chernobyl Register net into ’UkrMedNet’ and to create a WWW server containing the Chernobyl Register information. To provide access to the

Children's Search Engines from an Information Search Process Perspective.

ERIC Educational Resources Information Center

Broch, Elana

2000-01-01

Describes cognitive and affective characteristics of children and teenagers that may affect their Web searching behavior. Reviews literature on children's searching in online public access catalogs (OPACs) and using digital libraries. Profiles two Web search engines. Discusses some of the difficulties children have searching the Web, in the…

Special Educators' Perspectives on the Services and Benefits of Educational Audiologists

ERIC Educational Resources Information Center

Knickelbein, Becky A.; Richburg, Cynthia M.

2012-01-01

A 36-item survey was used to determine whether special educators have access to the services of an audiologist and whether they obtained benefit from the audiologist's services. Additional goals included gathering information about special educators' understanding of basic audiological concepts related to a school setting, added job…

Improving technical information use: what can be learnt from a manager's perspective?

PubMed

Jacobson, C; Lisle, A; Carter, R W; Hockings, M T

2013-07-01

Conservation practice reportedly suffers from low use of technical information. Understanding of factors that affect the influence of technical information on management decision-making is limited. We sought to identify leverage points for improved technical information dissemination in the New South Wales Parks and Wildlife Service, Australia, given the significant recent investments in monitoring and evaluation that had been made. We did so by exploring the inter-relationships between factors affecting the influence of different information types on management decisions. Results indicate that managers have a high inclination toward adaptive behavior, given they operate in an information poor environment. The most influential types of information were those that enabled interaction between information provider and recipient (e.g., staff experience and expertise). An analysis of the concordance in individuals' responses for different information types showed that neither accessibility nor organizational expectation of use was aligned with influence on decision-making. Alignment of responses also varied by work area. Raising expectations of information use or increasing access to particular types of information is therefore unlikely to result in an increase in influence on management decision-making. Rather than focussing on matching accessibility and expected use of particular information types, our results indicate that technical information uptake is best supported through existing peer networks tailored to specific work areas.

Perspectives in astrophysical databases

NASA Astrophysics Data System (ADS)

Frailis, Marco; de Angelis, Alessandro; Roberto, Vito

2004-07-01

Astrophysics has become a domain extremely rich of scientific data. Data mining tools are needed for information extraction from such large data sets. This asks for an approach to data management emphasizing the efficiency and simplicity of data access; efficiency is obtained using multidimensional access methods and simplicity is achieved by properly handling metadata. Moreover, clustering and classification techniques on large data sets pose additional requirements in terms of computation and memory scalability and interpretability of results. In this study we review some possible solutions.

A geographical perspective on access to sexual and reproductive health care for women in rural Africa.

PubMed

Yao, Jing; Murray, Alan T; Agadjanian, Victor

2013-11-01

Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. Copyright © 2013 Elsevier Ltd. All rights reserved.

A geographical perspective on access to sexual and reproductive health care for women in rural Africa

PubMed Central

Yao, Jing; Murray, Alan T.; Agadjanian, Victor

2015-01-01

Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. PMID:24034952

Community Pharmacists' Perspectives on Dispensing Medications With the Potential for Misuse, Diversion, and Intentional Overdose: Results of a Province-Wide Survey of Community Pharmacists in Canada.

PubMed

Leong, Christine; Alessi-Severini, Silvia; Sareen, Jitender; Enns, Murray W; Bolton, James

2016-11-09

Community pharmacists frequently encounter patients at risk of medication misuse, diversion, and intentional overdose. However, few studies have examined the perspective of the pharmacist on the identification and management of these patients. To understand the perspective of community pharmacists on the dispensing of select medications commonly associated with misuse, diversion, and overdose. An online survey was disseminated by electronic mail to community pharmacists listed in the College of Pharmacists of Manitoba directory. The survey was open from July to September 2014. Descriptive statistics were used to describe demographic information of the pharmacist and practice setting, and pharmacists' perceptions on the dispensing of select medications. A total of 82 community pharmacists completed the survey. Most pharmacists considered a one-month supply appropriate for a psychotropic agent; but a 7-10 day-supply was considered appropriate for an opioid for acute pain. Factors that aid pharmacist decisions on providing select medications to patients include familiarity with the patient, ease of access to medical history information, and ease of access to the prescribing physician. Only 10.3%, 16.2%, and 32.4% felt they have received adequate training on the management of patients at risk for suicide, drug diversion, and medication misuse, respectively. Findings from this study demonstrated a need for improved systems for managing patients at risk for medication misuse, diversion, and overdose. Strategies that warrant further attention for limiting the means of medication misuse include increased access to electronic medical records and providing additional continuing education support for community pharmacists.

Midwives' and women's views on accessing dental care during pregnancy: an Australian qualitative study.

PubMed

Lim, M; Riggs, E; Shankumar, R; Marwaha, P; Kilpatrick, N

2018-04-16

Maternal behaviours during pregnancy are likely to play a significant role in the development of dental caries in children. Although midwives are well placed to discuss oral health and provide information to women, dental attendance by women during pregnancy is minimal. This study aimed to explore midwives' experience of facilitating pregnant women's access to dental care and to document women's experience of receiving dental information and care during pregnancy. Focus groups with midwives and telephone interviews with women who were referred to Monash Health Dental Services were conducted to explore their perspectives and experiences. The qualitative data was thematically analysed. Three focus groups with 13 midwives and telephone interviews with eight women who recently gave birth were conducted. Three key themes were identified: maternal oral health knowledge; barriers to accessing dental information and care during pregnancy; and suggested recommendations. This study highlighted the barriers that exist for midwives to discuss oral health with women and refer women to dental care, and women's experiences of accessing dental care during pregnancy. Ongoing collaboration between the maternity and dental services is required to strengthen midwives' knowledge, confidence and practise in supporting women to access dental care during pregnancy. © 2018 Australian Dental Association.

[Publication of healthcare quality data to citizens--status and perspectives].

PubMed

Utzon, Jan; Kaergaard, Johan

2009-05-11

Public quality reports are intended to stimulate active consumer participation by enabling consumers to make informed choices about their healthcare providers. Despite all efforts, public reporting has been shown not to be effective in stimulating consumers to choose their healthcare provider based on performance information in Denmark and other countries. Numerous barriers are identified. In an effort to move towards an effective public reporting system in Denmark, the present article discusses how quality information can be made accessible and meaningful to wider groups of consumers.

Prostate Cancer Patient Perspectives on the Use of Information in Treatment Decision-Making: A Systematic Review and Qualitative Meta-synthesis

PubMed Central

Kandasamy, Sujane; Khalid, Ahmad Firas; Majid, Umair; Vanstone, Meredith

2017-01-01

Background Men with low- to intermediate-risk prostate cancer are typically asked to choose from a variety of treatment options, including active surveillance, radical prostatectomy, or brachytherapy. The Prolaris cell cycle progression test is intended to provide additional information on personal risk status to assist men with prostate cancer in their choice of treatment. To assist with assessing that new technology, this report synthesizes qualitative research on how men with prostate cancer use information to make decisions about treatment options. Methods We performed a systematic review and qualitative meta-synthesis to retrieve and synthesize findings across primary qualitative studies that report on patient perspectives during prostate cancer treatment decision-making. Results Of 8,610 titles and abstracts reviewed, 29 studies are included in this report. Most men diagnosed with prostate cancer express that their information-seeking pathway extends beyond the medical information received from their health care provider. They access other social resources to attain additional medical information, lived-experience information, and medical administrative information to help support their final treatment decision. Men value privacy, trust, honesty, control, power, organization, and open communication during interactions with their health care providers. They also emphasize the importance of gaining comfort with their treatment choice, having a chance to confirm their health care provider's recommendations (validation of treatment plan), and exercising their preferred level of independence in the treatment decision-making process. Conclusions Although each prostate cancer patient is unique, studies suggest that most patients seek extensive information to help inform their treatment decisions. This may happen before, during, and after the treatment choice is made. Given the amount of information patients may access, it is important that they also establish the trustworthiness of the various types and sources of information. When information conflicts, patients may be unsure about how to proceed. Open collaboration between patients and their health care providers can help patients manage and navigate their concerns so that their values and perspectives are captured in their treatment choices. PMID:28572868

206: TRACKING THE PATIENT'S RIGHT TO INFORMATION IN IRANIAN PATIENT RIGHT CHARTER FROM THE MEDICAL INFORMATION SCIENCE PERSPECTIVE: A QUALITATIVE STUDY

PubMed Central

Samadi, Soraya; Gavgani, Vahideh Zarea

2017-01-01

Background and aims From the information science perspective making the right information accessible to patients ensures the healthcare promotion and empowers the patient to contribute and involve in his/her healthcare decision making and change. This study aimed at analyzing and visualizing the Iran's Patients Right Charter from the Medical Library and Information Sciences' viewpoints. Methods A mix method of qualitative and quantitative was used to push the study. Content Analyzing and Descriptive method were used to analyze and describe data. It was also benefited the documentary methods to review the related literature in citation databases and gray literatures. And descriptive analysis also was hired to show the share of each concept in total knowledge depiction of Patient's Right to Information. The Iranian patient right charters were reviewed to trace the concept of information/right to information in every Para and articles. The Library Congress Subject Heading (LCHS) was used to extract the equivalent/parallel concepts related to ontology of information in the concept of health and medicine as well as law. All the LCSH based terms were then converted to main categories and subcategories. Patient right charters were reviewed with the LCSH based categories to reveal does the patient right charter include the right to information parameters, and which concepts, Para or articles is supporting right to information? Conclusion Access to the right information at the right time is advocated by ethical and legal issues of clinical governance through the patients' rights. But to execute the patient's rights to information in practice it is essential to create clinical guidelines and to develop rules for information therapy service in Iran.

Understanding the unique experiences, perspectives and sexual and reproductive health needs of very young adolescents: Somali refugees in Ethiopia.

PubMed

Ortiz-Echevarria, Luis; Greeley, Meghan; Bawoke, Tenaw; Zimmerman, Linnea; Robinson, Courtland; Schlecht, Jennifer

2017-01-01

Kobe Refugee camp hosts roughly 39,000 refugees displaced from Somalia during the 2011-2012 Horn of Africa Crisis. Sexual and reproductive health, as with the greater issues of health and well-being for adolescents displaced from this crisis remain largely unknown and neglected. In 2013, the Women's Refugee Commission, Johns Hopkins University, and International Medical Corps in Ethiopia, implemented qualitative and quantitative research to explore the factors and risks that impact the health of very young adolescents (VYAs), those 10-14 years of age, in this setting. This paper presents findings from the qualitative effort. Focus group discussions (FGD), incorporating community mapping and photo elicitation activities, were conducted with 10-12 and 13-14 year-olds to obtain information about their own perspectives, experiences and values. FGDs were also implemented with 15-16 year-olds and adults, to consider their perspectives on the sexual and reproductive health needs and risks of VYAs. This research identified several factors that were found to influence the health and well-being of VYAs in Kobe refugee camp, including newfound access to education and security, combined with gender divisions and parental communication around early SRH and puberty that remained intact from traditional Somali culture. Girls were found to face an additional risk of child marriage and early pregnancy exacerbated since displacement, which significantly limited their ability to access education and achieve future aspirations. Findings from this study could help to inform future programs in Kobe and similar contexts involving long-term displacement from conflict, focusing on the health and development needs of VYAs. Future programs should consider the determinants of positive VYA health and development, including access to education, gender equity, and safety.By better understanding the unique experiences, perspectives and needs of VYAs, practitioners, policy makers and donors can invest in the individual and community assets that reinforce positive behaviors established in early adolescence, in order to achieve long-term SRH impacts.

Campaign 96: A Perspective on Cyberspace Political Communication.

ERIC Educational Resources Information Center

Glenn, Robert J., III

In 1996 the Internet evolved into a key information source for voters interested in experiencing an unfiltered view of the political process through the lenses of political parties, news organizations, educational foundations, media outlets, and a host of specialized interest groups (e.g., Common Cause, Sierra Club). This access came in the form…

Perspectives On... Roaches, Guerrillas, and ''Librarians on the Loose''

ERIC Educational Resources Information Center

Macke, Barbara

2005-01-01

Sophistication and accessibility can be dangerous bedfellows, especially when it comes to information sources. One of the real challenges in undergraduate academic libraries can be connecting students in a meaningful way to the resources that will be most helpful and understandable for them. This article discusses how techniques borrowed from the…

Poverty, Disability, and Employment: Global Perspectives from the National Centre for Promotion of Employment for Disabled People

ERIC Educational Resources Information Center

Abidi, Javed; Sharma, Dorodi

2014-01-01

The worldwide problems of disability, poverty, and unemployment stem out of the interaction of multiple factors including social stigma, stereotypes, lack of access to physical infrastructure, information, and enabling environments. Given this, a singular approach toward tackling these interrelated issues falls short. This article attempts to…

WBDG: A Resource for All

ERIC Educational Resources Information Center

Brodt, Bill; Smith, Dana K.

2009-01-01

The Whole Building Design Guide (WBDG) (www.wbdg.org) is the only Web-based portal providing government and industry practitioners with one-stop access to up-to-date information on a wide range of building-related guidance, criteria, and technology from a "whole buildings" perspective. The resource is a product of the National Institute of…

The PhD Dissertation Defense in Canada: An Institutional Policy Perspective

ERIC Educational Resources Information Center

Chen, Shuhua

2008-01-01

Drawing upon publicly accessible information on the websites of ten Canadian research universities, this paper aims to shed some light on the assumed variation of institutional policies regarding the PhD dissertation defense in Canada. It discusses "How are the institutional policies on the doctoral dissertation defense different across…

The Hidden Picture: Administrators' Perspectives on Least Restrictive Environment

ERIC Educational Resources Information Center

Garner, Gina Marlene

2009-01-01

This study looks to better understand how administrators make a decision about a least restrictive environment placement recommendation. What decision processes do they engage in when merging information of individual and environment to create a working plan of access that will benefit all involved? It also seeks the factors that are primary in…

Backlash, Backwater, or Back to the Drawing Board: Feminist Thinking and Librarianship in the 1990s.

ERIC Educational Resources Information Center

Pritchard, Sarah

1994-01-01

Discusses the feminist perspective of librarianship, including following key issues: salaries, pay equity, and occupational segregation; faculty status, professional education, and recruitment; access to information; technology; and sociology of the workplace. A number of myths relating to this topic are addressed, and a bibliography of 18 recent…

Learning through Information Communication Technology: Critical Perspectives

ERIC Educational Resources Information Center

Severinsen, G.

2003-01-01

Technology in secondary schools has become of increasing interest as the power of the microchip has developed. For the students of Mathematics, computers and handheld graphic calculators need to be accessible to all. They are relevant to the needs of the students' courses and to support and develop their Mathematical learning (Smith, 1997).…

Opening Doors: Students' Perspectives on Juggling Work, Family, and College.

ERIC Educational Resources Information Center

Matus-Grossman, Lisa; Gooden, Susan

Information gathered in focus groups of current, former, and potential students at six community colleges was used to explore institutional and personal access and retention issues faced by students seeking a workable balance of their college, work, and family responsibilities. The six community colleges were as follows: Cabrillo College (Aptos,…

A Framework for Mobile Apps in Colleges and Universities: Data Mining Perspective

ERIC Educational Resources Information Center

Singh, Archana; Ranjan, Jayanthi

2016-01-01

The Enterprise mobility communication technology provides easy and quick accessibility to data and information integrated into one single touch point device. This device incorporates or integrates all the processes into small applications or App and thus increases the workforce capability of knowledge workers. "App" which is a small set…

Life at University with Asperger Syndrome: A Comparison of Student and Staff Perspectives

ERIC Educational Resources Information Center

Knott, Fiona; Taylor, Angela

2014-01-01

Although increasing numbers of students with disabilities are accessing higher education, there is relatively little information about the needs of students with Asperger syndrome (AS). Crucially, students themselves have rarely been included in research examining their needs or the supports they might find helpful. Three focus groups, one with…

Access to medicines from a health system perspective

PubMed Central

Bigdeli, Maryam; Jacobs, Bart; Tomson, Goran; Laing, Richard; Ghaffar, Abdul; Dujardin, Bruno; Van Damme, Wim

2013-01-01

Most health system strengthening interventions ignore interconnections between systems components. In particular, complex relationships between medicines and health financing, human resources, health information and service delivery are not given sufficient consideration. As a consequence, populations' access to medicines (ATM) is addressed mainly through fragmented, often vertical approaches usually focusing on supply, unrelated to the wider issue of access to health services and interventions. The objective of this article is to embed ATM in a health system perspective. For this purpose, we perform a structured literature review: we examine existing ATM frameworks, review determinants of ATM and define at which level of the health system they are likely to occur; we analyse to which extent existing ATM frameworks take into account access constraints at different levels of the health system. Our findings suggest that ATM barriers are complex and interconnected as they occur at multiple levels of the health system. Existing ATM frameworks only partially address the full range of ATM barriers. We propose three essential paradigm shifts that take into account complex and dynamic relationships between medicines and other components of the health system. A holistic view of demand-side constraints in tandem with consideration of multiple and dynamic relationships between medicines and other health system resources should be applied; it should be recognized that determinants of ATM are rooted in national, regional and international contexts. These are schematized in a new framework proposing a health system perspective on ATM. PMID:23174879

Issues and challenges of information fusion in contested environments: panel results

NASA Astrophysics Data System (ADS)

Blasch, Erik; Kadar, Ivan; Chong, Chee; Jones, Eric K.; Tierno, Jorge E.; Fenstermacher, Laurie; Gorman, John D.; Levchuk, Georgiy

2015-05-01

With the plethora of information, there are many aspects to contested environments such as the protection of information, network privacy, and restricted observational and entry access. In this paper, we review and contrast the perspectives of challenges and opportunities for future developments in contested environments. The ability to operate in a contested environment would aid societal operations for highly congested areas with limited bandwidth such as transportation, the lack of communication and observations after a natural disaster, or planning for situations in which freedom of movement is restricted. Different perspectives were presented, but common themes included (1) Domain: targets and sensors, (2) network: communications, control, and social networks, and (3) user: human interaction and analytics. The paper serves as a summary and organization of the panel discussion as towards future concerns for research needs in contested environments.

How ISO/IEC 17799 can be used for base lining information assurance among entities using data mining for defense, homeland security, commercial, and other civilian/commercial domains

NASA Astrophysics Data System (ADS)

Perry, William G.

2006-04-01

One goal of database mining is to draw unique and valid perspectives from multiple data sources. Insights that are fashioned from closely-held data stores are likely to possess a high degree of reliability. The degree of information assurance comes into question, however, when external databases are accessed, combined and analyzed to form new perspectives. ISO/IEC 17799, Information technology-Security techniques-Code of practice for information security management, can be used to establish a higher level of information assurance among disparate entities using data mining in the defense, homeland security, commercial and other civilian/commercial domains. Organizations that meet ISO/IEC information security standards have identified and assessed risks, threats and vulnerabilities and have taken significant proactive steps to meet their unique security requirements. The ISO standards address twelve domains: risk assessment and treatment, security policy, organization of information security, asset management, human resources security, physical and environmental security, communications and operations management, access control, information systems acquisition, development and maintenance, information security incident management and business continuity management and compliance. Analysts can be relatively confident that if organizations are ISO 17799 compliant, a high degree of information assurance is likely to be a characteristic of the data sets being used. The reverse may be true. Extracting, fusing and drawing conclusions based upon databases with a low degree of information assurance may be wrought with all of the hazards that come from knowingly using bad data to make decisions. Using ISO/IEC 17799 as a baseline for information assurance can help mitigate these risks.

Removing user fees for health services: A multi-epistemological perspective on access inequities in Senegal.

PubMed

Mladovsky, Philipa; Ba, Maymouna

2017-09-01

Plan Sésame (PS) is a user fee exemption policy launched in 2006 to provide free access to health services to Senegalese citizens aged 60 and over. Analysis of a large household survey evaluating PS echoes findings of other studies showing that user fee removal can be highly inequitable. 34 semi-structured interviews and 19 focus group discussions with people aged 60 and over were conducted in four regions in Senegal (Dakar, Diourbel, Matam and Tambacounda) over a period of six months during 2012. They were analysed to identify underlying causes of exclusion from/inclusion in PS and triangulated with the household survey. The results point to three steps at which exclusion occurs: (i) not being informed about PS; (ii) not perceiving a need to use health services under PS; and (iii) inability to access health services under PS, despite having the information and perceived need. We identify lay explanations for exclusion at these different steps. Some lay explanations point to social exclusion, defined as unequal power relations. For example, poor access to PS was seen to be caused by corruption, patronage, poverty, lack of social support, internalised discrimination and adverse incorporation. Other lay explanations do not point to social exclusion, for example: poor implementation; inadequate funding; high population demand; incompetent bureaucracy; and PS as a favour or moral obligation to friends or family. Within a critical realist paradigm, we interpret these lay explanations as empirical evidence for the presence of the following hidden underlying causal mechanisms: lacking capabilities; mobilisation of institutional bias; and social closure. However, social constructionist perspectives lead us to critique this paradigm by drawing attention to contested health, wellbeing and corruption discourses. These differences in interpretation lead to subsequent differential policy recommendations. This demonstrates the need for the adoption of a "multi-epistemological" perspective in studies of health inequity and social exclusion. Copyright © 2017 Elsevier Ltd. All rights reserved.

Overcoming structural constraints to patient utilization of electronic medical records: a critical review and proposal for an evaluation framework.

PubMed

Winkelman, Warren J; Leonard, Kevin J

2004-01-01

There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes.

Survivorship Care Plan Information Needs: Perspectives of Safety-Net Breast Cancer Patients.

PubMed

Burke, Nancy J; Napoles, Tessa M; Banks, Priscilla J; Orenstein, Fern S; Luce, Judith A; Joseph, Galen

2016-01-01

Despite the Institute of Medicine's (IOM) 2005 recommendation, few care organizations have instituted standard survivorship care plans (SCPs). Low health literacy and low English proficiency are important factors to consider in SCP development. Our study aimed to identify information needs and survivorship care plan preferences of low literacy, multi-lingual patients to support the transition from oncology to primary care and ongoing learning in survivorship. We conducted focus groups in five languages with African American, Latina, Russian, Filipina, White, and Chinese medically underserved breast cancer patients. Topics explored included the transition to primary care, access to information, knowledge of treatment history, and perspectives on SCPs. Analysis of focus group data identified three themes: 1) the need for information and education on the transition between "active treatment" and "survivorship"; 2) information needed (and often not obtained) from providers; and 3) perspectives on SCP content and delivery. Our data point to the need to develop a process as well as written information for medically underserved breast cancer patients. An SCP document will not replace direct communication with providers about treatment, symptom management and transition, a communication that is missing in participating safety-net patients' experiences of cancer care. Women turned to peer support and community-based organizations in the absence of information from providers. "Clear and effective" communication of survivorship care for safety-net patients requires dedicated staff trained to address wide-ranging information needs and uncertainties.

A mismatch between supply and demand of social support in dementia care: a qualitative study on the perspectives of spousal caregivers and their social network members.

PubMed

Dam, Alieske E H; Boots, Lizzy M M; van Boxtel, Martin P J; Verhey, Frans R J; de Vugt, Marjolein E

2017-06-13

Access to social support contributes to feelings of independence and better social health. This qualitative study aims to investigate multi-informant perspectives on informal social support in dementia care networks. Ten spousal caregivers of people with dementia (PwD) completed an ecogram, a social network card and a semi-structured interview. The ecogram aimed to trigger subjective experiences regarding social support. Subsequently, 17 network members were interviewed. The qualitative analyses identified codes, categories, and themes. Sixth themes emerged: (1) barriers to ask for support; (2) facilitators to ask for support; (3) barriers to offer support; (4) facilitators to offer support; (5) a mismatch between supply and demand of social support; and (6) openness in communication to repair the imbalance. Integrating social network perspectives resulted in a novel model identifying a mismatch between the supply and demand of social support, strengthened by a cognitive bias: caregivers reported to think for other social network members and vice versa. Openness in communication in formal and informal care systems might repair this mismatch.

Public Perspectives on Informed Consent for Biobanking

PubMed Central

Scott, Joan; Kaufman, David; Geller, Gail; LeRoy, Lisa; Hudson, Kathy

2009-01-01

The National Institutes of Health and other federal health agencies are considering establishing a national biobank to study the roles of genes and environment in health. We assessed the public's attitudes toward the proposed biobank, including preferences for providing informed consent. Sixteen focus groups were conducted, and themes arising from the focus groups were tested in a large, representative survey (n = 4659) of the general population. Our research demonstrates that when considering participating in a genomic biobank, individuals want ongoing choices and control over access to their samples and information. PMID:19833988

Pursuing College Education in the Context of Gender-Based Violence and Psychiatric Histories: Women's Lived Experiences of Resilience and Recovery

ERIC Educational Resources Information Center

Mongillo, Elizabeth A.

2009-01-01

There has been a growing movement toward expanding biomedical psychiatric models focused on individual psychopathology using contextually-sensitive, socio-politically informed, ecological approaches, and resilience and recovery perspectives emphasizing individuals' rights to access the necessary resources to resume life pursuits (e.g. education)…

Adapting Technology for School Improvement: A Global Perspective

ERIC Educational Resources Information Center

Chapman, David W., Ed.; Mahlck, Lars O., Ed.

2004-01-01

This book presents a compilation of articles based on the premise that the move to advanced technology use in primary and secondary schools offers great hope for improving the access, quality, and efficiency of basic education. The aim of the book is to identify and examine how information technologies can be, and are being, used to strengthen the…

The Influence of Context on Residents' Evaluations: Effects of Priming on Clinical Judgment and Affect

ERIC Educational Resources Information Center

Teunissen, P. W.; Stapel, D. A.; Scheele, F.; Scherpbier, A. J. J. A.; Boor, K.; van Diemen-Steenvoorde, J. A. A. M.; van der Vleuten, C. P. M.

2009-01-01

Different lines of research have suggested that context is important in acting and learning in the clinical workplace. It is not clear how contextual information influences residents' constructions of the situations in which they participate. The category accessibility paradigm from social psychology appears to offer an interesting perspective for…

Expanded Learning Time and Opportunities: Key Principles, Driving Perspectives, and Major Challenges

ERIC Educational Resources Information Center

Blyth, Dale A.; LaCroix-Dalluhn, Laura

2011-01-01

If expanded learning is going to make a real difference, then three key principles must inform how communities overcome challenges and assure equitable access to learning opportunities. Much of today's debate is framed in the language of formal education systems--students, classrooms, schools--even though part of the expansion seeks to engage a…

The Federal Depository Library Program in Transition: A Perspective at the Turn of a Century.

ERIC Educational Resources Information Center

O'Mahony, Daniel P.

1998-01-01

The legal framework covering government information procurement, production, and dissemination has been in place for over 100 years. Congress is currently developing revisions to the U.S. Code to reform this system. Fundamental principles of public access, embodied in the Federal Depository Library Program, must guide these revisions, and…

The Open World: Access to Knowledge as a Foundation for an Open World

ERIC Educational Resources Information Center

Rossini, Carolina

2010-01-01

The change brought about in the networked information environment is deep and structural, in a way that has the potential to empower cultures left out of the Industrial Revolution. Thus, the author stresses that it is fundamental for individuals to understand, from a developing nation's perspective, how the Internet changes the capacity of…

How Are Teacher-Librarians Finding Resources for Coursework?: Distance Learners and the Role of University Library Services

ERIC Educational Resources Information Center

de Jong, Cees-Jan; Branch, Jennifer L.

2005-01-01

Providing distance learners access to library services does not automatically translate into usage of those resources. The literature on information-seeking behaviour of distance learners has indicated that they prefer to use local resources, as well as Web-based resources. This study investigates perspectives on library services and available…

Analysis of the Demand for Distance Education at Eastern and Central European Higher Education Institutions

ERIC Educational Resources Information Center

Vasilevska, Daina; Rivza, Baiba; Pivac, Tatjana; Alekneviciene, Vilija; Parlinska, Agnieszka

2017-01-01

Distance education as one of the new and perspective forms of completing higher education increases in popularity around the world. At the same time, the development of this model of education generates new problems: organization of the study process and information security. Distance learning allows solving a problem of accessibility of higher…

Professional Development across the Islands of the South Pacific: A Perspective of a Blended Learning Facilitator

ERIC Educational Resources Information Center

Hoffmann-Dumienski, Kamila

2016-01-01

Access to information and communication technology (ICT) is becoming an increasingly important factor for education and training in the South Pacific region. While many studies have examined the attitudes and understanding of educators towards using ICT in their profession and for their professional development, studies that specifically deal with…

Teachers' Approaches to Finding and Using Research Evidence: An Information Literacy Perspective

ERIC Educational Resources Information Center

Williams, Dorothy; Coles, Louisa

2007-01-01

Background: The use of research evidence produced by others is seen as central to the reflective practice of school teachers. There have been many recent UK initiatives aimed at improving access to research evidence, but there are still concerns about the lack of engagement by teachers. Previous research has looked at this issue from different…

Moving Teaching and Learning with Technology from Adoption to Transformation

ERIC Educational Resources Information Center

Hartman, Joel L.

2008-01-01

Information technology has been an important part of higher education since the development of the lantern slide in the mid-1800s. However, occasions in which the academy has been "transformed" by technology are rare. Viewed in a historical perspective, these occasions can be considered as a series of three epochs: the online public-access catalog…

The National Biological Information Infrastructure: Coming of age

USGS Publications Warehouse

Cotter, G.; Frame, M.; Sepic, R.; Zolly, L.

2000-01-01

Coordinated by the US Geological Survey, the National Biological Information Infrastructure (NBII) is a Web-based system that provides increased access to data and information on the nation's biological resources. The NBII can be viewed from a variety of perspectives. This article - an individual case study and not a broad survey with extensive references to the literature - addresses the structure of the NBII related to thematic sections, infrastructure sections and place-based sections, and other topics such as the Integrated Taxonomic Information System (one of our more innovative tools) and the development of our controlled vocabulary.

Perspectives of a mobile application for people with communication disabilities in the community.

PubMed

Crook, Alice; Kenny, Julie; Johnson, Hilary; Davidson, Bronwyn

2017-02-01

Purpose To determine the perceptions of people with complex communication needs (CCN) and business staff regarding the uses and functionality of a mobile application to aid communication access. Method A qualitative study using thematic analysis of transcripts and field notes from focus groups and interviews of 19 people with CCN and nine business staff. Results Four themes and 10 subthemes were drawn from the data. Themes highlighted the desire for: increased communication strategies to support customer interactions, increased access to information, functionality of a mobile application to increase its utility, and preferred technical and visual features of mobile applications. Conclusion People with CCN and business staff perceived a mobile application as a useful tool to aid communication access. This research highlighted the importance of facilitating strategies to communicative interactions and information in the community as the fundamental goal of a mobile application developed to support communication access. Implications for Rehabilitation Mobile applications are widely accepted and used in modern customer service industries and have been identified as tools to increase communication access for people with complex communication needs (CCN). People with CCN identified accessibility, presentation, and customisation as important features of mobile applications for communication access. The diversity of user preferences and needs, and the rapid development of new technologies limit the applicability of a single design for mobile applications for people with CCN. People with CCN should be involved in application design and development. A mobile application for communication access would support customer-business interactions as well as enable more accessible information sharing about disability needs and services.

Web Search Studies: Multidisciplinary Perspectives on Web Search Engines

NASA Astrophysics Data System (ADS)

Zimmer, Michael

Perhaps the most significant tool of our internet age is the web search engine, providing a powerful interface for accessing the vast amount of information available on the world wide web and beyond. While still in its infancy compared to the knowledge tools that precede it - such as the dictionary or encyclopedia - the impact of web search engines on society and culture has already received considerable attention from a variety of academic disciplines and perspectives. This article aims to organize a meta-discipline of “web search studies,” centered around a nucleus of major research on web search engines from five key perspectives: technical foundations and evaluations; transaction log analyses; user studies; political, ethical, and cultural critiques; and legal and policy analyses.

Exploring Maori health worker perspectives on colorectal cancer and screening.

PubMed

Pitama, Suzanne; Cave, Tami; Huria, Tania; Lacey, Cameron; Cuddy, Jessica; Frizelle, Frank

2012-06-08

To explore Maori health worker perspectives on colorectal screening and identify factors that may influence Maori participation in a colorectal screening programme. Thirty Maori health workers were interviewed to explore their experience with screening programmes, knowledge of colorectal cancer and their perspective on a potential colorectal screening programme. Health workers shared their perspective informed by both their own whanau and whanau they encountered professionally through their health work. Participants were largely positive about potential colorectal screening; however, various access barriers were identified. These included patient-clinician engagement and communication, lack of provision for patient's privacy during screening and patients feeling discouraged to take part in screening. Factors enabling screening included having an established relationship with their General Practitioner, screening clinicians taking time to build rapport, answer questions and share information, screening practices that were inclusive of Maori cultural norms and possessing high health literacy. Evidence points to growing disparity between the colorectal cancer incidence rates of Maori and non-Maori; disparities in colorectal cancer survival rates are already marked. Participants in the current pilot could provide valuable information to help ensure that the health education, promotion, and clinical practice surrounding a national colorectal screening programme are effective for Maori in reducing disparity and improving health outcomes.

Primary care providers' lived experiences of genetics in practice.

PubMed

Harding, Brittany; Webber, Colleen; Ruhland, Lucia; Dalgarno, Nancy; Armour, Christine M; Birtwhistle, Richard; Brown, Glenn; Carroll, June C; Flavin, Michael; Phillips, Susan; MacKenzie, Jennifer J

2018-04-26

To effectively translate genetic advances into practice, engagement of primary care providers (PCPs) is essential. Using a qualitative, phenomenological methodology, we analyzed key informant interviews and focus groups designed to explore perspectives of urban and rural PCPs. PCPs endorsed a responsibility to integrate genetics into their practices and expected advances in genetic medicine to expand. However, PCPs reported limited knowledge and difficulties accessing resources, experts, and continuing education. Rural practitioners' additional concerns included cost, distance, and poor patient engagement. PCPs' perspectives are crucial to develop relevant educational and systems-based interventions to further expand genetic medicine in primary care.

Accessing numeric data via flags and tags: A final report on a real world experiment

NASA Technical Reports Server (NTRS)

Kottenstette, J. P.; Freeman, J. E.; Staskin, E. R.; Hargrave, C. W.

1978-01-01

An experiment is reported which: extended the concepts of data flagging and tagging to the aerospace scientific and technical literature; generated experience with the assignment of data summaries and data terms by documentation specialists; and obtained real world assessments of data summaries and data terms in information products and services. Inclusion of data summaries and data terms improved users' understanding of referenced documents from a subject perspective as well as from a data perspective; furthermore, a radical shift in document ordering behavior occurred during the experiment toward proportionately more requests for data-summarized items.

[Internet in medicine--development and perspectives].

PubMed

Dezelić, Gjuro

2002-01-01

Internet is one of information technologies marking the transition from the second to the third millennium. The present role and expansion of Internet in medicine and healthcare is reviewed together with the perspective of further development. The beginning and initial expansion of the use of Internet in medicine are described. The World Wide Web (WWW or Web) is recognized as a major reason for this expansion, reaching a state described as a Web-pandemic. The rapid increase of the number of papers dealing with Internet in medical literature is presented as well as the appearance of several journals dedicated to Internet in medicine. First specialized symposia, among them MEDNET world conferences, are noted. First uses of Internet in medicine comprised databases, discussion groups, electronic newsletters, software archives and online public access catalogues. The appearance of the Web has led to a significant improvement of the Internet use in medicine, which is reflected in an exponential increase in the number of publications. It is noted that Internet allows "to do old things in new ways", but also "to do new things". It has become clear that the information revolution evoked by the internet shall leave a deep trace in medicine, as health information has become accessible to the public and ceased to be in exclusive control of health professionals. New medical fields--telemedicine and cybermedicine--appeared as the result of the development and global expansion of information and communication technologies, with cybermedicine dealing more specifically with the use of Internet. The advantages and disadvantages of cybermedicine are discussed, and major problems related to the quality of health information are highlighted. Several systems for quality criteria of health related Web-sites are described, indicating that Websites have to conform with the quality criteria such as transparency and honesty, accountability, privacy and data protection, currency, accountability and accessibility. A review of the development of the use of Internet in medicine in Croatia is given. It is ever more recognized worldwide that the Internet is capable to create conditions for partnership between patients and clinicians. In concluding remarks, the reasons are given for a sooner access to the Internet and its daily use in healthcare activity.

String Theory - Using Kites for Introducing Remote Sensing and In-Situ Measurement Concepts

NASA Astrophysics Data System (ADS)

Bland, G.; Bydlowski, D.; Henry, A.

2016-12-01

Kites are often overlooked as a practical and accessible tool for gaining an aerial perspective. This perspective can be used as a proxy for the vantage points of space and aircraft, particularly when introducing the concepts of remote sensing and in-situ measurements that form the foundation of much of NASA's Earth science research. Kites combined with miniature cameras and instrumentation, can easily and affordably be used in formal and informal learning environments to demonstrate techniques and develop skills related to gathering information from above. Additionally, collaborative team work can play an important role, particularly in the form of synthesizing flight operations. Hands-on technology exploration can be a component as well, as there are numerous possibilities for creating sensor systems, line-handling techniques, and understanding kite flight itself.

Disaster risk reduction capacity assessment for precarious settlements in Guatemala City.

PubMed

Miles, Scott B; Green, Rebekah A; Svekla, Walter

2012-07-01

This study presents findings of an institutional capacity analysis of urban disaster risk reduction for informal settlements in the Guatemala Metropolitan Region. It uses a resource access perspective of vulnerability, actor-network theory, and qualitative data collection. The analysis reveals that there is interest in disaster risk reduction for the informal settlements; however, there is little in the way of direct financial or oversight relationships between informal settlement residents and all other actors. Respondents observed that informal settlements would probably remain inhabited; thus, there is a need for disaster risk reduction within these settlements. Disaster risk reduction capacity for informal settlements exists and can be further leveraged, as long as steps are taken to ensure appropriate access to and control of resources and oversight. Further, the nascent institutional arrangements should be strengthened through increased communication and coordination between actors, a decentralization of oversight and financial relationships, and mediation of identified resource conflicts. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

[Ethical reflection on multidisciplinarity and confidentiality of information in medical imaging through new information and communication technologies].

PubMed

Béranger, J; Le Coz, P

2012-05-01

Technological advances in medical imaging has resulted in the exponential increase of the number of images per examination, caused the irreversible decline of the silver film and imposed digital imaging. This digitization is a concept whose levels of development are multiple, reflecting the complexity of this process of technological change. Under these conditions, the use of medical information via new information and communication technologies is at the crossroads of several scientific approaches and several disciplines (medicine, ethics, law, economics, psychology, etc.) surrounding the information systems in health, doctor-patient relationship and concepts that are associated. Each day, these new information and communication technologies open up new horizons and the space of possibilities, spectacularly developing access to information and knowledge. In this perspective of digital technology emergence impacting the multidisciplinary use of health information systems, the ethical questions are numerous, especially on the preservation of privacy, confidentiality and security of medical data, and their accessibility and integrity. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Marketing to the consumer: perspectives from the pharmaceutical industry.

PubMed

David, C

2001-01-01

Individualized health management is one of the most exciting challenges facing health care marketing today. Greater access to health information has empowered consumers to take more control of their health needs, creating a whole new landscape for marketers, manufacturers, and service providers. Customization is the key to creating marketing campaigns that successfully target today's health-conscious consumers. Drawing on individualized market intelligence and available genetic information, pharmaceutical companies are learning to tailor products to meet the needs of this growing market.

A Critical Look at Perspectives of Access and Mission at High Latinx-Enrolling Urban Universities

ERIC Educational Resources Information Center

Zerquera, Desiree D.; Ballysingh, Tracy Arámbula; Templeton, Emerald

2017-01-01

This article examines administrators' perspectives related to embracing and fulfilling a diversity- and access-centered mission at urban-serving universities with high Latinx enrollment. Considering today's context of higher education--whereby access and opportunities for Latinx and other marginalized populations has become increasingly…

Telemedicine and security. Confidentiality, integrity, and availability: a Canadian perspective.

PubMed

Jennett, P; Watanabe, M; Igras, E; Premkumar, K; Hall, W

1996-01-01

The health care system is undergoing major reform, characterized by organized delivery systems (regionalization, decentralization, devolution, etc); shifts in care delivery sites; changing health provider roles; increasing consumer responsibilities; and accountability. Rapid advances in information technology and telecommunications have led to a new type of information infrastructure which can play a major role in this reform. Compatible health information systems are now being integrated and connected across institutional, regional, and sectorial boundaries. In the near future, these information systems will readily be accessed and shared by health providers, researchers, policy makers, health consumers, and the public. SECURITY is a critical characteristic of any health information system. This paper will address three fields associated with SECURITY: confidentiality, integrity, and availability. These will be defined and examined as they relate to specific aspects of Telemedicine, such as electronic integrated records and clinical databases; electronic transfer of documents; as well as data storage and disposal. The guiding principles, standards, and safeguards being considered and put in place to ensure that telemedicine information intrastructures can protect and benefit all stakeholders' rights and needs in both primary and secondary uses of information will be reviewed. Implemented, proposed, and tested institutional, System, and Network solutions will be discussed; for example, encryption-decryption methods; data transfer standards; individual and terminal access and entry I.D. and password levels; smart card access and PIN number control; data loss prevention strategies; interference alerts; information access keys; algorithm safeguards; and active marketing to users of standards and principles. Issues such as policy, implementation, and ownership will be addressed.

Shoes, Dues, and Other Barriers to College Attainment: Perspectives of Students Attending High-Poverty Urban High Schools

ERIC Educational Resources Information Center

Drotos, Stephanie M.; Cilesiz, Sebnem

2016-01-01

Facilitating economically disadvantaged students' access to higher education is an important goal of educational policy. However, some practices toward this goal are based on theories and assumptions not informed by the students' conditions or needs. The purpose of this study was to understand the challenges faced by students from high poverty,…

Physicians’ Perspectives on the Uncertainties and Implications of Chromosomal Microarray Testing of Children and Families

PubMed Central

Reiff, Marian; Ross, Kathryn; Mulchandani, Surabhi; Propert, Kathleen Joy; Pyeritz, Reed E.; Spinner, Nancy B.; Bernhardt, Barbara A.

2012-01-01

Chromosomal microarray analysis (CMA) has improved the diagnostic rate of genomic disorders in pediatric populations, but can produce uncertain and unexpected findings. This paper explores clinicians’ perspectives and identifies challenges in effectively interpreting results and communicating with families about CMA. Responses to an online survey were obtained from 40 clinicians who had ordered CMA. Content included practice characteristics and perceptions, and queries about a hypothetical case involving uncertain and incidental findings. Data were analyzed using non-parametric statistical tests. Clinicians’ comfort levels differed significantly for explaining uncertain, abnormal, and normal CMA results, with lowest levels for uncertain results. Despite clinical guidelines recommending informed consent, many clinicians did not consider it pertinent to discuss the potential for CMA to reveal information concerning biological parentage or predisposition to late-onset disease, in a hypothetical case. Many non-genetics professionals ordering CMA did not feel equipped to interpret the results for patients, and articulated needs for education and access to genetics professionals. This exploratory study highlights key challenges in the practice of genomic medicine, and identifies needs for education, disseminated practice guidelines, and access to genetics professionals, especially when dealing with uncertain or unexpected findings. PMID:22989118

In Women’s Eyes

PubMed Central

Orza, Luisa; Bass, Emily; Bell, Emma; Crone, E. Tyler; Damji, Nazneen; Dilmitis, Sophie; Tremlett, Liz; Aidarus, Nasra; Stevenson, Jacqui; Bensaid, Souhaila; Kenkem, Calorine; Ross, Gracia Violeta; Kudravtseva, Elena

2017-01-01

Abstract There is rightly a huge global effort to enable women living with HIV to have long productive lives, through treatment access. However, many women living with HIV experience violence against women (VAW), in both domestic and health care settings. The ways in which VAW might prevent treatment access and adherence for women has not to date been reviewed coherently at the global level, from women’s own perspectives. Meanwhile, funding for global health care, including HIV treatment, is shrinking. To optimize women’s health and know how best to optimize facilitators and minimize barriers to access and adherence, especially in this shrinking funding context, we need to understand more about these issues from women’s own perspectives. In response, we conducted a three-phase review: (1) a literature review (phase one); (2) focus group discussions and interviews with nearly 200 women living with HIV from 17 countries (phase two); and (3) three country case studies (phase three). The results presented here are based predominantly on women’s own experiences and are coherent across all three phases. Recommendations are proposed regarding laws, policies, and programs which are rights-based, gendered, and embrace diversity, to maximize women’s voluntary, informed, confidential, and safe access to and adherence to medication, and optimize their long-term sexual and reproductive health. PMID:29302173

Patient and provider perspectives on Bedsider.org, an online contraceptive information tool, in a low income, racially diverse clinic population.

PubMed

Gressel, Gregory M; Lundsberg, Lisbet S; Illuzzi, Jessica L; Danton, Cheryl M; Sheth, Sangini S; Xu, Xiao; Gariepy, Aileen

2014-12-01

To explore patient and provider perspectives regarding a new Web-based contraceptive support tool. We conducted a qualitative study at an urban Medicaid-based clinic among sexually active women interested in starting a new contraceptive method, clinic providers and staff. All participants were given the opportunity to explore Bedsider, an online contraceptive support tool developed for sexually active women ages 18-29 by the National Campaign to Prevent Teen and Unplanned Pregnancy and endorsed by the American Congress of Obstetricians and Gynecologists. Focus groups were conducted separately among patient participants and clinic providers/staff using open-ended structured interview guides to identify specific themes and key concepts related to use of this tool in an urban clinic setting. Patient participants were very receptive to this online contraceptive support tool, describing it as trustworthy, accessible and empowering. In contrast, clinic providers and staff had concerns regarding the Website's legitimacy, accessibility, ability to empower patients and applicability, which limited their willingness to recommend its use to patients. Contrasting opinions regarding Bedsider may point to a potential disconnect between how providers and patients view contraception information tools. Further qualitative and quantitative studies are needed to explore women's perspectives on contraceptive education and counseling and providers' understanding of these perspectives. This study identifies a contrast between how patients and providers in an urban clinic setting perceive a Web-based contraceptive tool. Given a potential patient-provider discrepancy in preferred methods and approaches to contraceptive counseling, additional research is needed to enhance this important arena of women's health care. Copyright © 2014 Elsevier Inc. All rights reserved.

Effective chronic disease management: patients' perspectives on medication-related problems.

PubMed

Gordon, Karen; Smith, Felicity; Dhillon, Soraya

2007-03-01

To examine medication-related problems from the perspective of patients with a chronic condition and to identify how they may be supported in managing their medication. Patients prescribed medication for cardiovascular disease were recruited through five general medical surgeries and four community pharmacies in south London. Data were collected in 98 face-to-face interviews in participants' own homes. Interviews were designed to enable a detailed and holistic exploration of medication-related problems from participants' perspectives. Data were audio-recorded and transcribed verbatim to allow qualitative analysis. Five broad categories of medication-related problem emerged which were examined in the context of patients' perspectives on, and experiences of, the use of medicines and health services. These were concerns about and management of side effects; differing views regarding the use of medicines; cognitive, practical and sensory problems; lack of information or understanding; and problems with access to, and organisation of, services. All categories of problem had potential implications for the success of therapy in that they created barriers to adherence, access to medication or informed decision-making. The study demonstrated how patients actively engage in decision-making about their medicines in the home, if not in the consultation. The five categories of problem provide a focus for interventions by health professionals to support patients in achieving optimal theory outcomes. They demonstrate the need for a comprehensive approach, spanning patient education to the systems of delivery of care. Within the NHS in Britain, policy and practice initiatives are being designed to achieve this end. Further research should focus on the evaluation of professional practices and service developments in supporting patients in the self-management of their medicines.

Perspective on Open-Access Publishing: An Interview with Peter Suber

ERIC Educational Resources Information Center

Cornwell, Reid; Suber, Peter

2008-01-01

In this edition of Perspectives, Reid Cornwell discusses open-access publishing with Peter Suber, senior researcher at the Scholarly Publishing and Academic Resources Coalition, senior research professor of philosophy at Earlham College, and currently visiting fellow at Yale Law School. Open access means that scholarly work is freely and openly…

Repository on maternal child health: health portal to improve access to information on maternal child health in India.

PubMed

Khanna, Rajesh; Karikalan, N; Mishra, Anil Kumar; Agarwal, Anchal; Bhattacharya, Madhulekha; Das, Jayanta K

2013-01-02

Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. The portal 'Repository on Maternal Child Health' was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01), increase in the web traffic through search engines (p-value 0.00), and decrease in the bounce rate (p-value 0.03). There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa statistic 0.72). Efficient management of health information is imperative for informed decision making, and digital repositories have now-a-days become the preferred source of information management. The growing popularity of the portal indicates the potential of such initiatives in improving access to quality and essential health information in India. There is a need to develop similar mechanisms for other health domains and interlink them to facilitate access to a variety of health information from a single platform.

Repository on maternal child health: Health portal to improve access to information on maternal child health in India

PubMed Central

2013-01-01

Background Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. Methods The portal ‘Repository on Maternal Child Health’ was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. Results The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01), increase in the web traffic through search engines (p-value 0.00), and decrease in the bounce rate (p-value 0.03). There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa statistic 0.72). Conclusions Efficient management of health information is imperative for informed decision making, and digital repositories have now-a-days become the preferred source of information management. The growing popularity of the portal indicates the potential of such initiatives in improving access to quality and essential health information in India. There is a need to develop similar mechanisms for other health domains and interlink them to facilitate access to a variety of health information from a single platform. PMID:23281735

Chemical information matters: an e-Research perspective on information and data sharing in the chemical sciences.

PubMed

Bird, Colin L; Frey, Jeremy G

2013-08-21

Recently, a number of organisations have called for open access to scientific information and especially to the data obtained from publicly funded research, among which the Royal Society report and the European Commission press release are particularly notable. It has long been accepted that building research on the foundations laid by other scientists is both effective and efficient. Regrettably, some disciplines, chemistry being one, have been slow to recognise the value of sharing and have thus been reluctant to curate their data and information in preparation for exchanging it. The very significant increases in both the volume and the complexity of the datasets produced has encouraged the expansion of e-Research, and stimulated the development of methodologies for managing, organising, and analysing "big data". We review the evolution of cheminformatics, the amalgam of chemistry, computer science, and information technology, and assess the wider e-Science and e-Research perspective. Chemical information does matter, as do matters of communicating data and collaborating with data. For chemistry, unique identifiers, structure representations, and property descriptors are essential to the activities of sharing and exchange. Open science entails the sharing of more than mere facts: for example, the publication of negative outcomes can facilitate better understanding of which synthetic routes to choose, an aspiration of the Dial-a-Molecule Grand Challenge. The protagonists of open notebook science go even further and exchange their thoughts and plans. We consider the concepts of preservation, curation, provenance, discovery, and access in the context of the research lifecycle, and then focus on the role of metadata, particularly the ontologies on which the emerging chemical Semantic Web will depend. Among our conclusions, we present our choice of the "grand challenges" for the preservation and sharing of chemical information.

MyDas, an Extensible Java DAS Server

PubMed Central

Jimenez, Rafael C.; Quinn, Antony F.; Jenkinson, Andrew M.; Mulder, Nicola; Martin, Maria; Hunter, Sarah; Hermjakob, Henning

2012-01-01

A large number of diverse, complex, and distributed data resources are currently available in the Bioinformatics domain. The pace of discovery and the diversity of information means that centralised reference databases like UniProt and Ensembl cannot integrate all potentially relevant information sources. From a user perspective however, centralised access to all relevant information concerning a specific query is essential. The Distributed Annotation System (DAS) defines a communication protocol to exchange annotations on genomic and protein sequences; this standardisation enables clients to retrieve data from a myriad of sources, thus offering centralised access to end-users. We introduce MyDas, a web server that facilitates the publishing of biological annotations according to the DAS specification. It deals with the common functionality requirements of making data available, while also providing an extension mechanism in order to implement the specifics of data store interaction. MyDas allows the user to define where the required information is located along with its structure, and is then responsible for the communication protocol details. PMID:23028496

MyDas, an extensible Java DAS server.

PubMed

Salazar, Gustavo A; García, Leyla J; Jones, Philip; Jimenez, Rafael C; Quinn, Antony F; Jenkinson, Andrew M; Mulder, Nicola; Martin, Maria; Hunter, Sarah; Hermjakob, Henning

2012-01-01

A large number of diverse, complex, and distributed data resources are currently available in the Bioinformatics domain. The pace of discovery and the diversity of information means that centralised reference databases like UniProt and Ensembl cannot integrate all potentially relevant information sources. From a user perspective however, centralised access to all relevant information concerning a specific query is essential. The Distributed Annotation System (DAS) defines a communication protocol to exchange annotations on genomic and protein sequences; this standardisation enables clients to retrieve data from a myriad of sources, thus offering centralised access to end-users.We introduce MyDas, a web server that facilitates the publishing of biological annotations according to the DAS specification. It deals with the common functionality requirements of making data available, while also providing an extension mechanism in order to implement the specifics of data store interaction. MyDas allows the user to define where the required information is located along with its structure, and is then responsible for the communication protocol details.

Policy Perspective: Ensuring Comprehensive Care and Support for Gender Nonconforming Children and Adolescents

PubMed Central

Dowshen, Nadia; Meadows, Rachel; Byrnes, Maureen; Hawkins, Linda; Eder, Jennifer; Noonan, Kathleen

2016-01-01

Abstract Despite recent notable advances in societal equality for lesbian, gay, bisexual, and transgender (LGBT) individuals, youth who identify as trans* or gender nonconforming, in particular, continue to experience significant challenges accessing the services they need to grow into healthy adults. This policy perspective first offers background information describing this population, their unique healthcare needs, and obstacles when seeking care, including case study examples. The authors then provide recommendations for medical education, health systems, and insurance payers, as well as recommendations for school systems and broader public policy changes to improve the health and well-being of gender nonconforming youth. PMID:28861528

Equity and Access in the Workplace: A Feminist HRD Perspective

ERIC Educational Resources Information Center

Valenziano, Laura

2008-01-01

The issues of equity and access are becoming increasingly important as the workforce becomes diversified. As the number of minority groups in the ranks of organizations grows, there is a need to examine the issues related to equity and access from a perspective that strives for equality, e.g. feminist theory. This paper examines feminism's…

Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records: A Critical Review and Proposal for an Evaluation Framework

PubMed Central

Winkelman, Warren J.; Leonard, Kevin J.

2004-01-01

There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes. PMID:14633932

The Impact of Varying Statutory Arrangements on Spatial Data Sharing and Access in Regional NRM Bodies

NASA Astrophysics Data System (ADS)

Paudyal, D. R.; McDougall, K.; Apan, A.

