Perceived parent-child relational qualities and parental behavioral and psychological control in Chinese adolescents in Hong Kong.

PubMed

Shek, Daniel T L

2006-01-01

Chinese secondary school students (N = 3,017) were asked to respond to instruments measuring their perceived parent-child relational qualities (parental trust of the child, child's trust of parents, child's readiness to communicate with parents, and child's satisfaction with parental control), parental behavioral control (including indicators of knowledge, expectation, monitoring, discipline, and demandingness), and parental psychological control. Results showed that parental trust of the child and child's trust of parents were positively related to child's readiness to communicate with the parents and satisfaction with parental control. While parental trust of the child and child's trust of parents were basically negatively related to different aspects of behavioral control (except parental knowledge), readiness to communicate with the parents and satisfaction with parental control were positively associated with parental control. Parent-child relational quality measures were negatively related to psychological control. Relative to measures of parental behavioral control, parental psychological control was a stronger predictor of parent-child relational qualities. The present findings clarify the parent-child relational quality correlates of parental behavioral and psychological control.

The trust-commitment challenge in service quality-loyalty relationships.

PubMed

Moreira, Antonio Carrizo; Silva, Pedro Miguel

2015-01-01

The purpose of this paper is to develop and empirically test a model to examine service quality, satisfaction, trust and commitment as loyalty antecedents in a private healthcare service. The approach was tested using structural equation modelling, involving 175 patients from a private Portuguese healthcare unit, using a revised Service Quality Assessment Scale (SQAS) scale for service quality evaluation. The scale used to evaluate service quality is valid and meaningful. Service quality proved to be a multidimensional construct and relevant to build satisfaction. The path satisfaction→trust→loyalty was validated, whereas the path satisfaction→commitment→loyalty was not statistically supported. The revised SQAS scale showed good internal consistency in healthcare context. Further trust-commitment antecedents must be examined in a private healthcare landscape to generalise the findings. Healthcare quality managers must explore the service quality dimensions to generate satisfaction among their patients. Developing trust generates positive patient attitudes and loyalty. This study explores using the SQAS scale in a private healthcare context. The authors provide further evidence that service quality is an antecedent and different from satisfaction. All the measures used proved to be valid and reliable. Trust and commitment play different roles in their relationship with loyalty.

'Trust my doctor, trust my pancreas': trust as an emergent quality of social practice.

PubMed

Cohn, Simon

2015-06-11

Growing attention is being paid to the importance of trust, and its corollaries such as mistrust and distrust, in health service and the central place they have in assessments of quality of care. Although initially focussing on doctor-patient relationships, more recent literature has broadened its remit to include trust held in more abstract entities, such as organisations and institutions. There has consequently been growing interest to develop rigorous and universal measures of trust. Drawing on illustrative ethnographic material from observational research in a UK diabetes clinic, this paper supports an approach that foregrounds social practice and resists conceiving trust as solely a psychological state that can be divorced from its context. Beyond exploring the less-than-conscious nature of trust, the interpretations attend to the extent to which trust practices are distributed across a range of actors. Data from clinical encounters reveal the extent to which matters of trust can emerge from the relationships between people, and sometimes people and things, as a result of a wide range of pragmatic concerns, and hence can usefully be conceived of as an extended property of a situation rather than a person. Trust is rarely explicitly articulated, but remains a subtle feature of experience that is frequently ineffable. A practice approach highlights some of the problems with adopting a general psychological or intellectualist conception of trust. In particular, assuming it is a sufficiently stable internal state that can be stored or measured not only transforms a diffuse and often ephemeral quality into a durable thing, but ultimately presents it as a generic state that has meaning independent of the specific relationships and context that achieve it. Emphasising the context-specific nature of trust practices does not dismiss the potential of matters of trust, when they emerge, to be transposed to other contexts. But it does highlight how, on each occasion, trust as a relational quality is ways 'done' or 'achieved' anew.

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

PubMed

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

2009-10-01

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

Trust and Influence

DTIC Science & Technology

2012-03-05

DISTRIBUTION A: Approved for public release; distribution is unlimited. Program Trends •Trust in Autonomous Systems • Cross - cultural Trust...Trust & trustworthiness are independent (Mayer et al, 1995) •Trust is relational •Humans in cross - cultural interactions •Complex human-machine...Interpersonal Trustworthiness •Ability •Benevolence •Integrity Trust Metrics Cross - Cultural Trust Issues Human-Machine Interactions Autonomous

Modelling End-User of Electronic-Government Service: The Role of Information quality, System Quality and Trust

NASA Astrophysics Data System (ADS)

Witarsyah Jacob, Deden; Fudzee, Mohd Farhan Md; Aizi Salamat, Mohamad; Kasim, Shahreen; Mahdin, Hairulnizam; Azhar Ramli, Azizul

2017-08-01

Many governments around the world increasingly use internet technologies such as electronic government to provide public services. These services range from providing the most basic informational website to deploying sophisticated tools for managing interactions between government agencies and beyond government. Electronic government (e-government) aims to provide a more accurate, easily accessible, cost-effective and time saving for the community. In this study, we develop a new model of e-government adoption service by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) through the incorporation of some variables such as System Quality, Information Quality and Trust. The model is then tested using a large-scale, multi-site survey research of 237 Indonesian citizens. This model will be validated by using Structural Equation Modeling (SEM). The result indicates that System Quality, Information Quality and Trust variables proven to effect user behavior. This study extends the current understanding on the influence of System Quality, Information Quality and Trust factors to researchers, practitioners, and policy makers.

The Complexity of Trust-Control Relationships in Creative Organizations: Insights from a Qualitative Analysis of a Conductorless Orchestra

ERIC Educational Resources Information Center

Khodyakov, Dmitry M.

2007-01-01

Using a qualitative approach, I study two processes of intra-organizational cooperation and coordination--control and trust--in creative organizations. Specifically, I analyze the complex nature of trust-control relationships in Orpheus orchestra, the world's largest contemporary conductorless orchestra. I discuss how it rehearses and performs…

Developing skills in clinical leadership for ward sisters.

PubMed

Fenton, Katherine; Phillips, Natasha

The Francis report has called for a strengthening of the ward sister's role. It recommends that sisters should operate in a supervisory capacity and should not be office bound. Effective ward leadership has been recognised as being vital to high-quality patient care and experience, resource management and interprofessional working. However, there is evidence that ward sisters are ill equipped to lead effectively and lack confidence in their ability to do so. University College London Hospitals Foundation Trust has recognised that the job has become almost impossible in increasingly large and complex organisations. Ward sisters spend less than 40% of their time on clinical leadership and the trust is undertaking a number of initiatives to support them in this role.

36 CFR 1010.16 - Actions to encourage agency cooperation early in the NEPA process.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRUST ENVIRONMENTAL QUALITY § 1010.16 Actions to encourage agency cooperation early in the NEPA process. Consistent with 40 CFR 1501.6, the Trust may request the NPS to be a cooperating agency for actions or projects significantly affecting the quality of the Presidio. In addition, upon request of the Trust, any...

The Complex Relationship between Cyberbullying and Trust

ERIC Educational Resources Information Center

Pieschl, Stephanie; Porsch, Torsten

2017-01-01

Theoretically, there are strong arguments for a relationship between cyberbullying and trust. On the one hand, trust is built on experiences; thus, experiences of malevolence such as cyberbullying might contribute to low trust. On the other hand, high trust may lead to risky online behavior such as self-disclosures that could increase the risk of…

Social Milieu Oriented Routing: A New Dimension to Enhance Network Security in WSNs.

PubMed

Liu, Lianggui; Chen, Li; Jia, Huiling

2016-02-19

In large-scale wireless sensor networks (WSNs), in order to enhance network security, it is crucial for a trustor node to perform social milieu oriented routing to a target a trustee node to carry out trust evaluation. This challenging social milieu oriented routing with more than one end-to-end Quality of Trust (QoT) constraint has proved to be NP-complete. Heuristic algorithms with polynomial and pseudo-polynomial-time complexities are often used to deal with this challenging problem. However, existing solutions cannot guarantee the efficiency of searching; that is, they can hardly avoid obtaining partial optimal solutions during a searching process. Quantum annealing (QA) uses delocalization and tunneling to avoid falling into local minima without sacrificing execution time. This has been proven a promising way to many optimization problems in recently published literatures. In this paper, for the first time, with the help of a novel approach, that is, configuration path-integral Monte Carlo (CPIMC) simulations, a QA-based optimal social trust path (QA_OSTP) selection algorithm is applied to the extraction of the optimal social trust path in large-scale WSNs. Extensive experiments have been conducted, and the experiment results demonstrate that QA_OSTP outperforms its heuristic opponents.

Social trust and grassroots governance in rural China.

PubMed

Huhe, Narisong; Chen, Jie; Tang, Min

2015-09-01

The relationship between social trust and governance has been one of the focal points of the academic and policy-making communities. Empirical studies on this relationship, however, have focused mostly on democracies. The scarcity of such studies in authoritarian countries has left many important questions unanswered: Is social trust associated with effective governance only in democratic settings? Can social trust improve the quality of governance in non-democracies as well? Drawing on data from 2005 China General Social Survey-a representative survey conducted nationwide at both the individual- and village-level in rural China, this paper attempts to answer these questions empirically by examining the relationship between social trust and the quality of governance in rural China. The findings reveal that different types of social trust-particularized trust and generalized trust-correspond with different effects in rural governance: whereas villagers' trust in people whom they knew personally was positively and significantly associated with the provision of various public goods and services, their trust in strangers had virtually no impact on rural governance. Copyright © 2015 Elsevier Inc. All rights reserved.

Honoring the Trust: Quality and Cost Containment in Higher Education.

ERIC Educational Resources Information Center

Massy, William F.

This book asserts that improvements in quality and cost containment are required not only for the well-being of individual institutions of higher education, but also to honor the trust placed in academe by society. The book outlines a practical program for improvement. The chapters of part 1, "The Case for Change," are: (1) "The Erosion of Trust";…

User-Oriented Quality for OER: Understanding Teachers' Views on Re-Use, Quality, and Trust

ERIC Educational Resources Information Center

Clements, K. I.; Pawlowski, J. M.

2012-01-01

We analysed how teachers as users of open educational resources (OER) repositories act in the re-use process and how they perceive quality. Based on a quantitative empirical study, we also surveyed which quality requirements users have and how they would contribute to the quality process. Trust in resources, organizations, and technologies seem to…

26 CFR 1.662(a)-1 - Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 8 2012-04-01 2012-04-01 false Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general. 1.662(a)-1 Section 1.662(a)-1 Internal Revenue INTERNAL...) Estates and Trusts Which May Accumulate Income Or Which Distribute Corpus § 1.662(a)-1 Inclusion of...

26 CFR 1.662(a)-1 - Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 8 2013-04-01 2013-04-01 false Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general. 1.662(a)-1 Section 1.662(a)-1 Internal Revenue INTERNAL...) Estates and Trusts Which May Accumulate Income Or Which Distribute Corpus § 1.662(a)-1 Inclusion of...

26 CFR 1.662(a)-1 - Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 8 2014-04-01 2014-04-01 false Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general. 1.662(a)-1 Section 1.662(a)-1 Internal Revenue INTERNAL...) Estates and Trusts Which May Accumulate Income Or Which Distribute Corpus § 1.662(a)-1 Inclusion of...

26 CFR 1.662(a)-1 - Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 8 2011-04-01 2011-04-01 false Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general. 1.662(a)-1 Section 1.662(a)-1 Internal Revenue INTERNAL...) Estates and Trusts Which May Accumulate Income Or Which Distribute Corpus § 1.662(a)-1 Inclusion of...

Service quality and clinical outcomes: an example from mental health rehabilitation services in England.

PubMed

Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael

2013-01-01

Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

Online bargaining and interpersonal trust.

PubMed

Naquin, Charles E; Paulson, Gaylen D

2003-02-01

The presented study explores the effect of interacting over the Internet on interpersonal trust when bargaining online. Relative to face-to-face negotiations, online negotiations were characterized by (a) lower levels of pre-negotiation trust and (b) lower levels of post-negotiation trust. The reduced levels of pre-negotiation trust in online negotiations (i.e., before any interaction took place) demonstrate that negotiators bring different expectations to the electronic bargaining table than to face-to-face negotiations. These negative perceptions of trust were found to mediate another aspect of the relationship, namely, desired future interaction. Those who negotiated online reported less desire for future interactions with the other party. Online negotiators also were less satisfied with their outcome and less confident in the quality of their performance, despite the absence of observable differences in economic outcome quality.

Cooperative management of riparian forest habitats to maintain biological quality and ecosystem integrity

Treesearch

David Deardorff; Kathryn Wadsworth

1996-01-01

The New Mexico State Land Office has initiated a rare plant survey of state trust land, an inventory and assessment of riparian areas on the trust land, and the development of a biological resources data base and information management system. Some riparian sites that still belong to the trust have been negatively impacted by livestock such that biological quality and...

Any qualified provider: a qualitative case study of one community NHS Trust's response

PubMed Central

Walumbe, Jackie; Swinglehurst, Deborah; Shaw, Sara

2016-01-01

Objective To examine how those managing and providing community-based musculoskeletal (MSK) services have experienced recent policy allowing patients to choose any provider that meets certain quality standards from the National Health Service (NHS), private or voluntary sector. Design Intrinsic case study combining qualitative analysis of interviews and field notes. Setting An NHS Community Trust (the main providers of community health services in the NHS) in England, 2013–2014. Participants NHS Community Trust employees involved in delivering MSK services, including clinical staff and managerial staff in senior and mid-range positions. Findings Managers (n=4) and clinicians (n=4) working within MSK services understood and experienced the Any Qualified Provider (AQP) policy as involving: (1) a perceived trade-off between quality and cost in its implementation; (2) deskilling of MSK clinicians and erosion of professional values; and (3) a shift away from interprofessional collaboration and dialogue. These ways of making sense of AQP policy were associated with dissatisfaction with market-based health reforms. Conclusions AQP policy is poorly understood. Clinicians and managers perceive AQP as synonymous with competition and privatisation. From the perspective of clinicians providing MSK services, AQP, and related health policy reforms, tend, paradoxically, to drive down quality standards, supporting reconfiguration of services in which the complex, holistic nature of specialised MSK care may become marginalised by policy concerns about efficiency and cost. Our analysis indicates that the potential of AQP policy to increase quality of care is, at best, equivocal, and that any consideration of how AQP impacts on practice can only be understood by reference to a wider range of health policy reforms. PMID:26908521

Any qualified provider: a qualitative case study of one community NHS Trust's response.

PubMed

Walumbe, Jackie; Swinglehurst, Deborah; Shaw, Sara

2016-02-23

To examine how those managing and providing community-based musculoskeletal (MSK) services have experienced recent policy allowing patients to choose any provider that meets certain quality standards from the National Health Service (NHS), private or voluntary sector. Intrinsic case study combining qualitative analysis of interviews and field notes. An NHS Community Trust (the main providers of community health services in the NHS) in England, 2013-2014. NHS Community Trust employees involved in delivering MSK services, including clinical staff and managerial staff in senior and mid-range positions. Managers (n=4) and clinicians (n=4) working within MSK services understood and experienced the Any Qualified Provider (AQP) policy as involving: (1) a perceived trade-off between quality and cost in its implementation; (2) deskilling of MSK clinicians and erosion of professional values; and (3) a shift away from interprofessional collaboration and dialogue. These ways of making sense of AQP policy were associated with dissatisfaction with market-based health reforms. AQP policy is poorly understood. Clinicians and managers perceive AQP as synonymous with competition and privatisation. From the perspective of clinicians providing MSK services, AQP, and related health policy reforms, tend, paradoxically, to drive down quality standards, supporting reconfiguration of services in which the complex, holistic nature of specialised MSK care may become marginalised by policy concerns about efficiency and cost. Our analysis indicates that the potential of AQP policy to increase quality of care is, at best, equivocal, and that any consideration of how AQP impacts on practice can only be understood by reference to a wider range of health policy reforms. 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/

Quality Measures for Digital Business Ecosystems Formation

NASA Astrophysics Data System (ADS)

Raza, Muhammad; Hussain, Farookh Khadeer; Chang, Elizabeth

To execute a complex business task, business entities may need to collaborate with each other as individually they may not have the capability or willingness to perform the task on its own. Such collaboration can be seen implemented in digital business ecosystems in the form of simple coalitions using multi-agent systems or by employing Electronic Institutions. A major challenge is choosing optimal partners who will deliver the agreed commitments, and act in the coalition’s interest. Business entities are scaled according to their quality level. Determining the quality of previously unknown business entities and predicting the quality of such an entity in a dynamic environment are crucial issues in Business Ecosystems. A comprehensive quality management system grounded in the concepts of Trust and Reputation can help address these issues.

26 CFR 1.662(a)-1 - Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general. 1.662(a)-1 Section 1.662(a)-1 Internal Revenue INTERNAL... Trusts Which May Accumulate Income Or Which Distribute Corpus § 1.662(a)-1 Inclusion of amounts in gross...

Re-thinking accountability: trust versus confidence in medical practice.

PubMed

Checkland, K; Marshall, M; Harrison, S

2004-04-01

In seeking to prevent a reoccurrence of scandals such as that involving cardiac surgery in Bristol, the UK government has adopted a model of regulation that uses rules and surveillance as a way of both improving the quality of care delivered and increasing confidence in healthcare institutions. However, this approach may actually act to reduce confidence and trust while also reducing the moral motivation of practitioners. Accountability in health care is discussed, and it is suggested that openness about the difficult dilemmas that arise when practitioners have a duty to be accountable to more than one audience may be an alternative means of restoring trust. A greater emphasis on the sharing of information between individual health professionals and their patients would increase trust and would allow patients to hold their doctors to account for the quality of care they receive. Concentrating more on developing trust by the sharing of information and less on the futile search for complete confidence in systems and rules may improve the quality of care delivered while also nurturing the moral motivation of professionals upon which the delivery of high quality health care depends.

26 CFR 1.1441-0 - Outline of regulation provisions for section 1441.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Proof that tax liability has been satisfied. (iii) Liability for interest and penalties. (iv) Special...) General rule. (B) Foreign partnerships. (C) Foreign simple trusts and foreign grantor trusts. (D) Other... amounts. (23) Flow-through entity. (24) Foreign simple trust. (25) Foreign complex trust. (26) Foreign...

36 CFR 1010.13 - Trust decision-making procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Trust decision-making procedures. 1010.13 Section 1010.13 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant...

Establishing a Cloud Computing Success Model for Hospitals in Taiwan.

PubMed

Lian, Jiunn-Woei

2017-01-01

The purpose of this study is to understand the critical quality-related factors that affect cloud computing success of hospitals in Taiwan. In this study, private cloud computing is the major research target. The chief information officers participated in a questionnaire survey. The results indicate that the integration of trust into the information systems success model will have acceptable explanatory power to understand cloud computing success in the hospital. Moreover, information quality and system quality directly affect cloud computing satisfaction, whereas service quality indirectly affects the satisfaction through trust. In other words, trust serves as the mediator between service quality and satisfaction. This cloud computing success model will help hospitals evaluate or achieve success after adopting private cloud computing health care services.

Establishing a Cloud Computing Success Model for Hospitals in Taiwan

PubMed Central

Lian, Jiunn-Woei

2017-01-01

The purpose of this study is to understand the critical quality-related factors that affect cloud computing success of hospitals in Taiwan. In this study, private cloud computing is the major research target. The chief information officers participated in a questionnaire survey. The results indicate that the integration of trust into the information systems success model will have acceptable explanatory power to understand cloud computing success in the hospital. Moreover, information quality and system quality directly affect cloud computing satisfaction, whereas service quality indirectly affects the satisfaction through trust. In other words, trust serves as the mediator between service quality and satisfaction. This cloud computing success model will help hospitals evaluate or achieve success after adopting private cloud computing health care services. PMID:28112020

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/.

Intelligent Monitoring? Assessing the ability of the Care Quality Commission's statistical surveillance tool to predict quality and prioritise NHS hospital inspections.

PubMed

Griffiths, Alex; Beaussier, Anne-Laure; Demeritt, David; Rothstein, Henry

2017-02-01

The Care Quality Commission (CQC) is responsible for ensuring the quality of the health and social care delivered by more than 30 000 registered providers in England. With only limited resources for conducting on-site inspections, the CQC has used statistical surveillance tools to help it identify which providers it should prioritise for inspection. In the face of planned funding cuts, the CQC plans to put more reliance on statistical surveillance tools to assess risks to quality and prioritise inspections accordingly. To evaluate the ability of the CQC's latest surveillance tool, Intelligent Monitoring (IM), to predict the quality of care provided by National Health Service (NHS) hospital trusts so that those at greatest risk of providing poor-quality care can be identified and targeted for inspection. The predictive ability of the IM tool is evaluated through regression analyses and χ 2 testing of the relationship between the quantitative risk score generated by the IM tool and the subsequent quality rating awarded following detailed on-site inspection by large expert teams of inspectors. First, the continuous risk scores generated by the CQC's IM statistical surveillance tool cannot predict inspection-based quality ratings of NHS hospital trusts (OR 0.38 (0.14 to 1.05) for Outstanding/Good, OR 0.94 (0.80 to -1.10) for Good/Requires improvement, and OR 0.90 (0.76 to 1.07) for Requires improvement/Inadequate). Second, the risk scores cannot be used more simply to distinguish the trusts performing poorly-those subsequently rated either 'Requires improvement' or 'Inadequate'-from the trusts performing well-those subsequently rated either 'Good' or 'Outstanding' (OR 1.07 (0.91 to 1.26)). Classifying CQC's risk bandings 1-3 as high risk and 4-6 as low risk, 11 of the high risk trusts were performing well and 43 of the low risk trusts were performing poorly, resulting in an overall accuracy rate of 47.6%. Third, the risk scores cannot be used even more simply to distinguish the worst performing trusts-those subsequently rated 'Inadequate'-from the remaining, better performing trusts (OR 1.11 (0.94 to 1.32)). Classifying CQC's risk banding 1 as high risk and 2-6 as low risk, the highest overall accuracy rate of 72.8% was achieved, but still only 6 of the 13 Inadequate trusts were correctly classified as being high risk. Since the IM statistical surveillance tool cannot predict the outcome of NHS hospital trust inspections, it cannot be used for prioritisation. A new approach to inspection planning is therefore required. 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/.

HealthTrust: a social network approach for retrieving online health videos.

PubMed

Fernandez-Luque, Luis; Karlsen, Randi; Melton, Genevieve B

2012-01-31

Social media are becoming mainstream in the health domain. Despite the large volume of accurate and trustworthy health information available on social media platforms, finding good-quality health information can be difficult. Misleading health information can often be popular (eg, antivaccination videos) and therefore highly rated by general search engines. We believe that community wisdom about the quality of health information can be harnessed to help create tools for retrieving good-quality social media content. To explore approaches for extracting metrics about authoritativeness in online health communities and how these metrics positively correlate with the quality of the content. We designed a metric, called HealthTrust, that estimates the trustworthiness of social media content (eg, blog posts or videos) in a health community. The HealthTrust metric calculates reputation in an online health community based on link analysis. We used the metric to retrieve YouTube videos and channels about diabetes. In two different experiments, health consumers provided 427 ratings of 17 videos and professionals gave 162 ratings of 23 videos. In addition, two professionals reviewed 30 diabetes channels. HealthTrust may be used for retrieving online videos on diabetes, since it performed better than YouTube Search in most cases. Overall, of 20 potential channels, HealthTrust's filtering allowed only 3 bad channels (15%) versus 8 (40%) on the YouTube list. Misleading and graphic videos (eg, featuring amputations) were more commonly found by YouTube Search than by searches based on HealthTrust. However, some videos from trusted sources had low HealthTrust scores, mostly from general health content providers, and therefore not highly connected in the diabetes community. When comparing video ratings from our reviewers, we found that HealthTrust achieved a positive and statistically significant correlation with professionals (Pearson r₁₀ = .65, P = .02) and a trend toward significance with health consumers (r₇ = .65, P = .06) with videos on hemoglobinA(1c), but it did not perform as well with diabetic foot videos. The trust-based metric HealthTrust showed promising results when used to retrieve diabetes content from YouTube. Our research indicates that social network analysis may be used to identify trustworthy social media in health communities.

Love, Trust, and HIV Risk Among Female Sex Workers and Their Intimate Male Partners

PubMed Central

Bazzi, Angela Robertson; Martinez, Gustavo; Rangel, M. Gudelia; Ulibarri, Monica D.; Fergus, Kirkpatrick B.; Amaro, Hortensia; Strathdee, Steffanie A.

2015-01-01

Objectives. We examined correlates of love and trust among female sex workers and their noncommercial male partners along the Mexico–US border. Methods. From 2011 to 2012, 322 partners in Tijuana and Ciudad Juárez, Mexico, completed assessments of love and trust. Cross-sectional dyadic regression analyses identified associations of relationship characteristics and HIV risk behaviors with love and trust. Results. Within 161 couples, love and trust scores were moderately high (median 70/95 and 29/40 points, respectively) and correlated with relationship satisfaction. In regression analyses of HIV risk factors, men and women who used methamphetamine reported lower love scores, whereas women who used heroin reported slightly higher love. In an alternate model, men with concurrent sexual partners had lower love scores. For both partners, relationship conflict was associated with lower trust. Conclusions. Love and trust are associated with relationship quality, sexual risk, and drug use patterns that shape intimate partners’ HIV risk. HIV interventions should consider the emotional quality of sex workers’ intimate relationships. PMID:26066947

Love, Trust, and HIV Risk Among Female Sex Workers and Their Intimate Male Partners.

PubMed

Syvertsen, Jennifer L; Bazzi, Angela Robertson; Martinez, Gustavo; Rangel, M Gudelia; Ulibarri, Monica D; Fergus, Kirkpatrick B; Amaro, Hortensia; Strathdee, Steffanie A

2015-08-01

We examined correlates of love and trust among female sex workers and their noncommercial male partners along the Mexico-US border. From 2011 to 2012, 322 partners in Tijuana and Ciudad Juárez, Mexico, completed assessments of love and trust. Cross-sectional dyadic regression analyses identified associations of relationship characteristics and HIV risk behaviors with love and trust. Within 161 couples, love and trust scores were moderately high (median 70/95 and 29/40 points, respectively) and correlated with relationship satisfaction. In regression analyses of HIV risk factors, men and women who used methamphetamine reported lower love scores, whereas women who used heroin reported slightly higher love. In an alternate model, men with concurrent sexual partners had lower love scores. For both partners, relationship conflict was associated with lower trust. Love and trust are associated with relationship quality, sexual risk, and drug use patterns that shape intimate partners' HIV risk. HIV interventions should consider the emotional quality of sex workers' intimate relationships.

Authentic leadership and nurses' voice behaviour and perceptions of care quality.

PubMed

Wong, Carol A; Spence Laschinger, Heather K; Cummings, Greta G

2010-11-01

The purpose of the present study was to test a theoretical model linking authentic leadership with staff nurses' trust in their manager, work engagement, voice behaviour and perceived unit care quality. Authentic leadership is a guide for effective leadership needed to build trust and healthier work environments because there is special attention given to honesty, integrity and high ethical standards in the development of leader-follower relationships. A non-experimental, predictive survey design was used to test the hypothesized model in a random sample of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario. The final model fitted the data acceptably (χ(2)=17.24, d.f.=11, P=0.10, IFI=0.99, CFI=0.99, RMSEA=0.045). Authentic leadership significantly and positively influenced staff nurses' trust in their manager and work engagement which in turn predicted voice behaviour and perceived unit care quality. These findings suggest that authentic leadership and trust in the manager play a role in fostering trust, work engagement, voice behaviour and perceived quality of care. Nursing leaders can improve care quality and workplace conditions by paying attention to facilitating genuine and positive relationships with their staff. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

A Conceptualisation of Available Trust-Building Mechanisms for International Quality Assurance of Higher Education

ERIC Educational Resources Information Center

Stensaker, Bjørn; Maassen, Peter

2015-01-01

While external quality assurance in higher education was originally developed to cater for various domestic needs, recent decades have seen various attempts in the use of quality assurance also as a mechanism for creating more trust in cross-national higher education activities. In this article, a conceptual framework for analysing available…

The role of trust in residents’ fire wise actions

Treesearch

Jim Absher; Jerry J. Vaske

2011-01-01

Residents’ trust in the managing agency has been heralded as a necessary precursor to success in preventing wildland fire losses in the wildland–urban interface. Trust, however, is a complex concept. Homeowners’ specific fire wise actions may not be easily linked to general measures of trust. This article uses two distinct trust indices to predict residents’ intention...

AST: Activity-Security-Trust driven modeling of time varying networks.

PubMed

Wang, Jian; Xu, Jiake; Liu, Yanheng; Deng, Weiwen

2016-02-18

Network modeling is a flexible mathematical structure that enables to identify statistical regularities and structural principles hidden in complex systems. The majority of recent driving forces in modeling complex networks are originated from activity, in which an activity potential of a time invariant function is introduced to identify agents' interactions and to construct an activity-driven model. However, the new-emerging network evolutions are already deeply coupled with not only the explicit factors (e.g. activity) but also the implicit considerations (e.g. security and trust), so more intrinsic driving forces behind should be integrated into the modeling of time varying networks. The agents undoubtedly seek to build a time-dependent trade-off among activity, security, and trust in generating a new connection to another. Thus, we reasonably propose the Activity-Security-Trust (AST) driven model through synthetically considering the explicit and implicit driving forces (e.g. activity, security, and trust) underlying the decision process. AST-driven model facilitates to more accurately capture highly dynamical network behaviors and figure out the complex evolution process, allowing a profound understanding of the effects of security and trust in driving network evolution, and improving the biases induced by only involving activity representations in analyzing the dynamical processes.

An action research approach for developing research and innovation in nursing and midwifery practice: building research capacity in one NHS foundation trust.

PubMed

Moore, Jenny; Crozier, Kenda; Kite, Katharine

2012-01-01

The National Health Service in the United Kingdom is committed to a process of reform centred on quality care and innovative practice. Central to this process is the need for research capacity building within the workforce. The aim of this study was to develop an infrastructure for research capacity building within one National Health Service Foundation Trust. Using an Action Research methodology, sixteen individuals were purposefully selected from a population of nurses and midwives to participate in the study. This nonprobability sampling method enabled the researchers to select participants on the basis of who would be most informative about existing research capacity building structures and processes within the Trust. Data were collected in the form of semi-structured individual interviews with each participant. The main findings were that research activity was not embedded in the culture of the organisation, and initiating and undertaking change was a complex process. As a result, a range of structures and processes which were considered necessary to enable the Trust move forward in developing capacity and capability for research were developed and implemented. This paper reports the first two stages of this process, namely: the findings from the pre-step and an outline of how these findings were used to create an infrastructure to support research capacity building within one NHS Foundation Trust Hospital in the United Kingdom. Copyright © 2011 Elsevier Ltd. All rights reserved.

Perceptions of the quality of generic medicines: implications for trust in public services within the local health system in Tumkur, India.

PubMed

Aivalli, Praveen Kumar; Elias, Maya Annie; Pati, Manoj Kumar; Bhanuprakash, Srinath; Munegowda, Chikkagollahalli; Shroff, Zubin Cyrus; Srinivas, Prashanth N

2017-01-01

Generic medicines are an important policy option to reduce out-of-pocket expenditure on medicines. However, negative perceptions of their quality affect utilisation and raise issues of confidence and trust in medicines and health services. The aim of the study was to test the quality of generic and branded medicines and explain negative perceptions towards generic medicines. The study was part of a larger study on access to medicines. Information on various quality parameters was collected for branded medicines and branded and unbranded generic versions of the same medicines from government and private pharmacies in Karnataka in Southern India. To assess perceptions related to quality and drivers of preferred point of care (public vs private), focus group discussions were conducted with diabetes and hypertension patients, health workers and private pharmacists. The results of the quality tests were assessed and thematic analysis was conducted on the qualitative data to develop a conceptual framework to explain perceptions of medicine and care quality in the local health system. The generic and branded variants of the medicines tested were of comparable quality. Contrary to the quality test results, patients' and health workers' perceptions of quality were largely in favour of branded medicines. Negative perceptions of medicine quality along with other drivers contribute towards choosing more expensive medicines in the private sector. Trust in the health system emerged as an underlying central theme that explained and drove choice of medicines and providers within the local health system. Negative perceptions of generic medicines and preferential promotion of branded medicines over generics by pharmaceutical companies could influence prescriber behaviour and affect trust in healthcare provided in public services. To succeed, access to medicines programmes need to systematically invest in information on quality of medicines and develop strategies to build trust in healthcare offered in government health services.

Perceptions of the quality of generic medicines: implications for trust in public services within the local health system in Tumkur, India

PubMed Central

Aivalli, Praveen Kumar; Elias, Maya Annie; Pati, Manoj Kumar; Bhanuprakash, Srinath; Munegowda, Chikkagollahalli; Shroff, Zubin Cyrus

2017-01-01

Introduction Generic medicines are an important policy option to reduce out-of-pocket expenditure on medicines. However, negative perceptions of their quality affect utilisation and raise issues of confidence and trust in medicines and health services. The aim of the study was to test the quality of generic and branded medicines and explain negative perceptions towards generic medicines. Methods The study was part of a larger study on access to medicines. Information on various quality parameters was collected for branded medicines and branded and unbranded generic versions of the same medicines from government and private pharmacies in Karnataka in Southern India. To assess perceptions related to quality and drivers of preferred point of care (public vs private), focus group discussions were conducted with diabetes and hypertension patients, health workers and private pharmacists. The results of the quality tests were assessed and thematic analysis was conducted on the qualitative data to develop a conceptual framework to explain perceptions of medicine and care quality in the local health system. Results The generic and branded variants of the medicines tested were of comparable quality. Contrary to the quality test results, patients’ and health workers’ perceptions of quality were largely in favour of branded medicines. Negative perceptions of medicine quality along with other drivers contribute towards choosing more expensive medicines in the private sector. Trust in the health system emerged as an underlying central theme that explained and drove choice of medicines and providers within the local health system. Conclusion Negative perceptions of generic medicines and preferential promotion of branded medicines over generics by pharmaceutical companies could influence prescriber behaviour and affect trust in healthcare provided in public services. To succeed, access to medicines programmes need to systematically invest in information on quality of medicines and develop strategies to build trust in healthcare offered in government health services. PMID:29531844

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

PubMed Central

Topp, Stephanie M; Chipukuma, Julien M

2016-01-01

Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers’ organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers’ clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients’ trust in health workers’ service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational management to strengthen providers’ trust in their employer(s) and colleagues, as an entry-point for developing both the capacity and a work culture oriented towards respectful and patient-centred care. PMID:25999586

Controlled human malaria infection trials: How tandems of trust and control construct scientific knowledge.

PubMed

Bijker, Else M; Sauerwein, Robert W; Bijker, Wiebe E

2016-02-01

Controlled human malaria infections are clinical trials in which healthy volunteers are deliberately infected with malaria under controlled conditions. Controlled human malaria infections are complex clinical trials: many different groups and institutions are involved, and several complex technologies are required to function together. This functioning together of technologies, people, and institutions is under special pressure because of potential risks to the volunteers. In this article, the authors use controlled human malaria infections as a strategic research site to study the use of control, the role of trust, and the interactions between trust and control in the construction of scientific knowledge. The authors argue that tandems of trust and control play a central role in the successful execution of clinical trials and the construction of scientific knowledge. More specifically, two aspects of tandems of trust and control will be highlighted: tandems are sites where trust and control coproduce each other, and tandems link the personal, the technical, and the institutional domains. Understanding tandems of trust and control results in setting some agendas for both clinical trial research and science and technology studies.

Why Trust the Head? Key Practices for Transformational School Leaders to Build a Purposeful Relationship of Trust

ERIC Educational Resources Information Center

Browning, Paul

2014-01-01

Trust is widely recognized as one of the key qualities that a successful leader needs to bring about change within his/her organization. Literature has also shown that trust plays a pivotal role in effective school leadership. However, little research has been undertaken to identify specific actions of a transformational school leader enabling…

The Dynamics of Trust in the Shanghai Water Supply Regime

NASA Astrophysics Data System (ADS)

Zhen, Nahui; Barnett, Jon; Webber, Michael

2018-02-01

Trust in natural resource managers and planners is recognized as a crucial component of the public's perception of environmental risks, including the risk of consuming water in cities. Although China is famous for its dubious water quality, public perception of the performance of water suppliers in China has scarcely been considered. Yet this is important, not least because improvements in urban water quality are most likely if the public perceives that there is a risk, which is a function of their levels of trust. We, therefore, examine the Shanghai public's trust in urban water authorities through analysis of the results from a face-to-face questionnaire that 5007 residents responded to. We find that although respondents show a moderate level of overall trust in water suppliers, they have less trust in the honesty and fairness of these organizations. In addition, we find that hukou status and education help explain the differences in people's trust in Shanghai's water authorities, and that these are more influential than factors such as gender and age. For water managers in Shanghai, this implies trust can be improved through a greater effort at public relations and increased transparency about decision making and levels of pollution.

Socio-Technical Considerations for the Use of Blockchain Technology in Healthcare.

PubMed

Wong, Ming Chao; Yee, Kwang Chien; Nøhr, Christian

2018-01-01

Blockchain technology is often considered as the fourth industrial revolution that will change the world. The enthusiasm of the transformative nature of blockchain technology has infiltrated healthcare. Blockchain is often seen as the much needed and perfect technology for healthcare, addressing the difficult and complex issues of security and inter-operability. More importantly, the "value" and trust-based system can deliver automated action and response via its smart contract mechanism. Healthcare, however, is a complex system. Health information technology (HIT) so far, has not delivered its promise of transforming healthcare due to its complex socio-technical and context sensitive interaction. The introduction of blockchain technology will need to consider a whole range of socio-technical issues in order to improve the quality and safety of patient care. This paper presents a discussion on these socio-technical issues. More importantly, this paper argues that in order to achieve the best outcome from blockchain technology, there is a need to consider a clinical transformation from "information" to "value " and trust. This paper argues that urgent research is needed to address these socio-technical issues in order to facilitate best outcomes for blockchain in healthcare. These socio-technical issues must then be further evaluated by means of working prototypes in the medical domain in coming years.

AST: Activity-Security-Trust driven modeling of time varying networks

PubMed Central

Wang, Jian; Xu, Jiake; Liu, Yanheng; Deng, Weiwen

2016-01-01

Network modeling is a flexible mathematical structure that enables to identify statistical regularities and structural principles hidden in complex systems. The majority of recent driving forces in modeling complex networks are originated from activity, in which an activity potential of a time invariant function is introduced to identify agents’ interactions and to construct an activity-driven model. However, the new-emerging network evolutions are already deeply coupled with not only the explicit factors (e.g. activity) but also the implicit considerations (e.g. security and trust), so more intrinsic driving forces behind should be integrated into the modeling of time varying networks. The agents undoubtedly seek to build a time-dependent trade-off among activity, security, and trust in generating a new connection to another. Thus, we reasonably propose the Activity-Security-Trust (AST) driven model through synthetically considering the explicit and implicit driving forces (e.g. activity, security, and trust) underlying the decision process. AST-driven model facilitates to more accurately capture highly dynamical network behaviors and figure out the complex evolution process, allowing a profound understanding of the effects of security and trust in driving network evolution, and improving the biases induced by only involving activity representations in analyzing the dynamical processes. PMID:26888717

The impact of characteristics of nurses' relationships with their supervisor, engagement and trust, on performance behaviours and intent to quit.