2014-12-01

Spatial information plays an important role in many social, environmental and economic decisions and increasingly acknowledged as a national resource essential for wider societal and environmental benefits. Natural Resource Management is one area where spatial information can be used for improved planning and decision making processes. In Australia, state government organisations are the custodians of spatial information necessary for natural resource management and regional NRM bodies are responsible to regional delivery of NRM activities. The access and sharing of spatial information between government agencies and regional NRM bodies is therefore as an important issue for improving natural resource management outcomes. The aim of this paper is to evaluate the current status of spatial information access, sharing and use with varying statutory arrangements and its impacts on spatial data infrastructure (SDI) development in catchment management sector in Australia. Further, it critically examined whether any trends and significant variations exist due to different institutional arrangements (statutory versus non-statutory) or not. A survey method was used to collect primary data from 56 regional natural resource management (NRM) bodies responsible for catchment management in Australia. Descriptive statistics method was used to show the similarities and differences between statutory and non-statutory arrangements. The key factors which influence sharing and access to spatial information are also explored. The results show the current statutory and administrative arrangements and regional focus for natural resource management is reasonable from a spatial information management perspective and provides an opportunity for building SDI at the catchment scale. However, effective institutional arrangements should align catchment SDI development activities with sub-national and national SDI development activities to address catchment management issues. We found minor differences in spatial information access, use and sharing due to varying institutional environment (statutory versus non-statutory). The non-statutory group appears to be more flexible and selfsufficient whilst statutory regional NRM bodies may lack flexibility in their spatial information management practices. We found spatial information access, use and sharing has significant impacts on spatial data infrastructure development in catchment management sector in Australia.

The importance of interaction in the implementation of information technology in health care: a symbolic interactionism study on the meaning of accessibility.

PubMed

Nilsson, Lina; Hofflander, Malin; Eriksén, Sara; Borg, Christel

2012-12-01

A challenge when groups from different disciplines work together in implementing health information technology (HIT) in a health-care context is that words often have different meanings depending upon work practices, and definition of situations. Accessibility is a word commonly associated with HIT implementation. This study aimed to investigate different meanings of accessibility when implementing HIT in everyday work practice in a health-care context. It focused on the perspective of nurses to highlight another view of the complex relationship between HIT and information in a health-care context. This is a qualitative study influenced by institutional ethnographic. District nurses and student nurses were interviewed. The results indicate that when implementing HIT accessibility depends on working routines, social structures and patient relationship. The findings of the study suggest that interaction needs to take on a more important role when implementing HIT because people act upon words from the interpreted meaning of them. Symbolic interactionism is proposed as a way to set a mutual stage to facilitate an overall understanding of the importance of the meaning of words. There is a need for making place and space for negotiation of the meaning of words when implementing HIT in everyday work practice.

'Use what God has given me': difference and disparity in breast reconstruction.

PubMed

Rubin, Lisa R; Chavez, Jessica; Alderman, Amy; Pusic, Andrea L

2013-01-01

African-American women are significantly less likely to undergo postmastectomy breast reconstruction compared to white women in the USA. These observed differences have been interpreted as evidence of a healthcare disparity. The current study examines breast reconstruction decision-making among African-American women, locating reconstruction decisions in a context of culture, racial inequality and biomedicalisation. Semi-structured interviews were conducted with 27 African-American women who underwent mastectomy for breast cancer to add patient-centred perspectives to existing conceptualisations of racial/ethnic differences in reconstruction. Participants were socio-demographically diverse, and resided in the New York metropolitan area. Data analysis was informed by grounded theory. Spiritually and culturally informed body ethics often guided surgery decisions. Participants expressed reservations about breast implants, preferring autologous procedures that use 'what God has given'. For some, breast reconstruction restored a sense of normalcy after cancer; others challenged an imperative to reconstruct. Several participants redirected our focus on access to reconstruction toward access to alternatives, noting the low reimbursement for prostheses, or their unavailability in patients' skin tones. We suggest that a framework of 'stratified biomedicalization' better addresses the complexities of race, class and gender that inform preference, access and recommendations for breast reconstruction, and focuses attention on access to high and low-tech interventions.

Family Caregivers and Consumer Health Information Technology.

PubMed

Wolff, Jennifer L; Darer, Jonathan D; Larsen, Kevin L

2016-01-01

Health information technology has been embraced as a strategy to facilitate patients' access to their health information and engagement in care. However, not all patients are able to access, or are capable of using, a computer or mobile device. Although family caregivers assist individuals with some of the most challenging and costly health needs, their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of engaging family caregivers through the use of consumer-oriented health information technology. We compile existing evidence to make the case that involving family caregivers in health information technology as desired by patients is technically feasible and consistent with the principles of patient-centered and family-centered care. We discuss how more explicit and purposeful engagement of family caregivers in health information technology could advance clinical quality and patient safety by increasing the transparency, accuracy, and comprehensiveness of patient health information across settings of care. Finally, we describe how clarifying and executing patients' desires to involve family members or friends through health information technology would provide family caregivers greater legitimacy, convenience, and timeliness in health system interactions, and facilitate stronger partnerships between patients, family caregivers, and health care professionals.

Community pharmacists' perspectives of online health-related information: A qualitative insight from Kuala Lumpur, Malaysia.

PubMed

See Wan, Ong; Hassali, Mohamed Azmi; Saleem, Fahad

2017-01-01

The Internet is a resource used by health professionals as well as the public to access health information. Within this context, little is reported on community pharmacists' (CPs') perceptions of online health-related information. The objective of this study was to explore the attitudes of Malaysian CPs towards online health-related information. A qualitative research method was adopted with face-to-face interviews, using a semi-structured interview guide. Purposive and snowball sampling techniques were used to recruit a convenient sample of CPs who were practising in the Federal Territory of Kuala Lumpur, Malaysia. All interviews were audio recorded and transcribed verbatim. The data were analysed by the research team using a thematic content analysis framework. Eleven CPs participated in the study. Participants reported that online health-related information was accessible, useful, fast, and in some respects, the Internet is a unique source of information. It was reported that there was a need to establish websites for trusted information. CPs also reported that training was needed in Internet searching and website evaluation skills. Most information accessed by CPs related to drugs and diseases and to knowledge-based information. Barriers to efficacy of Internet usage were related to the reliability and volume of information available on the Internet. Frequent use of online health-related information among CPs was reported. Many CPs supported the use of the Internet for health-related information but certain reservations were also reported. An analysis of the reasons for information seeking and barriers suggests that a wider range of influences on health information seeking should be investigated.

Analysis of governmental Web sites on food safety issues: a global perspective.

PubMed

Namkung, Young; Almanza, Barbara A

2006-10-01

Despite a growing concern over food safety issues, as well as a growing dependence on the Internet as a source of information, little research has been done to examine the presence and relevance of food safety-related information on Web sites. The study reported here conducted Web site analysis in order to examine the current operational status of governmental Web sites on food safety issues. The study also evaluated Web site usability, especially information dimensionalities such as utility, currency, and relevance of content, from the perspective of the English-speaking consumer. Results showed that out of 192 World Health Organization members, 111 countries operated governmental Web sites that provide information about food safety issues. Among 171 searchable Web sites from the 111 countries, 123 Web sites (71.9 percent) were accessible, and 81 of those 123 (65.9 percent) were available in English. The majority of Web sites offered search engine tools and related links for more information, but their availability and utility was limited. In terms of content, 69.9 percent of Web sites offered information on foodborne-disease outbreaks, compared with 31.5 percent that had travel- and health-related information.

A qualitative study on the use of personal information technology by persons with spinal cord injury.

PubMed

Mattar, Andrew A G; Hitzig, Sander L; McGillivray, Colleen F

2015-01-01

Previous work has shown that information technology (IT), such as personal computers and other digital devices (e.g. tablets, laptops, etc.), software, online resources and hand-held communication tools (e.g. cellphones), has benefits for health and well-being for persons with chronic health conditions. To date, the ways that persons with spinal cord injury (SCI) use IT in their daily activities has not been fully explored. Thus, the purpose of the study was to obtain an in-depth perspective of how people with SCI regularly use IT to gain insight on ways IT can be used to support health and well-being in the community for this population. Semi-structured interviews were conducted with community-dwelling persons with SCI (N = 10) who identified themselves as frequent-or-daily-users of IT. Qualitative content analysis was used to identify the ways that persons with SCI use personal IT. Ten themes related to IT use were identified: (1) Modifications allowing access to IT; (2) Convenience of IT and its perceived value; (3) IT as a scheduler/planner; (4) Challenges; (5) Contributions of IT to participation; (6) Access to information; (7) Influence of IT on well-being; (8) IT as a connector; (9) Issues of IT acquisition; and (10) Desires for future devices/technology. The findings suggest that IT use by people with SCI contributes to general health and well-being, by increasing access to SCI-related health information and opportunity for social participation. Despite the benefits offered by IT, persons with SCI have identified a degree of skepticism about the reliability and applicability of the health information they find online. Future work on developing and implementing IT for health and well-being post-SCI should take into account consumers' perspectives to facilitate uptake. Implications for Rehabilitation There is a need for a more refined understanding of how people with spinal cord injury (SCI) use information technology (IT) in their daily lives in order to understand how IT can support health and well-being post-injury in the community. IT use holds implications for the physical and mental well-being of persons with SCI. IT allows access to a variety of information, and facilitates participation in the community. The enthusiasm for the use of IT is tempered by a degree of skepticism about the reliability and applicability of the health information available online. This highlights the need to raise awareness of existing sources vetted for this population, and to develop content that meets the particular health needs for SCI.

How Accessible Are the Geosciences? a Study of Professionally Held Perceptions and What They Mean for the Future of Geoscience Workforce Development

NASA Astrophysics Data System (ADS)

Atchison, C.; Libarkin, J. C.

2014-12-01

Individuals with disabilities are not entering pathways leading to the geoscience workforce; the reasons for which continue to elude access-focused geoscience educators. While research has focused on barriers individuals face entering into STEM disciplines, very little research has considered the role that practitioner perceptions play in limiting access and accommodation to scientific disciplines. The authors argue that changing the perceptions within the geoscience community is an important step to removing barriers to entry into the myriad fields that make up the geosciences. This paper reports on an investigation of the perceptions that geoscientist practitioners hold about opportunities for engagement in geoscience careers for people with disabilities. These perspectives were collected through three separate iterations of surveys at three professional geoscience meetings in the US and Australia between 2011 and 2012. Respondents were asked to indicate the extent to which individuals with specific types of disabilities would be able to perform various geoscientific tasks. The information obtained from these surveys provides an initial step in engaging the larger geoscience community in a necessary discussion of minimizing the barriers of access to include students and professionals with disabilities. The results imply that a majority of the geoscience community believes that accessible opportunities exist for inclusion regardless of disability. This and other findings suggest that people with disabilities are viewed as viable professionals once in the geosciences, but the pathways into the discipline are prohibitive. Perceptions of how individuals gain entry into the field are at odds with perceptions of accessibility. This presentation will discuss the common geoscientist perspectives of access and inclusion in the geoscience discipline and how these results might impact the future of the geoscience workforce pathway for individuals with disabilities.

Specializing network analysis to detect anomalous insider actions

PubMed Central

Chen, You; Nyemba, Steve; Zhang, Wen; Malin, Bradley

2012-01-01

Collaborative information systems (CIS) enable users to coordinate efficiently over shared tasks in complex distributed environments. For flexibility, they provide users with broad access privileges, which, as a side-effect, leave such systems vulnerable to various attacks. Some of the more damaging malicious activities stem from internal misuse, where users are authorized to access system resources. A promising class of insider threat detection models for CIS focuses on mining access patterns from audit logs, however, current models are limited in that they assume organizations have significant resources to generate label cases for training classifiers or assume the user has committed a large number of actions that deviate from “normal” behavior. In lieu of the previous assumptions, we introduce an approach that detects when specific actions of an insider deviate from expectation in the context of collaborative behavior. Specifically, in this paper, we introduce a specialized network anomaly detection model, or SNAD, to detect such events. This approach assesses the extent to which a user influences the similarity of the group of users that access a particular record in the CIS. From a theoretical perspective, we show that the proposed model is appropriate for detecting insider actions in dynamic collaborative systems. From an empirical perspective, we perform an extensive evaluation of SNAD with the access logs of two distinct environments: the patient record access logs a large electronic health record system (6,015 users, 130,457 patients and 1,327,500 accesses) and the editing logs of Wikipedia (2,394,385 revisors, 55,200 articles and 6,482,780 revisions). We compare our model with several competing methods and demonstrate SNAD is significantly more effective: on average it achieves 20–30% greater area under an ROC curve. PMID:23399988

The application and value of information sources in clinical practice: an examination of the perspective of naturopaths.

PubMed

Steel, Amie; Adams, Jon

2011-06-01

The approach of evidence-based medicine (EBM), providing a paradigm to validate information sources and a process for critiquing their value, is an important platform for guiding practice. Researchers have explored the application and value of information sources in clinical practice with regard to a range of health professions; however, naturopathic practice has been overlooked. An exploratory study of naturopaths' perspectives of the application and value of information sources has been undertaken. Semi-structured interviews with 12 naturopaths in current clinical practice, concerning the information sources used in clinical practice and their perceptions of these sources. Thematic analysis identified differences in the application of the variety of information sources used, depending upon the perceived validity. Internet databases were viewed as highly valid. Textbooks, formal education and interpersonal interactions were judged based upon a variety of factors, whilst validation of general internet sites and manufacturers information was required prior to use. The findings of this study will provide preliminary aid to those responsible for supporting naturopaths' information use and access. In particular, it may assist publishers, medical librarians and professional associations in developing strategies to expand the clinically useful information sources available to naturopaths. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

Self-Injury, Help-Seeking, and the Internet: Informing Online Service Provision for Young People.

PubMed

Frost, Mareka; Casey, Leanne; Rando, Natalie

2016-01-01

Although increasing numbers of young people are seeking help online for self-injury, relatively little is known about their online help-seeking preferences. To investigate the perspectives of young people who self-injure regarding online services, with the aim of informing online service delivery. A mixed-methods exploratory analysis regarding the perspectives of a subsample of young people who reported a history of self-injury and responded to questions regarding preferences for future online help-seeking (N = 457). The sample was identified as part of a larger study (N = 1,463) exploring self-injury and help-seeking. Seven themes emerged in relation to preferences for future online help-seeking: information, guidance, reduced isolation, online culture, facilitation of help-seeking, access, and privacy. Direct contact with a professional via instant messaging was the most highly endorsed form of online support. Young people expressed clear preferences regarding online services for self-injury, supporting the importance of consumer consultation in development of online services.

Breast cancer patients' narrative experiences about communication during the oncology care process: a qualitative study.

PubMed

Abt Sacks, A; Perestelo-Perez, L; Rodriguez-Martin, B; Cuellar-Pompa, L; Algara López, M; González Hernández, N; Serrano-Aguilar, P

2016-09-01

To analyse the perception about the information and communication received to evaluate oncologic care of breast cancer patients in Spain. Qualitative study based on conducting in-depth interviews. An inductive thematic analysis of the illness narratives was performed. Intentional theoretical sampling of 41 people diagnosed with breast cancer. The information provided during care process is assessed as appropriate, as it includes personalised skills focused on communication and considers organisational and contextual issues. In some cases, the information was considered partial, heterogeneous and at times contradictory, which revealed a lack of continuity. To provide and adequately cover information needs from the patient perspective, it is necessary to ensure access, both in its physical (material) and intellectual (comprehension) dimension, keeping in mind elements of social capital (social networks) and cultural capital (values, beliefs, non-verbal language) that facilitate or hinder access. The current state of transition to a horizontal model in the doctor-patient relationship, could account for the difficulties, deficits and contradictions in communication and information that breast cancer patients perceive in many contexts. © 2015 John Wiley & Sons Ltd.

Market Access Advancements and Challenges in “Drug-Companion Diagnostic Test” Co-Development in Europe

PubMed Central

Akhmetov, Ildar; Ramaswamy, Rakshambikai; Akhmetov, Illias; Thimmaraju, Phani Kishore

2015-01-01

The pharma ecosphere is witnessing a measured transformation from the one-size-fits-all or blockbuster model of drugs to more informed and tailored personalized treatments that facilitate higher safety and efficacy for a relevant sub-population. However, with several breakthroughs still in a nascent stage, market access becomes a crucial factor for commercial success, especially when it comes to co-creating value for pertinent stakeholders. This article highlights diverse issues from stakeholder perspectives in Europe, specifically the ones which require immediate resolution. Furthermore, the article also discusses case studies articulating potential solutions for the issues discussed. PMID:26075972

Expanding patient access to quality medication-related information: the potential of medication hotlines to improve patient adherence in schizophrenia.

PubMed

Pettit, Amy R; Marcus, Steven C

2015-05-01

Medication nonadherence is a widespread problem that compromises treatment outcomes, particularly in schizophrenia. Weersink et al. (Soc Psychiatry Psychiatr Epidemiol, 2015) describe telephone calls to a national medicines information line, with a focus on queries related to antipsychotic medications. Their analysis of callers' questions and concerns offers a valuable window into patient and caregiver perspectives. Given that many callers reported that they had not shared these concerns with a health care provider, this study also highlights the capacity of medication hotlines to address unmet needs. Establishing and maintaining long-term treatment regimens is a complex task, and truly patient-centered care requires a variety of creative and accessible support resources. Medication lines have the potential to serve as a resource and to provide proactive and timely adherence support.

Beyond Access. Diversity and Opportunity in Higher Education. Proceedings of the Annual European Access Network (EAN) Convention (5th, Amsterdam, The Netherlands, July 1-3, 1996).

ERIC Educational Resources Information Center

de Bie, Marloes, Ed.; Derks, Bas, Ed.; Suikjer, Firiel, Ed.

This proceedings presents papers given at a 1996 European conference on access to higher education. Following two introductory papers are the following 13 plenary session papers: "A European Perspective" (James Wimberley); "An American Perspective--Diversity in American Higher Education and U.S. Federal Policy" (Tom Wolanin); "An Eastern European…

An Exploration of Teacher, School and District Leaders' Perspectives Regarding the Integration of Instructional Technology in an Alternative Middle School: A Descriptive Case Study

ERIC Educational Resources Information Center

Kohl, Lauren M.

2017-01-01

The promise of using instructional technology to enhance student learning has been a dream and a goal for more than 30 years. During these past few decades, the reasoning has shifted from providing word processing, to supporting information access, to preparing students to become global citizens in our continually evolving technological world.…

'Not yet' and 'Just ask': barriers and facilitators to advance care planning--a qualitative descriptive study of the perspectives of seriously ill, older patients and their families.

PubMed

Simon, Jessica; Porterfield, Pat; Bouchal, Shelley Raffin; Heyland, Daren

2015-03-01

To explore seriously ill, older hospitalised patients' and their family members' perspectives on the barriers and facilitators of advance care planning (ACP). We used qualitative descriptive study methodology to analyse data from an interviewer administered, questionnaire-based, Canadian multicentre, prospective study of this population. Three main categories described these barriers and facilitators: (1) person (beliefs, attitudes, experiences, health status), (2) access (to doctors and healthcare providers, information, tools and infrastructure to communicate ACP preferences) and (3) the interaction with the doctor (who and how initiated, location, timing, quality of communication, relationship with doctor). Based on the findings, we suggest strategies for both healthcare systems and individual healthcare providers to improve the quality and quantity of ACP with this population. These include assessing readiness for participation in ACP and personalising relevance of ACP to each individual, routinely offering scheduled family meetings for exploring a person's own goals and sharing information, ensuring systems and policies are in place to access previous ACP documentation and ensuring doctors' education includes ACP communication skills. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Use of indicators of geographical accessibility to primary health care centers in addressing inequities].

PubMed

De Pietri, Diana; Dietrich, Patricia; Mayo, Patricia; Carcagno, Alejandro; de Titto, Ernesto

2013-12-01

Characterize geographical indicators in relation to their usefulness in measuring regional inequities, identify and describe areas according to their degree of geographical accessibility to primary health care centers (PHCCs), and detect populations at risk from the perspective of access to primary care. Analysis of spatial accessibility using geographic information systems (GIS) involved three aspects: population without medical coverage, distribution of PHCCs, and the public transportation network connecting them. The development of indicators of demand (real, potential, and differential) and analysis of territorial factors affecting population mobility enabled the characterization of PHCCs with regard to their environment, thereby contributing to local and regional analysis and to the detection of different zones according to regional connectivity levels. Indicators developed in a GIS environment were very useful in analyzing accessibility to PHCCs by vulnerable populations. Zoning the region helped identify inequities by differentiating areas of unmet demand and fragmentation of spatial connectivity between PHCCs and public transportation.

Quantum game theory and open access publishing

NASA Astrophysics Data System (ADS)

Hanauske, Matthias; Bernius, Steffen; Dugall, Berndt

2007-08-01

The digital revolution of the information age and in particular the sweeping changes of scientific communication brought about by computing and novel communication technology, potentiate global, high grade scientific information for free. The arXiv, for example, is the leading scientific communication platform, mainly for mathematics and physics, where everyone in the world has free access on. While in some scientific disciplines the open access way is successfully realized, other disciplines (e.g. humanities and social sciences) dwell on the traditional path, even though many scientists belonging to these communities approve the open access principle. In this paper we try to explain these different publication patterns by using a game theoretical approach. Based on the assumption, that the main goal of scientists is the maximization of their reputation, we model different possible game settings, namely a zero sum game, the prisoners’ dilemma case and a version of the stag hunt game, that show the dilemma of scientists belonging to “non-open access communities”. From an individual perspective, they have no incentive to deviate from the Nash equilibrium of traditional publishing. By extending the model using the quantum game theory approach it can be shown, that if the strength of entanglement exceeds a certain value, the scientists will overcome the dilemma and terminate to publish only traditionally in all three settings.

Hearing Health Care: perception of the users of a public service.

PubMed

Jardim, Débora Soares; Maciel, Fernanda Jorge; Piastrelli, Marina Teixeira; Lemos, Stela Maris Aguiar

2017-03-30

Evaluate hearing health service under the users' perspective according to the aspects: access, care, communication, and professional competence, and its correlation with clinical, sociodemographic and assistance characteristics. This is an observational analytic cross-sectional study with a probability sample stratified by gender and age. The Hearing Health Care Assessment questionnaire and the Brazilian Economic Classification Criterion questionnaire were used. In total, 214 users were interviewed, which were assisted from May 2009 to May 2013. It was observed that most of the evaluated users are female, elderly, literate, presenting moderate degree of hearing impairment, who had access to transportation out-of-pocket, was submitted to ENT evaluation for diagnosis and sought the service to purchase a hearing aid, besides belonging to class C. Regarding user satisfaction, most were satisfied with access, hearing evaluation, personalized service, benefit for the family, communication and information, and professional competence. In the analysis of correlation between the scores, it was found that when users are satisfied with access, as well as with communication and information, the total score increases with moderate correlation coefficient. The users showed greater satisfaction with the professional competence domain and lower satisfaction with the benefit for the family. In addition, assessment proved that access and communication are considered important quality indicators for the hearing health service according to users.

An Ecosystem Perspective On Asset Management Information

NASA Astrophysics Data System (ADS)

Metso, Lasse; Kans, Mirka

2017-09-01

Big Data and Internet of Things will increase the amount of data on asset management exceedingly. Data sharing with an increased number of partners in the area of asset management is important when developing business opportunities and new ecosystems. An asset management ecosystem is a complex set of relationships between parties taking part in asset management actions. In this paper, the current barriers and benefits of data sharing are identified based on the results of an interview study. The main benefits are transparency, access to data and reuse of data. New services can be created by taking advantage of data sharing. The main barriers to sharing data are an unclear view of the data sharing process and difficulties to recognize the benefits of data sharing. For overcoming the barriers in data sharing, this paper applies the ecosystem perspective on asset management information. The approach is explained by using the Swedish railway industry as an example.

Filamentary model in resistive switching materials

NASA Astrophysics Data System (ADS)

Jasmin, Alladin C.

2017-12-01

The need for next generation computer devices is increasing as the demand for efficient data processing increases. The amount of data generated every second also increases which requires large data storage devices. Oxide-based memory devices are being studied to explore new research frontiers thanks to modern advances in nanofabrication. Various oxide materials are studied as active layers for non-volatile memory. This technology has potential application in resistive random-access-memory (ReRAM) and can be easily integrated in CMOS technologies. The long term perspective of this research field is to develop devices which mimic how the brain processes information. To realize such application, a thorough understanding of the charge transport and switching mechanism is important. A new perspective in the multistate resistive switching based on current-induced filament dynamics will be discussed. A simple equivalent circuit of the device gives quantitative information about the nature of the conducting filament at different resistance states.

Beyond procedure's content: the role of accessibility experiences and personal uncertainty in procedural justice judgements.

PubMed

Greifeneder, Rainer; Müller, Patrick; Stahlberg, Dagmar; Van den Bos, Kees; Bless, Herbert

2011-01-01

Procedural justice concerns play a critical role in economic settings, politics, and other domains of human life. Despite the vast evidence corroborating their relevance, considerably less is known about how procedural justice judgments are formed. Whereas earlier theorizing focused on the systematic integration of content information, the present contribution provides a new perspective on the formation of justice judgments by examining the influence of accessibility experiences. Specifically, we hypothesize that procedural justice judgments may be formed based on the ease or difficulty with which justice-relevant information comes to mind. Three experiments corroborate this prediction in that procedures were evaluated less positively when the retrieval of associated unfair aspects was easy compared to difficult. Presumably this is because when it feels easy (difficult) to retrieve unfair aspects, these are perceived as frequent (infrequent), and hence the procedure as unjust (just). In addition to demonstrating that ease-of-retrieval may influence justice judgments, the studies further revealed that reliance on accessibility experiences is high in conditions of personal certainty. We suggest that this is because personal uncertainty fosters systematic processing of content information, whereas personal certainty may invite less taxing judgmental strategies such as reliance on ease-of-retrieval.

Cross-National User Priorities for Housing Provision and Accessibility — Findings from the European innovAge Project

PubMed Central

Haak, Maria; Slaug, Björn; Oswald, Frank; Schmidt, Steven M.; Rimland, Joseph M.; Tomsone, Signe; Ladö, Thomas; Svensson, Torbjörn; Iwarsson, Susanne

2015-01-01

To develop an innovative information and communication technology (ICT) tool intended to help older people in their search for optimal housing solutions, a first step in the development process is to gain knowledge from the intended users. Thus the aim of this study was to deepen the knowledge about needs and expectations about housing options as expressed and prioritized by older people, people ageing with disabilities and professionals. A participatory design focus was adopted; 26 people with a range of functional limitations representing the user perspective and 15 professionals with a variety of backgrounds, participated in research circles that were conducted in four European countries. An additional 20 experts were invited as guests to the different research circle meetings. Three themes illustrating cross-national user priorities for housing provision and accessibility were identified: “Information barrier: accessible housing”, “Information barrier: housing adaptation benefits”, and “Cost barrier: housing adaptations”. In conclusion, early user involvement and identification of cross-national differences in priorities and housing options will strengthen the development of a user-friendly ICT tool that can empower older people and people with disabilities to be more active consumers regarding housing provision. PMID:25739003

Judicialization 2.0: Understanding right-to-health litigation in real time.

PubMed

Biehl, João; Socal, Mariana P; Gauri, Varun; Diniz, Debora; Medeiros, Marcelo; Rondon, Gabriela; Amon, Joseph J

2018-05-21

Over the past two decades, debate over the whys, the hows, and the effects of the ever-expanding phenomenon of right-to-health litigation ('judicialization') throughout Latin America have been marked by polarised arguments and limited information. In contrast to claims of judicialization as a positive or negative trend, less attention has been paid to ways to better understand the phenomenon in real time. In this article, we propose a new approach-Judicialization 2.0-that recognises judicialization as an integral part of democratic life. This approach seeks to expand access to information about litigation on access to medicines (and health care generally) in order to better characterise the complexity of the phenomenon and thus inform new research and more robust public discussions. Drawing from our multi-disciplinary perspectives and field experiences in highly judicialized contexts, we thus describe a new multi-source, multi-stakeholder mixed-method approach designed to capture the patterns and heterogeneity of judicialization and understand its medical and socio-political impact in real time, along with its counterfactuals. By facilitating greater data availability and open access, we can drive advancements towards transparent and participatory priority setting, as well as accountability mechanisms that promote quality universal health coverage.

National water-information clearinghouse activities; ground-water perspective

USGS Publications Warehouse

Haupt, C.A.; Jensen, R.A.

1988-01-01

The US Geological Survey (USGS) has functioned for many years as an informal clearinghouse for water resources information, enabling users to access groundwater information effectively. Water resources clearinghouse activities of the USGS are conducted through several separate computerized water information programs that are involved in the collection, storage, retrieval, and distribution of different types of water information. The following USGS programs perform water information clearinghouse functions and provide the framework for a formalized National Water-Information Clearinghouse: (1) The National Water Data Exchange--a nationwide confederation of more than 300 Federal, State, local, government, academic, and private water-oriented organizations that work together to improve access to water data; (2) the Water Resources Scientific Information Center--acquires, abstracts, and indexes the major water-resources-related literature of the world, and provides this information to the water resources community; (3) the Information Transfer Program--develops innovative approaches to transfer information and technology developed within the USGS to audiences in the public and private sectors; (4) the Hydrologic Information Unit--provides responses to a variety of requests, both technical and lay-oriented, for water resources information , and helps efforts to conduct water resources research; (5) the Water Data Storage and Retrieval System--maintains accessible computerized files of hydrologic data collected nationwide, by the USGS and other governmental agencies, from stream gaging stations, groundwater observation wells, and surface- and groundwater quality sampling sites; (6) the Office of Water Data Coordination--coordinate the water data acquisition activities of all agencies of the Federal Government, and is responsible for the planning, design, and inter-agency coordination of a national water data and information network; and (7) the Water Resources Research Institute Program--coordinates and evaluates activities performed by a variety of groundwater contamination studies ranging from field investigations to analysis of socioeconomic issues. (Lantz-PTT)

'And when a certain health issue happen, they try to cover it': Stakeholder perspectives on the health of temporary foreign workers and their families.

PubMed

Salami, Bukola; Hegadoren, Kathleen; Kirova, Anna; Meherali, Salima; Nsaliwa, Christina; Chiu, Yvonne

2018-01-01

This study examines stakeholders' perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. We used a critically informed qualitative methodology. We interviewed 13 stakeholders, including service providers and policy makers. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada.

"It's our DNA, we deserve the right to test!" A content analysis of a petition for the right to access direct-to-consumer genetic testing.

PubMed

Su, Yeyang; Borry, Pascal; Otte, Ina C; Howard, Heidi C

2013-09-01

Various companies are currently advertising or selling genetic tests over the internet using a model of provision referred to as 'direct-to-consumer' (DTC). This commercial offer of DTC genetic testing (GT) has fueled a number of scientific, ethical and policy debates. To date there have been few studies published regarding the users' perspective. This study aimed to obtain information regarding the issues raised by individuals who signed a petition in support of DTC GT and the 'unrestricted' access to their genetic information. We conducted qualitative content analysis of comments written by individuals who signed a public online petition initiated by DIYgenomics (CA, USA) to support "personal access to genetic information". Of the 523 individuals who signed the petition sponsored by DIYgenomics, 247 individuals also wrote individual comments. A content analysis of these comments reveals that petitioners raised six main issues in support of unrestricted access to DTC GT: that their ownership of their DNA should allow them to have unrestricted access to their genomic information; that they should have the right to their genomic information; that the government has no place in (further) regulating DTC GT; that healthcare professionals should not be placed as intermediaries when purchasing DTC GT services; that many petioners who had already obtained DTC GT had positive experiences with this model of provision; and that genealogy or ancestry DNA testing is one of the main activities petitioners wish to have 'unrestricted' or 'direct' access. These results give insight into why individuals may support unrestricted access to their genomic information and confirm some of the motivations of users for purchasing DTC GT. Our analysis also brings to the forefront themes that have been raised less often in empirical studies involving motivations to purchase DTC GT services; these include the strongly held beliefs of some petitioners that, since they own their DNA, they should have the right to access the information without (further) government control or physician involvement. Interestingly, the comments left by petitioners also reveal a certain distrust of governmental agencies and healthcare professionals. This urges us to further study the public's views of these services and the potential impact of these views in order to responsibly address the ongoing debate on DTC GT.

Rural food deserts: low-income perspectives on food access in Minnesota and Iowa.

PubMed

Smith, Chery; Morton, Lois W

2009-01-01

To investigate how low-income rural residents living in food deserts access the normal food system and food safety net services within their communities, and explore how social, personal, and environment drives food access and food choice. Seven focus groups (90 minutes each) were conducted with 2 moderators present and were audiotaped. Food deserts in rural Minnesota and Iowa. Fifty-seven residents (Minnesota: 13 females and 8 males; Iowa: 24 females and 12 males). Most participants were white and had not completed high school or higher education. Food choice and food access among rural residents. Transcripts were evaluated for consistency and coded for themes and subthemes. Three dominant themes influence food access and choice and were identified as: (a) personal and household determinants of food; (b) social and cultural environment; and (c) structure of place or the external environment. Personal, environmental, and dietary behavioral factors are all interconnected; each plays a major role in influencing dietary behavior and the resulting health outcomes in rural Minnesotans and Iowans living in food deserts. However, although personal factors impact eating behavior for rural people, it is the physical and social environments that place constraints on food access, even in civically engaged communities. Food access may be improved in communities where civic engagement is strong, and where local organizations join in providing solutions to decrease barriers of food access by increasing access to the normal and food safety net systems and by creating informal alternatives, such as community gardens and informal transportation networks, or enhancing federal programs through greater volunteer involvement.

A qualitative study of professional and client perspectives on information flows and decision aid use.

PubMed

Stirling, Christine; Lloyd, Barbara; Scott, Jenn; Abbey, Jenny; Croft, Toby; Robinson, Andrew

2012-03-29

This paper explores the meanings given by a diverse range of stakeholders to a decision aid aimed at helping carers of people in early to moderate stages of dementia (PWD) to select community based respite services. Decision aids aim to empower clients to share decision making with health professionals. However, the match between health professionals' perspectives on decision support needs and their clients' perspective is an important and often unstudied aspect of decision aid use. A secondary analysis was undertaken of qualitative data collected as part of a larger study. The data included twelve interviews with carers of people with dementia, three interviews with expert advisors, and three focus groups with health professionals. A theoretical analysis was conducted, drawing on theories of 'positioning' and professional identity. Health professionals are seen to hold varying attitudes and beliefs about carers' decision support needs, and these appeared to be grounded in the professional identity of each group. These attitudes and beliefs shaped their attitudes towards decision aids, the information they believed should be offered to dementia carers, and the timing of its offering. Some groups understood carers as needing to be protected from realistic information and consequently saw a need to filter information to carer clients. Health professionals' beliefs may cause them to restrict information flows, which can limit carers' ability to make decisions, and limit health services' ability to improve partnering and shared decision making. In an era where information is freely available to those with the resources to access it, we question whether health professionals should filter information.

Caregiver and Health Care Provider Perspectives on Cloud-Based Shared Care Plans for Children With Medical Complexity.

PubMed

Desai, Arti D; Jacob-Files, Elizabeth A; Wignall, Julia; Wang, Grace; Pratt, Wanda; Mangione-Smith, Rita; Britto, Maria T

2018-06-05

Shared care plans play an essential role in coordinating care across health care providers and settings for children with medical complexity (CMC). However, existing care plans often lack shared ownership, are out-of-date, and lack universal accessibility. In this study, we aimed to establish requirements for shared care plans to meet the information needs of caregivers and providers and to mitigate current information barriers when caring for CMC. We followed a user-centered design methodology and conducted in-depth semistructured interviews with caregivers and providers of CMC who receive care at a tertiary care children's hospital. We applied inductive, thematic analysis to identify salient themes. Analysis occurred concurrently with data collection; therefore, the interview guide was iteratively revised as new questions and themes emerged. Interviews were conducted with 17 caregivers and 22 providers. On the basis of participant perspectives, we identified 4 requirements for shared care plans that would help meet information needs and mitigate current information barriers when caring for CMC. These requirements included the following: (1) supporting the accessibility of care plans from multiple locations (eg, cloud-based) and from multiple devices, with alert and search features; (2) ensuring the organization is tailored to the specific user; (3) including collaborative functionality such as real-time, multiuser content management and secure messaging; and (4) storing care plans on a secure platform with caregiver-controlled permission settings. Although further studies are needed to understand the optimal design and implementation strategies, shared care plans that meet these specified requirements could mitigate perceived information barriers and improve care for CMC. Copyright © 2018 by the American Academy of Pediatrics.

Patients' perspectives of accessibility and digital delivery of factual content provided by official medical and surgical specialty society websites: a qualitative assessment.

PubMed

Ow, Darren; Wetherell, David; Papa, Nathan; Bolton, Damien; Lawrentschuk, Nathan

2015-03-27

Health care websites provide a valuable resource of health information to online consumers, especially patients. Official surgical and medical society websites should be a reliable first point of contact. The primary aim of this study was to quantitatively assess medical and surgical society websites for content and highlight the essential features required for a high-quality, user-friendly society website. Twenty specialty association websites from each of the regions, Australia, UK, Canada, Europe, and the USA were selected for a total of 100 websites. Medical and surgical specialities were consistent across each region. Each website was systematically and critically analysed for content and usability. The average points scored per website was 3.2 out of 10. Of the total (N=100) websites, 12 scored at least 7 out of 10 points and 2 scored 9 out of 10. As well, 35% (35.0/100) of the websites had an information tab for patients on their respective homepages while 38% (38.0/100) had download access to patient information. A minority of the websites included different forms of multimedia such as pictures and diagrams (24.0/100, 24%) and videos (18.0/100, 18%). We found that most society websites did not meet an adequate standard for delivery of information. Half of the websites were not patient accessible, with the primary focus being for health professionals. As well, most required logins for information access. Specialty health care societies should create patient-friendly websites that would be beneficial to all online consumers.

The Role of Internet Paleo Perspective Overviews in Making Data About Past Climate and Environmental Change More Accessible

NASA Astrophysics Data System (ADS)

Anderson, D. M.; Bauer, B. A.; Gille, E. P.; Gross, W. S.; Hartman, M. A.; Shah, A. M.; Woodhouse, C. A.

2005-12-01

The cornerstone of scientific discovery is the peer-reviewed journal article, yet for non-specialists these articles can be difficult to appreciate. Scientific writing and the sheer number of articles published each month compound the problem. At the World Data Center for Paleoclimatology, a primary goal is to make published scientific results more accessible to non-specialists. In partnership with scientists, we have created Paleo Perspectives, online essays that provide an introduction to the scientific literature on a topic, background needed to appreciate the results, figures with detailed captions, photographs, short movies and visualizations, summaries, glossaries, direct links to the data, and links to additional information. The power and flexibility of the Internet enables us to provide and update this rich array of material. We have produced three paleo perspectives (global warming, drought, abrupt climate change), with a fourth in review (arctic climate variability). Web statistics indicate these are some of the Data Center`s most often-used web pages (more so for hot topics such as global warming), and awards and accolades indicate that the content is appreciated and on-target. Review by scientists assures the accuracy of the presentations, and newly-contributed data provide material for updates.

Health worker perspectives on the possible use of intramuscular artesunate for the treatment of severe malaria at lower-level health facilities in settings with poor access to referral facilities in Nigeria: a qualitative study.

PubMed

Adesoro, Olatunde; Shumba, Constance; Kpamor, John; Achan, Jane; Kivumbi, Harriet; Dada, John; Maxwell, Kolawole; Tibenderana, James; Marasciulo, Madeline; Hamade, Prudence; Oresanya, Olusola; Nankabirwa, Joanita; Baba, Ebenezer

2016-10-12

Innovative strategies are needed to reduce malaria mortality in high burden countries like Nigeria. Given that one of the important reasons for this high malaria mortality is delay in receiving effective treatment, improved access to such treatment is critical. Intramuscular artesunate could be used at lower-level facilities given its proven efficacy, ease of use and excellent safety profile. The objective of this study was therefore to explore health workers' perspectives on the possible use of intramuscular artesunate as definitive treatment for severe malaria at lower-level facilities, especially when access to referral facilities is challenging. The study was to provide insight as a formative step into the conduct of future experimental studies to ascertain the feasibility of the use of intramuscular artesunate for definitive treatment of severe malaria in lower level facilities where access to referral care is limited. This qualitative study was done across three southern States in Nigeria (Oyo, Cross River and Enugu). Key informant interviews were conducted over a period of three months between October and December 2014 among 90 purposively selected health workers with different roles in malaria case management from primary care to policy level. A thematic content analysis was used to analyse data. Overall, most of health workers and other key informant groups thought that the use of intramuscular artesunate for definitive treatment of severe malaria at lower-level facilities was possible. They however reported human resource and infrastructure constraints as factors affecting the feasibility of intramuscular artesunate use as definitive treatment for severe malaria in lower-level facilities.. Specifically identified barriers included limited numbers of skilled health workers available to manage potential complications of severe malaria and poorly equipped facilities for supportive treatment. Intramuscular artesunate was considered easy to administer and the proximity of lower-level facilities to communities was deemed important in considering the possibility of its use at lower-level facilities. Health workers also emphasised the important role of operational research to provide additional evidence to guide the implementation of existing policy recommendations and inform future policy revisions. From the perspective of health workers, use of intramuscular artesunate for definitive treatment of severe malaria at lower-level health facilities in Nigeria is possible but dependent on availability of skilled workers, well-equipped lower-level facilities to provide supportive treatment There is need for further operational research to establish feasibility and guide the implementation of such an intervention.

Rural women's perspectives of maternity services in the Midland Region of New Zealand.

PubMed

Gibbons, Veronique; Lancaster, Gytha; Gosman, Kim; Lawrenson, Ross

2016-09-01

INTRODUCTION Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women's perspectives of antenatal care provision. These were analysed thematically. RESULTS Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts.

Student Standpoints about Access Programs in Higher Education

ERIC Educational Resources Information Center

Lundell, Dana B., Ed.; Higbee, Jeanne L., Ed.; Duranczyk, Irene M., Ed.; Goff, Emily, Ed.

2007-01-01

This monograph consists of 13 chapters featuring a diverse range of perspectives centralizing student standpoints about their experiences in higher education and access programs. Chapter 1, "Student Perspectives on College Readiness" (Jeanne L. Higbee), provides the results of a survey of developmental education students regarding college…

A Digital Ethnography of Medical Students who Use Twitter for Professional Development.

PubMed

Chretien, Katherine C; Tuck, Matthew G; Simon, Michael; Singh, Lisa O; Kind, Terry

2015-11-01

While researchers have studied negative professional consequences of medical trainee social media use, little is known about how medical students informally use social media for education and career development. This knowledge may help future and current physicians succeed in the digital age. We aimed to explore how and why medical students use Twitter for professional development. This was a digital ethnography. Medical student "superusers" of Twitter participated in the study The postings ("tweets") of 31 medical student superusers were observed for 8 months (May-December 2013), and structured field notes recorded. Through purposive sampling, individual key informant interviews were conducted to explore Twitter use and values until thematic saturation was reached (ten students). Three faculty key informant interviews were also conducted. Ego network and subnetwork analysis of student key informants was performed. Qualitative analysis included inductive coding of field notes and interviews, triangulation of data, and analytic memos in an iterative process. Twitter served as a professional tool that supplemented the traditional medical school experience. Superusers approached their use of Twitter with purpose and were mindful of online professionalism as well as of being good Twitter citizens. Their tweets reflected a mix of personal and professional content. Student key informants had a high number of followers. The subnetwork of key informants was well-connected, showing evidence of a social network versus information network. Twitter provided value in two major domains: access and voice. Students gained access to information, to experts, to a variety of perspectives including patient and public perspectives, and to communities of support. They also gained a platform for advocacy, control of their digital footprint, and a sense of equalization within the medical hierarchy. Twitter can serve as a professional tool that supplements traditional education. Students' practices and guiding principles can serve as best practices for other students as well as faculty.

Safeguarding patient privacy in electronic healthcare in the USA: the legal view.

PubMed

Walsh, Diana; Passerini, Katia; Varshney, Upkar; Fjermestad, Jerry

2008-01-01

The conflict between the sweeping power of technology to access and assemble personal information and the ongoing concern about our privacy and security is ever increasing. While we gradually need higher electronic access to medical information, issues relating to patient privacy and reducing vulnerability to security breaches surmount. In this paper, we take a legal perspective and examine the existing patchwork of laws and obligations governing health information in the USA. The study finds that as Electronic Medical Records (EMRs) increase in scope and dissemination, privacy protections gradually decrease due to the shortcomings in the legal system. The contributions of this paper are (1) an overview of the legal EMR issues in the USA, and (2) the identification of the unresolved legal issues and how these will escalate when health information is transmitted over wireless networks. More specifically, the paper discusses federal and state government regulations such as the Electronic Communications Privacy Act, the Health Insurance Portability and Accountability Act (HIPAA) and judicial intervention. Based on the legal overview, the unresolved challenges are identified and suggestions for future research are included.

Adults in Higher Education: International Perspectives in Access and Participation.

ERIC Educational Resources Information Center

Davies, Pat, Ed.

This book presents international perspectives on access and participation of adults in higher education in selected European countries. The book begins with an introduction by Pat Davies and includes papers detailing and providing examples of practices and policies of higher educational institutions regarding adult students in the following…

Integrated Access to Cultural Heritage Information Pieces in Iran over Imam Reza's 4th Zarih (Burial Chamber) as a Sample

ERIC Educational Resources Information Center

Farrokhnia, Maliheh; Zarei, Mitra

2013-01-01

Purpose: The purpose of this paper is to offer an example of how ontology, such as CIDOC, can be turned into a format from the perspective of an object. In fact, it illustrates the possible semantic analysis of an object description into a view neutral machine-interpretable form. The aim is to show that a museum object located in a museum can be…

Use of human rights to meet the unmet need for family planning.

PubMed

Cottingham, Jane; Germain, Adrienne; Hunt, Paul

2012-07-14

In this report, we describe how human rights can help to shape laws, policies, programmes, and projects in relation to contraceptive information and services. Applying a human rights perspective and recognising the International Conference on Population and Development and Millennium Development Goal commitments to universal access to reproductive health including family planning, we support measurement of unmet need for family planning that encompasses more groups than has been the case until recently. We outline how human rights can be used to identify, reduce, and eliminate barriers to accessing contraception; the ways in which human rights can enhance laws and policies; and governments' legal obligations in relation to contraceptive information and services. We underline the crucial importance of accountability of states and identify some of the priorities for making family planning available that are mandated by human rights. Copyright © 2012 Elsevier Ltd. All rights reserved.

Holding personal information in a disease-specific register: the perspectives of people with multiple sclerosis and professionals on consent and access.

PubMed

Baird, W; Jackson, R; Ford, H; Evangelou, N; Busby, M; Bull, P; Zajicek, J

2009-02-01

To determine the views of people with multiple sclerosis (MS) and professionals in relation to confidentiality, consent and access to data within a proposed MS register in the UK. Qualitative study using focus groups (10) and interviews (13). England and Northern Ireland. 68 people with MS, neurologists, MS nurses, health services management professionals, researchers, representatives from pharmaceutical companies and social care professionals. People with MS expressed open and altruistic views towards the use of their personal information to facilitate service provision and research, placing trust in responsible guardianship and legitimate use of their information. Participant's proposed that people with MS should be able to select their individual level of involvement in a register using levels of consent. It was agreed that access to the register should be governed by a guardianship committee composed of a range of stakeholders. People with MS did not wish their details to be used by marketing agencies and did not consider this a legitimate use of their data. Whilst participants were positive of the role a register could play in promoting research, participants felt that access to data by pharmaceutical industries should be administered by the guardianship committee. People with MS are concerned should their employers be able to access their personal information. Professionals were more cautious than people with MS in their approach to the use of patient personal data within a register. Whilst all stakeholders were positive of the benefits of an MS register, development of such a resource must incorporate robust data security and guardianship measures in order to ensure that, whilst opportunities are maximised, risks to the privacy of individuals and legal challenges to professionals are avoided.

An Overview of Value, Perspective, and Decision Context-A Health Economics Approach: An ISPOR Special Task Force Report [2].

PubMed

Garrison, Louis P; Pauly, Mark V; Willke, Richard J; Neumann, Peter J

2018-02-01

The second section of our Special Task Force builds on the discussion of value and perspective in the previous article of the report by 1) defining a health economics approach to the concept of value in health care systems; 2) discussing the relationship of value to perspective and decision context, that is, how recently proposed value frameworks vary by the types of decisions being made and by the stakeholders involved; 3) describing the patient perspective on value because the patient is a key stakeholder, but one also wearing the hat of a health insurance purchaser; and 4) discussing how value is relevant in the market-based US system of mixed private and public insurance, and differs from its use in single-payer systems. The five recent value frameworks that motivated this report vary in the types of decisions they intend to inform, ranging from coverage, access, and pricing decisions to those defining appropriate clinical pathways and to supporting provider-clinician shared decision making. Each of these value frameworks must be evaluated in its own decision context for its own objectives. Existing guidelines for cost-effectiveness analysis emphasize the importance of clearly specifying the perspective from which the analysis is undertaken. Relevant perspectives may include, among others, 1) the health plan enrollee, 2) the patient, 3) the health plan manager, 4) the provider, 5) the technology manufacturer, 6) the specialty society, 7) government regulators, or 8) society as a whole. A valid and informative cost-effectiveness analysis could be conducted from the perspective of any of these stakeholders, depending on the decision context. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Reviewing information support during the Great East Japan Earthquake disaster : From the perspective of a hospital library that received support

NASA Astrophysics Data System (ADS)

Terasawa, Motoko

The Great East Japan Earthquake of March 11, 2011 caused extensive damage over a widespread area. Our hospital library, which is located in the affected area, was no exception. A large collection of books was lost, and some web content was inaccessible due to damage to the network environment. This greatly hindered our efforts to continue providing post-disaster medical information services. Information support, such as free access to databases, journals, and other online content related to the disaster areas, helped us immensely during this time. We were fortunate to have the cooperation of various medical employees and library members via social networks, such as twitter, during the process of attaining this information support.

Advanced Techniques for Deploying Reliable and Efficient Access Control: Application to E-healthcare.

PubMed

Jaïdi, Faouzi; Labbene-Ayachi, Faten; Bouhoula, Adel

2016-12-01

Nowadays, e-healthcare is a main advancement and upcoming technology in healthcare industry that contributes to setting up automated and efficient healthcare infrastructures. Unfortunately, several security aspects remain as main challenges towards secure and privacy-preserving e-healthcare systems. From the access control perspective, e-healthcare systems face several issues due to the necessity of defining (at the same time) rigorous and flexible access control solutions. This delicate and irregular balance between flexibility and robustness has an immediate impact on the compliance of the deployed access control policy. To address this issue, the paper defines a general framework to organize thinking about verifying, validating and monitoring the compliance of access control policies in the context of e-healthcare databases. We study the problem of the conformity of low level policies within relational databases and we particularly focus on the case of a medical-records management database defined in the context of a Medical Information System. We propose an advanced solution for deploying reliable and efficient access control policies. Our solution extends the traditional lifecycle of an access control policy and allows mainly managing the compliance of the policy. We refer to an example to illustrate the relevance of our proposal.

Making a Visual Impression (or Not): Current Design Practices of Nutritional Websites.

PubMed

Lazard, Allison J; Dudo, Anthony; Dennis, Tessa; Ewald, Mary Grace; Love, Brad

2017-04-01

Understanding the influence of visual design, as the access point for online health communication, is key as Americans are increasingly sickened by an obesity epidemic. Nutritional websites that deliver critical health information should be considered as a potential strategy to fight against the grave consequences of obesity, as research indicates that consumers are consistently turning to the Internet as a resource for health information. Focusing on nutritional websites, this study analyzes the use of visual design principles that are known to greatly influence first impressions and appeal of the information from the user's perspective. The results suggest there are opportunities for improvement to the online communication of nutritional information to increase the likelihood of users' favorable first impressions, the critical first steps for nutritional information delivery goals.

A technology ecosystem perspective on hospital management information systems: lessons from the health literature.

PubMed

Bain, Christopher A; Standing, Craig

2009-01-01

Hospital managers have a large range of information needs including quality metrics, financial reports, access information needs, educational, resourcing and decision support needs. Currently these needs involve interactions by managers with numerous disparate systems, both electronic such as SAP, Oracle Financials, PAS' (patient administration systems) like HOMER, and relevant websites; and paper-based systems. Hospital management information systems (HMIS) can be thought of sitting within a Technology Ecosystem (TE). In addition, Hospital Management Information Systems (HMIS) could benefit from a broader and deeper TE model, and the HMIS environment may in fact represents its own TE (the HMTE). This research will examine lessons from the health literature in relation to some of these issues, and propose an extension to the base model of a TE.

Provider Perspectives about Latino Patients: Determinants of Care and Implications for Treatment

ERIC Educational Resources Information Center

Valdez, Carmen R.; Dvorscek, Michael J.; Budge, Stephanie L.; Esmond, Sarah

2011-01-01

Primary care settings are the gateway through which the majority of Latinos access care for their physical and mental health concerns. This study explored the perspectives of primary care providers concerning their Latino patients, in particular issues affecting their patients' access to and utilization of services. Interviews were conducted with…

Analysis of ehealth search perspectives among female college students in the health professions using Q methodology.

PubMed

Stellefson, Michael; Hanik, Bruce; Chaney, J Don; Tennant, Bethany

2012-04-27

The current "Millennial Generation" of college students majoring in the health professions has unprecedented access to the Internet. Although some research has been initiated among medical professionals to investigate the cognitive basis for health information searches on the Internet, little is known about Internet search practices among health and medical professional students. To systematically identify health professional college student perspectives of personal eHealth search practices. Q methodology was used to examine subjective perspectives regarding personal eHealth search practices among allied health students majoring in a health education degree program. Thirteen (n = 13) undergraduate students were interviewed about their attitudes and experiences conducting eHealth searches. From the interviews, 36 statements were used in a structured ranking task to identify clusters and determine which specific perceptions of eHealth search practices discriminated students into different groups. Scores on an objective measure of eHealth literacy were used to help categorize participant perspectives. Q-technique factor analysis of the rankings identified 3 clusters of respondents with differing views on eHealth searches that generally coincided with participants' objective eHealth literacy scores. The proficient resourceful students (pattern/structure coefficient range 0.56-0.80) described themselves as using multiple resources to obtain eHealth information, as opposed to simply relying on Internet search engines. The intermediate reluctant students (pattern/structure coefficient range 0.75-0.90) reported engaging only Internet search engines to locate eHealth information, citing undeveloped evaluation skills when considering sources of information located on the Internet. Both groups of advanced students reported not knowing how to use Boolean operators to conduct Internet health searches. The basic hubristic students (pattern/structure coefficient range 0.54-0.76) described themselves as independent procrastinators when searching for eHealth information. Interestingly, basic hubristic students represented the only cluster of participants to describe themselves as (1) having received instruction on using the Internet to conduct eHealth searches, and (2) possessing relative confidence when completing a search task. Subjective perspectives of eHealth search practices differed among students possessing different levels of eHealth literacy. These multiple perspectives present both challenges and opportunities for empowering college students in the health professions to use the Internet to obtain and appraise evidence-based health information using the Internet.

Analysis of eHealth Search Perspectives Among Female College Students in the Health Professions Using Q Methodology

PubMed Central

Hanik, Bruce; Chaney, J. Don; Tennant, Bethany

2012-01-01

Background The current “Millennial Generation” of college students majoring in the health professions has unprecedented access to the Internet. Although some research has been initiated among medical professionals to investigate the cognitive basis for health information searches on the Internet, little is known about Internet search practices among health and medical professional students. Objective To systematically identify health professional college student perspectives of personal eHealth search practices. Methods Q methodology was used to examine subjective perspectives regarding personal eHealth search practices among allied health students majoring in a health education degree program. Thirteen (n = 13) undergraduate students were interviewed about their attitudes and experiences conducting eHealth searches. From the interviews, 36 statements were used in a structured ranking task to identify clusters and determine which specific perceptions of eHealth search practices discriminated students into different groups. Scores on an objective measure of eHealth literacy were used to help categorize participant perspectives. Results Q-technique factor analysis of the rankings identified 3 clusters of respondents with differing views on eHealth searches that generally coincided with participants’ objective eHealth literacy scores. The proficient resourceful students (pattern/structure coefficient range 0.56-0.80) described themselves as using multiple resources to obtain eHealth information, as opposed to simply relying on Internet search engines. The intermediate reluctant students (pattern/structure coefficient range 0.75-0.90) reported engaging only Internet search engines to locate eHealth information, citing undeveloped evaluation skills when considering sources of information located on the Internet. Both groups of advanced students reported not knowing how to use Boolean operators to conduct Internet health searches. The basic hubristic students (pattern/structure coefficient range 0.54-0.76) described themselves as independent procrastinators when searching for eHealth information. Interestingly, basic hubristic students represented the only cluster of participants to describe themselves as (1) having received instruction on using the Internet to conduct eHealth searches, and (2) possessing relative confidence when completing a search task. Conclusions Subjective perspectives of eHealth search practices differed among students possessing different levels of eHealth literacy. These multiple perspectives present both challenges and opportunities for empowering college students in the health professions to use the Internet to obtain and appraise evidence-based health information using the Internet. PMID:22543437

[Gender-related achievements and challenges in the 2006 National Health Survey: analysis of adults and households].

PubMed

Ruiz-Cantero, María Teresa; Carrasco-Portiño, Mercedes; Artazcoz, Lucía

2011-01-01

To examine the ability of the 2006 Spanish Health Survey (SHS-2006) to analyze the population's health from a gender perspective and identify gender-related inequalities in health, and to compare the 2006 version with that of 2003. A contents analysis of the adults and households questionnaires was performed from the gender perspective, taking gender as (a) the basis of social norms and values, (b) the organizer of social structure: gender division of labor, double workload, vertical/horizontal segregation, and access to resources and power, and (c) a component of individual identity. The 2006 SHS uses neutral language. The referent is the interviewee, substituting the head of the family/breadwinner of past surveys. A new section focuses on reproductive labor (caregiving and domestic tasks) and the time distribution for these tasks. However, some limitations in the questions about time distribution were identified, hampering accurate estimations. The time devoted to paid labor is not recorded. The 2006 version includes new information about family commitments as an obstacle to accessing healthcare and on the delay between seeking and receiving healthcare appointments. The SHS 2006 introduces sufficient variations to confirm its improvement from a gender perspective. Future surveys should reformulate the questions about the time devoted to paid and reproductive labor, which is essential to characterize gender division of labor and double workload. Updating future versions of the SHS will also involve gathering information on maternity/paternity and parental leave. The 2006 survey allows delays in receiving healthcare to be measured, but does not completely allow other delays, such as diagnostic and treatment delays, to be quantified. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

[Access to high-cost drugs in Brazil from the perspective of physicians, pharmacists and patients].

PubMed

Rover, Marina Raijche Mattozo; Vargas-Pelaez, Claudia Marcela; Rocha Farias, Mareni; Nair Leite, Silvana

2016-01-01

To explore perceptions on access to medication supplied by the Specialized Component of Pharmaceutical Assistance (CEAF) within the Brazilian Unified Health System (which includes high-cost drugs) by the actors involved in the healthcare services of this component. A descriptive, qualitative study was carried out by using a focal group with 7 users and 11 semi-structured interviews with health professionals (physicians and pharmacist) in the state of Santa Catarina. According to the participants, access to medicines had improved. Two main perceptions of the CEAF Clinical Guidelines were identified: the requirements constitute a bureaucracy that limits access, and the requisites increase the demand for tests and specialized healthcare services, exceeding the capacity of the healthcare services network. These assumptions generated the search for other means of access that revealed a lack of information and understanding of the right to health among the users. In addition, according to the participants, because of the difficulties of accessing services as a whole, full access to CEAF medicines is a goal that remains to be achieved. Although access to CEAF medicines has improved, there are still some difficulties in guaranteeing treatment access and comprehensiveness. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Cross-Cutting Risk Framework: Mining Data for Common Risks Across the Portfolio

NASA Technical Reports Server (NTRS)

Klein, Gerald A., Jr.; Ruark, Valerie

2017-01-01

The National Aeronautics and Space Administration (NASA) defines risk management as an integrated framework, combining risk-informed decision making and continuous risk management to foster forward-thinking and decision making from an integrated risk perspective. Therefore, decision makers must have access to risks outside of their own project to gain the knowledge that provides the integrated risk perspective. Through the Goddard Space Flight Center (GSFC) Flight Projects Directorate (FPD) Business Change Initiative (BCI), risks were integrated into one repository to facilitate access to risk data between projects. With the centralized repository, communications between the FPD, project managers, and risk managers improved and GSFC created the cross-cutting risk framework (CCRF) team. The creation of the consolidated risk repository, in parallel with the initiation of monthly FPD risk managers and risk governance board meetings, are now providing a complete risk management picture spanning the entire directorate. This paper will describe the challenges, methodologies, tools, and techniques used to develop the CCRF, and the lessons learned as the team collectively worked to identify risks that FPD programs projects had in common, both past and present.

How deaf American Sign Language/English bilingual children become proficient readers: an emic perspective.

PubMed

Mounty, Judith L; Pucci, Concetta T; Harmon, Kristen C

2014-07-01

A primary tenet underlying American Sign Language/English bilingual education for deaf students is that early access to a visual language, developed in conjunction with language planning principles, provides a foundation for literacy in English. The goal of this study is to obtain an emic perspective on bilingual deaf readers transitioning from learning to read to reading to learn. Analysis of 12 interactive, semi-structured interviews identified informal and formal teaching and learning practices in ASL/English bilingual homes and classrooms. These practices value, reinforce, and support the bidirectional acquisition of both languages and provide a strong foundation for literacy. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Multimedia Workstations: Electronic Assistants for Health-Care Professionals.

PubMed

Degoulet, P; Jean, F-C; Safran, C

1996-01-01

The increasing costs of health care and the economic reality has produced an interesting paradox for the health professional to perform more clinical work with fewer support personnel. Moreover, an explosion of the knowledge-base that underlies sound clinical care not only makes effective time management critical, but also knowledge management compelling. A multimedia workstation is an electronic assistant for the busy health professional that can help with administrative tasks and give access to clinical information and knowledge networks. The multimedia nature of processed information reflects an evolution of medical technologies that involve more and more complex objects such as video sequences or digitized signals. Analysis of the 445 Medline-indexed publications for the January 1991 to December 1994 period, that included the word "workstation" either in their title or in their abstract, helps in refining objectives and challenges both for health professionals and decision makers. From an engineering perspective, development of a workstation requires the integration into the same environments of tools to localize, access, manipulate and communicate the required information. The long-term goal is to establish an easy access in a collaborative working environment that gives the end-user the feeling of a single virtual health enterprise, driven by an integrated computer system when the information system relies on a set of heterogeneous and geographically distributed components. Consequences in terms of migration from traditional client/server architectures to more client/network architectures are considered.

Evaluation of the SCA instrument for measuring patient satisfaction with cancer care administered via paper or via the Internet.

PubMed

Kamo, N; Dandapani, S V; Miksad, R A; Houlihan, M J; Kaplan, I; Regan, M; Greenfield, T K; Sanda, M G

2011-03-01

Patients' perspectives provide valuable information on quality of care. This study evaluates the feasibility and validity of Internet administration of Service Satisfaction Scale for Cancer Care (SCA) to assess patient satisfaction with outcome, practitioner manner/skill, information, and waiting/access. Primary data collected from November 2007 to April 2008. Patients receiving cancer care within 1 year were recruited from oncology, surgery, and radiation clinics at a tertiary care hospital. An Internet-based version of the 16-item SCA was developed. Participants were randomised to Internet SCA followed by paper SCA 2 weeks later or vice versa. Seven-point Likert scale responses were converted to a 0-100 scale (minimum-maximum satisfaction). Response distribution, Cronbach's alpha, and test-retest correlations were calculated. Among 122 consenting participants, 78 responded to initial SCA. Mean satisfaction scores for paper/Internet were 91/90 (outcome), 95/94 (practitioner manner/skill), 89/90 (information), and 86/86 (waiting/access). Response rate and item missingness were similar for Internet and paper. Except for practitioner manner/skill, test-retest correlations were robust r = 0.77 (outcome), 0.74 (information), and 0.75 (waiting/access) (all P < 0.001). Internet SCA administration is a feasible and a valid measurement of cancer care satisfaction for a wide range of cancer diagnoses, treatment modalities, and clinic settings.

A Qualitative Study of Prescription Contraception Use: The Perspectives of Users, General Practitioners and Pharmacists.

PubMed

Sweeney, Leigh-Ann; Molloy, Gerard J; Byrne, Molly; Murphy, Andrew W; Morgan, Karen; Hughes, Carmel M; Ingham, Roger

2015-01-01

The oral contraceptive pill (OCP) remains the most popular form of prescription contraception in many countries, despite adherence difficulties for many. Uptake of long acting reversible contraceptives (LARCs), which are less reliant on user adherence, remains low. The aim of this study was to explore the experiences of, and attitudes towards, prescription contraception amongst samples of contraception users, general practitioners (GPs) and pharmacists. We conducted a qualitative study using semi-structured interviews with 18 contraception users, 18 GPs and 9 pharmacists. The study took place in Galway, Republic of Ireland between June and September 2014. Thematic analysis was used to analyse the data. Overall, contraception users were more familiar with the OCP, and all the women interviewed began their prescription contraception journey using this method. All participants identified episodes of poor adherence throughout the reproductive life course. The identified barriers for use of LARCs were lack of information, misconceptions, lack of access and high cost. In contrast, GPs believed that adherence to the OCP was good and stated they were more likely to prescribe the OCP than other methods, as they were most familiar with this option. Barriers to prescribing LARCSs were time, cost to practice, training and deskilling. Pharmacists also believed that adherence to the OCP was generally good and that their role was limited to dispensing medication and providing information when asked. There are contrasting perspectives between contraception service providers and contraceptive users. Training for healthcare providers is required to support informed contraceptive choice and adherence. It is necessary to address the practice barriers of cost and lack of time, to promote better communication around adherence issues and prescription contraception options. There is a need for more easily-accessible public health information to promote awareness on all methods of prescription contraception.

Can the right to health inform public health planning in developing countries? A case study for maternal healthcare from Indonesia.

PubMed

D'Ambruoso, Lucia; Byass, Peter; Nurul Qomariyah, Siti

2008-09-09

Maternal mortality remains unacceptably high in developing countries despite international advocacy, development targets, and simple, affordable and effective interventions. In recent years, regard for maternal mortality as a human rights issue as well as one that pertains to health, has emerged. We study a case of maternal death using a theoretical framework derived from the right to health to examine access to and quality of maternal healthcare. Our objective was to explore the potential of rights-based frameworks to inform public health planning from a human rights perspective. Information was elicited as part of a verbal autopsy survey investigating maternal deaths in rural settings in Indonesia. The deceased's relatives were interviewed to collect information on medical signs, symptoms and the social, cultural and health systems circumstances surrounding the death. In this case, a prolonged, severe fever and a complicated series of referrals culminated in the death of a 19-year-old primagravida at 7 months gestation. The cause of death was acute infection. The woman encountered a range of barriers to access; behavioural, socio-cultural, geographic and economic. Several serious health system failures were also apparent. The theoretical framework derived from the right to health identified that none of the essential elements of the right were upheld. The rights-based approach could identify how and where to improve services. However, there are fundamental and inherent conflicts between the public health tradition (collective and preventative) and the right to health (individualistic and curative). As a result, and in practice, the right to health is likely to be ineffective for public health planning from a human rights perspective. Collective rights such as the right to development may provide a more suitable means to achieve equity and social justice in health planning.

Accessing care summaries at point-of-care:Implementation of mobile devices for personal carers in aged care.

PubMed

Brimelow, Rachel E; Gibney, Annie; Meakin, Suzanne; Wollin, Judy A

2017-04-01

Continued development of mobile technology now allows access to information at the point-of-care. This study was conducted to evaluate the use of one such tool on a mobile device, from the carer perspective. Caregivers across 12 aged-care facilities were supplied mobile devices to access a Picture Care Plan (PCP), a specific tool designed around the role of the personal carer. An anonymous questionnaire was subsequently completed by 85 carers with questions relating to participants' experience. Perceived helpfulness of the PCP at the point-of-care was high (87%). A significant number of participants believed the use of the PCP increased resident safety and quality of care (76%). Practical components related to the carrying of the device, network speed and the requirement to maintain communication with senior members of staff to ascertain updates were also expressed by participants. Findings suggest that staff are receptive to adoption of mobile devices to access care directives at the point-of-care and that the technology is useful.

Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care

PubMed Central

Thompson, Hale M.

2016-01-01

Abstract Purpose: In 2015, the Centers for Medicare and Medicaid Services ruled that health organizations comply with additional requirements for electronic health records (EHRs), known as “Meaningful Use,” and develop the capacity to collect gender identity data. Research has established effectiveness of a two-step gender identity question to collect these data. This study examines transgender patient perspectives on the use of a two-step question and experiences with privacy and sensitive disclosures in EHRs and healthcare settings. Methods: Four focus groups (N=30) were conducted in Chicago, Illinois in 2014–2015. Participants were asked to compare two intake forms—one with a two-step question and one with a single question—and discuss experiences with gender identity disclosure, privacy, and access to care. Narratives were transcribed verbatim to identify patterns and themes; the extended case method was used and grounded the data analysis process in the concept of intersectionality. Results: Participants expressed appreciation for improved reliability and competencies that the two-part question may afford. Narratives reveal concerns related to patient privacy, safety, and access because of the contexts in which these data are collected and transmitted. Virtually all participants described situations whereby sensitive gender identity information had been involuntarily disclosed, misinterpreted, or abused, and safety and care were compromised. Conclusion: Participants recognized the potential of the two-part question as a measurement and competency tool, but anticipated new privacy violations and involuntary disclosures. Narratives indicate that effects of sensitive disclosures may vary intersectionally, whereby white participants experienced lesser harms than their immigrant, HIV-positive, and black trans feminine counterparts. Discrimination and privacy violations may occur regardless of a two-part or one-part gender identity question, but increasing these sensitive disclosures within expanding EHR infrastructures may require a range of mechanisms that have flexibility across contexts to safeguard sensitive information and access to care. PMID:28861535

Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care.

PubMed

Thompson, Hale M

2016-01-01

Purpose: In 2015, the Centers for Medicare and Medicaid Services ruled that health organizations comply with additional requirements for electronic health records (EHRs), known as "Meaningful Use," and develop the capacity to collect gender identity data. Research has established effectiveness of a two-step gender identity question to collect these data. This study examines transgender patient perspectives on the use of a two-step question and experiences with privacy and sensitive disclosures in EHRs and healthcare settings. Methods: Four focus groups ( N =30) were conducted in Chicago, Illinois in 2014-2015. Participants were asked to compare two intake forms-one with a two-step question and one with a single question-and discuss experiences with gender identity disclosure, privacy, and access to care. Narratives were transcribed verbatim to identify patterns and themes; the extended case method was used and grounded the data analysis process in the concept of intersectionality. Results: Participants expressed appreciation for improved reliability and competencies that the two-part question may afford. Narratives reveal concerns related to patient privacy, safety, and access because of the contexts in which these data are collected and transmitted. Virtually all participants described situations whereby sensitive gender identity information had been involuntarily disclosed, misinterpreted, or abused, and safety and care were compromised. Conclusion: Participants recognized the potential of the two-part question as a measurement and competency tool, but anticipated new privacy violations and involuntary disclosures. Narratives indicate that effects of sensitive disclosures may vary intersectionally, whereby white participants experienced lesser harms than their immigrant, HIV-positive, and black trans feminine counterparts. Discrimination and privacy violations may occur regardless of a two-part or one-part gender identity question, but increasing these sensitive disclosures within expanding EHR infrastructures may require a range of mechanisms that have flexibility across contexts to safeguard sensitive information and access to care.

The role of assessment in enhancing the vocational success of people with multiple sclerosis.

PubMed

Roessler, R T

1996-01-01

The person/environment or ecological perspective on vocational evaluation provides a comprehensive assessment strategy for people with multiple sclerosis. The ecological model requires assessment of both personal variables such as rehabilitation outlook and MS symptoms and environmental variables such as barriers to workplace accessibility and performance of essential job functions. Measures of person and environment constructs are presented as are applications of the resulting information in vocational counseling and disability management services.

Health Assessment and the Right to Health in Sweden: Asylum Seekers’ Perspectives

PubMed Central

Lobo Pacheco, Lubin; Jonzon, Robert; Hurtig, Anna-Karin

2016-01-01

Background Swedish law entitles asylum seekers to a voluntary health assessment and to “health care that cannot be postponed”. The last expression suggests, however, restrictions on the entitlement, and what it may or may not include remains ultimately a decision for health professionals in the specific case. Indeed, the health assessment constitutes the sole active effort from Swedish authorities to fulfill this right. This study was therefore aimed at assessing how the information, procedures and services related to the health assessment are accessible and acceptable to fulfill the right to health of asylum seekers, from their own perspective. Methods The study has a cross-sectional design. A questionnaire was administrated in 16 language schools for immigrants, in four counties of Sweden. Three hundred eighty-six individuals fulfilled the inclusion criteria. The frequency of their answers was tabulated to estimate how the information, procedures and services related to the health assessment correspond to the criteria for accessibility and acceptability regarding the right to health. Findings Forty-eight (12.4%) respondents did not undergo the health assessment. Thirty-one of them did not even receive the invitation letter. They said they lost the opportunity to know their health status, to obtain treatment for or advice about their health problems. Additionally, 55.2% of those who attended the health assessment indicated that their needs were overlooked, particularly when these were of a psychological nature. Two in three participants also considered the health assessment to be a communicable disease control, rather than an effort to take care of their health needs. Nevertheless, the respondents had a positive attitude towards the health assessment as such. Conclusions Although being an important contribution, the health assessment does not suffice to fulfill the right to health of asylum seekers because there are shortcomings regarding the accessibility and acceptability of the information, procedures and services that it includes. PMID:27589238

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

PubMed

Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and healthcare service contexts. Despite the explicit provider focus, this study was limited by a lack of Indigenous stakeholder perspectives. Key study findings are of direct relevance to inform the future implementation and delivery of culturally appropriate primary mental healthcare programs for Indigenous populations in Australia and internationally.

Access and privacy rights using web security standards to increase patient empowerment.

PubMed

Falcão-Reis, Filipa; Costa-Pereira, Altamiro; Correia, Manuel E

2008-01-01

Electronic Health Record (EHR) systems are becoming more and more sophisticated and include nowadays numerous applications, which are not only accessed by medical professionals, but also by accounting and administrative personnel. This could represent a problem concerning basic rights such as privacy and confidentiality. The principles, guidelines and recommendations compiled by the OECD protection of privacy and trans-border flow of personal data are described and considered within health information system development. Granting access to an EHR should be dependent upon the owner of the record; the patient: he must be entitled to define who is allowed to access his EHRs, besides the access control scheme each health organization may have implemented. In this way, it's not only up to health professionals to decide who have access to what, but the patient himself. Implementing such a policy is walking towards patient empowerment which society should encourage and governments should promote. The paper then introduces a technical solution based on web security standards. This would give patients the ability to monitor and control which entities have access to their personal EHRs, thus empowering them with the knowledge of how much of his medical history is known and by whom. It is necessary to create standard data access protocols, mechanisms and policies to protect the privacy rights and furthermore, to enable patients, to automatically track the movement (flow) of their personal data and information in the context of health information systems. This solution must be functional and, above all, user-friendly and the interface should take in consideration some heuristics of usability in order to provide the user with the best tools. The current official standards on confidentiality and privacy in health care, currently being developed within the EU, are explained, in order to achieve a consensual idea of the guidelines that all member states should follow to transfer such principles into national laws. A perspective is given on the state of the art concerning web security standards, which can be used to easily engineer health information systems complying with the patient empowering goals. In conclusion health systems with the characteristics thus described are technically feasible and should be generally implemented and deployed.

E-Government Goes Semantic Web: How Administrations Can Transform Their Information Processes

NASA Astrophysics Data System (ADS)

Klischewski, Ralf; Ukena, Stefan

E-government applications and services are built mainly on access to, retrieval of, integration of, and delivery of relevant information to citizens, businesses, and administrative users. In order to perform such information processing automatically through the Semantic Web,1 machine-readable2 enhancements of web resources are needed, based on the understanding of the content and context of the information in focus. While these enhancements are far from trivial to produce, administrations in their role of information and service providers so far find little guidance on how to migrate their web resources and enable a new quality of information processing; even research is still seeking best practices. Therefore, the underlying research question of this chapter is: what are the appropriate approaches which guide administrations in transforming their information processes toward the Semantic Web? In search for answers, this chapter analyzes the challenges and possible solutions from the perspective of administrations: (a) the reconstruction of the information processing in the e-government in terms of how semantic technologies must be employed to support information provision and consumption through the Semantic Web; (b) the required contribution to the transformation is compared to the capabilities and expectations of administrations; and (c) available experience with the steps of transformation are reviewed and discussed as to what extent they can be expected to successfully drive the e-government to the Semantic Web. This research builds on studying the case of Schleswig-Holstein, Germany, where semantic technologies have been used within the frame of the Access-eGov3 project in order to semantically enhance electronic service interfaces with the aim of providing a new way of accessing and combining e-government services.

ThinkHazard!: an open-source, global tool for understanding hazard information

NASA Astrophysics Data System (ADS)

Fraser, Stuart; Jongman, Brenden; Simpson, Alanna; Nunez, Ariel; Deparday, Vivien; Saito, Keiko; Murnane, Richard; Balog, Simone

2016-04-01

Rapid and simple access to added-value natural hazard and disaster risk information is a key issue for various stakeholders of the development and disaster risk management (DRM) domains. Accessing available data often requires specialist knowledge of heterogeneous data, which are often highly technical and can be difficult for non-specialists in DRM to find and exploit. Thus, availability, accessibility and processing of these information sources are crucial issues, and an important reason why many development projects suffer significant impacts from natural hazards. The World Bank's Global Facility for Disaster Reduction and Recovery (GFDRR) is currently developing a new open-source tool to address this knowledge gap: ThinkHazard! The main aim of the ThinkHazard! project is to develop an analytical tool dedicated to facilitating improvements in knowledge and understanding of natural hazards among non-specialists in DRM. It also aims at providing users with relevant guidance and information on handling the threats posed by the natural hazards present in a chosen location. Furthermore, all aspects of this tool will be open and transparent, in order to give users enough information to understand its operational principles. In this presentation, we will explain the technical approach behind the tool, which translates state-of-the-art probabilistic natural hazard data into understandable hazard classifications and practical recommendations. We will also demonstrate the functionality of the tool, and discuss limitations from a scientific as well as an operational perspective.

The Importance of Process-Oriented Accessibility Guidelines for Web Developers.

PubMed

Steen-Hansen, Linn; Fagernes, Siri

2016-01-01

Current accessibility research shows that in the web development, the process itself may lead to inaccessible web sites and applications. Common practices typically do not allow sufficient testing. The focus is mainly on complying with minimum standards, and treating accessibility compliance as a sort of bug-fixing process, missing the user perspective. In addition, there is an alarming lack of knowledge and experience with accessibility issues. It has also been argued that bringing accessibility into the development process at all stages is the only way to achieve the highest possible level of accessibility. The work presented in this paper is based on a previous project focusing on guidelines for developing accessible rich Internet applications. The guidelines were classified as either process-oriented or technology-oriented. In this paper, we examine the process-oriented guidelines and give a practical perspective on how these guidelines will make the development process more accessibility-friendly.

Medication management for community palliative care patients and the role of a specialist palliative care pharmacist: A qualitative exploration of consumer and health care professional perspectives.

PubMed

Kuruvilla, Lisha; Weeks, Greg; Eastman, Peter; George, Johnson

2018-05-01

Pharmacists have a key role to play in optimisation of medication regimens and promotion of medication safety. The role of specialist pharmacists as part of the multidisciplinary palliative care team, especially in the primary care setting, is not widely recognised. To explore the perspectives of stakeholders about the gaps in the current model of community palliative care services in relation to medication management and to assess their opinions pertaining to the role of a specialist palliative care pharmacist in addressing some of those gaps. Qualitative study utilising three focus groups involving 20 stakeholders. Thematic analysis was carried out using a framework approach and interpreted in the context of the Chronic Care Model for improving primary care for patients with chronic illness. Setting was a large regional Australian palliative care service. Participants included palliative care consumers and clinicians specifically patients, caregivers, physicians, nurses and pharmacists. Five major themes emerged from the focus groups: access to resources, medicines and information; shared care; challenges of polypharmacy; informal caregiver needs and potential roles of a palliative care pharmacist. Gaps in access to medicines/resources, training for generalist practitioners, communication between treating teams and lack of support for patients and carers were cited as factors adversely impacting medication management in community-based palliative care. While community-based palliative care is an essential aspect of meeting the health care demands of an ageing society, the current model has several gaps and limitations. An appropriately qualified and skilled pharmacist within the palliative care team may help to address some of the gaps in relation to medication access and appropriateness.

Perceived medical benefit, peer/partner influence and safety and cost to access the service: client motivators for voluntary seeking of medical male circumcision in Iganga district eastern Uganda, a qualitative study.

PubMed

Muhamadi, Lubega; Ibrahim, Musenze; Wabwire-Mangen, Fred; Peterson, Stefan; Reynolds, Steven J

2013-01-01

Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings. In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC. Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service. Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC.

Palliating inside the lines: The effects of borders and boundaries on palliative care in rural Canada.

PubMed

Giesbrecht, Melissa; Crooks, Valorie A; Castleden, Heather; Schuurman, Nadine; Skinner, Mark; Williams, Allison

2016-11-01

We draw lines to divide our world into specific places, territories, and categories. Although borders and boundaries are dynamic and socially constructed, their existence creates many broad impacts on our lives by geographically distinguishing between groups (e.g., us/them; here/there; inside/outside) at various scales from the national down to the personal spaces of the individual. Particularly, borders and boundaries can be used to define a variety of differing spaces such as the familial, social, economic, political, as well as issues of access - including access to health services. Despite the implicit connection between borders, boundaries, and health, little research has investigated this connection from a health geography perspective. As such, this secondary thematic analysis contributes to addressing this notable gap by examining how borders and boundaries are experienced and perceived to impact access to palliative care in rural Canada from the perspectives of the formal and informal providers of such care. Drawing upon data from qualitative interviews (n = 40) with formal and informal palliative caregivers residing in four different rural Canadian communities, five forms of borders and boundaries were found to directly impact care delivery/receipt: political; jurisdictional; geographical; professional; and cultural. Implicitly and explicitly, participants discussed these borders and boundaries while sharing their experiences of providing palliative care in rural Canada. We conclude by discussing the implications of our findings for palliative care in rural Canada, while also emphasizing the need for more health geography, and related social science, researchers to recognize the significance of borders and boundaries in relation to health and healthcare delivery. Lastly, we emphasize the transferability of these findings to other health sectors, geographical settings, and disciplines. Copyright © 2016 Elsevier Ltd. All rights reserved.

Student perceptions of secondary science: A performance technology application

NASA Astrophysics Data System (ADS)

Small, Belinda Rusnak

The primary purpose of this study was to identify influences blocking or promoting science performance from the lived K-12 classroom experience. Human Performance Technology protocols were used to understand factors promoting or hindering science performance. The goal was to gain information from the individual students' perspective to enhance opportunities for stakeholders to improve the current state of performance in science education. Individual perspectives of 10 secondary science students were examined using grounded theory protocols. Findings include students' science learning behaviors are influenced by two major themes, environmental supports and individual learning behaviors. The three environmental support factors identified include the methods students receive instruction, students' opportunities to access informal help apart from formal instruction, and students' feelings of teacher likability. Additionally, findings include three major factors causing individual learners to generate knowledge in science. Factors reported include personalizing information to transform data into knowledge, customizing learning opportunities to maximize peak performance, and tapping motivational opportunities to persevere through complex concepts. The emergent theory postulated is that if a performance problem exists in an educational setting, then integrating student perspectives into the cause analysis opens opportunity to align interventions for influencing student performance outcomes. An adapted version of Gilbert's Behavioral Engineering Model is presented as an organizational tool to display the findings. The boundaries of this Performance Technology application do not extend to the identification, selection, design, or implementation of solutions to improved science performance. However, as stakeholders begin to understand learner perspectives then aligned decisions may be created to support learners of science in a direct, cost effective manner.

Conceptualising Knowledge for Access in the Sciences: Academic Development from a Social Realist Perspective

ERIC Educational Resources Information Center

Ellery, Karen

2017-01-01

Whilst arguing from a social realist perspective that knowledge matters in academic development (AD) curricula, this paper addresses the question of what knowledge types and practices are necessary for enabling epistemological access. It presents a single, in-depth, qualitative case study in which the curriculum of a science AD course is…

What's in Your Refrigerator? Children's Views on Equality, Work, Money and Access to Food

ERIC Educational Resources Information Center

Hammond, Libby-Lee; Hesterman, Sandra; Knaus, Marianne

2015-01-01

This study investigates young children's theorising about families and their differential access to food from a perspective of wealth and poverty. Fifty-two children, aged 6-7 years, attending a Western Australian school were invited to share their perspectives on this global issue. The single case study method utilised three children's focus…

Off the rails in rural South Carolina: a qualitative study of healthcare provider perspectives on the long-term health impact of the Graniteville train disaster.

PubMed

Annang Ingram, Lucy; Tinago, Chiwoneso B; Estrada, Robin; Wilson, Sacoby; Wright Sanders, Louisiana; Bevington, Tina; Carlos, Bethany; Cornelius, Evangeline; Svendsen, Erik R; Ball, Julia

2016-01-01

In 2005, a train derailment and subsequent chlorine spill ravaged the rural town of Graniteville in South Carolina, resulting in one of the worst chlorine gas exposures in US. Significant health and economic challenges persist in the community more than a decade later. Healthcare providers offered healthcare services to community members in the immediate aftermath of the disaster, and many still live in the community and continue to provide healthcare services. As such, healthcare professionals provide a unique and important perspective to help understand the impact of the disaster on the community's health. The purpose of this study was to explore healthcare providers' perspectives about the long-term effects of the disaster on community health, healthcare access, and wellbeing. Semi-structured interviews were conducted with 30 healthcare providers who treated survivors of the Graniteville train disaster. A qualitative, essentialist, inductive thematic analytic approach was used to analyze study data. Four themes emerged regarding the disaster's long-term impact: effects of chlorine exposure on physical health, issues with healthcare access, residual effects of the disaster on personal and community wellbeing, and improving health and community wellbeing. Disaster recovery should not be considered solely an acute event; agencies must be prepared for long-term, potentially chronic ailments, particularly in underserved, rural communities. Efforts to address the long-term health needs of communities post-disaster should consider the perspectives of healthcare providers to offer a well-rounded assessment of community needs. Study findings can help inform future disaster response strategies in communities locally and globally.

Asthma Management in New York City Schools: a Classroom Teacher Perspective

PubMed Central

Cain, Agnieszka; Reznik, Marina

2016-01-01

Objective Classroom teachers play an important role in facilitating asthma management in school but little is known about their perspectives around asthma management. We examined the perspectives of classroom teachers around barriers to school asthma management. Methods We conducted key informant interviews with 21 inner-city classroom teachers from 3rd to 5th grades in 10 Bronx, New York elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and independently coded for common themes. We used thematic and content review to analyze interview data. Results Seven themes representing teachers’ perspectives on in-school asthma management emerged: (1) the problematic process of identifying students with asthma; (2) poor familiarity with the city health department’s asthma initiative and poor general knowledge of school policies on asthma management (3) lack of competency in managing an acute asthma attack in the classroom and poor recognition of symptoms of an asthma attack; (4) lack of confidence in dealing with a hypothetical asthma attack in the classroom; (5) lack of quick access to asthma medication in school; (6) limited communication between school staff; and (7) enthusiasm about learning more about asthma management. Conclusions Our results revealed several barriers contributing to suboptimal in-school asthma management: ineffective ways of identifying students with asthma, lack of teacher knowledge of guidelines on asthma management, lack of comfort in managing students’ asthma, inadequate access to asthma medication in school, and limited communication between school staff. These issues should be considered in the design of interventions to improve in-school asthma management. PMID:27031532

Sparse aperture endoscope

DOEpatents

Fitch, J.P.

1999-07-06

An endoscope is disclosed which reduces the volume needed by the imaging part, maintains resolution of a wide diameter optical system, while increasing tool access, and allows stereographic or interferometric processing for depth and perspective information/visualization. Because the endoscope decreases the volume consumed by imaging optics such allows a larger fraction of the volume to be used for non-imaging tools, which allows smaller incisions in surgical and diagnostic medical applications thus produces less trauma to the patient or allows access to smaller volumes than is possible with larger instruments. The endoscope utilizes fiber optic light pipes in an outer layer for illumination, a multi-pupil imaging system in an inner annulus, and an access channel for other tools in the center. The endoscope is amenable to implementation as a flexible scope, and thus increases it's utility. Because the endoscope uses a multi-aperture pupil, it can also be utilized as an optical array, allowing stereographic and interferometric processing. 7 figs.

Sparse aperture endoscope

DOEpatents

Fitch, Joseph P.

1999-07-06

An endoscope which reduces the volume needed by the imaging part thereof, maintains resolution of a wide diameter optical system, while increasing tool access, and allows stereographic or interferometric processing for depth and perspective information/visualization. Because the endoscope decreases the volume consumed by imaging optics such allows a larger fraction of the volume to be used for non-imaging tools, which allows smaller incisions in surgical and diagnostic medical applications thus produces less trauma to the patient or allows access to smaller volumes than is possible with larger instruments. The endoscope utilizes fiber optic light pipes in an outer layer for illumination, a multi-pupil imaging system in an inner annulus, and an access channel for other tools in the center. The endoscope is amenable to implementation as a flexible scope, and thus increases the utility thereof. Because the endoscope uses a multi-aperture pupil, it can also be utilized as an optical array, allowing stereographic and interferometric processing.

eHealth for inflammatory bowel disease self-management - the patient perspective.

PubMed

Con, Danny; Jackson, Belinda; Gray, Kathleen; De Cruz, Peter

2017-09-01

Electronic health (eHealth) solutions may help address the growing pressure on IBD outpatient services as they encompass a component of self-management. However, information regarding patients' attitudes towards the use of eHealth solutions in IBD is lacking. The aim of this study was to evaluate eHealth technology use and explore the perspectives of IBD patients on what constitutes the ideal eHealth solution to facilitate self-management. A mixed methods qualitative and quantitative analysis of the outcomes of a discussion forum and an online survey conducted at a tertiary hospital in Melbourne, Australia between November 2015 and January 2016 was undertaken. Eighteen IBD patients and parents participated in the discussion forum. IBD patients expressed interest in eHealth tools that are convenient and improve access to care, communication, disease monitoring and adherence. Eighty six patients with IBD responded to the online survey. A majority of patients owned a mobile phone (98.8%), had access to the internet (97.7%), and felt confident entering data onto a phone or computer (73.3%). Most patients (98.8%) were willing to use at least one form of information and communication technology to help manage their IBD. Smartphone apps and internet websites were the two most preferred technologies to facilitate IBD self-management. This study demonstrates the willifngness of patients to engage with eHealth as a potential solution to facilitate IBD self-management. Future development and testing of eHealth solutions should be informed by all major stakeholders including patients to maximise their uptake and efficacy to facilitate IBD self-management.

Understanding child sexual abuse by Catholic priests from a situational perspective.

PubMed

Terry, Karen J; Freilich, Joshua D

2012-01-01

Most sexual offense research focuses on offender motivation and individual risk factors rather than the criminal events themselves. This article provides an analysis of data from two studies on child sexual abuse by Catholic priests to help understand the opportunities clergy had or created to abuse youth. Findings show that situational factors played a role in victim choice among a heterogeneous group of abusers. Priests abused more male than female victims and had significantly greater access to male youth historically. When access to female youth increased in the 1990s, abuse of females as a percentage of victims also increased. The article concludes with a discussion about how ecological information can be used to craft intervention policies to prevent sexual offenses.

The Computational Complexity of Valuation and Motivational Forces in Decision-Making Processes.

PubMed

Redish, A David; Schultheiss, Nathan W; Carter, Evan C

2016-01-01

The concept of value is fundamental to most theories of motivation and decision making. However, value has to be measured experimentally. Different methods of measuring value produce incompatible valuation hierarchies. Taking the agent's perspective (rather than the experimenter's), we interpret the different valuation measurement methods as accessing different decision-making systems and show how these different systems depend on different information processing algorithms. This identifies the translation from these multiple decision-making systems into a single action taken by a given agent as one of the most important open questions in decision making today. We conclude by looking at how these different valuation measures accessing different decision-making systems can be used to understand and treat decision dysfunction such as in addiction.

Information Literacy in a Digital Era: Understanding the Impact of Mobile Information for Undergraduate Nursing Students.

PubMed

Doyle, Glynda J; Furlong, Karen E; Secco, Loretta

2016-01-01

Recent entry-to-practice nursing informatics competencies for Registered Nurses in Canada mean nurse educators need educational strategies to promote student competency within the rapidly evolving informatics field. A collaborative research team from three Canadian nursing programs completed a mixed method survey to describe how nursing students used mobile nursing information support and the extent of this support for learning. The Mobile Information Support Evaluation Tool (MISET) assessed Usefulness/Helpfulness, Information Literacy Support, and Use of Evidence-Based Sources. The quantitative and qualitative data were analyzed to describe students' perspectives and the ways they used mobile resources in learning situations. Findings suggest nursing students mainly accessed mobile resources to support clinical learning, and specifically for task-oriented information such as drug medication or patient conditions/diagnoses. Researchers recommend a paradigm shift whereby educators emphasize information literacy in a way that supports evidence-based quality care.

Cost-effectiveness of population-level expansion of highly active antiretroviral treatment for HIV in British Columbia, Canada: a modelling study.

PubMed

Nosyk, Bohdan; Min, Jeong E; Lima, Viviane D; Hogg, Robert S; Montaner, Julio S G

2015-09-01

Widespread HIV screening and access to highly active antiretroviral treatment (ART) were cost effective in mathematical models, but population-level implementation has led to questions about cost, value, and feasibility. In 1996, British Columbia, Canada, introduced universal coverage of drug and other health-care costs for people with HIV/AIDS and and began extensive scale-up in access to ART. We aimed to assess the cost-effectiveness of ART scale-up in British Columbia compared with hypothetical scenarios of constrained treatment access. Using comprehensive linked population-level data, we populated a dynamic, compartmental transmission model to simulate the HIV/AIDS epidemic in British Columbia from 1997 to 2010. We estimated HIV incidence, prevalence, mortality, costs (in 2010 CAN$), and quality-adjusted life-years (QALYs) for the study period, which was 1997-2010. We calculated incremental cost-effectiveness ratios from societal and third-party-payer perspectives to compare actual practice (true numbers of individuals accessing ART) to scenarios of constrained expansion (75% and 50% probability of accessing ART). We also investigated structural and parameter uncertainty. Actual practice resulted in 263 averted incident cases compared with 75% of observed access and 676 averted cases compared with 50% of observed access to ART. From a third-party-payer perspective, actual practice resulted in incremental cost-effectiveness ratios of $23 679 per QALY versus 75% access and $24 250 per QALY versus 50% access. From a societal perspective, actual practice was cost saving within the study period. When the model was extended to 2035, current observed access resulted in cumulative savings of $25·1 million compared with the 75% access scenario and $65·5 million compared with the 50% access scenario. ART scale-up in British Columbia has decreased HIV-related morbidity, mortality, and transmission. Resulting incremental cost-effectiveness ratios for actual practice, derived within a limited timeframe, were within established cost-effectiveness thresholds and were cost saving from a societal perspective. BC Ministry of Health, National Institute of Drug Abuse at the US National Institutes of Health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dynamics of Inequalities in Access to Higher Education: Bulgaria in a Comparative Perspective

ERIC Educational Resources Information Center

Ilieva-Trichkova, Petya; Boyadjieva, Pepka

2014-01-01

This paper aims at studying the dynamics of inequalities in access to higher education (HE) both in a historical and a comparative perspective. It uses Bulgaria as a case study and places it among five other countries such as Estonia, Hungary, Poland, Slovakia and Slovenia. The adopted approach differentiates between equity in HE and inequalities…

Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border.

PubMed

Servin, Argentina E; Muñoz, Fátima A; Zúñiga, María Luisa

2014-01-01

Latinos living with HIV residing in the US-Mexico border region frequently seek care on both sides of the border. Given this fact, a border health perspective to understanding barriers to care is imperative to improve patient health outcomes. This qualitative study describes and compares experiences and perceptions of Mexican and US HIV care providers regarding barriers to HIV care access for Latino patients living in the US-Mexico border region. In 2010, we conducted in-depth qualitative interviews with HIV care providers in Tijuana (n = 10) and San Diego (n = 9). We identified important similarities and differences between Mexican and US healthcare provider perspectives on HIV care access and barriers to service utilisation. Similarities included the fact that HIV-positive Latino patients struggle with access to ART medication, mental health illness, substance abuse and HIV-related stigma. Differences included Mexican provider perceptions of medication shortages and US providers feeling that insurance gaps influenced medication access. Differences and similarities have important implications for cross-border efforts to coordinate health services for patients who seek care in both countries.

Electronic Warfare (EW) Historical Perspectives and Its Relationship to Information Operations (IO) - Considerations for Turkey

DTIC Science & Technology

2006-09-01

MILDEC) Military Deception is one of the oldest tools used in the history of military action; an example is the Trojan Horse myth. According to an...ancient Greek mythology, the Greeks defeated the Trojans by deceiving them with a giant wooden horse , presented as a gift. The Trojan’s accepted the...targets The medium or media should be readily accessible and readily available 23 inside the wooden horse . These men snuck out at night and

Identifying How Patient Portals May Be Effectively Used Among Mental Health Populations to Support Digital Inclusion: A Study Protocol.

PubMed

Strudwick, Gillian; Booth, Richard; Strauss, John

2018-01-01

Patient portals are secure online websites that allow patients access to their medical information from a particular healthcare organization. Currently, it is unknown how this technology can best be used to support patients with mental illness, and what types of indicators of portal adoption are meaningful to these patients. This study addresses this gap in our knowledge by obtaining the perspectives on this topic from patients, family members and Peer Support Workers.

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

Elber, Ron

Atomically detailed computer simulations of complex molecular events attracted the imagination of many researchers in the field as providing comprehensive information on chemical, biological, and physical processes. However, one of the greatest limitations of these simulations is of time scales. The physical time scales accessible to straightforward simulations are too short to address many interesting and important molecular events. In the last decade significant advances were made in different directions (theory, software, and hardware) that significantly expand the capabilities and accuracies of these techniques. This perspective describes and critically examines some of these advances.

Has the Web really empowered health care consumers? The truth is customers may not have changed as much as we think.

PubMed

Wilkins, S T; Navarro, F H

2001-01-01

The experts tell us that fueled by unprecedented access to health information online, today's new health care consumer will revolutionize the way health care services are organized and delivered. An examination of consumers from a health value-graphic perspective, however, casts some doubt on these predictions. Patterns emerging online are simply making us more aware of existing consumer segments that have always been actively involved in their own health.

Provider and service-user perspectives of volunteer health-worker service provision in Ayeyarwady Region, Myanmar: a qualitative study.

PubMed

Watt, Nicola; Yupar, Aye; Sender, Paul; Campbell, Fiona; Legido-Quigley, Helena; Howard, Natasha

2016-12-09

To explore perspectives and reported experiences of service users, community providers and policymakers related to volunteer health-worker services provision in a rural area of Myanmar. A qualitative interview study was conducted in rural communities with 54 service users and 17 community providers in Ayeyarwady Region, Myanmar, and with 14 national managers and policymakers in Yangon Myanmar. Topics included reasons for seeking health services, views and experiences, and comparison with experiences of other services. Data were analysed thematically using deductive and inductive coding. Accessibility and affordability were important to all participants. Service users described the particular relevance of trust, familiarity and acceptability in choosing a provider. Perceived quality and effectiveness were necessary for trust to develop. Perceived value of volunteers was a cross-cutting dimension, which was interpreted differently by different participants. Results suggest that volunteers are appropriate and valued, and support 'availability', 'accessibility' and 'acceptability' as dimensions of health services access in this setting. However, social complexities should be considered to ensure effective service delivery. Further research into trust-building, developing quality perceptions and resulting service-user choices would be useful to inform effective policy and planning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Water insecurity in 3 dimensions: An anthropological perspective on water and women's psychosocial distress in Ethiopia

PubMed Central

Stevenson, Edward G. J.; Greene, Leslie E.; Maes, Kenneth C.; Ambelu, Argaw; Tesfaye, Yihenew Alemu; Rheingans, Richard; Hadley, Craig

2012-01-01

Water insecurity is a primary underlying determinant of global health disparities. While public health research on water insecurity has focused mainly on two dimensions, water access and adequacy, an anthropological perspective highlights the cultural or lifestyle dimension of water insecurity, and its implications for access / adequacy and for the phenomenology of water insecurity. Recent work in Bolivia has shown that scores on a water insecurity scale derived from ethnographic observations are associated with emotional distress. We extend this line of research by assessing the utility of a locally developed water insecurity scale, compared with standard measures of water access and adequacy, in predicting women's psychosocial distress in Ethiopia. In 2009-2010 we conducted two phases of research. Phase I was mainly qualitative and designed to identify locally relevant experiences of water insecurity, and Phase II used a quantitative survey to test the association between women's reported water insecurity and the Falk Self-Reporting Questionnaire (SRQ-F), a measure of psychosocial distress. In multiple regression models controlling for food insecurity and reported quantity of water used, women's water insecurity scores were significantly associated with psychosocial distress. Including controls for time required to collect water and whether water sources were protected did not further predict psychosocial distress. This approach highlights the social dimension of water insecurity, and may be useful for informing and evaluating interventions to improve water supplies. PMID:22575697

Development of a cross-cultural HPV community engagement model within Scotland.

PubMed

Carnegie, Elaine; Whittaker, Anne; Gray Brunton, Carol; Hogg, Rhona; Kennedy, Catriona; Hilton, Shona; Harding, Seeromanie; Pollock, Kevin G; Pow, Janette

2017-06-01

To examine cultural barriers and participant solutions regarding acceptance and uptake of the human papillomavirus (HPV) vaccine from the perspective of Black African, White-Caribbean, Arab, Indian, Bangladeshi and Pakistani young people. In total, 40 young people from minority ethnic communities in Scotland took part in a qualitative study, involving seven focus groups and four paired interviews, to explore their views and experiences of the HPV vaccine. Using critical discursive psychology, the analysis focused on young people's accounts of barriers and enablers to information, access and uptake of the HPV vaccination programme. Participants suggested innovative strategies to tackle intergenerational concerns, information design and accessibility, and public health communications across diverse contexts. A cross-cultural community engagement model was developed, embracing diversity and contradiction across different ethnic groups. This included four inter-related strategies: providing targeted and flexible information for young people, vaccine provision across the life-course, intergenerational information and specific cross-cultural communications. This is the first HPV cross-cultural model inductively derived from accounts of young people from different ethnic communities. We recommend public health practitioners and policymakers consider using the processes and strategies within this model to increase dialogue around public engagement, awareness and receptivity towards HPV vaccination.

Obesity in primary care: a qualitative synthesis of patient and practitioner perspectives on roles and responsibilities.

PubMed

Henderson, Emily

2015-04-01

Obesity is a top-priority global health issue; however, a clear way to address obesity in primary care is not yet in view. To conduct a meta-ethnography of patient and primary care practitioner perspectives of roles and responsibilities in how to address obesity in the UK, to inform evidence-based services that are acceptable to, and appropriate for, patients and practitioners. Qualitative synthesis applying meta-ethnographic methods according to the Noblit and Hare monograph. Database searches in MEDLINE(®), Social Sciences Citation Index(®), CINAHL, and Health Management Information Consortium were limited to 1997-2012 to examine recent perspectives. Full articles of practitioner and/or patient perspectives on obesity services in primary care were reviewed, and included semi-structured or unstructured interviews and focus groups, and participant observations. Nine studies were synthesised with perspectives from patients (n = 105) and practitioners (n = 144). Practitioners believe that patients are responsible for obesity, and that primary care should not help, or is poorly equipped to do so. Patients 'take responsibility' by 'blaming' themselves, but feel that practitioners should demonstrate more leadership. The empowerment of patients to access health services is reliant on the empowerment of practitioners to take an unambiguous position. Primary care has the potential either to perpetuate or counter obesity-related stigma. There needs to be a firm decision as to what role primary care will take in the prevention and treatment of obesity. To remain ambiguous runs the risk of losing patients' confidence and adding to a growing sense of futility. © British Journal of General Practice 2015.

Medical device innovation: prospective solutions for an ecosystem in crisis. Adding a professional society perspective.

PubMed

Krucoff, Mitchell W; Brindis, Ralph G; Hodgson, Patricia K; Mack, Michael J; Holmes, David R

2012-07-01

Barriers to medical device innovation compromise timelines and costs from bench to bedside. Fragmented strategies by individual competitors are no longer sustainable. Pragmatically focused pre-competitive collaboration across stakeholders approaches innovation as an ecosystem. Desiloing experience and expertise encourages high-impact infrastructure efficiencies unique to pre-competitive constructs. Alignment of processes and objectives across the regulatory, reimbursement, clinical research, and clinical practice enterprises, with particular attention to the total product life cycle and continuous accrual of safety information, promotes more predictable equipoise for speed of access relative to residual safety concerns. Professional societies are well positioned to convene pre-competitive dialogue, facilitate alignment, and add perspective to equipoise within the innovation ecosystem. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Reducing Negative Outcomes of Online Consumer Health Information: Qualitative Interpretive Study with Clinicians, Librarians, and Consumers

PubMed Central

Pluye, Pierre; Thoër, Christine; Rodriguez, Charo

2018-01-01

Background There has been an exponential increase in the general population’s usage of the internet and of information accessibility; the current demand for online consumer health information (OCHI) is unprecedented. There are multiple studies on internet access and usage, quality of information, and information needs. However, few studies explored negative outcomes of OCHI in detail or from different perspectives, and none examined how these negative outcomes could be reduced. Objective The aim of this study was to describe negative outcomes associated with OCHI use in primary care and identify potential preventive strategies from consumers’, health practitioners’, and health librarians’ perspectives. Methods This included a two-stage interpretive qualitative study. In the first stage, we recruited through a social media survey, a purposeful sample of 19 OCHI users who had experienced negative outcomes associated with OCHI. We conducted semistructured interviews and performed a deductive-inductive thematic analysis. The results also informed the creation of vignettes that were used in the next stage. In the second stage, we interviewed a convenient sample of 10 key informants: 7 health practitioners (3 family physicians, 2 nurses, and 2 pharmacists) and 3 health librarians. With the support of the vignettes, we asked participants to elaborate on (1) their experience with patients who have used OCHI and experienced negative outcomes and (2) what strategies they suggest to reduce these outcomes. We performed a deductive-inductive thematic analysis. Results We found that negative outcomes of OCHI may occur at three levels: internal (such as increased worrying), interpersonal (such as a tension in the patient-clinician relationship), and service-related (such as postponing a clinical encounter). Participants also proposed three types of strategies to reduce the occurrence of these negative outcomes, namely, providing consumers with reliable OCHI, educating consumers on how to assess OCHI websites, and helping consumers present and discuss the OCHI they find with a health professional in their social network or a librarian for instance. Conclusions We examined negative outcomes associated with using OCHI from five complementary perspectives (consumers, family physicians, pharmacists, nurses, and health librarians). We identified a construct of OCHI use–related tension that included and framed all negative outcomes. This construct has three dimensions (three interdependent levels): internal, interpersonal, and service-related tensions. Future research can focus on the implementation and effectiveness of the proposed strategies, which might contribute to reducing these tensions. PMID:29728350

Perspectives of policy and political decision makers on access to formal dementia care: expert interviews in eight European countries.

PubMed

Broda, Anja; Bieber, Anja; Meyer, Gabriele; Hopper, Louise; Joyce, Rachael; Irving, Kate; Zanetti, Orazio; Portolani, Elisa; Kerpershoek, Liselot; Verhey, Frans; Vugt, Marjolein de; Wolfs, Claire; Eriksen, Siren; Røsvik, Janne; Marques, Maria J; Gonçalves-Pereira, Manuel; Sjölund, Britt-Marie; Woods, Bob; Jelley, Hannah; Orrell, Martin; Stephan, Astrid

2017-08-03

As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers. Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4-7 experts (total N = 38). The interview guide addressed the topics "Complexity and Continuity of Care", "Formal Services", and "Public Awareness". Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries. The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness. Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations.

Assessing barriers to health insurance and threats to equity in comparative perspective: The Health Insurance Access Database

PubMed Central

2012-01-01

Background Typologies traditionally used for international comparisons of health systems often conflate many system characteristics. To capture policy changes over time and by service in health systems regulation of public and private insurance, we propose a database containing explicit, standardized indicators of policy instruments. Methods The Health Insurance Access Database (HIAD) will collect policy information for ten OECD countries, over a range of eight health services, from 1990–2010. Policy indicators were selected through a comprehensive literature review which identified policy instruments most likely to constitute barriers to health insurance, thus potentially posing a threat to equity. As data collection is still underway, we present here the theoretical bases and methodology adopted, with a focus on the rationale underpinning the study instruments. Results These harmonized data will allow the capture of policy changes in health systems regulation of public and private insurance over time and by service. The standardization process will permit international comparisons of systems’ performance with regards to health insurance access and equity. Conclusion This research will inform and feed the current debate on the future of health care in developed countries and on the role of the private sector in these changes. PMID:22551599

Perspectives on Breast Health Education and Services Among Recent Hispanic Immigrant Women in the Midwest: a Qualitative Study in Lancaster County, Nebraska.