PubMed

Rodwell, John; McWilliams, John; Gulyas, Andre

2017-01-01

The aim of this study was to investigate the influence of characteristics of nurses' relationship quality with their manager on engagement and trust, onto in-role or discretionary behaviours and intent to quit. Nurses having a good relationship with their manager are seen as important, yet the mechanisms of how such relationships are beneficial, or which aspects of the relationship are important, is less clear. Two possible mechanisms are through the nurse being more engaged in work, or through building their trust in their employer. In turn, engagement and trust may impact in-role and discretionary behaviours as well as staff retention. Cross-sectional. An online survey in 2013 of 459 nurses across Australia. Structural analyses indicated that the affect dimension of relationship quality was negatively related to engagement, whereas contribution and respect were positively related to engagement. The affect and respect aspects were positively related to trust. Engagement positively related to discretionary and in-role behaviours. Engagement and trust were negatively related to quit intention, as was the loyalty dimension of the nurses' relationship with their supervisor. However, perceptions of variability in their team's relationship quality with their leader was negatively related to trust and positively related to intent to quit. Nurse managers with a nuanced understanding of social exchange at work are likely to maintain more engaged, well-performing and stable nursing teams. In particular, a willingness by the supervisor to come to their nurses' defence and having a consistent standard of relationship quality across their nurses is likely to improve nurse retention. © 2016 John Wiley & Sons Ltd.

Managing the complexity of nurse shortages: a case study of bank and agency staffing in an acute care Trust in Wales, UK.

PubMed

Massey, Lynn; Esain, Ann; Wallis, Marianne

2009-07-01

Managing nurse shortages is a major challenge in Trusts today given the worldwide shortage of nurses. To fill the gap created by a lack of permanent staff UK government agencies have increasingly used bank and agency staff. Managing this type of staffing effectively and efficiently, in the context of shrinking healthcare funds, is a major challenge in providing safe and quality healthcare. To analyse bank and agency nursing staffing patterns and factors that impact on these patterns. Case study within the largest hospital in one Welsh Integrated Healthcare Trust. De-identified bank and agency staffing electronic and manual database records and focus group interview with bank and agency office staff. A predictable bank and agency staffing pattern was found, wherein bank and agency nursing staff were used with increasing frequency towards the end of the week. Demand for bank and agency nursing staff occurred because of: hospital practices that fund a fixed staff establishment for nursing units, while patient numbers and acuity are variable; poor forward planning; sickness, and absence due to professional development or staff training. There is a need for managers to reconsider management and recruitment policies, particularly in relation to using bank and agency staff. The complexity of staffing challenges managers to focus on predictability of workload needs and other factors that affect staffing requirements, such as: professional development, flexible working rosters to match the need and minimize sickness and turnover of staff.

36 CFR 1010.1 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Trust's policy is to: (a) Use all practical means, consistent with the Trust's statutory authority, available resources, and national policy, to protect and enhance the quality of the human environment; (b... actions by the Trust; (c) Use systematic and timely approaches which will ensure the integrated use of the...

Game Theory Based Trust Model for Cloud Environment

PubMed Central

Gokulnath, K.; Uthariaraj, Rhymend

2015-01-01

The aim of this work is to propose a method to establish trust at bootload level in cloud computing environment. This work proposes a game theoretic based approach for achieving trust at bootload level of both resources and users perception. Nash equilibrium (NE) enhances the trust evaluation of the first-time users and providers. It also restricts the service providers and the users to violate service level agreement (SLA). Significantly, the problem of cold start and whitewashing issues are addressed by the proposed method. In addition appropriate mapping of cloud user's application to cloud service provider for segregating trust level is achieved as a part of mapping. Thus, time complexity and space complexity are handled efficiently. Experiments were carried out to compare and contrast the performance of the conventional methods and the proposed method. Several metrics like execution time, accuracy, error identification, and undecidability of the resources were considered. PMID:26380365

A game theory-based trust measurement model for social networks.

PubMed

Wang, Yingjie; Cai, Zhipeng; Yin, Guisheng; Gao, Yang; Tong, Xiangrong; Han, Qilong

2016-01-01

In social networks, trust is a complex social network. Participants in online social networks want to share information and experiences with as many reliable users as possible. However, the modeling of trust is complicated and application dependent. Modeling trust needs to consider interaction history, recommendation, user behaviors and so on. Therefore, modeling trust is an important focus for online social networks. We propose a game theory-based trust measurement model for social networks. The trust degree is calculated from three aspects, service reliability, feedback effectiveness, recommendation credibility, to get more accurate result. In addition, to alleviate the free-riding problem, we propose a game theory-based punishment mechanism for specific trust and global trust, respectively. We prove that the proposed trust measurement model is effective. The free-riding problem can be resolved effectively through adding the proposed punishment mechanism.

Facilitating Trust Engenderment in Secondary School Nurse Interactions with Students

ERIC Educational Resources Information Center

Summach, Anne H. J.

2011-01-01

School nurses are involved in a complex framework of interactions with students, other professionals, parents, and administrators. Trust between nurse and student is critical for interaction effectiveness. The goal of this study was to understand through phenomenology the process of engendering trust in school nurse-high school student…

Quality Assurance in UK Higher Education: Issues of Trust, Control, Professional Autonomy and Accountability

ERIC Educational Resources Information Center

Hoecht, Andreas

2006-01-01

This article explores the issues of trust, control, professional autonomy and accountability in higher education quality assurance in the UK. The main part of this article is conceptual, but it includes results from semi-structured interviews with academic staff that were conducted at two "new university" business schools. Both…

Parental Divorce and Interpersonal Trust in Adult Offspring.

ERIC Educational Resources Information Center

King, Valarie

2002-01-01

Examines whether parental divorce is associated with offspring trust in parents, intimate partners, and others. Results reveal that although parental divorce is negatively associated with trust, these effects largely disappear once the quality of the past parent-teen relationship is taken into account. (Contains 48 references and 4 tables.) (GCP)

36 CFR 1010.4 - NEPA Compliance Coordinator.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false NEPA Compliance Coordinator. 1010.4 Section 1010.4 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.4... Director, shall be the Trust official responsible for implementation and operation of the Trust's policies...

Trust in Physicians, Continuity and Coordination of Care, and Quality of Death in Patients with Advanced Cancer.

PubMed

Hamano, Jun; Morita, Tatsuya; Fukui, Sakiko; Kizawa, Yoshiyuki; Tunetou, Satoru; Shima, Yasuo; Kobayakawa, Makoto; Aoyama, Maho; Miyashita, Mitsunori

2017-11-01

Provider-centered factors contribute to unexplained variation in the quality of death (QOD). The relationship between healthcare providers (HCPs) and patients, bidirectional communication, and consistency of longitudinal care planning are important provider-centered factors. To explore whether the level of trust in HCPs, the quality of continuity of care, and the level of coordination of care among home HCPs are associated with the QOD for cancer patients dying at home. This study was a part of a nationwide multicenter questionnaire survey of bereaved family members of cancer patients evaluating the quality of end-of-life care in Japan. We investigated 702 family members of cancer patients who died at home. The QOD was evaluated from nine core domains of the short version of the Good Death Inventory (GDI). We measured five factors on a Likert scale, including patient and family trust in HCPs, continuity of care by home hospice and hospital physicians, and coordination of care among home hospice staff. A total of 538 responses (77%) were obtained and 486 responses were analyzed. Trust in HCPs was correlated with the GDI score (r = 0.300-0.387, p < 0.001). The quality of care coordination was associated with the GDI score (r = 0.242, p < 0.001). Trust of the patient and family in home hospice staff, as well as coordination of care among hospice staff, are associated with the QOD for cancer patients dying at home.

Influence of Data and Formulas on Trust in Information from Journal Articles in an Operating Room Management Course.

PubMed

Dexter, Franklin; Van Swol, Lyn M

2016-06-01

To make good decisions, operating room (OR) managers often act autocratically after obtaining expert advice. When such advice is provided by e-mail, attachments of research articles can be included. We performed a quasi-experimental study using an evaluation of 4 articles used in a 50-hour OR management course to assess how their content influences trust in the article's content, including its quality, usefulness, and reliability. There were (a) 2 articles containing data with specific examples of application for health systems and 2 without and (b) 2 articles containing appendices of formulas and 2 without. Some of the formulas in the readings were relatively complicated (e.g., stochastic optimization using the Lagrange method) and unlikely to be used by the subjects (i.e., they show what does not need to be done). Content complexity (±data, ±formulas) served both as sources of limitation in understanding the content and potentially as peripheral cues influencing perception of the content. The 2-page evaluation forms were generated with random sequences of articles and response items. The N = 17 subjects each completed 9 items about each of the 4 articles (i.e., answered 36 questions). The 9-item assessment of trust provided a unidimensional construct (Cronbach α, 0.94). Formulas in the articles significantly increased trust in the information (P = 0.0019). Presence of data did not significantly influence trust (P = 0.15). Therefore, when an expert sends e-mail to a manager who has completed this basic OR management science and asks a question, choosing a paper with formulas has no disadvantage.

The Strategic Direction for Army Science and Technology

DTIC Science & Technology

2013-02-01

methods to characterize the nature of trust (e.g., trust in information, trust in a network node or link), and to take measures to manage the trust...Science and Technology Executive, Dr. Thomas Killion, requested a study of peer review methods in use at Army laboratories. The paper discusses... sensors  Characterization of network dynamics and quality of information important to tactical decision-making Work that should be supported

Consumer evaluation of complaint handling in the Dutch health insurance market.

PubMed

Wendel, Sonja; de Jong, Judith D; Curfs, Emile C

2011-11-15

How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not influence consumer satisfaction evaluations and trust in the company to the same extent. Therefore, it is important for managers to be aware of the type of consumer satisfaction they are measuring when evaluating the handling of complaints within their company.

HealthTrust: A Social Network Approach for Retrieving Online Health Videos

PubMed Central

Karlsen, Randi; Melton, Genevieve B

2012-01-01

Background Social media are becoming mainstream in the health domain. Despite the large volume of accurate and trustworthy health information available on social media platforms, finding good-quality health information can be difficult. Misleading health information can often be popular (eg, antivaccination videos) and therefore highly rated by general search engines. We believe that community wisdom about the quality of health information can be harnessed to help create tools for retrieving good-quality social media content. Objectives To explore approaches for extracting metrics about authoritativeness in online health communities and how these metrics positively correlate with the quality of the content. Methods We designed a metric, called HealthTrust, that estimates the trustworthiness of social media content (eg, blog posts or videos) in a health community. The HealthTrust metric calculates reputation in an online health community based on link analysis. We used the metric to retrieve YouTube videos and channels about diabetes. In two different experiments, health consumers provided 427 ratings of 17 videos and professionals gave 162 ratings of 23 videos. In addition, two professionals reviewed 30 diabetes channels. Results HealthTrust may be used for retrieving online videos on diabetes, since it performed better than YouTube Search in most cases. Overall, of 20 potential channels, HealthTrust’s filtering allowed only 3 bad channels (15%) versus 8 (40%) on the YouTube list. Misleading and graphic videos (eg, featuring amputations) were more commonly found by YouTube Search than by searches based on HealthTrust. However, some videos from trusted sources had low HealthTrust scores, mostly from general health content providers, and therefore not highly connected in the diabetes community. When comparing video ratings from our reviewers, we found that HealthTrust achieved a positive and statistically significant correlation with professionals (Pearson r 10 = .65, P = .02) and a trend toward significance with health consumers (r 7 = .65, P = .06) with videos on hemoglobinA1 c, but it did not perform as well with diabetic foot videos. Conclusions The trust-based metric HealthTrust showed promising results when used to retrieve diabetes content from YouTube. Our research indicates that social network analysis may be used to identify trustworthy social media in health communities. PMID:22356723

Exploring the influence of trust relationships on motivation in the health sector: a systematic review.

PubMed

Okello, Dickson R O; Gilson, Lucy

2015-03-31

Dedicated and motivated health workers (HWs) play a major role in delivering efficient and effective health services that improve patients' experience of health care. Growing interest in HW motivation has led to a global focus on pay for performance strategies, but less attention has been paid to nurturing intrinsic motivation. Workplace trust relationships involve fair treatment and respectful interactions between individuals. Such relationships enable cooperation among HWs and their colleagues, supervisors, managers and patients and may act as a source of intrinsic motivation. This paper presents findings from a qualitative systematic review of empirical studies providing evidence on HW motivation, to consider what these studies suggest about the possible influence of workplace trust relationships over motivation. Five electronic databases were searched for articles reporting research findings about HW motivation for various cadres published in the 10-year period 2003 to 2013 and with available full free text in the English language. Data extraction involved consideration of the links between trust relationships and motivation, by identifying how studies directly or indirectly mention and discuss relevant factors. Twenty-three articles from low- and middle-income countries and eight from high-income countries that met predetermined quality and inclusion criteria were appraised and subjected to thematic synthesis. Workplace trust relationships with colleagues, supervisors and managers, employing organisation and patients directly and indirectly influence HW motivation. Motivational factors identified as linked to trust include respect; recognition, appreciation and rewards; supervision; teamwork; management support; autonomy; communication, feedback and openness; and staff shortages and resource inadequacy. To the authors' knowledge, this is the first systematic review on trust and motivation in the health sector. Evidence indicates that workplace trust relationships encourage social interactions and cooperation among HWs, have impact on the intrinsic motivation of HWs and have consequences for retention, performance and quality of care. Human resource management and organisational practices are critical in sustaining workplace trust and HW motivation. Research and assessment of the levels of motivation and factors that encourage workplace trust relationships should include how trust and motivation interact and operate for retention, performance and quality of care.

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres.

PubMed

Topp, Stephanie M; Chipukuma, Julien M

2016-03-01

Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational management to strengthen providers' trust in their employer(s) and colleagues, as an entry-point for developing both the capacity and a work culture oriented towards respectful and patient-centred care. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The Quality of School Life: Teacher-Student Trust Relationships and the Organizational School Context

ERIC Educational Resources Information Center

Van Maele, Dimitri; Van Houtte, Mieke

2011-01-01

In exploring the quality of schools' social system, this study provides insight into in which types of schools students may encounter barriers in developing supportive teacher-student relationships because of teachers exposing low levels of trust in students. Student culture and teachability perceptions are assessed as incentives for teachers'…

Perceived Parent-Child Relational Qualities and Parental Behavioral and Psychological Control in Chinese Adolescents in Hong Kong

ERIC Educational Resources Information Center

Shek, Daniel T. L.

2006-01-01

Chinese secondary school students (N = 3,017) were asked to respond to instruments measuring their perceived parent-child relational qualities (parental trust of the child, child's trust of parents, child's readiness to communicate with parents, and child's satisfaction with parental control), parental behavioral control (including indicators of…

Building Trust and Feeling Well: Examining Intraindividual and Interpersonal Outcomes and Underlying Mechanisms of Listening

ERIC Educational Resources Information Center

Lloyd, Karina J.; Boer, Diana; Kluger, Avraham N.; Voelpel, Sven C.

2015-01-01

We investigated perceived listening quality in relation to individual (self-clarity and emotional well-being) and dyadic variables (social attraction and trust). Specifically, we proposed that the link between perceived listening quality and emotional well-being is mediated by self-clarity, and that the link between perceived listening and trust…

Scientists' and science writers' experiences reporting genetic discoveries: toward an ethic of trust in science journalism.

PubMed

Geller, Gail; Bernhardt, Barbara A; Gardner, Mary; Rodgers, Joann; Holtzman, Neil A

2005-03-01

To describe the relationship between scientists and science writers and their experiences with media reporting of genetic discoveries. This study included individual interviews with 15 scientists who specialize in genetics and 22 science writers who have covered their stories and a qualitative analysis of the data. Scientists and science writers place an equally high priority on accuracy of media reports. They agree on what makes genetics stories newsworthy and the particular challenges in reporting genetic discoveries (i.e., poor public understanding of genetics, the association of genetics with eugenics, and the lack of immediately apparent applications of genetic discoveries to human health). The relationship between scientists and bona fide science writers is largely positive. Scientists tend to trust, respect, and be receptive to science writers. Both scientists and science writers acknowledge that trust is an essential component of a good interview. Science writers report a fair degree of autonomy with respect to the relationship they have with their editors. To the degree that trust facilitates the access that science writers have to scientists, as well as higher quality interviews between scientists and science writers, trust might also contribute to higher quality media reporting. Therefore, scientists and science writers have an ethical obligation to foster trusting relationships with each other. Future research should systematically explore ways to cultivate such relationships and assess their impact on the quality of science journalism.

Understanding Trust as an Essential Element of Trainee Supervision and Learning in the Workplace

ERIC Educational Resources Information Center

Hauer, Karen E.; ten Cate, Olle; Boscardin, Christy; Irby, David M.; Iobst, William; O'Sullivan, Patricia S.

2014-01-01

Clinical supervision requires that supervisors make decisions about how much independence to allow their trainees for patient care tasks. The simultaneous goals of ensuring quality patient care and affording trainees appropriate and progressively greater responsibility require that the supervising physician trusts the trainee. Trust allows the…

Public trust in primary care doctors, the medical profession and the healthcare system among Redhill residents in Singapore.

PubMed

Lee, Yi Yong; Ng, Choon Ta; Siti Aishah, M Ghazalie; Ngiam, Ju Zheng; Tai, Bee Choo; Lim, Meng Kin; Hughes, Kenneth

2007-08-01

There have been few studies on public trust in doctors and healthcare systems and this is the first in Singapore. A cross-sectional survey was carried out in Redhill in January 2005. Citizens or Permanent Residents aged > or =18 years were randomly selected, one per household to avoid cluster bias, and 361 participated (response rate 68.7%). An interview administered questionnaire included 3 questionnaires measuring public trust: "Interpersonal Trust in Physicians Scale" for primary care doctors; "Trust in Physicians Generally Scale" for the medical profession; and "Trust in Healthcare System Scale" for the Healthcare System. Questions were answered on a Likert scale: 1. Strongly Disagree, 2. Disagree, 3. Neutral, 4. Agree, 5. Strongly Agree. Individual transformed scores of trust (range, 0 to 100) were equally divided into 5 categories with their average being the transformed mean. Trust in primary care doctors (mean 59.7) had proportions (prevalence rates) of: very low 0.3%, low 2.5%, neutral 40.4%, high 54.0%, and very high 2.8%. Trust in the medical profession (mean 61.8) had proportions of: very low 1.0%, low 7.7%, neutral 33.7%, high 47.0%, and very high 10.5%. Trust in the healthcare system (mean 61.5) had proportions of: very low 0.5%, low 4.1%, neutral 40.0%, high 48.7%, and very high 6.7%. For areas of the healthcare system, proportions of high/very high trust were: "Healthcare Providers' Expertise" (70.8%), "Quality of Care" (61.5%), "Patient Focus of Providers" (58.7%), "Information Supply and Communication by Care Providers" (52.3%), "Quality of Cooperation" (43.3%), and Policies of the Healthcare System" (24.6%). While low proportions had low/very low trust, the high proportions with neutral trust and the rather low level of trust in "Policies of the Healthcare System" are causes for concern.

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters.

PubMed

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

2013-01-16

Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients' perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients' overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a direct effect; and (B) service quality and patient trust are used as intervening variables to affect patient satisfaction, which represents an indirect effect. Due to differences in the scale, resources and costs among medical institutions of different levels, it is a most urgent and concerning issue of how to control customers' demands and preferences and adopt correct marketing concepts under the circumstances of intense competition in order to satisfy the public and build up a competitive edge for medical institutions.

Exploring Communication, Trust in Government, and Vaccination Intention Later in the 2009 H1N1 Pandemic: Results of a National Survey

PubMed Central

Parmer, John; Freimuth, Vicki S.; Hilyard, Karen M.; Musa, Donald; Kim, Kevin H.

2013-01-01

With the growing recognition of the critical role that risk communication plays in a public health emergency, a number of articles have provided prescriptive best practices to enhance such communication. However, little empirical research has examined perceptions of the quality of communication, the impact of uncertainty on changing communication, use of information sources, and trust in specific government spokespersons. Similarly, although there is significant conceptual focus on trust and communication as important in vaccination intent and acceptance, little research has explored these relationships empirically. We conducted an online survey in late January 2010 with a nationally representative sample (N=2,079) that included Hispanic and African American oversamples. The completion rate was 56%. We found that public health officials were the most trusted spokespersons, with President Obama being the most highly trusted elected official. Demographic variables, including race, accounted for 21% of the variance in trust of the president. Perceptions of the quality of communication were high, including significant understanding of uncertainty and appreciation for officials' openness about evolving information. Other factors that contributed to vaccination acceptance were quality of communication, closely following the news, and confidence in the vaccine because of a role model effect of the Obama daughters' immunizations; these factors significantly increased trust in government actions. Because the challenges of communication often vary over the course of a pandemic, there is a consistent need to pay close attention to both communication content and delivery and prepare public health officials at all levels to be effective communicators. PMID:23617721

Familiarity Vs Trust: A Comparative Study of Domain Scientists' Trust in Visual Analytics and Conventional Analysis Methods.

PubMed

Dasgupta, Aritra; Lee, Joon-Yong; Wilson, Ryan; Lafrance, Robert A; Cramer, Nick; Cook, Kristin; Payne, Samuel

2017-01-01

Combining interactive visualization with automated analytical methods like statistics and data mining facilitates data-driven discovery. These visual analytic methods are beginning to be instantiated within mixed-initiative systems, where humans and machines collaboratively influence evidence-gathering and decision-making. But an open research question is that, when domain experts analyze their data, can they completely trust the outputs and operations on the machine-side? Visualization potentially leads to a transparent analysis process, but do domain experts always trust what they see? To address these questions, we present results from the design and evaluation of a mixed-initiative, visual analytics system for biologists, focusing on analyzing the relationships between familiarity of an analysis medium and domain experts' trust. We propose a trust-augmented design of the visual analytics system, that explicitly takes into account domain-specific tasks, conventions, and preferences. For evaluating the system, we present the results of a controlled user study with 34 biologists where we compare the variation of the level of trust across conventional and visual analytic mediums and explore the influence of familiarity and task complexity on trust. We find that despite being unfamiliar with a visual analytic medium, scientists seem to have an average level of trust that is comparable with the same in conventional analysis medium. In fact, for complex sense-making tasks, we find that the visual analytic system is able to inspire greater trust than other mediums. We summarize the implications of our findings with directions for future research on trustworthiness of visual analytic systems.

Performance of serological tests for syphilis in sexually transmitted diseases clinics in Guangxi Autonomous Region, China: implications for syphilis surveillance and control.

PubMed

Yin, Yue-Ping; Wei, Wan-Hui; Wang, Hong-Chun; Zhu, Bang-Yong; Yu, Yan-Hua; Chen, Xiang-Sheng; Peeling, Rosanna W; Cohen, Myron S

2009-03-01

China is experiencing a growing syphilis epidemic. Individuals are currently screened and cases are confirmed using traditional serological testing methods. A total of 11 558 serum specimens from patients at 14 sexually transmitted diseases (STD) clinics at provincial, prefecture and county levels in Guangxi Autonomous Region were tested at local clinics using the toluidine red unheated serum test (TRUST) and the SD Bioline Syphilis 3.0 Treponema Pallidum (SD-TP) test and then transported to the National STD Reference Laboratory for TRUST and confirmatory Treponema pallidum particle assay (TPPA) testing. In local clinics, 13.2% of specimens were TRUST positive and 12.8% were TRUST and SD-TP positive. At the Reference Laboratory, 15.4% of specimens were TRUST positive and 11.8% were TRUST and TPPA positive. Local clinics showed a significantly higher prevalence of active syphilis compared with results from the Reference Laboratory (12.8 v. 11.8%, chi(2) = 4.59, P = 0.03). The local TRUST tests had consistent results with Reference Laboratory tests qualitatively among 96.2% of the specimens and quantitatively among 95.5% of the specimens. The algorithm of TRUST screening and then SD-TP confirmation among positive TRUST specimens at local STD clinics had 96.6% sensitivity and 99.3% specificity in diagnosing active syphilis compared with the 'gold standard' based on TRUST and TPPA positivity at the Reference Laboratory (positive predictive value 95.1% and negative predictive value 99.5%). The TRUST screening and SD-TP confirmation in combination can be used at local STD clinics for the efficient diagnosis of serologically active syphilis. However, continuing capacity building and quality assurance remain critical in ensuring the quality of syphilis diagnosis at local clinics.

A multi-domain trust management model for supporting RFID applications of IoT

PubMed Central

Li, Feng

2017-01-01

The use of RFID technology in complex and distributed environments often leads to a multi-domain RFID system, in which trust establishment among entities from heterogeneous domains without past interaction or prior agreed policy, is a challenge. The current trust management mechanisms in the literature do not meet the specific requirements in multi-domain RFID systems. Therefore, this paper analyzes the special challenges on trust management in multi-domain RFID systems, and identifies the implications and the requirements of the challenges on the solutions to the trust management of multi-domain RFID systems. A multi-domain trust management model is proposed, which provides a hierarchical trust management framework include a diversity of trust evaluation and establishment approaches. The simulation results and analysis show that the proposed method has excellent ability to deal with the trust relationships, better security, and higher accuracy rate. PMID:28708855

A multi-domain trust management model for supporting RFID applications of IoT.

PubMed

Wu, Xu; Li, Feng

2017-01-01

The use of RFID technology in complex and distributed environments often leads to a multi-domain RFID system, in which trust establishment among entities from heterogeneous domains without past interaction or prior agreed policy, is a challenge. The current trust management mechanisms in the literature do not meet the specific requirements in multi-domain RFID systems. Therefore, this paper analyzes the special challenges on trust management in multi-domain RFID systems, and identifies the implications and the requirements of the challenges on the solutions to the trust management of multi-domain RFID systems. A multi-domain trust management model is proposed, which provides a hierarchical trust management framework include a diversity of trust evaluation and establishment approaches. The simulation results and analysis show that the proposed method has excellent ability to deal with the trust relationships, better security, and higher accuracy rate.

Investigating the Role of Collective Trust, Collective Efficacy, and Enabling School Structures on Overall School Effectiveness

ERIC Educational Resources Information Center

Gray, Julie

2016-01-01

This study investigated the role of collective trust, collective efficacy, and enabling school structures on overall school effectiveness. While the concept of organizational effectiveness can be complex and difficult to measure, the results of this research demonstrated a connection of these variables to school effectiveness. Collective trust had…

Determinants of patient loyalty to healthcare providers: An integrative review.

PubMed

Zhou, Wei-Jiao; Wan, Qiao-Qin; Liu, Cong-Ying; Feng, Xiao-Lin; Shang, Shao-Mei

2017-08-01

Patient loyalty is key to business success for healthcare providers and also for patient health outcomes. This study aims to identify determinants influencing patient loyalty to healthcare providers and propose an integrative conceptual model of the influencing factors. PubMed, CINAHL, OVID, ProQuest and Elsevier Science Direct databases were searched. Publications about determinants of patient loyalty to health providers were screened, and 13 articles were included. Date of publication, location of the research, sample details, objectives and findings/conclusions were extracted for 13 articles. Thirteen studies explored eight determinants: satisfaction, quality, value, hospital brand image, trust, commitment, organizational citizenship behavior and customer complaints. The integrated conceptual model comprising all the determinants demonstrated the significant positive direct impact of quality on satisfaction and value, satisfaction on trust and commitment, trust on commitment and loyalty, and brand image on quality and loyalty. This review identifies and models the determinants of patient loyalty to healthcare providers. Further studies are needed to explore the influence of trust, commitment, and switching barriers on patient loyalty. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Improving TSA’s Public Image: Customer-Focused Initiatives to Encourage Public Trust and Confidence

DTIC Science & Technology

2013-12-01

INITIATIVES TO ENCOURAGE PUBLIC TRUST AND CONFIDENCE Patricia S. Bierle Customer Support and Quality Improvement Manager, Transportation Security...PUBLIC IMAGE: CUSTOMER-FOCUSED INITIATIVES TO ENCOURAGE PUBLIC TRUST AND CONFIDENCE by Patricia S. Bierle December 2013 Thesis Co-Advisors...33 e . Government Leaders Impact Public Opinion ........................35 f. Aviation Stakeholders Also Impact

Improving the trust in results of numerical simulations and scientific data analytics

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

Cappello, Franck; Constantinescu, Emil; Hovland, Paul

This white paper investigates several key aspects of the trust that a user can give to the results of numerical simulations and scientific data analytics. In this document, the notion of trust is related to the integrity of numerical simulations and data analytics applications. This white paper complements the DOE ASCR report on Cybersecurity for Scientific Computing Integrity by (1) exploring the sources of trust loss; (2) reviewing the definitions of trust in several areas; (3) providing numerous cases of result alteration, some of them leading to catastrophic failures; (4) examining the current notion of trust in numerical simulation andmore » scientific data analytics; (5) providing a gap analysis; and (6) suggesting two important research directions and their respective research topics. To simplify the presentation without loss of generality, we consider that trust in results can be lost (or the results’ integrity impaired) because of any form of corruption happening during the execution of the numerical simulation or the data analytics application. In general, the sources of such corruption are threefold: errors, bugs, and attacks. Current applications are already using techniques to deal with different types of corruption. However, not all potential corruptions are covered by these techniques. We firmly believe that the current level of trust that a user has in the results is at least partially founded on ignorance of this issue or the hope that no undetected corruptions will occur during the execution. This white paper explores the notion of trust and suggests recommendations for developing a more scientifically grounded notion of trust in numerical simulation and scientific data analytics. We first formulate the problem and show that it goes beyond previous questions regarding the quality of results such as V&V, uncertainly quantification, and data assimilation. We then explore the complexity of this difficult problem, and we sketch complementary general approaches to address it. This paper does not focus on the trust that the execution will actually complete. The product of simulation or of data analytic executions is the final element of a potentially long chain of transformations, where each stage has the potential to introduce harmful corruptions. These corruptions may produce results that deviate from the user-expected accuracy without notifying the user of this deviation. There are many potential sources of corruption before and during the execution; consequently, in this white paper we do not focus on the protection of the end result after the execution.« less

Trust, Health Care Relationships, and Chronic Illness

PubMed Central

Robinson, Carole A.

2016-01-01

Trust in health care relationships is a key ingredient of effective, high-quality care. Although the indirect influence of trust on health outcomes has long been recognized, recent research has shown that trust has a direct effect on outcomes of care. Trust is important. However, the research on trust is disparate, organized around differing definitions, and primarily focused on patients’ trust in physicians. Morse’s method of theoretical coalescence was used to further develop and elaborate a grounded theory of the evolution of trust in health care relationships, in the context of chronic illness. This middle-range theory offers a clear conceptual framework for organizing and relating disparate studies, explaining the findings of different studies at a higher conceptual level, and identifying gaps in research and understanding. In addition, the grounded theory is relevant to practice. PMID:28508016

From vision to reality--managing change in the provision of library and information services to nurses, midwives, health visitors and PAMs: (professions allied to medicine) a case study of the North Thames experience with the Inner London Consortium.

PubMed

Godbolt, S; Williamson, J; Wilson, A

1997-06-01

One of the North Thames' pioneering consortia, the Inner London Consortium (ILC) is a complex body which includes NHS Trusts with teaching hospital university connections, community-based Trusts and general hospital acute Trusts. Within the consortium there are 12,000 trained nurses, midwives, health visitors and other professional staff working in the professions allied to medicine (PAMs), all of whom require access to and provision of appropriate library information services. In 1994, taking into account experiences elsewhere in the Region and nationally, it became clear that library issues were complex and would become acute with the move of nursing libraries from ILC Trust sites over a very short timescale. A report on the issues commissioned by the Consortium recommended that a library project, which built on existing NHS Trust PGMDE funded library resources and moved these to a multidisciplinary base to serve the consortium membership, be implemented. The objective of providing access to library information services for nurses and PAMs was achieved. Successes that emerged from the implementation included: The registration in Trust libraries of almost 12 000 new members within the initial 6-month monitoring period. The development of service level agreements and standards for the delivery of services to these new user groups. This paper describes the processes behind these significant and complex changes.

In regulation we trust.

PubMed

Wiig, Siri; Tharaldsen, Jorunn Elise

2012-01-01

The role of trust has been argued to play an increasingly important role in modern, complex, and ambivalent risk societies. Trust within organizational research is anticipated to have a general strategic impact on aspects such as organizational performance, communication and knowledge exchange, and learning from accidents. Trust is also an important aspect related to regulation of risk. Diverse regulatory regimes, their contexts and risks influence regulators use of trust and distrust in regulatory practice. The aim of this paper is to discuss the relationship between risk regulation and trust across diverse risk regulation regimes. By drawing from studies of risk regulation, risk perception, and trust the purpose is to discuss how regulation and trust are linked and used in practice to control risk across system levels in socio-technical systems in high risk industries. This paper provides new knowledge on 1) how functional and dysfunctional trust and distrust are grounded in the empirical realities of high risk industries, 2) how different perspectives on trust and distrust act together and bring new knowledge on how society control risk.

Trust in automation: designing for appropriate reliance.

PubMed

Lee, John D; See, Katrina A

2004-01-01

Automation is often problematic because people fail to rely upon it appropriately. Because people respond to technology socially, trust influences reliance on automation. In particular, trust guides reliance when complexity and unanticipated situations make a complete understanding of the automation impractical. This review considers trust from the organizational, sociological, interpersonal, psychological, and neurological perspectives. It considers how the context, automation characteristics, and cognitive processes affect the appropriateness of trust. The context in which the automation is used influences automation performance and provides a goal-oriented perspective to assess automation characteristics along a dimension of attributional abstraction. These characteristics can influence trust through analytic, analogical, and affective processes. The challenges of extrapolating the concept of trust in people to trust in automation are discussed. A conceptual model integrates research regarding trust in automation and describes the dynamics of trust, the role of context, and the influence of display characteristics. Actual or potential applications of this research include improved designs of systems that require people to manage imperfect automation.

Overseeing oversight: governance of quality and safety by hospital boards in the English NHS.

PubMed

Mannion, Russell; Davies, Huw; Freeman, Tim; Millar, Ross; Jacobs, Rowena; Kasteridis, Panos

2015-01-01

To contribute towards an understanding of hospital board composition and to explore board oversight of patient safety and health care quality in the English NHS. We reviewed the theory related to hospital board governance and undertook two national surveys about board management in NHS acute and specialist hospital trusts in England. The first survey was issued to 150 trusts in 2011/2012 and was completed online via a dedicated web tool. A total 145 replies were received (97% response rate). The second online survey was undertaken in 2012/2013 and targeted individual board members, using a previously validated standard instrument on board members' attitudes and competencies (the Board Self-Assessment Questionnaire). A total of 334 responses were received from 165 executive and 169 non-executive board members, providing at least one response from 95 of the 144 NHS trusts then in existence (66% response rate). Over 90% of the English NHS trust boards had 10-15 members. We found no significant difference in board size between trusts of different types (e.g. Foundation Trusts versus non-Foundation Trusts and Teaching Hospital Trusts versus non-Teaching Hospital Trusts). Clinical representation on boards was limited: around 62% had three or fewer members with clinical backgrounds. For about two-thirds of the trusts (63%), board members with a clinical background comprised less than 30% of the members. Boards were using a wide range and mix of quantitative performance metrics and soft intelligence (e.g. walk-arounds, patient stories) to monitor their organisations with regard to patient safety. The Board Self-Assessment Questionnaire data showed generally high or very high levels of agreement with desirable statements of practice in each of its six dimensions. Aggregate levels of agreement within each dimension ranged from 73% (for the dimension addressing interpersonal issues) to 85% (on the political). English NHS boards largely hold a wide range of attitudes and behaviours that might be expected to benefit patient safety and quality. However, there is significant scope for improvement as regards formal training for board members on quality and safety, routine morbidity reporting at boards and attention to the interpersonal dynamics within boards. Directors with clinical backgrounds remain a minority on most boards despite policies to increase their representation. A better understanding of board composition, actions and attitudes should help refine policy recommendations around boards. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Understanding Older Adult's Perceptions of Factors that Support Trust in Human and Robot Care Providers.

PubMed

Stuck, Rachel E; Rogers, Wendy A

2017-06-01

As the population of older adults increase so will the need for care providers, both human and robot. Trust is a key aspect to establish and maintain a successful older adult-care provider relationship. However, due to trust volatility it is essential to understand it within specific contexts. This proposed mixed methods study will explore what dimensions of trust emerge as important within the human-human and human-robot dyads in older adults and care providers. First, this study will help identify key qualities that support trust in a care provider relationship. By understanding what older adults perceive as needing to trust humans and robots for various care tasks, we can begin to provide recommendations based on user expectations for design to support trust.