PubMed

Ramos, Athena K; Correa, Antonia; Trinidad, Natalia

2016-12-01

Breast cancer is the most common cause of cancer death among Hispanic women in the USA. Throughout the country, Hispanic immigrants face many barriers to achieving optimal breast health. Three focus groups were conducted to explore challenges and opportunities in access to breast health services and information among recent Hispanic immigrant women in Lancaster Country, Nebraska. Respondents perceived breast cancer as a serious issue and were concerned about it, but there were few cues to action to improve health given the limited information and access to services available to low-income Spanish-speaking individuals in the community. Results highlighted the need for culturally and linguistically appropriate health education and services, accessibility and promotion of low-cost screening and treatment services, and inclusive policies to promote preventative healthcare services for all women regardless of immigration status. Health is more than just clinical care, and therefore, it is important to understand the contextual and cultural factors that have resulted in low screening rates and develop methods to address these them. Failure to address these aspects of social determinants of health could hamper efforts to improve breast health and reduce disparities.

Email solicitation for scholarly work--a single researcher's perspective.

PubMed

Bugeja, Justine; Grech, Victor

2015-01-01

Publishing is important for career progression. The traditional journal model results in subscribers bearing publication costs. The eagerness with which researchers seek journals for the publishing of their work, along with the internet, has resulted in the creation of a new model called open access (OA). Author/s or their institution/s pay an actual publication fee. This has in turn resulted in the creation of questionable journals which charge steep publishing fees. Emails soliciting publication to one of the authors (VG) were collected for the month of March 2015. Information collected included costs of OA publishing, and whether or not this information was readily available. The appropriateness of said solicitations was also assessed with regard to topics with which the targeted author was familiar. There was a total of 44 solicitations: 3 were duplicates. Out of 41 solicitations, 20 (49%) were appropriate. The open access fee was readily available in 27 out of 41 solicitations (66%). The open access fee averaged $475, ranging from $25 to $1500. The only journal which provided true OA was Medical Principles and Practice, with no fees charged whatsoever. Potential authors should carefully investigate OA journals prior to choosing journals wherein to submit their work.

Creating opportunities to learn in mathematics education: a sociocultural perspective

NASA Astrophysics Data System (ADS)

Goos, Merrilyn

2014-09-01

The notion of `opportunities to learn in mathematics education' is open to interpretation from multiple theoretical perspectives, where the focus may be on cognitive, social or affective dimensions of learning, curriculum and assessment design, issues of equity and access, or the broad policy and political contexts of learning and teaching. In this paper, I conceptualise opportunities to learn from a sociocultural perspective. Beginning with my own research on the learning of students and teachers of mathematics, I sketch out two theoretical frameworks for understanding this learning. One framework extends Valsiner's zone theory of child development, and the other draws on Wenger's ideas about communities of practice. My aim is then to suggest how these two frameworks might help us understand the learning of others who have an interest in mathematics education, such as mathematics teacher educator-researchers and mathematicians. In doing so, I attempt to move towards a synthesis of ideas to inform mathematics education research and development.

Access and acceptability of community-based services for older Greek migrants in Australia: user and provider perspectives.

PubMed

Hurley, Catherine; Panagiotopoulos, Georgia; Tsianikas, Michael; Newman, Lareen; Walker, Ruth

2013-03-01

In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball sampling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area. © 2012 Blackwell Publishing Ltd.

Defining Information Security.

PubMed

Lundgren, Björn; Möller, Niklas

2017-11-15

This article proposes a new definition of information security, the 'Appropriate Access' definition. Apart from providing the basic criteria for a definition-correct demarcation and meaning concerning the state of security-it also aims at being a definition suitable for any information security perspective. As such, it bridges the conceptual divide between so-called 'soft issues' of information security (those including, e.g., humans, organizations, culture, ethics, policies, and law) and more technical issues. Because of this it is also suitable for various analytical purposes, such as analysing possible security breaches, or for studying conflicting attitudes on security in an organization. The need for a new definition is demonstrated by pointing to a number of problems for the standard definition type of information security-the so-called CIA definition. Besides being too broad as well as too narrow, it cannot properly handle the soft issues of information security, nor recognize the contextual and normative nature of security.

Comprehensive effective and efficient global public health surveillance

PubMed Central

2010-01-01

At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources. Three movements now set the stage for transformation of surveillance: 1) adoption by Member States of the World Health Organization (WHO) of the revised International Health Regulations (IHR[2005]); 2) maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3) consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers. To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners. We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it’s needed, where it’s needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities to the ownership and stewardship of public health information; and second, the right of individuals to access real-time public health information that might impact their lives. The vision can be accomplished through an interoperable, global public health grid. Adopting guiding principles, the global community should circumscribe the overlapping interest, shared vision, and mutual benefit between the security and public health communities and define the boundaries. A global forum needs to be established to guide the consensus governance required for public health information sharing in the 21st century. PMID:21143825

Comprehensive effective and efficient global public health surveillance.

PubMed

McNabb, Scott J N

2010-12-03

At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources.Three movements now set the stage for transformation of surveillance: 1) adoption by Member States of the World Health Organization (WHO) of the revised International Health Regulations (IHR[2005]); 2) maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3) consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers.To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners.We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it's needed, where it's needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities to the ownership and stewardship of public health information; and second, the right of individuals to access real-time public health information that might impact their lives.The vision can be accomplished through an interoperable, global public health grid. Adopting guiding principles, the global community should circumscribe the overlapping interest, shared vision, and mutual benefit between the security and public health communities and define the boundaries. A global forum needs to be established to guide the consensus governance required for public health information sharing in the 21st century.

Consumer health information seeking on the Internet: the state of the art.

PubMed

Cline, R J; Haynes, K M

2001-12-01

Increasingly, consumers engage in health information seeking via the Internet. Taking a communication perspective, this review argues why public health professionals should be concerned about the topic, considers potential benefits, synthesizes quality concerns, identifies criteria for evaluating online health information and critiques the literature. More than 70 000 websites disseminate health information; in excess of 50 million people seek health information online, with likely consequences for the health care system. The Internet offers widespread access to health information, and the advantages of interactivity, information tailoring and anonymity. However, access is inequitable and use is hindered further by navigational challenges due to numerous design features (e.g. disorganization, technical language and lack of permanence). Increasingly, critics question the quality of online health information; limited research indicates that much is inaccurate. Meager information-evaluation skills add to consumers' vulnerability, and reinforce the need for quality standards and widespread criteria for evaluating health information. Extant literature can be characterized as speculative, comprised of basic 'how to' presentations, with little empirical research. Future research needs to address the Internet as part of the larger health communication system and take advantage of incorporating extant communication concepts. Not only should research focus on the 'net-gap' and information quality, it also should address the inherently communicative and transactional quality of Internet use. Both interpersonal and mass communication concepts open avenues for investigation and understanding the influence of the Internet on health beliefs and behaviors, health care, medical outcomes, and the health care system.

Evaluating improvements in landside access for airports.

DOT National Transportation Integrated Search

1998-10-01

The purpose of this research was to describe the elements that comprise airport access and develop a methodology for identifying and evaluating existing landside access performance and proposed improvements from a passenger perspective. The scope was...

Gaining Access to Late French-Immersion Programs: Class-Based Perspectives of Canadian Students in an Ottawa High School

ERIC Educational Resources Information Center

Makropoulos, Josee

2009-01-01

The question of access to French-immersion programs has become a timely subject in Canada as a result of shifting political priorities, cutbacks, and growing concern around finding the most efficient way to teach French as a second language (FSL). While drawing on social selection and identity perspectives on school choice, this article presents…

The Future of the New Media in the Communication of Science

NASA Astrophysics Data System (ADS)

Hanson, Joseph

2014-03-01

New media, that which is based around social networks, ubiquitous consumer technology, and today's near-universal access to information, has transformed the way that science is communicated to the scientist and non-scientist alike. We may be in the midst of mankind's greatest shift in information consumption and distribution since the invention of the printing press. Or maybe not. The problem with predicting the future is that it's very hard, and unless you're Isaac Asimov, it's very easy to be wrong. When one predicts the future regarding the internet, that risk becomes almost a certainty. Still, we can apply lessons learned from the near and distant history of science communication to put today's new media evolution into perspective, and to give us clues as to where social media, digital journalism, open access, and online education will lead science communication in years to come. Most importantly, it remains to be seen whether this new media evolution will translate into a shift in how science is viewed by citizens and their policymakers.

Do public health services in Egypt help young married women exercise their reproductive rights?

PubMed

Abdel-Tawab, Nahla; Rabie, Tamer; Boehmova, Zuzana; Hawkins, Loraine; Saher, Sally; El Shitany, Atef

2015-08-01

To assess supply and demand of family planning services from a reproductive rights perspective among young married women (YMW) in Egypt. Data sources related to family planning included structured interviews with service providers (n=216); an inventory of equipment and supplies (n=40); exit interviews with YMW (n=147); and focus group discussions (n=12) with YMW, husbands, and mothers and/or mothers in law. YMW, husbands and mothers in law were not necessarily related. Although family planning services were readily available and affordable, YMW had limited access to information and services. Shortfalls were noted regarding respect for privacy, choice of family planning method, access to fertility services, and premarital counseling. Few YMW had sufficient autonomy to make informed reproductive decisions. Effective accountability mechanisms and processes for redress were also lacking. Implementation of a rights-based approach and structural changes to family planning service delivery are recommended to empower YMW in Egypt to demand and exercise their reproductive rights. Copyright © 2015. Published by Elsevier Ireland Ltd.

Bridging Organizational Divides in Health Care: An Ecological View of Health Information Exchange

PubMed Central

Johnson, Kevin B; Gadd, Cynthia S; Lorenzi, Nancy M

2013-01-01

Background The fragmented nature of health care delivery in the United States leads to fragmented health information and impedes patient care continuity and safety. Technologies to support interorganizational health information exchange (HIE) are becoming more available. Understanding how HIE technology changes health care delivery and affects people and organizations is crucial to long-term successful implementation. Objective Our study investigated the impacts of HIE technology on organizations, health care providers, and patients through a new, context-aware perspective, the Regional Health Information Ecology. Methods We conducted more than 180 hours of direct observation, informal interviews during observation, and 9 formal semi-structured interviews. Data collection focused on workflow and information flow among health care team members and patients and on health care provider use of HIE technology. Results We structured the data analysis around five primary information ecology components: system, locality, diversity, keystone species, and coevolution. Our study identified three main roles, or keystone species, involved in HIE: information consumers, information exchange facilitators, and information repositories. The HIE technology impacted patient care by allowing providers direct access to health information, reducing time to obtain health information, and increasing provider awareness of patient interactions with the health care system. Developing the infrastructure needed to support HIE technology also improved connections among information technology support groups at different health care organizations. Despite the potential of this type of technology to improve continuity of patient care, HIE technology adoption by health care providers was limited. Conclusions To successfully build a HIE network, organizations had to shift perspectives from an ownership view of health data to a continuity of care perspective. To successfully integrate external health information into clinical work practices, health care providers had to move toward understanding potential contributions of external health information. Our study provides a foundation for future context-aware development and implementation of HIE technology. Integrating concepts from the Regional Health Information Ecology into design and implementation may lead to wider diffusion and adoption of HIE technology into clinical work. PMID:25600166

Publishing in Open Access Education Journals: The Authors' Perspectives

ERIC Educational Resources Information Center

Coonin, Bryna; Younce, Leigh M.

2010-01-01

Open access publishing is now an accepted method of scholarly communication. However, the greatest traction for open access publishing thus far has been in the sciences. Penetration of open access publishing has been much slower among the social sciences. This study surveys 309 authors from recent issues of open access journals in education to…

In the Information Age, do dementia caregivers get the information they need? Semi-structured interviews to determine informal caregivers' education needs, barriers, and preferences.

PubMed

Peterson, Kendra; Hahn, Howard; Lee, Amber J; Madison, Catherine A; Atri, Alireza

2016-09-23

Most patients with dementia or cognitive impairment receive care from family members, often untrained for this challenging role. Caregivers may not access publicly available caregiving information, and caregiver education programs are not widely implemented clinically. Prior large surveys yielded broad quantitative understanding of caregiver information needs, but do not illuminate the in-depth, rich, and nuanced caregiver perspectives that can be gleaned using qualitative methodology. We aimed to understand perspectives about information sources, barriers and preferences, through semi-structured interviews with 27 caregivers. Content analysis identified important themes. We interviewed 19 women, 8 men; mean age 58.5 years; most adult children (15) or spouses (8) of the care recipient. Dementia symptoms often developed insidiously, with delayed disease acknowledgement and caregiver self-identification. While memory loss was common, behavioral symptoms were most troublesome, often initially unrecognized as disease indicators. Emerging themes: 1.) Barriers to seeking information often result from knowledge gaps, rather than reluctance to assume the caregiver role; 2.) Most caregivers currently receive insufficient information. Caregivers are open to many information sources, settings, and technologies, including referrals to other healthcare professionals, print material, and community and internet resources, but expect the primary care provider (PCP) to recommend, endorse, and guide them to specific sources. These findings replicated and expanded on results from previous quantitative surveys and, importantly, revealed a previously unrecognized essential factor: despite receiving insufficient information, caregivers place critical value on their relationship with care recipient PCPs to receive recommendations, guidance and endorsement to sources of caregiving information. Implications include: 1.) Greater public education is needed to help caregivers identify and describe diverse cognitive, functional and behavioral symptoms that lead to dementia, and recognize the benefits of early detection in accessing information regarding multi-modality management and care; 2.) Improved methods are needed for PCPs to detect and manage cognitive and behavioral changes, as well as mechanisms that facilitate the busy PCP, either directly or via referral, to provide caregiver information, education, support, and services. The critical relationship between caregivers and PCPs should not be circumvented but should be facilitated to provide more effective guidance regarding dementia caregiver needs.

Practitioner Perspectives on a Disaster Management Architecture

NASA Astrophysics Data System (ADS)

Moe, K.; Evans, J. D.

2012-12-01

The Committee on Earth Observing Satellites (CEOS) Working Group on Information Systems and Services (WGISS) is constructing a high-level reference model for the use of satellites, sensors, models, and associated data products from many different global data and service providers in disaster response and risk assessment. To help streamline broad, effective access to satellite information, the reference model provides structured, shared, holistic views of distributed systems and services - in effect, a common vocabulary describing the system-of-systems building blocks and how they are composed for disaster management. These views are being inferred from real-world experience, by documenting and analyzing how practitioners have gone about using or providing satellite data to manage real disaster events or to assess or mitigate hazard risks. Crucial findings and insights come from case studies of three kinds of experience: - Disaster response and recovery (such as the 2008 Sichuan/Wenchuan earthquake in China; and the 2011 Tohoku earthquake and tsunami in Japan); - Technology pilot projects (such as NASA's Flood Sensor Web pilot in Namibia, or the interagency Virtual Mission Operation Center); - Information brokers (such as the International Charter: Space and Major Disasters, or the U.K.-based Disaster Management Constellation). Each of these experiences sheds light on the scope and stakeholders of disaster management; the information requirements for various disaster types and phases; and the services needed for effective access to information by a variety of users. They also highlight needs and gaps in the supply of satellite information for disaster management. One need stands out: rapid and effective access to complex data from multiple sources, across inter-organizational boundaries. This is the near-real-time challenge writ large: gaining access to satellite data resources from multiple organizationally distant and geographically disperse sources, to meet an urgent need. The case studies and reference model will highlight gaps in data supply and data delivery technologies, and suggest recommended priorities for satellite missions, ground data systems, and third-party service providers.

Weather Knowledge: No Longer the Privilege of Meteorologists and Weather Services - Information and the Overturning of the Gods

NASA Astrophysics Data System (ADS)

Leon, V. C.

2006-05-01

The advances in communications technology, sharing of data and information, are enabling the development of knowledge that was impossible a decade ago. A prime example is Meteorology students, regardless of their location, are now able to access and use massive amounts of current and historic hydro-meteorological data. This ability was the province of national weather services with their so expensive equipment in the not too distant past. Now, one only needs inexpensive personal computers and access to the Internet (with the help and vision of groups like Unidata) to study phenomena that affect society. There is no longer a need to operate expensive ground stations to be able to analyze satellite imagery, etc. Investigations of atmospheric phenomena are no longer restricted to students of Meteorology. Learners in diverse disciplines and increasingly amateurs are joining a vibrantly expanding community. There was a time when a medical doctor was a god. Now, as technology has allowed us to become better informed, we are increasingly capable of questioning diagnoses and making truly informed decisions. This talk will reflect the author's experience, thoughts, and some perspectives for the future, on "the extension of free and open information sharing in the pursuit of incubating international collaborations".

What new mothers need to know: perspectives from women and providers in Georgia.

PubMed

Gazmararian, Julie A; Dalmida, Safiya George; Merino, Yesenia; Blake, Sarah; Thompson, Winifred; Gaydos, Laura

2014-05-01

Identifying the educational and resource needs of new mothers is of paramount importance in developing programs to improve maternal and child health outcomes. The primary purpose of this study was to explore the educational needs of new mothers and identify opportunities to enhance healthcare providers' current educational efforts. A two-part methodology was utilized to qualitatively explore the topic of parenting information needs for new mothers in Georgia. Data collection included information from 11 focus groups with 92 first-time, new mothers and 20 interviews with healthcare providers who serve new mothers. Discussions with both new mothers and providers clearly indicated that new mothers face a significant informational deficit, especially regarding very basic, daily infant care information and health literacy challenges. Educational materials already exist; however, mothers report difficulty accessing and understanding this information. For this reason, both the mothers and the providers stressed a focus on developing programs or interventions that allow in-person education and/or alternative modalities to access information, as opposed to development of new written materials solely. Information from the focus group and interviews provided important insight regarding what improvements need to be made to help new mothers and their families during the early stages of parenthood. By improving the education of new mothers and their families, it is proposed that maternal and infant health status could be improved.

Surgeons' and Trauma Care Physicians' Perception of the Impact of the Globalization of Medical Education on Quality of Care in Lima, Peru.

PubMed

LaGrone, Lacey N; Isquith-Dicker, Leah N; Huaman Egoavil, Eduardo; Rodriguez Castro, Manuel J A; Allagual, Alfredo; Revoredo, Fernando; Mock, Charles N

2017-03-01

The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training. Observational study of qualitative interviews conducted from September 2015 to January 2016 using grounded theory qualitative research methods. The study was conducted at 10 large public institutions that provide most of the trauma care in Lima, Peru, and included urban resident and faculty surgery and trauma care physicians. Access to international surgical rotations and medical information. Outcome measures defining the impact of globalization on surgical care were developed as part of simultaneous data collection and analysis during qualitative research as part of a larger project on trauma quality improvement practices in Peru. Fifty qualitative interviews of surgeons and emergency medicine physicians were conducted at 10 hospitals, including multiple from the public and social security systems. A median of 4 interviews were conducted at each hospital, and fewer than 3 interviews were conducted at only 1 hospital. From the broader theme of globalization emerged subthemes of an eroded sense of agency and a perception of inadequate training on the adaptation of international standards as negative effects of globalization on surgical care in Peru. Access to research funds, provision of incentives for acquisition of advanced clinical training, increased expectations for patient outcomes, and education in quality improvement skills are ways in which globalization positively affected surgeons and their patients in Peru. Short-term overseas training of surgeons from low- and middle-income countries may improve care in the surgeons' country of origin through the acquisition of skills and altered expectations for excellence. Prioritization of evidence-based medical education is necessary given widespread internet access and thus clinician exposure to variable quality medical information. Finally, the establishment of centers of excellence in low- and middle-income countries may address the eroded sense of agency attributable to globalization and offer a local example of world-class surgical outcomes, diminishing surgeons' most frequently cited reason for emigration: access to better surgical training.

Task Delegation Based Access Control Models for Workflow Systems

NASA Astrophysics Data System (ADS)

Gaaloul, Khaled; Charoy, François

e-Government organisations are facilitated and conducted using workflow management systems. Role-based access control (RBAC) is recognised as an efficient access control model for large organisations. The application of RBAC in workflow systems cannot, however, grant permissions to users dynamically while business processes are being executed. We currently observe a move away from predefined strict workflow modelling towards approaches supporting flexibility on the organisational level. One specific approach is that of task delegation. Task delegation is a mechanism that supports organisational flexibility, and ensures delegation of authority in access control systems. In this paper, we propose a Task-oriented Access Control (TAC) model based on RBAC to address these requirements. We aim to reason about task from organisational perspectives and resources perspectives to analyse and specify authorisation constraints. Moreover, we present a fine grained access control protocol to support delegation based on the TAC model.

Exploring patient experiences and perspectives of a heart failure telerehabilitation program: A mixed methods approach.

PubMed

Hwang, Rita; Mandrusiak, Allison; Morris, Norman R; Peters, Robyn; Korczyk, Dariusz; Bruning, Jared; Russell, Trevor

To describe patient experiences and perspectives of a group-based heart failure (HF) telerehabilitation program delivered to the homes via online video-conferencing. Limited information currently exists on patient experiences of telerehabilitation for HF. Patient feedback and end-user perspectives provide important information regarding the acceptability of this new delivery model which may have a substantial impact on future uptake. We used mixed-methods design with purposive sampling of patients with HF. We used self-report surveys and semi-structured interviews to measure patient experiences and perspectives following a 12-week telerehabilitation program. The telerehabilitation program encompassed group-based exercise and education, and were delivered in real-time via videoconferencing. Interviews were transcribed and coded, with thematic analysis undertaken. Seventeen participants with HF (mean age [SD] of 69 [12] years and 88% males) were recruited. Participants reported high visual clarity and ease of use for the monitoring equipment. Major themes included motivating and inhibiting influences related to telerehabilitation and improvement suggestions. Participants liked the health benefits, access to care and social support. Participants highlighted a need for improved audio clarity and connectivity as well computer training for those with limited computer experience. The majority of participants preferred a combined face-to-face and online delivery model. Participants in this study reported high visual clarity and ease-of-use, but provided suggestions for further improvements in group-based video telerehabilitation for HF. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Using a geographic information system to enhance patient access to point-of-care diagnostics in a limited-resource setting.

PubMed

Ferguson, William J; Kemp, Karen; Kost, Gerald

2016-03-01

Rapid and accurate diagnosis drives evidence-based care in health. Point-of-care testing (POCT) aids diagnosis by bringing advanced technologies closer to patients. Health small-world networks are constrained by natural connectivity in the interactions between geography of resources and social forces. Using a geographic information system (GIS) we can understand how populations utilize their health networks, visualize their inefficiencies, and compare alternatives. This project focuses on cardiac care resource in rural Isaan, Thailand. A health care access analysis was created using ArcGIS Network Analyst 10.1 from data representing aggregated population, roads, health resource facilities, and diagnostic technologies. The analysis quantified cardiac health care access and identified ways to improve it using both widespread and resource-limited strategies. Results indicated that having diagnostic technologies closer to populations streamlines critical care paths. GIS allowed us to compare the effectiveness of the implementation strategies and put into perspective the benefits of adopting rapid POCT within health networks. Geospatial analyses derive high impact by improving alternative diagnostic placement strategies in limited-resource settings and by revealing deficiencies in health care access pathways. Additionally, the GIS provides a platform for comparing relative costs, assessing benefits, and improving outcomes. This approach can be implemented effectively by health ministries seeking to enhance cardiac care despite limited resources.

Learning chronobiology by improving Wikipedia.

PubMed

Chiang, C D; Lewis, C L; Wright, M D E; Agapova, S; Akers, B; Azad, T D; Banerjee, K; Carrera, P; Chen, A; Chen, J; Chi, X; Chiou, J; Cooper, J; Czurylo, M; Downs, C; Ebstein, S Y; Fahey, P G; Goldman, J W; Grieff, A; Hsiung, S; Hu, R; Huang, Y; Kapuria, A; Li, K; Marcu, I; Moore, S H; Moseley, A C; Nauman, N; Ness, K M; Ngai, D M; Panzer, A; Peters, P; Qin, E Y; Sadhu, S; Sariol, A; Schellhase, A; Schoer, M B; Steinberg, M; Surick, G; Tsai, C A; Underwood, K; Wang, A; Wang, M H; Wang, V M; Westrich, D; Yockey, L J; Zhang, L; Herzog, E D

2012-08-01

Although chronobiology is of growing interest to scientists, physicians, and the general public, access to recent discoveries and historical perspectives is limited. Wikipedia is an online, user-written encyclopedia that could enhance public access to current understanding in chronobiology. However, Wikipedia is lacking important information and is not universally trusted. Here, 46 students in a university course edited Wikipedia to enhance public access to important discoveries in chronobiology. Students worked for an average of 9 h each to evaluate the primary literature and available Wikipedia information, nominated sites for editing, and, after voting, edited the 15 Wikipedia pages they determined to be highest priorities. This assignment (http://www.nslc.wustl.edu/courses/Bio4030/wikipedia_project.html) was easy to implement, required relatively short time commitments from the professor and students, and had measurable impacts on Wikipedia and the students. Students created 3 new Wikipedia sites, edited 12 additional sites, and cited 347 peer-reviewed articles. The targeted sites all became top hits in online search engines. Because their writing was and will be read by a worldwide audience, students found the experience rewarding. Students reported significantly increased comfort with reading, critiquing, and summarizing primary literature and benefited from seeing their work edited by other scientists and editors of Wikipedia. We conclude that, in a short project, students can assist in making chronobiology widely accessible and learn from the editorial process.

Transportation Statistics Annual Report 1997

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

Fenn, M.

1997-01-01

This document is the fourth Transportation Statistics Annual Report (TSAR) prepared by the Bureau of Transportation Statistics (BTS) for the President and Congress. As in previous years, it reports on the state of U.S. transportation system at two levels. First, in Part I, it provides a statistical and interpretive survey of the system—its physical characteristics, its economic attributes, aspects of its use and performance, and the scale and severity of unintended consequences of transportation, such as fatalities and injuries, oil import dependency, and environment impacts. Part I also explores the state of transportation statistics, and new needs of the rapidlymore » changing world of transportation. Second, Part II of the report, as in prior years, explores in detail the performance of the U.S. transportation system from the perspective of desired social outcomes or strategic goals. This year, the performance aspect of transportation chosen for thematic treatment is “Mobility and Access,” which complements past TSAR theme sections on “The Economic Performance of Transportation” (1995) and “Transportation and the Environment” (1996). Mobility and access are at the heart of the transportation system’s performance from the user’s perspective. In what ways and to what extent does the geographic freedom provided by transportation enhance personal fulfillment of the nation’s residents and contribute to economic advancement of people and businesses? This broad question underlies many of the topics examined in Part II: What is the current level of personal mobility in the United States, and how does it vary by sex, age, income level, urban or rural location, and over time? What factors explain variations? Has transportation helped improve people’s access to work, shopping, recreational facilities, and medical services, and in what ways and in what locations? How have barriers, such as age, disabilities, or lack of an automobile, affected these accessibility patterns? How are commodity flows and transportation services responding to global competition, deregulation, economic restructuring, and new information technologies? How do U.S. patterns of personal mobility and freight movement compare with other advanced industrialized countries, formerly centrally planned economies, and major newly industrializing countries? Finally, how is the rapid adoption of new information technologies influencing the patterns of transportation demand and the supply of new transportation services? Indeed, how are information technologies affecting the nature and organization of transportation services used by individuals and firms?« less

The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

PubMed

Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

2016-10-18

Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable meeting achieved its purpose (to engage stakeholders, elicit feedback, refine policy directions). Third, our decision-maker partners' expectations of the policy roundtable meeting were exceeded; they re-affirmed its value and described the refined policy directions as foundational to establishing the vocabulary, vision and framework for improving access to scheduled clinical services in Manitoba. Finally, our adaptation of key design elements was conducive to discussion of issues surrounding access to care. Our policy roundtable process was an effective tool for acquiring broad input from stakeholders, refining policy directions and forming the necessary consensus starting points to move towards evidence-informed policy.

Technologies for security, military police and professional policing organizations, the Department of Energy perspective

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

Steele, B.J.

1996-12-31

There are many technologies emerging from this decade that can be used to help the law enforcement community protect the public as well as public and private facilities against ever increasing threats to this country and its resources. These technologies include sensors, closed circuit television (CCTV), access control, contraband detection, communications, control and display, barriers, and various component and system modeling techniques. This paper will introduce some of the various technologies that have been examined for the Department of Energy that could be applied to various law enforcement applications. They include: (1) scannerless laser radar; (2) next generation security systems;more » (3) response force video information helmet system; (4) access delay technologies; (5) rapidly deployable intrusion detection systems; and (6) cost risk benefit analysis.« less

The Computational Complexity of Valuation and Motivational Forces in Decision-Making Processes

PubMed Central

Schultheiss, Nathan W.; Carter, Evan C.

2015-01-01

The concept of value is fundamental to most theories of motivation and decision making. However, value has to be measured experimentally. Different methods of measuring value produce incompatible valuation hierarchies. Taking the agent’s perspective (rather than the experimenter’s), we interpret the different valuation measurement methods as accessing different decision-making systems and show how these different systems depend on different information processing algorithms. This identifies the translation from these multiple decision-making systems into a single action taken by a given agent as one of the most important open questions in decision making today. We conclude by looking at how these different valuation measures accessing different decision-making systems can be used to understand and treat decision dysfunction such as in addiction. PMID:25981912

Electronic medical record systems in critical access hospitals: leadership perspectives on anticipated and realized benefits.

PubMed

Mills, Troy R; Vavroch, Jared; Bahensky, James A; Ward, Marcia M

2010-04-01

The growth of electronic medical records (EMRs) is driven by the belief that EMRs will significantly improve healthcare providers' performance and reduce healthcare costs. Evidence supporting these beliefs is limited, especially for small rural hospitals. A survey that focused on health information technology (HIT) capacity was administered to all hospitals in Iowa. Structured interviews were conducted with the leadership at 15 critical access hospitals (CAHs) that had implemented EMRs in order to assess the perceived benefits of operational EMRs. The results indicate that most of the hospitals implemented EMRs to improve efficiency, timely access, and quality. Many CAH leaders also viewed EMR implementation as a necessary business strategy to remain viable and improve financial performance. While some reasons reflect external influences, such as perceived future federal mandates, other reasons suggest that the decision was driven by internal forces, including the hospital's culture and the desires of key leaders to embrace HIT. Anticipated benefits were consistent with goals; however, realized benefits were rarely obvious in terms of quantifiable results. These findings expand the limited research on the rationale for implementing EMRs in critical access hospitals.

Rural and remote speech-language pathology service inequities: An Australian human rights dilemma.

PubMed

Jones, Debra M; McAllister, Lindy; Lyle, David M

2018-02-01

Access to healthcare is a fundamental human right for all Australians. Article 19 of the Universal Declaration of Human Rights acknowledges the right to freedom of opinion and to seek, receive and impart information and ideas. Capacities for self-expression and effective communication underpin the realisation of these fundamental human rights. For rural and remote Australian children this realisation is compromised by complex disadvantages and inequities that contribute to communication delays, inequity of access to essential speech-language pathology services and poorer later life outcomes. Localised solutions to the provision of civically engaged, accessible, acceptable and sustainable speech-language pathology services within rural and remote Australian contexts are required if we are to make substantive human rights gains. However, civically engaged and sustained healthcare can significantly challenge traditional professionalised perspectives on how best to design and implement speech-language pathology services that seek to address rural and remote communication needs and access inequities. A failure to engage these communities in the identification of childhood communication delays and solutions to address these delays, ultimately denies children, families and communities of their human rights for healthcare access, self-expression, self-dignity and meaningful inclusion within Australian society.

User Interface Composition with COTS-UI and Trading Approaches: Application for Web-Based Environmental Information Systems

NASA Astrophysics Data System (ADS)

Criado, Javier; Padilla, Nicolás; Iribarne, Luis; Asensio, Jose-Andrés

Due to the globalization of the information and knowledge society on the Internet, modern Web-based Information Systems (WIS) must be flexible and prepared to be easily accessible and manageable in real-time. In recent times it has received a special interest the globalization of information through a common vocabulary (i.e., ontologies), and the standardized way in which information is retrieved on the Web (i.e., powerful search engines, and intelligent software agents). These same principles of globalization and standardization should also be valid for the user interfaces of the WIS, but they are built on traditional development paradigms. In this paper we present an approach to reduce the gap of globalization/standardization in the generation of WIS user interfaces by using a real-time "bottom-up" composition perspective with COTS-interface components (type interface widgets) and trading services.

The RCP Information Laboratory (iLab): breaking the cycle of poor data quality.

PubMed

Croft, Giles P; Williams, John G

2005-01-01

A review of data quality in the NHS by the Audit Commission cited a lack of clinician involvement in the validation and use of centrally held activity data as one of the key issues to resolve. The perception that hospital episode statistics cannot support the needs of the individual clinician results in mistrust and disinterest. This in turn leads to under-development of such data from a clinical perspective, and the cycle continues. The RCP Information Laboratory (iLab) aims to address this problem by accessing, analysing and presenting information from these central repositories concerning the activity of visiting individual consultant physicians. With support from iLab staff--an information analyst and a clinician--local data quality issues are highlighted and local solutions sought. The information obtained can be used as an objective measure of activity to support the processes of appraisal and revalidation.

A little more conversation please? Qualitative study of researchers' and patients' interview accounts of training for patient and public involvement in clinical trials.

PubMed

Dudley, Louise; Gamble, Carrol; Allam, Alison; Bell, Philip; Buck, Deborah; Goodare, Heather; Hanley, Bec; Preston, Jennifer; Walker, Alison; Williamson, Paula; Young, Bridget

2015-04-27

Training in patient and public involvement (PPI) is recommended, yet little is known about what training is needed. We explored researchers' and PPI contributors' accounts of PPI activity and training to inform the design of PPI training for both parties. We used semi-structured qualitative interviews with researchers (chief investigators and trial managers) and PPI contributors, accessed through a cohort of clinical trials, which had been funded between 2006 and 2010. An analysis of transcripts of audio-recorded interviews drew on the constant comparative method. We interviewed 31 researchers and 17 PPI contributors from 28 trials. Most researchers could see some value in PPI training for researchers, although just under half had received such training themselves, and some had concerns about the purpose and evidence base for PPI training. PPI contributors were evenly split in their perceptions of whether researchers needed training in PPI. Few PPI contributors had themselves received training for their roles. Many informants across all groups felt that training PPI contributors was unnecessary because they already possessed the skills needed. Informants were also concerned that training would professionalise PPI contributors, limiting their ability to provide an authentic patient perspective. However, informants welcomed informal induction 'conversations' to help contributors understand their roles and support them in voicing their opinions. Informants believed that PPI contributors should be confident, motivated, intelligent, focussed on helping others and have relevant experience. Researchers looked for these qualities when selecting contributors, and spoke of how finding 'the right' contributor was more important than accessing 'the right' training. While informants were broadly receptive to PPI training for researchers, they expressed considerable reluctance to training PPI contributors. Providers of training will need to address these reservations. Our findings point to the importance of reconsidering how training is conceptualised, designed and promoted and of providing flexible, learning opportunities in ways that flow from researchers' and contributors' needs and preferences. We also identify some areas of training content and the need for further consideration to be given to the selection of PPI contributors and models for implementing PPI to ensure clinical trials benefit from a diversity of patient perspectives.

Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border

PubMed Central

Servin, Argentina E.; Muñoz, Fátima A.; Zúñiga, María Luisa

2015-01-01

Latinos living with HIV residing in the US-Mexico border region frequently seek care on both sides of the border. Given this fact, a border health perspective to understanding barriers to care is imperative to improve patient health outcomes. This qualitative study describes and compares experiences and perceptions of Mexican and US HIV care providers regarding barriers to HIV care access for Latino patients living in the US-Mexico border region. In 2010, we conducted in-depth qualitative interviews with HIV care providers in Tijuana (n = 10) and San Diego (n = 9). We identified important similarities and differences between Mexican and US healthcare provider perspectives on HIV care access and barriers to service utilisation. Similarities included the fact that HIV-positive Latino patients struggle with access to ART medication, mental health illness, substance abuse and HIV-related stigma. Differences included Mexican provider perceptions of medication shortages and US providers feeling that insurance gaps influenced medication access. Differences and similarities have important implications for cross-border efforts to coordinate health services for patients who seek care in both countries. PMID:24592920

Potential of personal health record portals in the care of individuals with spinal cord injuries and disorders: Provider perspectives.

PubMed

Hill, Jennifer N; Smith, Bridget M; Weaver, Frances M; Nazi, Kim M; Thomas, Florian P; Goldstein, Barry; Hogan, Timothy P

2018-05-01

Although personal health record (PHR) portals are designed for patients, healthcare providers are a key influence in how patients use their features and realize benefits from them. A few studies have examined provider attitudes toward PHR portals, but none have focused on those who care for individuals with spinal cord injuries and disorders (SCI/D). We characterize SCI/D provider perspectives of PHR portals, including perceived advantages and disadvantages of PHR portal use in SCI/D care. Cross-sectional; semi-structured interviews. Spinal Cord Injury (SCI) Centers in the Veterans Health Administration. Twenty-six SCI/D healthcare providers. None. Perceived advantages and disadvantages of PHR portals. The complex situations of individuals with SCI/D shaped provider perspectives of PHR portals and their potential role in practice. Perceived advantages of PHR portal use in SCI/D care included the ability to coordinate information and care, monitor and respond to outpatient requests, support patient self-management activities, and provide reliable health information to patients. Perceived disadvantages of PHR portal use in SCI/D care included concerns about the quality of patient-generated health data, other potential liabilities for providers and workload burden, and the ability of individuals with SCI/D to understand clinical information accessed through a portal. Our study highlights advantages and disadvantages that should be considered when promoting engagement of SCI/D healthcare providers in use of PHR portals, and portal features that may have the most utility in SCI/D care.

CrowdOutAIDS: crowdsourcing youth perspectives for action.

PubMed

Hildebrand, Mikaela; Ahumada, Claudia; Watson, Sharon

2013-05-01

To develop a strategy for how to better engage young people in decision-making processes on AIDS, UNAIDS launched the participatory online policy project CrowdOutAIDS in 2011. A total of 3,497 young people aged 15-29 from 79 countries signed up to nine online forums, and volunteers recruited through the online platform hosted 39 community-based offline forums with an additional 1,605 participants. This article describes the participatory approach of using social media and crowdsourcing solutions to integrate youth perspectives into strategy and policy processes. In these forums, youth consistently identified the need to change the way sex and relationships are dealt with through changing how sex is talked about, putting comprehensive sexuality education in place, and overcoming social and cultural taboos. The outcome document recommended three major priorities: dispel taboos surrounding sex and sexuality, eliminate stigma and discrimination against young people living with HIV, and remove social and legal barriers. Six strategic actions were also recommended: strengthen young people's skills for effective leadership, ensure full youth participation in the AIDS response, increase access to HIV-related information, strengthen strategic networks, increase UNAIDS's outreach to young people, and increase young people's access to financial support. Through leveraging social media and crowdsourcing, it is possible to integrate grassroots perspectives from across the globe into a new model of engagement and participation, which should be further explored for community empowerment and mobilization. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program.

PubMed

Milette, Katherine; Thombs, Brett D; Maiorino, Kristina; Nielson, Warren R; Körner, Annett; Peláez, Sandra

2018-05-09

The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to communicate and advocate more effectively. Rehabilitation professionals can support people with scleroderma by providing them with information on connecting with scleroderma patient organizations or by facilitating local patient support networks.

A question of balance: Explaining differences between parental and grandparental perspectives on preschoolers' feeding and physical activity.

PubMed

Eli, Karin; Howell, Kyndal; Fisher, Philip A; Nowicka, Paulina

2016-04-01

Although one quarter of US and UK families rely on grandparents as the main providers of informal childcare, grandparental perspectives on the feeding and physical activity of young children remain understudied. The study's aim was to elucidate parents' and grandparents' perspectives on young children's feeding and physical activity, and identify how they negotiate potential differences between these perspectives. We interviewed 22 parents and 27 grandparents from 16 families of children aged 3-5 years in the Pacific Northwest, US. Using familial homeostasis as a novel theoretical framework, the interviews were analyzed to assess differences between parental and grandparental perspectives on feeding and physical activity. The analysis yielded six thematic categories: (1) disagreements about feeding stem from parents' and grandparents' differing definitions of healthy feeding; (2) differences between parents' and grandparents' feeding practices reflect differences in perceived caretaking roles; (3) parents and grandparents negotiate differences in feeding practices through grandparental compliance and parental compromise; (4) differences in preschoolers' physical activity are influenced by parents' and grandparents' own access to and engagement in physical activity; (5) parents and grandparents express few disagreements about preschoolers' screen-time; (6) parents and grandparents rarely discuss preschoolers' physical activity. The findings suggest that parental and grandparental decision-making about feeding and exercise is informed by ideas of what constitutes familial balance and a balanced lifestyle for a preschool aged child, rather than by the child's weight status. Parents and grandparents appear to engage in practices designed to preserve familial homeostasis, which may provide a compelling explanation for the persistent difficulties in implementing family-based childhood obesity interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

A question of balance: Explaining differences between parental and grandparental perspectives on preschoolers' feeding and physical activity

PubMed Central

Eli, Karin; Howell, Kyndal; Fisher, Philip A.; Nowicka, Paulina

2017-01-01

Rationale Although one quarter of US and UK families rely on grandparents as the main providers of informal childcare, grandparental perspectives on the feeding and physical activity of young children remain understudied. Objective The study's aim was to elucidate parents' and grandparents' perspectives on young children's feeding and physical activity, and identify how they negotiate potential differences between these perspectives. Methods We interviewed 22 parents and 27 grandparents from 16 families of children aged 3–5 years in the Pacific Northwest, US. Using familial homeostasis as a novel theoretical framework, the interviews were analyzed to assess differences between parental and grandparental perspectives on feeding and physical activity. Results The analysis yielded six thematic categories: (1) disagreements about feeding stem from parents' and grandparents' differing definitions of healthy feeding; (2) differences between parents' and grandparents' feeding practices reflect differences in perceived caretaking roles; (3) parents and grandparents negotiate differences in feeding practices through grandparental compliance and parental compromise; (4) differences in preschoolers' physical activity are influenced by parents' and grandparents' own access to and engagement in physical activity; (5) parents and grandparents express few disagreements about preschoolers' screen-time; (6) parents and grandparents rarely discuss preschoolers' physical activity. The findings suggest that parental and grandparental decision-making about feeding and exercise is informed by ideas of what constitutes familial balance and a balanced lifestyle for a preschool aged child, rather than by the child's weight status. Conclusions Parents and grandparents appear to engage in practices designed to preserve familial homeostasis, which may provide a compelling explanation for the persistent difficulties in implementing family-based childhood obesity interventions. PMID:26943011

Shared Medical Appointments: A Promising Innovation to Improve Patient Engagement and Ease the Primary Care Provider Shortage.

PubMed

Stults, Cheryl D; McCuistion, Mary H; Frosch, Dominick L; Hung, Dorothy Y; Cheng, Peter H; Tai-Seale, Ming

2016-02-01

The Affordable Care Act has extended coverage for uninsured and underinsured Americans, but it could exacerbate existing problems of access to primary care. Shared medical appointments (SMAs) are one way to improve access and increase practice productivity, but few studies have examined the patient's perspective on participation in SMAs. To understand patient experiences, 5 focus group sessions were conducted with a total of 30 people in the San Francisco Bay Area. The sessions revealed that most participants felt that they received numerous tangible and intangible benefits from SMAs, particularly enhanced engagement with other patients and physicians, learning, and motivation for health behavior change. Most importantly, participants noted changes in the power dynamic during SMA visits as they increasingly saw themselves empowered to impart information to the physician. Although SMAs improve access, engagement with physicians and other patients, and knowledge of patients' health, they also help to ease the workload for physicians.

The Resilience Activation Framework: A conceptual model of how access to social resources promotes adaptation and rapid recovery in post-disaster settings

PubMed Central

Abramson, David M.; Grattan, Lynn M.; Mayer, Brian; Colten, Craig E.; Arosemena, Farah A.; Rung, Ariane; Lichtveld, Maureen

2014-01-01

A number of governmental agencies have called for enhancing citizen’s resilience as a means of preparing populations in advance of disasters, and as a counter-balance to social and individual vulnerabilities. This increasing scholarly, policy and programmatic interest in promoting individual and communal resilience presents a challenge to the research and practice communities: to develop a translational framework that can accommodate multi-disciplinary scientific perspectives into a single, applied model. The Resilience Activation Framework provides a basis for testing how access to social resources, such as formal and informal social support and help, promotes positive adaptation or reduced psychopathology among individuals and communities exposed to the acute collective stressors associated with disasters, whether manmade, natural, or technological in origin. Articulating the mechanisms by which access to social resources activate and sustain resilience capacities for optimal mental health outcomes post-disaster can lead to the development of effective preventive and early intervention programs. PMID:24870399

Examining the perceptions, preferences, and practices that influence healthy aging for African American older adults: an ecological perspective.

PubMed

Waites, Cheryl

2013-10-01

This study explored the healthy aging and health promotion perceptions, preferences, and practices of a purposive sample of African American older adults who resided in two communities in the south. An ecological framework was used to capture environmental factors, perceptions regarding access to health promotion resources, and health behavior preferences and practices. A mixed-method approach was used. Health supporting amenities were mapped, focus groups were conducted, and demographic information was obtained. The data were merged to create consolidated themes. The results indicated that health promotion amenities were available, but with some limitations. Convenient access to transportation strongly affected ability to use resources. Older adults were interested in preserving their health and independence, but some had difficulty staying motivated to maintain a healthy lifestyle. They wanted easier access to amenities. Implications for best practice include attention to culturally responsive outreach, motivating with social support and incentives, and developing community-based culturally compatible programming.

The resilience activation framework: a conceptual model of how access to social resources promotes adaptation and rapid recovery in post-disaster settings.

PubMed

Abramson, David M; Grattan, Lynn M; Mayer, Brian; Colten, Craig E; Arosemena, Farah A; Bedimo-Rung, Ariane; Lichtveld, Maureen

2015-01-01

A number of governmental agencies have called for enhancing citizens' resilience as a means of preparing populations in advance of disasters, and as a counterbalance to social and individual vulnerabilities. This increasing scholarly, policy, and programmatic interest in promoting individual and communal resilience presents a challenge to the research and practice communities: to develop a translational framework that can accommodate multidisciplinary scientific perspectives into a single, applied model. The Resilience Activation Framework provides a basis for testing how access to social resources, such as formal and informal social support and help, promotes positive adaptation or reduced psychopathology among individuals and communities exposed to the acute collective stressors associated with disasters, whether human-made, natural, or technological in origin. Articulating the mechanisms by which access to social resources activate and sustain resilience capacities for optimal mental health outcomes post-disaster can lead to the development of effective preventive and early intervention programs.

An assessment of pharmacists’ readiness for paperless labeling: a national survey

PubMed Central

Ho, Yun-Xian; Chen, Qingxia; Nian, Hui; Johnson, Kevin B

2014-01-01

Objective To assess the state of readiness for the adoption of paperless labeling among a nationally representative sample of pharmacies, including chain pharmacies, independent retail pharmacies, hospitals, and other rural or urban dispensing sites. Methods Both quantitative and qualitative analyses were used to analyze responses to a cross-sectional survey disseminated to American Pharmacists Association pharmacists nationwide. The survey assessed factors related to pharmacists’ attitudinal readiness (ie, perceptions of impact) and pharmacies’ structural readiness (eg, availability of electronic resources, internet access) for the paperless labeling initiative. Results We received a total of 436 survey responses (6% response rate) from pharmacists representing 44 US states and territories. Across the spectrum of settings we studied, pharmacists had work access to computers, printers, fax machines and access to the internet or intranet. Approximately 79% of respondents believed that the initiative would improve the adequacy of drug information available in their work site and 95% believed it would either not change (33%) or would improve (62%) communication to patients. Overall, respondents’ comments supported advancing the initiative; however, some comments revealed reservations regarding corporate or pharmacy buy-in, success of implementation, and ease of adoption. Conclusions This is the first nationwide study to report about pharmacists’ perspectives on paperless labeling. In general, pharmacists believe they are ready and that their pharmacies are well equipped for the transition to paperless labeling. Further exploration of perspectives from product label manufacturers and corporate pharmacy offices is needed to understand fully what will be necessary to complete this transition. PMID:23523874

An assessment of pharmacists' readiness for paperless labeling: a national survey.

PubMed

Ho, Yun-Xian; Chen, Qingxia; Nian, Hui; Johnson, Kevin B

2014-01-01

To assess the state of readiness for the adoption of paperless labeling among a nationally representative sample of pharmacies, including chain pharmacies, independent retail pharmacies, hospitals, and other rural or urban dispensing sites. Both quantitative and qualitative analyses were used to analyze responses to a cross-sectional survey disseminated to American Pharmacists Association pharmacists nationwide. The survey assessed factors related to pharmacists' attitudinal readiness (ie, perceptions of impact) and pharmacies' structural readiness (eg, availability of electronic resources, internet access) for the paperless labeling initiative. We received a total of 436 survey responses (6% response rate) from pharmacists representing 44 US states and territories. Across the spectrum of settings we studied, pharmacists had work access to computers, printers, fax machines and access to the internet or intranet. Approximately 79% of respondents believed that the initiative would improve the adequacy of drug information available in their work site and 95% believed it would either not change (33%) or would improve (62%) communication to patients. Overall, respondents' comments supported advancing the initiative; however, some comments revealed reservations regarding corporate or pharmacy buy-in, success of implementation, and ease of adoption. This is the first nationwide study to report about pharmacists' perspectives on paperless labeling. In general, pharmacists believe they are ready and that their pharmacies are well equipped for the transition to paperless labeling. Further exploration of perspectives from product label manufacturers and corporate pharmacy offices is needed to understand fully what will be necessary to complete this transition.

An opportunity: improving client services during disaster relief.

PubMed

Helferich, Omar Keith; Griggs, John E

2006-11-01

Access to current, accurate, and relevant information is mandatory for effective disaster response. In-field observations, reviews of after-action reports, and basic research indicate that this most basic of requirements is not being met. Participating disaster recovery parties, in particular environmental health agencies, lack clarity about their exact roles and lack the most basic of technological solutions that could support any given role definition. There is a need, from both cost and training perspectives, for a single, integrated solution covering risk-based routine inspections, abnormalities, and major incidents.

Mind the gap: Exploring information gaps for the development of an online resource hub for epilepsy and depression.

PubMed

Crooks, Rachel E; Bell, Meaghan; Patten, Scott B; Wiebe, Samuel; Holroyd-Leduc, Jayna; Bulloch, Andrew G; Macrodimitris, Sophia; Mackie, Aaron; Sauro, Khara M; Federico, Paolo; Jetté, Nathalie

2017-05-01

Depression is common in epilepsy, and is often under-detected and under-treated. The motivation to create a depression eHub for persons with epilepsy is to connect them to the best available online resources to effectively manage their depression. The study sought to: 1) identify facilitators and barriers to accessing resources related to management of epilepsy and/or depression and 2) discuss gaps in available resources (free and in the public domain) and 3) identify suggestions for future content. Semi-structured interviews were conducted with ten patients with epilepsy and a history of depression. Using inductive analysis, two team members engaged in a process of textual open-coding utilizing a conventional content analysis approach whereby content was conceptually clustered based on the research questions. A phenomenological framework was applied to describe the phenomenon of online health resource access and utilization from the perspective of people with epilepsy. Facilitators to the use of online resources included information credibility, thoughtful organization, and accessibility of resources. Barriers included difficulties finding and piecing together information from many different sites. Patients reported difficulty having the motivation to seek out resources while depressed, which was compounded by feelings of stigma, social isolation, and lack of control. Gaps in resources included a lack of information about living with epilepsy day-to-day and resources for family and friends. Suggested content included information to raise awareness about epilepsy and depression; questionnaires to screen for symptoms of depression; stories of other patients with epilepsy and depression via video or moderated forums; current research and news; local community resources; and tools and strategies to manage depression in epilepsy. There is a gap in accessible resources for patients with epilepsy and depression as well as barriers that include epilepsy-related restrictions, depression-related impairments, lack of awareness, and stigmatization. These results should be used to guide the development of e-Health resources for patients with epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Freedom of the Press vs. Public Access.

ERIC Educational Resources Information Center

Schmidt, Benno C., Jr.

This book surveys the implications of freedom of the press for a constitutionally rooted public right of access to electronic and print media. Part one provides general perspectives on access to the media, including discussions of access in relation to the Supreme Court, to First Amendment history and theory, to current perceptions of the press,…

Prioritization and willingness to pay for bariatric surgery: the patient perspective

PubMed Central

Gill, Richdeep S.; Majumdar, Sumit R.; Wang, Xiaoming; Tuepah, Rebecca; Klarenbach, Scott W.; Birch, Daniel W.; Karmali, Shahzeer; Sharma, Arya M.; Padwal, Raj S.

2014-01-01

Background Access to publicly funded bariatric surgery is limited, potential candidates face lengthy waits, and no universally accepted prioritization criteria exist. We examined patients’ perspectives regarding prioritization for surgery. Methods We surveyed consecutively recruited patients awaiting bariatric surgery about 9 hypothetical scenarios describing patients waiting for surgery. Respondents were asked to rank the priority of these hypothetical patients on the wait list relative to their own. Scenarios examined variations in age, clinical severity, functional impairment, social dependence and socioeconomic status. Willingness to pay for faster access was assessed using a 5-point ordinal scale and analyzed using multivariable logistic regression. Results The 99 respondents had mean age of 44.7 ± 9.9 years, 76% were women, and the mean body mass index was 47.3 ± SD 7.6. The mean wait for surgery was 34.4 ± 9.4 months. Respondents assigned similar priority to hypothetical patients with characteristics identical to theirs (p = 0.22) and higher priority (greater urgency) to those exhibiting greater clinical severity (p < 0.001) and functional impairment (p = 0.003). Lower priority was assigned to patients at the extremes of age (p = 0.006), on social assistance (p < 0.001) and of high socioeconomic status (p < 0.001). Most (85%) respondents disagreed with payment to expedite access, although participants earning more than $80 000/year were less likely to disagree. Conclusion Most patients waiting for bariatric surgery consider greater clinical severity and functional impairments related to obesity to be important prioritization indicators and disagreed with paying for faster access. These findings may help inform future efforts to develop acceptable prioritization strategies for publicly funded bariatric surgery. PMID:24461224

Prioritization and willingness to pay for bariatric surgery: the patient perspective.

PubMed

Gill, Richdeep S; Majumdar, Sumit R; Wang, Xiaoming; Tuepah, Rebecca; Klarenbach, Scott W; Birch, Daniel W; Karmali, Shahzeer; Sharma, Arya M; Padwal, Raj S

2014-02-01

Access to publicly funded bariatric surgery is limited, potential candidates face lengthy waits, and no universally accepted prioritization criteria exist. We examined patients' perspectives regarding prioritization for surgery. We surveyed consecutively recruited patients awaiting bariatric surgery about 9 hypothetical scenarios describing patients waiting for surgery. Respondents were asked to rank the priority of these hypothetical patients on the wait list relative to their own. Scenarios examined variations in age, clinical severity, functional impairment, social dependence and socioeconomic status. Willingness to pay for faster access was assessed using a 5-point ordinal scale and analyzed using multivariable logistic regression. The 99 respondents had mean age of 44.7 ± 9.9 years, 76% were women, and the mean body mass index was 47.3 ± SD 7.6. The mean wait for surgery was 34.4 ± 9.4 months. Respondents assigned similar priority to hypothetical patients with characteristics identical to theirs (p = 0.22) and higher priority (greater urgency) to those exhibiting greater clinical severity (p < 0.001) and functional impairment (p = 0.003). Lower priority was assigned to patients at the extremes of age (p = 0.006), on social assistance (p < 0.001) and of high socioeconomic status (p < 0.001). Most (85%) respondents disagreed with payment to expedite access, although participants earning more than $80 000/year were less likely to disagree. Most patients waiting for bariatric surgery consider greater clinical severity and functional impairments related to obesity to be important prioritization indicators and disagreed with paying for faster access. These findings may help inform future efforts to develop acceptable prioritization strategies for publicly funded bariatric surgery.

We Work with Them? Healthcare Workers Interpretation of Organizational Relations Mined from Electronic Health Records

PubMed Central

Chen, You; Lorenzi, Nancy; Nyemba, Steve; Schildcrout, Jonathan S.; Malin, Bradley

2014-01-01

Objective Models of healthcare organizations (HCOs) are often defined up front by a select few administrative officials and managers. However, given the size and complexity of modern healthcare systems, this practice does not scale easily. The goal of this work is to investigate the extent to which organizational relationships can be automatically learned from utilization patterns of electronic health record (EHR) systems. Method We designed an online survey to solicit the perspectives of employees of a large academic medical center. We surveyed employees from two administrative areas: 1) Coding & Charge Entry and 2) Medical Information Services and two clinical areas: 3) Anesthesiology and 4) Psychiatry. To test our hypotheses we selected two administrative units that have work-related responsibilities with electronic records; however, for the clinical areas we selected two disciplines with very different patient responsibilities and whose accesses and people who accessed were similar. We provided each group of employees with questions regarding the chance of interaction between areas in the medical center in the form of association rules (e.g., Given someone from Coding & Charge Entry accessed a patient’s record, what is the chance that someone from Medical Information Services access the same record?). We compared the respondent predictions with the rules learned from actual EHR utilization using linear-mixed effects regression models. Results The findings from our survey confirm that medical center employees can distinguish between association rules of high and non-high likelihood when their own area is involved. Moreover, they can make such distinctions between for any HCO area in this survey. It was further observed that, with respect to highly likely interactions, respondents from certain areas were significantly better than other respondents at making such distinctions and certain areas’ associations were more distinguishable than others. Conclusions These results illustrate that EHR utilization patterns may be consistent with the expectations of HCO employees. Our findings show that certain areas in the HCO are easier than others for employees to assess, which suggests that automated learning strategies may yield more accurate models of healthcare organizations than those based on the perspectives of a select few individuals. PMID:24845147

Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making.

PubMed

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2015-03-27

Deciding what health services are provided is a key consideration in delivering appropriate and accessible health care for rural and remote populations. Despite residents of rural communities experiencing poorer health outcomes and exhibiting higher health need, workforce shortages and maldistribution mean that rural communities do not have access to the range of services available in metropolitan centres. Where demand exceeds available resources, decisions about resource allocation are required. A qualitative approach enabled the researchers to explore participant perspectives about decisions informing rural physiotherapy service provision. Stakeholder perspectives were obtained through surveys and in-depth interviews. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of rural, regional and remote communities. Thirty-nine surveys were received from participants in eleven communities. Nineteen in-depth interviews were conducted with physiotherapist and key decision-makers. Increasing demand, organisational priorities, fiscal austerity measures and workforce challenges were identified as factors influencing both decision-making and service provision. Rationing of physiotherapy services was common to all sites of this study. Rationing of services, more commonly expressed as service prioritisation, was more evident in responses of public sector physiotherapy participants compared to private physiotherapists. However, private physiotherapists in rural areas reported capacity limits, including expertise, space and affordability that constrained service provision. The imbalance between increasing service demands and limited physiotherapy capacity meant making choices was inevitable. Decreased community access to local physiotherapy services and increased workforce stress, a key determinant of retention, are two results of such choices or decisions. Decreased access was particularly evident for adults and children requiring neurological rehabilitation and for people requiring post-acute physiotherapy. It should not be presumed that rural private physiotherapy providers will cover service gaps that may emerge from changes to public sector service provision. Clinician preference combines with capacity limits and the imperative of financial viability to negate such assumptions. This study provides insight into rural physiotherapy service provision not usually evident and can be used to inform health service planning and decision-making and education of current and future rural physiotherapists.

Access to scientific publications: the scientist's perspective.

PubMed

Voronin, Yegor; Myrzahmetov, Askar; Bernstein, Alan

2011-01-01

Scientific publishing is undergoing significant changes due to the growth of online publications, increases in the number of open access journals, and policies of funders and universities requiring authors to ensure that their publications become publicly accessible. Most studies of the impact of these changes have focused on the growth of articles available through open access or the number of open-access journals. Here, we investigated access to publications at a number of institutes and universities around the world, focusing on publications in HIV vaccine research--an area of biomedical research with special importance to the developing world. We selected research papers in HIV vaccine research field, creating: 1) a first set of 50 most recently published papers with keywords "HIV vaccine" and 2) a second set of 200 articles randomly selected from those cited in the first set. Access to the majority (80%) of the recently published articles required subscription, while cited literature was much more accessible (67% freely available online). Subscriptions at a number of institutions around the world were assessed for providing access to subscription-only articles from the two sets. The access levels varied widely, ranging among institutions from 20% to 90%. Through the WHO-supported HINARI program, institutes in low-income countries had access comparable to that of institutes in the North. Finally, we examined the response rates for reprint requests sent to corresponding authors, a method commonly used before internet access became widespread. Contacting corresponding authors with requests for electronic copies of articles by email resulted in a 55-60% success rate, although in some cases it took up to 1.5 months to get a response. While research articles are increasingly available on the internet in open access format, institutional subscriptions continue to play an important role. However, subscriptions do not provide access to the full range of HIV vaccine research literature. Access to papers through subscriptions is complemented by a variety of other means, including emailing corresponding authors, joint affiliations, use of someone else's login information and posting requests on message boards. This complex picture makes it difficult to assess the real ability of scientists to access literature, but the observed differences in access levels between institutions suggest an unlevel playing field, in which some researchers have to spend more efforts than others to obtain the same information.

Culturally and linguistically diverse (CALD) families dealing with dementia: an examination of the experiences and perceptions of multicultural community link workers.

PubMed

Boughtwood, Desiree; Shanley, Chris; Adams, Jon; Santalucia, Yvonne; Kyriazopoulos, Helena; Pond, Dimity; Rowland, Jeffery

2011-12-01

Dementia is a chronic illness involving increasing levels of care, often provided by family members, particularly in culturally and linguistically diverse (CALD) communities. Multicultural community link workers are often the primary service providers assisting families to access health and welfare services and as such have extensive experience of, and possess in-depth knowledge about, CALD family care-giving for dementia. While research has been undertaken on dementia in CALD communities, this research has not focused on the experiences and perceptions of these multicultural workers with regards to CALD family care-giving. In response to this gap in the research, this paper presents the results of an empirical investigation of multicultural workers' perspectives with regard to the cultural traditions informing CALD family care-giving, CALD families' understandings of the term 'carer' and family arrangements regarding care. Due to their close relationship and knowledge of families, multicultural workers can offer an important perspective that is invaluable in informing the provision of carer education and support within CALD communities.

Basic Visual Disciplines in Heritage Conservation: Outline of Selected Perspectives in Teaching and Learning

NASA Astrophysics Data System (ADS)

Lobovikov-Katz, A.

2017-08-01

Acknowledgement of the value of a basic freehand sketch by the information and communication community of researchers and developers brought about the advanced developments for the use of sketches as free input to complicated processes of computerized visualization, so as to make them more widely accessible. However, a sharp reduction and even exclusion of this and other basic visual disciplines from education in sciences, technology, engineering and architecture dramatically reduces the number of future users of such applications. The unique needs of conservation of cultural heritage pose specific challenges as well as encourage the formulation of innovative development tasks in related areas of information and communication technologies (ICT). This paper claims that the introduction of basic visual disciplines to both communities is essential to the effectiveness of integration of heritage conservation needs and the advanced ICT development of conservation value, and beyond. It provides an insight into the challenges and advantages of introducing these subjects in a relevant educational context, presents some examples of their teaching and learning in the modern environment, including e-learning, and sketches perspectives to their application.

Synthetic environment employing a craft for providing user perspective reference

DOEpatents

Maples, Creve; Peterson, Craig A.

1997-10-21

A multi-dimensional user oriented synthetic environment system allows application programs to be programmed and accessed with input/output device independent, generic functional commands which are a distillation of the actual functions performed by any application program. A shared memory structure allows the translation of device specific commands to device independent, generic functional commands. Complete flexibility of the mapping of synthetic environment data to the user is thereby allowed. Accordingly, synthetic environment data may be provided to the user on parallel user information processing channels allowing the subcognitive mind to act as a filter, eliminating irrelevant information and allowing the processing of increase amounts of data by the user. The user is further provided with a craft surrounding the user within the synthetic environment, which craft, imparts important visual referential an motion parallax cues, enabling the user to better appreciate distances and directions within the synthetic environment. Display of this craft in close proximity to the user's point of perspective may be accomplished without substantially degrading the image resolution of the displayed portions of the synthetic environment.

Development of a mental health smartphone app: perspectives of mental health service users.

PubMed

Goodwin, John; Cummins, John; Behan, Laura; O'Brien, Sinead M

2016-10-01

Current mental health policy emphasises the importance of service user involvement in the delivery of care. Information Technology can have an effect on quality and efficiency of care. The aim of this study is to gain the viewpoint of service users from a local mental health service in developing a mental health app. A qualitative descriptive approach was used. Eight volunteers aged 18-49 years were interviewed with the aid of a semi-structured questionnaire. Interviewees defined a good app by its ease of use. Common themes included availability of contact information, identifying triggers, the ability to rate mood/anxiety levels on a scale, guided relaxation techniques, and the option to personalise the app. The researchers will aim to produce an app that is easily accessible, highly personalisable and will include functions highlighted as important (i.e. contact information, etc.). This research will assist in the development of an easy-to-use app that could increase access to services, and allow service users to take an active role in their care. In previous studies, apps were developed without the involvement of service users. This study recognises the important role of service users in this area.

Monitoring and controlling ATLAS data management: The Rucio web user interface

NASA Astrophysics Data System (ADS)

Lassnig, M.; Beermann, T.; Vigne, R.; Barisits, M.; Garonne, V.; Serfon, C.

2015-12-01

The monitoring and controlling interfaces of the previous data management system DQ2 followed the evolutionary requirements and needs of the ATLAS collaboration. The new data management system, Rucio, has put in place a redesigned web-based interface based upon the lessons learnt from DQ2, and the increased volume of managed information. This interface encompasses both a monitoring and controlling component, and allows easy integration for usergenerated views. The interface follows three design principles. First, the collection and storage of data from internal and external systems is asynchronous to reduce latency. This includes the use of technologies like ActiveMQ or Nagios. Second, analysis of the data into information is done massively parallel due to its volume, using a combined approach with an Oracle database and Hadoop MapReduce. Third, sharing of the information does not distinguish between human or programmatic access, making it easy to access selective parts of the information both in constrained frontends like web-browsers as well as remote services. This contribution will detail the reasons for these principles and the design choices taken. Additionally, the implementation, the interactions with external systems, and an evaluation of the system in production, both from a technological and user perspective, conclude this contribution.

Development of a cross-cultural HPV community engagement model within Scotland

PubMed Central

Carnegie, Elaine; Whittaker, Anne; Gray Brunton, Carol; Hogg, Rhona; Kennedy, Catriona; Hilton, Shona; Harding, Seeromanie; Pollock, Kevin G; Pow, Janette

2017-01-01

Objective: To examine cultural barriers and participant solutions regarding acceptance and uptake of the human papillomavirus (HPV) vaccine from the perspective of Black African, White-Caribbean, Arab, Indian, Bangladeshi and Pakistani young people. Methods: In total, 40 young people from minority ethnic communities in Scotland took part in a qualitative study, involving seven focus groups and four paired interviews, to explore their views and experiences of the HPV vaccine. Using critical discursive psychology, the analysis focused on young people’s accounts of barriers and enablers to information, access and uptake of the HPV vaccination programme. Results: Participants suggested innovative strategies to tackle intergenerational concerns, information design and accessibility, and public health communications across diverse contexts. A cross-cultural community engagement model was developed, embracing diversity and contradiction across different ethnic groups. This included four inter-related strategies: providing targeted and flexible information for young people, vaccine provision across the life-course, intergenerational information and specific cross-cultural communications. Conclusion: This is the first HPV cross-cultural model inductively derived from accounts of young people from different ethnic communities. We recommend public health practitioners and policymakers consider using the processes and strategies within this model to increase dialogue around public engagement, awareness and receptivity towards HPV vaccination. PMID:28596618

Strategic information is everyone's business: perspectives from an international stakeholder meeting to enhance strategic information data along the HIV Cascade for people who inject drugs.

PubMed

Pierce, Richard D; Hegle, Jennifer; Sabin, Keith; Agustian, Edo; Johnston, Lisa G; Mills, Stephen; Todd, Catherine S

2015-10-16

People who inject drugs (PWID) are at increased HIV transmission risk because of unsafe injecting practices and a host of other individual, network, and structural factors. Thus, PWID have a great need for services within the Cascade of HIV prevention, diagnosis, care, and treatment (HIV Cascade). Yet the systems that monitor their progress through the Cascade are often lacking. Subsequently, fewer reliable data are available to guide programs targeting this key population (KP). Programmatic data, which are helpful in tracking PWID through the Cascade, also are limited because not all countries have harm reduction programming from which to estimate Cascade indicators. Also, due to stigma and the illegal nature of drug use, PWID may not disclose their drug use behavior or HIV status when accessing services. Consequently, PWID appear to have low HIV testing rates and, for those living with HIV, lower access to health services and lower viral suppression rates than do other KP groups. This commentary, based on outcomes from an international stakeholder meeting, identifies data gaps and proposes solutions to strengthen strategic information (SI), the systematic collection, analysis, and dissemination of information, to optimize HIV prevention, care, and treatment programming for PWID.

Barriers in access to home care services among ethnic minority and Dutch elderly--a qualitative study.

PubMed

Suurmond, Jeanine; Rosenmöller, Doenja L; El Mesbahi, Hakima; Lamkaddem, Majda; Essink-Bot, Marie-Louise

2016-02-01

Ethnic minority elderly have a high prevalence of functional limitations and chronic conditions compared to Dutch elderly. However, their use of home care services is low compared to Dutch elderly. Explore the barriers to access to home care services for Turkish, Moroccan Surinamese and ethnic Dutch elderly. Qualitative semi-structured group interviews and individual interviews. The Netherlands. Seven group interviews (n=50) followed by individual interviews (n=5) were conducted, in the preferred language of the participants. Results were ordered and reported according to a framework of access to health care services. This framework describes five dimensions of accessibility to generate access to health care services, from the perspective of the users: ability to perceive health needs, ability to seek health care, ability to reach, ability to pay and ability to engage. This study shows that while barriers are common among all groups, several specific barriers in access to home care services exist for ethnic minority elderly. Language and communication barriers as well as limited networks and a preference for informal care seem to mutually enforce each other, resulting in many barriers during the navigation process to home care. In order to provide equal access to home care for all who need it, the language and communication barriers should be tackled by home care services and home care nurses. Copyright © 2015 Elsevier Ltd. All rights reserved.

Can the right to health inform public health planning in developing countries? A case study for maternal healthcare from Indonesia

PubMed Central

D'Ambruoso, Lucia; Byass, Peter; Nurul Qomariyah, Siti

2008-01-01

Background Maternal mortality remains unacceptably high in developing countries despite international advocacy, development targets, and simple, affordable and effective interventions. In recent years, regard for maternal mortality as a human rights issue as well as one that pertains to health, has emerged. Objective We study a case of maternal death using a theoretical framework derived from the right to health to examine access to and quality of maternal healthcare. Our objective was to explore the potential of rights-based frameworks to inform public health planning from a human rights perspective. Design Information was elicited as part of a verbal autopsy survey investigating maternal deaths in rural settings in Indonesia. The deceased's relatives were interviewed to collect information on medical signs, symptoms and the social, cultural and health systems circumstances surrounding the death. Results In this case, a prolonged, severe fever and a complicated series of referrals culminated in the death of a 19-year-old primagravida at 7 months gestation. The cause of death was acute infection. The woman encountered a range of barriers to access; behavioural, socio-cultural, geographic and economic. Several serious health system failures were also apparent. The theoretical framework derived from the right to health identified that none of the essential elements of the right were upheld. Conclusion The rights-based approach could identify how and where to improve services. However, there are fundamental and inherent conflicts between the public health tradition (collective and preventative) and the right to health (individualistic and curative). As a result, and in practice, the right to health is likely to be ineffective for public health planning from a human rights perspective. Collective rights such as the right to development may provide a more suitable means to achieve equity and social justice in health planning. PMID:20027244

A Qualitative Study of Prescription Contraception Use: The Perspectives of Users, General Practitioners and Pharmacists

PubMed Central

Sweeney, Leigh-Ann; Molloy, Gerard J.; Byrne, Molly; Murphy, Andrew W.; Morgan, Karen; Hughes, Carmel M.; Ingham, Roger

2015-01-01

Background The oral contraceptive pill (OCP) remains the most popular form of prescription contraception in many countries, despite adherence difficulties for many. Uptake of long acting reversible contraceptives (LARCs), which are less reliant on user adherence, remains low. The aim of this study was to explore the experiences of, and attitudes towards, prescription contraception amongst samples of contraception users, general practitioners (GPs) and pharmacists. Methodology and Findings We conducted a qualitative study using semi-structured interviews with 18 contraception users, 18 GPs and 9 pharmacists. The study took place in Galway, Republic of Ireland between June and September 2014. Thematic analysis was used to analyse the data. Overall, contraception users were more familiar with the OCP, and all the women interviewed began their prescription contraception journey using this method. All participants identified episodes of poor adherence throughout the reproductive life course. The identified barriers for use of LARCs were lack of information, misconceptions, lack of access and high cost. In contrast, GPs believed that adherence to the OCP was good and stated they were more likely to prescribe the OCP than other methods, as they were most familiar with this option. Barriers to prescribing LARCSs were time, cost to practice, training and deskilling. Pharmacists also believed that adherence to the OCP was generally good and that their role was limited to dispensing medication and providing information when asked. Discussion and Conclusion There are contrasting perspectives between contraception service providers and contraceptive users. Training for healthcare providers is required to support informed contraceptive choice and adherence. It is necessary to address the practice barriers of cost and lack of time, to promote better communication around adherence issues and prescription contraception options. There is a need for more easily-accessible public health information to promote awareness on all methods of prescription contraception. PMID:26633191

"Just like I'm saving money in the bank": client perspectives on care coordination services.

PubMed

Freij, Maysoun; Weiss, Linda; Gass, Jonathon; Trezza, Claudia; Wiener, Abigail; Melly, Jeannine; Volland, Patricia

2011-10-01

Older adults face many challenges to community living. The literature has not sufficiently explored the roles of care coordination in the maintenance of housing and access to health care among older adults, particularly from their own perspectives. This qualitative study analyzes the findings from 25 interviews and 6 focus group discussions (48 participants) with a multiethnic sample of older adults in the New York City area. Care coordination services appear to assist older adults access health care, and to a lesser extent, maintain affordable housing. Disparities in access to care coordination appear to remain for immigrant, minority and suburban populations.

The Crisis in Scholarly Communication, Open Access, and Open Data Policies: The Libraries' Perspective

NASA Astrophysics Data System (ADS)

Besara, Rachel

2015-03-01

For years the cost of STEM databases have exceeded the rate of inflation. Libraries have reallocated funds for years to continue to provide support to their scientific communities, but they are reaching a point at many institutions where they are no longer able to provide access to many databases considered standard to support research. A possible or partial alleviation to this problem is the federal open access mandate. However, this shift challenges the current model of publishing and data management in the sciences. This talk will discuss these topics from the perspective of research libraries supporting physics and the STEM disciplines.

The impact of negative emotions on self-concept abstraction depends on accessible information processing styles.

PubMed

Isbell, Linda M; Rovenpor, Daniel R; Lair, Elicia C

2016-10-01

Research suggests that anger promotes global, abstract processing whereas sadness and fear promote local, concrete processing (see Schwarz & Clore, 2007 for a review). Contrary to a large and influential body of work suggesting that specific affective experiences are tethered to specific cognitive outcomes, the affect-as-cognitive-feedback account maintains that affective experiences confer positive or negative value on currently dominant processing styles, and thus can lead to either global or local processing (Huntsinger, Isbell, & Clore, 2014). The current work extends this theoretical perspective by investigating the impact of discrete negative emotions on the self-concept. By experimentally manipulating information processing styles and discrete negative emotions that vary in appraisals of certainty, we demonstrate that the impact of discrete negative emotions on the spontaneous self-concept depends on accessible processing styles. When global processing was accessible, individuals in angry (negative, high certainty) states generated more abstract statements about themselves than individuals in either sad (Experiment 1) or fearful (Experiment 2; negative, low certainty) states. When local processing was made accessible, however, the opposite pattern emerged, whereby individuals in angry states generated fewer abstract statements than individuals in sad or fearful states. Together these studies provide new insights into the mechanisms through which discrete emotions influence cognition. In contrast to theories assuming a dedicated link between emotions and processing styles, these results suggest that discrete emotions provide feedback about accessible ways of thinking, and are consistent with recent evidence suggesting that the impact of affect on cognition is highly context-dependent. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Community perspectives

NASA Technical Reports Server (NTRS)

1975-01-01

General aviation is considered from the perspective of the local community's decision-making process in determining its needs for access to general aviation services. The decision-making model, preliminary decision, community characteristics, and planning processes are discussed.

A Peer Health Educator Program for Breast Cancer Screening Promotion: Arabic, Chinese, South Asian, and Vietnamese Immigrant Women's Perspectives

PubMed Central

Parascandalo, Faye

2015-01-01

This study explored Arabic, Chinese, South Asian, and Vietnamese immigrant women's experiences with a peer health educator program, a public health program that facilitated access to breast health information and mammography screening. Framed within critical social theory, this participatory action research project took place from July 2009 to January 2011. Ten focus groups and 14 individual interviews were conducted with 82 immigrant women 40 years of age and older. Qualitative methods were utilized. Thematic content analysis derived from grounded theory and other qualitative literature was employed to analyze data. Four dominant themes emerged: Breast Cancer Prevention focused on learning within the program, Social Support provided by the peer health educator and other women, Screening Services Access for Women centered on service provision, and Program Enhancements related to specific modifications required to meet the needs of immigrant women accessing the program. The findings provide insights into strategies used to promote breast health, mammography screening, and the improvement of public health programming. Perceived barriers that continue to persist are structural barriers, such as the provision of information on breast cancer and screening by family physicians. A future goal is to improve collaborations between public health and primary care to minimize this barrier. PMID:25810922

A Peer Health Educator Program for Breast Cancer Screening Promotion: Arabic, Chinese, South Asian, and Vietnamese Immigrant Women's Perspectives.

PubMed

Crawford, Joanne; Frisina, Angela; Hack, Tricia; Parascandalo, Faye

2015-01-01

This study explored Arabic, Chinese, South Asian, and Vietnamese immigrant women's experiences with a peer health educator program, a public health program that facilitated access to breast health information and mammography screening. Framed within critical social theory, this participatory action research project took place from July 2009 to January 2011. Ten focus groups and 14 individual interviews were conducted with 82 immigrant women 40 years of age and older. Qualitative methods were utilized. Thematic content analysis derived from grounded theory and other qualitative literature was employed to analyze data. Four dominant themes emerged: Breast Cancer Prevention focused on learning within the program, Social Support provided by the peer health educator and other women, Screening Services Access for Women centered on service provision, and Program Enhancements related to specific modifications required to meet the needs of immigrant women accessing the program. The findings provide insights into strategies used to promote breast health, mammography screening, and the improvement of public health programming. Perceived barriers that continue to persist are structural barriers, such as the provision of information on breast cancer and screening by family physicians. A future goal is to improve collaborations between public health and primary care to minimize this barrier.

On improving the communication between models and data.

PubMed

Dietze, Michael C; Lebauer, David S; Kooper, Rob

2013-09-01

The potential for model-data synthesis is growing in importance as we enter an era of 'big data', greater connectivity and faster computation. Realizing this potential requires that the research community broaden its perspective about how and why they interact with models. Models can be viewed as scaffolds that allow data at different scales to inform each other through our understanding of underlying processes. Perceptions of relevance, accessibility and informatics are presented as the primary barriers to broader adoption of models by the community, while an inability to fully utilize the breadth of expertise and data from the community is a primary barrier to model improvement. Overall, we promote a community-based paradigm to model-data synthesis and highlight some of the tools and techniques that facilitate this approach. Scientific workflows address critical informatics issues in transparency, repeatability and automation, while intuitive, flexible web-based interfaces make running and visualizing models more accessible. Bayesian statistics provides powerful tools for assimilating a diversity of data types and for the analysis of uncertainty. Uncertainty analyses enable new measurements to target those processes most limiting our predictive ability. Moving forward, tools for information management and data assimilation need to be improved and made more accessible. © 2013 John Wiley & Sons Ltd.

Digital Object Identifiers (DOI's) usage and adoption in U.S Geological Survey (USGS)

NASA Astrophysics Data System (ADS)

Frame, M. T.; Palanisamy, G.

2013-12-01

Addressing grand environmental science challenges requires unprecedented access to easily understood data that cross the breadth of temporal, spatial, and thematic scales. From a scientist's perspective, the big challenges lie in discovering the relevant data, dealing with extreme data heterogeneity, large data volumes, and converting data to information and knowledge. Historical linkages between derived products, i.e. Publications, and associated datasets has not existed in the earth science community. The USGS Core Science Analytics and Synthesis, in collaboration with DOE's Oak Ridge National Laboratory (ORNL) Mercury Consortium (funded by NASA, USGS and DOE), established a Digital Object Identifier (DOI) service for USGS data, metadata, and other media. This service is offered in partnership through the University of California Digital Library EZID service. USGS scientists, data managers, and other professionals can generate globally unique, persistent and resolvable identifiers for any kind of digital objects. Additional efforts to assign DOIs to historical data and publications have also been underway. These DOI identifiers are being used to cite data in journal articles, web-accessible datasets, and other media for distribution, integration, and in support of improved data management practices. The session will discuss the current DOI efforts within USGS, including a discussion on adoption, challenges, and future efforts necessary to improve access, reuse, sharing, and discoverability of USGS data and information.

Supporting global health goals with information and communications technology

PubMed Central

Boman, Magnus; Kruse, Erik

2017-01-01

ABSTRACT The objective of this study is to critically assess the possible roles of information and communications technology (ICT) in supporting global health goals. This is done by considering privilege and connectibility. In short, ICT can contribute by providing health information via four different kinds of access, each with its own history and prospective future. All four are analyzed here, in two perspectives: business-as-usual and disruptive. Health data analytics is difficult since the digital representation of past, current, and future health information is lacking. The flow of analytics that may prove beneficial to the individual and not just meet abstract population-level goals or ambitions is analyzed in detail. Sensemaking is also needed, to meet the minimum requirement of making prospective future services understandable to policymakers. Drivers as well as barriers for areas in which policy decisions have the potential to drive positive developments for meeting the Sustainable Development Goals are identified. PMID:28838300

Supporting global health goals with information and communications technology.

PubMed

Boman, Magnus; Kruse, Erik

2017-06-01

The objective of this study is to critically assess the possible roles of information and communications technology (ICT) in supporting global health goals. This is done by considering privilege and connectibility. In short, ICT can contribute by providing health information via four different kinds of access, each with its own history and prospective future. All four are analyzed here, in two perspectives: business-as-usual and disruptive. Health data analytics is difficult since the digital representation of past, current, and future health information is lacking. The flow of analytics that may prove beneficial to the individual and not just meet abstract population-level goals or ambitions is analyzed in detail. Sensemaking is also needed, to meet the minimum requirement of making prospective future services understandable to policymakers. Drivers as well as barriers for areas in which policy decisions have the potential to drive positive developments for meeting the Sustainable Development Goals are identified.

Access to Education with Online Learning and Open Educational Resources: Can They Close the Gap?

ERIC Educational Resources Information Center

Geith, Christine; Vignare, Karen

2008-01-01

One of the key concepts in the right to education is access: access to the means to fully develop as human beings as well as access to the means to gain skills, knowledge and credentials. This is an important perspective through which to examine the solutions to access enabled by Open Educational Resources (OER) and online learning. The authors…

Development of a breast self-examination program for the Internet: health information for Korean women.

PubMed

Kim, H S; Kim, E; Kim, J W

2001-04-01

Internet-based health information will enable us to interact with many people despite distance and time constraints. Informational media by computer is expected to become an important factor that affects health behavior. This study was done to develop an accessible multimedia program about breast self-examination on the Internet. This study was designed by using the two steps of need assessment and program development. For the need assessment step, a survey was carried out. The sample consisted of the 82 women of Yonsei University selected by convenient random sampling. At the program development step, screen design took into account perspectives of computer engineering. A storyboard for every screen was made via screen design and then ported to computer using the Netscape Navigator program. A breast self-examination program was developed using Netscape 4.0 on the Windows 98 platform. The multimedia program, including text, graphics, animation, and sound, was constructed with HTML language using Memo Sheet in Netscape Navigator. The contents of health information posted on the Internet included general information about breast cancer, the importance of breast self-examination, self-risk appraisal of breast cancer, the diverse methods about breast self-examination, the monthly check list graph, and social network for consultation. It is possible to interact with clients through the Question and Answer function on screen. This Internet-based health information program provides enough information, which can be accessed using search systems on the Internet.

Perceived medical benefit, peer/partner influence and safety and cost to access the service: client motivators for voluntary seeking of medical male circumcision in Iganga District Eastern Uganda, a qualitative study

PubMed Central

Muhamadi, Lubega; Ibrahim, Musenze; Wabwire-Mangen, Fred; Peterson, Stefan; Reynolds, Steven J

2013-01-01

Introduction Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings. Methods In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC. Results Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service. Conclusion Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC. PMID:24255723

Perspectives of resettled African refugees on accessing medicines and pharmacy services in Queensland, Australia.

PubMed

Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

2017-10-01

The aim of this study was to explore the barriers to accessing medicines and pharmacy services among refugees in Queensland, Australia, from the perspectives of resettled African refugees. A generic qualitative approach was used in this study. Resettled African refugees were recruited via a purposive snowball sampling method. The researcher collected data from different African refugee communities, specifically those from Sudanese, Congolese and Somalian communities. Participants were invited by a community health leader to participate in the study; a community health leader is a trained member of the refugee community who acts as a 'health information conduit' between refugees and the health system. Invitations were done either face-to-face, telephonically or by email. The focus groups were digitally recorded in English and transcribed verbatim by the researcher. Transcripts were entered into NVIVO© 11 and the data were analysed using inductive thematic analysis. Four focus groups were conducted between October and November 2014 in the city of Brisbane with African refugees, one with five Somali refugees, one with five Congolese refugees, one with three refugee community health leaders from South Sudan, Liberia and Eritrea and one with three refugee community health leaders from Uganda, Burundi and South Sudan. Eleven sub-themes emerged through the coding process, which resulted in four overarching themes: health system differences, navigating the Australian health system, communication barriers and health care-seeking behaviour. With regard to accessing medicines and pharmacy services, this study has shown that there is a gap between resettled refugees' expectations of health services and the reality of the Australian health system. Access barriers identified included language barriers, issues with the Translating and Interpreter Service, a lack of professional communication and cultural beliefs affecting health care-seeking behaviour. This exploratory study has established a foundation for further research into the barriers to accessing medicines and pharmacy services for resettled refugees. The findings are likely to be applicable to a wider population. © 2016 Royal Pharmaceutical Society.

Managing Self-Access Language Learning: Principles and Practice

ERIC Educational Resources Information Center

Gardner, David; Miller, Lindsay

2011-01-01

This paper is based on a research project looking at the management of self-access language learning (SALL) from the perspective of the managers of self-access centres. It looks at the factors which influence the practice of seven managers of self-access language learning in tertiary institutions in Hong Kong. The discussion centres around five…

Data Democracy and Decision Making: Enhancing the Use and Value of Geospatial Data and Scientific Information

NASA Astrophysics Data System (ADS)

Shapiro, C. D.

2014-12-01

Data democracy is a concept that has great relevance to the use and value of geospatial data and scientific information. Data democracy describes a world in which data and information are widely and broadly accessible, understandable, and useable. The concept operationalizes the public good nature of scientific information and provides a framework for increasing benefits from its use. Data democracy encompasses efforts to increase accessibility to geospatial data and to expand participation in its collection, analysis, and application. These two pillars are analogous to demand and supply relationships. Improved accessibility, or demand, includes increased knowledge about geospatial data and low barriers to retrieval and use. Expanded participation, or supply, encompasses a broader community involved in developing geospatial data and scientific information. This pillar of data democracy is characterized by methods such as citizen science or crowd sourcing.A framework is developed for advancing the use of data democracy. This includes efforts to assess the societal benefits (economic and social) of scientific information. This knowledge is critical to continued monitoring of the effectiveness of data democracy implementation and of potential impact on the use and value of scientific information. The framework also includes an assessment of opportunities for advancing data democracy both on the supply and demand sides. These opportunities include relatively inexpensive efforts to reduce barriers to use as well as the identification of situations in which participation can be expanded in scientific efforts to enhance the breadth of involvement as well as expanding participation to non-traditional communities. This framework provides an initial perspective on ways to expand the "scientific community" of data users and providers. It also describes a way forward for enhancing the societal benefits from geospatial data and scientific information. As a result, data democracy not only provides benefits to a greater population, it enhances the value of science.

Parental perspectives on the awareness and delivery of preconception care.

PubMed

Poels, M; Koster, M P H; Franx, A; van Stel, H F

2017-09-26

The attention for Preconception Care (PCC) has grown substantially in recent years, yet the implementation of PCC appears challenging as uptake rates remain low. The objective of this study was to assess parental perspectives on how PCC should be provided. Recruitment of participants took place among couples who received antenatal care at a Dutch community midwifery practice. Between June and September 2014, five focus group sessions were held with 29 women and one focus group session with 5 men. Thematic analysis was conducted using NVivo 10 software. Participants were generally unfamiliar with the concept of PCC. It was proposed to raise awareness by means of a promotional campaign, stipulating that PCC is suited for every couple with a (future) child wish. Suggestions were made to display marketing materials in both formal and informal (local community) settings. Addressing existing social networks and raising social dialogue was expected to be most efficient. It was recommended to make PCC more accessible by offering multiple forms and to involve male partners. Opportunistic offering PCC by healthcare providers was considered more acceptable when the subject was deliberately raised, for example while discussing contraceptives, lifestyle risks or drug prescriptions. GP's or midwifes were regarded the most suitable PCC providers, however provider characteristics such as experience, empathy and communication skills were considered more important. This study showed that from the parental perspective it is recommended to address every couple with a (future) child wish by means of enlarging the awareness and accessibility of PCC. In order to enlarge the awareness, it is recommended to address social networks, to raise the social dialogue and to conduct promotional campaigns regarding PCC. In order to improve the accessibility of PCC, it was suggested to simultaneously offer multiple forms: group sessions, individual consultations, walk-in-hours and online sessions, and to involve male partners.

Deaf community analysis for health education priorities.

PubMed

Jones, Elaine G; Renger, Ralph; Firestone, Rob

2005-01-01

Deaf persons' access to health-related information is limited by barriers to spoken or written language: they cannot overhear information; they have limited access to television, radio, and other channels for public information; and the average reading level of Deaf adults is at a 3rd to 4th grade level. However, literature searches revealed no published reports of community analysis focusing specifically on health education priorities for Deaf communities. A seven-step community analysis was conducted to learn the health education priorities in Arizona Deaf communities and to inform development of culturally relevant health education interventions in Deaf communities. The word "Deaf" is capitalized to reflect the cultural perspective of the Deaf community. A 14-member Deaf Health Committee collected data using multimethods that included review of state census data, review of national health priorities, key informant interviews, discussions with key community groups, a mail survey (n = 20), and semistructured interviews conducted in sign language with 111 Deaf adults. The community diagnosis with highest priority for health education was vulnerability to cardiovascular disease (CVD). Following completion of the community analysis, a heart-health education intervention (The Deaf Heart Health Intervention) was developed using a train-the-trainer, community health worker model. If this model proves to be effective in addressing vulnerability to CVD, then a similar protocol could be employed to address other health concerns identified in the Deaf community analysis.

Simplifying informed consent for biorepositories: stakeholder perspectives.

PubMed

Beskow, Laura M; Friedman, Joëlle Y; Hardy, N Chantelle; Lin, Li; Weinfurt, Kevin P

2010-09-01

Complex and sometimes controversial information must be conveyed during the consent process for participation in biorepositories, and studies suggest that consent documents in general are growing in length and complexity. As a first step toward creating a simplified biorepository consent form, we gathered data from multiple stakeholders about what information was most important for prospective participants to know when making a decision about taking part in a biorepository. We recruited 52 research participants, 12 researchers, and 20 institutional review board representatives from Durham and Kannapolis, NC. These subjects were asked to read a model biorepository consent form and highlight sentences they deemed most important. On average, institutional review board representatives identified 72.3% of the sentences as important; researchers selected 53.0%, and participants 40.4% (P = 0.0004). Participants most often selected sentences about the kinds of individual research results that might be offered, privacy risks, and large-scale data sharing. Researchers highlighted sentences about the biorepository's purpose, privacy protections, costs, and participant access to individual results. Institutional review board representatives highlighted sentences about collection of basic personal information, medical record access, and duration of storage. The differing mandates of these three groups can translate into widely divergent opinions about what information is important and appropriate to include a consent form. These differences could frustrate efforts to move simplified forms--for biobanking as well as for other kinds of research--into actual use, despite continued calls for such forms.

Changes in access to health care for immigrants in Catalonia during the economic crisis: Opinions of health professionals and immigrant users.

PubMed

Porthé, Victoria; Vargas, Ingrid; Sanz-Barbero, Belén; Plaza-Espuña, Isabel; Bosch, Lola; Vázquez, Maria Luisa

2016-11-01

Policy measures introduced in Spain during the economic crisis included a reduction in public health expenditure and in healthcare entitlements (RDL16/2012), which affected the general population as a whole, but especially immigrants. This paper analyzes changes in immigrants' access to health care during the economic crisis from the perspective of health professionals (medical and administrative) and immigrants. A qualitative descriptive-interpretative study was conducted in Catalonia through individual interviews with a theoretical sample of health professionals (n=34) and immigrant users (n=20). Thematic analysis was conducted and data quality was ensured through triangulation. Informants described barriers to enter the health system related to reduced healthcare entitlements and a stricter enforcement of administrative requirements: while medical professionals highlighted restrictions to accessing the healthcare continuum, immigrants accentuated barriers to obtaining the individual health card. With regard to use of services, an increase in waiting times due to cutbacks in human resources dominated the informants' discourse. Health professionals pointed out organizational changes to increase efficiency that may improve access to primary care. Informants related lower health services utilization to a deterioration in immigrants' living and working conditions. According to health professionals, these conditions limited the use of services during working hours and led to delays in seeking care and treatment interruptions. Results show an aggravation of pre-existing barriers to health services utilization and, simultaneously, the appearance of new barriers to enter the system. These changes in the healthcare services contradict the equity principles of the national health system (NHS), thus policy decisions are needed to address this problem. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Fulfilment of knowledge expectations among family members of patients undergoing arthroplasty: a European perspective.

PubMed

Sigurdardottir, Arun K; Leino-Kilpi, Helena; Charalambous, Andreas; Katajisto, Jouko; Stark, Åsa Johansson; Sourtzi, Panayota; Zabalegui, Adelaida; Valkeapää, Kirsi

2015-12-01

In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach. © 2015 Nordic College of Caring Science.

Exploring Privilege in the Digital Divide: Implications for Theory, Policy, and Practice.

PubMed

Fang, Mei Lan; Canham, Sarah L; Battersby, Lupin; Sixsmith, Judith; Wada, Mineko; Sixsmith, Andrew

2018-05-10

The digital revolution has resulted in innovative solutions and technologies that can support the well-being, independence, and health of seniors. Yet, the notion of the "digital divide" presents significant inequities in terms of who accesses and benefits from the digital landscape. To better understand the social and structural inequities of the digital divide, a realist synthesis was conducted to inform theoretical understandings of information and communication technologies (ICTs); to understand the practicalities of access and use inequities; to uncover practices that facilitate digital literacy and participation; and to recommend policies to mitigate the digital divide. A systematic search yielded 55 articles published between 2006 and 2016. Synthesis of existing knowledge, combined with user-experience elicited through a deliberative dialogue session with community stakeholders (n = 35), made visible a pattern of privilege that determined individual agency in ICT access and use. Though age is consistently centralized as the key determinant of the digital divide, our analyses, which encompassed both van Dijk's resources and appropriation theory and intersectionality, appraised this notion and revealed that age is not the sole determinant. Findings highlight the role of other factors that contribute to digital inequity among community-dwelling middle-aged (45-64) and older (65+) adults, including education, income, gender, and generational status. Informed by results of a realist synthesis that was guided by intersectional perspectives, a conceptual framework was developed outlining implications for theory, policy, and practice to address the wicked problem that is the digital divide.

Collective patient behaviours derailing ART roll-out in KwaZulu-Natal: perspectives of health care providers.

PubMed

Michel, Janet; Matlakala, Christina; English, Rene; Lessells, Richard; Newell, Marie-Louise

2013-07-19

Antiretroviral therapy (ART) roll-out is fraught with challenges, many with serious repercussions. We explored and described patient behaviour-related challenges from the perspective of health care providers from non-governmental organisations involved in ART programmes in KwaZulu-Natal, South Africa. A descriptive case study design using qualitative approach was applied during this study. Data was collected from nine key informants from the three biggest NGOs involved in ART roll-out using in-depth semi-structured interviews. Transcribing and coding for emergent themes was done by two independent reviewers. Ethical approval for the study was granted by the UNISA research ethics committee of The Faculty of Health Sciences. Written consent was obtained from directors of the three NGOs involved and individual audio taped informed consent was obtained from all study participants prior to data collection. Findings revealed six broad areas of patient behaviour challenges. These were patient behaviour related to socio-economic situation of patient (skipping of medication due to lack of food, or due to lack of transport fees), belief systems (traditional and religious), stigma (non- disclosure), sexual practices (non-acceptability of condoms, teenage pregnancies), escapism (drug and alcohol abuse) and opportunism (skipping medication in order to access disability grant, teenage pregnancies in order to access child grant). New programmes need to address patient behaviour as a complex phenomenon requiring a multi-pronged approach that also addresses social norms and institutions. In the face of continued ART scale up, this is further evidence for the need for multi-sectoral collaboration to ensure successful and sustainable ART roll-out.

Perspectives of Latina and Non-Latina White Women on Barriers and Facilitators to Exercise in Pregnancy

PubMed Central

Marquez, David X.; Bustamante, Eduardo E.; Bock, Beth C.; Markenson, Glenn; Tovar, Alison; Chasan-Taber, Lisa

2009-01-01

Exercise during pregnancy has been associated with reduced risk of gestational diabetes mellitus (GDM);, however, twice as many women are sedentary during pregnancy as compared to when they are not pregnant. We conducted 3 focus groups among 20 pregnant Latina and non-Latina white women to identify barriers and facilitators to exercise in pregnancy to inform a GDM intervention study. Quantitative analyses of demographic data, and qualitative analyses of focus groups were conducted. Women identified physical limitations and restrictions, lack of resources, energy, and time as powerful exercise barriers. Social support, access to resources, information, proper diet, scheduling and the weather were identified as powerful facilitators. Intervention programs designed for pregnant women should facilitate social support, provide information and resources, as well as promote short-term and long-term benefits. PMID:20013518

How Community Has Shaped the Protein Data Bank

PubMed Central

Berman, Helen M.; Kleywegt, Gerard J.; Nakamura, Haruki; Markley, John L.

2015-01-01

Following several years of community discussion, the Protein Data Bank (PDB) was established in 1971 as a public repository for the coordinates of three-dimensional models of biological macromolecules. Since then, the number, size, and complexity of structural models have continued to grow, reflecting the productivity of structural biology. Managed by the Worldwide PDB organization, the PDB has been able to meet increasing demands for the quantity of structural information and of quality. In addition to providing unrestricted access to structural information, the PDB also works to promote data standards and to raise the profile of structural biology with broader audiences. In this perspective, we describe the history of PDB and the many ways in which the community continues to shape the archive. PMID:24010707

Using ESB and BPEL for Evolving Healthcare Systems Towards Pervasive, Grid-Enabled SOA

NASA Astrophysics Data System (ADS)

Koufi, V.; Malamateniou, F.; Papakonstantinou, D.; Vassilacopoulos, G.

Healthcare organizations often face the challenge of integrating diverse and geographically disparate information technology systems to respond to changing requirements and to exploit the capabilities of modern technologies. Hence, systems evolution, through modification and extension of the existing information technology infrastructure, becomes a necessity. Moreover, the availability of these systems at the point of care when needed is a vital issue for the quality of healthcare provided to patients. This chapter takes a process perspective of healthcare delivery within and across organizational boundaries and presents a disciplined approach for evolving healthcare systems towards a pervasive, grid-enabled service-oriented architecture using the enterprise system bus middleware technology for resolving integration issues, the business process execution language for supporting collaboration requirements and grid middleware technology for both addressing common SOA scalability requirements and complementing existing system functionality. In such an environment, appropriate security mechanisms must ensure authorized access to integrated healthcare services and data. To this end, a security framework addressing security aspects such as authorization and access control is also presented.

Flexible and Transparent User Authentication for Mobile Devices

NASA Astrophysics Data System (ADS)

Clarke, Nathan; Karatzouni, Sevasti; Furnell, Steven

The mobile device has become a ubiquitous technology that is capable of supporting an increasingly large array of services, applications and information. Given their increasing importance, it is imperative to ensure that such devices are not misused or abused. Unfortunately, a key enabling control to prevent this, user authentication, has not kept up with the advances in device technology. This paper presents the outcomes of a 2 year study that proposes the use of transparent and continuous biometric authentication of the user: providing more comprehensive identity verification; minimizing user inconvenience; and providing security throughout the period of use. A Non-Intrusive and Continuous Authentication (NICA) system is described that maintains a continuous measure of confidence in the identity of the user, removing access to sensitive services and information with low confidence levels and providing automatic access with higher confidence levels. An evaluation of the framework is undertaken from an end-user perspective via a trial involving 27 participants. Whilst the findings raise concerns over education, privacy and intrusiveness, overall 92% of users felt the system offered a more secure environment when compared to existing forms of authentication.

Second national green pricing and green power marketing conference: Proceedings. Final report

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

Swezey, B.G.; Peterson, T.M.

1997-10-01

On May 13--14, 1997, DOE, EPRI, and EEI, in association with Central and South West Services, Inc., organized and conducted the second national green power conference in Corpus Christi, TX to: (1) provide an update and overview of existing and new green-pricing programs, (2) discuss lessons learned from selling green power in retail access pilot programs, and (3) hear perspectives on market facilitating issues such as green power certification and information disclosure. From a policy perspective, there was a general feeling that total reliance on market forces to foster greater renewables deployment is not desirable, particularly in the short termmore » as the rules of the competitive market are being developed. Policies that establish a minimum public obligation to fund renewables, such as universal system benefits charges and a renewables portfolio standard, should still be considered.« less

Iranian nursing students' perspectives of educational equity.

PubMed

Ghiyasvandian, Shahrzad; Nikbakht-Nasrabadi, Alireza; Mohammadpour, Ali; Abbasi, Mahmoud; Javadi, Mostafa

2014-01-01

Around the world there is a growing consensus that students' rights must be protected, regardless of race, creed, color, sex, religion, and socioeconomic status. One of these rights is the educational equity. However, little is known about these phenomena in nursing education. The aim of this study was to explore the educational equity from the perspective of nursing students. A qualitative study was conducted. Thus, we purposefully recruited for in-depth interviews 13 nursing students (8 female and 5 male). All interviews were transcribed verbatim and analyzed by thematic analysis approach to identify categories and themes. Four main themes emerged from the data: Fair Educational Opportunity, fair evaluation, attempts to combat discrimination, and employing qualified teachers.  It is argued that educational equity should be developed in higher education. Principles of equity and students' rights may form the most basic rationale for all formal and informal efforts to extend the right of equal access to education.

'It's my life': autonomy and people with intellectual disabilities.

PubMed

Björnsdóttir, Kristín; Stefánsdóttir, Guðrún V; Stefánsdóttir, Ástríður

2015-03-01

This article discusses autonomy in the lives of adults with intellectual disabilities. The article draws on inclusive research in Iceland with 25 women and 16 men and employs ideas of relational autonomy from the perspectives of the Nordic relational approach to disability. In this article, we examine autonomy in relation to private life, that is, homes and daily activities. The article demonstrates how practices have improved with time and seem less paternalistic. However, the article also demonstrates that the assistance people with intellectual disabilities receive in their homes often has institutional qualities, and they are often met with belittling perspectives from staff and family members. Furthermore, many did not have access to important information needed to develop individual autonomy and independence, including making their own choices. The research findings suggest that people with intellectual disabilities can with appropriate support develop individual autonomy and make their own choices. © The Author(s) 2014.

A glucose meter evaluation co-designed with both health professional and consumer input.

PubMed

Thompson, Harmony; Chan, Huan; Logan, Florence J; Heenan, Helen F; Taylor, Lynne; Murray, Chris; Florkowski, Christopher M; Frampton, Christopher M A; Lunt, Helen

2013-11-22

Health consumer's input into assessment of medical device safety is traditionally given either as part of study outcome (trial participants) or during post marketing surveillance. Direct consumer input into the methodological design of device assessment is less common. We discuss the difference in requirements for assessment of a measuring device from the consumer and clinician perspectives, using the example of hand held glucose meters. Around 80,000 New Zealanders with diabetes recently changed their glucose meter system, to enable ongoing access to PHARMAC subsidised meters and strips. Consumers were most interested in a direct comparison of their 'old' meter system (Accu-Chek Performa) with their 'new' meter system (CareSens brand, including the CareSens N POP), rather than comparisons against a laboratory standard. This direct comparison of meter/strip systems showed that the CareSens N POP meter read around 0.6 mmol/L higher than the Performa system. Whilst this difference is unlikely to result in major errors in clinical decision making such as major insulin dosing errors, this information is nevertheless of interest to consumers who switched meters so that they could maintain access to PHARMAC subsidised meters and strips. We recommend that when practical, the consumer perspective be incorporated into study design related to medical device assessment.

Prospect for Development of Open Access in Argentina

ERIC Educational Resources Information Center

Miguel, Sandra; Bongiovani, Paola C.; Gomez, Nancy D.; Bueno-de-la-Fuente, Gema

2013-01-01

This perspective article presents an overview of the Open Access movement in Argentina, from a global and regional (Latin American) context. The article describes the evolution and current state of initiatives by examining two principal approaches to Open Access in Argentina: "golden" and "green roads". The article will then…

Seeing the community's perspective through multiple emic and etic vistas.

PubMed

Gaber, John

2017-12-01

Health impact assessment (HIA) researchers regularly use community input in their investigations to help them better understand local health issues. Community data is commonly associated with the lived experiences of local impacted residents known as 'emic' data. It is becoming more common practice for HIA researchers to access outside experts and stakeholders ('etic' data) during the community input phase of their investigations. Utilizing published international HIA data, I look at who HIA researchers invite when they seek to get 'community input' in their HIA investigations. The HIA database was generated from an internet investigation of published HIAs (in English) from 1999 to 2011 and focused particularly on single authored assessments that were conducted by governments, non-governmental organizations (NGOs) or universities. HIA researchers access a wide range of emic and etic community perspectives in their search for the 'community's view'. Government, NGO and university investigators access community perspectives differently, with university HIA researchers inviting more emic-oriented community vistas than both government and NGO researchers. University and government HIA investigators are more likely to invite multiple emic and etic community perspectives during their community participation projects than NGO researchers. NGO HIA investigators tend to either invite emic perspectives or etic perspectives for their community input with less mixing of the two views in a single project. The paper concludes with a discussion on how HIA researchers can frame the 'community's perspective' in their HIA investigations through a combination of both 'insider' and 'outsider' community input sampling strategies. Published by Oxford University Press 2016. This work is written by a US Government employee and is in the public domain in the US.

Decreasing health disparities for people with disabilities through improved communication strategies and awareness.

PubMed

Sharby, Nancy; Martire, Katharine; Iversen, Maura D

2015-03-19

Factors influencing access to health care among people with disabilities (PWD) include: attitudes of health care providers and the public, physical barriers, miscommunication, income level, ethnic/minority status, insurance coverage, and lack of information tailored to PWD. Reducing health care disparities in a population with complex needs requires implementation at the primary, secondary and tertiary levels. This review article discusses common barriers to health care access from the patient and provider perspective, particularly focusing on communication barriers and how to address and ameliorate them. Articles utilized in this review were published from 2005 to present in MEDLINE and CINAHL and written in English that focused on people with disabilities. Topics searched for in the literature include: disparities and health outcomes, health care dissatisfaction, patient-provider communication and access issues. Ineffective communication has significant impacts for PWD. They frequently believe that providers are not interested in, or sensitive to their particular needs and are less likely to seek care or to follow up with recommendations. Various strategies for successful improvement of health outcomes for PWD were identified including changing the way health care professionals are educated regarding disabilities, improving access to health care services, and enhancing the capacity for patient centered care.

Semantic Repositories for eGovernment Initiatives: Integrating Knowledge and Services

NASA Astrophysics Data System (ADS)

Palmonari, Matteo; Viscusi, Gianluigi

In recent years, public sector investments in eGovernment initiatives have depended on making more reliable existing governmental ICT systems and infrastructures. Furthermore, we assist at a change in the focus of public sector management, from the disaggregation, competition and performance measurements typical of the New Public Management (NPM), to new models of governance, aiming for the reintegration of services under a new perspective in bureaucracy, namely a holistic approach to policy making which exploits the extensive digitalization of administrative operations. In this scenario, major challenges are related to support effective access to information both at the front-end level, by means of highly modular and customizable content provision, and at the back-end level, by means of information integration initiatives. Repositories of information about data and services that exploit semantic models and technologies can support these goals by bridging the gap between the data-level representations and the human-level knowledge involved in accessing information and in searching for services. Moreover, semantic repository technologies can reach a new level of automation for different tasks involved in interoperability programs, both related to data integration techniques and service-oriented computing approaches. In this chapter, we discuss the above topics by referring to techniques and experiences where repositories based on conceptual models and ontologies are used at different levels in eGovernment initiatives: at the back-end level to produce a comprehensive view of the information managed in the public administrations' (PA) information systems, and at the front-end level to support effective service delivery.