The Effectiveness of Health Care Information Technologies: Evaluation of Trust, Security Beliefs, and Privacy as Determinants of Health Care Outcomes

PubMed Central

2018-01-01

Background The diffusion of health information technologies (HITs) within the health care sector continues to grow. However, there is no theory explaining how success of HITs influences patient care outcomes. With the increase in data breaches, HITs’ success now hinges on the effectiveness of data protection solutions. Still, empirical research has only addressed privacy concerns, with little regard for other factors of information assurance. Objective The objective of this study was to study the effectiveness of HITs using the DeLone and McLean Information Systems Success Model (DMISSM). We examined the role of information assurance constructs (ie, the role of information security beliefs, privacy concerns, and trust in health information) as measures of HIT effectiveness. We also investigated the relationships between information assurance and three aspects of system success: attitude toward health information exchange (HIE), patient access to health records, and perceived patient care quality. Methods Using structural equation modeling, we analyzed the data from a sample of 3677 cancer patients from a public dataset. We used R software (R Project for Statistical Computing) and the Lavaan package to test the hypothesized relationships. Results Our extension of the DMISSM to health care was supported. We found that increased privacy concerns reduce the frequency of patient access to health records use, positive attitudes toward HIE, and perceptions of patient care quality. Also, belief in the effectiveness of information security increases the frequency of patient access to health records and positive attitude toward HIE. Trust in health information had a positive association with attitudes toward HIE and perceived patient care quality. Trust in health information had no direct effect on patient access to health records; however, it had an indirect relationship through privacy concerns. Conclusions Trust in health information and belief in the effectiveness of information security safeguards increases perceptions of patient care quality. Privacy concerns reduce patients’ frequency of accessing health records, patients’ positive attitudes toward HIE exchange, and overall perceived patient care quality. Health care organizations are encouraged to implement security safeguards to increase trust, the frequency of health record use, and reduce privacy concerns, consequently increasing patient care quality. PMID:29643052

Consumer evaluation of complaint handling in the Dutch health insurance market

PubMed Central

2011-01-01

Background How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. Methods A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Results Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Conclusions Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not influence consumer satisfaction evaluations and trust in the company to the same extent. Therefore, it is important for managers to be aware of the type of consumer satisfaction they are measuring when evaluating the handling of complaints within their company. PMID:22085762

A Preliminary Mixed-Method Investigation of Trust and Hidden Signals in Medical Consultations

PubMed Central

Riva, Silvia; Monti, Marco; Iannello, Paola; Pravettoni, Gabriella; Schulz, Peter J.; Antonietti, Alessandro

2014-01-01

Background Several factors influence patients' trust, and trust influences the doctor-patient relationship. Recent literature has investigated the quality of the personal relationship and its dynamics by considering the role of communication and the elements that influence trust giving in the frame of general practitioner (GP) consultations. Objective We analysed certain aspects of the interaction between patients and GPs to understand trust formation and maintenance by focusing on communication channels. The impact of socio-demographic variables in trust relationships was also evaluated. Method A cross-sectional design using concurrent mixed qualitative and quantitative research methods was employed. One hundred adults were involved in a semi-structured interview composed of both qualitative and quantitative items for descriptive and exploratory purposes. The study was conducted in six community-based departments adjacent to primary care clinics in Trento, Italy. Results The findings revealed that patients trusted their GP to a high extent by relying on simple signals that were based on the quality of the one-to-one communication and on behavioural and relational patterns. Patients inferred the ability of their GP by adopting simple heuristics based mainly on the so-called social “honest signals” rather than on content-dependent features. Furthermore, socio-demographic variables affected trust: less literate and elderly people tended to trust more. Conclusions This study is unique in attempting to explore the role of simple signals in trust relationships within medical consultation: people shape trust and give meaning to their relationships through a powerful channel of communication that orbits not around words but around social relations. The findings have implications for both clinicians and researchers. For doctors, these results suggest a way of thinking about encounters with patients. For researchers, the findings underline the importance of analysing some new key factors around trust for future investigations in medical practice and education. PMID:24618683

Trust and mindreading in adolescents: the moderating role of social value orientation.

PubMed

Derks, Jeffrey; Van Scheppingen, Manon A; Lee, Nikki C; Krabbendam, Lydia

2015-01-01

In adolescence, aspects of cognition that are required to deal with complex cooperation situations, such as mentalising and social value orientation, are still in development. In the Trust Game, cooperation may lead to better outcomes for both players, but can also lead to exploitation by the trustee. In the present study, we explore how mindreading, a crucial aspect of mentalising, and social value orientation (whether someone is prosocial or proself) are related to trust. In a group of 217 students (51% girls, Mage = 15.1) social value orientation, mindreading and trust (using the Trust Game) were measured. The result show that social value orientation moderates the relation between mindreading and trust. In the group of prosocials, we find no correlation between mindreading and trust. In the group of proselfs, mindreading is negatively correlated to trust, indicating that proselfs use their mentalising skills to assess that the trustee is likely to exploit them.

Assessing the effects of subject motion on T2 relaxation under spin tagging (TRUST) cerebral oxygenation measurements using volume navigators.

PubMed

Stout, Jeffrey N; Tisdall, M Dylan; McDaniel, Patrick; Gagoski, Borjan; Bolar, Divya S; Grant, Patricia Ellen; Adalsteinsson, Elfar

2017-12-01

Subject motion may cause errors in estimates of blood T 2 when using the T 2 -relaxation under spin tagging (TRUST) technique on noncompliant subjects like neonates. By incorporating 3D volume navigators (vNavs) into the TRUST pulse sequence, independent measurements of motion during scanning permit evaluation of these errors. The effects of integrated vNavs on TRUST-based T 2 estimates were evaluated using simulations and in vivo subject data. Two subjects were scanned with the TRUST+vNav sequence during prescribed movements. Mean motion scores were derived from vNavs and TRUST images, along with a metric of exponential fit quality. Regression analysis was performed between T 2 estimates and mean motion scores. Also, motion scores were determined from independent neonatal scans. vNavs negligibly affected venous blood T 2 estimates and better detected subject motion than fit quality metrics. Regression analysis showed that T 2 is biased upward by 4.1 ms per 1 mm of mean motion score. During neonatal scans, mean motion scores of 0.6 to 2.0 mm were detected. Motion during TRUST causes an overestimate of T 2 , which suggests a cautious approach when comparing TRUST-based cerebral oxygenation measurements of noncompliant subjects. Magn Reson Med 78:2283-2289, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Facilitating trust engenderment in secondary school nurse interactions with students.

PubMed

Summach, Anne H J

2011-04-01

School nurses are involved in a complex framework of interactions with students, other professionals, parents, and administrators. Trust between nurse and student is critical for interaction effectiveness. The goal of this study was to understand through phenomenology the process of engendering trust in school nurse-high school student interactions. The qualitative approach explored school nurse perceptions of experiences interacting with students, yielding insights into nurse- and setting-based factors contributing to the development of trust. Subthemes within these included key behaviors and attributes enhancing trust engenderment in school nurse-student interactions. Study findings were well supported by the existing nursing and psychological research literature. Nurses that purposefully strive to develop trust in young people will maximize adolescent health results.

DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES

PubMed Central

YSA, TAMYKO; SIERRA, VICENTA; ESTEVE, MARC

2014-01-01

The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized. PMID:25520529

DETERMINANTS OF NETWORK OUTCOMES: THE IMPACT OF MANAGEMENT STRATEGIES.

PubMed

Ysa, Tamyko; Sierra, Vicenta; Esteve, Marc

2014-09-01

The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more influence on network dynamics than previously theorized.

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

PubMed Central

2013-01-01

Background Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. Methods We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Results Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. Conclusions According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a direct effect; and (B) service quality and patient trust are used as intervening variables to affect patient satisfaction, which represents an indirect effect. Due to differences in the scale, resources and costs among medical institutions of different levels, it is a most urgent and concerning issue of how to control customers’ demands and preferences and adopt correct marketing concepts under the circumstances of intense competition in order to satisfy the public and build up a competitive edge for medical institutions. PMID:23320786

Influence of worklife on public health.

PubMed

Aronsson, G

1999-12-01

The paper discusses worklife changes with broad public health impacts. Central concepts for the analysis of the labor market are flexibility and differentiation. One conclusion is that there is ongoing polarization and differentiation--with an increased group of people in time-restricted (contingent) employment and self-employment and a reduced group of core workers. Greater demands for adaptability are being imposed on the majority of employees. Concepts related to flexibility and differentiation at an individual level are adaptability, identity formation, loss of control, trust and lack of trust, allostatic load, long-term strain, and psychological contracting. The labor market and organizational changes are discussed in relation to what can be called "institutional effectiveness". These changes refer to how institutions commissioned to act for the prevention of injuries and to contribute to worklife quality handle the new conditions. Finally, work-environment research is discussed in relation to a new and more complex pattern of exposures and interactions. One conclusion drawn is that it is becoming increasingly difficult to identify workplaces at risk.

Trust-based Access Control in Virtual Learning Community

NASA Astrophysics Data System (ADS)

Wang, Shujuan; Liu, Qingtang

The virtual learning community is an important application pattern of E-Learning. It emphasizes the cooperation of the members in the community, the members would like to share their learning resources, to exchange their experience and complete the study task together. This instructional mode has already been proved as an effective way to improve the quality and efficiency of instruction. At the present time, the virtual learning communities are mostly designed using static access control policy by which the access permission rights are authorized by the super administrator, the super administrator assigns different rights to different roles, but the virtual and social characteristics of virtual learning community make information sharing and collaboration a complex problem, the community realizes its instructional goal only if the members in it believe that others will offer the knowledge they owned and believe the knowledge others offered is well-meaning and worthy. This paper tries to constitute an effective trust mechanism, which could promise favorable interaction and lasting knowledge sharing.

Semi-regular remeshing based trust region spherical geometry image for 3D deformed mesh used MLWNN

NASA Astrophysics Data System (ADS)

Dhibi, Naziha; Elkefi, Akram; Bellil, Wajdi; Ben Amar, Chokri

2017-03-01

Triangular surface are now widely used for modeling three-dimensional object, since these models are very high resolution and the geometry of the mesh is often very dense, it is then necessary to remesh this object to reduce their complexity, the mesh quality (connectivity regularity) must be ameliorated. In this paper, we review the main methods of semi-regular remeshing of the state of the art, given the semi-regular remeshing is mainly relevant for wavelet-based compression, then we present our method for re-meshing based trust region spherical geometry image to have good scheme of 3d mesh compression used to deform 3D meh based on Multi library Wavelet Neural Network structure (MLWNN). Experimental results show that the progressive re-meshing algorithm capable of obtaining more compact representations and semi-regular objects and yield an efficient compression capabilities with minimal set of features used to have good 3D deformation scheme.

A Cross-Cultural Multi-agent Model of Opportunism in Trade

NASA Astrophysics Data System (ADS)

Hofstede, Gert Jan; Jonker, Catholijn M.; Verwaart, Tim

According to transaction cost economics, contracts are always incomplete and offer opportunities to defect. Some level of trust is a sine qua non for trade. If the seller is better informed about product quality than the buyer, the buyer has to rely on information the seller provides or has to check the information by testing the product or tracing the supply chain processes, thus incurring extra transaction cost. An opportunistic seller who assumes the buyer to trust, may deliver a lower quality product than agreed upon. In human decisions to deceive and to show trust or distrust, issues like mutual expectations, shame, self-esteem, personality, and reputation are involved. These factors depend in part on traders' cultural background. This paper proposes an agent model of deceit and trust and describes a multi-agent simulation where trading agents are differentiated according to Hofstede's dimensions of national culture. Simulations of USA and Dutch trading situations are compared.

Trust in health information websites: A systematic literature review on the antecedents of trust.

PubMed

Kim, Yeolib

2016-06-01

Health websites are important sources of information for consumers. In choosing websites, trust in websites largely determines which website to access and how to best utilize the information. Thus, it is critical to understand why consumers trust certain websites and distrust others. A systematic literature review was conducted with the goal of identifying the antecedents of trust in health information websites. After four rounds of screening process, 20 articles between 2000 and 2013 were harvested. Factors that determine trust are classified into individual difference antecedents, website-related antecedents, and consumer-to-website interaction-related antecedents. The most frequently studied antecedents were socio-demographics, information quality, appearance, and perceived reputation of the website. Each antecedent of trust are discussed in detail and future research directions are proposed. © The Author(s) 2014.

Consumer trust to a Web site: moderating effect of attitudes toward online shopping.

PubMed

San Martín, Sonia; Camarero, Carmen

2008-10-01

In this paper, authors suggest a model that reflects the role played by the Web site characteristics and the previous level of satisfaction as determinant factors of trust in the Web site. Also, authors consider the moderating effects of consumers' motives and inhibitors to purchase online. Results show that satisfaction with previous purchases, the Web site security and privacy policies, and service quality are the main determinants of trust. Also, the motives and inhibitors the individuals perceive when buying online determine the type of signals they consider to trust.

Direct and indirect effects of third-party relationships on interpersonal trust.

PubMed

Ferrin, Donald L; Dirks, Kurt T; Shah, Pri P

2006-07-01

Past studies of the determinants of interpersonal trust have focused primarily on how trust forms in isolated dyads. Yet within organizations, trust typically develops between individuals who are embedded in a complex web of existing and potential relationships. In this article, the authors identify 3 alternative ways in which a trustor and trustee may be linked to each other via third parties: network closure (linked via social interactions with third parties), trust transferability (linked via trusted third parties), and structural equivalence (linked via the similarity of their relationships with all potential third parties within the organization). Each of these is argued to influence interpersonal trust via a distinct social mechanism. The authors hypothesized that network closure and structural equivalence would predict interpersonal trust indirectly via their impact on interpersonal organizational citizenship behaviors performed within the interpersonal relationship, whereas trust transferability would predict trust directly. Social network analyses of data gathered from a medium-sized work organization provide substantial support for the hypotheses and also suggest important directions for future research. ((c) 2006 APA, all rights reserved).

Verification of Triple Modular Redundancy Insertion for Reliable and Trusted Systems

NASA Technical Reports Server (NTRS)

Berg, Melanie; LaBel, Kenneth

2016-01-01

If a system is required to be protected using triple modular redundancy (TMR), improper insertion can jeopardize the reliability and security of the system. Due to the complexity of the verification process and the complexity of digital designs, there are currently no available techniques that can provide complete and reliable confirmation of TMR insertion. We propose a method for TMR insertion verification that satisfies the process for reliable and trusted systems.

Factors influencing trust in doctors: a community segmentation strategy for quality improvement in healthcare

PubMed Central

Gopichandran, Vijayaprasad; Chetlapalli, Satish Kumar

2013-01-01

Background Trust is a forward-looking covenant between the patient and the doctor where the patient optimistically accepts his/her vulnerability. Trust is known to improve the clinical outcomes. Objectives To explore the factors that determine patients’ trust in doctors and to segment the community based on factors which drive their trust. Setting Resource-poor urban and rural settings in Tamil Nadu, a state in southern India. Participants A questionnaire was administered to a sample of 625 adult community-dwelling respondents from four districts of Tamil Nadu, India, chosen by multistage sampling strategy. Outcome measures The outcomes were to understand the main domains of factors influencing trust in doctors and to segment the community based on which of these domains predominantly influenced their trust. Results Factor analysis revealed five main categories, namely, comfort with the doctor, doctor with personal involvement with the patient, behaviourally competent doctor, doctor with a simple appearance and culturally competent doctor, which explained 49.3% of the total variance. Using k-means cluster analysis the respondents were segmented into four groups, namely, those who have ‘comfort-based trust’, ‘emotionally assessed trust’, who were predominantly older and belonging to lower socioeconomic status, those who had ‘personal trust’, who were younger people from higher socioeconomic strata of the community and the group who had ‘objectively assessed trust’, who were younger women. Conclusions Trust in doctors seems to be influenced by the doctor's behaviuor, perceived comfort levels, personal involvement with the patient, and to a lesser extent by cultural competence and doctor's physical appearance. On the basis of these dimensions, the community can be segmented into distinct groups, and trust building can happen in a strategic manner which may lead to improvement in perceived quality of care. PMID:24302512

Trust and Decision Making: An Empirical Platform

DTIC Science & Technology

2008-06-01

13th ICCRTS “C2 for Complex Endeavors” Trust and Decision Making : An Empirical Platform Topic(s): Cognitive and Social Issues...and Decision Making : An Empirical Platform 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...PERSON a. REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Trust and Decision Making : An Empirical Platform Dr. Joseph B

The patient, the doctor, and the patient’s loyalty: a qualitative study in French general practice

PubMed Central

Gérard, Laura; François, Mathilde; de Chefdebien, Marine; Saint-Lary, Oliver; Jami, Alain

2016-01-01

Background The term loyalty can be defined as the attachment that characterises someone who consistent in their feelings, affections, or habits. By introducing the Declaration of General Practitioner (or preferred doctor declaration) in 2004, France adopted a formal incentive for patients to be faithful to their doctor since it entailed optimal coverage of medical care by their national health insurance There has been no research evaluating the impact of this measure and to determine the components of doctor–patient loyalty. Aim To explore what builds and maintains patients’ loyalty to their GP. Design and setting Qualitative study based on semi-structured interviews close to Paris (the département of Yvelines’), France. Method Twenty-eight patients were interviewed in five surgeries of self-employed GPs with different demographics. Interviews were transcribed and a thematic analysis conducted to categorise the data. Phenomenological analysis was used to analyse the transcripts. Results Patient loyalty is based mainly on trust. Trust can be reinforced by certain comforting factors such as the ability to listen, a sense of carefulness, and the quality of care. Loyalty is both a dynamic construct and a relational exchange subject to various influences. Patients find advantages in being loyal. The model of the ‘family doctor’ has always been the archetype of loyalty for several generations within one family. A GP’s inability to meet all of the patient’s requirements is not necessarily a determining factor in breaking the patient’s loyalty. Conclusion Loyalty is more complex than commonly assumed and involves dimensions of trust, listening, quality of care, availability, and familiarity. The observations drawn out from this study warrant a larger scale investigation. PMID:27789510

Investigating the relationship between consultation length and patient experience: a cross-sectional study in primary care.

PubMed

Elmore, Natasha; Burt, Jenni; Abel, Gary; Maratos, Frances A; Montague, Jane; Campbell, John; Roland, Martin

2016-12-01

Longer consultations in primary care have been linked with better quality of care and improved health-related outcomes. However, there is little evidence of any potential association between consultation length and patient experience. To examine the relationship between consultation length and patient-reported communication, trust and confidence in the doctor, and overall satisfaction. Analysis of 440 videorecorded consultations and associated patient experience questionnaires from 13 primary care practices in England. Patients attending a face-to-face consultation with participating GPs consented to having their consultations videoed and completed a questionnaire. Consultation length was calculated from the videorecording. Linear regression (adjusting for patient and doctor demographics) was used to investigate associations between patient experience (overall communication, trust and confidence, and overall satisfaction) and consultation length. There was no evidence that consultation length was associated with any of the three measures of patient experience (P >0.3 for all). Adjusted changes on a 0-100 scale per additional minute of consultation were: communication score 0.02 (95% confidence interval [CI] = -0.20 to 0.25), trust and confidence in the doctor 0.07 (95% CI = -0.27 to 0.41), and satisfaction -0.14 (95% CI = -0.46 to 0.18). The authors found no association between patient experience measures of communication and consultation length, and patients may sometimes report good experiences from very short consultations. However, longer consultations may be required to achieve clinical effectiveness and patient safety: aspects also important for achieving high quality of care. Future research should continue to study the benefits of longer consultations, particularly for patients with complex multiple conditions. © British Journal of General Practice 2016.

The patient, the doctor, and the patient's loyalty: a qualitative study in French general practice.

PubMed

Gérard, Laura; François, Mathilde; de Chefdebien, Marine; Saint-Lary, Oliver; Jami, Alain

2016-11-01

The term loyalty can be defined as the attachment that characterises someone who consistent in their feelings, affections, or habits. By introducing the Declaration of General Practitioner (or preferred doctor declaration) in 2004, France adopted a formal incentive for patients to be faithful to their doctor since it entailed optimal coverage of medical care by their national health insurance There has been no research evaluating the impact of this measure and to determine the components of doctor-patient loyalty. To explore what builds and maintains patients' loyalty to their GP. Qualitative study based on semi-structured interviews close to Paris (the département of Yvelines'), France. Twenty-eight patients were interviewed in five surgeries of self-employed GPs with different demographics. Interviews were transcribed and a thematic analysis conducted to categorise the data. Phenomenological analysis was used to analyse the transcripts. Patient loyalty is based mainly on trust. Trust can be reinforced by certain comforting factors such as the ability to listen, a sense of carefulness, and the quality of care. Loyalty is both a dynamic construct and a relational exchange subject to various influences. Patients find advantages in being loyal. The model of the 'family doctor' has always been the archetype of loyalty for several generations within one family. A GP's inability to meet all of the patient's requirements is not necessarily a determining factor in breaking the patient's loyalty. Loyalty is more complex than commonly assumed and involves dimensions of trust, listening, quality of care, availability, and familiarity. The observations drawn out from this study warrant a larger scale investigation. © British Journal of General Practice 2016.

Hype and public trust in science.

PubMed

Master, Zubin; Resnik, David B

2013-06-01

Social scientists have begun elucidating the variables that influence public trust in science, yet little is known about hype in biotechnology and its effects on public trust. Many scholars claim that hyping biotechnology results in a loss of public trust, and possibly public enthusiasm or support for science, because public expectations of the biotechnological promises will be unmet. We argue for the need for empirical research that examines the relationships between hype, public trust, and public enthusiasm/support. We discuss the complexities in designing empirical studies that provide evidence for a causal link between hype, public trust, and public enthusiasm/support, but also illustrate how this may be remedied. Further empirical research on hype and public trust is needed in order to improve public communication of science and to design evidence-based education on the responsible conduct of research for scientists. We conclude that conceptual arguments made on hype and public trust must be nuanced to reflect our current understanding of this relationship.

Hype and Public Trust in Science

PubMed Central

Resnik, David B.

2014-01-01

Social scientists have begun elucidating the variables that influence public trust in science, yet little is known about hype in biotechnology and its effects on public trust. Many scholars claim that hyping biotechnology results in a loss of public trust, and possibly public enthusiasm or support for science, because public expectations of the biotechnological promises will be unmet. We argue for the need for empirical research that examines the relationships between hype, public trust, and public enthusiasm/support. We discuss the complexities in designing empirical studies that provide evidence for a causal link between hype, public trust, and public enthusiasm/support, but also illustrate how this may be remedied. Further empirical research on hype and public trust is needed in order to improve public communication of science and to design evidence-based education on the responsible conduct of research for scientists. We conclude that conceptual arguments made on hype and public trust must be nuanced to reflect our current understanding of this relationship. PMID:22045550

Quality Leadership and Quality Control

PubMed Central

Badrick, Tony

2003-01-01

Different quality control rules detect different analytical errors with varying levels of efficiency depending on the type of error present, its prevalence and the number of observations. The efficiency of a rule can be gauged by inspection of a power function graph. Control rules are only part of a process and not an end in itself; just as important are the trouble-shooting systems employed when a failure occurs. 'Average of patient normals' may develop as a usual adjunct to conventional quality control serum based programmes. Acceptable error can be based on various criteria; biological variation is probably the most sensible. Once determined, acceptable error can be used as limits in quality control rule systems. A key aspect of an organisation is leadership, which links the various components of the quality system. Leadership is difficult to characterise but its key aspects include trust, setting an example, developing staff and critically setting the vision for the organisation. Organisations also have internal characteristics such as the degree of formalisation, centralisation, and complexity. Medical organisations can have internal tensions because of the dichotomy between the bureaucratic and the shadow medical structures. PMID:18568046

Is It a Trust Issue? Factors That Influence Trust for Persons Living With HIV/AIDS.

PubMed

Krause, Denise D; May, Warren L

2016-09-01

Trust in one's health care provider, trust in the health care system in general, and even trust in one's community affects engagement in HIV-related health care. This article examines the issue of trust among a random sample of HIV-infected individuals residing in Mississippi, an area hard-hit by the HIV/AIDS epidemic. Five constructs based on survey responses from these individuals were developed: (1) trust in one's provider to offer the best possible medical care, (2) trust in one's provider to protect patient privacy, (3) willingness to disclose HIV status to one's provider, (4) trust in the health care system, and (5) trust in one's community. Findings suggest that interventions to improve trust in providers to deliver the highest quality of care should be targeted to young people, African Americans, and the more highly educated. Interventions to increase trust in providers to protect privacy should focus on creating and strengthening social support groups or networks that build relationships and foster trust. Interventions aimed to increase community trust also should be targeted to young people. This information is useful to researchers, policy makers, health care providers, and organizations interested in prioritizing interventions and strategies that have the greatest potential to reduce health disparities in HIV diagnosis and treatment in the Deep South. © 2016 Society for Public Health Education.

The Effectiveness of Health Care Information Technologies: Evaluation of Trust, Security Beliefs, and Privacy as Determinants of Health Care Outcomes.

PubMed

Kisekka, Victoria; Giboney, Justin Scott

2018-04-11

The diffusion of health information technologies (HITs) within the health care sector continues to grow. However, there is no theory explaining how success of HITs influences patient care outcomes. With the increase in data breaches, HITs' success now hinges on the effectiveness of data protection solutions. Still, empirical research has only addressed privacy concerns, with little regard for other factors of information assurance. The objective of this study was to study the effectiveness of HITs using the DeLone and McLean Information Systems Success Model (DMISSM). We examined the role of information assurance constructs (ie, the role of information security beliefs, privacy concerns, and trust in health information) as measures of HIT effectiveness. We also investigated the relationships between information assurance and three aspects of system success: attitude toward health information exchange (HIE), patient access to health records, and perceived patient care quality. Using structural equation modeling, we analyzed the data from a sample of 3677 cancer patients from a public dataset. We used R software (R Project for Statistical Computing) and the Lavaan package to test the hypothesized relationships. Our extension of the DMISSM to health care was supported. We found that increased privacy concerns reduce the frequency of patient access to health records use, positive attitudes toward HIE, and perceptions of patient care quality. Also, belief in the effectiveness of information security increases the frequency of patient access to health records and positive attitude toward HIE. Trust in health information had a positive association with attitudes toward HIE and perceived patient care quality. Trust in health information had no direct effect on patient access to health records; however, it had an indirect relationship through privacy concerns. Trust in health information and belief in the effectiveness of information security safeguards increases perceptions of patient care quality. Privacy concerns reduce patients' frequency of accessing health records, patients' positive attitudes toward HIE exchange, and overall perceived patient care quality. Health care organizations are encouraged to implement security safeguards to increase trust, the frequency of health record use, and reduce privacy concerns, consequently increasing patient care quality. ©Victoria Kisekka, Justin Scott Giboney. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.04.2018.

Can centralized sanctioning promote trust in social dilemmas? A two-level trust game with incomplete information.

PubMed

Wang, Raymond Yu; Ng, Cho Nam

2015-01-01

The problem of trust is a paradigmatic social dilemma. Previous literature has paid much academic attention on effects of peer punishment and altruistic third-party punishment on trust and human cooperation in dyadic interactions. However, the effects of centralized sanctioning institutions on decentralized reciprocity in hierarchical interactions remain to be further explored. This paper presents a formal two-level trust game with incomplete information which adds an authority as a strategic purposive actor into the traditional trust game. This model allows scholars to examine the problem of trust in more complex game theoretic configurations. The analysis demonstrates how the centralized institutions might change the dynamics of reciprocity between the trustor and the trustee. Findings suggest that the sequential equilibria of the newly proposed two-level model simultaneously include the risk of placing trust for the trustor and the temptation of short-term defection for the trustee. Moreover, they have shown that even a slight uncertainty about the type of the newly introduced authority might facilitate the establishment of trust and reciprocity in social dilemmas.

Can Centralized Sanctioning Promote Trust in Social Dilemmas? A Two-Level Trust Game with Incomplete Information

PubMed Central

Wang, Raymond Yu; Ng, Cho Nam

2015-01-01

The problem of trust is a paradigmatic social dilemma. Previous literature has paid much academic attention on effects of peer punishment and altruistic third-party punishment on trust and human cooperation in dyadic interactions. However, the effects of centralized sanctioning institutions on decentralized reciprocity in hierarchical interactions remain to be further explored. This paper presents a formal two-level trust game with incomplete information which adds an authority as a strategic purposive actor into the traditional trust game. This model allows scholars to examine the problem of trust in more complex game theoretic configurations. The analysis demonstrates how the centralized institutions might change the dynamics of reciprocity between the trustor and the trustee. Findings suggest that the sequential equilibria of the newly proposed two-level model simultaneously include the risk of placing trust for the trustor and the temptation of short-term defection for the trustee. Moreover, they have shown that even a slight uncertainty about the type of the newly introduced authority might facilitate the establishment of trust and reciprocity in social dilemmas. PMID:25879752

Influence of health literacy and trust in online information on food allergy quality of life and self-efficacy.

PubMed

Ditzler, Nicholas; Greenhawt, Matthew

2016-09-01

Health literacy among caregivers of food allergic individuals (FAIs) is poorly described, as are the information sources sought regarding food allergy. To assess the association among health literacy, trust in online sources of information, and food allergy quality of life (QoL) and self-efficacy. An online survey was administered to caregivers of FAIs assessing health literacy (Newest Vital Sign [NVS] and the eHeals Internet health literacy index), trust in online information (Hargittai Internet credibility index and Annenberg National Health Communication Survey [ANHCS]), QoL (Food Allergy Quality of Life Parental Burden), and self-efficacy (Food Allergy Self-Efficacy Questionnaire [FASEQ]). Among 1562 respondents, 94.6% (NVS) and 61.1% (eHeals) had good health literacy, and 58% had high levels of trust in online information (both indexes). The NVS correlated poorly with the eHeals and Hargittai indexes. Hargittai and eHeals scores were moderately correlated (r = 0.37, P < .001). A high NVS score was significantly associated with reported anaphylaxis and high eHeals and Hargittai scores with advocacy group membership. In unadjusted analyses, FAQL-PB scores were worse with high Hargiatti scores (P = .05) and ANHCS scores (P < .001). The FASEQ scores were better with high ANHCS scores (P = .02) and eHeals scores (P < .001). In an adjusted regression, high trust in online information (both indexes), worsening FASEQ score, blog readership, advocacy group membership, caring for multiple FAIs, and having milk or egg allergy were associated with worse FAQL-PB scores. In this sample, health literacy and trust in online information sources were high, with high trust in online information sources negatively associated with QoL. Advocacy group membership had an independent negative association with QoL. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China.

PubMed

Zhao, Junfeng; Li, Xiaoming; Barnett, Douglas; Lin, Xiuyun; Fang, Xiaoyi; Zhao, Guoxiang; Naar-King, Sylvie; Stanton, Bonita

2011-08-01

The objective of this study was to examine the relationship between parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China. In this study, cross-sectional data were collected from 755 AIDS orphans (296 double orphans and 459 single orphans), 466 vulnerable children living with HIV-infected parents, and 404 comparison children in China. The trusting relationship with current caregivers was measured with a 15-item scale (Cronbach's α = 0.84) modified from the Trusting Relationship Questionnaire developed by Mustillo et al. in 2005 (Quality of relationships between youth and community service providers: Reliability and validity of the trusting relationship questionnaire. Journal of Child and Family Studies, 14, 577-590). The psychosocial measures include rule compliance/acting out, anxiety/withdrawal, peer social skills, school interest, depressive symptoms, loneliness, self-esteem, future expectation, hopefulness about future, and perceived control over the future. Group mean comparisons using analysis of variance suggested a significant association (p < 0.0001) between the trusting relationship with current caregivers and all the psychosocial measures, except anxiety and depression. These associations remained significant in General Linear Model analysis, controlling for children's gender, age, family socioeconomic status, orphan status (orphans, vulnerable children, and comparison children), and appropriate interaction terms among factor variables. The findings in the current study support the global literature on the importance of attachment relationship with caregivers in promoting children's psychosocial development. Future prevention intervention efforts to improve AIDS orphans' psychosocial well-being will need to take into consideration the quality of the child's attachment relationships with current caregivers and help their current caregivers to improve the quality of care for these children. Future study is needed to explore the possible reasons for the lack of association between a trusting relationship and some internalizing symptoms such as anxiety and depression among children affected by HIV/AIDS.

Understanding and managing trust at the climate science-policy interface

NASA Astrophysics Data System (ADS)

Lacey, Justine; Howden, Mark; Cvitanovic, Christopher; Colvin, R. M.

2018-01-01

Climate change effects are accelerating, making the need for appropriate actions informed by sound climate knowledge ever more pressing. A strong climate science-policy relationship facilitates the effective integration of climate knowledge into local, national and global policy processes, increases society's responsiveness to a changing climate, and aligns research activity to policy needs. This complex science-policy relationship requires trust between climate science `producers' and `users', but our understanding of trust at this interface remains largely uncritical. To assist climate scientists and policymakers, this Perspective provides insights into how trust develops and operates at the interface of climate science and policy, and examines the extent to which trust can manage — or even create — risk at this interface.

Dimensions and Role-Specific Mediators of Surrogate Trust in the ICU

PubMed Central

Hutchison, Paul J.; McLaughlin, Katie; Corbridge, Tom; Michelson, Kelly N.; Emanuel, Linda; Sporn, Peter H. S.; Crowley-Matoka, Megan

2016-01-01

Objective In the ICU, discussions between clinicians and surrogate decision makers are often accompanied by conflict about a patient’s prognosis or care plan. Trust plays a role in limiting conflict, but little is known about the determinants of trust in the ICU. We sought to identify the dimensions of trust and clinician behaviors conducive to trust formation in the ICU. Design Prospective qualitative study. Setting Medical ICU of a major urban university hospital. Subjects Surrogate decision makers of intubated, mechanically ventilated patients in the medical ICU. Measurements and Main Results Semistructured interviews focused on surrogates’ general experiences in the ICU and on their trust in the clinicians caring for the patient. Interviews were audio-recorded, transcribed verbatim, and coded by two reviewers. Constant comparison was used to identify themes pertaining to trust. Thirty surrogate interviews revealed five dimensions of trust in ICU clinicians: technical competence, communication, honesty, benevolence, and interpersonal skills. Most surrogates emphasized the role of nurses in trust formation, frequently citing their technical competence. Trust in physicians was most commonly related to honesty and the quality of their communication with surrogates. Conclusions Interventions to improve trust in the ICU should be role-specific, since surrogate expectations are different for physicians and nurses with regard to behaviors relevant to trust. Further research is needed to confirm our findings and explore the impact of trust modification on clinician-family conflict. PMID:27513360

Dimensions and Role-Specific Mediators of Surrogate Trust in the ICU.

PubMed

Hutchison, Paul J; McLaughlin, Katie; Corbridge, Tom; Michelson, Kelly N; Emanuel, Linda; Sporn, Peter H S; Crowley-Matoka, Megan

2016-12-01

In the ICU, discussions between clinicians and surrogate decision makers are often accompanied by conflict about a patient's prognosis or care plan. Trust plays a role in limiting conflict, but little is known about the determinants of trust in the ICU. We sought to identify the dimensions of trust and clinician behaviors conducive to trust formation in the ICU. Prospective qualitative study. Medical ICU of a major urban university hospital. Surrogate decision makers of intubated, mechanically ventilated patients in the medical ICU. Semistructured interviews focused on surrogates' general experiences in the ICU and on their trust in the clinicians caring for the patient. Interviews were audio-recorded, transcribed verbatim, and coded by two reviewers. Constant comparison was used to identify themes pertaining to trust. Thirty surrogate interviews revealed five dimensions of trust in ICU clinicians: technical competence, communication, honesty, benevolence, and interpersonal skills. Most surrogates emphasized the role of nurses in trust formation, frequently citing their technical competence. Trust in physicians was most commonly related to honesty and the quality of their communication with surrogates. Interventions to improve trust in the ICU should be role-specific, since surrogate expectations are different for physicians and nurses with regard to behaviors relevant to trust. Further research is needed to confirm our findings and explore the impact of trust modification on clinician-family conflict.

Social Collaborative Filtering by Trust.

PubMed

Yang, Bo; Lei, Yu; Liu, Jiming; Li, Wenjie

2017-08-01

Recommender systems are used to accurately and actively provide users with potentially interesting information or services. Collaborative filtering is a widely adopted approach to recommendation, but sparse data and cold-start users are often barriers to providing high quality recommendations. To address such issues, we propose a novel method that works to improve the performance of collaborative filtering recommendations by integrating sparse rating data given by users and sparse social trust network among these same users. This is a model-based method that adopts matrix factorization technique that maps users into low-dimensional latent feature spaces in terms of their trust relationship, and aims to more accurately reflect the users reciprocal influence on the formation of their own opinions and to learn better preferential patterns of users for high-quality recommendations. We use four large-scale datasets to show that the proposed method performs much better, especially for cold start users, than state-of-the-art recommendation algorithms for social collaborative filtering based on trust.

Work-related change in residential elderly care: Trust, space and connectedness

PubMed Central

van der Borg, Wieke E; Verdonk, Petra; Dauwerse, Linda; Abma, Tineke A

2017-01-01

Increasing care needs and a declining workforce put pressure on the quality and continuity of long-term elderly care. The need to attract and retain a solid workforce is increasingly acknowledged. This study reports about a change initiative that aimed to improve the quality of care and working life in residential elderly care. The research focus is on understanding the process of workforce change and development, by retrospectively exploring the experiences of care professionals. A responsive evaluation was conducted at a nursing home department in the Netherlands one year after participating in the change program. Data were gathered by participant observations, interviews and a focus and dialogue group. A thematic analysis was conducted. Care professionals reported changes in workplace climate and interpersonal interactions. We identified trust, space and connectedness as important concepts to understand perceived change. Findings suggest that the interplay between trust and space fostered interpersonal connectedness. Connectedness improved the quality of relationships, contributing to the well-being of the workforce. We consider the nature and contradictions within the process of change, and discuss how gained insights help to improve quality of working life in residential elderly care and how this may reflect in the quality of care provision. PMID:28626242

Trust and health: testing the reverse causality hypothesis

PubMed Central

Giordano, Giuseppe Nicola; Lindström, Martin

2016-01-01

Background Social capital research has consistently shown positive associations between generalised trust and health outcomes over 2 decades. Longitudinal studies attempting to test causal relationships further support the theory that trust is an independent predictor of health. However, as the reverse causality hypothesis has yet to be empirically tested, a knowledge gap remains. The aim of this study, therefore, was to investigate if health status predicts trust. Methods Data employed in this study came from 4 waves of the British Household Panel Survey between years 2000 and 2007 (N=8114). The sample was stratified by baseline trust to investigate temporal relationships between prior self-rated health (SRH) and changes in trust. We used logistic regression models with random effects, as trust was expected to be more similar within the same individuals over time. Results From the ‘Can trust at baseline’ cohort, poor SRH at time (t−1) predicted low trust at time (t) (OR=1.38). Likewise, good health predicted high trust within the ‘Cannot’ trust cohort (OR=1.30). These patterns of positive association remained after robustness checks, which adjusted for misclassification of outcome (trust) status and the existence of other temporal pathways. Conclusions This study offers empirical evidence to support the circular nature of trust/health relationship. The stability of association between prior health status and changes in trust over time differed between cohorts, hinting at the existence of complex pathways rather than a simple positive feedback loop. PMID:26546287

The management of ultrasound equipment at Sheffield Teaching Hospitals NHS Foundation Trust

PubMed Central

Peacock, M

2013-01-01

Management of ultrasound equipment at Sheffield Teaching Hospitals NHS Foundation Trust is described. The organisation and input of various stakeholders and their involvement with ultrasound equipment management and scientific ultrasound is discussed. Two important stakeholders are the Medical Equipment Management Group and the Radiation Safety Steering Committee. The Medical Equipment Management Group has a specific sub-group, the Ultrasound sub-group, and its role is to coordinate the purchase, replacement and quality assurance of ultrasound equipment in the Trust. The Radiation Safety Steering Committee has a non-ionising radiation representative and the role of this committee is to provide corporate assurance that any health and safety issues arising from the use of radiation to either patients, members of the public or staff within the Trust are being effectively managed. The Ultrasound sub-group of the Medical Equipment Management Group has successfully brought together management of all ultrasound equipment within the Trust and is in the process of fulfilling the quality assurance and training milestones set out by the Medical Equipment Management Group. Advice from the Radiation Safety Steering Committee has helped to increase awareness of ultrasound safety and good scanning practice, especially in the case of neonatal ultrasound imaging, within the Trust. In addition, the RSSC has given advice on clinical pathways for patients undergoing ionising radiation imaging while being treated by extra-corporeal shockwave lithotripsy. PMID:27433195

Evidence-based health care: development and audit of a clinical standard for research and its impact on an NHS trust.

PubMed

Parkin, Claire; Bullock, Ian

2005-04-01

Working within a modern National Health Service in the United Kingdom, the place for research and its dissemination is increasingly important. The organization of this within each National Health Service (NHS) Trust is challenging but nevertheless essential. If health care professionals are to be empowered to adopt an evidence-based approach in both the planning and delivery of care, research aware employees are crucial. This paper highlights the importance of NHS hospital trusts implementing initiatives that will facilitate this process. One such initiative has been the development and survey of a clinical standard for research. The primary development aim was to provide a benchmark standard for all nursing research. The standard was developed to fit within the current dynamic quality improvement (DQI) programme and has directly contributed to an evolving culture of research by shaping nurses' awareness, and offering a support and consultancy network within the Trust. The standard is one aspect of a research awareness programme, with the primary objective of providing guidance and education whilst developing nurses throughout the research process. The planned strategic outcome is to see a positive outcome on the quality of research in the Trust. A baseline survey was conducted to provide a definitive snap shot of research understanding and practice within the Trust following the introduction of the research standard. The standard was developed by a team of clinicians led by a member of the quality team, to ensure that it fitted the DQI structure, and a member of the Nursing Research Unit (NRU). The standard was distributed to every clinical area and 192 nurses were surveyed to evaluate its impact on their awareness of educational opportunities, their use of the consultancy and support service, their use of other support services, their research utilization and research quality. The survey demonstrated that the implementation of the standard had increased awareness related to both formal and informal educational and research opportunities. It identified current nurses' strengths and weaknesses relative to all aspects of the research process, particularly in obtaining ethical approval for studies. A rolling programme of research education enabled nurses to gain essential knowledge and skills in supporting their developing research awareness, consumption and conduct of research. The NRU, through this process, has formed an effective alliance between clinical nurses and research facilitators in promoting high quality research. The foundations to continue to support this within the Trust are now well established.

36 CFR 1010.12 - Public involvement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 1010.12 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.12 Public... announcements in the Trust's monthly newsletter, postings on its web site (www.presidiotrust.gov), placement of... public scoping meetings will be given in a timely manner. Interested persons may also obtain information...

36 CFR 1010.12 - Public involvement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 1010.12 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.12 Public... announcements in the Trust's monthly newsletter, postings on its web site (www.presidiotrust.gov), placement of... public scoping meetings will be given in a timely manner. Interested persons may also obtain information...

36 CFR 1010.12 - Public involvement.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 1010.12 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.12 Public... announcements in the Trust's monthly newsletter, postings on its web site (www.presidiotrust.gov), placement of... public scoping meetings will be given in a timely manner. Interested persons may also obtain information...

36 CFR 1010.12 - Public involvement.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 1010.12 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.12 Public... announcements in the Trust's monthly newsletter, postings on its web site (www.presidiotrust.gov), placement of... public scoping meetings will be given in a timely manner. Interested persons may also obtain information...

Robot transparency, trust and utility

NASA Astrophysics Data System (ADS)

Wortham, Robert H.; Theodorou, Andreas

2017-07-01

As robot reasoning becomes more complex, debugging becomes increasingly hard based solely on observable behaviour, even for robot designers and technical specialists. Similarly, non-specialist users have difficulty creating useful mental models of robot reasoning from observations of robot behaviour. The EPSRC Principles of Robotics mandate that our artefacts should be transparent, but what does this mean in practice, and how does transparency affect both trust and utility? We investigate this relationship in the literature and find it to be complex, particularly in nonindustrial environments where, depending on the application and purpose of the robot, transparency may have a wider range of effects on trust and utility. We outline our programme of research to support our assertion that it is nevertheless possible to create transparent agents that are emotionally engaging despite having a transparent machine nature.

Investigating Public trust in Expert Knowledge: Narrative, Ethics, and Engagement.

PubMed

Camporesi, Silvia; Vaccarella, Maria; Davis, Mark

2017-03-01

"Public Trust in Expert Knowledge: Narrative, Ethics, and Engagement" examines the social, cultural, and ethical ramifications of changing public trust in the expert biomedical knowledge systems of emergent and complex global societies. This symposium was conceived as an interdisciplinary project, drawing on bioethics, the social sciences, and the medical humanities. We settled on public trust as a topic for our work together because its problematization cuts across our fields and substantive research interests. For us, trust is simultaneously a matter of ethics, social relations, and the cultural organization of meaning. We share a commitment to narrative inquiry across our fields of expertise in the bioethics of transformative health technologies, public communications on health threats, and narrative medicine. The contributions to this symposium have applied, in different ways and with different effects, this interdisciplinary mode of inquiry, supplying new reflections on public trust, expertise, and biomedical knowledge.

The role of similarity cues in the development of trust in sources of information about GM food.

PubMed

Meijnders, Anneloes; Midden, Cees; Olofsson, Anna; Ohman, Susanna; Matthes, Jörg; Bondarenko, Olha; Gutteling, Jan; Rusanen, Maria

2009-08-01

In evaluating complex new technologies, people are usually dependent on information provided by others, for example, experts or journalists, and have to determine whether they can trust these information sources. This article focuses on similarity as the basis for trust. The first experiment (N = 261) confirmed that a journalist writing about genetically modified (GM) food was trusted more when his attitude was congruent with that of his readers. In addition, the experiment showed that this effect was mediated by the perceived similarity of the journalist. The second experiment (N = 172) revealed that trust in a journalist writing about the focal domain of GM food was even influenced by him expressing a congruent attitude in an unrelated domain. This result supports a general similarity account of the congruence effect on trust, as opposed to a confirmatory bias account.

Trust, control strategies and allocation of function in human-machine systems.

PubMed

Lee, J; Moray, N

1992-10-01

As automated controllers supplant human intervention in controlling complex systems, the operators' role often changes from that of an active controller to that of a supervisory controller. Acting as supervisors, operators can choose between automatic and manual control. Improperly allocating function between automatic and manual control can have negative consequences for the performance of a system. Previous research suggests that the decision to perform the job manually or automatically depends, in part, upon the trust the operators invest in the automatic controllers. This paper reports an experiment to characterize the changes in operators' trust during an interaction with a semi-automatic pasteurization plant, and investigates the relationship between changes in operators' control strategies and trust. A regression model identifies the causes of changes in trust, and a 'trust transfer function' is developed using time series analysis to describe the dynamics of trust. Based on a detailed analysis of operators' strategies in response to system faults we suggest a model for the choice between manual and automatic control, based on trust in automatic controllers and self-confidence in the ability to control the system manually.

Trust Management in Swarm-Based Autonomic Computing Systems

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

Maiden, Wendy M.; Haack, Jereme N.; Fink, Glenn A.

2009-07-07

Reputation-based trust management techniques can address issues such as insider threat as well as quality of service issues that may be malicious in nature. However, trust management techniques must be adapted to the unique needs of the architectures and problem domains to which they are applied. Certain characteristics of swarms such as their lightweight ephemeral nature and indirect communication make this adaptation especially challenging. In this paper we look at the trust issues and opportunities in mobile agent swarm-based autonomic systems and find that by monitoring the trustworthiness of the autonomic managers rather than the swarming sensors, the trust managementmore » problem becomes much more scalable and still serves to protect the swarms. We also analyze the applicability of trust management research as it has been applied to architectures with similar characteristics. Finally, we specify required characteristics for trust management mechanisms to be used to monitor the trustworthiness of the entities in a swarm-based autonomic computing system.« less

The 'dark side' of social capital: trust and self-rated health in European countries.

PubMed

Campos-Matos, Inês; Subramanian, S V; Kawachi, Ichiro

2016-02-01

Generalized interpersonal trust (as an indicator of social capital) has been linked to health status at both the individual and ecological level. We sought to examine how changes in contextual and individual trust are associated with changes in self-rated health in the European Social Surveys 2002-12. A multilevel analysis using a variance components model was performed on 203 452 individuals nested within 145 country cohorts covering 35 countries. Conditional on sociodemographic covariates, we sought to examine the association between self-rated health and individual trust, country average trust and a cross-level interaction between the two. Although individual trust perceptions were significantly correlated with self-rated health [OR = 0.95, 95% confidence interval (0.94-0.96)], country-level trust was not associated [OR = 1.12, 95% confidence interval (0.95-1.32)]. There was, however, a strong crosslevel interaction between contextual and individual trust (P < 0.001), such that individuals with high interpersonal trust reported better health in contexts in which other individuals expressed high average interpersonal trust. Conversely, low trust individuals reported worse health in high trust contexts. Our findings suggest that contexts with increasing average trust can be harmful for low trust individuals, which might reflect the negative impact that social capital can have in certain groups. These findings suggest that contextual trust has a complex role in explaining health inequalities and individual self-rated health. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The lost art of the covenant: trust as a commodity in health care.

PubMed

Bruhn, John G

2005-01-01

Physicians argue that the advent of managed care has turned medicine into a business and that they spend more time learning the art of doing business than practicing medicine, while losing their professional spirit, patient loyalty, autonomy, and income. Medicine was a business before it was a science. Holding on to Hippocratic ideals in a world of on-demand consumers has made the covenantal physician-patient relationship ineffective and devoid of mutual trust. Physicians have argued that trust is time-dependent and a casualty of time-bound managed care guidelines. The author suggests that the principle of trust is not outdated, not exclusively time-dependent, and is still relevant to a modern Hippocrates loyalist. A relationship of trust is built on the style and quality of verbal and nonverbal communication. Trust is not an acquired trait; it is an expectation resulting from an interactive process of human concern and caring.

76 FR 41056 - Amendment to Rule Filing Requirements for Dually-Registered Clearing Agencies

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... we receive and intend to respond as necessary or appropriate. I. Introduction A. Background on... successor entity of ICE Trust (``ICE Trust'') will become Registered Clearing Agencies solely for the... rule amendments that, among other things, present novel or complex issues that require additional time...

Self-adaptive trust based ABR protocol for MANETs using Q-learning.

PubMed

Kumar, Anitha Vijaya; Jeyapal, Akilandeswari

2014-01-01

Mobile ad hoc networks (MANETs) are a collection of mobile nodes with a dynamic topology. MANETs work under scalable conditions for many applications and pose different security challenges. Due to the nomadic nature of nodes, detecting misbehaviour is a complex problem. Nodes also share routing information among the neighbours in order to find the route to the destination. This requires nodes to trust each other. Thus we can state that trust is a key concept in secure routing mechanisms. A number of cryptographic protection techniques based on trust have been proposed. Q-learning is a recently used technique, to achieve adaptive trust in MANETs. In comparison to other machine learning computational intelligence techniques, Q-learning achieves optimal results. Our work focuses on computing a score using Q-learning to weigh the trust of a particular node over associativity based routing (ABR) protocol. Thus secure and stable route is calculated as a weighted average of the trust value of the nodes in the route and associativity ticks ensure the stability of the route. Simulation results show that Q-learning based trust ABR protocol improves packet delivery ratio by 27% and reduces the route selection time by 40% over ABR protocol without trust calculation.

Self-Adaptive Trust Based ABR Protocol for MANETs Using Q-Learning

PubMed Central

Jeyapal, Akilandeswari

2014-01-01

Mobile ad hoc networks (MANETs) are a collection of mobile nodes with a dynamic topology. MANETs work under scalable conditions for many applications and pose different security challenges. Due to the nomadic nature of nodes, detecting misbehaviour is a complex problem. Nodes also share routing information among the neighbours in order to find the route to the destination. This requires nodes to trust each other. Thus we can state that trust is a key concept in secure routing mechanisms. A number of cryptographic protection techniques based on trust have been proposed. Q-learning is a recently used technique, to achieve adaptive trust in MANETs. In comparison to other machine learning computational intelligence techniques, Q-learning achieves optimal results. Our work focuses on computing a score using Q-learning to weigh the trust of a particular node over associativity based routing (ABR) protocol. Thus secure and stable route is calculated as a weighted average of the trust value of the nodes in the route and associativity ticks ensure the stability of the route. Simulation results show that Q-learning based trust ABR protocol improves packet delivery ratio by 27% and reduces the route selection time by 40% over ABR protocol without trust calculation. PMID:25254243

Trust recovery model of Ad Hoc network based on identity authentication scheme

NASA Astrophysics Data System (ADS)

Liu, Jie; Huan, Shuiyuan

2017-05-01

Mobile Ad Hoc network trust model is widely used to solve mobile Ad Hoc network security issues. Aiming at the problem of reducing the network availability caused by the processing of malicious nodes and selfish nodes in mobile Ad Hoc network routing based on trust model, an authentication mechanism based on identity authentication mobile Ad Hoc network is proposed, which uses identity authentication to identify malicious nodes, And trust the recovery of selfish nodes in order to achieve the purpose of reducing network congestion and improving network quality. The simulation results show that the implementation of the mechanism can effectively improve the network availability and security.

How did rapid scale-up of HIV services impact on workplace and interpersonal trust in Zambian primary health centres: a case-based health systems analysis

PubMed Central

Topp, Stephanie M; Chipukuma, Julien M

2016-01-01

Background In sub-Saharan Africa, large amounts of funding continue to be directed towards HIV-specific care and treatment, often with claims of ‘health system strengthening’ effect. Such claims rarely account for the impact on human relationships and decisions that are core to functional health systems. This research examined how establishment of externally funded HIV services influenced trusting relationships in Zambian health centres. Methods An in-depth, multicase study included four health centres selected for urban, peri-urban and rural characteristics. Case data included healthcare worker (HCW) interviews (60); patient interviews (180); direct observation of facility operations (2 weeks/centre) and key informant interviews (14) which were recorded and transcribed verbatim. Thematic analysis adopted inductive and deductive coding guided by a framework incorporating concepts of workplace trust, patient–provider trust, intrinsic and extrinsic motivation. Results HIV service scale-up impacted trust in positive and negative ways. Investment in HIV-specific infrastructure, supplies and quality assurance mechanisms strengthened workplace trust, HCW motivation and patient–provider trust in HIV departments in the short-term. In the health centres more broadly and over time, however, non-governmental organisation-led investment and support of HIV departments reinforced HCW's perceptions of the government as uninterested or unable to provide a quality work environment. Exacerbating existing perceptions of systemic workplace inequity and nepotism, uneven distribution of personal and professional opportunities related to HIV service establishment contributed to interdepartmental antagonism and reinforced workplace practices designed to protect individual HCW's interests. Conclusions Findings illustrate long-term negative effects of the vertical HIV resourcing and support structures which failed to address and sometimes exacerbated HCW (dis)trust with their own government and supervisors. The short-term and long-term effects of weakened workplace trust on HCWs' motivation and performance signal the importance of understanding how such relationships play a role in generating virtuous or perverse cycles of actor interactions, with implications for service outcomes. PMID:28588985

Developing critical care skills for nurses in the ward environment: a work-based learning approach.

PubMed

Thorne, Linda; Hackwood, Helen

2002-01-01

An account of collaborative working between an NHS trust and university in responding to the critical care agenda. An 'Introduction to Critical Care Skills' course initiative, which addresses the needs of nurses caring for level 1 and 2 patients in ward areas, is discussed. Work-based learning forms the focus of skills development using core competencies related to a holistic approach to caring for patients with complex needs. A dynamic evolving process of course development is promoting quality care for patients and closely reflects the needs of those caring for acutely ill patients outside the designated critical care environment.

Avatar-Mediated Networking: Increasing Social Presence and Interpersonal Trust in Net-Based Collaborations

ERIC Educational Resources Information Center

Bente, Gary; Ruggenberg, Sabine; Kramer, Nicole C.; Eschenburg, Felix

2008-01-01

This study analyzes the influence of avatars on social presence, interpersonal trust, perceived communication quality, nonverbal behavior, and visual attention in Net-based collaborations using a comparative approach. A real-time communication window including a special avatar interface was integrated into a shared collaborative workspace.…

36 CFR § 1010.12 - Public involvement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section § 1010.12 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.12... announcements in the Trust's monthly newsletter, postings on its web site (www.presidiotrust.gov), placement of... public scoping meetings will be given in a timely manner. Interested persons may also obtain information...

Quality? Is it Allowed? FACTC Focus, 2006

ERIC Educational Resources Information Center

Doerr, Mark, Ed.

2006-01-01

"FACTC Focus" is a publication of Faculty Association of Community and Technical Colleges (FACTC) with the purpose of presenting diverse views on faculty issues. Included in this issue are: (1) Shooting In The Dark: Evaluating Distance Learning Instruction (Stephanie Delaney); (2) Trust Who? - Trust and Learning: Crafting a Conversation That…

Trust and Parents' Involvement in Schools of Choice

ERIC Educational Resources Information Center

Strier, Michal; Katz, Hagai

2016-01-01

Education researchers and policymakers have been focusing for the last three decades on increasing parental involvement in schools. Their work focused on the positive effects that parental involvement has on varied aspects of school quality and functioning. In this study we examined "trust," a known predictor of parental involvement in…

Measuring patient trust in telemedicine services: Development of a survey instrument and its validation for an anticoagulation web-service.

PubMed

Velsen, Lex van; Tabak, Monique; Hermens, Hermie

2017-01-01

For many eServices, end-user trust is a crucial prerequisite for use. For the telemedicine context however, knowledge about the coming about and measurement of end-user trust is scarce. To develop and validate the PAtient Trust Assessment Tool (PATAT): a survey instrument to quantitatively assess patient trust in a telemedicine service. Informed by focus groups, we developed a survey that includes measurement scales for the following factors: trust in the care organization, care professional, treatment, and technology, as well as a scale that assesses a holistic view on trust in the telemedicine service. The survey was completed by 795 patients that use a telemedicine application to manage their anticoagulation treatment. Data were analyzed by means of Partial Least Squares Structural Equation Modeling (PLS-SEM). The measurement model yielded good to excellent quality measures, after the removal of one item. The causal model resulted in high explained variance (R 2 =0.68). Trust in healthcare professionals and the treatment had a small effect on overall trust, while trust in the technology displayed a large effect. Trust in the care organization did not result in a significant effect on overall trust. The PATAT is a valid means to assess patient trust in a telemedicine service and can be used to benchmark such a service or to elicit redesign input. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Improving patient safety and healthcare quality: examples of good practice.

PubMed

Tingle, John

2017-07-27

John Tingle, Reader in Health Law at Nottingham Trent University, discusses a recent report by the Care Quality Commission that showcases eight NHS trusts that have improved their patient safety and healthcare quality.

Design of a cluster-randomized minority recruitment trial: RECRUIT.

PubMed

Tilley, Barbara C; Mainous, Arch G; Smith, Daniel W; McKee, M Diane; Amorrortu, Rossybelle P; Alvidrez, Jennifer; Diaz, Vanessa; Ford, Marvella E; Fernandez, Maria E; Hauser, Robert A; Singer, Carlos; Landa, Veronica; Trevino, Aron; DeSantis, Stacia M; Zhang, Yefei; Daniels, Elvan; Tabor, Derrick; Vernon, Sally W

2017-06-01

Racial/ethnic minority groups remain underrepresented in clinical trials. Many strategies to increase minority recruitment focus on minority communities and emphasize common diseases such as hypertension. Scant literature focuses on minority recruitment to trials of less common conditions, often conducted in specialty clinics and dependent on physician referrals. We identified trust/mistrust of specialist physician investigators and institutions conducting medical research and consequent participant reluctance to participate in clinical trials as key-shared barriers across racial/ethnic groups. We developed a trust-based continuous quality improvement intervention to build trust between specialist physician investigators and community minority-serving physicians and ultimately potential trial participants. To avoid the inherent biases of non-randomized studies, we evaluated the intervention in the national Randomized Recruitment Intervention Trial (RECRUIT). This report presents the design of RECRUIT. Specialty clinic follow-up continues through April 2017. We hypothesized that specialist physician investigators and coordinators trained in the trust-based continuous quality improvement intervention would enroll a greater proportion of minority participants in their specialty clinics than specialist physician investigators in control specialty clinics. Specialty clinic was the unit of randomization. Using continuous quality improvement, the specialist physician investigators and coordinators tailored recruitment approaches to their specialty clinic characteristics and populations. Primary analyses were adjusted for clustering by specialty clinic within parent trial and matching covariates. RECRUIT was implemented in four multi-site clinical trials (parent trials) supported by three National Institutes of Health institutes and included 50 associated specialty clinics from these parent trials. Using current data, we have 88% power or greater to detect a 0.15 or greater difference from the currently observed control proportion adjusting for clustering. We detected no differences in baseline matching criteria between intervention and control specialty clinics (all p values > 0.17). RECRUIT was the first multi-site randomized control trial to examine the effectiveness of a trust-based continuous quality improvement intervention to increase minority recruitment into clinical trials. RECRUIT's innovations included its focus on building trust between specialist investigators and minority-serving physicians, the use of continuous quality improvement to tailor the intervention to each specialty clinic's specific racial/ethnic populations and barriers to minority recruitment, and the use of specialty clinics from more than one parent multi-site trial to increase generalizability. The effectiveness of the RECRUIT intervention will be determined after the completion of trial data collection and planned analyses.

Trusted Advisors, Decision Models and Other Keys to Communicating Science to Decision Makers

NASA Astrophysics Data System (ADS)

Webb, E.

2006-12-01

Water resource management decisions often involve multiple parties engaged in contentious negotiations that try to navigate through complex combinations of legal, social, hydrologic, financial, and engineering considerations. The standard approach for resolving these issues is some form of multi-party negotiation, a formal court decision, or a combination of the two. In all these cases, the role of the decision maker(s) is to choose and implement the best option that fits the needs and wants of the community. However, each path to a decision carries the risk of technical and/or financial infeasibility as well as the possibility of unintended consequences. To help reduce this risk, decision makers often rely on some type of predictive analysis from which they can evaluate the projected consequences of their decisions. Typically, decision makers are supported in the analysis process by trusted advisors who engage in the analysis as well as the day to day tasks associated with multi-party negotiations. In the case of water resource management, the analysis is frequently a numerical model or set of models that can simulate various management decisions across multiple systems and output results that illustrate the impact on areas of concern. Thus, in order to communicate scientific knowledge to the decision makers, the quality of the communication between the analysts, the trusted advisor, and the decision maker must be clear and direct. To illustrate this concept, a multi-attribute decision analysis matrix will be used to outline the value of computer model-based collaborative negotiation approaches to guide water resources decision making and communication with decision makers. In addition, the critical role of the trusted advisor and other secondary participants in the decision process will be discussed using examples from recent water negotiations.

A review on leadership of head nurses and patient safety and quality of care.

PubMed

Verschueren, Marc; Kips, Johan; Euwema, Martin

2013-01-01

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care. We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit. We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level. This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

A perspective on emerging law, consumer trust and social responsibility in China's food sector: the "bleaching" case study.

PubMed

Roberts, Michael T

2011-01-01

Trust underpins the Chinese social system, and yet it is lacking from a Chinese food system that is riddled with safety disasters and disgruntled consumers. Government and industry play a major role in rehabilitating consumer trust in China. To this end, food safety and quality laws have been constructed to foster this process; however, safety scandals continue even in the face of stricter regulations and increased enforcement. A potential toll to abate food-safety problems and to build trust is the implementation of Corporate Social Responsibility ("CSR"). Mandates by the government promote CSR in enterprise activity, including Article 3 of the 2009 China Food Safety Law. Officials have also recently touted the need for "moral education" of operators in the food industry. Regardless of government activity or whether CSR is employed by food enterprises, it is imperative that the food industry recognizes how critical it is to establish trust with Chinese consumers, who increasingly expect safe, quality food. The case study with pistachios highlights this evolving consumer expectation and the principles of social responsibility in the framework of the relationship between government and industry and consumers, while demonstrating the benefits of doing the right thing for food companies doing business in China.

DTC commissioning. An arranged marriage.

PubMed

Mooney, Helen

2004-04-22

The first privately run diagnostic and treatment centre required nine months of complex talks between the strategic health authority, the trust and Bupa. The contract cost more than if it had been run by the trust, but it increased access and transferred risk. One lesson was that staff should have been better acclimatised to the idea.

Communication Strategies for Developing Trust in the Salesperson/Prospect Exchange.

ERIC Educational Resources Information Center

Cochran, Daniel S.; Gibson, C. Kendrick

A review of literature in the sales area reveals that the communication process between salespeople and their customers is a complex one offering a wide range of relationships. To develop a feeling of trust between the two parties, salespeople can use practical communication skills emphasizing their expertness, reliability, and dynamism. Sales…

Trust in food in the age of mad cow disease: a comparative study of consumers' evaluation of food safety in Belgium, Britain and Norway.

PubMed

Berg, Lisbet

2004-02-01

How do food scandals like dioxines in food in Belgium (summer 1999) and the detection of mad cow disease (BSE) in Britain affect consumers' confidence in food safety? In this paper, based on three thousand telephone interviews during the last quarter of 1999, consumers in Belgium and Britain are compared with consumers in Norway, where there has been no such serious food scandal in recent years. 'Trust' is a diffuse and complex concept to measure. In this article a consumer trust typology is developed and operationalised. Combining a trust-distrust dimension and a reflexivity dimension, it is possible to differentiate between four main consumer types, which are called 'sensible', 'sceptical', 'naive' and 'denying' consumers, respectively. Does the distribution of these consumer types vary in our selected countries? Are there gender differences across national borders? Four hypotheses of how consumers could respond to food scares are investigated: the Reflexivity hypothesis, the Risk-reducing hypothesis, the Complexity-reducing hypothesis and finally the Don't worry, be happy hypothesis.

Early experiences with the multidose drug dispensing system – A matter of trust?

PubMed Central

Wekre, Liv Johanne; Melby, Line; Grimsmo, Anders

2011-01-01

Objective To study early experiences with multidose drug dispensing (MDD) among different groups of health personnel. Design Qualitative study based on focus-group interviews. Setting Primary health care, Trondheim, Norway. Main outcome The importance of trust in the technology and in collaborating partners is actualized in the early implementation of MDD. Results GPs, home-care nurses, pharmacists, and medical secretaries trusted the new MDD technology. The quality of the GPs’ medication records improved. However, health personnel, including the GPs themselves, would not always trust the medication records of the GPs. Checking the multidose bags arriving from the pharmacy was considered unnecessary in the written routines dealing with MDD. However, home-care nurses experienced errors and continued to manually check the bags. Nurses in the home-care service felt a loss of knowledge with regard to the patients’ medications and in turn experienced reduced ability to give medical information to patients and to observe the effects of the drugs. The home-care services’ routines for drug handling were not always trusted by the other groups of health personnel involved. Conclusion Health personnel faced some challenges during the implementation of the MDD system, but most of them remained confident in the new system. Building trust has to be a process that runs in parallel with the introduction of new technology and the establishment of new routines for improving the quality in handling of medicines and to facilitate better cooperation and communication. PMID:21323496

Fruit and vegetable consumption - the influence of aspects associated with trust in food and safety and quality of food.

PubMed

Taylor, Anne W; Coveney, John; Ward, Paul R; Henderson, Julie; Meyer, Samantha B; Pilkington, Rhiannon; Gill, Tiffany K

2012-02-01

To profile adults who eat less than the recommended servings of fruit and vegetables per day. Australia-wide population telephone survey on a random sample of the Australian population, with results analysed by univariate and multivariate models. Australia. One thousand one hundred and eight interviews, respondents' (49·3 % males) mean age was 45·12 (sd 17·63) years. Overall 54·8 % and 10·7 % were eating the recommended number of servings of fruit and vegetables. Variables included in the multivariate model indicating low fruit consumption included gender, age, employment, education and those who were less likely to consider the safety and quality of food as important. In regard to low vegetable consumption, people who were more likely to do the food shopping only 'some of the time' and have a high level of trust in groups of people such as immediate family, neighbours, doctors and different levels of government were included in the final model. They were also less likely to neither consider the safety and quality of food as important nor trust organisations/institutions such as the press, television and politicians. In the final model depicting both low fruit and low vegetable servings, sex, age and a low level of importance with regard to safety and quality of food were included. To increase fruit and vegetable consumption, research into a broad range of determinants associated with behaviours should be coupled with a deeper understanding of the process associated with changing behaviours. While levels of trust are related to behaviour change, knowledge and attitudes about aspects associated with safety and quality of food are also of importance.

The interaction of criminal procedure and outcome.

PubMed

Laxminarayan, Malini; Pemberton, Antony

2014-01-01

Procedural quality is an important aspect of crime victims' experiences in criminal proceedings and consists of different dimensions. Two of these dimensions are procedural justice (voice) and interpersonal justice (respectful treatment). Social psychological research has suggested that both voice and respectful treatment are moderated by the impact of outcomes of justice procedures on individuals' reactions. To add to this research, we extend this assertion to the criminal justice context, examining the interaction between the assessment of procedural quality and outcome favorability with victim's trust in the legal system and self-esteem. Hierarchical regression analyses reveal that voice, respectful treatment and outcome favorability are predictive of trust in the legal system and self-esteem. Further investigation reveals that being treated with respect is only related to trust in the legal system when outcome favorability is high. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Novel Consensus-Based Particle Swarm Optimization-Assisted Trust-Tech Methodology for Large-Scale Global Optimization.

PubMed

Zhang, Yong-Feng; Chiang, Hsiao-Dong

2017-09-01

A novel three-stage methodology, termed the "consensus-based particle swarm optimization (PSO)-assisted Trust-Tech methodology," to find global optimal solutions for nonlinear optimization problems is presented. It is composed of Trust-Tech methods, consensus-based PSO, and local optimization methods that are integrated to compute a set of high-quality local optimal solutions that can contain the global optimal solution. The proposed methodology compares very favorably with several recently developed PSO algorithms based on a set of small-dimension benchmark optimization problems and 20 large-dimension test functions from the CEC 2010 competition. The analytical basis for the proposed methodology is also provided. Experimental results demonstrate that the proposed methodology can rapidly obtain high-quality optimal solutions that can contain the global optimal solution. The scalability of the proposed methodology is promising.

Interpersonal Trust Consistency and the Quality of Peer Relationships during Childhood

ERIC Educational Resources Information Center

Rotenberg, Ken J.; Boulton, Michael

2013-01-01

Five hundred five children (267 female) enrolled in school years 5 and 6 in the UK (M = 9 years and 9 months) completed measures of trust beliefs in peers, best friendships, ascriptions of trustworthiness, and trustworthiness toward peers. Children's social disengagement, peer preference, and peer victimization were assessed by sociometric…

Connect, then lead.

PubMed

Cuddy, Amy J C; Kohut, Matthew; Neffinger, John

2013-01-01

In puzzling over whether it's better to be feared or loved as a leader, Machiavelli famously said that, because it's nigh impossible to do both, leaders should opt for fear. Research from Harvard Business School's Amy Cuddy and consultants Matthew Kohut and John Neffinger refutes that theory, arguing that leaders would do much better to begin with "love"--that is, to establish trust through warmth and understanding. Most leaders today approach their jobs by emphasizing competence, strength, and credentials. But without first building a foundation of trust, they run the risk of eliciting fear, resentment, or envy. Beginning with warmth allows trust to develop, facilitating both the exchange and the acceptance of ideas--people really hear your message and become open to it. Cultivating warmth and trust also boosts the quantity and quality of novel ideas that are produced. The best way to gain influence is to combine warmth and strength--as difficult as Machiavelli says that may be to do. In this article, the authors look at research from behavioral economics, social psychology, and other disciplines and offer practical tactics for leaders hoping to project a healthy amount of both qualities.

Improving Care And Research Electronic Data Trust Antwerp (iCAREdata): a research database of linked data on out-of-hours primary care.

PubMed

Colliers, Annelies; Bartholomeeusen, Stefaan; Remmen, Roy; Coenen, Samuel; Michiels, Barbara; Bastiaens, Hilde; Van Royen, Paul; Verhoeven, Veronique; Holmgren, Philip; De Ruyck, Bernard; Philips, Hilde

2016-05-04

Primary out-of-hours care is developing throughout Europe. High-quality databases with linked data from primary health services can help to improve research and future health services. In 2014, a central clinical research database infrastructure was established (iCAREdata: Improving Care And Research Electronic Data Trust Antwerp, www.icaredata.eu ) for primary and interdisciplinary health care at the University of Antwerp, linking data from General Practice Cooperatives, Emergency Departments and Pharmacies during out-of-hours care. Medical data are pseudonymised using the services of a Trusted Third Party, which encodes private information about patients and physicians before data is sent to iCAREdata. iCAREdata provides many new research opportunities in the fields of clinical epidemiology, health care management and quality of care. A key aspect will be to ensure the quality of data registration by all health care providers. This article describes the establishment of a research database and the possibilities of linking data from different primary out-of-hours care providers, with the potential to help to improve research and the quality of health care services.

Patient Satisfaction with Hospital Inpatient Care: Effects of Trust, Medical Insurance and Perceived Quality of Care.

PubMed

Shan, Linghan; Li, Ye; Ding, Ding; Wu, Qunhong; Liu, Chaojie; Jiao, Mingli; Hao, Yanhua; Han, Yuzhen; Gao, Lijun; Hao, Jiejing; Wang, Lan; Xu, Weilan; Ren, Jiaojiao

2016-01-01

Deteriorations in the patient-provider relationship in China have attracted increasing attention in the international community. This study aims to explore the role of trust in patient satisfaction with hospital inpatient care, and how patient-provider trust is shaped from the perspectives of both patients and providers. We adopted a mixed methods approach comprising a multivariate logistic regression model using secondary data (1200 people with inpatient experiences over the past year) from the fifth National Health Service Survey (NHSS, 2013) in Heilongjiang Province to determine the associations between patient satisfaction and trust, financial burden and perceived quality of care, followed by in-depth interviews with 62 conveniently selected key informants (27 from health and 35 from non-health sectors). A thematic analysis established a conceptual framework to explain deteriorating patient-provider relationships. About 24% of respondents reported being dissatisfied with hospital inpatient care. The logistic regression model indicated that patient satisfaction was positively associated with higher level of trust (OR = 14.995), lower levels of hospital medical expenditure (OR = 5.736-1.829 as compared with the highest quintile of hospital expenditure), good staff attitude (OR = 3.155) as well as good ward environment (OR = 2.361). But patient satisfaction was negatively associated with medical insurance for urban residents and other insurance status (OR = 0.215-0.357 as compared with medical insurance for urban employees). The qualitative analysis showed that patient trust-the most significant predictor of patient satisfaction-is shaped by perceived high quality of service delivery, empathic and caring interpersonal interactions, and a better designed medical insurance that provides stronger financial protection and enables more equitable access to health care. At the core of high levels of patient dissatisfaction with hospital care is the lack of trust. The current health care system reform in China has yet to address the fundamental problems embedded in the system that caused distrust. A singular focus on doctor-patient inter-personal interactions will not offer a successful solution to the deteriorated patient-provider relationships unless a systems approach to accountability is put into place involving all stakeholders.

Hypothesized predictors of patient–physician trust and distrust in the elderly: implications for health and disease management

PubMed Central

Mascarenhas, Oswald AJ; Cardozo, Lavoisier J; Afonso, Nelia M; Siddique, Mohamed; Steinberg, Joel; Lepczyk, Marybeth; Aranha, Anil NF

2006-01-01

This study notes the differences between trust and distrust perceptions by the elderly as compared with younger populations. Given the importance of trust and distrust in compliance, changing behaviors, and forming partnerships for both health and disease management, it is necessary to be able to measure patient–doctor trust and distrust (PDTD). Following recent conceptualizations on trust and distrust as coexistent states, this study hypothesizes predictors of PDTD. We are proposing that these predictors form the basis for designing, developing and validating a PDTD scale (PDTDS). It is important to capture the trust–distrust perceptions of older patients as they confront the complexities and vulnerabilities of the modern healthcare delivery system. This is necessary if we are to design interventions to change behaviors of both the healthcare provider and the older patient. PMID:18044114

What Is Trust? Ethics and Risk Governance in Precision Medicine and Predictive Analytics

PubMed Central

Adjekum, Afua; Ienca, Marcello

2017-01-01

Abstract Trust is a ubiquitous term used in emerging technology (e.g., Big Data, precision medicine), innovation policy, and governance literatures in particular. But what exactly is trust? Even though trust is considered a critical requirement for the successful deployment of precision medicine initiatives, nonetheless, there is a need for further conceptualization with regard to what qualifies as trust, and what factors might establish and sustain trust in precision medicine, predictive analytics, and large-scale biology. These new fields of 21st century medicine and health often deal with the “futures” and hence, trust gains a temporal and ever-present quality for both the present and the futures anticipated by new technologies and predictive analytics. We address these conceptual gaps that have important practical implications in the way we govern risk and unknowns associated with emerging technologies in biology, medicine, and health broadly. We provide an in-depth conceptual analysis and an operative definition of trust dynamics in precision medicine. In addition, we identify three main types of “trust facilitators”: (1) technical, (2) ethical, and (3) institutional. This three-dimensional framework on trust is necessary to building and maintaining trust in 21st century knowledge-based innovations that governments and publics invest for progressive societal change, development, and sustainable prosperity. Importantly, we analyze, identify, and deliberate on the dimensions of precision medicine and large-scale biology that have carved out trust as a pertinent tool to its success. Moving forward, we propose a “points to consider” on how best to enhance trust in precision medicine and predictive analytics. PMID:29257733

What Is Trust? Ethics and Risk Governance in Precision Medicine and Predictive Analytics.

PubMed

Adjekum, Afua; Ienca, Marcello; Vayena, Effy

2017-12-01

Trust is a ubiquitous term used in emerging technology (e.g., Big Data, precision medicine), innovation policy, and governance literatures in particular. But what exactly is trust? Even though trust is considered a critical requirement for the successful deployment of precision medicine initiatives, nonetheless, there is a need for further conceptualization with regard to what qualifies as trust, and what factors might establish and sustain trust in precision medicine, predictive analytics, and large-scale biology. These new fields of 21st century medicine and health often deal with the "futures" and hence, trust gains a temporal and ever-present quality for both the present and the futures anticipated by new technologies and predictive analytics. We address these conceptual gaps that have important practical implications in the way we govern risk and unknowns associated with emerging technologies in biology, medicine, and health broadly. We provide an in-depth conceptual analysis and an operative definition of trust dynamics in precision medicine. In addition, we identify three main types of "trust facilitators": (1) technical, (2) ethical, and (3) institutional. This three-dimensional framework on trust is necessary to building and maintaining trust in 21st century knowledge-based innovations that governments and publics invest for progressive societal change, development, and sustainable prosperity. Importantly, we analyze, identify, and deliberate on the dimensions of precision medicine and large-scale biology that have carved out trust as a pertinent tool to its success. Moving forward, we propose a "points to consider" on how best to enhance trust in precision medicine and predictive analytics.

Neighbourhood social trust and youth perceptions of safety during daily activities.