Mapping the Health Information Landscape in a Rural, Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality.

PubMed

Ramírez, A Susana; Estrada, Erendira; Ruiz, Ariana

2017-08-01

The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin. We conducted a census of all available print news sources and then used content analysis to identify and characterize all health information printed in a 6-month study period. A total of 570 health-related articles were published. Five newspapers accounted for more than 80% of published health-related articles (n = 466); only one targeted the majority Latino population. The most common topic was access to health care/insurance/policy (33%), followed by diet/nutrition (13%), infectious disease (10%), and general prevention (9%). Just over one-quarter of health-related articles included useful information. Differences across newspaper types existed: independent newspapers reported more on health-related events compared with chain newspapers, and both ethnic-targeted newspapers and independently-published papers were more likely to include useful information compared with chain newspapers. While this region suffers from high rates of obesity and diabetes, there were relatively few articles on obesity and diabetes themselves, or linking behavioral risk factors with these conditions. One area we found absent from coverage pertained to the numerous environmental health threats prevalent in this heavily polluted, agricultural area (just 40 articles discussed environmental health threats). We also discovered that coverage of social determinants of health was lacking (just 24 of the 570 health articles), which was notable in a region that suffers extreme economic, educational, and health disparities. This analysis of a rural region's local news coverage of health issues demonstrates significant opportunity to engage with rural local media, particularly ethnic media, to disseminate health information. Such a strategy holds considerable promise to advance public health goals using a multilevel approach: From an individual perspective, improving the amount and utility of the information can inform and educate publics in areas with otherwise low levels of health information access. From a policy perspective, improving coverage of the social determinants of health could shape public opinion to support policies that improve health.

A socio-ecological perspective of access to and acceptability of HIV/AIDS treatment and care services: a qualitative case study research.

PubMed

Yakob, Bereket; Ncama, Busisiwe Purity

2016-02-16

Access to healthcare is an essential element of health development and a fundamental human right. While access to and acceptability of healthcare are complex concepts that interact with different socio-ecological factors (individual, community, institutional and policy), it is not known how these factors affect HIV care. This study investigated the impact of socio-ecological factors on access to and acceptability of HIV/AIDS treatment and care services (HATCS) in Wolaita Zone of Ethiopia. Qualitative case study research was conducted in six woredas (districts). Focus group discussions (FGDs) were conducted with 68 participants in 11 groups (six with people using antiretroviral therapy (ART) and five with general community members). Key informant interviews (KIIs) were conducted with 28 people involved in HIV care, support services and health administration at different levels. Individual in-depth interviews (IDIs) were conducted with eight traditional healers and seven defaulters from (ART). NVIVO 10 was used to assist qualitative content data analysis. A total of 111 people participated in the study, of which 51 (45.9%) were male and 60 (54.1%) were female, while 58 (53.3%) and 53 (47.7%) were urban and rural residents, respectively. The factors that affect access to and acceptability of HATCS were categorized in four socio-ecological units of analysis: client-based factors (awareness, experiences, expectations, income, employment, family, HIV disclosure and food availability); community-based factors (care and support, stigma and discrimination and traditional healing); health facility-based factors (interactions with care providers, availability of care, quality of care, distance, affordability, logistics availability, follow up and service administration); and policy and standards (healthcare financing, service standards, implementation manuals and policy documents). A socio-ecological perspective provides a useful framework to investigate the interplay among multilevel and interactive factors that impact on access to and acceptability of HATCS such as clients, community, institution and policy. Planners, resource allocators and implementers could consider these factors during planning, implementation and evaluation of HATCS. Further study is required to confirm the findings.

Guilt as a Motivator for Moral Judgment: An Autobiographical Memory Study

PubMed Central

Knez, Igor; Nordhall, Ola

2017-01-01

The aim was to investigate the phenomenology of self-defining moral memory and its relations to self-conscious feelings of guilt and willingness to do wrong (moral intention) in social and economic moral situations. We found that people use guilt as a moral motivator for their moral intention. The reparative function of guilt varied, however, with type of situation; that is, participants felt guiltier and were less willing to do wrong in economic compared to social moral situations. The self-defining moral memory was shown to be relatively more easy to access (accessibility), logically structured (coherence), vivid, seen from the first-person perspective (visual perspective), real (sensory detail); but was relatively less positive (valence), emotionally intense, chronologically clear (time perspective), in agreement with the present self (distancing), and shared. Finally, it was indicated that the more guilt people felt the more hidden/denied (less accessible), but more real (more sensory details), the self-defining moral memory. PMID:28539906

Maternity patients' access to their electronic medical records: use and perspectives of a patient portal.

PubMed

Megan Forster, Megan; Dennison, Kerrie; Callen, Joanne; Andrew, Andrew; Westbrook, Johanna I

Patients have been able to access clinical information from their paper-based health records for a number of years. With the advent of Electronic Medical Records (EMRs) access to this information can now be achieved online using a secure electronic patient portal. The purpose of this study was to investigate maternity patients' use and perceptions of a patient portal developed at the Mater Mothers' Hospital in Brisbane, Australia. A web-based patient portal, one of the first developed and deployed in Australia, was introduced on 26 June 2012. The portal was designed for maternity patients booked at Mater Mothers' Hospital, as an alternative to the paper-based Pregnancy Health Record. Through the portal, maternity patients are able to complete their hospital registration form online and obtain current health information about their pregnancy (via their EMR), as well as access a variety of support tools to use during their pregnancy such as tailored public health advice. A retrospective cross-sectional study design was employed. Usage statistics were extracted from the system for a one year period (1 July 2012 to 30 June 2013). Patients' perceptions of the portal were obtained using an online survey, accessible by maternity patients for two weeks in February 2013 (n=80). Descriptive statistics were employed to analyse the data. Between July 2012 and June 2013, 10,892 maternity patients were offered a patient portal account and access to their EMR. Of those 6,518 created one (60%; 6,518/10,892) and 3,104 went on to request access to their EMR (48%; 3,104/6,518). Of these, 1,751 had their access application granted by 30 June 2013. The majority of maternity patients submitted registration forms online via the patient portal (56.7%). Patients could view their EMR multiple times: there were 671 views of the EMR, 2,781 views of appointment schedules and 135 birth preferences submitted via the EMR. Eighty survey responses were received from EMR account holders, (response rate of 8.1%; 80/985). The majority of respondents indicated they would use the portal and access their EMR for future pregnancies (86.2%; 69/80). Approximately half looked at their EMR after a visit with their care provider (51.3%); 41/80) and 37.5% (30/80) viewed their EMR before, to prepare for their visit. The majority (65.8%) thought that the EMR improved their ability to understand and recall appointments and almost half (48.1%) thought that with the EMR they were less likely to repeat pregnancy information to caregivers. This study provides the first Australian evidence of a patient portal system, tied to an EMR, working effectively in a maternity care context. It provides new evidence that portals can deliver benefits to maternity patients in terms of providing quick and easy access to current personal and general health information and support patients in their ability to recall and prepare for appointments.

Can community health workers play a greater role in increasing access to medical abortion services? A qualitative study.

PubMed

Gupta, Pallavi; Iyengar, Sharad D; Ganatra, Bela; Johnston, Heidi Bart; Iyengar, Kirti

2017-05-25

Despite being legally available in India since 1971, barriers to safe and legal abortion remain, and unsafe and/or illegal abortion continues to be a problem. Community health workers have been involved in improving access to health information and care for maternal and child health in resource poor settings, but their role in facilitating accurate information about and access to safe abortion has been relatively unexplored. A qualitative study was conducted in Rajasthan, India to study acceptability, perspectives and preferences of women and community health workers, regarding the involvement of community health workers in medical abortion referrals. In-depth interviews were conducted with 24 women seeking early medical abortion at legal abortion facilities or presenting at these facilities for a follow-up assessment after medical abortion. Ten community health workers who were trained to assess eligibility for early medical abortion and/or to assess whether women needed a follow-up visit after early medical abortion were also interviewed. The transcripts were coded using ATLAS-ti 7 (version 7.1.4) in the local language and reports were generated for all the codes, emerging themes were identified and the findings were analysed. Community health workers (CHWs) were willing to play a role in assessing eligibility for medical abortion and in identifying women who are in need of follow-up care after early medical abortion, when provided with appropriate training, regular supplies and job aids. Women however had apprehensions about contacting CHWs in relation to abortions. Important barriers that prevented women from seeking information and assistance from community health workers were fear of breach of confidentiality and a perception that they would be pressurised to undergo sterilisation. Our findings support a potential for greater role of CHWs in making safe abortion information and services accessible to women, while highlighting the need to address women's concerns about approaching CHWs in case of unwanted pregnancy. Further intervention research would be needed to shed light on the effectiveness of role of CHWs in facilitating access to safe abortion and to outline specific components in a programme setting. Not applicable.

How youth-friendly are pharmacies in New Zealand? Surveying aspects of accessibility and the pharmacy environment using a youth participatory approach.

PubMed

Horsfield, Emma; Kelly, Fiona; Clark, Terryann; Sheridan, Janie

2014-01-01

The international youth population has significant unmet health needs, and there have been many calls to increase youth health care access. Community pharmacies may be able to help address these needs, but very little research has investigated this area and it is not known whether the current community pharmacy setting is acceptable or appropriate for youth. 1) To obtain information on physical factors which could affect young people's use of community pharmacies in New Zealand, including accessibility, opening times and the physical youth-friendliness of the pharmacy environment. 2) To involve and utilize young people in the research process, in order to understand their needs and interpretation of survey data. This study applied a cross sectional survey design, informed by a sequential youth participatory approach. A questionnaire was developed in consultation with a youth advisory group (YAG). Questionnaires distributed to pharmacists at 500 randomly selected pharmacies nationwide between May and September 2011 collected information on whether the pharmacy met selected youth-friendly criteria. These included physical aspects of youth-friendliness, such as opening times and the pharmacy environment. The YAG also provided a youth perspective in the interpretation of the results. Three mail shots achieved a response rate of 50.5%. Most respondents reported the pharmacy to be accessible by public transport and many had extended opening hours. Although most pharmacies met some youth-friendly criteria with regards to the pharmacy environment (e.g. having a private consultation area), more specific criteria (such as displaying youth health information) were usually not met. Interpretive feedback from the YAG highlighted areas for improvement. Pharmacies show potential as youth-friendly health care access points and most already meet some youth-friendly criteria. Areas identified for improvement will require a greater youth focus from the profession, and should be undertaken in consultation with young people. We recommend the use of youth participation approaches in future pharmacy practice research into youth health services. Copyright © 2014 Elsevier Inc. All rights reserved.

Use of Patient Portals for Personal Health Information Management: The Older Adult Perspective

PubMed Central

Turner, Anne M.; Osterhage, Katie; Hartzler, Andrea; Joe, Jonathan; Lin, Lorelei; Kanagat, Natasha; Demiris, George

2015-01-01

The personal health information management (PHIM) practices and needs of older adults are poorly understood. We describe initial results from the UW SOARING project (Studying Older Adults & Researching Information Needs and Goals), a participatory design investigation of PHIM in older adults (60 years and older). We conducted in-depth interviews with older adults (n=74) living in a variety of residential settings about their management of personal health information. A surprising 20% of participants report using patient portals and another 16% reported prior use or anticipated use of portals in the future. Participants cite ease of access to health information and direct communication with providers as valuable portal features. Barriers to the use of patient portals include a general lack of computer proficiency, high internet costs and security concerns. Design features based on consideration of needs and practices of older adults will facilitate appeal and maximize usability; both are elements critical to adoption of tools such as patient portals that can support older adults and PHIM. PMID:26958263

Health and Health Care From the Perspective of Intimate Partner Violence Adult Female Victims in Shelters: Impact of IPV, Unmet Needs, Barriers, Experiences, and Preferences.

PubMed

Wadsworth, Pamela; Kothari, Catherine; Lubwama, Grace; Brown, Cathy L; Frank Benton, Jennifer

Intimate partner violence (IPV) predicts poor health for victims and their children, but little is known about the perspective of victims. This study reports the perspectives of adult female IPV victims about the impact of IPV on their health and barriers of health care access for themselves and their children. The majority rated their health as good to excellent (69%). However, 83.5% indicated that IPV negatively affected their health; 53.5% had unmet health care needs. Mental health care was the most common unmet need for women; children's unmet needs were immunizations and preventive care. Transportation difficulties posed the biggest barrier to health care access.

Globalization of healthcare: a U.K. perspective.

PubMed

Ellis, Peter

2003-01-01

This commentary identifies the ability of the globalization of healthcare information and knowledge to empower populations and individuals. This, in turn, allows people to better hold to account the vested political and professional interests in order to provide or enable improvements to access and delivery of modern and effective health services. The author argues the importance of the wealth of the population to the availability of good healthcare and the contribution that healthcare industries and services could make to the economy of a particular country, notwithstanding its status as a developed, a developing or an underdeveloped nation.

A critical review of published research literature reviews on nursing and healthcare ageism.

PubMed

Wilson, Donna M; Nam, Mavis A; Murphy, Jill; Victorino, João P; Gondim, Ellen C; Low, Gail

2017-12-01

To establish how common and impactful nursing and healthcare ageism is and whether proven interventions or prevention methods exist. Ageism has been a concern since 1969 when it was first introduced as a concept for social reform. As ageism has been linked to lower quality health services and reduced health care access, it is imperative that healthcare and nursing ageism is prevented or identified and reduced or eliminated. A qualitative narrative review of published research literature reviews using a scoping design to map all published reviews was undertaken. The EBSCO Discovery Service (providing access to articles in 271 databases, including MEDLINE and CINAHL) and Directory of Open Access Journals (providing access to over 9,000 open access journals) were used to find review articles. Using predetermined inclusion and exclusion criteria, and limited by English language and peer-review publications, 12 eligible reviews were identified and information from them was systematically identified, assessed and synthesised. The 12 reviews did not provide clear and convincing information to determine how common and impactful nursing or healthcare ageism is, nor what can best be done to prevent or address it. Although each review had value since research literature was collected and discussed on nursing or healthcare ageism, the array of literature search and analysis methods, and diversity in conclusions reached about the evidence is highly problematic. Research literature reviews offering a more balanced perspective and demonstrating greater care in finding and using quality evidence are needed. At this point in time, there is no clear understanding of how widespread and impactful nursing or healthcare ageism is, and what can best be done to prevent or address it. Nurses need to be aware that ageism may be common and impactful, and guard against it. © 2017 John Wiley & Sons Ltd.

Health policy and systems research in access to medicines: a prioritized agenda for low- and middle-income countries.

PubMed

Bigdeli, Maryam; Javadi, Dena; Hoebert, Joelle; Laing, Richard; Ranson, Kent

2013-10-14

To identify priority policy issues in access to medicines (ATM) relevant for low- and middle-income countries, to identify research questions that would help address these policy issues, and to prioritize these research questions in a health policy and systems research (HPSR) agenda. The study involved i) country- and regional-level priority-setting exercises performed in 17 countries across five regions, with a desk review of relevant grey and published literature combined with mapping and interviews of national and regional stakeholders; ii) interviews with global-level stakeholders; iii) a scoping of published literature; and iv) a consensus building exercise with global stakeholders which resulted in the formulation and ranking of HPSR questions in the field of ATM. A list of 18 priority policy issues was established following analysis of country-, regional-, and global-level exercises. Eighteen research questions were formulated during the global stakeholders' meeting and ranked according to four ranking criteria (innovation, impact on health and health systems, equity, and lack of research). The top three research questions were: i) In risk protection schemes, which innovations and policies improve equitable access to and appropriate use of medicines, sustainability of the insurance system, and financial impact on the insured? ii) How can stakeholders use the information available in the system, e.g., price, availability, quality, utilization, registration, procurement, in a transparent way towards improving access and use of medicines? and iii) How do policies and other interventions into private markets, such as information, subsidies, price controls, donation, regulatory mechanisms, promotion practices, etc., impact on access to and appropriate use of medicines? Our HPSR agenda adopts a health systems perspective and will guide relevant, innovative research, likely to bear an impact on health, health systems and equity.

Access to Higher Education in Chile: A Public vs. Private Analysis

ERIC Educational Resources Information Center

Espinoza, Oscar; González, Luis Eduardo

2013-01-01

This study analyzes how access to public and private institutions of higher education in Chile has changed as the post-secondary system has become increasingly privatized. It analyses access by young people to higher education from four perspectives: funding type (public/private), gender, family income level, and ethnicity. The study uses…

Supporting Access to Open Online Courses for Learners of Developing Countries

ERIC Educational Resources Information Center

Nti, Kwame

2015-01-01

This paper examines how access to, and use of, open online courses may be enhanced for learners of developing countries from a learner perspective. Using analysis of the open education concept, factors that affect access to open educational resources content, and universal standards for delivering online learning, the author demonstrates that the…

Frame of Reference: Open Access Starts with You

ERIC Educational Resources Information Center

Goetsch, Lori A.

2010-01-01

Federal legislation now requires the deposit of some taxpayer-funded research in "open-access" repositories--that is, sites where scholarship and research are made freely available over the Internet. The institutions whose faculty produce the research have begun to see the benefit of open-access publication as well. From the perspective of faculty…

College Prep and Access from the Perspective of Diversity College Admission Professionals

ERIC Educational Resources Information Center

Bethea, Kathryn A.

2016-01-01

Studies have found that there is a college access gap for students of color in P-16 education. I utilize Perna's (2006) integrated college access model in exploring college admission's knowledge of college preparation in education. The present study uses qualitative questionnaires to measure diversity college admission professionals' (DCAPs)…

"I want to know everything": a qualitative study of perspectives from patients with chronic diseases on sharing health information during hospitalization.

PubMed

Benham-Hutchins, Marge; Staggers, Nancy; Mackert, Michael; Johnson, Alisha H; deBronkart, Dave

2017-08-04

Patient-centered care promotes the inclusion of the most prominent and important member of the health care team, the patient, as an active participant in information exchange and decision making. Patient self-management of a chronic disease requires the patient to bridge the gap between multiple care settings and providers. Hospitalizations often disrupt established self-management routines. Access to medical information during hospitalization reflects patients' rights to partner in their own care and has the potential to improve self-management as well as promote informed decision making during and after hospitalization. The objectives of this study were to elicit the perspectives of patients with chronic disease about desired medical information content and access during hospitalization. This exploratory study incorporated a qualitative approach. The online survey included the research team created open and limited response survey, demographic and hospital characteristic questions, and the Patient Activation Measurement instrument (PAM®). Convenience and social media snowball sampling were used to recruit participants through patient support groups, email invitations, listservs, and blogs. The research team employed descriptive statistics and qualitative content analysis techniques. The study sample (n = 34) ranged in age from 20 to 76 (μ = 48; SD = 16.87), Caucasian (91%, n = 31), female (88%, n = 30) and very highly educated (64%, n = 22 were college graduates). The PAM® survey revealed a highly activated sample. Qualitative analysis of the open-ended question responses resulted in six themes: Caring for myself; I want to know everything; Include me during handoff and rounds; What I expect; You're not listening; and Tracking my health information. This study revealed that hospitalized patients want to be included in provider discussions, such as nursing bedside handoff and medical rounds. Only a few participants had smooth transitions from hospital to home. Participants expressed frustration with failures in communication among their providers during and after hospitalization and provider behaviors that interfered with patient provider communication processes. Patients also identified interest in maintaining their own health histories and information but most had to "cobble together" a myriad of methods to keep track of their evolving condition during hospitalization.

Population groups: indexing, coverage, and retrieval effectiveness of ethnically related health care issues in health sciences databases.

PubMed Central

Efthimiadis, E N; Afifi, M

1996-01-01

OBJECTIVES: This study examined methods of accessing (for indexing and retrieval purposes) medical research on population groups in the major abstracting and indexing services of the health sciences literature. DESIGN: The study of diseases in specific population groups is facilitated by the indexing of both diseases and populations in a database. The MEDLINE, PsycINFO, and Embase databases were selected for the study. The published thesauri for these databases were examined to establish the vocabulary in use. Indexing terms were identified and examined as to their representation in the current literature. Terms were clustered further into groups thought to reflect an end user's perspective and to facilitate subsequent analysis. The medical literature contained in the three online databases was searched with both controlled vocabulary and natural language terms. RESULTS: The three thesauri revealed shallow pre-coordinated hierarchical structures, rather difficult-to-use terms for post-coordination, and a blurring of cultural, genetic, and racial facets of populations. Post-coordination is difficult because of the system-oriented terminology, which is intended mostly for information professionals. The terminology unintentionally restricts access by the end users who lack the knowledge needed to use the thesauri effectively for information retrieval. CONCLUSIONS: Population groups are not represented adequately in the index languages of health sciences databases. Users of these databases need to be alerted to the difficulties that may be encountered in searching for information on population groups. Information and health professionals may not be able to access the literature if they are not familiar with the indexing policies on population groups. Consequently, the study points to a problem that needs to be addressed, through either the redesign of existing systems or the design of new ones to meet the goals of Healthy People 2000 and beyond. PMID:8883987

Fragmented Inclusion: Community Participation and Lesbian, Gay, Bisexual, Trans, and Queer People with Diagnoses of Schizophrenia and Bipolar Disorder

PubMed Central

Pilling, Merrick; Howison, Meg; Frederick, Tyler; Ross, Lori; Bellamy, Chyrell D.; Davidson, Larry; McKenzie, Kwame; Kidd, Sean

2017-01-01

Community participation is often cited as a crucial component of wellness for people with mental health diagnoses. Few studies explore community participation from the perspective of LGBTQ people with diagnoses of schizophrenia and bipolar disorder. This paper describes an in-depth qualitative study with 16 lesbian, gay, bisexual, trans, and queer (LGBTQ) people and 18 social service workers, and 2 key informants in Toronto, Ontario that examined access to communities for LGBTQ people with mental health diagnoses. Results indicate that community participation is particularly relevant to this group given the functions of communities for marginalized people as a source of support and resistance. However, the participants faced barriers to accessing support and creating social networks due to the lack of intersectional inclusion in various contexts, including LGBTQ communities and mental health/mad communities. PMID:28253016

Freedom to read: A personal account of the ‘book famine’

PubMed Central

2014-01-01

Even in the digital age, access to literature and other information for people with print impairments remains extremely poor, especially in the developing world. Reading access holds cascading implications for education, economic empowerment, social participation and self-worth. In June 2013 member states of WIPO (the World Intellectual Property Organization) concluded a landmark treaty to reduce copyright impediments to the dissemination of literature to print impaired people. Its effectiveness is not yet clear. Meanwhile, critics hold that disability studies’ analyses have too often lacked insight into the personal and psychological ramifications of exclusion. This article provides an account of the ‘book famine’ from the perspective of a print impaired South African disability researcher, arguing that thorough investigation of the impressions of exclusion is necessary for change. The account highlights the personal, even malignant psychological reverberations of deprivations such as the ‘book famine’, which may carry traumatic effects which cement the status quo. PMID:28730006

Feminist ethics must inform practice: interventions with perinatal substance users.

PubMed

Marcellus, Lenora

2004-09-01

Substance use during pregnancy is a major health and social issue in countries around the world. Even though many health professional associations recommend a voluntary health promotion approach to treatment, some professionals and legislators have pursued mandatory treatment, or protective intervention. A feminist ethic perspective of treatment invites us to consider a broader notion of autonomy, which includes the contexts in which women live, the difficulty they often have in accessing treatment services, and their endurance of systematic oppression related to ethnicity, socioeconomics, and politics. A punitive approach to treatment is not associated with improved outcomes for the fetus; in fact, the fetus may be at greater risk as women are fearful of accessing health services. Treatment is best pursued on a common ground basis within an embodied model of maternal-fetal relationship that will help support women and at the same time help ensure fetal health.

Perceptions of the effect of information and communication technology on the quality of care delivered in emergency departments: a cross-site qualitative study.

PubMed

Callen, Joanne; Paoloni, Richard; Li, Julie; Stewart, Michael; Gibson, Kathryn; Georgiou, Andrew; Braithwaite, Jeffrey; Westbrook, Johanna

2013-02-01

We identify and describe emergency physicians' and nurses' perceptions of the effect of an integrated emergency department (ED) information system on the quality of care delivered in the ED. A qualitative study was conducted in 4 urban EDs, with each site using the same ED information system. Participants (n=97) were physicians and nurses with data collected by 69 detailed interviews, 5 focus groups (28 participants), and 26 hours of structured observations. Results revealed new perspectives on how an integrated ED information system was perceived to affect incentives for use, awareness of colleagues' activities, and workflow. A key incentive was related to the positive effect of the ED information system on clinical decisionmaking because of improved and quicker access to patient-specific and knowledge-base information compared with the previous stand-alone ED information system. Synchronous access to patient data was perceived to lead to enhanced awareness by individual physicians and nurses of what others were doing within and outside the ED, which participants claimed contributed to improved care coordination, communication, clinical documentation, and the consultation process. There was difficulty incorporating the use of the ED information system with clinicians' work, particularly in relation to increased task complexity; duplicate documentation, and computer issues related to system usability, hardware, and individuals' computer skills and knowledge. Physicians and nurses perceived that the integrated ED information system contributed to improvements in the delivery of patient care, enabling faster and better-informed decisionmaking and specialty consultations. The challenge of electronic clinical documentation and balancing data entry demands with system benefits necessitates that new methods of data capture, suited to busy clinical environments, be developed. Copyright © 2012. Published by Mosby, Inc.

Cell Line Data Base: structure and recent improvements towards molecular authentication of human cell lines

PubMed Central

Romano, Paolo; Manniello, Assunta; Aresu, Ottavia; Armento, Massimiliano; Cesaro, Michela; Parodi, Barbara

2009-01-01

The Cell Line Data Base (CLDB) is a well-known reference information source on human and animal cell lines including information on more than 6000 cell lines. Main biological features are coded according to controlled vocabularies derived from international lists and taxonomies. HyperCLDB (http://bioinformatics.istge.it/hypercldb/) is a hypertext version of CLDB that improves data accessibility by also allowing information retrieval through web spiders. Access to HyperCLDB is provided through indexes of biological characteristics and navigation in the hypertext is granted by many internal links. HyperCLDB also includes links to external resources. Recently, an interest was raised for a reference nomenclature for cell lines and CLDB was seen as an authoritative system. Furthermore, to overcome the cell line misidentification problem, molecular authentication methods, such as fingerprinting, single-locus short tandem repeat (STR) profile and single nucleotide polymorphisms validation, were proposed. Since this data is distributed, a reference portal on authentication of human cell lines is needed. We present here the architecture and contents of CLDB, its recent enhancements and perspectives. We also present a new related database, the Cell Line Integrated Molecular Authentication (CLIMA) database (http://bioinformatics.istge.it/clima/), that allows to link authentication data to actual cell lines. PMID:18927105

Cell Line Data Base: structure and recent improvements towards molecular authentication of human cell lines.

PubMed

Romano, Paolo; Manniello, Assunta; Aresu, Ottavia; Armento, Massimiliano; Cesaro, Michela; Parodi, Barbara

2009-01-01

The Cell Line Data Base (CLDB) is a well-known reference information source on human and animal cell lines including information on more than 6000 cell lines. Main biological features are coded according to controlled vocabularies derived from international lists and taxonomies. HyperCLDB (http://bioinformatics.istge.it/hypercldb/) is a hypertext version of CLDB that improves data accessibility by also allowing information retrieval through web spiders. Access to HyperCLDB is provided through indexes of biological characteristics and navigation in the hypertext is granted by many internal links. HyperCLDB also includes links to external resources. Recently, an interest was raised for a reference nomenclature for cell lines and CLDB was seen as an authoritative system. Furthermore, to overcome the cell line misidentification problem, molecular authentication methods, such as fingerprinting, single-locus short tandem repeat (STR) profile and single nucleotide polymorphisms validation, were proposed. Since this data is distributed, a reference portal on authentication of human cell lines is needed. We present here the architecture and contents of CLDB, its recent enhancements and perspectives. We also present a new related database, the Cell Line Integrated Molecular Authentication (CLIMA) database (http://bioinformatics.istge.it/clima/), that allows to link authentication data to actual cell lines.

Identifying promising accessions of cherry tomato: a sensory strategy using consumers and chefs.

PubMed

Rocha, Mariella C; Deliza, Rosires; Ares, Gastón; Freitas, Daniela De G C; Silva, Aline L S; Carmo, Margarida G F; Abboud, Antonio C S

2013-06-01

An increased production of cherry and gourmet tomato cultivars that are harvested at advanced colour stages and sold at a higher price has been observed in the last 10 years. In this context, producers need information on the sensory characteristics of new cultivars and their perception by potential consumers. The aim of the present work was to obtain a sensory characterisation of nine cherry tomato cultivars produced under Brazilian organic cultivation conditions from a chef and consumer perspective. Nine organic cherry tomato genotypes were evaluated by ten chefs using an open-ended question and by 110 consumers using a check-all-that-apply question. Both methodologies provided similar information on the sensory characteristics of the cherry tomato accessions. The superimposed representation of the samples in a multiple factor analysis was similar for consumers' and chefs' descriptions (RV coefficient 0.728), although they used different methodologies. According to both panels, cherry tomatoes were sorted into five groups of samples with similar sensory characteristics. Results from the present work may provide information to help organic producers in the selection of the most promising cultivars for cultivation, taking into account consumers' and chefs' perceptions, as well as in the design of communication and marketing strategies. © 2012 Society of Chemical Industry.

A comprehensive operating room information system using the Kinect sensors and RFID.

PubMed

Nouei, Mahyar Taghizadeh; Kamyad, Ali Vahidian; Soroush, Ahmad Reza; Ghazalbash, Somayeh

2015-04-01

Occasionally, surgeons do need various types of information to be available rapidly, efficiently and safely during surgical procedures. Meanwhile, they need to free up hands throughout the surgery to necessarily access the mouse to control any application in the sterility mode. In addition, they are required to record audio as well as video files, and enter and save some data. This is an attempt to develop a comprehensive operating room information system called "Medinav" to tackle all mentioned issues. An integrated and comprehensive operating room information system is introduced to be compatible with Health Level 7 (HL7) and digital imaging and communications in medicine (DICOM). DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. Besides, a natural user interface (NUI) is designed specifically for operating rooms where touch-less interactions with finger and hand tracking are in use. Further, the system could both record procedural data automatically, and view acquired information from multiple perspectives graphically. A prototype system is tested in a live operating room environment at an Iranian teaching hospital. There are also contextual interviews and usability satisfaction questionnaires conducted with the "MediNav" system to investigate how useful the proposed system could be. The results reveal that integration of these systems into a complete solution is the key to not only stream up data and workflow but maximize surgical team usefulness as well. It is now possible to comprehensively collect and visualize medical information, and access a management tool with a touch-less NUI in a rather quick, practical, and harmless manner.

PERSPECTIVE OF HANGAR AND ACCESS ROAD LOOKING EAST (During the ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PERSPECTIVE OF HANGAR AND ACCESS ROAD LOOKING EAST (During the 1940s the Arnold family leased part of their land to serve as a runway and airplane hangar. The building on the right of the photograph was originally two separate airplane hangars - they were joined in the early 1950s to provide covered combine parking between them. The building on the left of the photograph is a tractor shed. The building at a distance was gasoline and oil shed for the planes) - Arnold Farm, Hangar / Workshop, 1948 Arnold Road, Coupeville, Island County, WA

A human rights approach to the WHO Model List of Essential Medicines.

PubMed Central

Seuba, Xavier

2006-01-01

Since the first WHO Model List of Essential Medicines was adopted in 1977, it has become a popular tool among health professionals and Member States. WHO's joint effort with the United Nations Committee on Economic, Social and Cultural Rights has resulted in the inclusion of access to essential medicines in the core content of the right to health. The Committee states that the right to health contains a series of elements, such as availability, accessibility, acceptability and quality of health goods, services and programmes, which are in line with the WHO statement that essential medicines are intended to be available within the context of health systems in adequate amounts at all times, in the appropriate dosage forms, with assured quality and information, and at a price that the individual and the community can afford. The author considers another perspective by looking at the obligations to respect, protect and fulfil the right to health undertaken by the states adhering to the International Covenant of Economic, Social and Cultural Rights (ICESCR) and explores the relationship between access to medicines, the protection of intellectual property, and human rights. PMID:16710552

Matroids and quantum-secret-sharing schemes

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

Sarvepalli, Pradeep; Raussendorf, Robert

A secret-sharing scheme is a cryptographic protocol to distribute a secret state in an encoded form among a group of players such that only authorized subsets of the players can reconstruct the secret. Classically, efficient secret-sharing schemes have been shown to be induced by matroids. Furthermore, access structures of such schemes can be characterized by an excluded minor relation. No such relations are known for quantum secret-sharing schemes. In this paper we take the first steps toward a matroidal characterization of quantum-secret-sharing schemes. In addition to providing a new perspective on quantum-secret-sharing schemes, this characterization has important benefits. While previousmore » work has shown how to construct quantum-secret-sharing schemes for general access structures, these schemes are not claimed to be efficient. In this context the present results prove to be useful; they enable us to construct efficient quantum-secret-sharing schemes for many general access structures. More precisely, we show that an identically self-dual matroid that is representable over a finite field induces a pure-state quantum-secret-sharing scheme with information rate 1.« less

Patient-Controlled Attribute-Based Encryption for Secure Electronic Health Records System.

PubMed

Eom, Jieun; Lee, Dong Hoon; Lee, Kwangsu

2016-12-01

In recent years, many countries have been trying to integrate electronic health data managed by each hospital to offer more efficient healthcare services. Since health data contain sensitive information of patients, there have been much research that present privacy preserving mechanisms. However, existing studies either require a patient to perform various steps to secure the data or restrict the patient to exerting control over the data. In this paper, we propose patient-controlled attribute-based encryption, which enables a patient (a data owner) to control access to the health data and reduces the operational burden for the patient, simultaneously. With our method, the patient has powerful control capability of his/her own health data in that he/she has the final say on the access with time limitation. In addition, our scheme provides emergency medical services which allow the emergency staffs to access the health data without the patient's permission only in the case of emergencies. We prove that our scheme is secure under cryptographic assumptions and analyze its efficiency from the patient's perspective.

Research on Quantum Authentication Methods for the Secure Access Control Among Three Elements of Cloud Computing

NASA Astrophysics Data System (ADS)

Dong, Yumin; Xiao, Shufen; Ma, Hongyang; Chen, Libo

2016-12-01

Cloud computing and big data have become the developing engine of current information technology (IT) as a result of the rapid development of IT. However, security protection has become increasingly important for cloud computing and big data, and has become a problem that must be solved to develop cloud computing. The theft of identity authentication information remains a serious threat to the security of cloud computing. In this process, attackers intrude into cloud computing services through identity authentication information, thereby threatening the security of data from multiple perspectives. Therefore, this study proposes a model for cloud computing protection and management based on quantum authentication, introduces the principle of quantum authentication, and deduces the quantum authentication process. In theory, quantum authentication technology can be applied in cloud computing for security protection. This technology cannot be cloned; thus, it is more secure and reliable than classical methods.

Transition to adult-oriented health care: perspectives of youth and adults with complex physical disabilities.

PubMed

Young, Nancy L; Barden, Wendy S; Mills, Wendy A; Burke, Tricia A; Law, Mary; Boydell, Katherine

2009-01-01

The transition to adulthood is extremely difficult for individuals with disabilities. We sought to explore the specific issue of transition to adult-oriented health care in a Canadian context. We conducted semi-structured individual interviews with 15 youth and 15 adults with cerebral palsy, spina bifida, and acquired brain injuries of childhood, and their parents (n = 30). Respondents discussed their health care services, their experience with clinical transition, and contributing factors. We analyzed the transcripts using qualitative methods. All participants identified challenges in transition, including: lack of access to health care; lack of professionals' knowledge; lack of information and uncertainty regarding the transition process. Two solutions were identified: early provision of detailed information and more extensive support throughout the clinical transition process. The challenges of clinical transition were universal. More extensive information and support is needed during transition to ensure an efficient move to appropriate adult-oriented health care.

Research synthesis and dissemination as a bridge to knowledge management: the Cochrane Collaboration.

PubMed Central

Volmink, Jimmy; Siegfried, Nandi; Robertson, Katharine; Gülmezoglu, A. Metin

2004-01-01

In the current information age, research synthesis is a particularly useful tool for keeping track of scientific research and making sense of the large volumes of frequently conflicting data derived from primary studies. The Cochrane Collaboration is a global initiative "to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of healthcare interventions". In this paper we set the work of the Cochrane Collaboration in historical perspective, explain what a Cochrane review is, and describe initiatives for promoting worldwide dissemination of synthesized information. We also consider emerging evidence of the Cochrane Collaboration's impact on health-care practice, policy, research and education. Finally, we highlight the need for increased investment in the preparation and maintenance of Cochrane reviews, particularly those that address health issues that are relevant to people living in low- and middle-income countries. PMID:15643800

2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines.

PubMed

Simons, F Estelle R; Ebisawa, Motohiro; Sanchez-Borges, Mario; Thong, Bernard Y; Worm, Margitta; Tanno, Luciana Kase; Lockey, Richard F; El-Gamal, Yehia M; Brown, Simon Ga; Park, Hae-Sim; Sheikh, Aziz

2015-01-01

The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis provide a unique global perspective on this increasingly common, potentially life-threatening disease. Recommendations made in the original WAO Anaphylaxis Guidelines remain clinically valid and relevant, and are a widely accessed and frequently cited resource. In this 2015 update of the evidence supporting recommendations in the Guidelines, new information based on anaphylaxis publications from January 2014 through mid- 2015 is summarized. Advances in epidemiology, diagnosis, and management in healthcare and community settings are highlighted. Additionally, new information about patient factors that increase the risk of severe and/or fatal anaphylaxis and patient co-factors that amplify anaphylactic episodes is presented and new information about anaphylaxis triggers and confirmation of triggers to facilitate specific trigger avoidance and immunomodulation is reviewed. The update includes tables summarizing important advances in anaphylaxis research.

Information technologies and the sharing of disaster knowledge: the critical role of professional culture.

PubMed

Marincioni, Fausto

2007-12-01

A comparative survey of a diverse sample of 96 US and Italian emergency management agencies shows that the diffusion of new information technologies (IT) has transformed disaster communications. Although these technologies permit access to and the dissemination of massive amounts of disaster information with unprecedented speed and efficiency, barriers rooted in the various professional cultures still hinder the sharing of disaster knowledge. To be effective the available IT must be attuned to the unique settings and professional cultures of the local emergency management communities. Findings show that available technology, context, professional culture and interaction are key factors that affect the knowledge transfer process. Cultural filters appear to influence emergency managers' perceptions of their own professional roles, their vision of the applicability of technology to social issues, and their perspective on the transferability of disaster knowledge. Four cultural approaches to the application of IT to disaster communications are defined: technocentric; geographic,; anthropocentric; and ecocentric.

Nurses' use of mobile instant messaging applications: A uses and gratifications perspective.

PubMed

Bautista, John Robert; Lin, Trisha T C

2017-10-01

To explore how and why mobile instant messaging applications are used by Filipino nurses as part of their work. Guided by the uses and gratifications theory, in-depth interviews with 20 staff nurses working in 9 hospitals (ie, 4 private and 5 public hospitals) in the Philippines were conducted in July 2015. Interview data were analysed through a phenomenological perspective to thematic analysis. Results show that mobile instant messaging applications such as Facebook Messenger and Viber were mostly used by staff nurses and these were accessed using their own smartphones. Thematic analysis indicates that they were used to meet staff nurses' need for information exchange, socialization, and catharsis. Moreover, user interactions vary depending on members within a chat group. For instance, communication via mobile instant messaging applications are much formal when superiors are included in a chat group. In general, the results show that mobile instant messaging applications are routinely used by Filipino staff nurses not only for clinical purposes (ie, information exchange) but also for non-clinical purposes (ie, socialization and catharsis). This paper ends with several practical and theoretical implications including future research directions. © 2017 John Wiley & Sons Australia, Ltd.

Understanding Barriers for Communicating Injury Prevention Messages and Strategies Moving Forward: Perspectives from Community Stakeholders.

PubMed

Mack, Diane E; Aymar, Matt; Cosby, Jarold; Wilson, Philip M; Bradley, Christina; Walters Gray, Casey

2016-01-01

The primary objective of this study was to elicit the perspectives of direct care providers on barriers and facilitators to communicating injury prevention messages to parents/caregivers of children under 4 years of age. The secondary objective was to examine characteristics of an injury prevention messaging strategy preferred by direct care providers. This qualitative study was conducted across four regions in Ontario Canada. Fifty-nine direct care providers were purposefully sampled and data interpreted using focus group analysis. Transcripts were analyzed verbatim using content and discourse analysis. Several barriers to communicating injury prevention messages were identified encompassing (a) role, (b) parental, (c) social determinants, and (d) evidence impediments. In an effort to offset some of these barriers, participants endorsed the development of a tailored multicomponent injury prevention strategy adopting action-based messages. The results of this study provide an in-depth exploration of direct care providers perceptions that can inform the design of materials and dissemination strategies to help increase and optimize access to injury prevention information. Injury prevention messages should be action-oriented, specifically tailored to the stage of child development, and disseminated through both face-to-face interactions and mobile technology. © 2015 Wiley Periodicals, Inc.

Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective.

PubMed

Sidek, Yusof Haji; Martins, Jorge Tiago

2017-11-01

Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients' medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics. This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context. We used Grounded Theory to analyse data collected in the context of Brunei's national EHR - the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding. Six perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives. Workflow changes were significant challenges to clinicians' confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Online surveillance of media health event reporting in Nepal: digital disease detection from a One Health perspective.

PubMed

Schwind, Jessica S; Norman, Stephanie A; Karmacharya, Dibesh; Wolking, David J; Dixit, Sameer M; Rajbhandari, Rajesh M; Mekaru, Sumiko R; Brownstein, John S

2017-09-21

Traditional media and the internet are crucial sources of health information. Media can significantly shape public opinion, knowledge and understanding of emerging and endemic health threats. As digital communication rapidly progresses, local access and dissemination of health information contribute significantly to global disease detection and reporting. Health event reports in Nepal (October 2013-December 2014) were used to characterize Nepal's media environment from a One Health perspective using HealthMap - a global online disease surveillance and mapping tool. Event variables (location, media source type, disease or risk factor of interest, and affected species) were extracted from HealthMap. A total of 179 health reports were captured from various sources including newspapers, inter-government agency bulletins, individual reports, and trade websites, yielding 108 (60%) unique articles. Human health events were reported most often (n = 85; 79%), followed by animal health events (n = 23; 21%), with no reports focused solely on environmental health. By expanding event coverage across all of the health sectors, media in developing countries could play a crucial role in national risk communication efforts and could enhance early warning systems for disasters and disease outbreaks.

How community has shaped the Protein Data Bank.

PubMed

Berman, Helen M; Kleywegt, Gerard J; Nakamura, Haruki; Markley, John L

2013-09-03

Following several years of community discussion, the Protein Data Bank (PDB) was established in 1971 as a public repository for the coordinates of three-dimensional models of biological macromolecules. Since then, the number, size, and complexity of structural models have continued to grow, reflecting the productivity of structural biology. Managed by the Worldwide PDB organization, the PDB has been able to meet increasing demands for the quantity of structural information and of quality. In addition to providing unrestricted access to structural information, the PDB also works to promote data standards and to raise the profile of structural biology with broader audiences. In this perspective, we describe the history of PDB and the many ways in which the community continues to shape the archive. Copyright © 2013 Elsevier Ltd. All rights reserved.

Impact of social factors on labour discrimination of disabled women.

PubMed

Mondéjar-Jiménez, José; Vargas-Vargas, Manuel; Meseguer-Santamaría, María-Leticia; Mondéjar-Jiménez, Juan-Antonio

2009-01-01

Disabled women suffer from a double labour discrimination due to their gender and their disability. In rural areas, in addition, they also suffer from a lack of specific services, the isolation of the disabled associations, problems with public transport, the dispersion of population centres, and a limited access to information that could improve their chances of entering the labour market. The current work adopts a constructivist perspective on disability and offers a preliminary examination of the influence of social factors, such as the rural or urban nature of the disabled women's place of residence, the assistance they receive from their family or outside the family, the quantity of information they receive about the labour market, and their educational level, on the activity and employment status of this group of people.

Outreach and online training services at the Saccharomyces Genome Database.

PubMed

MacPherson, Kevin A; Starr, Barry; Wong, Edith D; Dalusag, Kyla S; Hellerstedt, Sage T; Lang, Olivia W; Nash, Robert S; Skrzypek, Marek S; Engel, Stacia R; Cherry, J Michael

2017-01-01

The Saccharomyces Genome Database (SGD; www.yeastgenome.org ), the primary genetics and genomics resource for the budding yeast S. cerevisiae , provides free public access to expertly curated information about the yeast genome and its gene products. As the central hub for the yeast research community, SGD engages in a variety of social outreach efforts to inform our users about new developments, promote collaboration, increase public awareness of the importance of yeast to biomedical research, and facilitate scientific discovery. Here we describe these various outreach methods, from networking at scientific conferences to the use of online media such as blog posts and webinars, and include our perspectives on the benefits provided by outreach activities for model organism databases. http://www.yeastgenome.org. © The Author(s) 2017. Published by Oxford University Press.

Perspectives on Open Access Opportunities for IS Research Publication: Potential Benefits for Researchers, Educators, and Students

ERIC Educational Resources Information Center

Woszczynski, Amy B.; Whitman, Michael E.

2016-01-01

Access to current research materials, pedagogical best practices, and relevant knowledge has become problematic as journal subscription costs have increased. Increasing delays in the traditional publication timeline, coupled with high subscription costs, have resulted in a diminished ability for IS faculty and their students to access the most…

Comparison and Evaluation of End-User Interfaces for Online Public Access Catalogs.

ERIC Educational Resources Information Center

Zumer, Maja

End-user interfaces for the online public access catalogs (OPACs) of OhioLINK, a system linking major university and research libraries in Ohio, and its 16 member libraries, accessible through the Internet, are compared and evaluated from the user-oriented perspective. A common, systematic framework was used for the scientific observation of the…

Associations between Motivational Orientations and Chronically Accessible Outcomes in Leisure-Time Physical Activity: Are Appearance-Related Outcomes Controlling in Nature?

ERIC Educational Resources Information Center

McLachlan, Sarah; Hagger, Martin S.

2010-01-01

This study aimed to explore relations between chronically accessible outcomes in physical activity and scaled measures of motivational orientations from a self-determination perspective. Methods from construct and attitude accessibility research and the Levesque and Pelletier (2003) study were used to identify participants' chronically accessible…

Rural Food Deserts: Low-Income Perspectives on Food Access in Minnesota and Iowa

ERIC Educational Resources Information Center

Smith, Chery; Morton, Lois W.

2009-01-01

Objective: To investigate how low-income rural residents living in food deserts access the normal food system and food safety net services within their communities, and explore how social, personal, and environment drives food access and food choice. Design: Seven focus groups (90 minutes each) were conducted with 2 moderators present and were…

Pharmacists' perspectives on the Patient Protection and Affordable Care Act.

PubMed

Khanna, Rahul; Mahabaleshwarkar, Rohan; Holmes, Erin R; Jariwala, Krutika

2015-01-01

Passed in 2010, the Patient Protection and Affordable Care Act (PPACA) resulted in significant changes to the health care system in the United States (US). Though general population surveys reveal the fractious political debate surrounding the law, insights on pharmacists' perspectives on the PPACA are lacking in the literature. The objectives of this study were to determine pharmacists' perspectives on the PPACA and determine whether pharmacists' demographic and practice-related characteristics and political beliefs influence their perspectives on the PPACA. This study was conducted using a descriptive, cross-sectional design. Study data were collected with a self-administered online questionnaire distributed to 21,769 registered pharmacists in five states. A total of 1127 completed surveys were received (5.6% response rate). Roughly 37% of pharmacists reported that they understood the major provisions of the PPACA although most (89%) respondents agreed that understanding such policies is important for practicing pharmacy. Just over half (50.6%) of respondents did not support the PPACA while 47.7% supported the legislation. Political orientation, age, gender, and race were found to be significantly related to pharmacists' perspectives on the PPACA. Respondent pharmacists' perceptions of the PPACA appear to be related to political orientation and demographic characteristics. Given that pharmacists will be impacted by the implementation of the PPACA and are so accessible to the public, additional information on health care policy and PPACA should be provided to pharmacists. Copyright © 2015 Elsevier Inc. All rights reserved.

Why high tech needs high touch: Supporting continuity of community primary health care.

PubMed

Meyer, Ellenore D; Hugo, Johannes F M; Marcus, Tessa S; Molebatsi, Rebaone; Komana, Kabelo

2018-06-21

 Integrated care through community-oriented primary care (COPC) deployed through municipal teams of community health workers (CHWs) has been part of health reform in South Africa since 2011. The role of COPC and integration of information and communication technology (ICT) information to improve patient health and access to care, require a better understanding of patient social behaviour. Aim: The study sought to understand how COPC with CHWs visiting households offering health education can support antenatal follow-up and what the barriers for access to care would be. Method: A mixed methodological approach was followed. Quantitative patient data were recorded on an electronic health record-keeping system. Qualitative data collection was performed through interviews of the COPC teams at seven health posts in Mamelodi and telephonic patient interviews. Interviews were analysed according to themes and summarised as barriers to access care from a social and community perspective. Results: An integrated COPC approach increased the number of traceable pregnant women followed up at home from 2016 - 2017. Wrong addresses or personal identification were given at the clinic because of fear of being denied care. Allocating patients correctly to a ward-based outreach team (WBOT) proved to be a challenge as many patients did not know their street address. Conclusion: Patient health data available to a health worker on a smartphone as part of COPC improve patient traceability and follow-up at home making timely referral possible. Health system developments that support patient care on community level could strengthen patient health access and overall health.

MyOcean Central Information System - Achievements and Perspectives

NASA Astrophysics Data System (ADS)

de Dianous, Rémi; Jolibois, Tony; Besnard, Sophie

2015-04-01

MyOcean (http://www.myocean.eu) is providing a pre-operational service, for forecasts, analysis and expertise on ocean currents, temperature, salinity, sea level, primary ecosystems and ice coverage. Since 2009, three successive projects (MyOcean-I, MyOcean-II and MyOcean-Follow-on) have been designed to prepare and to lead the demonstration phases of the future Copernicus Marine Environment Monitoring Service. The main goal of these projects was to build a system of systems offering the users a unique access point to European oceanographic data. Reaching this goal at European level with 59 partners from 28 different countries was a real challenge: initially, each local system had its own human processes and methodology, its own interfaces for production and dissemination. At the end of MyOcean Follow-on, any user can connect to one web portal, browse an interactive catalogue of products and services, use one login to access all data disseminated through harmonized interfaces in a common format and contact a unique centralized service desk. In this organization the central information system plays a key role. The production of observation and forecasting data is done by 48 Production Units (PU). Product download and visualisation are hosted by 26 Dissemination Units (DU). All these products and associated services are gathered in a single system hiding the intricate distributed organization of PUs and DUs. This central system will be presented in detail, including notably the technical choices in architecture and technologies which have been made and why, and the lessons learned during these years of real life of the system, taking into account internal and external feedbacks. Then, perspectives will be presented to sketch the future of such system in the next Marine Copernicus Service which is meant to be fully operational from 2015 onwards.

Health needs and priorities of Syrian refugees in camps and urban settings in Jordan: perspectives of refugees and health care providers.

PubMed

Al-Rousan, Tala; Schwabkey, Zaker; Jirmanus, Lara; Nelson, Brett D

2018-06-10

The United Nations has declared the Syrian refugee crisis to be the biggest humanitarian emergency of our era. Neighbouring countries, such as Jordan, strain to meet the health needs of Syrian refugees in addition to their own citizens given limited resources. This study aimed to determine the perspectives of Syrian refugees in Jordan, Jordanian health care providers and other stakeholders in addressing the public health issues of the refugee crisis. Qualitative and quantitative methodologies were used to explore Syrian refugee health needs and services in camp and urban settings in Jordan. Focus group discussions and key informant interviews were used to identify needs, challenges and potential solutions to providing quality health care to refugees. By-person factor analysis divided refugee participants into 4 unique respondent types and compared priorities for interventions. Focus group discussions and key informant interviews revealed a many different problems. Cost, limited resources, changing policies, livelihoods and poor health literacy impeded delivery of public and clinical health services. Respondent Type 1 emphasized the importance of policy changes to improve Syrian refugee health. Type 2 highlighted access to fresh foods and recreational activities for children. For Type 3, poor quality drinking-water was the primary concern, and Type 4 believed the lack of good, free education for Syrian children exacerbated their mental health problems. Syrian refugees identified cost as the main barrier to health care access. Both refugees and health care providers emphasized the importance of directing more resources to chronic diseases and mental health. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

Providing Online-Based Sexual Health Outreach to Gay, Bisexual, and Queer Men in Ontario, Canada: Qualitative Interviews with Multisectoral Frontline Service Providers and Managers.

PubMed

Brennan, David J; Souleymanov, Rusty; Lachowsky, Nathan; Betancourt, Gerardo; Pugh, Daniel; McEwen, Owen

2018-06-13

The Internet is a common tool for gay, bisexual, and other men who have sex with men (MSM) to find sexual partners and sexual health information. Given persistently high human immunodeficiency virus (HIV) infection rates among MSM, it is important to examine the role of online outreach for MSM as part of HIV prevention and care. We provide an overview of the unique perspectives of online sexual health outreach, delivered through AIDS Service Organizations (ASOs) through sociosexual Internet sites and mobile applications. Data were drawn from the qualitative arm of the community-based Cruising Counts study conducted across Ontario from December 2013 to January 2014. ASO online outreach providers and managers (n = 22) were recruited to complete a 1-h in-person/telephone interview to explore in-depth their experiences with, and perspectives on, delivering online outreach services for MSM in Ontario. Thematic analyses were conducted inductively using NVivo 10. Service providers suggested a high demand for online outreach services for MSM. Strengths and advantages of online outreach over face-to-face outreach included anonymity, instant access to services, peer model, and accessing hard-to-reach populations of MSM. Barriers included consistent quality of service, collaborations between companies that own online technologies and outreach service agencies, budgetary and staff capacity issues, and uncertainty of best practices and evaluation parameters for online outreach. Findings from these interviews can inform service providers, policy makers, and researchers on how online sexual health outreach can play a greater role in HIV prevention by better acknowledging and addressing the opportunities and barriers experienced by service providers working with MSM communities online.

The patient's perspective in the Dutch National Technical Agreement on Telemedicine.