PubMed

Flynn, Kalen; Richmond, Therese S; Branas, Charles C; Wiebe, Douglas J

2017-10-07

Exposure to adverse neighbourhood conditions can negatively impact adolescent well-being and perceived safety. However, the impact of neighbourhood social trust on perceived safety is largely unknown. We studied 139 adolescent men to investigate how their perceptions of safety varied as a function of social trust levels in the neighbourhoods they traversed; neighbourhoods that were not necessarily their own. Adolescents mapped their minute-by-minute activities over a recent day and rated their perceived safety on a 10-point scale during in-person interviews. Neighbourhood social trust was measured via a citywide random sample survey. Mixed effects regression showed that, compared with their safety perceptions when in areas of low social trust, older adolescents were 73% more likely to feel unsafe when in areas of medium social trust, and 89% more likely to feel unsafe when in areas of high social trust. Inverse relationships between neighbourhood social trust and adolescents' perceived safety highlight the complex interplay between youth, environmental contexts and safety. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Rescheduling nursing shifts: scoping the challenge and examining the potential of mathematical model based tools.

PubMed

Clark, Alistair; Moule, Pam; Topping, Annie; Serpell, Martin

2015-05-01

To review research in the literature on nursing shift scheduling / rescheduling, and to report key issues identified in a consultation exercise with managers in four English National Health Service trusts to inform the development of mathematical tools for rescheduling decision-making. Shift rescheduling is unrecognised as an everyday time-consuming management task with different imperatives from scheduling. Poor rescheduling decisions can have quality, cost and morale implications. A systematic critical literature review identified rescheduling issues and existing mathematic modelling tools. A consultation exercise with nursing managers examined the complex challenges associated with rescheduling. Minimal research exists on rescheduling compared with scheduling. Poor rescheduling can result in greater disruption to planned nursing shifts and may impact negatively on the quality and cost of patient care, and nurse morale and retention. Very little research examines management challenges or mathematical modelling for rescheduling. Shift rescheduling is a complex and frequent management activity that is more challenging than scheduling. Mathematical modelling may have potential as a tool to support managers to minimise rescheduling disruption. The lack of specific methodological support for rescheduling that takes into account its complexity, increases the likelihood of harm for patients and stress for nursing staff and managers. © 2013 John Wiley & Sons Ltd.

The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV.

PubMed

Pellowski, Jennifer A; Price, Devon M; Allen, Aerielle M; Eaton, Lisa A; Kalichman, Seth C

2017-09-01

The purpose of this study was to examine the relationships between medical mistrust and trust and to determine if these measures differentially predict antiretroviral therapy (ART) medication adherence for African-American adults living with HIV. A total of 458 HIV positive African-Americans completed a cross-sectional survey. Self-reported ART adherence was collected using the visual-analog scale. The Beliefs About Medicines Questionnaire was used to assess medication necessity and concern beliefs. All measures of medical mistrust and trust were significantly negatively correlated, ranging from r = -.339 to -.504. Race-based medical mistrust significantly predicted medication necessity and concern beliefs, whereas general medical mistrust only significantly predicted medication concerns. Both measures of trust significantly predicted medication necessity beliefs and medication concerns. Higher levels of race-based medical mistrust predicted lower medication adherence, whereas, neither trust in own physician nor trust in health care provider significantly predicted medication adherence. However, trust in own physician significantly predicted medication necessity beliefs, which predicted medication adherence. Trust and mistrust are not simply opposites of one another. These findings provide evidence for the complexity of understanding the relationship between health care trust, mistrust and patient-related health beliefs and behaviours.

The impact of leadership and quality climate on hospital performance.

PubMed

Shipton, Helen; Armstrong, Claire; West, Michael; Dawson, Jeremy

2008-12-01

To explore the relationship between leadership effectiveness and health-care trust performance, taking into account external quality measures and the number of patient complaints; also, to examine the role of care quality climate as a mediator. We developed scales for rating leadership effectiveness and care quality climate. We then drew upon UK national indices of health-care trust performance-Commission for Health Improvement star ratings, Clinical Governance Review ratings and the number of patient complaints per thousand. We conducted statistical analysis to examine any significant relationships between predictor and outcome variables. The study is based on 86 hospital trusts run by the National Health Service (NHS) in the UK. The data collection is part of an annual staff survey commissioned by the NHS to explore the quality of working life. A total of 17,949 employees were randomly surveyed (41% of the total sample). Leadership effectiveness is associated with higher Clinical Governance Review ratings and Commission for Health Improvement star ratings for our sample (beta = 0.42, P < 0.05; beta = 0.37, P < 0.05, respectively), and lower patient complaints (beta = -0.57, P < 0.05). In addition, 98% of the relationship between leadership and patient complaints is explained by care quality climate. Results offer insight into how non-clinical leadership may foster performance outcomes for health-care organizations. A frequently neglected area-patient complaints-may be a valid measure to consider when assessing leadership and quality in a health-care context.

Social capital and trust in providers.

PubMed

Ahern, Melissa M; Hendryx, Michael S

2003-10-01

Trust in providers has been in decline in recent decades. This study attempts to identify sources of trust in characteristics of health care systems and the wider community. The design is cross-sectional. Data are from (1) the 1996 Household Survey of the Community Tracking Study, drawn from 24 Metropolitan Statistical Areas; (2) a 1996 multi-city broadcast media marketing database including key social capital indicators; (3) Interstudy; (4) the American Hospital Association; and (5) the American Medical Association. Independent variables include individual socio-demographic variables, HMO enrollment, community-level health sector variables, and social capital. The dependent variable is self-reported trust in physicians. Data are merged from the various sources and analyzed using SUDAAN. Subjects include adults in the Household Survey who responded to the items on trust in physicians (N=17,653). Trust in physicians is independently predicted by community social capital (p<0.001). Trust is also negatively related to HMO enrollment and to many individual characteristics. The effect of HMOs is not uniform across all communities. Social capital plays a role in how health care is perceived by citizens, and how health care is delivered by providers. Efforts to build trust and collaboration in a community may improve trust in physicians, health care quality, access, and preserve local health care control.

Perceived threat and corroboration: key factors that improve a predictive model of trust in internet-based health information and advice.

PubMed

Harris, Peter R; Sillence, Elizabeth; Briggs, Pam

2011-07-27

How do people decide which sites to use when seeking health advice online? We can assume, from related work in e-commerce, that general design factors known to affect trust in the site are important, but in this paper we also address the impact of factors specific to the health domain. The current study aimed to (1) assess the factorial structure of a general measure of Web trust, (2) model how the resultant factors predicted trust in, and readiness to act on, the advice found on health-related websites, and (3) test whether adding variables from social cognition models to capture elements of the response to threatening, online health-risk information enhanced the prediction of these outcomes. Participants were asked to recall a site they had used to search for health-related information and to think of that site when answering an online questionnaire. The questionnaire consisted of a general Web trust questionnaire plus items assessing appraisals of the site, including threat appraisals, information checking, and corroboration. It was promoted on the hungersite.com website. The URL was distributed via Yahoo and local print media. We assessed the factorial structure of the measures using principal components analysis and modeled how well they predicted the outcome measures using structural equation modeling (SEM) with EQS software. We report an analysis of the responses of participants who searched for health advice for themselves (N = 561). Analysis of the general Web trust questionnaire revealed 4 factors: information quality, personalization, impartiality, and credible design. In the final SEM model, information quality and impartiality were direct predictors of trust. However, variables specific to eHealth (perceived threat, coping, and corroboration) added substantially to the ability of the model to predict variance in trust and readiness to act on advice on the site. The final model achieved a satisfactory fit: χ(2) (5) = 10.8 (P = .21), comparative fit index = .99, root mean square error of approximation = .052. The model accounted for 66% of the variance in trust and 49% of the variance in readiness to act on the advice. Adding variables specific to eHealth enhanced the ability of a model of trust to predict trust and readiness to act on advice.

Perceived Threat and Corroboration: Key Factors That Improve a Predictive Model of Trust in Internet-based Health Information and Advice

PubMed Central

Harris, Peter R; Briggs, Pam

2011-01-01

Background How do people decide which sites to use when seeking health advice online? We can assume, from related work in e-commerce, that general design factors known to affect trust in the site are important, but in this paper we also address the impact of factors specific to the health domain. Objective The current study aimed to (1) assess the factorial structure of a general measure of Web trust, (2) model how the resultant factors predicted trust in, and readiness to act on, the advice found on health-related websites, and (3) test whether adding variables from social cognition models to capture elements of the response to threatening, online health-risk information enhanced the prediction of these outcomes. Methods Participants were asked to recall a site they had used to search for health-related information and to think of that site when answering an online questionnaire. The questionnaire consisted of a general Web trust questionnaire plus items assessing appraisals of the site, including threat appraisals, information checking, and corroboration. It was promoted on the hungersite.com website. The URL was distributed via Yahoo and local print media. We assessed the factorial structure of the measures using principal components analysis and modeled how well they predicted the outcome measures using structural equation modeling (SEM) with EQS software. Results We report an analysis of the responses of participants who searched for health advice for themselves (N = 561). Analysis of the general Web trust questionnaire revealed 4 factors: information quality, personalization, impartiality, and credible design. In the final SEM model, information quality and impartiality were direct predictors of trust. However, variables specific to eHealth (perceived threat, coping, and corroboration) added substantially to the ability of the model to predict variance in trust and readiness to act on advice on the site. The final model achieved a satisfactory fit: χ2 5 = 10.8 (P = .21), comparative fit index = .99, root mean square error of approximation = .052. The model accounted for 66% of the variance in trust and 49% of the variance in readiness to act on the advice. Conclusions Adding variables specific to eHealth enhanced the ability of a model of trust to predict trust and readiness to act on advice. PMID:21795237

Development and validation of an abbreviated version of the Trust in Oncologist Scale-the Trust in Oncologist Scale-short form (TiOS-SF).

PubMed

Hillen, Marij A; Postma, Rosa-May; Verdam, Mathilde G E; Smets, Ellen M A

2017-03-01

The original 18-item, four-dimensional Trust in Oncologist Scale assesses cancer patients' trust in their oncologist. The current aim was to develop and validate a short form version of the scale to enable more efficient assessment of cancer patients' trust. Existing validation data of the full-length Trust in Oncologist Scale were used to create a short form of the Trust in Oncologist Scale. The resulting short form was validated in a new sample of cancer patients (n = 92). Socio-demographics, medical characteristics, trust in the oncologist, satisfaction with communication, trust in healthcare, willingness to recommend the oncologist to others and to contact the oncologist in case of questions were assessed. Internal consistency, reliability, convergent and structural validity were tested. The five-item Trust in Oncologist Scale Short Form was created by selecting the statistically best performing item from each dimension of the original scale, to ensure content validity. Mean trust in the oncologist was high in the validation sample (response rate 86%, M = 4.30, SD = 0.98). Exploratory factor analyses supported one-dimensionality of the short form. Internal consistency was high, and temporal stability was moderate. Initial convergent validity was suggested by moderate correlations between trust scores with associated constructs. The Trust in Oncologist Scale Short Form appears to efficiently, reliably and validly measures cancer patients' trust in their oncologist. It may be used in research and as a quality indicator in clinical practice. More thorough validation of the scale is recommended to confirm this initial evidence of its validity.

(Dis)-Trust in transitioning ventilator-dependent children from hospital to homecare.

PubMed

Manhas, Kiran Pohar; Mitchell, Ian

2015-12-01

Scholarly work is needed to develop the conceptual and theoretical understanding of trust to nursing practice. The transition from hospital care to complex pediatric homecare involves nurses in myriad roles, including management and care provision. Complex pediatric homecare transforms children, families, professionals, and communities, but its exact implications are unclear. To conduct an ethical inquiry into the role and responsibilities of nurses in the qualitative experience of adults involved in the hospital-to-home transition of young, ventilator-dependent children. We followed methods described by Franco Carnevale. We used a sociologically grounded theoretical orientation-trust-to re-interpret qualitative data for an ethical inquiry into a specific facet of that data. The participants included 26 adults, including 14 nurses, involved in the hospital-to-home transition in a Canadian province. Participants represented family, hospital, home, and government. The Conjoint Health Research Ethics Board at the University of Calgary approved this study. First, the concept and practice of trust was salient to the experience of transition. For example, responsibilities' allocation between hospital-based professionals to mothers, home-based nurses, and non-professionals necessitated reliance and vulnerability. Second, the consequences of distrust connected to recognized challenges. For example, tensions along rural-urban, medical-family, and professional-personal divide each revealed suspicion and uncertainty that led to isolation and anxiety for all involved. Third, recommendations to improve the experience and mitigate the challenges of transition can be grounded in trust promotion. For example, transition-specific education programs and codes of ethics would promote openness, recognize mutual vulnerability, and advance trust in transition. The challenges to transition evidenced distrust, while trust represents a powerful tool to counter these challenges and their implications. A climate of trust could bridge divides between mothers and professionals; rural and urban professionals; and professionals with differing relationships with the family. © The Author(s) 2014.

Trust and Distrust Among Appalachian Women Regarding Cervical Cancer Screening: A Qualitative Study

PubMed Central

McAlearney, Ann Scheck; Oliveri, Jill M.; Post, Douglas M.; Song, Paula H.; Jacobs, Elizabeth; Waibel, Jason; Harrop, J. Phil; Steinman, Kenneth; Paskett, Electra D.

2011-01-01

Objective To explore Appalachian women’s perceptions of trust and distrust of healthcare providers and the medical care system as they relate to views about cervical cancer and screening. Methods Thirty-six Ohio Appalachia female residents participated in community focus groups conducted by trained facilitators. Discussion topics included factors related to cervical cancer, and the issues of trust and distrust in medical care. The tape-recorded focus groups were transcribed and analyzed to identify salient themes. Results Five themes emerged related to trust in healthcare. Patient-centered communication and encouragement from a healthcare provider led women to trust their physicians and the medical care system. In contrast, lack of patient-centered communication by providers and perceptions of poor quality of care led to distrust. Physician gender concordance also contributed to trust as women reported trust of female physicians and distrust of male physicians; trust in male physicians was reported to be increased by presence of a female nurse. Conclusions Important factors associated with trust and distrust of providers and the medical care system may impact health-seeking behaviors among underserved women. Practice Implications Opportunities to improve patient-centered communication around the issues of prevention and cervical cancer screening (such as providing patient-focused information about access to appropriate screening tests) could be used to improve patient care and build patients’ trust. PMID:21458195

Determinants of trust in B2C e-commerce and their relationship with consumer online trust

NASA Astrophysics Data System (ADS)

Bojang, Ismaila; Medvedev, Maxim A.; Spasov, Kamen B.; Matvevnina, Arina I.

2017-12-01

The aim of this research was to investigate specific determinants or factors that influence consumer online trust in the B2C e-commerce with a focus on consumers. Constructs such as perceived security, perceived privacy, perceived third party assurance, perceived reputation, perceived familiarity and perceived website quality and their relationship with online trust in the B2C context were studied. In conducting the research, a convenience sampling technique was adopted in carrying out the survey. Questionnaires were distributed to the target respondents and the data were analyzed using SPSS version 24. A Pearson's correlation was used to test the six hypotheses identified in this study. The results provided evidence that perceived security has the greatest influence on online trust. This was followed closely by perceived reputation and finally perceived privacy. This clearly shows that e-commerce consumer population considers these factors very imperative in engendering their trust in the virtual B2C e-commerce environment.

Public trust in Dutch health care.

PubMed

Straten, G F M; Friele, R D; Groenewegen, P P

2002-07-01

This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used in a research project to monitor trust and to predict behaviour of people such as consulting "alternative practitioners". The idea for the research was suggested by economic research into public trust. In the study, a phased design was used to overcome the operationalization problem. In the first phase, a qualitative study was conducted; and, in the second, a quantitative study. In the first phase, more than 100 people were interviewed to gain insight into the issues they associated with trust. Eight categories of issues that were derived from the interviews were assumed to be possible dimensions of trust. On the basis of these eight categories and the interviews, a questionnaire was developed that was used in the second phase. In this phase, the questionnaire was sent to 1500 members of a consumer panel; the response was 70 percent. The analysis reveals that six of the eight possible dimensions appear in factor analysis. These dimensions are trust in: the patient-focus of health care providers; macro policies level will have no consequences for patients; expertise of health care providers; quality of care; information supply and communication by care providers and the quality of cooperation. The reliability of most scales is higher than 0.8. The validity of the dimensions is assessed by determining the correlation between the scales on the one hand, and people's experience and a general mark they would assign on the other. We conclude that public trust is a multi-dimensional concept, including not only issues that relate to the patient-doctor relationship, but also issues that relate to health care institutions. The instrument appears to be reliable and valid.

How Residents Develop Trust in Interns: A Multi-Institutional Mixed-Methods Study.

PubMed

Sheu, Leslie; O'Sullivan, Patricia S; Aagaard, Eva M; Tad-Y, Darlene; Harrell, Heather E; Kogan, Jennifer R; Nixon, James; Hollander, Harry; Hauer, Karen E

2016-10-01

Although residents trust interns to provide patient care, little is known about how trust forms. Using a multi-institutional mixed-methods study design, the authors interviewed (March-September 2014) internal medicine (IM) residents in their second or third postgraduate year at a single institution to address how they develop trust in interns. Transcript analysis using grounded theory yielded a model for resident trust. Authors tested (January-March 2015) the model with residents from five IM programs using a two-section quantitative survey (38 items; 31 rated 0 = not at all to 100 = very much; 7 rated 0 = strongly disagree to 100 = strongly agree) to identify influences on how residents form trust. Qualitative analysis of 29 interviews yielded 14 themes within five previously identified factors of trust (resident, intern, relationship, task, and context). Of 478 residents, 376 (78.7%) completed the survey. Factor analysis yielded 11 factors that influence trust. Respondents rated interns' characteristics (reliability, competence, and propensity to make errors) highest when indicating importance to trust (respective means 86.3 [standard deviation = 9.7], 76.4 [12.9], and 75.8 [20.0]). They also rated contextual factors highly as influencing trust (access to an electronic medical record, duty hours, and patient characteristics; respective means 79.8 [15.3], 73.1 [14.4], and 71.9 [20.0]). Residents form trust based on primarily intern- and context-specific factors. Residents appear to consider trust in a way that prioritizes interns' execution of essential patient care tasks safely within the complexities and constraints of the hospital environment.

Organisational effectiveness within National Health Service (NHS) Trusts.

PubMed

Jackson, S

1998-01-01

In view of the dearth of information relating to organisational effectiveness of NHS Trusts in comparison with clinical effectiveness, a complex study was undertaken to determine whether overall effectiveness was a result of management processes, people, or a combination of both. The study incorporated two phases involving the distribution of a comprehensive questionnaire to identify the "whats" of organisational effectiveness, and a bench-marking exercise aimed at identifying the "hows". In the main, the better performing trusts were found to be subscribing to the concepts of "keeping it simple", innovation and attainment of highly efficient processes. A number of examples of better/best practices were observed which included visible leadership, a commitment towards stakeholder involvement and the practice of teamworking. Given the complexity of the study area, the findings were deemed valuable to managers practising within all areas of healthcare. However, a need for further research was identified in order to substantiate the results.

Commitment and Trust in Librarian-Faculty Relationships: A Systematic Review of the Literature

ERIC Educational Resources Information Center

Phelps, Sue F.; Campbell, Nicole

2012-01-01

Objective: The goal of this study was to examine the methodologies used to study librarian-faculty relationships and to use the Key Mediating Variable model (KMV) of The Trust and Commitment Theory of Relationship Marketing to assess the quality of the librarian-faculty relationship as it has been portrayed in the literature. Relationship…

External Accountability of Collaborative Arrangements; A Case Study of a Multi Academy Trust in England

ERIC Educational Resources Information Center

Ehren, Melanie C. M.; Godfrey, David

2017-01-01

This paper explores the impact of external accountability on four mechanisms of network-internal quality control and the properties of (mandated) inter-organizational networks. An explorative case study approach examines the external accountability of a newly established educational network (MAT) and how schools and the Trust are held accountable…

Dialing in to a Circle of Trust: A "Medium" Tech Experiment and Poetic Evaluation

ERIC Educational Resources Information Center

Love, Christine T.

2012-01-01

In his 2004 book "A Hidden Wholeness," Parker Palmer makes explicit the unique qualities of the transformational "circle of trust." He describes a group of people embracing the paradox of "being alone together," where the only goal of the group is to invite the emergence of the soul of each individual, through…

36 CFR § 1010.11 - Preparation of an EA.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Preparation of an EA. § 1010.11 Section § 1010.11 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010... Trust may prepare or require an EA at any time to assist planning and decision-making. (b) Content and...

International educational partnerships for doctors in training: a collaborative framework with the RCP.

PubMed

Thomson, George A; Foster, Matthew; Sheriff, Rezvi; Mendis, Lalitha; Fernando, Devaka J S; Blundell, Caroline; Worrall, Jeffrey; Black, Carol

2005-01-01

The UK offers excellent postgraduate medical education, and overseas doctors in training often covet a period of training in the UK. Some overseas training authorities make UK training mandatory prior to appointment as a consultant. Unfortunately, the organisation of such training often proves to be ad hoc, and may lack educational value. UK training faces challenges as a result of reduced hours of work, more structured and intensive educational needs, and pressures of increasing clinical demand. A plethora of new 'trust' posts have developed, often with limited educational value, creating a risk that training quality for overseas doctors is reduced. Against this background, such posts can be used to create international training partnerships such as that at Sherwood Forest Hospitals NHS Trust (SFHT), providing high-quality general and specialty training. Given the success of this strategy, it would be desirable for other UK trusts to provide similar schemes offering specialties not covered at SFHT.

WDS Trusted Data Services in Support of International Science

NASA Astrophysics Data System (ADS)

Mokrane, M.; Minster, J. B. H.

2014-12-01

Today's research is international, transdisciplinary, and data-enabled, which requires scrupulous data stewardship, full and open access to data, and efficient collaboration and coordination. New expectations on researchers based on policies from governments and funders to share data fully, openly, and in a timely manner present significant challenges but are also opportunities to improve the quality and efficiency of research and its accountability to society. Researchers should be able to archive and disseminate data as required by many institutions or funders, and civil society to scrutinize datasets underlying public policies. Thus, the trustworthiness of data services must be verifiable. In addition, the need to integrate large and complex datasets across disciplines and domains with variable levels of maturity calls for greater coordination to achieve sufficient interoperability and sustainability. The World Data System (WDS) of the International Council for Science (ICSU) promotes long-term stewardship of, and universal and equitable access to, quality-assured scientific data and services across a range of disciplines in the natural and social sciences. WDS aims at coordinating and supporting trusted scientific data services for the provision, use, and preservation of relevant datasets to facilitate scientific research, in particular under the ICSU umbrella, while strengthening their links with the research community. WDS certifies it Members, holders and providers of data or data products, using internationally recognized standards. Thus, providing the building blocks of a searchable common infrastructure, from which a data system that is both interoperable and distributed can be formed. This presentation will describe the coordination role of WDS and more specifically activities developed by its Scientific Committee to: Improve and stimulate basic level Certification for Scientific Data Services, in particular through collaboration with the Data Seal of Approval. Identify and define best practices for Publishing Data and to test their implementation by involving the core stakeholders i.e. researchers, institutions, data centres, scholarly publishers, and funders. Establish an open WDS Metadata Catalogue, Knowledge Network, and Global Registry of Trusted Data Services.

Quality of life and trust among young people with narcolepsy and their families, after the Pandemrix® vaccination: protocol for a case-control study.

PubMed

Blomberg, Karin; Carlsson, Agneta Anderzén; Hagberg, Lars; Jonsson, Östen; Leissner, Lena; Eriksson, Mats H

2017-08-23

The extensive vaccination programme against swine flu resulted in an increased incidence of narcolepsy among children and adolescents. There is a need to explore if these young persons' experiences have affected their trust in healthcare, their willingness to participate in future prevention programmes, and their contacts with the healthcare system. The overall aim is to identify factors important for the life-situation of children and adolescents with narcolepsy and their families, and factors that correlate with trust in healthcare. Data will be collected via questionnaires from all available children with narcolepsy following the vaccination and their families, as well as a control group of children with diabetes and their families. Longitudinal descriptive interviews will also be conducted with a selection of 20-25 children and their families. Techniques from media research will be used for Internet-based data collection and analysis of information relating to narcolepsy from social media. This project will use the situation of young persons with narcolepsy after the swine flu vaccination as a case to build a model that can be used in situations where trust in healthcare is essential. This model will be based on findings from the included studies on how trust is influenced by support, quality of life, burden of disease, impact on family, and use of social media. The model developed in this project will be beneficial in future situations where trust in healthcare is essential, such as new pandemic outbreaks but also for "everyday" adherence to health advice.

The importance of social exchange to nurses and nurse assistants: impact on retention factors.

PubMed

Trybou, Jeroen; De Pourcq, Kaat; Paeshuyse, Michel; Gemmel, Paul

2014-07-01

The purpose of this study was to test the norm of reciprocity by examining relationships between perceived organisational support (POS), the quality of leader-member exchange (LMX) and psychological contract breach (PCB) and important nurse retention factors identified in the literature. A major cause of turnover among nurses is related to unsatisfying workplaces. Previous research, mainly outside the nursing setting, found that social exchange affects employees' work-related attitudes. A cross-sectional survey was conducted on 217 nurses and nursing assistants to test and refine a model linking POS, LMX, PCB with job satisfaction, trust and turnover intentions. Hierarchical multiple linear regression revealed that POS, PCB and LMX explained significant variance in all three retention factors: job satisfaction (adjusted R² = 0.502), trust (adjusted R² = 0.462) and turnover intentions (adjusted R² = 0.196). POS and PCB predicted most strongly job satisfaction (P < 0.001) and trust (P < 0.001 and P < 0.01, respectively). LMX predicted most strongly intention to leave (P < 0.01). In our study, POS, the quality of LMX and PCB were strongly related to job satisfaction, trust and turnover intentions. Nursing managers and leaders should recognize the importance of social exchange within their organisation to build trust, satisfy and retain scarce nurses and nursing assistants. © 2013 John Wiley & Sons Ltd.

The structure of service quality perceptions for multiple-encounter services.

PubMed

Andaleeb, Syed Saad; Kara, Ali

2013-01-01

The objective of this study was to examine a complex service environment-hospitals-to suggest how service quality could be reframed and measured for multiple-encounter service situations more effectively. In this cross-sectional study, a sample of 371 patients completed the survey instrument. Service quality measures were guided by the literature but allowed to flow from the respondents at the preliminary stage. Confirmatory factor analysis, along with structural equation modeling, was used to test the hypothesized relationships among key actors' performance metrics (KAPMs). Patient satisfaction is significantly influenced by perceived service quality based on KAPMs. For multiple-encounter services, service quality dimensions and measures ought to be tied to KAPMs. Primary actors-ie, doctors-need knowledge and skills about patient psychology, negotiation, handling difficult patients, and, importantly, "putting the customer first." Sensitivity training on such matters should be provided. The secondary actors are the nurses who have more frequent contact with the patients. Nurses need to be perceived as "patient advocates." Effective advocacy begins with prompt and caring services to build trust. The tertiary actors in their support role also ought to be integrated into becoming vital part of the service provided.

Credible investigation of air accidents.

PubMed

Smart, K

2004-07-26

Within the United Kingdom the Air Accidents Investigation Branch (AAIB) has been used as a model for the other transport modes accident investigation bodies. Government Ministers considered that the AAIB's approach had established the trust of the public and the aviation industry in its ability to conduct independent and objective investigations. The paper will examine the factors that are involved in establishing this trust. They include: the investigation framework; the actual and perceived independence of the accident investigating body; the aviation industry's safety culture; the qualities of the investigators and the quality of their liaison with bereaved families those directly affected by the accidents they investigate.

Finding Complex Roots: Can You Trust Your Calculator?

ERIC Educational Resources Information Center

Ciesla, Barbara A.; Watson, John W.

2006-01-01

This article investigates a specific instance when the textbook answer for finding a root of a complex number differed with the answer given by the TI-83. After explaining the reason for the difference the article then expands the definition of the integral root of a complex number to an arbitrary complex power of a complex number.

Beyond Wiki to Judgewiki for Transparent Climate Change Decisions

NASA Astrophysics Data System (ADS)

Capron, M. E.

2008-12-01

Climate Change is like the prisoner's dilemma, a zero-sum game, or cheating in sports. Everyone and every country is tempted to selfishly maintain or advance their standard of living. The tremendous difference between standards of living amplifies the desire to opt out of Climate Change solutions adverse to economic competitiveness. Climate Change is also exceedingly complex. No one person, one organization, one country, or partial collection of countries has the capacity and the global support needed to make decisions on Climate Change solutions. There are thousands of potential actions, tens of thousands of known and unknown environmental and economic impacts. Some actions are belatedly found to be unsustainable beyond token volumes, corn ethanol or soy-biodiesel for example. Mankind can address human nature and complexity with a globally transparent information and decision process available to all 7 billion of us. We need a process that builds trust and simplifies complexity. Fortunately, we have the Internet for trust building communication and computers to simplify complexity. Mankind can produce new software tailored to the challenge. We would combine group information collection software (a wiki) with a decision-matrix (a judge), market forecasting, and video games to produce the tool mankind needs for trust building transparent decisions on Climate Change actions. The resulting software would be a judgewiki.

Balancing emotion and cognition: a case for decision aiding in conservation efforts.

PubMed

Wilson, Robyn S

2008-12-01

Despite advances in the quality of participatory decision making for conservation, many current efforts still suffer from an inability to bridge the gap between science and policy. Judgment and decision-making research suggests this gap may result from a person's reliance on affect-based shortcuts in complex decision contexts. I examined the results from 3 experiments that demonstrate how affect (i.e., the instantaneous reaction one has to a stimulus) influences individual judgments in these contexts and identified techniques from the decision-aiding literature that help encourage a balance between affect-based emotion and cognition in complex decision processes. In the first study, subjects displayed a lack of focus on their stated conservation objectives and made decisions that reflected their initial affective impressions. Value-focused approaches may help individuals incorporate all the decision-relevant objectives by making the technical and value-based objectives more salient. In the second study, subjects displayed a lack of focus on statistical risk and again made affect-based decisions. Trade-off techniques may help individuals incorporate relevant technical data, even when it conflicts with their initial affective impressions or other value-based objectives. In the third study, subjects displayed a lack of trust in decision-making authorities when the decision involved a negatively affect-rich outcome (i.e., a loss). Identifying shared salient values and increasing procedural fairness may help build social trust in both decision-making authorities and the decision process.

Public Trust in Health Information Sharing: Implications for Biobanking and Electronic Health Record Systems

PubMed Central

Platt, Jodyn; Kardia, Sharon

2015-01-01

Biobanks are made all the more valuable when the biological samples they hold can be linked to health information collected in research, electronic health records, or public health practice. Public trust in such systems that share health information for research and health care practice is understudied. Our research examines characteristics of the general public that predict trust in a health system that includes researchers, health care providers, insurance companies and public health departments. We created a 119-item survey of predictors and attributes of system trust and fielded it using Amazon’s MTurk system (n = 447). We found that seeing one’s primary care provider, having a favorable view of data sharing and believing that data sharing will improve the quality of health care, as well as psychosocial factors (altruism and generalized trust) were positively and significantly associated with system trust. As expected, privacy concern, but counterintuitively, knowledge about health information sharing were negatively associated with system trust. We conclude that, in order to assure the public’s trust, policy makers charged with setting best practices for governance of biobanks and access to electronic health records should leverage critical access points to engage a diverse public in joint decision making. PMID:25654300

A blessing and a curse? Political institutions in the growth and decay of generalized trust: a cross-national panel analysis, 1980-2009.

PubMed

Robbins, Blaine G

2012-01-01

Despite decades of research on social capital, studies that explore the relationship between political institutions and generalized trust-a key element of social capital-across time are sparse. To address this issue, we use various cross-national public-opinion data sets including the World Values Survey and employ pooled time-series OLS regression and fixed- and random-effects estimation techniques on an unbalanced panel of 74 countries and 248 observations spread over a 29-year time period. With these data and methods, we investigate the impact of five political-institutional factors-legal property rights, market regulations, labor market regulations, universality of socioeconomic provisions, and power-sharing capacity-on generalized trust. We find that generalized trust increases monotonically with the quality of property rights institutions, that labor market regulations increase generalized trust, and that power-sharing capacity of the state decreases generalized trust. While generalized trust increases as the government regulation of credit, business, and economic markets decreases and as the universality of socioeconomic provisions increases, both effects appear to be more sensitive to the countries included and the modeling techniques employed than the other political-institutional factors. In short, we find that political institutions simultaneously promote and undermine generalized trust.

Institutional (mis)trust in colorectal cancer screening: a qualitative study with Greek, Iranian, Anglo-Australian and Indigenous groups.

PubMed

Ward, Paul R; Coffey, Cushla; Javanparast, Sara; Wilson, Carlene; Meyer, Samantha B

2015-12-01

Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups - Anglo-Australian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation. © 2014 John Wiley & Sons Ltd.

Trust - Essential Requirement and Basis for pHealth Services.

PubMed

Ruotsalainen, Pekka; Blobel, Bernd

2017-01-01

Trust is a social code and glue between persons and organizations in any business domain including health. pHealth is a complex concept that is built around health service providers, individuals and artefacts such as sensors, mobile devices, networks, computers, and software applications. It has many stakeholders such as organizations, persons, patients, customers, and tele-operators. pHealth services are increasingly offered in insecure information space, and used over organizational, geographical and jurisdictional borders. This all means that trust is an essential requirement for successful pHealth services. To make pHealth a successful business, organizations offering pHealth services should establish inter-organizational trust and trusted relationship between their customers. Before starting to use services, the pHealth user should have a possibility to define how much it trusts on the service provider and on the surrounding information infrastructure. The authors' analysis show that trust models used in today's health care and e-commerce are insufficient for networked pHealth. Calculated trust as proposed by the authors is stronger than the predefined dispositional trust model currently used in health care, other's recommendations used in e-commerce and risk assessment. Until now, caused by the lack of business incentive, lack of regulatory and political pressure, pHealth providers have not demonstrated meaningful interest in moving from the current unsatisfactory situation to trust calculation by making information necessary for this methodology available. To make pHealth successful, a combination of legal, political, organizational, technological and educational efforts is needed to initiate the paradigm change and start the era of trust-based pHealth services.

Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care.

PubMed

Fotaki, Marianna

2014-11-01

Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care. © 2014 The Author. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

The dynamics of socio-connective trust within support networks accessed by informal caregivers.

PubMed

Ray, Robin A; Street, Annette F

2011-03-01

This article introduces the concept of socio-connective trust, the synapse between the social structures and processes that underpin relationships in supportive care networks. Data from an ethnographic case study of 18 informal caregivers providing in-home care for people with life-limiting illness were analysed drawing on theoretical concepts from the work of Giddens and writings on social capital, as well as the construction of trust in the caregiving literature. While conceptions of trust were found to contribute to understanding supportive care relationships, they did not account for the dynamic nature of the availability and use of support networks. Instead, informal caregivers undertook ongoing reflexive negotiation of relationship boundaries in response to their own conception of the current situation and their perception of trust in their relationships with the various members of the support network. The concept of socio-connective trust describes the movement and flow of the flexible bonds that influence relationships among care networks and determine the type and range of support accessed by informal caregivers. Understanding the complexities of socio-connective trust in caregiving relationships will assist health and social care workers to mobilize relevant resources to support informal caregivers.

36 CFR § 1010.16 - Actions to encourage agency cooperation early in the NEPA process.

Code of Federal Regulations, 2013 CFR

2013-07-01

... cooperation early in the NEPA process. § 1010.16 Section § 1010.16 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.16 Actions to encourage agency cooperation early in the NEPA... Trust, any other Federal, State, local, or tribal agency that has jurisdiction by law or special...

Huggable Communication Medium Maintains Level of Trust during Conversation Game.

PubMed

Takahashi, Hideyuki; Ban, Midori; Osawa, Hirotaka; Nakanishi, Junya; Sumioka, Hidenobu; Ishiguro, Hiroshi

2017-01-01

There have been several attempts in recent years to develop a remote communication device using sensory modalities other than speech that would induce a user's positive experience with his/her conversation partner. Specifically, Hugvie is a human-shaped pillow as well as a remote communication device enabling users to combine a hugging experience with telecommunication to improve the quality of remote communication. The present research is based on the hypothesis that using Hugvie maintains users' level of trust toward their conversation partners in situations prone to suspicion. The level of trust felt toward other remote game players was compared between participants using Hugvie and those using a basic communication device while playing a modified version of Werewolf , a conversation-based game, designed to evaluate trust. Although there are always winners and losers in the regular version of Werewolf , the rules were modified to generate a possible scenario in which no enemy was present among the players and all players would win if they trusted each other. We examined the effect of using Hugvie while playing Werewolf on players' level of trust toward each other and our results demonstrated that in those using Hugvie , the level of trust toward other players was maintained.

Huggable Communication Medium Maintains Level of Trust during Conversation Game

PubMed Central

Takahashi, Hideyuki; Ban, Midori; Osawa, Hirotaka; Nakanishi, Junya; Sumioka, Hidenobu; Ishiguro, Hiroshi

2017-01-01

There have been several attempts in recent years to develop a remote communication device using sensory modalities other than speech that would induce a user’s positive experience with his/her conversation partner. Specifically, Hugvie is a human-shaped pillow as well as a remote communication device enabling users to combine a hugging experience with telecommunication to improve the quality of remote communication. The present research is based on the hypothesis that using Hugvie maintains users’ level of trust toward their conversation partners in situations prone to suspicion. The level of trust felt toward other remote game players was compared between participants using Hugvie and those using a basic communication device while playing a modified version of Werewolf, a conversation-based game, designed to evaluate trust. Although there are always winners and losers in the regular version of Werewolf, the rules were modified to generate a possible scenario in which no enemy was present among the players and all players would win if they trusted each other. We examined the effect of using Hugvie while playing Werewolf on players’ level of trust toward each other and our results demonstrated that in those using Hugvie, the level of trust toward other players was maintained. PMID:29118727

WILDLIFE HEALTH AND PUBLIC TRUST RESPONSIBILITIES FOR WILDLIFE RESOURCES.

PubMed

Decker, Daniel J; Schuler, Krysten; Forstchen, Ann B; Wild, Margaret A; Siemer, William F

2016-10-01

A significant development in wildlife management is the mounting concern of wildlife professionals and the public about wildlife health and diseases. Concurrently, the wildlife profession is reexamining implications of managing wildlife populations as a public trust and the concomitant obligation to ensure the quality (i.e., health) and sustainability of wildlife. It is an opportune time to emphasize the importance of wildlife health, specifically to advocate for comprehensive and consistent integration of wildlife health in wildlife management. We summarize application of public trust ideas in wildlife population management in the US. We argue that wildlife health is essential to fulfilling public trust administration responsibilities with respect to wildlife, due to the central responsibility of trustees for ensuring the well-being of wildlife species (i.e., the core resources of the trust). Because both health of wildlife and risk perceptions regarding threats posed by wildlife disease to humans and domestic animals are issues of growing concern, managing wildlife disease and risk communication vis-à-vis wildlife health is critical to wildlife trust administration. We conclude that wildlife health professionals play a critical role in protecting the wildlife trust and that current conditions provide opportunities for important contributions by wildlife health professionals in wildlife management.

Correlates of consumer trust in online health information: findings from the health information national trends survey.

PubMed

Ye, Yinjiao

2011-01-01

The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.

ITrace: An implicit trust inference method for trust-aware collaborative filtering

NASA Astrophysics Data System (ADS)

He, Xu; Liu, Bin; Chen, Kejia

2018-04-01

The growth of Internet commerce has stimulated the use of collaborative filtering (CF) algorithms as recommender systems. A CF algorithm recommends items of interest to the target user by leveraging the votes given by other similar users. In a standard CF framework, it is assumed that the credibility of every voting user is exactly the same with respect to the target user. This assumption is not satisfied and thus may lead to misleading recommendations in many practical applications. A natural countermeasure is to design a trust-aware CF (TaCF) algorithm, which can take account of the difference in the credibilities of the voting users when performing CF. To this end, this paper presents a trust inference approach, which can predict the implicit trust of the target user on every voting user from a sparse explicit trust matrix. Then an improved CF algorithm termed iTrace is proposed, which takes advantage of both the explicit and the predicted implicit trust to provide recommendations with the CF framework. An empirical evaluation on a public dataset demonstrates that the proposed algorithm provides a significant improvement in recommendation quality in terms of mean absolute error.

"It's all about trust": reflections of researchers on the complexity and controversy surrounding biobanking in South Africa.

PubMed

Moodley, Keymanthri; Singh, Shenuka

2016-10-10

Biobanks are precariously situated at the intersection of science, genetics, genomics, society, ethics, the law and politics. This multi-disciplinarity has given rise to a new discourse in health research involving diverse stakeholders. Each stakeholder is embedded in a unique context and articulates his/her biobanking activities differently. To researchers, biobanks carry enormous transformative potential in terms of advancing scientific discovery and knowledge. However, in the context of power asymmetries in Africa and a distrust in science born out of historical exploitation, researchers must balance the scientific imperative of collecting, storing and sharing high quality biological samples with obligations to donors/participants, communities, international collaborators, regulatory and ethics authorities. To date, researcher perspectives on biobanking in South Africa have not been explored and documented. In-depth qualitative interviews were conducted with a purposive sample of 21 researchers - 8 in the Western Cape, 3 in Gauteng and 10 in Kwa-Zulu Natal. Interviews lasted approximately 40-60 min and were audiotaped with consent. Thematic analysis of the transcribed interviews was conducted by the co-authors. Researchers articulated serious concerns over standardised regulatory approaches that failed to consider the heterogeneity of biobanks. Given that biobanks differ considerably, guidelines and RECs need to stratify risk accordingly and governance processes and structures must be flexible. While RECs were regarded as an important component of the governance structure researchers expressed concern about their expertise in biobanking. Operational management of biobanks was regarded as an ethical imperative and a pre-requisite to building trust during consent processes. While broad general consent was preferred, tiered consent was thought to be more consistent with respect for autonomy and building trust. Material Transfer Agreements (MTAs) were often lacking when biosamples were exported and this was perceived to impact negatively on trust. On the other hand, researchers believed that authentic community engagement would help to build trust. Building trust will best be achieved via a system of governance structures and processes that precede the establishment of a biobank and monitor progress from the point of sample collection through to future use, including export. Such governance structures must be robust and must include comprehensive national legislation, policy and contextualised guidelines. Currently such governance infrastructure appears to be lacking in many African countries including South Africa. Capacity development of all stakeholders including REC members will enhance expeditious and efficient review of biobanking protocols which in turn will reinforce trust in the researcher-donor relationship. Science translation and community engagement in biobanking is integral to the success of biobanking in South Africa.

Hidden costs in the physician-insurer relationship.

PubMed

Cote, Jane; Latham, Claire

2003-01-01

Numerous reports document the frictions in health care funding systems, particularly related to the physician-insurer dyad. Efforts to improve efficient patient care by improving interactions between the physician and insurer are ongoing. This article examines one dimension--relationship quality--and demonstrates how attention to building commitment and trust within the relationship has financial benefits. Using a survey of physician practice personnel, commitment and trust are shown to have a positive influence on financial performance metrics. Commitment and trust antecedents are empirically documented. These antecedents provide a starting point for physician practices seeking to enhance their insurer relationships as a mechanism for improved operations.

Building trust and diversity in patient-centered oncology clinical trials: An integrated model.

PubMed

Hurd, Thelma C; Kaplan, Charles D; Cook, Elise D; Chilton, Janice A; Lytton, Jay S; Hawk, Ernest T; Jones, Lovell A

2017-04-01

Trust is the cornerstone of clinical trial recruitment and retention. Efforts to decrease barriers and increase clinical trial participation among diverse populations have yielded modest results. There is an urgent need to better understand the complex interactions between trust and clinical trial participation. The process of trust-building has been a focus of intense research in the business community. Yet, little has been published about trust in oncology clinical trials or the process of building trust in clinical trials. Both clinical trials and business share common dimensions. Business strategies for building trust may be transferable to the clinical trial setting. This study was conducted to understand and utilize contemporary thinking about building trust to develop an Integrated Model of Trust that incorporates both clinical and business perspectives. A key word-directed literature search of the PubMed, Medline, Cochrane, and Google Search databases for entries dated between 1 January 1985 and 1 September 2015 was conducted to obtain information from which to develop an Integrated Model of Trust. Successful trial participation requires both participants and clinical trial team members to build distinctly different types of interpersonal trust to effect recruitment and retention. They are built under conditions of significant emotional stress and time constraints among people who do not know each other and have never worked together before. Swift Trust and Traditional Trust are sequentially built during the clinical trial process. Swift trust operates during the recruitment and very early active treatment phases of the clinical trial process. Traditional trust is built over time and operates during the active treatment and surveillance stages of clinical trials. The Psychological Contract frames the participants' and clinical trial team members' interpersonal trust relationship. The "terms" of interpersonal trust are negotiated through the psychological contract. Contract renegotiation occurs in response to cyclical changes within the trust relationship throughout trial participation. The Integrated Model of Trust offers a novel framework to interrogate the process by which diverse populations and clinical trial teams build trust. To our knowledge, this is the first model of trust-building in clinical trials that frames trust development through integrated clinical and business perspectives. By focusing on the process, rather than outcomes of trust-building diverse trial participants, clinical trials teams, participants, and cancer centers may be able to better understand, measure, and manage their trust relationships in real time. Ultimately, this may foster increased recruitment and retention of diverse populations to clinical trials.

Rumor Spreading Model with Trust Mechanism in Complex Social Networks

NASA Astrophysics Data System (ADS)

Wang, Ya-Qi; Yang, Xiao-Yuan; Han, Yi-Liang; Wang, Xu-An

2013-04-01

In this paper, to study rumor spreading, we propose a novel susceptible-infected-removed (SIR) model by introducing the trust mechanism. We derive mean-field equations that describe the dynamics of the SIR model on homogeneous networks and inhomogeneous networks. Then a steady-state analysis is conducted to investigate the critical threshold and the final size of the rumor spreading. We show that the introduction of trust mechanism reduces the final rumor size and the velocity of rumor spreading, but increases the critical thresholds on both networks. Moreover, the trust mechanism not only greatly reduces the maximum rumor influence, but also postpones the rumor terminal time, which provides us with more time to take measures to control the rumor spreading. The theoretical results are confirmed by sufficient numerical simulations.

A Qualitative Study of Factors Affecting Morale in Psychiatry Residency Training.

PubMed

Caravella, Rachel A; Robinson, Lee A; Wilets, Ilene; Weinberg, Michael; Cabaniss, Deborah L; Cutler, Janis L; Kymissis, Carisa; Arbuckle, Melissa R

2016-10-01

Resident morale is an important yet poorly understood aspect of the residency training experience. Despite implications for program quality, resident satisfaction, patient care, and recruitment, little is known about the variables influencing this complex phenomenon. This study sought to identify important factors affecting morale in psychiatry residency training. The authors conducted four semi-structured focus groups at a moderately sized, urban, psychiatry residency program during the 2013-2014 academic year. They used qualitative data analysis techniques, including grounded theory and content analysis, to identify key themes affecting resident morale across training levels. Twenty-seven residents participated in the focus groups with equal distribution across post-graduate years (PGY) 1-4. Five major conceptual categories affecting resident morale emerged: Sense of Community, Individual Motivators, Clinical Work, Feeling Cared For, and Trust in the Administration. Morale is an important topic in residency education. The qualitative results suggest that factors related to a Sense of Community and Individual Motivators generally enhanced resident morale whereas factors related to a lack of Feeling Cared For and Trust in the Administration tended to contribute to lower morale. The authors describe the possible interventions to promote stronger program morale suggested by these findings.

The Influence of Cultural Factors on Trust in Automation

ERIC Educational Resources Information Center

Chien, Shih-Yi James

2016-01-01

Human interaction with automation is a complex process that requires both skilled operators and complex system designs to effectively enhance overall performance. Although automation has successfully managed complex systems throughout the world for over half a century, inappropriate reliance on automation can still occur, such as the recent…

An Alternative Front End Analysis Strategy for Complex Systems

DTIC Science & Technology

2014-12-01

Mutual trust Trust across and between team members Team/collective efficacy How well the team works together effectively Team/collective orientation...and experts. Finally, it has been shown that one effect of expertise is the development of applicable schemas, which, in turn, reduce the working ...TASK NUMBER 409 5e. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) U.S. Army Research Institute

Toward an Understanding of the Role of Relational Trust for New Heads of Independent Schools

ERIC Educational Resources Information Center

Batiste, Harold Eugene, III

2012-01-01

Within the context of schools, it can be argued that trust is a complex absolute necessity if students are to be successful learners; if educators are to be successful facilitators and champions of learning; if the staff is to be successful providers of educational support; if parents, guardians, and families are to be successful partners with the…

Trust-Based Relational Intervention (TBRI): A Systemic Approach to Complex Developmental Trauma

PubMed Central

Purvis, Karyn B.; Cross, David R.; Dansereau, Donald F.; Parris, Sheri R.

2013-01-01

Children and youth who have experienced foster care or orphanage-rearing have often experienced complex developmental trauma, demonstrating an interactive set of psychological and behavioral issues. Trust-Based Relational Intervention (TBRI) is a therapeutic model that trains caregivers to provide effective support and treatment for at-risk children. TBRI has been applied in orphanages, courts, residential treatment facilities, group homes, foster and adoptive homes, churches, and schools. It has been used effectively with children and youth of all ages and all risk levels. This article provides the research base for TBRI and examples of how it is applied. PMID:24453385

On the night shift: advanced nurse practice in emergency medicine.

PubMed

Jenkins, Jennifer

2016-05-01

Advanced nurse practitioners in the author's emergency department (ED) work autonomously and as part of a team to assess, diagnose and treat patients with unexplained and undiagnosed illnesses and injuries over a 24-hour cycle of care. The complexity of the role in EDs is often not fully understood, and expectations can vary between trusts and between different clinical areas within trusts. This article describes one night shift in the author's ED to explain the complexity of advanced nurse practitioners' roles in this environment. The article focuses on autonomous decision-making skills and the use of advanced clinical skills in the context of evidence-based practice.

The disorder-specific psychological impairment in complex PTSD: A flawed working model for restoration of trust.

PubMed

Laddis, Andreas

2018-03-22

This article methodically gathers concepts and findings from related disciplines to propose that there is a fundamental, disorder-specific psychological impairment, which defines Complex Posttraumatic Stress Disorder (PTSD) as etiologically different from simple PTSD. This impairment is a flawed working model for restoration of trust when one partner fears betrayal. This working model is legacy of childhood relationships with manipulative caretakers who kept the child powerless to test the trustworthiness of their reasons to break promises and to fail the child's expectations. Manipulative caretakers invert the respective roles and responsibilities for restoration of trust, which constitutes perversion of intimacy. This article describes how that fundamental flaw becomes the cause of patients' disorder, by episodically rendering them powerless to ascertain a perception of grave betrayal as true or false in later relationships. Repeated failure with experiments for certainty about others' love explains the characteristic personality traits and beliefs of persons with Complex PTSD, i.e., cynicism about the world's benevolence, self-derogation and sense of a foreshortened future. This article closes with reference to a study that investigated the efficacy of a crisis intervention designed to remediate this fundamental impairment.

Tribal Air Grants Framework - Menu of Options

EPA Pesticide Factsheets

Tool to assist tribes that apply for CAA funding to draft moreeffective work plans for projects that will develop tribal knowledge of air quality issues andbuild tribal expertise to manage air quality on reservations and tribal trust land

Parental Loss, Trusting Relationship with Current Caregivers and Psychosocial Adjustment among Children Affected by AIDS in China

PubMed Central

Zhao, Junfeng; Li, Xiaoming; Barnett, Douglas; Lin, Xiuyun; Fang, Xiaoyi; Zhao, Guoxiang; Naar-King, Sylvie; Stanton, Bonita

2011-01-01

Objective to examine the relationship between parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China. Methods Cross-sectional data were collected from 755 AIDS orphans (296 double orphans and 459 single orphans), 466 vulnerable children living with HIV-infected parents, and 404 comparison children in China. The trusting relationship with current caregivers was measured with a 15-item scale (Cronbach alpha=.84) modified from the Trusting Relationship Questionnaire (TRQ) developed by Mustillo and colleagues (2005). The psychosocial measures include rule compliance/acting out, anxiety/withdrawal, peer social skills, school interest, depressive symptoms, loneliness, self-esteem, future expectation, hopefulness about future, and perceived control over the future. Results Group mean comparisons using ANOVA suggested a significant association (p<.0001) between the trusting relationship with current caregivers and all the psychosocial measures except anxiety and depression. These associations remained significant in General Linear Model analysis, controlling for children's gender, age, family SES, orphan status (orphans, vulnerable children, and comparison children), and appropriate interaction terms among factor variables. Discussion The findings in the current study support the global literature on the importance of attachment relationship with caregivers in promoting children's psychosocial development. Future prevention intervention efforts to improve AIDS orphans' psychosocial well-being will need to take into consideration the quality of the child's attachment relationships with current caregivers and help their current caregivers to improve the quality of care for these children. Future study is needed to explore the possible reasons for the lack of association between a trusting relationship and some internalizing symptoms such as anxiety and depression among children affected by HIV/AIDS. PMID:21749241

The antecedents, attributes and consequences of trust among nurses and nurse managers: a concept analysis.

PubMed

McCabe, T J; Sambrook, Sally

2014-05-01

Although trust has been investigated in the health context, limited research explores nurse and nurse manager perceptions of trust. To explore the concept of trust amongst nurses and nurse managers at individual, interpersonal and organisational levels. Our paper reports the findings from an interpretivist study conducted within the British National Health Service, involving thirty-nine semi-structured interviews with nurses and nurse managers. Large acute and small community organisation within the British National Health Service. 28 nurses and 11 nurse managers working within an Acute and a Community sector organisation - 20 and 19 in each organisation. Participants were selected through a process of purposive sampling, reflecting variations in terms of age, grade, ward and tenure. We utilise a concept analysis framework in exploring the antecedents, attributes and consequences of trust amongst nurses and nurse managers at individual, interpersonal and organisational levels. Key findings suggest that trust is formed within the immediate ward environment, and is significantly influenced by the role of line manager. Other positively influencing factors include professionalism and commitment to the nursing profession. These form the basis for the teamwork, delegation, support, open communication systems, confidentiality and discretion essential to delivering quality patient care. Negatively influencing factors include new management concepts, practices and styles overseen by managers recruited from the private sector. New management concepts were associated with reductions in the number of qualified nurses and increasing numbers of untrained nursing staff, reduced direct patient contact, less opportunities for professional training and development and deteriorating terms and conditions of employment. Our findings offer insight for managers, nurses and human resource practitioners to help build high trust relationships in a health care context. Of particular import is the need for managers to communicate more effectively organisational and financial constraints, in a manner that does not 'alienate' nurses and nurse managers, by highlighting their value and acknowledging their role in delivering high quality patient care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Trust and people who inject drugs: The perspectives of clients and staff of Needle Syringe Programs.

PubMed

Treloar, Carla; Rance, Jake; Yates, Kenneth; Mao, Limin

2016-01-01

Interest in health-care related trust is growing with the recognition that trust is essential for effective therapeutic encounters. While most trust-related research has been conducted with general patient groups, the experiences of people who inject drugs cannot be understood without acknowledging the critical role social stigma plays in shaping (mis)trust, both generally and in regards to health services specifically. This study examined the experiences of trust among clients and staff of Needle and Syringe Programs (NSPs) in one area of Sydney, Australia. In-depth interviews with 12 NSP staff and 31 NSP clients were conducted. Analysis was informed by a five component model of trust, with particular emphasis on the notion of "global trust" as encompassing experiences of stigma and other negative social processes related to injecting drug use. Participant experiences of trust in NSPs were compared with those within other drug-related health services. Particular attention was paid to understanding the relationship between 'identity' (as a drug user) and 'legitimacy' (as a service user) and the centrality of this relationship to the experience of global trust for PWID. Notions of identity and legitimacy were inextricably bound up with the stigmatisation of drug use, shaping participants' experiences and accounts of trust in NSPs and drug treatment services. Client participants reported high levels of trust in NSPs, especially when compared with drug treatment services, describing being treated like "any other person" even when negotiating 'sensitive' issues. NSP staff participants described the establishment of trust as not only underpinning their work with clients but as something that required ongoing renewal and demonstration. "Global trust" assists us to better understand the complex experiences shaping PWID decisions to engage with and trust health services. The high levels of trust reported between client and NSP need to be recognised as a valuable resource for the delivery of effective health care for people who inject drugs, including encouraging behaviours to support the prevention of blood-borne viruses. Copyright © 2015 Elsevier B.V. All rights reserved.

Hazardous Waste Site Analysis (Small Site Technology)

DTIC Science & Technology

1990-08-01

Act HSRT - Hazardous Substance Response Trust (Superfund Trust) HSWA - Hdzardeus and Solid Waste Amendments (to RCRA) NAAQSD - National Ambient Air...impoundments (basically, any area where hazardous substances are located). * Under CERCLA, "Environment" includes surface and groundwater, ambient air, land...34 provisions with permit requirements for new source construction). " Ambient Air Quality standards (NAAQs) have been issued for six "criteria" pollutants

Building Trust Through Servant Leadership

DTIC Science & Technology

2016-06-10

to fight. Additionally , it demonstrated he valued the lives of those under his command more than his own. This presence, and his conversation with...it. Additionally , they serve by displaying the qualities of trust and valuing people. Puckett’s actions on the battlefield of Vietnam are...implement its principles. In addition , quantitative data collection from senior and organizational level leaders may be required to determine the value

The Construct of State-Level Suspicion A Model and Research Agenda for Automated and Information Technology (IT) Contexts

DTIC Science & Technology

2013-08-01

Explaining and Predicting the Impact of Branding Alliances and Web Site Quality ...on Initial Consumer Trust of e - Commerce Web Sites . Journal of Management Information Systems, 24, 199-224. Lyons, J., Stokes, C., Eschleman, K...Organizations. Academy of Management Journal, 38, 24-59. McKnight, D., Choudhury, V., & Kacmar, C. (2002). The Impact of Initial Consumer Trust

Patient Satisfaction with Hospital Inpatient Care: Effects of Trust, Medical Insurance and Perceived Quality of Care

PubMed Central

Wu, Qunhong; Liu, Chaojie; Jiao, Mingli; Hao, Yanhua; Han, Yuzhen; Gao, Lijun; Hao, Jiejing; Wang, Lan; Xu, Weilan; Ren, Jiaojiao

2016-01-01

Objective Deteriorations in the patient-provider relationship in China have attracted increasing attention in the international community. This study aims to explore the role of trust in patient satisfaction with hospital inpatient care, and how patient-provider trust is shaped from the perspectives of both patients and providers. Methods We adopted a mixed methods approach comprising a multivariate logistic regression model using secondary data (1200 people with inpatient experiences over the past year) from the fifth National Health Service Survey (NHSS, 2013) in Heilongjiang Province to determine the associations between patient satisfaction and trust, financial burden and perceived quality of care, followed by in-depth interviews with 62 conveniently selected key informants (27 from health and 35 from non-health sectors). A thematic analysis established a conceptual framework to explain deteriorating patient-provider relationships. Findings About 24% of respondents reported being dissatisfied with hospital inpatient care. The logistic regression model indicated that patient satisfaction was positively associated with higher level of trust (OR = 14.995), lower levels of hospital medical expenditure (OR = 5.736–1.829 as compared with the highest quintile of hospital expenditure), good staff attitude (OR = 3.155) as well as good ward environment (OR = 2.361). But patient satisfaction was negatively associated with medical insurance for urban residents and other insurance status (OR = 0.215–0.357 as compared with medical insurance for urban employees). The qualitative analysis showed that patient trust—the most significant predictor of patient satisfaction—is shaped by perceived high quality of service delivery, empathic and caring interpersonal interactions, and a better designed medical insurance that provides stronger financial protection and enables more equitable access to health care. Conclusion At the core of high levels of patient dissatisfaction with hospital care is the lack of trust. The current health care system reform in China has yet to address the fundamental problems embedded in the system that caused distrust. A singular focus on doctor-patient inter-personal interactions will not offer a successful solution to the deteriorated patient-provider relationships unless a systems approach to accountability is put into place involving all stakeholders. PMID:27755558

The Quality Movement: What's It Really About?

ERIC Educational Resources Information Center

Bonstingl, John Jay

1993-01-01

Alfie Kohn seems ill-informed about Total Quality Management's educational benefits. Students have always been workers; what is changing is the nature of that work. In schools of quality, teachers and students learn together as they create collaborative, trusting environments where failure is but a temporary step on the road to continuous…

Customer Loyalty in Virtual Environments: An Empirical Study in e-Bank

NASA Astrophysics Data System (ADS)

Chao, Yu; Lee, Gin-Yuan; Ho, Yung-Ching

2009-08-01

The advent of e-commerce has increased the importance of consumer financing operations. Internet banking helps banks to develop relationship marketing, thus improve customer loyalty. This study proposes a research framework to examine the relationships among e-service quality, customer satisfaction, customer trust and e-loyalty in e-bank in Taiwan. Data are collected through a survey using a structured questionnaire. The 442 valid respondents who have experience with e-bank are analyzed by partial least squares structural equation modeling (PLS-SEM) method. The managerial implication is e-bank must focus on e-service quality to increase customer satisfaction and trust for obtaining the e-loyalty.

Water pollution and the public trust doctrine

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

Johnson, R.W.

The prior appropriation system has served well in the Western US for 125 years, providing a legal regime that permits and encourages enormous economic growth of agriculture, industry and municipalities. This system, however, both in its inception and current application, fails to address or protect public interests in fisheries, recreation, environmental quality, and clean water. As a result, serious nonpoint water pollution problems are occurring throughout the West. Such pollution can be regulated either by the courts or the legislatures under the public trust doctrine, which antedates the prior appropriation system, and which protects fisheries and water quality. No onemore » - including irrigators, industries or cities with appropriative rights - has a vested, constitutionally protected property right to degrade the quality of public waters. Some states are adopting police power regulations to control nonpoint pollution. Others are approaching the problem through the prior appropriation system itself, taking the position that beneficial use means use that does not harm the public through pollution. The public trust doctrine is not a panacea that will instantly solve all the conflicts that now surround the prior appropriation system. It should be considered, however, as a basis for setting standards as best practicable technology or best management practice.« less

Trust Pathways, Trust Catalysts, Theory of Change and Citizen Science: A COASST Case Study

NASA Astrophysics Data System (ADS)

Burgess, H. K.; Parrish, J.; Dolliver, J.; Metes, J.; Ballard, H. L.

2017-12-01

Environmental challenges, from local water quality to the effects of global climate change, are overwhelming the mainstream science community. We need help. Citizen science offers one solution pathway - in the ideal, thousands of participants engaged in authentic science that delivers high quality information not otherwise obtainable. But in the real world, are citizen science data used? And more broadly: what are the interactions between citizen science and natural resource management in service of conserving or protecting system structure and function? The Coastal Observation and Seabird Survey Team (COASST) is a rigoros citizen science program focused on documenting patterns of beached bird and marine debris abundance on beaches along the coast of the Pacific Northwest and Alaska. Housed at the University of Washington, COASST partners directly with a wide range of local, tribal, state and federal agencies to effect positive change and a wide range of scientific, community and educational outcomes. Following from years of trial, error and adaptive management, we propose a "trust pathway" between citizen science and agencies that moves from an initial contact and multiple interaction types to eventual partnership and capacity sharing. Along the way are trust catalysts, including but not limited to: stakeholder engagement, data QA/QC, interactive data analysis, housing at an academic institution, and timely, repeated communication. In this presentation, we will discuss strategies and outcomes employed by COASST for fostering trust and successful partnerships, drawing on 20 years of program experience as well as reflections from a variety of partners and stakholdres.

Can We Really Trust Anyone Who Profits from Ranking Higher Education Institutions, or How Would One Evaluate Institutional Quality?

ERIC Educational Resources Information Center

Micceri, Ted

2005-01-01

Although numerous quality ratings exist in today's media-centric environment (Money Magazine, and U.S. News and World Report, etc.), it is quite difficult to provide any reasonably meaningful estimates of institutional quality, either qualitative or quantitative. Global ratings of university "quality" abound, despite the fact that there…

In the interest of food safety: a qualitative study investigating communication and trust between food regulators and food industry in the UK, Australia and New Zealand.

PubMed

Meyer, Samantha B; Wilson, Annabelle M; Calnan, Michael; Henderson, Julie; Coveney, John; McCullum, Dean; Pearce, Alex R; Ward, Paul; Webb, Trevor

2017-02-13

Food regulatory bodies play an important role in public health, and in reducing the costs of food borne illness that are absorbed by both industry and government. Regulation in the food industry involves a relationship between regulators and members of the industry, and it is imperative that these relationships are built on trust. Research has shown in a variety of contexts that businesses find the most success when there are high levels of trust between them and their key stakeholders. An evidence-based understanding of the barriers to communication and trust is imperative if we are to put forward recommendations for facilitating the (re)building of trusting and communicative relationships. We present data from 72 interviews with regulators and industry representatives regarding their trust in and communication with one another. Interviews were conducted in the UK, New Zealand, and Australia in 2013. Data identify a variety of factors that shape the dynamic and complex relationships between regulators and industry, as well as barriers to communication and trust between the two parties. Novel in our approach is our emphasis on identifying solutions to these barriers from the voices of industry and regulators. We provide recommendations (e.g., development of industry advisory boards) to facilitate the (re)building of trusting and communicative relationships between the two parties.

Application of the AHP method in modeling the trust and reputation of software agents

NASA Astrophysics Data System (ADS)

Zytniewski, Mariusz; Klementa, Marek; Skorupka, Dariusz; Stanek, Stanislaw; Duchaczek, Artur

2016-06-01

Given the unique characteristics of cyberspace and, in particular, the number of inherent security threats, communication between software agents becomes a highly complex issue and a major challenge that, on the one hand, needs to be continuously monitored and, on the other, awaits new solutions addressing its vulnerabilities. An approach that has recently come into view mimics mechanisms typical of social systems and is based on trust and reputation that assist agents in deciding which other agents to interact with. The paper offers an enhancement to existing trust and reputation models, involving the application of the AHP method that is widely used for decision support in social systems, notably for risks analysis. To this end, it is proposed to expand the underlying conceptual basis by including such notions as self-trust and social trust, and to apply these to software agents. The discussion is concluded with an account of an experiment aimed at testing the effectiveness of the proposed solution.

Adopting Quality Assurance Technology in Customer-Vendor Relationships: A Case Study of How Interorganizational Relationships Influence the Process

NASA Astrophysics Data System (ADS)

Heeager, Lise Tordrup; Tjørnehøj, Gitte

Quality assurance technology is a formal control mechanism aiming at increasing the quality of the product exchanged between vendors and customers. Studies of the adoption of this technology in the field of system development rarely focus on the role of the relationship between the customer and vendor in the process. We have studied how the process of adopting quality assurance technology by a small Danish IT vendor developing pharmacy software for a customer in the public sector was influenced by the relationship with the customer. The case study showed that the adoption process was shaped to a high degree by the relationship and vice versa. The prior high level of trust and mutual knowledge helped the parties negotiate mutually feasible solutions throughout the adoption process. We thus advise enhancing trust-building processes to strengthen the relationships and to balance formal control and social control to increase the likelihood of a successful outcome of the adoption of quality assurance technology in a customer-vendor relationship.

Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care

PubMed Central

Dawson-Rose, Carol; Cuca, Yvette P.; Webel, Allison R.; Solís Báez, Solymar S.; Holzemer, William L.; Rivero-Méndez, Marta; Eller, Lucille Sanzero; Reid, Paula; Johnson, Mallory O.; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Nicholas, Patrice K.; Matshediso, Ellah; Mogobe, Keitshokile Dintle; Sabone, Motshedisi B.; Ntsayagae, Esther I.; Shaibu, Sheila; Corless, Inge B.; Wantland, Dean; Lindgren, Teri

2016-01-01

Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient–provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient’s trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient–provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care. PMID:27080926

"Easy But Not Simple"--Nursing Students' Descriptions of the Process of Care in a Psychiatric Context.

PubMed

Looi, Git-Marie Ejneborn; Sävenstedt, Stefan; Engström, Åsa

2016-01-01

The nurse-patient interaction is the cornerstone of psychiatric care, yet the concept "mental health nursing" is difficult to describe. This article aims to address this problem through the experiences of nursing students. Online journals from 14 nursing students were analyzed using qualitative content analysis, resulting in three categories: Trusting the Trusting Relationship, Voicing the Unspoken Needs, and Balancing the Dynamics of Doing and Being. This study demonstrates that providing nursing care based on trusting relationships is not a demanding task, but it takes place in a complex environment that has a tendency to make easy things complicated.

Privacy as an enabler, not an impediment: building trust into health information exchange.

PubMed

McGraw, Deven; Dempsey, James X; Harris, Leslie; Goldman, Janlori

2009-01-01

Building privacy and security protections into health information technology systems will bolster trust in such systems and promote their adoption. The privacy issue, too long seen as a barrier to electronic health information exchange, can be resolved through a comprehensive framework that implements core privacy principles, adopts trusted network design characteristics, and establishes oversight and accountability mechanisms. The public policy challenges of implementing this framework in a complex and evolving environment will require improvements to existing law, new rules for entities outside the traditional health care sector, a more nuanced approach to the role of consent, and stronger enforcement mechanisms.

Strategies to enhance price and quality competition in health care: lessons learned from tracking local markets.

PubMed

Lesser, Cara S; Ginsburg, Paul B

2006-06-01

Drawing on observations from tracking changes in local health care markets over the past ten years, this article critiques two Federal Trade Commission and Department of Justice recommendations to enhance price and quality competition. First, we take issue with the notion that consumers, acting independently, will drive greater competition in health care markets. Rather we suggest an important role remains for trusted agents who can analyze inherently complex price and quality information and negotiate on consumers' behalf. With aggregated information identifying providers who deliver cost-effective care, consumers would be better positioned to respond to financial incentives about where to seek care and thereby drive more meaningful competition among providers to reduce costs and improve quality. Second, we take issue with the FTC/DOJ recommendation to provide more direct subsidies to prevent distortions in competition. In the current political environment, it is not practical to provide direct subsidies for all of the unfunded care that exists in health care markets today; instead, some interference with competition may be necessary to protect cross subsidies. Barriers can be reduced, though, by revising pricing policies that have resulted in marked disparities in the relative profitability of different services.

The timing is never right: Mexican views of condom use.

PubMed

McQuiston, C; Gordon, A

2000-06-01

Unprotected sex is a critical issue in the Hispanic community, with the incidence of new Hispanic acquired immune deficiency syndrome (AIDS) cases three times that of non-Hispanic Whites. The researchers used focus groups to examine: (a) whether newly immigrated Mexican men and women in the Southeast United States discussed human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention with each other, and (b) how condom use was discussed. For the women, communication was safe sex, and for the men, trust was safe sex. Both communication and trust were dependent on timing in the relationship. Participants could not discuss condoms in a new or established relationship because of issues of trust. This study highlights the complexity of HIV/STD prevention and suggests that trust and timing should be considered within the cultural context of condom introduction.

A review of nursing skill-mix to optimise care in an acute trust.

PubMed

Browne, Alison C; Odell, Mandy

The main resource of the NHS is its workforce. However, achieving the correct mix of staff is crucial if it is to provide high-quality patient care in a cost-effective manner. When an acute trust was singled out in an independent analysis as having 'too rich' a skill-mix (compared with the rest of the strategic health authority), an internal review was undertaken to determine the ratio of qualified to unqualified nursing staff, and to compare these with acuity and dependency in each clinical area. The information was used to revise the nursing skill-mix within the trust.

Blockchain technology for improving clinical research quality.

PubMed

Benchoufi, Mehdi; Ravaud, Philippe

2017-07-19

Reproducibility, data sharing, personal data privacy concerns and patient enrolment in clinical trials are huge medical challenges for contemporary clinical research. A new technology, Blockchain, may be a key to addressing these challenges and should draw the attention of the whole clinical research community.Blockchain brings the Internet to its definitive decentralisation goal. The core principle of Blockchain is that any service relying on trusted third parties can be built in a transparent, decentralised, secure "trustless" manner at the top of the Blockchain (in fact, there is trust, but it is hardcoded in the Blockchain protocol via a complex cryptographic algorithm). Therefore, users have a high degree of control over and autonomy and trust of the data and its integrity. Blockchain allows for reaching a substantial level of historicity and inviolability of data for the whole document flow in a clinical trial. Hence, it ensures traceability, prevents a posteriori reconstruction and allows for securely automating the clinical trial through what are called Smart Contracts. At the same time, the technology ensures fine-grained control of the data, its security and its shareable parameters, for a single patient or group of patients or clinical trial stakeholders.In this commentary article, we explore the core functionalities of Blockchain applied to clinical trials and we illustrate concretely its general principle in the context of consent to a trial protocol. Trying to figure out the potential impact of Blockchain implementations in the setting of clinical trials will shed new light on how modern clinical trial methods could evolve and benefit from Blockchain technologies in order to tackle the aforementioned challenges.

A Blessing and a Curse? Political Institutions in the Growth and Decay of Generalized Trust: A Cross-National Panel Analysis, 1980–2009

PubMed Central

Robbins, Blaine G.

2012-01-01

Despite decades of research on social capital, studies that explore the relationship between political institutions and generalized trust–a key element of social capital–across time are sparse. To address this issue, we use various cross-national public-opinion data sets including the World Values Survey and employ pooled time-series OLS regression and fixed- and random-effects estimation techniques on an unbalanced panel of 74 countries and 248 observations spread over a 29-year time period. With these data and methods, we investigate the impact of five political-institutional factors–legal property rights, market regulations, labor market regulations, universality of socioeconomic provisions, and power-sharing capacity–on generalized trust. We find that generalized trust increases monotonically with the quality of property rights institutions, that labor market regulations increase generalized trust, and that power-sharing capacity of the state decreases generalized trust. While generalized trust increases as the government regulation of credit, business, and economic markets decreases and as the universality of socioeconomic provisions increases, both effects appear to be more sensitive to the countries included and the modeling techniques employed than the other political-institutional factors. In short, we find that political institutions simultaneously promote and undermine generalized trust. PMID:22558122

Patient Communication, Satisfaction, and Trust Before and After Use of a Standardized Birth Plan.

PubMed

Anderson, Clare-Marie; Monardo, Rosie; Soon, Reni; Lum, Jennifer; Tschann, Mary; Kaneshiro, Bliss

2017-11-01

The birth plan was developed as a way for pregnant women to communicate their desires and expectations for labor and delivery. Standardized birth plans have been used by some birth facilities as a communication tool. In this quality improvement project, we sought to describe communication, trust, and satisfaction scores after delivery in a group of patients who used a standardized birth plan. All pregnant women at 24 or more weeks of gestation were asked to complete a short, standardized birth plan. Communication, trust, and satisfaction were assessed before and after delivery. Descriptive analyses showed that communication, trust, and satisfaction scores were high following delivery. Scores for all three factors increased significantly following delivery though increases were modest. Most patients (84%) indicated they would use a birth plan with a subsequent delivery.

Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use

USGS Publications Warehouse

Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane

2016-01-01

Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

Trust of community health workers influences the acceptance of community-based maternal and child health services.

PubMed

Grant, Merridy; Wilford, Aurene; Haskins, Lyn; Phakathi, Sifiso; Mntambo, Ntokozo; Horwood, Christiane M

2017-05-29

Community health workers (CHWs) are a component of the health system in many countries, providing effective community-based services to mothers and infants. However, implementation of CHW programmes at scale has been challenging in many settings. To explore the acceptability of CHWs conducting household visits to mothers and infants during pregnancy and after delivery, from the perspective of community members, professional nurses and CHWs themselves. Primary health care clinics in five rural districts in KwaZulu-Natal, South Africa. A qualitative exploratory study was conducted where participants were purposively selected to participate in 19 focus group discussions based on their experience with CHWs or child rearing. Poor confidentiality and trust emerged as key barriers to CHW acceptability in delivering maternal and child health services in the home. Most community members felt that CHWs could not be trusted because of their lack of professionalism and inability to maintain confidentiality. Familiarity and the complex relationships between household members and CHWs caused difficulties in developing and maintaining a relationship of trust, particularly in high HIV prevalence settings. Professional staff at the clinic were crucial in supporting the CHW's role; if they appeared to question the CHW's competency or trustworthiness, this seriously undermined CHW credibility in the eyes of the community. Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

"It's All about Developing the Whole Child": An Examination of the "Legacy" Benefits of Youth Sport Trust's School-Based Inclusion Initiatives

ERIC Educational Resources Information Center

Black, Alison; Costello, Rebecca; Craft, Anna; Katene, Will

2015-01-01

Between 2011 and 2013, the Department for Education (DfE) in England made £3.3 million available to support the development of opportunities for young disabled people to access high-quality physical education and school sport. The DfE with the Youth Sport Trust (YST) developed a range of initiatives to help meet this aim, including Project…

[The information required for trust to be established].

PubMed

Phanuel, Dominique; Hamon-Mekki, Françoise

2013-10-01

Law 2002-303 of 4th March 2002 relating to patients' rights and the quality of the healthcare system, specifies the content of the information which must be made available to each patient, whether they are an adult, child or legally incapacitated. This establishment of the informed consent of the patient implies that he or she has been given the relevant information contributing to the fostering of a trust-based relationship.