PubMed

Meijer, Wouter J

2008-01-01

In 2007, the Dutch National Technical Agreement (NTA) for Telemedicine was established. Telemedicine deals with care processes. The goals of Telemedicine were defined broadly, including quality of life in non-medical terms as seen from the patient's perspective: 1) independence, 2) self-reliance; 3) participation in society and social life and 4) self-determination (autonomy through freedom of choice) for the care consumer and his environment. Quality aspects were defined at three levels:1) patient level Telemedicine must be in line with his needs. 2) level of information provision, such as: patient's rights in information control were also defined in the NTA: the care consumer has ultimate control over his own data. The care consumer decides who, in which functional capacity within the care process, is entitled to access which data at which level (reading) and is entitled to process it in some way: making additions, changes or possibly deleting (writing). On request, the healthcare provider must allow the care consumer access to his own data as quickly as possible and/or provide a copy of (part of) the record.3) level of business processes, e.g.it is important that the care process is designed on the basis of statutory requirements for the allocation and registration of the roles, rights and obligations of all actors concerned. For quality assurance, the processes must be defined on the basis of the function that they perform in the achievement of the goals (intended outcome), from the starting situation (input). The intended outcome means that the needs or requirements of the involved parties are fulfilled. The quality of the Telemedicine service must be assured in a cyclical and ongoing process. This can best be done by developing a quality management system based on indicators and criteria for quality.

Me and You in Caregivinghood - Dyadic resistance resources and deficits out of the informal caregiver's perspective.

PubMed

Wennerberg, Mia M T; Lundgren, Solveig M; Eriksson, Monica; Danielson, Ella

2018-05-21

To present Specific and Generalized Resistance Resources (SRRs/GRRs) and Deficits (SRDs/GRDs) described by 32 informal caregivers as originating from themselves and their older adult carerecipients as dyads. Salutogenic interviewing was used to assemble data from caregivers. A theory-driven, memo-guided and comparative analysis using within- and across- case analysis was applied to unravel resources and deficits influencing the outcomes when they managed tension associated with caregiving. Living in fellowship in a well-functioning dyad unites the essence of having access to dyadic SRRs/GRRs. Such access enables dyads to use their specific dyadic tension management to resolve challenges through cooperation, derives 'positive' life-experiences and preserves dyad functioning. Struggling alone in a malfunctioning dyad indicates the presence of dyadic SRDs/GRDs counteracting such a development. If these SRDs/GRDs accumulate, the dyad become less able to resolve challenges, 'negative' life-experiences accumulates, the carerecipient's capability to cooperate decreases, caregiver's workload increases, the dyad becomes increasingly malfunctioning and moves towards the point where caregiving ends due to lack of usable SRRs/GRRs. Findings reveals the complex duality of caregiving and the necessity to assess all available SRRs/GRRs and SRDs/GRDs for caregiving dyads, including out of the carerecipient's perspective. Appropriate 'salutogenic' support reduces SRDs/GRDs, makes available SRRs/GRRs usable or provides alternative SRRs/GRRs, thereby dyadic tension management and dyadic functionality is preserved during this phase of life labelled Caregivinghood. The study adds new knowledge to the salutogenic framework regarding central, theoretical concepts and suggests how data for health promoting initiatives conducted the 'salutogenic way' may be acquired.

Acute care patient portals: a qualitative study of stakeholder perspectives on current practices.

PubMed

Collins, Sarah A; Rozenblum, Ronen; Leung, Wai Yin; Morrison, Constance Rc; Stade, Diana L; McNally, Kelly; Bourie, Patricia Q; Massaro, Anthony; Bokser, Seth; Dwyer, Cindy; Greysen, Ryan S; Agarwal, Priyanka; Thornton, Kevin; Dalal, Anuj K

2017-04-01

To describe current practices and stakeholder perspectives of patient portals in the acute care setting. We aimed to: (1) identify key features, (2) recognize challenges, (3) understand current practices for design, configuration, and use, and (4) propose new directions for investigation and innovation. Mixed methods including surveys, interviews, focus groups, and site visits with stakeholders at leading academic medical centers. Thematic analyses to inform development of an explanatory model and recommendations. Site surveys were administered to 5 institutions. Thirty interviews/focus groups were conducted at 4 site visits that included a total of 84 participants. Ten themes regarding content and functionality, engagement and culture, and access and security were identified, from which an explanatory model of current practices was developed. Key features included clinical data, messaging, glossary, patient education, patient personalization and family engagement tools, and tiered displays. Four actionable recommendations were identified by group consensus. Design, development, and implementation of acute care patient portals should consider: (1) providing a single integrated experience across care settings, (2) humanizing the patient-clinician relationship via personalization tools, (3) providing equitable access, and (4) creating a clear organizational mission and strategy to achieve outcomes of interest. Portals should provide a single integrated experience across the inpatient and ambulatory settings. Core functionality includes tools that facilitate communication, personalize the patient, and deliver education to advance safe, coordinated, and dignified patient-centered care. Our findings can be used to inform a "road map" for future work related to acute care patient portals. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Quantum interactions with closed timelike curves and superluminal signaling

NASA Astrophysics Data System (ADS)

Bub, Jeffrey; Stairs, Allen

2014-02-01

There is now a significant body of results on quantum interactions with closed timelike curves (CTCs) in the quantum information literature, for both the Deutsch model of CTC interactions (D-CTCs) and the projective model (P-CTCs). As a consequence, there is a prima facie argument exploiting entanglement that CTC interactions would enable superluminal and, indeed, effectively instantaneous signaling. In cases of spacelike separation between the sender of a signal and the receiver, whether a receiver measures the local part of an entangled state or a disentangled state to access the signal can depend on the reference frame. We propose a consistency condition that gives priority to either an entangled perspective or a disentangled perspective in spacelike-separated scenarios. For D-CTC interactions, the consistency condition gives priority to frames of reference in which the state is disentangled, while for P-CTC interactions the condition selects the entangled state. Using the consistency condition, we show that there is a procedure that allows Alice to signal to Bob in the past via relayed superluminal communications between spacelike-separated Alice and Clio, and spacelike-separated Clio and Bob. This opens the door to time travel paradoxes in the classical domain. Ralph [T. C. Ralph, arXiv:1107.4675 [quant-ph].] first pointed this out for P-CTCs, but we show that Ralph's procedure for a "radio to the past" is flawed. Since both D-CTCs and P-CTCs allow classical information to be sent around a spacetime loop, it follows from a result by Aaronson and Watrous [S. Aaronson and J. Watrous, Proc. R. Soc. A 465, 631 (2009), 10.1098/rspa.2008.0350] for CTC-enhanced classical computation that a quantum computer with access to P-CTCs would have the power of PSPACE, equivalent to a D-CTC-enhanced quantum computer.

Collective patient behaviours derailing ART roll-out in KwaZulu-Natal: perspectives of health care providers

PubMed Central

2013-01-01

Background Antiretroviral therapy (ART) roll-out is fraught with challenges, many with serious repercussions. We explored and described patient behaviour-related challenges from the perspective of health care providers from non-governmental organisations involved in ART programmes in KwaZulu-Natal, South Africa. Methods A descriptive case study design using qualitative approach was applied during this study. Data was collected from nine key informants from the three biggest NGOs involved in ART roll-out using in-depth semi-structured interviews. Transcribing and coding for emergent themes was done by two independent reviewers. Ethical approval for the study was granted by the UNISA research ethics committee of The Faculty of Health Sciences. Written consent was obtained from directors of the three NGOs involved and individual audio taped informed consent was obtained from all study participants prior to data collection. Results Findings revealed six broad areas of patient behaviour challenges. These were patient behaviour related to socio-economic situation of patient (skipping of medication due to lack of food, or due to lack of transport fees), belief systems (traditional and religious), stigma (non- disclosure), sexual practices (non-acceptability of condoms, teenage pregnancies), escapism (drug and alcohol abuse) and opportunism (skipping medication in order to access disability grant, teenage pregnancies in order to access child grant). Conclusion New programmes need to address patient behaviour as a complex phenomenon requiring a multi-pronged approach that also addresses social norms and institutions. In the face of continued ART scale up, this is further evidence for the need for multi-sectoral collaboration to ensure successful and sustainable ART roll-out. PMID:23870285

Drama and Theatre in a Nordic Curriculum Perspective--A Challenged Arts Subject Used as a Learning Medium in Compulsory Education

ERIC Educational Resources Information Center

Österlind, Eva; Østern, Anna-Lena; Thorkelsdóttir, Rannveig Björk

2016-01-01

The aim of this article is to present a Nordic curriculum perspective on drama and theatre in education ranging from preschool to upper secondary education and cultural schools. Underlined in the Nordic welfare model is an equity, inclusive and democracy perspective, which guarantees free access to compulsory education and to upper secondary…

Personal utility in genomic testing: is there such a thing?

PubMed

Bunnik, Eline M; Janssens, A Cecile J W; Schermer, Maartje H N

2015-04-01

In ethical and regulatory discussions on new applications of genomic testing technologies, the notion of 'personal utility' has been mentioned repeatedly. It has been used to justify direct access to commercially offered genomic testing or feedback of individual research results to research or biobank participants. Sometimes research participants or consumers claim a right to genomic information with an appeal to personal utility. As of yet, no systematic account of the umbrella notion of personal utility has been given. This paper offers a definition of personal utility that places it in the middle of the spectrum between clinical utility and personal perceptions of utility, and that acknowledges its normative charge. The paper discusses two perspectives on personal utility, the healthcare perspective and the consumer perspective, and argues that these are too narrow and too wide, respectively. Instead, it proposes a normative definition of personal utility that postulates information and potential use as necessary conditions of utility. This definition entails that perceived utility does not equal personal utility, and that expert judgment may be necessary to help determine whether a genomic test can have personal utility for someone. Two examples of genomic tests are presented to illustrate the discrepancies between perceived utility and our proposed definition of personal utility. The paper concludes that while there is room for the notion of personal utility in the ethical evaluation and regulation of genomic tests, the justificatory role of personal utility is not unlimited. For in the absence of clinical validity and reasonable potential use of information, there is no personal utility. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Lack of access to health care for African indigents: a social exclusion perspective

PubMed Central

2013-01-01

Background Lack of access to health care is a persistent condition for most African indigents, to which the common technical approach of targeting initiatives is an insufficient antidote. To overcome the standstill, an integrated technical and political approach is needed. Such policy shift is dependent on political support, and on alignment of international and national actors. We explore if the analytical framework of social exclusion can contribute to the latter. Methods We produce a critical and evaluative account of the literature on three themes: social exclusion, development policy, and indigence in Africa–and their interface. First, we trace the concept of social exclusion as it evolved over time and space in policy circles. We then discuss the relevance of a social exclusion perspective in developing countries. Finally, we apply this perspective to Africa, its indigents, and their lack of access to health care. Results The concept of social exclusion as an underlying process of structural inequalities has needed two decades to find acceptance in international policy circles. Initial scepticism about the relevance of the concept in developing countries is now giving way to recognition of its universality. For a variety of reasons however, the uptake of a social exclusion perspective in Africa has been limited. Nevertheless, social exclusion as a driver of poverty and inequity in Africa is evident, and manifestly so in the case of the African indigents. Conclusion The concept of social exclusion provides a useful framework for improved understanding of origins and persistence of the access problem that African indigents face, and for generating political space for an integrated approach. PMID:24238000

The quality of radiation care: the results of focus group interviews and concept mapping to explore the patient's perspective.

PubMed

Nijman, Jessica L; Sixma, Herman; van Triest, Baukelien; Keus, Ronald B; Hendriks, Michelle

2012-01-01

In this study, we explore the quality aspects of radiation care from the patient's perspective in order to develop a draft Consumer Quality Index (CQI) Radiation Care instrument. Four focus group discussions with (former) cancer patients were held to explore the aspects determining the quality of radiation care. The list of aspects generated was categorised based on similarity and importance in a concept mapping procedure. Four focus group discussions revealed seven main themes related to the quality of radiation care: information provision, a patient-centred approach, professional competence, planning and waiting times, accessibility, cooperation and communication, and follow-up care. Results of concept mapping procedures revealed which items the patients considered to be most important. A radiation oncologist who is up to date about the patient's file is of paramount importance for cancer patients receiving radiotherapy. The quality aspects found through focus group discussions provided useful insight into how patients experience radiation care. Furthermore, concept mapping made these results more solid. To evaluate the quality of radiation care from the patient's perspective, these quality aspects will be guiding in the development of a CQI Radiation Care. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

integrative literature review.

PubMed

Fage-Butler, Antoinette Mary; Jensen, Matilde Nisbeth

2015-01-01

Email communication is being integrated relatively slowly into doctor–patient communication. Patients have expressed enthusiasm for the medium, while doctors are generally more reluctant. As existing health communication models have characteristically assumed the co-presence of doctor and patient and primarily reflect medical practitioners’ perspectives, their suitability in relation to email communication and patients’ perspectives warrants further investigation. Following a two-step process and using the methodology of the integrative literature review, 29 articles from 2004–2014 are analysed with the aim of investigating the advantages and disadvantages of the medium of email from the patient’s perspective. The findings are compared to the health communication models of biomedicine, patient-centeredness, patient education and patient empowerment to investigate these models’ relevance for doctor–patient email communication. Results show that patients identify numerous advantages with email communication, including improved convenience and access, more detailed informational exchanges, greater reflection opportunities, freedom from the medical gaze and the potential to level out power imbalances, as well as a number of primarily medium-related disadvantages. The findings indicate that email can counteract some of the communicative problems associated with biomedicine and suggest the ongoing relevance of aspects of the models of patient empowerment, patient-centeredness and patient education for email communication.

Designing visual displays and system models for safe reactor operations based on the user`s perspective of the system

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

Brown-VanHoozer, S.A.

Most designers are not schooled in the area of human-interaction psychology and therefore tend to rely on the traditional ergonomic aspects of human factors when designing complex human-interactive workstations related to reactor operations. They do not take into account the differences in user information processing behavior and how these behaviors may affect individual and team performance when accessing visual displays or utilizing system models in process and control room areas. Unfortunately, by ignoring the importance of the integration of the user interface at the information process level, the result can be sub-optimization and inherently error- and failure-prone systems. Therefore, tomore » minimize or eliminate failures in human-interactive systems, it is essential that the designers understand how each user`s processing characteristics affects how the user gathers information, and how the user communicates the information to the designer and other users. A different type of approach in achieving this understanding is Neuro Linguistic Programming (NLP). The material presented in this paper is based on two studies involving the design of visual displays, NLP, and the user`s perspective model of a reactor system. The studies involve the methodology known as NLP, and its use in expanding design choices from the user`s ``model of the world,`` in the areas of virtual reality, workstation design, team structure, decision and learning style patterns, safety operations, pattern recognition, and much, much more.« less

Perspectives of Stakeholders on Implementing a Farm-to-University Program at an HBCU.

PubMed

Vilme, Helene; López, Ivette A; Walters, Lurleen; Suther, Sandra; Brown, C Perry; Dutton, Matthew; Barber, Janet

2015-07-01

To explore the perspectives of various stakeholders on whether an HBCU has the resources to establish a farm-to-university program that can improve fruits and vegetables intake among African American students. Additionally, this study assessed students' satisfaction with fruits and vegetables served in University dining halls, and their desire for changes in policies to increase local fruits and vegetables access on campus. This study employed a mixed method data collection strategy. Semi-structured interviews were used to explore the stakeholders' perspectives and self-administered questionnaires were used to assess students' satisfaction with fruits and vegetables and desire for policy changes. Barriers reported by both food service administrators and farmers were cost and variation in supply and demand. Students expressed lack of satisfaction with fresh produce served in campus dining halls and a desire for change in policies to increase local fruits and vegetables access on campus. While there is student desire for improved access to fresh produce on campus, there are perceived barriers to overcome. University partnerships are needed to address the desired nutritional improvements.

Exploring dispositional tendencies to seek online information about direct-to-consumer genetic testing.

PubMed

Paquin, Ryan S; Richards, Adam S; Koehly, Laura M; McBride, Colleen M

2012-12-01

Varying perspectives exist regarding the implications of genetic susceptibility testing for common disease, with some anticipating adverse effects and others expecting positive outcomes; however, little is known about the characteristics of people who are most likely to be interested in direct-to-consumer genetic testing. To that end, this study examines the association of individual dispositional differences with health risk perceptions and online information seeking related to a free genetic susceptibility test. Healthy adults enrolled in a large health maintenance organization were surveyed by telephone. Eligible participants (N = 1,959) were given access to a secure website that provided risk and benefit information about a genetic susceptibility test and given the option to be tested. Neuroticism was associated with increased perceptions of disease risk but not with logging on. Those scoring high in conscientiousness were more likely to log on. We found no evidence that neuroticism, a dispositional characteristic commonly linked to adverse emotional response, was predictive of online genetic information seeking in this sample of healthy adults.

User-oriented views in health care information systems.

PubMed

Portoni, Luisa; Combi, Carlo; Pinciroli, Francesco

2002-12-01

In this paper, we present the methodology we adopted in designing and developing an object-oriented database system for the management of medical records. The designed system provides technical solutions to important requirements of most clinical information systems, such as 1) the support of tools to create and manage views on data and view schemas, offering to different users specific perspectives on data tailored to their needs; 2) the capability to handle in a suitable way the temporal aspects related to clinical information; and 3) the effective integration of multimedia data. Remote data access for authorized users is also considered. As clinical application, we describe here the prototype of a user-oriented clinical information system for the archiving and the management of multimedia and temporally oriented clinical data related to percutaneous transluminal coronary angioplasty (PTCA) patients. Suitable view schemas for various user roles (cath-lab physician, ward nurse, general practitioner) have been modeled and implemented on the basis of a detailed analysis of the considered clinical environment, carried out by an object-oriented approach.

EARLY PARENTING SUPPORT AND INFORMATION: A CONSUMER PERSPECTIVE.

PubMed

Morawska, Alina; Weston, Kate; Bowd, Courtney

2018-03-01

The transition to parenthood is a period of both joy and challenge for most parents. There is a recognized need to support parents during this period, yet existing interventions have shown limited evidence of efficacy. This study takes a consumer-focused approach to examine the needs and preferences of parents both prenatally (n = 77) and postnatally (n = 123) for parenting support. The study used a cross-sectional design with a purpose-built online survey. Parents were recruited via online forums, Facebook and parenting blogs, childcare centers, and playgroups. In general, all parents were satisfied with their current levels of both formal and informal support, and about one fourth of parents had accessed a parenting intervention. Parents expressed a moderate level of interest in additional parenting information, and parents expecting their first baby indicated preferences for information about basic baby care needs whereas postnatally, parents expressed more interest in topics around self-care and behavior management. The implications for developing interventions and engaging families are discussed. © 2018 Michigan Association for Infant Mental Health.

Perspective image comprehension depends on both visual and proprioceptive information.

PubMed

Michel, Christian W; Ray, Devin G; Kaup, Barbara; Hesse, Friedrich W

2014-11-01

Proprioceptive information can supplement visual information in the comprehension of ambiguous perspective images. The importance of proprioceptive information in unambiguous perspective image comprehension is untested, however. We explored the role of proprioception in perspective image comprehension using three experiments in which participants took or imagined taking an upward- or downward-oriented posture and then made judgments about images viewed from below or viewed from above. Participants were faster and more accurate in their judgments when their actual or simulated posture was consistent with the posture implied by the perspective of the image they were judging. These results support a role for proprioception in the comprehension of unambiguous perspective images as well as ambiguous perspective images.

"Workhood"-a useful concept for the analysis of health workers' resources? an evaluation from Tanzania

PubMed Central

2012-01-01

Background International debates on improving health system performance and quality of care are strongly coined by systems thinking. There is a surprising lack of attention to the human (worker) elements. Although the central role of health workers within the health system has increasingly been acknowledged, there are hardly studies that analyze performance and quality of care from an individual perspective. Drawing on livelihood studies in health and sociological theory of capitals, this study develops and evaluates the new concept of workhood. As an analytical device the concept aims at understanding health workers' capacities to access resources (human, financial, physical, social, cultural and symbolic capital) and transfer them to the community from an individual perspective. Methods Case studies were conducted in four Reproductive-and-Child-Health (RCH) clinics in the Kilombero Valley, south-eastern Tanzania, using different qualitative methods such as participant observation, informal discussions and in-depth interviews to explore the relevance of the different types of workhood resources for effective health service delivery. Health workers' ability to access these resources were investigated and factors facilitating or constraining access identified. Results The study showed that lack of physical, human, cultural and financial capital constrained health workers' capacity to act. In particular, weak health infrastructure and health system failures led to the lack of sufficient drug and supply stocks and chronic staff shortages at the health facilities. However, health workers' capacity to mobilize social, cultural and symbolic capital played a significant role in their ability to overcome work related problems. Professional and non-professional social relationships were activated in order to access drug stocks and other supplies, transport and knowledge. Conclusions By evaluating the workhood concept this study highlights the importance of understanding health worker performance by looking at their resources and capacities. Rather than blaming health workers for health system failures, applying a strength-based approach offers new insights into health workers' capacities and identifies entry points for target actions. PMID:22401037

Challenging logics of complex intervention trials: community perspectives of a health care improvement intervention in rural Uganda.

PubMed

Okwaro, Ferdinand M; Chandler, Clare I R; Hutchinson, Eleanor; Nabirye, Christine; Taaka, Lilian; Kayendeke, Miriam; Nayiga, Susan; Staedke, Sarah G

2015-04-01

Health systems in many African countries are failing to provide populations with access to good quality health care. Morbidity and mortality from curable diseases such as malaria remain high. The PRIME trial in Tororo, rural Uganda, designed and tested an intervention to improve care at health centres, with the aim of reducing ill-health due to malaria in surrounding communities. This paper presents the impact and context of this trial from the perspective of community members in the study area. Fieldwork was carried out for a year from the start of the intervention in June 2011, and involved informal observation and discussions as well as 13 focus group discussions with community members, 10 in-depth interviews with local stakeholders, and 162 context descriptions recorded through quarterly interviews with community members, health workers and district officials. Community members observed a small improvement in quality of care at most, but not all, intervention health centres. However, this was diluted by other shortfalls in health services beyond the scope of the intervention. Patients continued to seek care at health centres they considered inadequate as well as positioning themselves and their children to access care through other sources such as research and nongovernmental organization (NGO) projects. These findings point to challenges of designing and delivering interventions within a paradigm that requires factorial (reduced to predictable factors) problem definition with easily actionable and evaluable solutions by small-scale projects. Such requirements mean that interventions often work on the periphery of a health system rather than tackling the murky political and economic realities that shape access to care but are harder to change or evaluate with randomized controlled trials. Highly projectified settings further reduce the ability to genuinely 'control' for different health care access scenarios. We argue for a raised consciousness of how evaluation paradigms impact on intervention choices. Copyright © 2015 Elsevier Ltd. All rights reserved.

"Workhood"-a useful concept for the analysis of health workers' resources? An evaluation from Tanzania.

PubMed

Gross, Karin; Pfeiffer, Constanze; Obrist, Brigit

2012-03-08

International debates on improving health system performance and quality of care are strongly coined by systems thinking. There is a surprising lack of attention to the human (worker) elements. Although the central role of health workers within the health system has increasingly been acknowledged, there are hardly studies that analyze performance and quality of care from an individual perspective. Drawing on livelihood studies in health and sociological theory of capitals, this study develops and evaluates the new concept of workhood. As an analytical device the concept aims at understanding health workers' capacities to access resources (human, financial, physical, social, cultural and symbolic capital) and transfer them to the community from an individual perspective. Case studies were conducted in four Reproductive-and-Child-Health (RCH) clinics in the Kilombero Valley, south-eastern Tanzania, using different qualitative methods such as participant observation, informal discussions and in-depth interviews to explore the relevance of the different types of workhood resources for effective health service delivery. Health workers' ability to access these resources were investigated and factors facilitating or constraining access identified. The study showed that lack of physical, human, cultural and financial capital constrained health workers' capacity to act. In particular, weak health infrastructure and health system failures led to the lack of sufficient drug and supply stocks and chronic staff shortages at the health facilities. However, health workers' capacity to mobilize social, cultural and symbolic capital played a significant role in their ability to overcome work related problems. Professional and non-professional social relationships were activated in order to access drug stocks and other supplies, transport and knowledge. By evaluating the workhood concept this study highlights the importance of understanding health worker performance by looking at their resources and capacities. Rather than blaming health workers for health system failures, applying a strength-based approach offers new insights into health workers' capacities and identifies entry points for target actions.

The Indigenous Red Ribbon Storytelling Study: What does it mean for Indigenous peoples living with HIV and a substance use disorder to access antiretroviral therapy in Saskatchewan?

PubMed Central

Nowgesic, Earl; Meili, Ryan; Stack, Sandra; Myers, Ted

2016-01-01

Indigenous peoples living with HIV are less likely than non-Indigenous peoples living with HIV to access antiretroviral therapy; however, there is not enough contextual information surrounding this issue. The Indigenous Red Ribbon Storytelling Study was conducted in part to examine how Indigenous peoples living with HIV construct and understand their experiences accessing antiretroviral therapy. Our study design was critical Indigenous qualitative research, using the Behavioral Model of Health Services Use and community-based participatory research approaches. The study was conducted in partnership with Indigenous and non-Indigenous organizations. Study participants were adults from two Canadian cities. The study methods included 20 individual and two Indigenous sharing circle interviews, six participant observation sessions, a short survey and thematic analysis. Accessing antiretroviral therapy within the context of living with a substance use disorder was an overarching theme. Indigenous peoples living with HIV felt they had to choose between living with their active substance use disorder and accessing antiretroviral therapy. They felt misunderstood as a person living with a substance use disorder and often felt coerced into using antiretroviral therapy. Despite these challenges, they persevered as Indigenous peoples living with HIV and a substance use disorder. Further research on antiretroviral therapy access among Indigenous peoples living with HIV and a substance use disorder, particularly from the perspective of health service providers, is needed. PMID:27867444

Access to Essential Medicines in Pakistan: Policy and Health Systems Research Concerns

PubMed Central

Zaidi, Shehla; Bigdeli, Maryam; Aleem, Noureen; Rashidian, Arash

2013-01-01

Introduction Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i) gaps related to access to essential medicine in Pakistan; and ii) prioritization of emerging policy and research concerns. Methods An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder’s Roundtable. Findings A synthesis of evidence found major gaps in essential medicine access in Pakistan driven by weaknesses in the health care system as well as weak pharmaceutical regulation. 7 major policy concerns and 11 emerging research concerns were identified through consultative Roundtable. These related to weaknesses in medicine registration and quality assurance systems, unclear and counterproductive pricing policies, irrational prescribing and sub-optimal drug availability. Available research, both locally and globally, fails to target most of the identified policy concerns, tending to concentrate on irrational prescriptions. It overlooks trans-disciplinary areas of policy effectiveness surveillance, consumer behavior, operational pilots and pricing interventions review. Conclusion Experience from Pakistan shows that policy concerns related to essential medicine access need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda. PMID:23717442

The Indigenous Red Ribbon Storytelling Study: What does it mean for Indigenous peoples living with HIV and a substance use disorder to access antiretroviral therapy in Saskatchewan?

PubMed

Nowgesic, Earl; Meili, Ryan; Stack, Sandra; Myers, Ted

2015-01-01

Indigenous peoples living with HIV are less likely than non-Indigenous peoples living with HIV to access antiretroviral therapy; however, there is not enough contextual information surrounding this issue. The Indigenous Red Ribbon Storytelling Study was conducted in part to examine how Indigenous peoples living with HIV construct and understand their experiences accessing antiretroviral therapy. Our study design was critical Indigenous qualitative research, using the Behavioral Model of Health Services Use and community-based participatory research approaches. The study was conducted in partnership with Indigenous and non-Indigenous organizations. Study participants were adults from two Canadian cities. The study methods included 20 individual and two Indigenous sharing circle interviews, six participant observation sessions, a short survey and thematic analysis. Accessing antiretroviral therapy within the context of living with a substance use disorder was an overarching theme. Indigenous peoples living with HIV felt they had to choose between living with their active substance use disorder and accessing antiretroviral therapy. They felt misunderstood as a person living with a substance use disorder and often felt coerced into using antiretroviral therapy. Despite these challenges, they persevered as Indigenous peoples living with HIV and a substance use disorder. Further research on antiretroviral therapy access among Indigenous peoples living with HIV and a substance use disorder, particularly from the perspective of health service providers, is needed.

Surfing for juvenile idiopathic arthritis: perspectives on quality and content of information on the Internet.

PubMed

Stinson, Jennifer N; Tucker, Lori; Huber, Adam; Harris, Heather; Lin, Carmen; Cohen, Lindsay; Gill, Navreet; Lukas-Bretzler, Jacqueline; Proulx, Laurie; Prowten, David

2009-08-01

To determine the quality and content of English language Internet information about juvenile idiopathic arthritis (JIA) from the perspectives of consumers and healthcare professionals. Key words relevant to JIA were searched across 10 search engines. Quality of information was appraised independently by 2 health professionals, 1 young adult with JIA, and a parent using the DISCERN tool. Concordance of the website content (i.e., accuracy and completeness) with available evidence about the management of JIA was determined. Readability was determined using Flesch-Kincaid grade level and Reading Ease Score. Out of the 3000 Web pages accessed, only 58 unique sites met the inclusion criteria. Of these sites only 16 had DISCERN scores above 50% (indicating fair quality). These sites were then rated by consumers. Most sites targeted parents and none were specifically developed for youth with JIA. The overall quality of website information was fair, with a mean DISCERN quality rating score of 48.92 out of 75 (+/- 6.56, range 34.0-59.5). Overall completeness of sites was 9.07 out of 16 (+/- 2.28, range 5.25-13.25) and accuracy was 3.09 out of 4 (+/- 0.86, range 2-4), indicating a moderate level of accuracy. Average Flesch-Kincaid grade level and Reading Ease Score were 11.48 (+/- 0.74, range 10.1-12.0) and 36.36 (+/- 10.86, range 6.30-48.1), respectively, indicating that the material was difficult to read. Our study highlights the paucity of high quality Internet health information at an appropriate reading level for youth with JIA and their parents.

Addressing key issues in the consanguinity-related risk of autosomal recessive disorders in consanguineous communities: lessons from a qualitative study of British Pakistanis.

PubMed

Darr, A; Small, N; Ahmad, W I U; Atkin, K; Corry, P; Modell, B

2016-01-01

Currently, there is no consensus regarding services required to help families with consanguineous marriages manage their increased genetic reproductive risk. Genetic services for communities with a preference for consanguineous marriage in the UK remain patchy, often poor. Receiving two disparate explanations of the cause of recessive disorders (cousin marriage and recessive inheritance) leads to confusion among families. Further, the realisation that couples in non-consanguineous relationships have affected children leads to mistrust of professional advice. British Pakistani families at-risk for recessive disorders lack an understanding of recessive disorders and their inheritance. Such an understanding is empowering and can be shared within the extended family to enable informed choice. In a three-site qualitative study of British Pakistanis, we explored family and health professional perspectives on recessively inherited conditions. Our findings suggest, firstly, that family networks hold strong potential for cascading genetic information, making the adoption of a family-centred approach an efficient strategy for this community. However, this is dependent on provision of high-quality and timely information from health care providers. Secondly, families' experience was of ill-coordinated and time-starved services, with few having access to specialist provision from Regional Genetics Services; these perspectives were consistent with health professionals' views of services. Thirdly, we confirm previous findings that genetic information is difficult to communicate and comprehend, further complicated by the need to communicate the relationship between cousin marriage and recessive disorders. A communication tool we developed and piloted is described and offered as a useful resource for communicating complex genetic information.

Quality of care, quality of life, and attitudes toward disabilities: perspectives from a qualitative focus group study in Porto Alegre, Brazil.

PubMed

Mattevi, Betina S; Bredemeier, Juliana; Fam, Cláudia; Fleck, Marcelo P

2012-03-01

To explore the concepts of quality of life (QOL), quality of care (QOC), and attitudes toward disabilities in Porto Alegre, Brazil, from the perspective of people living with disabilities, including their relatives and caregivers. This was a qualitative study that interviewed a total of 23 participants in five focus groups, during May-August 2006. After an open discussion about QOL, the WHOQOL-Bref, a generic questionnaire for the assessment of QOL, was presented to participants. The study was performed simultaneously in 15 international centers. Analysis was based on Bardin's content analysis. Regarding QOL, important themes that emerged were: work, education, leisure, universal accessibility, integration in the society, and social inclusion. Concerning QOC, professional qualifications, disabilities-related training for health and education professionals, and access to health services were considered important. Regarding attitudes toward disabilities, the participants perceived the attitudes of others, especially of caregivers, to significantly impact the QOL of people with disabilities. People living with disabilities value many of the same themes considered important by the general public; however, several additional themes specific to disabilities and specific to these groups of participants emerged. This information highlights the importance of taking into account the unique perceptions and cultural traits of the target population when measuring QOL, QOC, and attitudes toward disabilities.

An Investigation of Perspectives of Respite Admission Among People Living With Amyotrophic Lateral Sclerosis and the Hospitals That Support Them.

PubMed

Nakai, Michiko; Narita, Yugo; Tomimoto, Hidekazu

2017-07-01

Amyotrophic lateral sclerosis is a progressive disease with rapid degeneration. Respite care is an essential service for improving the well-being of both patients with this disease and their family caregivers, but accessibility of respite services is limited. This study investigates perspectives on respite admission among people living with amyotrophic lateral sclerosis and the hospitals supporting them. We conducted semistructured interviews among 3 patients with amyotrophic lateral sclerosis and 12 family members, exploring demographic information and their awareness and experience of respite admission. We also interviewed 16 representatives from hospitals about awareness of and preparation for respite admission for patients with this disease, the role of regional networks for intractable diseases, and knowledge about communication support schemes. We found significant differences in the revised Amyotrophic Lateral Sclerosis Functional Rating Scale between patients who had and had not received respite admission. Qualitative analysis of the data indicated that respite admission was a contributory factor in continuing and stabilizing home care. Limited provision of social services and hospital care quality were barriers to respite admission. Respite admission was essential to continued home care for patients with amyotrophic lateral sclerosis. Severe-stage patients were eligible for respite admission. Its accessibility, however, was limited, especially for patients living in rural areas. Supporting hospitals had limited capacity to respond to patients' needs. Individualized care and communication were internal barriers to respite admission.

Perspectives from the Patient and the Healthcare Professional in Multiple Sclerosis: Social Media and Patient Education.

PubMed

Kantor, Daniel; Bright, Jeremy R; Burtchell, Jeri

2018-06-01

A diagnosis of multiple sclerosis (MS) is life-altering. Because the course of MS is heterogeneous, patients may face uncertainty in terms of long-term physical and cognitive challenges, potential loss of employment, and the risk of social isolation. Patients often turn to the Internet and social media for information about MS and its management, and to seek out fellow patients and support groups. Here, we examine the use of social media and the Internet among patients with MS, considering its impact on patient education. We consider the access that these conduits provide not only to other patients with MS but also to a wealth of disease-related information online. These themes are further illustrated with first-hand experiences of the patient author and her physician. We also explore the impact of the Internet and social media on the education and support of patients with MS from the healthcare professional's (HCP's) perspective, including opportunities for HCPs to promote disease education among their patients, and the advantages that arise from patients being better informed about their disease. The rise of the Internet and social media has changed the patient experience, helping patients to support each other, to educate themselves proactively about their condition, and to participate more actively in decisions relating to disease management than perhaps was the case historically. Funding Novartis Pharmaceuticals Corporation.

The struggling student: a thematic analysis from the self-regulated learning perspective.

PubMed

Patel, Rakesh; Tarrant, Carolyn; Bonas, Sheila; Yates, Janet; Sandars, John

2015-04-01

Students who engage in self-regulated learning (SRL) are more likely to achieve academic success compared with students who have deficits in SRL and tend to struggle with academic performance. Understanding how poor SRL affects the response to failure at assessment will inform the development of better remediation. Semi-structured interviews were conducted with 55 students who had failed the final re-sit assessment at two medical schools in the UK to explore their use of SRL processes. A thematic analysis approach was used to identify the factors, from an SRL perspective, that prevented students from appropriately and adaptively overcoming failure, and confined them to a cycle of recurrent failure. Struggling students did not utilise key SRL processes, which caused them to make inappropriate choices of learning strategies for written and clinical formats of assessment, and to use maladaptive strategies for coping with failure. Their normalisation of the experience and external attribution of failure represented barriers to their taking up of formal support and seeking informal help from peers. This study identified that struggling students had problems with SRL, which caused them to enter a cycle of failure as a result of their limited attempts to access formal and informal support. Implications for how medical schools can create a culture that supports the seeking of help and the development of SRL, and improves remediation for struggling students, are discussed. © 2015 John Wiley & Sons Ltd.

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand

PubMed Central

2010-01-01

Background Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. Methods A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Results Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. Conclusions The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations. PMID:21138584

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand.

PubMed

Ameratunga, Shanthi; Abel, Sally; Tin Tin, Sandar; Asiasiga, Lanuola; Milne, Sharon; Crengle, Sue

2010-12-07

Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations.

Accessing Social Grants to Meet Orphan Children School Needs: Namibia and South Africa Perspective

ERIC Educational Resources Information Center

Taukeni, Simon; Matshidiso, Taole

2013-01-01

In this comparative paper we interrogate the access of social grants to meet orphan children school needs in Namibia and South Africa. We noted that the two governments are committed to provide orphan children with social grants to enable them to meet the school needs. However, accessing social grant to benefit most vulnerable orphan children…

Is French Immersion a Special Education Loophole? … And Does It Intensify Issues of Accessibility and Exclusion?

ERIC Educational Resources Information Center

Cobb, Cam

2015-01-01

What happens when children are asked to give up their right to special education in order to access a French immersion program? By examining one mother's efforts to secure gifted support in a French immersion program, this critical inquiry offers a parental perspective of the special education issues of accessibility and inclusion. The two…

New Technology and Digital Worlds: Analyzing Evidence of Equity in Access, Use, and Outcomes

ERIC Educational Resources Information Center

Warschauer, Mark; Matuchniak, Tina

2010-01-01

In this chapter, the authors take a broad perspective on how to analyze issues of technology and equity for youth in the United States. They begin with "access" as a starting point, but consider not only whether diverse groups of youth have digital media available to them but also how that access is supported or constrained by…

Cyber Charter Schools and Students with Dis/abilities: Rebooting the IDEA to Address Equity, Access, and Compliance

ERIC Educational Resources Information Center

Collins, Kathleen M.; Green, Preston C., III; Nelson, Steven L.; Madahar, Santosh

2015-01-01

This article takes up the question of equity, access, and cyber charter schools from the perspective of disability studies in education (DSE). DSE positions inclusion and educational access as social justice concerns. In doing so, we assert the importance of making visible the social justice implications of the current laws that impact cyber…

Science communication podcasting in Brazil: the potential and challenges depicted by two podcasts.

PubMed

Dantas-Queiroz, Marcos V; Wentzel, Lia C P; Queiroz, Luciano L

2018-01-01

Podcasts - online distributed audio files - are easy access and production media, which can be used for Scientific Communication (SC) but few are presented in Portuguese. The objective of this work is to perform a case study with data from a survey for two Brazilian SC podcasts (Dragões de Garagem and Fronteiras da Ciência) to evaluate the increase of science podcast media in Brazil, the involved potential, their advantages, shortcomings, and perspectives. We noted an increase of listeners over the years, probably due to the internet popularization and the massive increase of mobile phones. Scientific content is underexplored, despite the great interest of the public. Humorous and informal podcasts are the most appealing to the public and they usually listen to them on informal educational sites. The majority of the public is from the South and Southeast regions, they are young male adults with undergraduate or graduate degrees. SC podcasts, despite their potential to communicate science, still have shortcomings to overcome. Nevertheless, independent initiatives can solve this difficulty, making possible for the media to reach a varied audience, affecting different groups that would not have interest in a specific content before, or even the access itself to the scientific knowledge.

Prenatal whole exome sequencing: the views of clinicians, scientists, genetic counsellors and patient representatives.

PubMed

Quinlan-Jones, Elizabeth; Kilby, Mark D; Greenfield, Sheila; Parker, Michael; McMullan, Dominic; Hurles, Matthew E; Hillman, Sarah C

2016-10-01

Focus groups were conducted with individuals involved in prenatal diagnosis to determine their opinions relating to whole exome sequencing in fetuses with structural anomalies. Five representatives of patient groups/charities (PRGs) and eight clinical professionals (CPs) participated. Three focus groups occurred (the two groups separately and then combined). Framework analysis was performed to elicit themes. A thematic coding frame was identified based on emerging themes. Seven main themes (consent, analysis, interpretation/reinterpretation of results, prenatal issues, uncertainty, incidental findings and information access) with subthemes emerged. The main themes were raised by both groups, apart from 'analysis', which was raised by CPs only. Some subthemes were raised by PRGs and CPs (with different perspectives). Others were raised either by PRGs or CPs, showing differences in patient/clinician agendas. Prenatal consent for whole exome sequencing is not a 'perfect' process, but consent takers should be fully educated regarding the test. PRGs highlighted issues involving access to results, feeling that women want to know all information. PRGs also felt that patients want reinterpretation of results over time, whilst CPs felt that interpretation should be performed at the point of testing only. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

Social exchange as a framework for client-nurse interaction during public health nursing maternal-child home visits.

PubMed

Byrd, Mary E

2006-01-01

The purpose of this paper was to develop a nursing-focused use of social exchange theory within the context of maternal-child home visiting. The nature of social exchange theory, its application to client-nurse interaction, and its fit with an existing data set from a field research investigation were examined. Resources exchanged between the nurse and clients were categorized and compared across the patterns of home visiting, nursing strategies based on exchange notions were identified, and variations in exchange were linked with client outcomes. The nurse provided resources within the categories of information, status, service, and goods. Clients provided time, access to the home, space within the home to conduct the visit, opportunities to observe maternal-child interaction, access to the infant, and information. The ease and breadth of resource exchange varied across the patterns of home visiting. The social exchange perspective was useful in categorizing resources, specifying and uncovering new resource categories, understanding nursing strategies to initiate and maintain the client-nurse relationship, and linking client-nurse interactive phenomena with client outcomes. Social exchange theory is potentially useful for understanding client-nurse interaction in the context of maternal-child home visits.

'As many options as there are, there are just not enough for me': contraceptive use and barriers to access among Australian women.

PubMed

Dixon, Suzanne C; Herbert, Danielle L; Loxton, Deborah; Lucke, Jayne C

2014-10-01

A comprehensive life course perspective of women's experiences in obtaining and using contraception in Australia is lacking. This paper explores free-text comments about contraception provided by women born between 1973 and 1978 who participated in the Australian Longitudinal Study on Women's Health (ALSWH). The ALSWH is a national population-based cohort study involving over 40,000 women from three age groups, who are surveyed every three years. An initial search identified 1600 comments from 690 women across five surveys from 1996 (when they were aged 18-23 years) to 2009 (31-36 years). The analysis included 305 comments from 289 participants. Factors relating to experiences of barriers to access and optimal contraceptive use were identified and explored using thematic analysis. Five themes recurred across the five surveys as women aged: (i) side effects affecting physical and mental health; (ii) lack of information about contraception; (iii) negative experiences with health services; (iv) contraceptive failure; and (v) difficulty with accessing contraception. Side effects of hormonal contraception and concerns about contraceptive failure influence women's mental and physical health. Many barriers to effective contraception persist throughout women's reproductive lives. Further research is needed into reducing barriers and minimising negative experiences, to ensure optimal contraceptive access for Australian women.

Decreasing Health Disparities for People with Disabilities through Improved Communication Strategies and Awareness

PubMed Central

Sharby, Nancy; Martire, Katharine; Iversen, Maura D.

2015-01-01

Factors influencing access to health care among people with disabilities (PWD) include: attitudes of health care providers and the public, physical barriers, miscommunication, income level, ethnic/minority status, insurance coverage, and lack of information tailored to PWD. Reducing health care disparities in a population with complex needs requires implementation at the primary, secondary and tertiary levels. This review article discusses common barriers to health care access from the patient and provider perspective, particularly focusing on communication barriers and how to address and ameliorate them. Articles utilized in this review were published from 2005 to present in MEDLINE and CINAHL and written in English that focused on people with disabilities. Topics searched for in the literature include: disparities and health outcomes, health care dissatisfaction, patient-provider communication and access issues. Ineffective communication has significant impacts for PWD. They frequently believe that providers are not interested in, or sensitive to their particular needs and are less likely to seek care or to follow up with recommendations. Various strategies for successful improvement of health outcomes for PWD were identified including changing the way health care professionals are educated regarding disabilities, improving access to health care services, and enhancing the capacity for patient centered care. PMID:25809511

Wideband, mobile networking technologies

NASA Astrophysics Data System (ADS)

Hyer, Kevin L.; Bowen, Douglas G.; Pulsipher, Dennis C.

2005-05-01

Ubiquitous communications will be the next era in the evolving communications revolution. From the human perspective, access to information will be instantaneous and provide a revolution in services available to both the consumer and the warfighter. Services will be from the mundane - anytime, anywhere access to any movie ever made - to the vital - reliable and immediate access to the analyzed real-time video from the multi-spectral sensors scanning for snipers in the next block. In the former example, the services rely on a fixed infrastructure of networking devices housed in controlled environments and coupled to fixed terrestrial fiber backbones - in the latter, the services are derived from an agile and highly mobile ad-hoc backbone established in a matter of minutes by size, weight, and power-constrained platforms. This network must mitigate significant changes in the transmission media caused by millisecond-scale atmospheric temperature variations, the deployment of smoke, or the drifting of a cloud. It must mitigate against structural obscurations, jet wash, or incapacitation of a node. To maintain vital connectivity, the mobile backbone must be predictive and self-healing on both near-real-time and real-time time scales. The nodes of this network must be reconfigurable to mitigate intentional and environmental jammers, block attackers, and alleviate interoperability concerns caused by changing standards. The nodes must support multi-access of disparate waveform and protocols.

Consumer health organisations for chronic conditions: why do some people access them and others don’t?

PubMed

Sav, Adem; McMillan, Sara S; Kelly, Fiona; Whitty, Jennifer A; Kendall, Elizabeth; King, Michelle A; Wheeler, Amanda J

2014-10-01

Consumer health organisations (CHOs), which operate outside the mainstream healthcare system with a specific focus on supporting people to self-manage their health conditions, have become widespread. Yet, there has been little systematic research into CHOs, including their perceived benefits and barriers, which encourage or deter their access by people with a variety of chronic health conditions. This study explored the benefits of CHOs in self-management and also the barriers that inhibit their access, from the perspective of people with chronic conditions and their unpaid carers. In-depth, semi-structured interviews were completed with 97 participants across four regions of Australia. The sample included a high representation of people from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander people as well as non-indigenous Australians. Three inter-related themes were identified that represented the benefits of involvement and participation in CHOs: knowledge and information, connection and support and experiential learning. However, limited access pathways emerged as a barrier that inhibited a person’s entry into CHOs. Furthermore, the person’s beliefs and experiences about their own health condition(s) also inhibited their continued participation in CHO programmes. Although our findings confirm that CHOs are a valuable resource in alleviating the ‘work of being a patient’ for some people, there seems to be some barriers that prevent their full access and utilisation.Structured integration systems to increase the reliable delivery and accessibility of CHOs are needed to ensure that people who would benefit from accessing them can do so.

Historical Perspectives on the Current Education Reforms.

ERIC Educational Resources Information Center

Ravitch, Diane, Ed.; Vinovskis, Maris, Ed.

This document contains 14 individual papers by prominent scholars who provide a historical perspective on current educational reforms. The three essays in part 1 examine some of the major changes in educational development and reform. These include: (1) "Antiquarianism and American Education: Assimilation, Adjustment, Access" (Patricia Graham);…

Perspectives. Fall 2009

ERIC Educational Resources Information Center

PEPNet, 2009

2009-01-01

PEPNet's "Perspectives" is the collaborative newsletter of the four PEPNet regional centers. This newsletter combines each centers' individual strengths into a single resource that can be used on a national level. PEPNet's mission is to improve transition services and educational access for students who are deaf or hard of hearing, including those…

What Counts as Outcomes? Community Perspectives of an Engineering Partnership

ERIC Educational Resources Information Center

Reynolds, Nora Pillard

2014-01-01

This study explored the perspectives of community organization representatives and community residents about a partnership between a College of Engineering and a rural municipality in Nicaragua. The intended community outcomes described by university participants during interviews corresponded with tangible project outcomes, such as access to…

Internet and Computer Technology Hazards: Perspectives for Family Counselling.

ERIC Educational Resources Information Center

Oravec, Jo Ann

2000-01-01

Explores the social construction of the various computer hazards that households are encountering, such as computer addiction and children's access to on-line pornography. Discusses these issues in terms of constructivist counseling perspectives that are sensitive to cultural and environmental contexts. Outlines specific strategies for countering…

What's in Your Techno-Future? Vendors Share Their Views.

ERIC Educational Resources Information Center

Gerber, Carole

1995-01-01

Examines vendors' views on the future of CD-ROM technology. Topics include the library role, single point access, costs, tape backup, user-friendly library automation systems and databases, improved quality, the growth of Internet access, and perspectives on technology in schools. (AEF)

A concise history of central venous access.

PubMed

Beheshti, Michael V

2011-12-01

Central venous access has become a mainstay of modern interventional radiology practice. Its history has paralleled and enabled many current medical therapies. This short overview provides an interesting historical perspective of these increasingly common interventional procedures. Copyright © 2011 Elsevier Inc. All rights reserved.

Mining microarray data at NCBI's Gene Expression Omnibus (GEO)*.

PubMed

Barrett, Tanya; Edgar, Ron

2006-01-01

The Gene Expression Omnibus (GEO) at the National Center for Biotechnology Information (NCBI) has emerged as the leading fully public repository for gene expression data. This chapter describes how to use Web-based interfaces, applications, and graphics to effectively explore, visualize, and interpret the hundreds of microarray studies and millions of gene expression patterns stored in GEO. Data can be examined from both experiment-centric and gene-centric perspectives using user-friendly tools that do not require specialized expertise in microarray analysis or time-consuming download of massive data sets. The GEO database is publicly accessible through the World Wide Web at http://www.ncbi.nlm.nih.gov/geo.

Human System Integration: Regulatory Analysis

NASA Technical Reports Server (NTRS)

2005-01-01

This document was intended as an input to the Access 5 Policy Integrated Product team. Using a Human System Integration (HIS) perspective, a regulatory analyses of the FARS (specifically Part 91), the Airman s Information Manual (AIM) and the FAA Controllers Handbook (7110.65) was conducted as part of a front-end approach needed to derive HSI requirements for Unmanned Aircraft Systems (UAS) operations in the National Airspace System above FL430. The review of the above aviation reference materials yielded eighty-four functions determined to be necessary or highly desirable for flight within the Air Traffic Management System. They include categories for Flight, Communications, Navigation, Surveillance, and Hazard Avoidance.

Social Media as Catalyzer for Connected Health: Hype or Hope? Perspectives from IMIA Working Groups.

PubMed

Fernandez-Luque, Luis; Vilmarlund, Vivian; Borycki, Elizabeth; Schulz, Stefan; Kuziemsky, Craig; Marschollek, Michael; Kulikowski, Casimir A

2016-01-01

The Internet and social media are becoming ubiquitous technologies that are transforming the health sector. Social media has become an avenue for accessing, creating and sharing health information among patients and healthcare professionals. Furthermore, social media has become a key feature in many eHealth solutions, including wearable technologies, Big Data solutions, eLearning systems, Serious Games, Medical imaging, etc. These hyper-connected technologies are facilitating a paradigm shift towards more connected health. In this panel, representatives of different IMIA Working Groups will explore how both hope and hype contribute to social media's catalyzing role in creating connected health solutions.

ECONOMIC AND PUBLIC HEALTH IMPACTS OF POLICIES RESTRICTING ACCESS TO HEPATITIS C TREATMENT FOR MEDICAID PATIENTS

PubMed Central

Chidi, Alexis P.; Bryce, Cindy L.; Donohue, Julie; Fine, Michael J.; Landsittel, Doug; Myaskovsky, Larissa; Rogal, Shari; Switzer, Galen; Tsung, Allan; Smith, Kenneth

2016-01-01

INTRODUCTION Interferon-free hepatitis C treatment regimens are effective but very costly. The cost-effectiveness, budget and public health impacts of current Medicaid treatment policies restricting treatment to patients with advanced disease remain unknown. METHODS Using a Markov model, we compared two strategies for 45–55 year old Medicaid beneficiaries: (1) Current Practice - only advanced disease is treated before Medicare eligibility; and (2) Full Access – both early-stage and advanced disease are treated before Medicare eligibility. Patients could develop progressive fibrosis, cirrhosis or hepatocellular carcinoma, undergo transplantation, or die each year. Morbidity was reduced after successful treatment. We calculated the incremental cost-effectiveness ratio and compared the costs and public health effects of each strategy from the perspective of Medicare alone as well as the Centers for Medicare and Medicaid Services (CMS) perspective. We varied model inputs in one-way and probabilistic sensitivity analyses. RESULTS Full Access was less costly and more effective than Current Practice for all cohorts and perspectives, with differences in cost from $5,369–$11,960 and in effectiveness from 0.82–3.01 quality adjusted life-years). In a probabilistic sensitivity analysis, Full Access was cost saving in 93% of model iterations. Compared to Current Practice, Full Access averted 5,994 hepatocellular carcinoma cases and 121 liver transplants per 100,000 patients. CONCLUSIONS Current Medicaid policies restricting hepatitis C treatment to patients with advanced disease are more costly and less effective than unrestricted, full access strategies. Collaboration between state and federal payers may be needed to realize the full public health impact of recent innovations in hepatitis C treatment. PMID:27325324

Gaps in universal health coverage in Malawi: A qualitative study in rural communities

PubMed Central

2014-01-01

Background In sub-Saharan Africa, universal health coverage (UHC) reforms have often adopted a technocratic top-down approach, with little attention being paid to the rural communities’ perspective in identifying context specific gaps to inform the design of such reforms. This approach might shape reforms that are not sufficiently responsive to local needs. Our study explored how rural communities experience and define gaps in universal health coverage in Malawi, a country which endorses free access to an Essential Health Package (EHP) as a means towards universal health coverage. Methods We conducted a qualitative cross-sectional study in six rural communities in Malawi. Data was collected from 12 Focus Group Discussions with community residents and triangulated with 8 key informant interviews with health care providers. All respondents were selected through stratified purposive sampling. The material was tape-recorded, fully transcribed, and coded by three independent researchers. Results The results showed that the EHP has created a universal sense of entitlements to free health care at the point of use. However, respondents reported uneven distribution of health facilities and poor implementation of public-private service level agreements, which have led to geographical inequities in population coverage and financial protection. Most respondents reported affordability of medical costs at private facilities and transport costs as the main barriers to universal financial protection. From the perspective of rural Malawians, gaps in financial protection are mainly triggered by supply-side access-related barriers in the public health sector such as: shortages of medicines, emergency services, shortage of health personnel and facilities, poor health workers’ attitudes, distance and transportation difficulties, and perceived poor quality of health services. Conclusions Moving towards UHC in Malawi, therefore, implies the introduction of appropriate interventions to fill the financial protection gaps in the private sector and the access-related gaps in the public sector and/or an effective public-private partnership that completely integrates both sectors. Current universal health coverage reforms need to address context specific gaps and be carefully crafted to avoid creating a sense of universal entitlements in principle, which may not be effectively received by beneficiaries due to contextual and operational bottlenecks. PMID:24884788

Availability of information in Public Health on the Internet: An analysis of national health authorities in the Spanish-speaking Latin American and Caribbean countries.