Analysis of MOOCs Practices from the Perspective of Learner Experiences and Quality Culture

ERIC Educational Resources Information Center

Ossiannilsson, Ebba; Altinay, Fahriye; Altinay, Zehra

2015-01-01

This explanatory analysis of the relevant literature seeks to identify factors affecting quality in massive open online courses (MOOCs). The paper highlights sub-dimensions of quality in MOOCs using the ladder of analytical abstraction. Communication, trust, collaboration, inclusiveness, innovation, and commitment are identified as key elements in…

Recent Trends in Quality Assurance

ERIC Educational Resources Information Center

Amaral, Alberto; Rosa, Maria Joao

2010-01-01

In this paper we present a brief description of the evolution of quality assurance in Europe, paying particular attention to its relationship to the rising loss of trust in higher education institutions. We finalise by analysing the role of the European Commission in the setting up of new quality assurance mechanisms that tend to promote…

The Accountability Dimension in Quality Assurance: An International Comparison

ERIC Educational Resources Information Center

Stensaker, Bjorn; Harvey, Lee

2013-01-01

The paper reports from a comparative study on systems of quality assurance in 19 countries around the globe, and how these systems function as accountability mechanisms. Based on a theoretical framework for assessing how accountability mechanisms can contribute to build trust in the higher education sector, the analysis of the quality assurance…

EPA guidance on building trust in mental health services.

PubMed

Gaebel, W; Muijen, M; Baumann, A E; Bhugra, D; Wasserman, D; van der Gaag, R J; Heun, R; Zielasek, J

2014-02-01

To advance mental health care use by developing recommendations to increase trust from the general public and patients, those who have been in contact with services, those who have never been in contact and those who care for their families in the mental health care system. We performed a systematic literature search and the retrieved documents were evaluated by two independent reviewers. Evidence tables were generated and recommendations were developed in an expert and stakeholder consensus process. We developed five recommendations which may increase trust in mental health care services and advance mental health care service utilization. Trust is a mutual, complex, multidimensional and dynamic interrelationship of a multitude of factors. Its components may vary between individuals and over time. They may include, among others, age, place of residence, ethnicity, culture, experiences as a service user, and type of disorder. For mental health care services, issues of knowledge about mental health services, confidentiality, continuity of treatment, dignity, safety and avoidance of stigma and coercion are central elements to increase trust. Evidence-based recommendations to increase mutual trust of service users and psychiatrists have been developed and may help to increase mental health care service utilization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The issue of trust and its influence on risk communication during a volcanic crisis

NASA Astrophysics Data System (ADS)

Haynes, Katharine; Barclay, Jenni; Pidgeon, Nick

2008-03-01

This paper investigates trust in the scientists, government authorities and wider risk management team during the ongoing volcanic crisis in Montserrat, WI. Identifying the most trusted communicator and how trust in information can be enhanced are considered important for improving the efficacy of volcanic risk communication. Qualitative interviews, participant observations and a quantitative survey were utilised to investigate the views and attitudes of the public, authorities and scientists. Trust was found to be dynamic, influenced by political factors made more complex by the colonial nature of Montserrat’s governance and the changing level of volcanic activity. The scientists were viewed by the authorities as a highly trusted expert source of volcanic information. Mistrust among some of the local authorities towards the scientists and British Governor was founded in the uncertainty of the volcanic situation and influenced by differences in levels of acceptable risk and suspicions about integrity (e.g. as a consequence of employment by the British Government). The public viewed friends and relatives as the most trusted source for volcanic information. High trust in this source allowed competing messages to reinforce beliefs of lower risk than were officially being described. The scientists were the second most trusted group by the public and considered significantly more competent, reliable, caring, fair and open than the authorities. The world press was the least trusted, preceded closely by the British Governor’s Office and Montserratian Government officials. These results tally well with other empirical findings suggesting that government ministers and departments are typically distrusted as sources of risk-related information. These findings have implications for risk communication on Montserrat and other volcanic crises. The importance and potential effectiveness of scientists as communicators, because of, and despite, the existence of political, cultural and institutional barriers, is exemplified by this study.

Trust in health care encounters and systems: a case study of British pensioners living in Spain

PubMed Central

Legido-Quigley, Helena; McKee, Martin; Green, Judith

2014-01-01

Research on trust in health care faces two enduring challenges. Firstly, there are conceptual ambiguities in distinguishing trust from related concepts, such as confidence or dependence. Second, the tacit understandings which underpin the ‘faith’ element of trust are difficult to explicate. A case study of British pensioners who have moved to Spain provides an opportunity to explore trust in a setting where they often have a choice of where to access health care (UK or Spain), and are therefore not in a state of dependence, and in which the ‘differences’ of a new field generates reflection on their tacit expectations of providers and systems. In accounting for decisions to use (or not to use) Spanish health care, British pensioners cited experiential knowledge of symbolic indicators of trustworthy institutions (they were hygienic, modern, efficient), which contributed to background confidence in the system, and interpersonal qualities of practitioners (respect for older people, embodied empathy and reciprocity) which evoked familiar relations, within which faith is implicit. In contrast, with limited recent access to the British system, their background confidence had been compromised by reports of poor performance, with few opportunities to rebuild the interrelational bases of trust. PMID:25470324

Trust and the regulation of pharmaceuticals: South Asia in a globalised world.

PubMed

Brhlikova, Petra; Harper, Ian; Jeffery, Roger; Rawal, Nabin; Subedi, Madhusudhan; Santhosh, Mr

2011-04-29

Building appropriate levels of trust in pharmaceuticals is a painstaking and challenging task, involving participants from different spheres of life, including producers, distributors, retailers, prescribers, patients and the mass media. Increasingly, however, trust is not just a national matter, but involves cross-border flows of knowledge, threats and promises. Data for this paper comes from the project 'Tracing Pharmaceuticals in South Asia', which used ethnographic fieldwork and qualitative interviews to compared the trajectories of three pharmaceuticals (Rifampicin, Oxytocin and Fluoxetine) from producer to patient in three sites (north India, West Bengal and Nepal) between 2005-08. We argue that issues of trust are crucial in reducing the likelihood of appropriate use of medicines. Unlike earlier discussions of trust, we suggest that trust contexts beyond the patient-practitioner relationship are important. We illustrate these arguments through three case studies: (i) a conflict over ethics in Nepal, involving a suggested revised ethical code for retailers, medical representatives, producers and prescribers; (ii) disputes over counterfeit, fake, substandard and spurious medicines, and quality standards in Indian generic companies, looking particularly at the role played by the US FDA; and (iii) the implications of lack of trust in the DOTS programmes in India and Nepal for the relationships among patients, government and the private sector. We conclude that the building of trust is a necessary but always vulnerable and contingent process. While it might be desirable to outline steps that can be taken to build trust, the range of conflicting interests in the pharmaceutical field make feasible solutions hard to implement.

Respect, trust, and the management of sickle cell disease pain in hospital: comparative analysis of concern-raising behaviors, preliminary model, and agenda for international collaborative research to inform practice

PubMed Central

Elander, James; Beach, Mary Catherine; Haywood, Carlton

2011-01-01

Background/objectives Qualitative interview studies suggest that adult patients’ experiences of hospital treatment for sickle cell disease (SCD) pain reflect an absence of respect by providers for patients, and an absence or breakdown of trust. Systematic comparisons between treatment settings could help identify contextual influences on respect and trust. Design Quantitative comparison of concern-raising behaviors (pain treatment outcomes indicating breakdowns of trust) among adult SCD patients in Baltimore, Maryland, USA, and London, UK, followed by analysis of potential explanations for differences, including socio-cultural and behavioral factors, with a preliminary model of the processes leading to concern-raising behaviors. Results Rates of concern-raising behaviors were significantly higher in Baltimore than London. The model identifies respect and trust as key factors which could be targeted in efforts to improve the quality of SCD pain management in hospital. Conclusion An agenda for international, interdisciplinary research to improve the treatment of SCD pain in hospital should include: comparative analyses between countries and treatment settings of factors that could influence respect and trust; research to test hypotheses derived from models about the roles of respect and trust in the treatment of pain; studies of the impact of healthcare structures and policy on patients’ experiences of care; research focusing on developmental and interpersonal processes related to respect and trust; applications of attribution and other social psychology theories; and development and evaluation of interventions to improve the hospital treatment of SCD pain by increasing respect and trust. PMID:21797726

Trust and the regulation of pharmaceuticals: South Asia in a globalised world

PubMed Central

2011-01-01

Background Building appropriate levels of trust in pharmaceuticals is a painstaking and challenging task, involving participants from different spheres of life, including producers, distributors, retailers, prescribers, patients and the mass media. Increasingly, however, trust is not just a national matter, but involves cross-border flows of knowledge, threats and promises. Methods Data for this paper comes from the project 'Tracing Pharmaceuticals in South Asia', which used ethnographic fieldwork and qualitative interviews to compared the trajectories of three pharmaceuticals (Rifampicin, Oxytocin and Fluoxetine) from producer to patient in three sites (north India, West Bengal and Nepal) between 2005-08. Results We argue that issues of trust are crucial in reducing the likelihood of appropriate use of medicines. Unlike earlier discussions of trust, we suggest that trust contexts beyond the patient-practitioner relationship are important. We illustrate these arguments through three case studies: (i) a conflict over ethics in Nepal, involving a suggested revised ethical code for retailers, medical representatives, producers and prescribers; (ii) disputes over counterfeit, fake, substandard and spurious medicines, and quality standards in Indian generic companies, looking particularly at the role played by the US FDA; and (iii) the implications of lack of trust in the DOTS programmes in India and Nepal for the relationships among patients, government and the private sector. Conclusions We conclude that the building of trust is a necessary but always vulnerable and contingent process. While it might be desirable to outline steps that can be taken to build trust, the range of conflicting interests in the pharmaceutical field make feasible solutions hard to implement. PMID:21529358

Improving service quality in NHS Trust hospitals: lessons from the hotel sector.

PubMed

Desombre, T; Eccles, G

1998-01-01

This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.

A comprehensive audit of nursing record keeping practice.

PubMed

Griffiths, Paul; Debbage, Samantha; Smith, Alison

Good quality record keeping is essential to safe and effective patient care. To ensure that high standards of record keeping are maintained, regular clinical audit should be undertaken. This article describes an audit and re-audit of nursing record keeping at Sheffield Teaching Hospital NHS Foundation Trust. The article demonstrates improving audit data in 2005 and 2006 and describes how audit and the resulting recommendations and action plans can result in real improvements in the quality of record keeping. The keys to success in this ongoing audit programme are identified as stakeholder involvement, support from the senior nurses in the organization and the use of the data for both local and trust-wide purposes.

Trust: Implications for the Army Profession

DTIC Science & Technology

2013-10-01

not competent to handle the tough challenges; that they are not telling us the truth; and that they are more motivated by greed and self -interest...perceive the Army as an opportunistic component of a self - serving civil-military industrial complex, behaving more as a political interest group than a...between cohorts within the Army. Currently, the Army enjoys the public’s trust and the profession is held in high- esteem by most Ameri- cans

Secure ASIC Architecture for Optimized Utilization of a Trusted Supply Chain for Common Architecture A and D Applications

DTIC Science & Technology

2017-03-01

overseas. Concurrently, time to market and complex system requirements are increasingly outside the budget range of standalone DoD projects. This paper...expense and delay to market concerns, a major FPGA vendor has offered an FPGA specifically targeting the A&D market . Architecturally, this offering...time-to- market Such services could individually be engaged, each spanning commercial to Trusted handling levels, as appropriate for balancing

Self-Organized Service Negotiation for Collaborative Decision Making

PubMed Central

Zhang, Bo; Zheng, Ziming

2014-01-01

This paper proposes a self-organized service negotiation method for CDM in intelligent and automatic manners. It mainly includes three phases: semantic-based capacity evaluation for the CDM sponsor, trust computation of the CDM organization, and negotiation selection of the decision-making service provider (DMSP). In the first phase, the CDM sponsor produces the formal semantic description of the complex decision task for DMSP and computes the capacity evaluation values according to participator instructions from different DMSPs. In the second phase, a novel trust computation approach is presented to compute the subjective belief value, the objective reputation value, and the recommended trust value. And in the third phase, based on the capacity evaluation and trust computation, a negotiation mechanism is given to efficiently implement the service selection. The simulation experiment results show that our self-organized service negotiation method is feasible and effective for CDM. PMID:25243228

Self-organized service negotiation for collaborative decision making.

PubMed

Zhang, Bo; Huang, Zhenhua; Zheng, Ziming

2014-01-01

This paper proposes a self-organized service negotiation method for CDM in intelligent and automatic manners. It mainly includes three phases: semantic-based capacity evaluation for the CDM sponsor, trust computation of the CDM organization, and negotiation selection of the decision-making service provider (DMSP). In the first phase, the CDM sponsor produces the formal semantic description of the complex decision task for DMSP and computes the capacity evaluation values according to participator instructions from different DMSPs. In the second phase, a novel trust computation approach is presented to compute the subjective belief value, the objective reputation value, and the recommended trust value. And in the third phase, based on the capacity evaluation and trust computation, a negotiation mechanism is given to efficiently implement the service selection. The simulation experiment results show that our self-organized service negotiation method is feasible and effective for CDM.

Trust in health Websites: a survey among Norwegian Internet users.

PubMed

Rosenvinge, Jan H; Laugerud, Stein; Hjortdahl, Per

2003-01-01

Whether consumers feel able to trust the information presented on a health-related Website is as important a quality criterion as more objective criteria. We investigated whether trust was related to five aspects of health Websites: the involvement of health professionals, a facility for interactive communication, information about those responsible for the site, a picture of those responsible for the site, and the impression of site update frequency. A polling agency invited, by email, a sample of 600 Norwegian users of e-health information to participate in the study and 476 subjects did so (a 79% response rate), by completing a questionnaire online. Their mean age was 41 years and 53% were female. All five aspects of health Websites were related to the trust placed in the site but they were not consistently related to gender or age. Trust in Websites that were frequently updated was related to being a frequent e-health user, while those who trusted interactive e-health sites were low-frequency users who tended to order drugs and health products from the sites. The probability of taking action as a result of e-health information was related to the frequency of visits to health Websites but not to the five aspects of them investigated in relation to trust. However, respondents who trusted sites that were perceived as being frequently updated and to have health professionals involved were more likely to be frequent users of e-health information.

Where does the neighborhood go? Trust, social engagement, and health among older adults in Baltimore City.

PubMed

Garoon, Joshua; Engelman, Michal; Gitlin, Laura; Szanton, Sarah

2016-09-01

Trust is often cited as a necessary predecessor of social engagement, and a public-health good. We question those suppositions through analysis of the life histories of lower-income older adults aging in place in Baltimore. These people desired to continue living independently, but also expressed a complex mix of trust and mistrust in their neighbors, neighborhoods, and broader environments. This was the product of interrelated processes of multilevel physical and social changes over time and space - and, we argue, often featured a "healthy mistrust" that pushed participants to pursue personally meaningful forms of social engagement, whether new or continued. Copyright © 2016 Elsevier Ltd. All rights reserved.

A comprehensive Reputation mechanism for ubiquitous healthcare environment exploiting cloud model.

PubMed

Athanasiou, Georgia; Lymberopoulos, Dimitrios

2016-08-01

Absence of trust foundations may outweigh benefits of ubiquitous and personalized mental healthcare supervision provided within a Ubiquitous Healthcare environment (UH). Trust is composed by patient's Personal Interaction Experience (PIE) and social entourage accumulated PIE, i.e. Reputation (R). In this paper, a cloud-based Reputation mechanism is proposed. Since PIE is the elementary trust information source, also an Updating mechanism of PIE, is introduced, in this paper. Cloud materialization of combined mechanisms provides adaptability to UH Providers' dynamic behavior, facilitates detection of milking behaviors and complex malicious attacks while meets the challenge of limited accuracy in case of data sparseness. The effectiveness of the proposed mechanisms is verified via simulation in MATLAB.

76 FR 22158 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

... ``Complex Order'' to: (i) Pay a Customer Complex Order Rebate for Adding Liquidity of $0.25 per contract for...'') \\4\\; the PowerShares QQQ Trust (``QQQ'')[supreg]; and Apple, Inc. (``AAPL'') [sic]. The Exchange is... Exchange pays the following Complex Order Rebates for Adding Liquidity in the Select Symbols: Specialist...

Making Me Feel Comfortable: Developing Trust in the Nurse for Mexican Americans.

PubMed

Jones, Sharon M

2015-11-01

Trust (confianza) is an important component of patient-centered care and culturally competent care and a major element in the Hispanic culture. The aim of this study was to conceptualize the process of the development of interpersonal trust by hospitalized patients in their nurses. Using the grounded theory method, English-speaking Mexican American patients (N = 22) were interviewed. The core category was Making Me Feel Comfortable. The cyclical process included a beginning stage (Having Needs, Relying on the Nurse), middle stage (Coming Across to Me, Taking Care of Me, Connecting), and end point (Feeling Confianza) with two outcomes (Confiding in the Nurse, Taking Away the Negative). Anytime there was a negative element during the middle stage, this element halted any further development of trust with the nurse. Unique findings were related to Hispanic cultural values of familism and personalismo. The findings have implications which impact patient safety and quality care. © The Author(s) 2014.

Service user governors in mental health foundation trusts: accountability or business as usual?

PubMed

MacDonald, Dee; Barnes, Marian; Crawford, Mike; Omeni, Edward; Wilson, Aaron; Rose, Diana

2015-12-01

National Health Foundation Trusts present opportunities for individual mental health service users to be active in the governance of trusts. This is one of a range of mechanisms for patient and public involvement and one which promotes an individual rather than collective approach to involvement. Within the context of a broader study of the impact of service user involvement in mental health services, the objective of this article was to explore the experience of service user governors in foundation trusts and their capacity to hold boards to account. The Council of Governors in three foundation trusts were observed for a year. Focus groups with service user governors were undertaken in each trust. Service users had different expectations and understandings of the role and approached it in different ways. Key themes that emerged concerned: the role of a governor, conduct and content of meetings, agenda setting, relationships and representation. The experiences of mental health service user governors need to be understood within the complex environment of patient and public involvement in general and of mental health service user involvement in particular. The dislocation of the service user governor role from other forms of service user activity and involvement result in confusion about how notions of holding a trust to account and representation of other service users can be addressed within a boundaried institutional environment. © 2014 John Wiley & Sons Ltd.

Parochial trust and cooperation across 17 societies

PubMed Central

Romano, Angelo; Balliet, Daniel; Liu, James H.

2017-01-01

International challenges such as climate change, poverty, and intergroup conflict require countries to cooperate to solve these complex problems. However, the political tide in many countries has shifted inward, with skepticism and reluctance to cooperate with other countries. Thus, cross-societal investigations are needed to test theory about trust and cooperation within and between groups. We conducted an experimental study in 17 countries designed to test several theories that explain why, who, and where people trust and cooperate more with ingroup members, compared with outgroup members. The experiment involved several interactions in the trust game, either as a trustor or trustee. We manipulated partner group membership in the trust game (ingroup, outgroup, or unknown) and if their reputation was at stake during the interaction. In addition to the standard finding that participants trust and cooperate more with ingroup than outgroup members, we obtained findings that reputational concerns play a decisive role for promoting trust and cooperation universally across societies. Furthermore, men discriminated more in favor of their ingroup than women. Individual differences in cooperative preferences, as measured by social value orientation, predicted cooperation with both ingroup and outgroup members. Finally, we did not find support for three theories about the cross-societal conditions that influence the degree of ingroup favoritism observed across societies (e.g., material security, religiosity, and pathogen stress). We discuss the implications for promoting cooperation within and between countries. PMID:29133403

Automation trust and attention allocation in multitasking workspace.

PubMed

Karpinsky, Nicole D; Chancey, Eric T; Palmer, Dakota B; Yamani, Yusuke

2018-07-01

Previous research suggests that operators with high workload can distrust and then poorly monitor automation, which has been generally inferred from automation dependence behaviors. To test automation monitoring more directly, the current study measured operators' visual attention allocation, workload, and trust toward imperfect automation in a dynamic multitasking environment. Participants concurrently performed a manual tracking task with two levels of difficulty and a system monitoring task assisted by an unreliable signaling system. Eye movement data indicate that operators allocate less visual attention to monitor automation when the tracking task is more difficult. Participants reported reduced levels of trust toward the signaling system when the tracking task demanded more focused visual attention. Analyses revealed that trust mediated the relationship between the load of the tracking task and attention allocation in Experiment 1, an effect that was not replicated in Experiment 2. Results imply a complex process underlying task load, visual attention allocation, and automation trust during multitasking. Automation designers should consider operators' task load in multitasking workspaces to avoid reduced automation monitoring and distrust toward imperfect signaling systems. Copyright © 2018. Published by Elsevier Ltd.

Trust Management Considerations For the Cooperative Infrastructure Defense Framework: Trust Relationships, Evidence, and Decisions

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

Maiden, Wendy M.

Cooperative Infrastructure Defense (CID) is a hierarchical, agent-based, adaptive, cyber-security framework designed to collaboratively protect multiple enclaves or organizations participating in a complex infrastructure. CID employs a swarm of lightweight, mobile agents called Sensors designed to roam hosts throughout a security enclave to find indications of anomalies and report them to host-based Sentinels. The Sensors’ findings become pieces of a larger puzzle, which the Sentinel puts together to determine the problem and respond per policy as given by the enclave-level Sergeant agent. Horizontally across multiple enclaves and vertically within each enclave, authentication and access control technologies are necessary but insufficientmore » authorization mechanisms to ensure that CID agents continue to fulfill their roles in a trustworthy manner. Trust management fills the gap, providing mechanisms to detect malicious agents and offering more robust mechanisms for authorization. This paper identifies the trust relationships throughout the CID hierarchy, the types of trust evidence that could be gathered, and the actions that the CID system could take if an entity is determined to be untrustworthy.« less

Creating Partnerships: Forging a Chain of Service Quality.

ERIC Educational Resources Information Center

Lynch, Richard; And Others

1993-01-01

Advocates the need for libraries to identify, nurture, and sustain new partnerships given rapid technological advancements and trends in information economics. Principles of partnerships are described, including Total Quality Management (TQM), negotiation, seamless connectivity, performance data, trust, patience, and perseverance; and steps in the…

NHS Trusts' clinical research activity and overall CQC performance - Is there a correlation?

PubMed

Jonker, L; Fisher, S J

2015-11-01

Since the late 2000's, the creation of the National Institute for Health Research (NIHR) has transformed clinical research activity in the United Kingdom. This study sought to establish if there is a link between clinical research activity and overall NHS Trust performance. Retrospective cohort study. Data for NHS Trust performance were obtained from public databases, namely the Care Quality Commission (CQC) 2013 risk rating for overall performance, and 2012-13 NIHR records for clinical research activity. Applying Spearman's rank analysis, none of the Trust categories showed a correlation with CQC risk rating: small hospitals, r = -0.062 (P = 0.76; n = 27); medium, r = -0.224 (P = 0.13; n = 47); large, r = -0.008 (P = 0.96; n = 57); academic, r = -0.18 (P = 0.41; n = 24). Similar results were observed when CQC risk rating was compared with the number of different clinical research studies conducted per Trust. The degree of NIHR National Portfolio clinical research activity is not significantly related to CQC risk rating, used as an indicator of overall NHS Trust performance. Other studies have previously shown that increased research activity correlates with improved mortality rates, one component of CQC risk rating scores. Alternative tools may have to be explored to evaluate the impact of clinical research on NHS Trusts and its patients. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Perceptions of the health system and public trust in government in low- and middle-income countries: evidence from the World Health Surveys.

PubMed

Rockers, Peter C; Kruk, Margaret E; Laugesen, Miriam J

2012-06-01

In low- and middle-income countries, health care systems are an important means by which individuals interact with their government. As such, aspects of health systems in these countries may be associated with public trust in government. Greater trust in government may in turn improve governance and government effectiveness. We identify health system and non-health system factors hypothesized to be associated with trust in government and fit several multilevel regression models to cross-national data from 51,300 respondents in thirty-eight low- and middle-income countries participating in the World Health Surveys. We find that health system performance factors are associated with trust in government while controlling for a range of non-health system covariates. Taken together, higher technical quality of health services, more responsive service delivery, fair treatment, better health outcomes, and financial risk protection accounted for a 13 percentage point increase in the probability of having trust in government. Health system performance and good governance may be more inter-related than previously thought. This finding is particularly important for low-income and fragile states, where health systems and governments tend to be weakest. Future research efforts should focus on determining the causal mechanisms that underlie the observed associations between health system performance and trust in government.

Achieving progress through clinical governance? A national study of health care managers' perceptions in the NHS in England

PubMed Central

Freeman, T; Walshe, K

2004-01-01

Background: A national cross sectional study was undertaken to explore the perceptions concerning the importance of, and progress in, aspects of clinical governance among board level and directorate managers in English acute, ambulance, and mental health/learning disabilities (MH/LD) trusts. Participants: A stratified sample of acute, ambulance, and mental health/learning disabilities trusts in England (n = 100), from each of which up to 10 board level and 10 directorate level managers were randomly sampled. Methods: Fieldwork was undertaken between April and July 2002 using the Organisational Progress in Clinical Governance (OPCG) schedule to explore managers' perceptions of the importance of, and organisational achievement in, 54 clinical governance competency items in five aggregated domains: improving quality; managing risks; improving staff performance; corporate accountability; and leadership and collaboration. The difference between ratings of importance and achievement was termed a shortfall. Results: Of 1916 individuals surveyed, 1177 (61.4%) responded. The competency items considered most important and recording highest perceived achievement related to corporate accountability structures and clinical risks. The highest shortfalls between perceived importance and perceived achievement were reported in joint working across local health communities, feedback of performance data, and user involvement. When aggregated into domains, greatest achievement was perceived in the assurance related areas of corporate accountability and risk management, with considerably less perceived achievement and consequently higher shortfalls in quality improvement and leadership and collaboration. Directorate level managers' perceptions of achievement were found to be significantly lower than those of their board level colleagues on all domains other than improving performance. No differences were found in perceptions of achievement between different types of trusts, or between trusts at different stages in the Commission for Health Improvement (CHI) review cycle. Conclusions: While structures and systems for clinical governance seem well established, there is more perceived progress in areas concerned with quality assurance than quality improvement. This study raises some uncomfortable questions about the impact of CHI review visits. PMID:15465936

Achieving progress through clinical governance? A national study of health care managers' perceptions in the NHS in England.

PubMed

Freeman, T; Walshe, K

2004-10-01

A national cross sectional study was undertaken to explore the perceptions concerning the importance of, and progress in, aspects of clinical governance among board level and directorate managers in English acute, ambulance, and mental health/learning disabilities (MH/LD) trusts. A stratified sample of acute, ambulance, and mental health/learning disabilities trusts in England (n = 100), from each of which up to 10 board level and 10 directorate level managers were randomly sampled. Fieldwork was undertaken between April and July 2002 using the Organisational Progress in Clinical Governance (OPCG) schedule to explore managers' perceptions of the importance of, and organisational achievement in, 54 clinical governance competency items in five aggregated domains: improving quality; managing risks; improving staff performance; corporate accountability; and leadership and collaboration. The difference between ratings of importance and achievement was termed a shortfall. Of 1916 individuals surveyed, 1177 (61.4%) responded. The competency items considered most important and recording highest perceived achievement related to corporate accountability structures and clinical risks. The highest shortfalls between perceived importance and perceived achievement were reported in joint working across local health communities, feedback of performance data, and user involvement. When aggregated into domains, greatest achievement was perceived in the assurance related areas of corporate accountability and risk management, with considerably less perceived achievement and consequently higher shortfalls in quality improvement and leadership and collaboration. Directorate level managers' perceptions of achievement were found to be significantly lower than those of their board level colleagues on all domains other than improving performance. No differences were found in perceptions of achievement between different types of trusts, or between trusts at different stages in the Commission for Health Improvement (CHI) review cycle. While structures and systems for clinical governance seem well established, there is more perceived progress in areas concerned with quality assurance than quality improvement. This study raises some uncomfortable questions about the impact of CHI review visits.

Personal values, marketing attitudes and nutrition trust are associated with patronage of convenience food outlets in the Asia-Pacific region: a cross-sectional study.

PubMed

De Jong, Breanna; Worsley, Anthony; Wang, Wei Chun; Sarmugam, Rani; Pham, Quynh; Februhartanty, Judhiastuty; Ridley, Stacey

2017-02-16

An online cross-sectional survey examined the relationships between the demographic characteristics, personal values, trust in sources of nutrition information and the use of convenience food outlets among middle-class household food providers in the Asia-Pacific region. The survey was administered to 3945 household food providers in Melbourne, Singapore, Shanghai, Vietnam and Indonesia in late 2013. Information about demographics, personal values, trust in sources of nutrition information and use of convenience food outlets was elicited. Exploratory factor analysis, two-step clustering and logistic regression were employed. The analyses found that the use of convenience food outlets was positively related to hedonist values and trust in food industry sources of nutrition information. However, lesser use of convenience food outlets and trust in health sources of nutrition information was associated with traditional (community-oriented) values. Further replication and extension of these findings would be useful. However, they suggest that improvements in the quality of foods sold in convenience food outlets combined with stronger regulation of food marketing and long-term food education are required.

Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care.

PubMed

Dawson-Rose, Carol; Cuca, Yvette P; Webel, Allison R; Solís Báez, Solymar S; Holzemer, William L; Rivero-Méndez, Marta; Sanzero Eller, Lucille; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Nicholas, Patrice K; Matshediso, Ellah; Mogobe, Keitshokile Dintle; Sabone, Motshedisi B; Ntsayagae, Esther I; Shaibu, Sheila; Corless, Inge B; Wantland, Dean; Lindgren, Teri

2016-01-01

Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient-provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient's trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient-provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Online health information seeking: the influence of age, information trustworthiness, and search challenges.

PubMed

Miller, Lisa M Soederberg; Bell, Robert A

2012-04-01

The Internet holds great potential to support information gathering and decision making surrounding health education and self-care. Older adults, however, underutilize the Internet for health information searches relative to younger adults. The goal of the present study was to examine age differences in the role of trust and ease of search in predicting whether or not individuals use (adopters) or do notuse (nonadopters) the Internet to search for health information. We used logistic regressions todetermine whether there were age differences in the extent to which trust and ease of search predicted online health information searches within a nationally-representative sample of 3796 adults from the Health Information National Trends Survey (HINTS). Adopters were more trusting of Internet health informationthan nonadopters. However, a significant age by trust interaction indicated that this difference increased in magnitude with age, a pattern that held even after controlling for demographic and health variables. Older adults may benefit from special instructions designed to boost Internet trust, for example, learning how to distinguish between high and low quality health-related websites.

Impact of case-mix on comparisons of patient-reported experience in NHS acute hospital trusts in England.

PubMed

Raleigh, Veena; Sizmur, Steve; Tian, Yang; Thompson, James

2015-04-01

To examine the impact of patient-mix on National Health Service (NHS) acute hospital trust scores in two national NHS patient surveys. Secondary analysis of 2012 patient survey data for 57,915 adult inpatients at 142 NHS acute hospital trusts and 45,263 adult emergency department attendees at 146 NHS acute hospital trusts in England. Changes in trust scores for selected questions, ranks, inter-trust variance and score-based performance bands were examined using three methods: no adjustment for case-mix; the current standardization method with weighting for age, sex and, for inpatients only, admission method; and a regression model adjusting in addition for ethnicity, presence of a long-term condition, proxy response (inpatients only) and previous emergency attendances (emergency department survey only). For both surveys, all the variables examined were associated with patients' responses and affected inter-trust variance in scores, although the direction and strength of impact differed between variables. Inter-trust variance was generally greatest for the unadjusted scores and lowest for scores derived from the full regression model. Although trust scores derived from the three methods were highly correlated (Kendall's tau coefficients 0.70-0.94), up to 14% of trusts had discordant ranks of when the standardization and regression methods were compared. Depending on the survey and question, up to 14 trusts changed performance bands when the regression model with its fuller case-mix adjustment was used rather than the current standardization method. More comprehensive case-mix adjustment of patient survey data than the current limited adjustment reduces performance variation between NHS acute hospital trusts and alters the comparative performance bands of some trusts. Given the use of these data for high-impact purposes such as performance assessment, regulation, commissioning, quality improvement and patient choice, a review of the long-standing method for analysing patient survey data would be timely, and could improve rigour and comparability across the NHS. Performance comparisons need to be perceived as fair and scientifically robust to maintain confidence in publicly reported data, and to support their use by both the public and the NHS. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Trusted Autonomy for Space Flight Systems

NASA Technical Reports Server (NTRS)

Freed, Michael; Bonasso, Pete; Ingham, Mitch; Kortenkamp, David; Perix, John

2005-01-01

NASA has long supported research on intelligent control technologies that could allow space systems to operate autonomously or with reduced human supervision. Proposed uses range from automated control of entire space vehicles to mobile robots that assist or substitute for astronauts to vehicle systems such as life support that interact with other systems in complex ways and require constant vigilance. The potential for pervasive use of such technology to extend the kinds of missions that are possible in practice is well understood, as is its potential to radically improve the robustness, safety and productivity of diverse mission systems. Despite its acknowledged potential, intelligent control capabilities are rarely used in space flight systems. Perhaps the most famous example of intelligent control on a spacecraft is the Remote Agent system flown on the Deep Space One mission (1998 - 2001). However, even in this case, the role of the intelligent control element, originally intended to have full control of the spacecraft for the duration of the mission, was reduced to having partial control for a two-week non-critical period. Even this level of mission acceptance was exceptional. In most cases, mission managers consider intelligent control systems an unacceptable source of risk and elect not to fly them. Overall, the technology is not trusted. From the standpoint of those who need to decide whether to incorporate this technology, lack of trust is easy to understand. Intelligent high-level control means allowing software io make decisions that are too complex for conventional software. The decision-making behavior of these systems is often hard to understand and inspect, and thus hard to evaluate. Moreover, such software is typically designed and implemented either as a research product or custom-built for a particular mission. In the former case, software quality is unlikely to be adequate for flight qualification and the functionality provided by the system is likely driven largely by the need to publish innovative work. In the latter case, the mission represents the first use of the system, a risky proposition even for relatively simple software.

Factor selection for service quality evaluation: a hospital case study.

PubMed

Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad

2017-02-13

Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.

Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study.

PubMed

Manley, Kim; Martin, Anne; Jackson, Carolyn; Wright, Toni

2016-08-09

Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. A multiple case study design framed around systems thinking was conducted in South East England across one Trust consisting of five hospitals, one community healthcare trust and one ambulance trust. Data sources included 14 clinical settings where upstream or downstream pinch points are likely to occur including discharge planning and rapid response teams; ten regional stakeholder events (n = 102); a qualitative survey (n = 48); and a review of literature and analysis of policy documents including care pathways and protocols. The key workforce enablers for whole systems urgent and emergency care delivery identified were: clinical systems leadership, a single integrated career and competence framework and skilled facilitation of work based learning. In this study, participants agreed that whole systems urgent and emergency care allows for the design and implementation of care delivery models that meet complexity of population healthcare needs, reduce duplication and waste and improve healthcare outcomes and patients' experiences. For this to be achieved emphasis needs to be placed on holistic changes in structures, processes and patterns of the urgent and emergency care system. Often overlooked, patterns that drive the thinking and behavior in the workplace directly impact on staff recruitment and retention and the overall effectiveness of the organization. These also need to be attended to for transformational change to be achieved and sustained. Research to refine and validate a single integrated career and competence framework and to develop standards for an integrated approach to workplace facilitation to grow the capacity of facilitators that can use the workplace as a resource for learning is needed.

Comparison of patients' assessments of the quality of stroke care with audit findings.

PubMed

Howell, Esther; Graham, Chris; Hoffman, A; Lowe, D; McKevitt, Christopher; Reeves, Rachel; Rudd, A G

2007-12-01

To determine the extent of correlation between stroke patients' experiences of hospital care with the quality of services assessed in a national audit. Patients' assessments of their care derived from survey data were linked to data obtained in the National Sentinel Stroke Audit 2004 for 670 patients in 51 English NHS trusts. A measure of patients' experience of hospital stroke care was derived by summing responses to 31 survey items and grouping these into three broad concept domains: quality of care; information; and relationships with staff. Audit data were extracted from hospital admissions data and management information to assess the organisation of services, and obtained retrospectively from patient records to evaluate the delivery of care. Patient survey responses were compared with audit measures of organisation of care and compliance with clinical process standards. Patient experience scores were positively correlated with clinicians' assessment of the organisational quality of stroke care, but were largely unrelated to clinical process standards. Responses to individual questions regarding communication about diagnosis revealed a discrepancy between clinicians' and patients' reports. Better organised stroke care is associated with more positive patient experiences. Examining areas of disparity between patients' and clinicians' reports is important for understanding the complex nature of healthcare and for identifying areas for quality improvement. Future evaluations of the quality of stroke services should include a validated patient experience survey in addition to audit of clinical records.

Does capitation payment under national health insurance affect subscribers' trust in their primary care provider? a cross-sectional survey of insurance subscribers in Ghana.

PubMed

Andoh-Adjei, Francis-Xavier; Cornelissen, Dennis; Asante, Felix Ankomah; Spaan, Ernst; van der Velden, Koos

2016-08-24

Ghana introduced capitation payment for primary care in 2012 with the view to containing escalating claims expenditure. This shift in provider payment method raised issues about its potential impact on patient-provider trust relationship and insured-patients' trust in the Ghana National Health Insurance Scheme. This paper presents findings of a study that explored insured-patients' perception about, and attitude towards capitation payment in Ghana; and determined whether capitation payment affect insured-patients' trust in their preferred primary care provider and the National Health Insurance Scheme in general. We adopted a survey design for the study. We administered closed-ended questionnaires to collect data from insurance card-bearing members aged 18 years and above. We performed both descriptive statistics to determine proportions of observations relating to the variables of interest and chi-square test statistics to determine differences within gender and setting. Sixty-nine per cent (69 %) out of 344 of respondents selected hospital level of care as their primary care provider. The two most important motivations for the choice of a provider were proximity in terms of geographical access (40 %) and perceived quality of care (38 %). Eighty-eight per cent (88 %) rated their trust in their provider as (very) high. Eighty-two per cent (82 %) actively selected their providers. Eighty-eight per cent (88 %) had no intention to switch provider. A majority (91 %) would renew their membership when it expires. Female respondents (91 %; n = 281) were more likely to renew their membership than males (87 %; n = 63). Notwithstanding capitation payment experience, 81 % of respondents would recommend to their peers to enrol with the NHIS with rural dwellers (87 %; n = 156) being more likely to do so than urban dwellers (76 %; n = 188). Almost all respondents (92 %) rated the NHIS as (very) good. Health Insurance subscribers in Ghana have high trust in their primary care provider giving them quality care under capitation payment despite their negative attitude towards capitation payment. They are guided by proximity and quality of care considerations in their choice of provider. The NHIA would, however, have to address itself to the negative perceptions about the capitation payment policy.