PubMed

Novillo-Ortiz, David; Hernández-Pérez, Tony; Saigí-Rubió, Francesc

2017-04-01

Access to reliable and quality health information and appropriate medical advice can contribute to a dramatic reduction in the mortality figures of countries. The governments of the Americas are faced with the opportunity to continue working on this challenge, and their institutional presence on their websites should play a key role in this task. In a setting where the access to information is essential to both health professionals and citizens, it is relevant to analyze the role of national health authorities. Given that search engines play such a key role in the access to health information, it is important to specifically know - in connection to national health authorities - whether health information offered is easily available to the population, and whether this information is well-ranked in search engines. Quantitative methods were used to gather data on the institutional presence of national health authorities on the web. An exploratory and descriptive research served to analyze and interpret data and information obtained quantitatively from different perspectives, including an analysis by country, and also by leading causes of death. A total of 18 web pages were analyzed. Information on leading causes of death was searched on websites of national health authorities in the week of August 10-14, 2015. The probability of finding information of national health authorities on the 10 leading causes of death in a country, among the top 10 results on Google, is 6.66%. Additionally, ten out the 18 countries under study (55%) do not have information ranked among the top results in Google when searching for the selected terms. Additionally, a total of 33 websites represent the sources of information with the highest visibility for all the search strategies in each country on Google for the ten leading causes of death in a country. Two websites, the National Library of Medicine and Wikipedia, occur as a result with visibility in the total of eighteen countries of the sample. Taking into consideration that providing reliable and quality information on these topics to the population should be one of the priorities of national health authorities, these results suggest that national health authorities need to take measures to try to better position their contents. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level.

PubMed

O'Connell, Thomas S; Bedford, K Juliet A; Thiede, Michael; McIntyre, Di

2015-06-09

A key element of the global drive to universal health coverage is ensuring access to needed health services for everyone, and to pursue this goal in an equitable way. This requires concerted efforts to reduce disparities in access through understanding and acting on barriers facing communities with the lowest utilisation levels. Financial barriers dominate the empirical literature on health service access. Unless the full range of access barriers are investigated, efforts to promote equitable access to health care are unlikely to succeed. This paper therefore focuses on exploring the nature and extent of non-financial access barriers. We draw upon two structured literature reviews on barriers to access and utilization of maternal, newborn and child health services in Ghana, Bangladesh, Vietnam and Rwanda. One review analyses access barriers identified in published literature using qualitative research methods; the other in published literature using quantitative analysis of household survey data. We then synthesised the key qualitative and quantitative findings through a conjoint iterative analysis. Five dominant themes on non-financial access barriers were identified: ethnicity; religion; physical accessibility; decision-making, gender and autonomy; and knowledge, information and education. The analysis highlighted that non-financial factors pose considerable barriers to access, many of which relate to the acceptability dimension of access and are challenging to address. Another key finding is that quantitative research methods, while yielding important findings, are inadequate for understanding non-financial access barriers in sufficient detail to develop effective responses. Qualitative research is critical in filling this gap. The analysis also indicates that the nature of non-financial access barriers vary considerably, not only between countries but also between different communities within individual countries. To adequately understand access barriers as a basis for developing effective strategies to address them, mixed-methods approaches are required. From an equity perspective, communities with the lowest utilisation levels should be prioritised and the access barriers specific to that community identified. It is, therefore, critical to develop approaches that can be used at the district level to diagnose and act upon access barriers if we are to pursue an equitable path to universal health coverage.

Multilevel Perspectives on Female Sterilization in Low-Income Communities in Mumbai, India.

PubMed

Brault, Marie A; Schensul, Stephen L; Singh, Rajendra; Verma, Ravi K; Jadhav, Kalpita

2016-09-01

Surgical sterilization is the primary method of contraception among low-income women in India. This article, using qualitative analysis of key informant, in-depth interviews, and quantitative analyses, examines the antecedents, process, and outcomes of sterilization for women in a low-income area in Mumbai, India. Family planning policies, socioeconomic factors, and gender roles constrain women's reproductive choices. Procedures for sterilization rarely follow protocol, particularly during pre-procedure counseling and consent. Women who choose sterilization often marry early, begin conceiving soon after marriage, and reach or exceed ideal family size early due to problems in accessing reversible contraceptives. Despite these constraints, this study indicates that from the perspective of women, the decision to undergo sterilization is empowering, as they have fulfilled their reproductive duties and can effectively exercise control over their fertility and sexuality. This empowerment results in little post-sterilization regret, improved emotional health, and improved sexual relationships following sterilization. © The Author(s) 2015.

Advancing nursing practice through social media: a global perspective.

PubMed

Barry, Jean; Hardiker, Nicholas R

2012-08-14

Social media has been used globally as a key vehicle for communication. As members of an innovative profession, many nurses have embraced social media and are actively utilizing its potential to enhance practice and improve health. The ubiquity of the Internet provides social media with the potential to improve both access to health information and services and equity in health care. Thus there are a number of successful nurse-led initiatives. However, the open and democratising nature of social media creates a number of potential risks, both individual and organisational. This article considers the use of social media within nursing from a global perspective, including discussion of policy and guidance documents. The impact of social media on both healthcare consumers and nurses is reviewed, followed by discussion of selected risks associated with social media. To help nurses make the most of social media tools and avoid potential pitfalls, the article conclusion suggests implications appropriate for global level practice based on available published guidance.

Combat veterans and the death penalty: a forensic neuropsychiatric perspective.

PubMed

Wortzel, Hal S; Arciniegas, David B

2010-01-01

With our nation's present conflicts, a new generation of veterans are returning home, many of whom have substantial psychopathology and are encountering significant barriers in accessing care. Headlines from around the nation reflect that some of these wounded warriors go on to commit offenses that are potentially punishable by death. Existing circumstances speak to the urgency with which the subject of combat veterans with post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), or both facing capital crimes ought to be addressed. This publicity has led to a recent call for a legislatively or judicially enacted, narrow, categorical exclusion for combat veterans who were affected by either PTSD or TBI at the time of their capital offenses. In the present article, we illustrate the reality that combat veterans who commit capital offenses may face execution, summarize legal arguments offered in favor of a categorical exclusion, and provide a neuropsychiatric perspective on PTSD, TBI, and aggression, to help inform further dialogue on this weighty subject.

A study of general practitioners' perspectives on electronic medical records systems in NHSScotland.

PubMed

Bouamrane, Matt-Mouley; Mair, Frances S

2013-05-21

Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs' perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees' responses, using Normalisation Process Theory as the underpinning conceptual framework. The majority of GPs' interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities - for example: in relation to usability, system navigation and information visualisation. Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs' interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors.

A study of general practitioners’ perspectives on electronic medical records systems in NHSScotland

PubMed Central

2013-01-01

Background Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. Methods We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs’ perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees’ responses, using Normalisation Process Theory as the underpinning conceptual framework. Results The majority of GPs’ interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities – for example: in relation to usability, system navigation and information visualisation. Conclusion Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs’ interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors. PMID:23688255

"We don't know her history, her background": adoptive parents' perspectives on whole genome sequencing results.

PubMed

Crouch, Julia; Yu, Joon-Ho; Shankar, Aditi G; Tabor, Holly K

2015-02-01

Exome sequencing and whole genome sequencing (ES/WGS) can provide parents with a wide range of genetic information about their children, and adoptive parents may have unique issues to consider regarding possible access to this information. The few papers published on adoption and genetics have focused on targeted genetic testing of children in the pre-adoption context. There are no data on adoptive parents' perspectives about pediatric ES/WGS, including their preferences about different kinds of results, and the potential benefits and risks of receiving results. To explore these issues, we conducted four exploratory focus groups with adoptive parents (N = 26). The majority lacked information about their children's biological family health history and ancestry, and many viewed WGS results as a way to fill in these gaps in knowledge. Some expressed concerns about protecting their children's future privacy and autonomy, but at the same time stated that WGS results could possibly help them be proactive about their children's health. A few parents expressed concerns about the risks of WGS in a pre-adoption context, specifically about decreasing a child's chance of adoption. These results suggest that issues surrounding genetic information in the post-adoption and ES/WGS contexts need to be considered, as well as concerns about risks in the pre-adoption context. A critical challenge for ES/WGS in the context of adoption will be balancing the right to know different kinds of genetic information with the right not to know. Specific guidance for geneticists and genetic counselors may be needed to maximize benefits of WGS while minimizing harms and prohibiting misuse of the information in the adoption process.

“We don’t know her history, her background”: Adoptive parents’ perspectives on whole genome sequencing results

PubMed Central

Crouch, Julia; Yu, Joon-Ho; Shankar, Aditi G.; Tabor, Holly K.

2014-01-01

Exome sequencing and whole genome sequencing (ES/WGS) can provide parents with a wide range of genetic information about their children, and adoptive parents may have unique issues to consider regarding possible access to this information. The few papers published on adoption and genetics have focused on targeted genetic testing of children in the pre-adoption context. There are no data on adoptive parent perspectives about pediatric ES/WGS, including their preferences about different kinds of results, and the potential benefits and risks of receiving results. To explore these issues, we conducted four exploratory focus groups with adoptive parents (N=26). The majority lacked information about their children’s biological family health history and ancestry, and many viewed WGS results as a way to fill in these gaps in knowledge. Some expressed concerns about protecting their children’s future privacy and autonomy, but at the same time stated that WGS results could possibly help them be proactive about their children’s health. A few parents expressed concerns about the risks of WGS in a pre-adoption context, specifically about decreasing a child’s chance of adoption. These results suggest that issues surrounding genetic information in the post-adoption and ES/WGS contexts need to be considered, as well as concerns about risks in the pre-adoption context. A critical challenge for ES/WGS in the context of adoption will be balancing the right to know different kinds of genetic information with the right not to know. Specific guidance for geneticists and genetic counselors may be needed to maximize benefits of WGS while minimizing harms and prohibiting misuse of the information in the adoption process. PMID:25011977

An information model to support user-centered design of medical devices.

PubMed

Hagedorn, Thomas J; Krishnamurty, Sundar; Grosse, Ian R

2016-08-01

The process of engineering design requires the product development team to balance the needs and limitations of many stakeholders, including those of the user, regulatory organizations, and the designing institution. This is particularly true in medical device design, where additional consideration must be given for a much more complex user-base that can only be accessed on a limited basis. Given this inherent challenge, few projects exist that consider design domain concepts, such as aspects of a detailed design, a detailed view of various stakeholders and their capabilities, along with the user-needs simultaneously. In this paper, we present a novel information model approach that combines a detailed model of design elements with a model of the design itself, customer requirements, and of the capabilities of the customer themselves. The information model is used to facilitate knowledge capture and automated reasoning across domains with a minimal set of rules by adopting a terminology that treats customer and design specific factors identically, thus enabling straightforward assessments. A uniqueness of this approach is that it systematically provides an integrated perspective on the key usability information that drive design decisions towards more universal or effective outcomes with the very design information impacted by the usability information. This can lead to cost-efficient optimal designs based on a direct inclusion of the needs of customers alongside those of business, marketing, and engineering requirements. Two case studies are presented to show the method's potential as a more effective knowledge management tool with built-in automated inferences that provide design insight, as well as its overall effectiveness as a platform to develop and execute medical device design from a holistic perspective. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality of life and economic burdens of malocclusion in U.S. patients enrolled in Medicaid.

PubMed

Bresnahan, Brian W; Kiyak, H Asuman; Masters, Samuel H; McGorray, Susan P; Lincoln, Adam; King, Gregory

2010-10-01

Patients enrolled in Medicaid have limited access to orthodontic services in the United States. No studies are available, to the authors' knowledge, regarding the clinical and psychosocial burdens of malocclusion on these patients from an economic perspective. The authors conducted a systematic review of the relevant economic literature. They identified issues from the perspectives of the various stakeholders (dentists, patients and parents, Medicaid programs) and developed a conceptual model for studying decision making focused on the strategy of providing early interceptive and preventive treatment rather than, or in addition to, comprehensive care in the patient's permanent dentition. Medicaid coverage and reimbursement amounts vary nationwide, and decision making associated with obtaining care can be complex. The perspectives of all relevant stakeholders deserve assessment. A conceptual framework of the cost-effectiveness of interceptive orthodontic treatment compared with comprehensive treatment illustrates the issues to be considered when evaluating these strategies. Policymakers and the dental community should identify creative solutions to addressing low-income families' limited access to orthodontic services and compare them from various perspectives with regard to their relative cost-effectiveness. Dentists should be aware of the multiple problems faced by low-income families in obtaining orthodontic services and the impact of stakeholder issues on access to care; they also should be proactive in helping low-income patients obtain needed orthodontic services.

PERSPECTIVE WITH LEANTO, LOOKING NORTHWEST. The leanto on the west ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PERSPECTIVE WITH LEAN-TO, LOOKING NORTHWEST. The lean-to on the west façade was removed after it collapsed in severe weather in the late 1990s. The access drive leads to South Fort Casey Road. - Boyer Farm, Barn, 711 South Fort Casey Road, Coupeville, Island County, WA

Higher Education: Access, Experiences, and Outcomes

ERIC Educational Resources Information Center

Lehmann, Wolfgang

2017-01-01

This article reviews three books: (1) "Access to Higher Education: Theoretical Perspectives and Contemporary Challenges" (edited by A. Mountford-Zimdars and N. Harrison); (2) "Student Lives in Crisis: Deepening Inequality in Times of Austerity" (L. Antonucci); and (3) "Higher Education, Social Class and Social Mobility:…

Critical Social Theories. 2nd Edition

ERIC Educational Resources Information Center

Agger, Ben

2006-01-01

Praised for its clarity and accessibility, this fully updated edition of "Critical Social Theories" presents a comprehensive analysis of leading social and cultural theories today. Diverse perspectives are addressed from feminism and cultural studies to postmodernism and critical theory. Written accessibly for students and faculty, the second…

Educating Librarians and Information Resource Managers: Differing Management Perspectives?

ERIC Educational Resources Information Center

Bouthillier, France

1993-01-01

Examines differences between library management and information resource management (IRM). Highlights include a historical perspective of library management education and IRM; the organizational perspective of library management and the emphasis of information as a resource in IRM; library management and advances in information technology; and…

A Study on the Perceptions About Potential Advantages of FMS (Foreign Military Sales) and Commercial Sales: Seller and Buyer Perspectives

DTIC Science & Technology

1987-09-01

SFl WILE coP DTIC ELECTEI DEC0 419871 OFD IIN A STUDY ON THE PERCEPTIONS ABOUT COMMERCIAL SALES: SELLER ANDI • BUYER PERSPECTIVES THESIS Yong Sang Kim...PERCEPTIONS ABOUT H𔃾 POTENTIAL ADVANTAGES OF FMS AND COMMERCIAL SALES: SELLER AND BUYER PERSPECTIVES THESIS Accession For Yong Sang Kim NTIS ,RA&I Major...AND COMMERCIAL SALES: SELLER AND BUYER PERSPECTIVES THESIS Presented to the Faculty of the School of Systems and Logistics of the Air Force Institute

Biomedical device interfacing to clinical information systems: a primer.

PubMed

Moorman, Bridget

2008-01-01

I am pleased that we get to take advantage of Bridget Moorman's background, experience, and perspective in this installment of IT World. One of the most nerve-racking tasks we run into these days is getting disparate medical devices to talk to each other over a network. This is especially so if the device you're trying to communicate with doesn't support network connectivity. Bridget shares her experience here not only with a great high-level view of network interfacing, but also with references to dig into all the grim details. She shows us a lot of facets to consider when assembling such a network. You've got to convert to hit the ramp then translate and aggregate before gaining access to the clinical information system cloud. If that doesn't make sense, read on! -Jeff Kabachinski, IT World columnist.

30th Annual Drug Information Association (DIA) Europe 2018 (April 17-19, 2018 - Basel, Switzerland).

PubMed

Hamaui Cuadrado, S; Guinart Vidal, M

2018-05-01

The Drug Information Association (DIA) Europe held its annual meeting from April 17-19, 2018, in Basel, Switzerland. The key topics discussed in the 3-day meeting were related to pharmacovigilance, clinical development, patient engagement, data and data standards, preclinical development and early-phase clinical research, regulatory science, translational medicine and science, and value and access. The program was principally focused on the current opportunities and future landscape of the healthcare system as a result of the increasingly innovative technologies and effective utilization of big data. In addition, the critical need for collaboration and partnership between all the stakeholders of the healthcare system was highlighted. This report covers some of the regulatory sessions presented at the meeting in which regulators, payers, industry and patients presented their perspectives for discussion. Copyright 2018 Clarivate Analytics.

The creation and dissemination of downloadable information on dementia and driving from a social health perspective.

PubMed

Arai, Yumiko; Arai, Asuna; Mizuno, Yoko; Kamimura, Naoto; Ikeda, Manabu

2017-07-01

Driving cessation is a likely consequence of progressive dementia. Patients and families can benefit from support through this transition, both to safeguard the patient and public and to help preserve healthy social activity of the patient. To provide appropriate supportive information, we developed a 35-page manual ('Supporting family caregivers of older drivers with dementia') available as a free download from our department website. We then informed municipal governments of its availability, tracked website access metrics, and followed up 7 months later with a postal survey to the heads of each municipal government's department of welfare for older citizens. From February to September 2010, the manual was accessed 33 494 times. Of the 1750 municipalities sent surveys, we received 1067 responses (61%). The responses showed that 943 professionals (94.6%) were able to obtain information they needed from the manual, 247 (23%) had used the manual to help residents during the 7 months, and 89% of those who used the manual used it to provide relevant advice to family caregivers. The responses also showed that significantly more use occurred in towns and villages as opposed to cities, consistent with the limited public transportation options in smaller municipalities (P = 0.002). We anticipate that use of this manual will raise general awareness of this social health issue and facilitate collaborations to provide more social support for those with dementia and their family members. © 2017 Japanese Psychogeriatric Society.

Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study.

PubMed

Digiacomo, Michelle; Davidson, Patricia M; Taylor, Kate P; Smith, Julie S; Dimer, Lyn; Ali, Mohammed; Wood, Marianne M; Leahy, Timothy G; Thompson, Sandra C

2010-01-01

Aboriginal Australians have low rates of participation in cardiac rehabilitation (CR), despite having high rates of cardiovascular disease. Barriers to CR participation reflect multiple patient-related issues. However, an examination of the broader context of health service delivery design and implementation is needed. To identify health professionals' perspectives of systems related barriers to implementation of the National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples. Semi-structured interviews were conducted with health professionals involved in CR within mainstream and Aboriginal Community Controlled Health Services in Western Australia (WA). Thirty-eight health professionals from 17 services (ten rural, seven metropolitan) listed in the WA Directory of CR services and seven Aboriginal Medical Services in WA were interviewed. Respondents reported barriers encountered in health information management and the impact of access to CR services for Aboriginal people. Crucial issues identified by participants were: poor communication across the health care sector and between providers, inconsistent and insufficient data collection processes (particularly relating to Aboriginal ethnicity identification), and challenges resulting from multiple clinical information systems and incompatible technologies. This study has demonstrated that inadequate information systems and communication strategies, particularly those representing the interface between primary and secondary care, contribute to the low participation rates of Aboriginal Australians in CR. Although these challenges are shared by non-Aboriginal Australians, the needs are greater for Aboriginal Australians and innovative solutions are required.

The media and access issues: content analysis of Canadian newspaper coverage of health policy decisions.

PubMed

Rachul, Christen; Caulfield, Timothy

2015-08-25

Previous studies have demonstrated how the media has an influence on policy decisions and healthcare coverage. Studies of Canadian media have shown that news coverage often emphasizes and hypes certain aspects of high profile health debates. We hypothesized that in Canadian media coverage of access to healthcare issues about therapies and technologies including for rare diseases, the media would be largely sympathetic towards patients, thus adding to public debate that largely favors increased access to healthcare-even in the face of equivocal evidence regarding efficacy. In order to test this hypothesis, we conducted a content analysis of 530 news articles about access to health therapies and technologies from 15 major Canadian newspapers over a 10-year period. Articles were analyzed for the perspectives presented in the articles and the types of reasons or arguments presented either for or against the particular access issue portrayed in the news articles. We found that news media coverage was largely sympathetic towards increasing healthcare funding and ease of access to healthcare (77.4 %). Rare diseases and orphan drugs were the most common issues raised (22.6 %). Patients perspectives were often highlighted in articles (42.3 %). 96.8 % of articles discussed why access to healthcare needs to increase, and discussion that questioned increased access was only included in 33.6 % articles. We found that news media favors a patient access ethos, which may contribute to a difficult policy-making environment.

Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives’ perspectives

PubMed Central

Otero-Garcia, Laura; Goicolea, Isabel; Gea-Sánchez, Montserrat; Sanz-Barbero, Belen

2013-01-01

Background There is insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. Objectives The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. Design A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ) of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives’ perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Results Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Conclusions Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy terminations, and the delay in the first prenatal visit, as discerned by midwives. Future research should involve samples of immigrant women themselves, to provide a deeper understanding of the current knowledge, attitudes, and practices of the immigrant population regarding reproductive and sexual health to provide better health services. PMID:24206651

Arctic Climate Change, Economy and Society (ACCESS): Integrated perspectives.

PubMed

Crépin, Anne-Sophie; Karcher, Michael; Gascard, Jean-Claude

2017-12-01

This introduction to the special issue presents an overview of the wide range of results produced during the European Union project Arctic Climate Change, Economy and Society (ACCESS). This project assessed the main impacts of climate change on Arctic Ocean's geophysical variables and how these impending changes could be expected to impact directly and indirectly on socio-economic activities like transportation, marine sea food production and resource exploitation. Related governance issues were examined. These results were used to develop several management tools that can live on beyond ACCESS. In this article, we synthesize most of the project results in the form of tentative responses to questions raised during the project. By doing so, we put the findings of the project in a broader perspective and introduce the contributions made in the different articles published in this special issue.

Clinical and Insurance Perspectives on Intermediate Levels of Care in Psychiatry.

PubMed

Plakun, Eric M

2018-03-01

This column compares a clinical perspective on the continuum of care for mental health and substance use disorders with a different perspective derived from publicly available insurance company documents and experience dealing with managed care utilization reviewers. The latter perspective tends to determine the need for access to levels of care based on the need for crisis stabilization, whereas the generally accepted clinical standard is more nuanced than the need for crisis stabilization alone. The column proposes that this discrepancy in perspectives makes a substantial contribution to disagreements between treating clinicians, such as therapists, and insurance utilization reviewers concerning the medical necessity of various requested levels of care.

How Often Are Drugs Made Available Under the Food and Drug Administration's Expanded Access Process Approved?

PubMed

McKee, Amy E; Markon, André O; Chan-Tack, Kirk M; Lurie, Peter

2017-10-01

In this review of individual patient expanded-access requests to the Center for Drug Evaluation and Research for the period Fiscal Year 2010 to Fiscal Year 2014, we evaluated the number of applications received and the number allowed to proceed. We also evaluated whether drugs and certain biologics obtained under expanded access went on to be approved by the Food and Drug Administration. Finally, we considered concerns that adverse events occurring during expanded access might place sponsors at risk for legal liability. Overall, 98% of individual patient expanded-access requests were allowed to proceed. During the study period, among drugs without a previous approval for any indication or dosage form, 24% of unique drugs (ie, multiple applications for access to the same drug were considered to relate to 1 unique drug), and 20% of expanded-access applications received marketing approval by 1 year after initial submission; 43% and 33%, respectively, were approved by 5 years after initial submission. A search of 3 legal databases and a database of news articles did not appear to identify any product liability cases arising from the use of a product in expanded access. Our analyses seek to give physicians and patients a realistic perspective on the likelihood of a drug's approval as well as certain information regarding the product liability risks for commercial sponsors when providing expanded access to investigational drugs. The US Food and Drug Administration (FDA)'s expanded-access program maintains a careful balance between authorizing patient access to potentially beneficial drugs and protecting them from drugs that may have unknown risks. At the same time, the agency wishes to maintain the integrity of the clinical trials process, ultimately the best way to get safe and effective drugs to patients. © 2017, The American College of Clinical Pharmacology.

Information literacy during entry to practice: information-seeking behaviors in student nurses and recent nurse graduates.

PubMed

Wahoush, Olive; Banfield, Laura

2014-02-01

The ability to locate information pertinent to guide clinical practice is important for quality nursing care and patient safety. To date, little is known about the transfer of information literacy skills as student nurses transition to clinical practice as new graduates. This study begins to address this gap from the perspective of student nurses, recent nurse graduates (RNs), nurse leaders and library staff. To describe the information-seeking behaviors of student nurses and RNs within their clinical settings. This is a descriptive study that included both cross-sectional surveys and key informant interviews. Participants were senior-level undergraduate students and recently graduated RNs (graduated since 2008), and nurse leaders and library staff employed in one of the clinical sites accepting undergraduate students from the McMaster Mohawk and Conestoga BScN program. The study was completed in two large hospital corporations in Hamilton, Ontario, Canada. Student nurses and RNs were invited to complete online surveys to assess their access to and use of information sources and resources within clinical practice. Students completed a survey comprised of five open-ended questions, while RNs completed a survey comprised of 13 fixed choice and open-ended questions. Nurse leaders and library staff participated in qualitative interviews to verify the extent and availability of information resources. Eighteen RNs and 62 students completed their respective surveys. Three categories of information sources and resources were identified: electronic, print and interpersonal. Electronic sources of information were the most used resource by both students and RNs. More RNs reported using interpersonal sources, while students reported using more print sources of information. Recent RN graduates meet the Canadian Association of Schools of Nursing performance indicators related to information access for the entry to practice Nursing Informatics competencies. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Does small equal predatory? Analysis of publication charges and transparency of editorial policies in Croatian open access journals.

PubMed

Stojanovski, Jadranka; Marušić, Ana

2017-06-15

We approach the problem of "predatory" journals and publishers from the perspective of small scientific communities and small journals that may sometimes be perceived as "predatory". Among other characteristics of "predatory" journals two most relevant are their business model and the quality of the editorial work. We analysed 444 Croatian open access (OA) journals in the Hrčak (portal of Croatian scientific journals) digital journal repository for the presence of article processing charges as a business model and the transparency of editorial policies. The majority of journals do not charge authors or require submission or article processing charges, which clearly distinguishes them from "predatory" journals. Almost all Hrčak OA journals have publicly available information on editorial boards, including full names and affiliations, and detailed contact information for the editorial office at the Hrčak website. The journal names are unique and cannot be easily confused with another journal or intend to mislead about the journal's origin. While most journals provide information on peer review process, many do not provide guidelines for reviewers or other editorial and publication ethics standards. In order to clearly differentiate themselves from predatory journals, it is not enough for journals from small research communities to operate on non-commercial bases, but also to have transparent editorial policies.

Does small equal predatory? Analysis of publication charges and transparency of editorial policies in Croatian open access journals

PubMed Central

Stojanovski, Jadranka; Marušić, Ana

2017-01-01

Introduction We approach the problem of "predatory" journals and publishers from the perspective of small scientific communities and small journals that may sometimes be perceived as "predatory". Among other characteristics of "predatory" journals two most relevant are their business model and the quality of the editorial work. Materials and methods We analysed 444 Croatian open access (OA) journals in the Hrčak (portal of Croatian scientific journals) digital journal repository for the presence of article processing charges as a business model and the transparency of editorial policies. Results The majority of journals do not charge authors or require submission or article processing charges, which clearly distinguishes them from “predatory” journals. Almost all Hrčak OA journals have publicly available information on editorial boards, including full names and affiliations, and detailed contact information for the editorial office at the Hrčak website. The journal names are unique and cannot be easily confused with another journal or intend to mislead about the journal’s origin. While most journals provide information on peer review process, many do not provide guidelines for reviewers or other editorial and publication ethics standards. Conclusion In order to clearly differentiate themselves from predatory journals, it is not enough for journals from small research communities to operate on non-commercial bases, but also to have transparent editorial policies. PMID:28694721

Fair Access to Higher Education: Global Perspectives

ERIC Educational Resources Information Center

Mountford-Zimdars, Anna, Ed.; Sabbagh, Daniel, Ed.; Post, David, Ed.

2015-01-01

What does "fairness" mean internationally in terms of access to higher education? Increased competition for places in elite universities has prompted a worldwide discussion regarding the fairness of student admission policies. Despite budget cuts from governments--and increasing costs for students--competition is fierce at the most…

Everyday Inclusive Web Design: An Activity Perspective

ERIC Educational Resources Information Center

Kane, Shaun K.

2007-01-01

Introduction: Website accessibility is a problem that affects millions of people with disabilities. While most current accessibility initiatives target government or commercial sites, a growing segment of online content is being created by non-professionals. This content is often inaccessible to users with disabilities. Everyday inclusive Web…

Deja Vu--The Access/Success Pendulum

ERIC Educational Resources Information Center

Gandara, Patricia; Orfield, Gary

2010-01-01

In education, reform tends to follow cycles, often bouncing from one extreme to another without considering the possibility of incorporating multiple perspectives simultaneously. Policies aimed at helping more underrepresented students enter college and complete degrees have bounced from one pole to another, embracing access as the primary goal…

Telepharmacy: a pharmacist’s perspective on the clinical benefits and challenges

PubMed Central

Poudel, Arjun; Nissen, Lisa M

2016-01-01

The use of information and telecommunication technologies has expanded at a rapid rate, which has a strong influence on healthcare delivery in many countries. Rural residents and communities, however, often lack easy access to healthcare services due to geographical and demographical factors. Telepharmacy, a more recent concept that refers to pharmaceutical service provision, enables healthcare services, such as medication review, patients counseling, and prescription verification, by a qualified pharmacist for the patients located at a distance from a remotely located hospital, pharmacy, or healthcare center. Telepharmacy has many recognizable benefits such as the easy access to healthcare services in remote and rural locations, economic benefits, patient satisfaction as a result of medication access and information in rural areas, effective patient counseling, and minimal scarcity of local pharmacist and pharmacy services. Telepharmacy undoubtedly is a great concept, but it is sometimes challenging to put into practice. Inherent to the adoption of these practices are legal challenges and pitfalls that need to be addressed. The start-up of telepharmacy (hardware, software, connectivity, and operational cost) involves considerable time, effort, and money. For rural hospitals with fewer patients, the issue of costs appears to be one of the biggest barriers to telepharmacy services. Moreover, execution and implementation of comprehensive and uniform telepharmacy law is still a challenge. A well-developed system, however, can change the practice of pharmacy that is beneficial to both the rural communities and the hospitals or retail pharmacies that deliver these services. PMID:29354542

Deaf New Zealand Sign Language users' access to healthcare.

PubMed

Witko, Joanne; Boyles, Pauline; Smiler, Kirsten; McKee, Rachel

2017-12-01

The research described was undertaken as part of a Sub-Regional Disability Strategy 2017-2022 across the Wairarapa, Hutt Valley and Capital and Coast District Health Boards (DHBs). The aim was to investigate deaf New Zealand Sign Language (NZSL) users' quality of access to health services. Findings have formed the basis for developing a 'NZSL plan' for DHBs in the Wellington sub-region. Qualitative data was collected from 56 deaf participants and family members about their experiences of healthcare services via focus group, individual interviews and online survey, which were thematically analysed. Contextual perspective was gained from 57 healthcare professionals at five meetings. Two professionals were interviewed, and 65 staff responded to an online survey. A deaf steering group co-designed the framework and methods, and validated findings. Key issues reported across the health system include: inconsistent interpreter provision; lack of informed consent for treatment via communication in NZSL; limited access to general health information in NZSL and the reduced ability of deaf patients to understand and comply with treatment options. This problematic communication with NZSL users echoes international evidence and other documented local evidence for patients with limited English proficiency. Deaf NZSL users face multiple barriers to equitable healthcare, stemming from linguistic and educational factors and inaccessible service delivery. These need to be addressed through policy and training for healthcare personnel that enable effective systemic responses to NZSL users. Deaf participants emphasise that recognition of their identity as members of a language community is central to improving their healthcare experiences.

Towards accessible integrated palliative care: Perspectives of leaders from seven European countries on facilitators, barriers and recommendations for improvement.

PubMed

den Herder-van der Eerden, Marlieke; Ewert, Benjamin; Hodiamont, Farina; Hesse, Michaela; Hasselaar, Jeroen; Radbruch, Lukas

2017-01-01

Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice. A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis. IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems. Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.

Knowledge deficit of patients with stage 1-4 CKD: a focus group study.

PubMed

Lopez-Vargas, Pamela A; Tong, Allison; Phoon, Richard K S; Chadban, Steven J; Shen, Yvonne; Craig, Jonathan C

2014-04-01

Patients with early-stage chronic kidney disease (CKD) must make lifestyle modifications and adhere to treatment regimens to prevent their progression to end-stage kidney disease. The aim of this study was to elicit the perspectives of patients with stage 1-4 CKD about their disease, with a specific focus on their information needs in managing and living with CKD and its sequelae. Patients with CKD stages 1-4 were purposively sampled from three major hospitals in Sydney, Australia to participate in focus groups. Transcripts were thematically analysed. From nine focus groups including 38 participants, six major themes were identified: medical attentiveness (shared decision-making, rapport, indifference and insensitivity); learning self-management (diet and nutrition, barriers to physical activity, medication safety); contextualizing comorbidities (prominence of CKD, contradictory treatment); prognostic uncertainty (hopelessness, fear of disease progression, disbelief regarding diagnosis); motivation and coping mechanisms (engage in research, pro-active management, optimism, feeling normal); and knowledge gaps (practical advice, access to information, comprehension of pathology results and CKD diagnosis, education for general practitioners). Patients capacity to slow the progression of CKD may be limited by their lack of knowledge about the disease, its comorbidities, psychosocial influences and their ability to interact and communicate effectively with their health-care provider. Support from a multidisciplinary care team, combined with provision of comprehensive, accessible and practical educational resources may enhance patients' ability and motivation to access and adhere to therapeutic and lifestyle interventions to retard progression of CKD. © 2014 Asian Pacific Society of Nephrology.

Insiders' Insight: Discrimination against Indigenous Peoples through the Eyes of Health Care Professionals.

PubMed

Wylie, Lloy; McConkey, Stephanie

2018-05-07

Discrimination in the health care system has a direct negative impact on health and wellbeing. Experiences of discrimination are considered a root cause for the health inequalities that exist among Indigenous peoples. Experiences of discrimination are commonplace, with patients noting abusive treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This research project examined the perspectives of health care providers and decision-makers to identify what challenges they see facing Indigenous patients and families when accessing health services in a large city in southern Ontario. Discrimination against Indigenous people was identified as major challenges by respondents, noting that it is widespread. This paper discusses the three key discrimination subthemes that were identified, including an unwelcoming environment, stereotyping and stigma, and practice informed by racism. These findings point to the conclusion that in order to improve health care access for Indigenous peoples, we need to go beyond simply making health services more welcoming and inclusive. Practice norms shaped by biases informed by discrimination against Indigenous people are widespread and compromise standards of care. Therefore, the problem needs to be addressed throughout the health care system as part of a quality improvement strategy. This will require not only a significant shift in the attitudes, knowledge, and skills of health care providers, but also the establishment of accountabilities for health care organizations to ensure equitable health services for Indigenous peoples.

Perspectives on quality of care for people who experience disability.

PubMed

Fadyl, Joanna K; McPherson, Kathryn M; Kayes, Nicola M

2011-01-01

Quality of care is considered to be of central importance in healthcare, disability services and rehabilitation. People experiencing disability often access a range of health and social care services; for some, these services are integral parts of daily life. Little research has explored perspectives of disabled people regarding what constitutes good quality care. This qualitative study aimed to explore and synthesise these perspectives to build a better picture of what constitutes good-quality care for disabled people in New Zealand. Qualitative focus groups and interviews were conducted with a range of participants including people with physical, sensory and/or intellectual impairment; informal and formal carers; and health and social care professionals. Data analysis used constant comparison methods as described in Strauss and Corbin (1998) to determine the factors of most importance and how they contributed to quality of care in health and social care services from the perspectives of people who use these services. Thirty-one participants took part, representing a range of ages and disabilities. Three main themes identified from data analysis were: (1) technical competence of care service and professionals; (2) a 'human' approach to service provision; and (3) context-appropriate response to needs. Findings offer a service-user perspective on what makes a difference to quality of care for people experiencing disability. They suggest that to provide context-appropriate care which addresses individual needs, the right mix of technical competence and a 'human' approach to care is needed. The mix required for the 'right' balance may depend on the type of service.

Designing the Microbial Research Commons

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

Uhlir, Paul F.

Recent decades have witnessed an ever-increasing range and volume of digital data. All elements of the pillars of science--whether observation, experiment, or theory and modeling--are being transformed by the continuous cycle of generation, dissemination, and use of factual information. This is even more so in terms of the re-using and re-purposing of digital scientific data beyond the original intent of the data collectors, often with dramatic results. We all know about the potential benefits and impacts of digital data, but we are also aware of the barriers, the challenges in maximizing the access, and use of such data. There ismore » thus a need to think about how a data infrastructure can enhance capabilities for finding, using, and integrating information to accelerate discovery and innovation. How can we best implement an accessible, interoperable digital environment so that the data can be repeatedly used by a wide variety of users in different settings and with different applications? With this objective: to use the microbial communities and microbial data, literature, and the research materials themselves as a test case, the Board on Research Data and Information held an International Symposium on Designing the Microbial Research Commons at the National Academy of Sciences in Washington, DC on 8-9 October 2009. The symposium addressed topics such as models to lower the transaction costs and support access to and use of microbiological materials and digital resources from the perspective of publicly funded research, public-private interactions, and developing country concerns. The overall goal of the symposium was to stimulate more research and implementation of improved legal and institutional models for publicly funded research in microbiology.« less

Genetics and Personal Insurance: the Perspectives of Canadian Cancer Genetic Counselors.

PubMed

Lane, Michelle; Ngueng Feze, Ida; Joly, Yann

2015-12-01

Genetic discrimination in the context of genetic testing has been identified as a concern for symptomatic and asymptomatic individuals for more than three decades. Genetic counselors are often the health care professionals who discuss risks and benefits of genetic testing with patients, thereby making them most appropriate to address patient concerns about genetics and personal insurance (i.e., life, life as related to mortgage or group insurance, disability, critical illness and travel). A pilot study was conducted to ascertain the current practices of Canadian cancer genetic counselors in regard to their discussions with patients about genetic testing and access to personal insurance. Among the 36 counselors surveyed, 100 % reported discussing the issue of genetic testing and personal insurance with their patients. Several factors influenced the content, depth and length of these discussions including age, cancer status, family members, and patients' current and future insurance needs. Counselors reported discussing with patients the possible impact of genetic test results on access to personal insurance, possible access and use of patient genetic information by insurance companies, and whom patients should contact if they have additional questions. The most commonly reported inquiries from patients included questions about the possible impact of genetic testing on their ability to obtain insurance, and the insurability of family members. While 28 % of counselors reported having been contacted by an insurer requesting access to patient information, only one counselor was aware of or could recall the outcome of such a request. This pilot study revealed that issues concerning genetics and personal insurance are commonly discussed in Canadian cancer genetic counseling sessions. Counselors furthermore expressed a need for additional educational resources on the topic of genetics and personal insurance for themselves and their patients.

Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors

PubMed Central

Greenwood, Nan; Holley, Jess; Ellmers, Theresa; Mein, Gill; Cloud, Geoffrey

2016-01-01

Objectives Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge. Design This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups. Setting Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK. Participants 41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups. Results Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups. Conclusions Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers’ part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face. PMID:26826148

Communicative Access Measures for Stroke: Development and Evaluation of a Quality Improvement Tool.

PubMed

Kagan, Aura; Simmons-Mackie, Nina; Victor, J Charles; Chan, Melodie T

2017-11-01

To (1) develop a systems-level quality improvement tool targeting communicative access to information and decision-making for stroke patients with language disorders; and (2) evaluate the resulting tool-the Communicative Access Measures for Stroke (CAMS). Survey development and evaluation was in line with accepted guidelines and included item generation and reduction, survey formatting and composition, pretesting, pilot testing, and reliability assessment. Development and evaluation were carried out in hospital and community agency settings. The project used a convenience sample of 31 participants for the survey development, and 63 participants for the CAMS reliability study (broken down into 6 administrators/managers, 32 frontline staff, 25 participants with aphasia). Eligible participants invited to the reliability study included individuals from 45 community-based organizations in Ontario as well as 4400 individuals from communities of practice. Not applicable. Data were analyzed using kappa statistics and intraclass correlations for each item score on all surveys. A tool, the CAMS, comprising 3 surveys, was developed for health facilities from the perspectives of (1) administrators/policymakers, (2) staff/frontline health care providers, and (3) patients with aphasia (using a communicatively accessible version). Reliability for items on the CAMS-Administrator and CAMS-Staff surveys was moderate to high (kappa/intraclass correlation coefficients [ICCs], .54-1.00). As expected, reliability was lower for the CAMS-Patient survey, with most items having ICCs between 0.4 and 0.6. These findings suggest that CAMS may provide useful quality improvement information for health care facilities with an interest in improving care for patients with stroke and aphasia. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Using focus groups to design systems science models that promote oral health equity.

PubMed

Kum, Susan S; Northridge, Mary E; Metcalf, Sara S

2018-06-04

While the US population overall has experienced improvements in oral health over the past 60 years, oral diseases remain among the most common chronic conditions across the life course. Further, lack of access to oral health care contributes to profound and enduring oral health inequities worldwide. Vulnerable and underserved populations who commonly lack access to oral health care include racial/ethnic minority older adults living in urban environments. The aim of this study was to use a systematic approach to explicate cause and effect relationships in creating a causal map, a type of concept map in which the links between nodes represent causality or influence. To improve our mental models of the real world and devise strategies to promote oral health equity, methods including system dynamics, agent-based modeling, geographic information science, and social network simulation have been leveraged by the research team. The practice of systems science modeling is situated amidst an ongoing modeling process of observing the real world, formulating mental models of how it works, setting decision rules to guide behavior, and from these heuristics, making decisions that in turn affect the state of the real world. Qualitative data were obtained from focus groups conducted with community-dwelling older adults who self-identify as African American, Dominican, or Puerto Rican to elicit their lived experiences in accessing oral health care in their northern Manhattan neighborhoods. The findings of this study support the multi-dimensional and multi-level perspective of access to oral health care and affirm a theorized discrepancy in fit between available dental providers and patients. The lack of information about oral health at the community level may be compromising the use and quality of oral health care among racial/ethnic minority older adults. Well-informed community members may fill critical roles in oral health promotion, as they are viewed as highly credible sources of information and recommendations for dental providers. The next phase of this research will involve incorporating the knowledge gained from this study into simulation models that will be used to explore alternative paths toward improving oral health and health care for racial/ethnic minority older adults.

Wireless access to a pharmaceutical database: a demonstrator for data driven Wireless Application Protocol (WAP) applications in medical information processing.

PubMed

Schacht Hansen, M; Dørup, J

2001-01-01

The Wireless Application Protocol technology implemented in newer mobile phones has built-in facilities for handling much of the information processing needed in clinical work. To test a practical approach we ported a relational database of the Danish pharmaceutical catalogue to Wireless Application Protocol using open source freeware at all steps. We used Apache 1.3 web software on a Linux server. Data containing the Danish pharmaceutical catalogue were imported from an ASCII file into a MySQL 3.22.32 database using a Practical Extraction and Report Language script for easy update of the database. Data were distributed in 35 interrelated tables. Each pharmaceutical brand name was given its own card with links to general information about the drug, active substances, contraindications etc. Access was available through 1) browsing therapeutic groups and 2) searching for a brand name. The database interface was programmed in the server-side scripting language PHP3. A free, open source Wireless Application Protocol gateway to a pharmaceutical catalogue was established to allow dial-in access independent of commercial Wireless Application Protocol service providers. The application was tested on the Nokia 7110 and Ericsson R320s cellular phones. We have demonstrated that Wireless Application Protocol-based access to a dynamic clinical database can be established using open source freeware. The project opens perspectives for a further integration of Wireless Application Protocol phone functions in clinical information processing: Global System for Mobile communication telephony for bilateral communication, asynchronous unilateral communication via e-mail and Short Message Service, built-in calculator, calendar, personal organizer, phone number catalogue and Dictaphone function via answering machine technology. An independent Wireless Application Protocol gateway may be placed within hospital firewalls, which may be an advantage with respect to security. However, if Wireless Application Protocol phones are to become effective tools for physicians, special attention must be paid to the limitations of the devices. Input tools of Wireless Application Protocol phones should be improved, for instance by increased use of speech control.

Wireless access to a pharmaceutical database: A demonstrator for data driven Wireless Application Protocol applications in medical information processing

PubMed Central

Hansen, Michael Schacht

2001-01-01

Background The Wireless Application Protocol technology implemented in newer mobile phones has built-in facilities for handling much of the information processing needed in clinical work. Objectives To test a practical approach we ported a relational database of the Danish pharmaceutical catalogue to Wireless Application Protocol using open source freeware at all steps. Methods We used Apache 1.3 web software on a Linux server. Data containing the Danish pharmaceutical catalogue were imported from an ASCII file into a MySQL 3.22.32 database using a Practical Extraction and Report Language script for easy update of the database. Data were distributed in 35 interrelated tables. Each pharmaceutical brand name was given its own card with links to general information about the drug, active substances, contraindications etc. Access was available through 1) browsing therapeutic groups and 2) searching for a brand name. The database interface was programmed in the server-side scripting language PHP3. Results A free, open source Wireless Application Protocol gateway to a pharmaceutical catalogue was established to allow dial-in access independent of commercial Wireless Application Protocol service providers. The application was tested on the Nokia 7110 and Ericsson R320s cellular phones. Conclusions We have demonstrated that Wireless Application Protocol-based access to a dynamic clinical database can be established using open source freeware. The project opens perspectives for a further integration of Wireless Application Protocol phone functions in clinical information processing: Global System for Mobile communication telephony for bilateral communication, asynchronous unilateral communication via e-mail and Short Message Service, built-in calculator, calendar, personal organizer, phone number catalogue and Dictaphone function via answering machine technology. An independent Wireless Application Protocol gateway may be placed within hospital firewalls, which may be an advantage with respect to security. However, if Wireless Application Protocol phones are to become effective tools for physicians, special attention must be paid to the limitations of the devices. Input tools of Wireless Application Protocol phones should be improved, for instance by increased use of speech control. PMID:11720946

Perceptions of Oral Health, Preventive Care, and Care-Seeking Behaviors Among Rural Adolescents

PubMed Central

Dodd, Virginia J.; Logan, Henrietta; Brown, Cameron D.; Calderon, Angela; Catalanotto, Frank

2015-01-01

BACKGROUND An asymmetrical oral disease burden is endured by certain population subgroups, particularly children and adolescents. Reducing oral health disparities requires understanding multiple oral health perspectives, including those of adolescents. This qualitative study explores oral health perceptions and dental care behaviors among rural adolescents. METHODS Semistructured individual interviews with 100 rural, minority, low socioeconomic status adolescents revealed their current perceptions of oral health and dental care access. Respondents age ranged from 12 to 18 years. The sample was 80% black and 52% male. RESULTS Perceived threat from dental disease was low. Adolescents perceived regular brushing and flossing as superseding the need for preventive care. Esthetic reasons were most often cited as reasons to seek dental care. Difficulties accessing dental care include finances, transportation, fear, issues with Medicaid coverage and parental responsibility. In general, adolescents and their parents are in need of information regarding the importance of preventive dental care. CONCLUSIONS Findings illuminate barriers to dental care faced by low-income rural adolescents and counter public perceptions of government-sponsored dental care programs as being “free” or without cost. The importance of improved oral health knowledge, better access to care, and school-based dental care is discussed. PMID:25388597

Perceptions of oral health, preventive care, and care-seeking behaviors among rural adolescents.

PubMed

Dodd, Virginia J; Logan, Henrietta; Brown, Cameron D; Calderon, Angela; Catalanotto, Frank

2014-12-01

An asymmetrical oral disease burden is endured by certain population subgroups, particularly children and adolescents. Reducing oral health disparities requires understanding multiple oral health perspectives, including those of adolescents. This qualitative study explores oral health perceptions and dental care behaviors among rural adolescents. Semistructured individual interviews with 100 rural, minority, low socioeconomic status adolescents revealed their current perceptions of oral health and dental care access. Respondents age ranged from 12 to 18 years. The sample was 80% black and 52% male. Perceived threat from dental disease was low. Adolescents perceived regular brushing and flossing as superseding the need for preventive care. Esthetic reasons were most often cited as reasons to seek dental care. Difficulties accessing dental care include finances, transportation, fear, issues with Medicaid coverage and parental responsibility. In general, adolescents and their parents are in need of information regarding the importance of preventive dental care. Findings illuminate barriers to dental care faced by low-income rural adolescents and counter public perceptions of government-sponsored dental care programs as being "free" or without cost. The importance of improved oral health knowledge, better access to care, and school-based dental care is discussed. © 2014, American School Health Association.

Dissemination of assistive technology information to farmers and ranchers with disabilities.

PubMed

Racz, C W; Field, W E

2011-07-01

Since induction of the AgrAbility program through appropriations contained in the 1990 Farm Bill, the national and state/regional AgrAbility projects have used a variety of methods to disseminate information about assistive technology (AT) to farmers, ranchers, and other agricultural workers with disabilities. To date, no known research has been conducted to assess those delivery methods from the perspectives of either the persons with disabilities in need of information or the education and rehabilitation professionals who work with them. This study's purpose was two-fold: (1) review various dissemination strategies to identify those documented as being more effective, and (2) conduct surveys to ascertain the perspectives of AgrAbility project professionals and a national network of farmers and ranchers with disabilities (called the Barn Builders). Key findings of the study were as follows: (1) the farmers and ranchers most preferred receiving information via printed newsletters (71%) and printed publications (67%); (2) AgrAbility staff most preferred receiving information via internet-based publication access (61%), e-mail (60%), and printed publications (58%); (3) many farmers and ranchers perceived that dissemination strategies were moving toward the internet (53%) and that AT information was generally more available now than in the past (38%); (4) both AgrAbility staff and the Barn Builders tended to agree that farmers still wanted to receive information in printed form; and (5) neither age nor education level appeared to be a strong predictor of internet use by farmers. Key recommendations to enhance the effectiveness of current AT information delivery methods included: (1) implementing effective document management strategies for all information resources, especially for online content; and (2) minimizing language translation efforts, since such a small percentage of the AgrAbility project customer base is primarily non-English speaking. It is believed that the findings of this study also have implications for service delivery strategies in other areas, including topics relating to agricultural safety and health.

Computational perspectives in the history of science: to the memory of Peter Damerow.

PubMed

Laubichler, Manfred D; Maienschein, Jane; Renn, Jürgen

2013-03-01

Computational methods and perspectives can transform the history of science by enabling the pursuit of novel types of questions, dramatically expanding the scale of analysis (geographically and temporally), and offering novel forms of publication that greatly enhance access and transparency. This essay presents a brief summary of a computational research system for the history of science, discussing its implications for research, education, and publication practices and its connections to the open-access movement and similar transformations in the natural and social sciences that emphasize big data. It also argues that computational approaches help to reconnect the history of science to individual scientific disciplines.

Cross-border healthcare directive: Assessing stakeholders' perspectives in Poland and Portugal.

PubMed

Helena, Ricardo

2016-04-01

Within the context of the EU, a succession of rulings from the European Court of Justice addressed the gap of specific healthcare legislation. These rulings shook the member states assumption of health provision autonomy and led the European Commission to produce a specific directive concerning cross-border healthcare. In spite of different viewpoints of member states, including Poland and Portugal, the directive was approved and expected to be implemented by October 2013. The objective of this study was to analyse stakeholders' perspective towards the directive, unveiling the factors that supported a different viewpoint, and to identify challenges and assess the expected impact associated with the directive implementation on Poland and Portugal, using the WHO health systems conceptual framework. Information was collected through a literature review, identifying potential stakeholders. Primary qualitative analysis was conducted through the dissemination of open-ended questionnaires. Content and critical analysis was performed considering the available literature intertwined with the WHO health systems conceptual framework. The directive appears to be positive regarding patient rights, increased transparency, and potential to set new information technologies and healthcare networks. However, it also seems to potentially generate access inequalities between home and foreign patients, and increase healthcare costs due to the short-term investments needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stereograms

ERIC Educational Resources Information Center

Kuchemann, Dietmar

2007-01-01

Perspective is a rich area for mathematical work, and one that should be accessible to many students, since it is based on the everyday experience of viewing the 3D world directly and through familiar 2D representations (drawings, photographs, images on a television or cinema screen, etc). A nice feature of perspective tasks is that they can be…

Reconstructing Virgil in the Classroom in Late Antiquity

ERIC Educational Resources Information Center

Foster, Frances

2014-01-01

This essay considers how teaching and learning may have functioned in late antique Roman classrooms by examining two texts: one is from the teacher's perspective, the other--which, until recently, was unedited--provides some access to the student's perspective. Despite much recent scholarly work on education in antiquity, there has been no attempt…

Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China

PubMed Central

Zeng, Jiazhi; Shi, Leiyu; Zou, Xia; Chen, Wen; Ling, Li

2015-01-01

Objectives China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants’ experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China. Methods The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool—Adult Short Version (PCAT-AS), representing 10 primary care domains was used to collect information on migrants’ quality of primary care experiences. These domains include first contact (utilization), first contact (accessibility), ongoing care, coordination (referrals), coordination (information systems), comprehensiveness (services available), comprehensiveness (services provided), family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients’ perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49) reported the highest PCAT total scores, followed by municipal hospitals (25.02), community health centers/community health stations (24.24), and township health centers/rural health stations (24.18). Tertiary hospital users reported significantly better performance in first contact (utilization), first contact (accessibility), coordination (information system), comprehensiveness (service available), and cultural competence. Community health center/community health station users reported significantly better experience in the community orientation domain. Township health center/rural health station users expressed significantly better experience in the ongoing care domain. There were no statistically significant differences across settings in the ongoing care, comprehensiveness (services provided), and family-centeredness domains. Multiple linear regression models showed that factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P<0.001). Conclusions This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. PMID:26474161

University Access for Social Justice: A Capabilities Perspective

ERIC Educational Resources Information Center

Wilson-Strydom, Merridy

2011-01-01

The closely related, but often contradictory, issues of increasing access to university and improving students' chances of success in their university studies have been and continue to be an important research focus within higher education studies and policy in South Africa and beyond. More recently, the challenge of underpreparedness of students…