Association between social capital and the prevalence of gestational diabetes mellitus: An interim report of the Japan Environment and Children's Study.

PubMed

Mizuno, Satoshi; Nishigori, Hidekazu; Sugiyama, Takashi; Takahashi, Fumiaki; Iwama, Noriyuki; Watanabe, Zen; Sakurai, Kasumi; Ishikuro, Mami; Obara, Taku; Tatsuta, Nozomi; Nishijima, Ichiko; Fujiwara, Ikuma; Arima, Takahiro; Kuriyama, Shinichi; Metoki, Hirohito; Nakai, Kunihiko; Inadera, Hidekuni; Yaegashi, Nobuo

2016-10-01

Social capital is generally defined as the quality and frequency of social interactions with relatives, neighbors, and society. Social capital refers to broad concepts of social interactions and structures in individuals, communities and societies such as trust (e.g., neighborhood trust, which is social cohesion with neighbors) and social support (e.g., emotional support, which is the level of the feeling of being loved). Studies during the last few decades have shown that there is a significant inverse association between social capital and the prevalences of diseases such as depression and acute coronary syndrome. Significant inverse associations between trust, social support and the prevalence of diabetes have also been shown. However, associations between social capital and the prevalence of gestational diabetes mellitus (GDM) are less clear. We used the primary dataset of the Japan Environment and Children's Study (JECS), including 10,228 mothers with recorded obstetric outcomes from January to December 2011. In this study, we included 8874 the 10,228 participants. Diagnosis of GDM was determined using the criteria of the Japan Diabetes Society (JDS). The quality and quantity of social capital were measured with nine questions on a self-administered questionnaire during the second or third trimester. Using principal component analysis (PCA), we distinguished the following three components (indices) of social capital: (A) index of all nine questions about social capital, (B) index of emotional support and neighborhood trust and (C) index of generalized trust. The high factor loading variants of indices were as follows; (A) all nine variants, (B) five variants about emotional support and neighborhood trust and (C) two variants about generalized trust. Multivariate random effect modeling was used to calculate the odd ratios (ORs) for evaluating the association between these indices of social capital and the prevalence of GDM. This model was adjusted for baseline characteristics such as family income, BMI before pregnancy and smoking during pregnancy. Of the 8874 participants, 204 women developed GDM (2.30%). Multivariable logistic regression analysis showed that index B, the index of emotional support and neighborhood trust (adjusted OR: 0.651, 95% CI: 0.429, 0.987) was significantly and independently associated with the prevalence of GDM. We found that the 5-question index of emotional support and neighborhood trust is significantly associated with the prevalence of GDM during pregnancy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Embedding quality improvement and patient safety at Liverpool Women's NHS Foundation Trust.

PubMed

Scholefield, Helen

2007-08-01

The provision of safe high-quality care in obstetrics and gynaecology is a key target in the UK National Health Service (NHS), in part because of the high cost of litigation in this area. Good risk management processes should improve safety and reduce the cost of litigation to the NHS. This chapter looks at structures and processes for improving quality and patient safety, using the stepwise approach described by the National Patient Safety Authority (NPSA). This encompasses building a safety culture, leading and supporting staff, integrating risk management activity, promoting reporting, involving and communicating with patients and the public, learning and sharing safety lessons, and implementing solutions to prevent harm. Examples from the Liverpool Women's NHS Foundation Trust are used to illustrate these steps, including how they were developed, what obstacles had to be overcome, ongoing challenges, and whether good risk management has translated into better, safer health care.

Trust Management - Building Trust for International Cross Disciplinary Collaboration on Climate Change

NASA Astrophysics Data System (ADS)

Oakley, K. V.; Gurney, R. J.

2014-12-01

Successful communication and collaboration entails mutual understanding, and transfer, of information. The risk of misunderstanding and/or miscommunication between collaborating groups is tackled in different ways around the globe; some are well documented whereas others may be unknown outside particular groups, whether defined geographically or by specialism. For example; in some countries legally binding contracts define the terms of collaboration. Some regions place greater emphasis on developing trust relationships, and sometimes an official agreement is implied, such as many electronic data transfers on the web. International collaboration on climate change increasingly involves electronic data exchange (e.g. open access publications, shared documents, data repositories etc.) and with this increased reliance on electronic data a need has arisen for scientists to collaborate both internationally and cross-disciplinarily particularly with information technology and data management specialists. Trust of data and metadata on the internet (e.g. privacy, legitimacy etc.) varies, possibly due to a lack of internationally agreed standards for data governance and management, leaving many national, regional and institutional practices tailored to the needs of that group only. It is proposed that building trust relationships between cross-disciplinary and international groups could help facilitate further communication, understanding and benefits from the relationship, while still maintaining independence as separate groups. Complex international cross-disciplinary group relationship dynamics are not easily mapped and producing a set of trust building rules that can be applied to any current and future collaboration with equal validity may be unfeasible. An alternative to such a set of rules may be found in a Trust Manager, whose role is to improve mutually beneficial knowledge exchange between groups, build trust and increase future collaborative potential. This presentation will report on the potential of trust management to improve international cross disciplinary climate change collaboration.

Problems with traditional science publishing and finding a wider niche for post-publication peer review.

PubMed

Teixeira da Silva, Jaime A; Dobránszki, Judit

2015-01-01

Science affects multiple basic sectors of society. Therefore, the findings made in science impact what takes place at a commercial level. More specifically, errors in the literature, incorrect findings, fraudulent data, poorly written scientific reports, or studies that cannot be reproduced not only serve as a burden on tax-payers' money, but they also serve to diminish public trust in science and its findings. Therefore, there is every need to fortify the validity of data that exists in the science literature, not only to build trust among peers, and to sustain that trust, but to reestablish trust in the public and private academic sectors that are witnessing a veritable battle-ground in the world of science publishing, in some ways spurred by the rapid evolution of the open access (OA) movement. Even though many science journals, traditional and OA, claim to be peer reviewed, the truth is that different levels of peer review occur, and in some cases no, insufficient, or pseudo-peer review takes place. This ultimately leads to the erosion of quality and importance of science, allowing essentially anything to become published, provided that an outlet can be found. In some cases, predatory OA journals serve this purpose, allowing papers to be published, often without any peer review or quality control. In the light of an explosion of such cases in predatory OA publishing, and in severe inefficiencies and possible bias in the peer review of even respectable science journals, as evidenced by the increasing attention given to retractions, there is an urgent need to reform the way in which authors, editors, and publishers conduct the first line of quality control, the peer review. One way to address the problem is through post-publication peer review (PPPR), an efficient complement to traditional peer-review that allows for the continuous improvement and strengthening of the quality of science publishing. PPPR may also serve as a way to renew trust in scientific findings by correcting the literature. This article explores what is broadly being said about PPPR in the literature, so as to establish awareness and a possible first-tier prototype for the sciences for which such a system is undeveloped or weak.

Outlier identification in colorectal surgery should separate elective and nonelective service components.

PubMed

Byrne, Ben E; Mamidanna, Ravikrishna; Vincent, Charles A; Faiz, Omar D

2014-09-01

The identification of health care institutions with outlying outcomes is of great importance for reporting health care results and for quality improvement. Historically, elective surgical outcomes have received greater attention than nonelective results, although some studies have examined both. Differences in outlier identification between these patient groups have not been adequately explored. The aim of this study was to compare the identification of institutional outliers for mortality after elective and nonelective colorectal resection in England. This was a cohort study using routine administrative data. Ninety-day mortality was determined by using statutory records of death. Adjusted Trust-level mortality rates were calculated by using multiple logistic regression. High and low mortality outliers were identified and compared across funnel plots for elective and nonelective surgery. All English National Health Service Trusts providing colorectal surgery to an unrestricted patient population were studied. Adults admitted for colorectal surgery between April 2006 and March 2012 were included. Segmental colonic or rectal resection was performed. The primary outcome measured was 90-day mortality. Included were 195,118 patients, treated at 147 Trusts. Ninety-day mortality rates after elective and nonelective surgery were 4% and 18%. No unit with high outlying mortality for elective surgery was a high outlier for nonelective mortality and vice versa. Trust level, observed-to-expected mortality for elective and nonelective surgery, was moderately correlated (Spearman ρ = 0.50, p< 0.001). This study relied on administrative data and may be limited by potential flaws in the quality of coding of clinical information. Status as an institutional mortality outlier after elective and nonelective colorectal surgery was not closely related. Therefore, mortality rates should be reported for both patient cohorts separately. This would provide a broad picture of the state of colorectal services and help direct research and quality improvement activities.

Conference report: interdisciplinary workshop in the philosophy of medicine: parentalism and trust.

PubMed

Bullock, Emma; Gergel, Tania; Kingma, Elselijn

2015-06-01

On 13 June 2014, the Centre for the Humanities and Health at King's College London hosted a 1-day workshop on 'parentalism and trust'. This workshop was the sixth in a series of workshops whose aim is to provide a new model for high-quality open interdisciplinary engagement between medical professionals and philosophers. This report briefly describes the workshop methodology and the discussions on the day. © 2015 John Wiley & Sons, Ltd.

The Student Experience of Community-Based Research: An Autoethnography

ERIC Educational Resources Information Center

Ingman, Benjamin C.

2016-01-01

This autoethnography provides a description and thematic illustration of the student experience of a community-based research (CBR) course and partnership. Through evaluating personal experiences with CBR, the author identified three qualities of meaningful CBR experiences: trust, indeterminacy, and emotion. These qualities are explored, and…

Towards Assisted Moderation in Online Healthcare Social Networks: Improving Trust in YouTube Searches.

PubMed

Cañon, Daniel E; Lopez, Diego M; Blobel, Bernd

2014-01-01

Moderation of content in online Health Social Networks (HSN) is critical because information is not only published and produced by experts or health professionals, but also by users of that information. The objective of this paper is to propose a semi-automatic moderation Web Service for assessing the quality (trustworthiness) of health-related videos published on the YouTube social network. The service is relevant for moderators or community managers, who get enabled to control the quality of videos published on their online HSN sites. The HealthTrust metric was selected as the metric to be implemented in the service in order to support the assessment of trustworthiness of videos in Online HSN. The service is a RESTful service which can be integrated into open source Virtual Social Network Platforms, therefore improving trust in the process of searching and publishing content extracted from YouTube. A preliminary pilot evaluation in a simple use case demonstrated that the relevance of videos retrieved using the moderation service was higher compared to the relevance of the videos retrieved using the YouTube search engine.

The antecedents of buyers' perceived justice in online markets.

PubMed

Chiu, Shun-Po; Chou, Huey-Wen; Chiu, Chao-Min

2013-07-01

The success of a business largely depends upon customers' intentions to continue to purchase, but this can be a challenge for vendors in online markets. This study proposes a model which identifies an initial set of justice antecedents and evaluates their relation to perceived justice, trust, and repurchase intention in online markets. The theoretical model is tested by using structural equation modeling on a data set of 424 buyers in Yahoo! Kimo online auction market. The results demonstrate that three dimensions of justice (distributive, procedural, and interactional) are positively and significantly related to trust, which in turn affects buyers' intention to repurchase. Moreover, among the three dimensions of justice judgments, distributive justice and interactional justice are relatively more important than procedural justice in predicting buyers' trust in sellers. In terms of the antecedents of justice, this study provides evidence that product quality and delivery performance are significantly related to distributive justice, while information quality and contact channel are important antecedents of procedural justice. This study also finds that responsiveness is important in enhancing buyers' judgments of interactional justice.

The secret to health information technology's success within the diabetes patient population: a comprehensive privacy and security framework.

PubMed

Pandya, Sheel M

2010-05-01

Congress made an unprecedented investment in health information technology (IT) when it passed the American Recovery and Reinvestment Act in February 2009. Health IT provides enormous opportunities to improve health care quality, reduce costs, and engage patients in their own care. But the potential payoff for use of health IT for diabetes care is magnified given the prevalence, cost, and complexity of the disease. However, without proper privacy and security protections in place, diabetes patient data are at risk of misuse, and patient trust in the system is undermined. We need a comprehensive privacy and security framework that articulates clear parameters for access, use, and disclosure of diabetes patient data for all entities storing and exchanging electronic data. (c) 2010 Diabetes Technology Society.

An intelligent algorithm for identification of optimum mix of demographic features for trust in medical centers in Iran.

PubMed

Yazdanparast, R; Zadeh, S Abdolhossein; Dadras, D; Azadeh, A

2018-06-01

Healthcare quality is affected by various factors including trust. Patients' trust to healthcare providers is one of the most important factors for treatment outcomes. The presented study identifies optimum mixture of patient demographic features with respect to trust in three large and busy medical centers in Tehran, Iran. The presented algorithm is composed of adaptive neuro-fuzzy inference system and statistical methods. It is used to deal with data and environmental uncertainty. The required data are collected from three large hospitals using standard questionnaires. The reliability and validity of the collected data is evaluated using Cronbach's Alpha, factor analysis and statistical tests. The results of this study indicate that middle age patients with low level of education and moderate illness severity and young patients with high level of education, moderate illness severity and moderate to weak financial status have the highest trust to the considered medical centers. To the best of our knowledge this the first study that investigates patient demographic features using adaptive neuro-fuzzy inference system in healthcare sector. Second, it is a practical approach for continuous improvement of trust features in medical centers. Third, it deals with the existing uncertainty through the unique neuro-fuzzy approach. Copyright © 2018 Elsevier B.V. All rights reserved.

Breast cancer patients' trust in physicians: the impact of patients' perception of physicians' communication behaviors and hospital organizational climate.

PubMed

Kowalski, Christoph; Nitzsche, Anika; Scheibler, Fueloep; Steffen, Petra; Albert, Ute-Susann; Pfaff, Holger

2009-12-01

To examine whether patients' perception of a hospital's organizational climate has an impact on their trust in physicians after accounting for physicians' communication behaviors as perceived by the patients and patient characteristics. Patients undergoing treatment in breast centers in the German state of North Rhein-Westphalia in 2006 were asked to complete a standardized postal questionnaire. Disease characteristics were then added by the medical personnel. Multiple linear regressions were performed. 80.5% of the patients responded to the survey. 37% of the variance in patients' trust in physicians can be explained by the variables included in our final model (N=2226; R(2) adj.=0.372; p<0.001). Breast cancer patients' trust in their physicians is strongly associated with their perception of a hospital's organizational climate. The impact of their perception of physicians' communication behaviors persists after introducing hospital organizational characteristics. Perceived physician accessibility shows the strongest association with trust. A trusting physician-patient relationship among breast cancer patients is associated with both the perceived quality of the hospital organizational climate and perceived physicians' communication behaviors. With regard to clinical organization, efforts should be put into improving the organizational climate and making physicians more accessible to patients.

The relational underpinnings of quality internal auditing in medical clinics in Israel.

PubMed

Carmeli, Abraham; Zisu, Malka

2009-03-01

Internal auditing is a key mechanism in enhancing organizational reliability. However, research on the ways quality internal auditing is enabled through learning, deterrence, motivation and process improvement is scant. In particular, the relational underpinnings of internal auditing have been understudied. This study attempts to address this need by examining how organizational trust, perceived organizational support and psychological safety enable internal auditing. Data collected from employees in medical clinics of one of the largest healthcare organizations in Israel at two points in time six months apart. Our results show that organizational trust and perceived organizational support are positively related to psychological safety (measured at time 1), which, in turn, is associated with internal auditing (measured at time 2).

Specific Remedy for Specific Problem: Measuring Service Quality in South African Higher Education

ERIC Educational Resources Information Center

de Jager, Johan; Gbadamosi, Gbolahan

2010-01-01

This study commences a process of developing a scale for the measurement of service quality in higher education in South Africa and also examines the relationship between the measures of service quality on the one hand and some other related variables such as intention to leave the university, trust in management of the university and the overall…

Trust between managers and physicians in community hospitals: the effects of power over hospital decisions.

PubMed

Succi, M J; Lee, S Y; Alexander, J A

1998-01-01

Trust is a key element of effective work relationships between managers and physicians. Despite its importance, little is known about the factors that promote trust between these two professional groups. We examine whether manager and physician power over hospital decisions fosters manager-physician trust. We expect that with more power, managers and physicians will have greater control to enforce decisions that benefit the interests of both groups. Subsequently, they may gain confidence that their interests are supported and have more trust for each other. We test proposed hypotheses with data collected in a national study of chief executive officers and physician leaders in community hospitals in 1993. Findings indicate that power of managers and physicians over hospital decisions is related to manager-physician trust. Consistent with our expectations, physicians perceive greater trust between the two groups when they hold more power in four separate decision-making areas. Our hypotheses, however, are only partially supported in the manager sample. The relationship between power and trust holds in only one decision area: cost/quality management. Our findings have important implications for physician integration in hospitals. A direct implication is that physicians should be given the opportunity to influence hospital decisions. New initiatives, such as task force committees with open membership or open forums on hospital management, allow physicians a more substantial involvement in decisions. Such initiatives will give physicians more "voice" in hospital decision making, thus creating opportunities for physicians to express their interests and play a more active role in the pursuit of the hospital's mission and objectives.

Qualities of online friendships with different gender compositions and durations.

PubMed

Cheng, Grand H L; Chan, Darius K S; Tong, Po Yee

2006-02-01

This study was designed to examine the qualities of online friendships with different gender compositions that had been maintained for varying periods of time. A total of 167 Hong Kong Internet-users rated the qualities of their same-sex and cross-sex online friendships on measures such as intimacy, trust, self-disclosure, and relational satisfaction. A 2 (gender of respondents: male vs. female) x 2 (gender of online friends: same-sex vs. opposite-sex) x 3 (duration of friendships: less than 1 year vs. 1-2 years vs. more than 2 years) factorial design was adopted. MANOVA results reveal the three-way interaction effect on intimacy, trust, and relational satisfaction. Specifically, the qualities of male-female, female-male, and female-female online friendships were generally higher for those with a longer duration than those at the early stage of friendship development. However, the qualities of male-male friendships that had been maintained for more than 2 years were lower than those maintained for 2 years or less. These findings suggest that qualities of online friendships are subject to effects of gender composition and duration. The conceptual implications of these results are discussed.

Verification of Triple Modular Redundancy (TMR) Insertion for Reliable and Trusted Systems

NASA Technical Reports Server (NTRS)

Berg, Melanie; LaBel, Kenneth A.

2016-01-01

We propose a method for TMR insertion verification that satisfies the process for reliable and trusted systems. If a system is expected to be protected using TMR, improper insertion can jeopardize the reliability and security of the system. Due to the complexity of the verification process, there are currently no available techniques that can provide complete and reliable confirmation of TMR insertion. This manuscript addresses the challenge of confirming that TMR has been inserted without corruption of functionality and with correct application of the expected TMR topology. The proposed verification method combines the usage of existing formal analysis tools with a novel search-detect-and-verify tool. Field programmable gate array (FPGA),Triple Modular Redundancy (TMR),Verification, Trust, Reliability,

Training to raise staff awareness about safeguarding children.

PubMed

Fleming, Jane

2015-04-01

To improve outcomes for children and young people health organisations are required to train all staff in children's safeguarding. This creates difficulties for large complex organisations where most staff provide services to the adult population. Heart of England NHS Foundation Trust is a large acute and community trust that had difficulties in engaging staff in children's safeguarding training. Compliance rates for clinical staff who were trained in children's safeguarding were low and needed to be addressed. This article sets out why safeguarding training is important for all staff and how the trust achieved staff engagement and improved compliance rates. To evaluate, maintain and develop safeguarding knowledge, understanding, skills, attitude and behaviour further resources are planned to allow access to learning resources in a variety of formats.

Sick Note to Fit Note: one trust’s project to improve usage by hospital clinicians

PubMed Central

Moran, Amy; Mainwaring, Cathryn; Keane, Oliver; Sanctuary, Thomas; Watson, Kathryn; Lasoye, Tunji

2018-01-01

Introduction In April 2010, the government introduced a new Statement of Fitness to Work or ’Fit Note' for patients requiring time off of work or adaptations to their work due to illness. Responsibility to issue these documents has shifted from primary to secondary care. Hospital clinicians are required to issue for inpatients and for outpatients where clinical responsibility has not been taken over by the general practitioner (GP). However, awareness of this change is lacking. Misdirecting patients to their GP for the sole purpose of receiving a ’Fit Note' is an unnecessary use of appointment time and negatively impacts on patients. King’s College Hospital NHS Trust receives a number of quality alerts from primary care regarding this issue. Methods A trust-wide educational initiative was designed and implemented to increase staff awareness of Fit Notes and their correct usage in order to reduce the number of patients being misdirected to their GP to obtain one. Interventions included direct staff engagement, a trust-wide promotional campaign and creation of an electronic version of the document. Results Uptake of the electronic version of the Fit Note has steadily increased and there has been a fall in the number of quality alerts received by the trust. However, staff awareness on the whole remains low. Conclusions Patients being misdirected to their general practice for Fit Notes is an important issue and one on which the baseline level of awareness among hospital clinicians is low. Challenges during this intervention have been in penetrating a trust of this size and getting the message across to staff. However, digitising the Fit Note can help to increase its use. PMID:29333499

A multisite audit to assess how women with complex social factors access and engage with maternity services.

PubMed

Rayment-Jones, Hannah; Butler, Eleanor; Miller, Chelsie; Nay, Christine; O'Dowd, Jennifer

2017-09-01

to audit women with socially complex lives' documented access to and engagement with antenatal care provided by three inner city, UK maternity services in relation to birth and neonatal outcomes, and referral processes. women living socially complex lives, including young mothers, recently arrived immigrants, non-English speaking, and those experiencing domestic violence, poor mental health, drug and alcohol abuse, and poverty experience high rates of morbidity, mortality and poor birth outcomes. This is associated with late access to and poor engagement with antenatal care. data was collected from three separate NHS trusts data management systems for a total of 182 women living socially complex lives, between January and December 2015. Data was presented by individual trust and compared to standards derived from NICE guidelines, local trust policy and national statistic using Excel and SPSS Version 22. Tests of correlation were carried out to minimise risks of confounding factors in characteristic differences. non-English speaking women were much less likely to have accessed care within the recommended timeframes, with over 70% of the sample not booked for maternity care by 12 weeks gestation. On average 89% primiparous women across all samples had less than the recommended number of antenatal appointments. No sample met the audit criteria in terms of number of antenatal appointments attended. Data held on the perinatal data management systems for a number of outcomes and processes was largely incomplete and appeared unreliable. this data forms a baseline against which to assess the impact of future service developments aimed at improving access and engagement with services for women living with complex social factors. The audit identified issues with the completeness and reliability of data on the perinatal data management system. Copyright © 2017 Elsevier Ltd. All rights reserved.

36 CFR 1010.1 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Policy. 1010.1 Section 1010.1 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.1 Policy. The Presidio..., available resources, and national policy, to protect and enhance the quality of the human environment; (b...

36 CFR 1010.1 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Policy. 1010.1 Section 1010.1 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.1 Policy. The Presidio..., available resources, and national policy, to protect and enhance the quality of the human environment; (b...

Accountability and Professionalism: A Contradiction in Terms?

ERIC Educational Resources Information Center

Cheng, Ming

2012-01-01

Declining trust in public services has led to increasing calls for higher education to be "accountable" for the quality of its teaching and learning provision. However, increasing levels of quality evaluation have led academics to feel that their professionalism is under attack. Reflecting on this history and various dimensions of…

Encountering the Unexpected: Revelations of Trust, Vulnerability, and Embodied Ways of Knowing.

PubMed

Russell, Laura D

2018-05-31

Health communication scholars grapple with complex issues, many of which probe embodied sensibilities. This essay narrates a profound, unexpected moment that gives rise to notions of trust, vulnerability, and risks involved when conducting fieldwork. The author explains how embodied interactions bring forth latent constructs pertinent to health communication research, both for investigative practices and applied purposes. Furthermore, the author questions how symbolic acts demonstrated by research participants may illuminate powerful meanings yet simultaneously pose potential dangers for researchers.

Contaminated salmon and the public's trust

USGS Publications Warehouse

Luoma, Samuel N.; Löfstedt, Ragnar E.

2007-01-01

Scientific uncertainties often make it difficult for environmental policy makers to determine how to communicate risks to the public. A constructive, holistic, multisectoral dialogue about an issue can improve understanding of uncertainties from different perspectives and clarify options for risk communication. Many environmental issues could benefit from explicit promotion of such a dialogue. When issues are complex, unconstructive advocacy, narrow focus, and exclusion of selected parties from decision making can erode public trust in science and lead to cynicism about the policies of government and the private sector.

Distrust and patients in intercultural healthcare: A qualitative interview study.

PubMed

Alpers, Lise-Merete

2018-05-01

The importance of trust between patients and healthcare personnel is emphasised in nurses' and physicians' ethical codes. Trust is crucial for an effective healthcare personnel-patient relationship and thus for treatment and treatment outcomes. Cultural and linguistic differences may make building a trusting and positive relationship with ethnic minority patients particularly challenging. Although there is a great deal of research on cultural competence, there is a conspicuous lack of focus on the concepts of trust and distrust concerning ethnic minority patients, particularly in relation to the concept of 'othering'. To study which factors help build trust or create distrust in encounters between healthcare professionals and hospitalised ethnic minority patients, as well as study the dynamic complexities inherent within the process of 'othering'. Qualitative design, in-depth interviews and hermeneutic analysis. Participants and research context: The interviewees were 10 immigrant patients (six women and four men - eight Asians, two Africans - ages 32-85 years) recruited from a south-eastern Norwegian hospital. Ethical considerations: Study approval was obtained from the hospital's Privacy Ombudsman for Research and the hospital's leadership. Participation was voluntary and participants signed an informed consent form. Distrust and othering may be caused by differences in belief systems, values, perceptions, expectations, and style of expression and behaviour. Othering is a reciprocal phenomenon in minority ethnic patient-healthcare personnel encounters, and it influences trust building negatively. Besides demonstrating general professional skill and competence, healthcare personnel require cultural competence to create trust.

Parochial trust and cooperation across 17 societies.

PubMed

Romano, Angelo; Balliet, Daniel; Yamagishi, Toshio; Liu, James H

2017-11-28

International challenges such as climate change, poverty, and intergroup conflict require countries to cooperate to solve these complex problems. However, the political tide in many countries has shifted inward, with skepticism and reluctance to cooperate with other countries. Thus, cross-societal investigations are needed to test theory about trust and cooperation within and between groups. We conducted an experimental study in 17 countries designed to test several theories that explain why, who, and where people trust and cooperate more with ingroup members, compared with outgroup members. The experiment involved several interactions in the trust game, either as a trustor or trustee. We manipulated partner group membership in the trust game (ingroup, outgroup, or unknown) and if their reputation was at stake during the interaction. In addition to the standard finding that participants trust and cooperate more with ingroup than outgroup members, we obtained findings that reputational concerns play a decisive role for promoting trust and cooperation universally across societies. Furthermore, men discriminated more in favor of their ingroup than women. Individual differences in cooperative preferences, as measured by social value orientation, predicted cooperation with both ingroup and outgroup members. Finally, we did not find support for three theories about the cross-societal conditions that influence the degree of ingroup favoritism observed across societies (e.g., material security, religiosity, and pathogen stress). We discuss the implications for promoting cooperation within and between countries. Copyright © 2017 the Author(s). Published by PNAS.

Combinations of social participation and trust, and association with health status-an Australian perspective.

PubMed

Williams, Susan L; Ronan, Kevin

2014-12-01

A limited number of studies have examined the 'miniaturization of community' model which is based on belief that 'new' individualistic, and narrower forms of social participation, do not promote generalized trust in others. Little is known about miniaturization of community and self-reported health, physical health and psychological health in Australia. Data from a 2009 computer-assisted-telephone-interview survey was used to investigate generalized trust, social participation and health-related quality of life in a regional Australian population (n = 1273; mean age 51.2 years). Logistic regression analyses were performed to investigate the associations between generalized trust, social participation and poor self-reported health (global self-rated, psychological and physical), and included four social participation/trust categories. A majority (67%) reported high generalized trust of others, 54% were categorized as high social participators. Miniaturization of community was a risk factor for poor self-rated psychological health across genders, and a risk factor for poor self-rated health for males. For women, low social participation (irrespective of trust level) was associated with poor self-reported health. Given current and previous findings, there is a need for further research in a range of contexts which explores the underlying concept of miniaturization of community, that is, the changes in social participation and social networks which may negatively impact community health. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Participants' Accounts on Their Decision to Join a Cohort Study With an Attached Biobank: A Qualitative Content Analysis Study Within Two German Studies.

PubMed

Nobile, Hélène; Bergmann, Manuela M; Moldenhauer, Jennifer; Borry, Pascal

2016-07-01

Reliable participation and sustained retention rates are crucial in longitudinal studies involving human subjects and biomaterials. Understanding the decision to enroll is an essential step to develop adequate strategies promoting long-term participation. Semi-structured interviews were implemented with newly recruited and long-term participants randomly drawn from two ongoing longitudinal studies with a biobank component in Germany. Iterative qualitative content analysis was applied to the transcribed interviews. Participants (n = 31) expressed their decision to enroll or remain in the study as the result of the complex interplay of individual factors, institutional cues, study-related features, and societal dynamics. Different forms of trust were identified as central within the elements used to explain participation and could be compared to Dibben, Morris, and Lean's dynamic model of interpersonal trust. Given these high levels of trust, an investigation of the morality of the trustful relationship at stake between participants and research(ers) is warranted. © The Author(s) 2016.

Identification of influencing factors and strategies to improve communication between general practitioners and community nurses: a qualitative focus group study.

PubMed

Nieuwboer, Minke S; Perry, Marieke; van der Sande, Rob; Maassen, Irma T H M; Olde Rikkert, Marcel G M; van der Marck, Marjolein A

2018-02-26

As the number of patients with complex healthcare needs grows, inter-professional collaboration between primary care professionals must be constantly optimized. General practitioners (GPs) and community nurses (CNs) are key professions in primary care; however, poor GP-CN communication is common, and research into the factors influencing its quality is limited. To explore patient-related GP-CN communication and facilitating and hindering factors, and to identify strategies to enhance this communication. A qualitative focus group design was used to identify the facilitating and hindering factors and strategies for improvement. In a Dutch primary care setting, 6 mono-professional focus group interviews (3 meetings of 13 GPs; 3 meetings of 18 CNs) were organized between June 2015 and April 2016, recorded and transcribed verbatim. Two independent researchers performed the coding of these interviews, identifying their categories and themes. Results show that, despite the regular contact between GPs and CNs, communication was generally perceived as poor in effectiveness and efficiency by both professions. Mutual trust was considered the most important facilitating factor for effective communication. Profession-specific factors (e.g. differences in responsibility and profession-specific language) and organizational factors (e.g. lack of shared care plans, no in-person communication, lack of time) may be of influence on communication. Participants' suggestions for improvement included organizing well-structured and reimbursed team meetings and facilitating face-to-face contact. GP-CN patient-related communication benefits most from trusting inter-personal relationships. Inter-professional training programmes should address both professional and organizational factors and should be evaluated for their effect on quality of care.

Clinical audit: shining a light on good practice.

PubMed

Grainger, Angela

2010-07-01

Healthcare organisations undertake quality assurance to produce safe and effective patient care systems. Statutory quality assurance requirements are met through external reviews, monitoring and inspection processes, and each NHS trust must produce a corporate annual quality account. However, this can result in approaching audits as if they are 'tick-box activities'. This article discusses how organisations can avoid this trap by applying audit results to practice.

When Is a School Environment Perceived as Supportive by Beginning Mathematics Teachers? Effects of Leadership, Trust, Autonomy and Appraisal on Teaching Quality

ERIC Educational Resources Information Center

Blömeke, Sigrid; Klein, Patricia

2013-01-01

This study examines the hypothesis that the more support beginning mathematics teachers perceive and the better they evaluate the management of their school, the higher their teaching quality is. Indicators of teaching quality were how the teachers, who were in their third year in the profession, regarded themselves able to cope with the…

Loss of Trust in the Neighborhood: The Experience of Older African Americans in Detroit.

PubMed

Fritz, Heather; Cutchin, Malcolm P; Cummins, Emily R

2018-02-19

Although evidence suggests that neighborhood conditions are related to stress and health, the processes connecting neighborhood conditions and stress for older minorities is little explored. The purpose of this analysis is to contribute new insights into this issue. We conducted a qualitative analysis as part of a larger mixed methods study of 100 African Americans aged 55 and older living in neighborhoods of varying quality in Detroit, Michigan. A subsample of (n = 20) older adults took photographs of bothersome aspects of their neighborhoods and participated in in-depth photo-elicitation interviews. Data were analyzed using a grounded theory approach. 'Loss of trust in the neighborhood' emerged as the core category to explain how older African Americans in our sample experienced neighborhood stressors in their daily lives. Loss of trust in physical, social, and institutional dimensions of the neighborhood contributed to the core category. The life course of neighborhoods and the trust placed in them appears to be intimately connected to the well-being of older African Americans. We therefore hypothesize that a fundamental pathway through which neighborhood stressors are experienced for older African Americans in U.S. 'Rust Belt' cities is the multifaceted loss of trust in the neighborhood.

Hospital Trusts productivity in the English NHS: Uncovering possible drivers of productivity variations.

PubMed

Aragon Aragon, María Jose; Castelli, Adriana; Gaughan, James

2017-01-01

Health care systems in OECD countries are increasingly facing economic challenges and funding pressures. These normally demand interventions (political, financial and organisational) aimed at improving the efficiency of the health system as a whole and its single components. In 2009, the English NHS Chief Executive, Sir David Nicholson, warned that a potential funding gap of £20 billion should be met by extensive efficiency savings by March 2015. Our study investigates possible drivers of differential Trust performance (productivity) for the financial years 2010/11-2012/13. Following accounting practice, we define Productivity as the ratio of Outputs over Inputs. We analyse variation in both Total Factor and Labour Productivity using ordinary least squares regressions. We explicitly included in our analysis factors of differential performance highlighted in the Nicholson challenge as the sources were the efficiency savings should come from. Explanatory variables include efficiency in resource use measures, Trust and patient characteristics, and quality of care. We find that larger Trusts and Foundation Trusts are associated with lower productivity, as are those treating a greater proportion of both older and/or younger patients. Surprisingly treating more patients in their last year of life is associated with higher Labour Productivity.

What do troubled adolescents expect from their GPs?

PubMed

Tudrej, Benoit V; Heintz, Anne-Laure; Ingrand, Pierre; Gicquel, Ludovic; Binder, Philippe

2016-12-01

Adolescents often have emotional and behavioural problems that general practitioners are likely to miss. While nearly 80% of them consult their GP every year, it is usually for physical, not psychological reasons. Trust in their GPs in necessary for screening. To identify the key quality desired by adolescents for them to feel free to confide in GPs. To determine whether this quality differed according to gender, level of at-risk behaviours or interlocutor: friend, parent or GP. A descriptive cross-sectional study was conducted in 182 French educational institutions chosen by lot. Fifteen-year-olds completed a self-administered questionnaire under examination conditions. While the questions on behaviour were drawn from the cross-national survey entitled 'Health behaviour in school-aged children (HBSC),' the questions on conditions conducive to trust were drawn from previous studies. A total of 1817 (911 boys, 906 girls) questionnaires were analysed. Adolescents said they seldom confided. The main quality they expected from a GP to whom they could confide in was 'honesty', which meant ensuring secrecy, refraining from judgment, and putting forward the right questions. This priority was modified by neither gender nor experience with health-risk behaviour. The quality of 'reliability' was more closely associated with their parents or friends, while 'emotionality' was cited less often. To gain the trust of adolescents, GPs have to be sincere and non-manipulative and have the ability to ensure confidentiality and to put forward the right questions without passing judgment. Can this be verified during consultations? Prospective studies could shed light on this point.[Box: see text].

Clinical governance is "ACE"--using the EFQM excellence model to support baseline assessment.

PubMed

Holland, K; Fennell, S

2000-01-01

The introduction of clinical governance in the "new NHS" means that National Health Service (NHS) organisations are now accountable for the quality of the services they provide to their local communities. As part of the implementation of clinical governance in the NHS, Trusts and health authorities had to complete a baseline assessment of their capability and capacity by September 1999. Describes one Trust's approach to developing and implementing its baseline assessment tool, based upon its existing use of the European Foundation for Quality Management (EFQM) Excellence Model. An initial review of the process suggests that the model provides an adaptable framework for the development of a comprehensive and practical assessment tool and that self-assessment ensures ownership of action plans at service level.

A Trust-Based Pact in Research Biobanks. From Theory to Practice.

PubMed

Sanchini, Virginia; Bonizzi, Giuseppina; Disalvatore, Davide; Monturano, Massimo; Pece, Salvatore; Viale, Giuseppe; Di Fiore, Pier Paolo; Boniolo, Giovanni

2016-05-01

Traditional Informed Consent is becoming increasingly inadequate, especially in the context of research biobanks. How much information is needed by patients for their consent to be truly informed? How does the quality of the information they receive match up to the quality of the information they ought to receive? How can information be conveyed fairly about future, non-predictable lines of research? To circumvent these difficulties, some scholars have proposed that current consent guidelines should be reassessed, with trust being used as a guiding principle instead of information. Here, we analyse one of these proposals, based on a Participation Pact, which is already being offered to patients at the Istituto Europeo di Oncologia, a comprehensive cancer hospital in Milan, Italy. © 2015 John Wiley & Sons Ltd.

Principles of Faithful Execution in the implementation of trusted objects.

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

Tarman, Thomas David; Campbell, Philip LaRoche; Pierson, Lyndon George

2003-09-01

We begin with the following definitions: Definition: A trusted volume is the computing machinery (including communication lines) within which data is assumed to be physically protected from an adversary. A trusted volume provides both integrity and privacy. Definition: Program integrity consists of the protection necessary to enable the detection of changes in the bits comprising a program as specified by the developer, for the entire time that the program is outside a trusted volume. For ease of discussion we consider program integrity to be the aggregation of two elements: instruction integrity (detection of changes in the bits within an instructionmore » or block of instructions), and sequence integrity (detection of changes in the locations of instructions within a program). Definition: Faithful Execution (FE) is a type of software protection that begins when the software leaves the control of the developer and ends within the trusted volume of a target processor. That is, FE provides program integrity, even while the program is in execution. (As we will show below, FE schemes are a function of trusted volume size.) FE is a necessary quality for computing. Without it we cannot trust computations. In the early days of computing FE came for free since the software never left a trusted volume. At that time the execution environment was the same as the development environment. In some circles that environment was referred to as a ''closed shop:'' all of the software that was used there was developed there. When an organization bought a large computer from a vendor the organization would run its own operating system on that computer, use only its own editors, only its own compilers, only its own debuggers, and so on. However, with the continuing maturity of computing technology, FE becomes increasingly difficult to achieve« less

Acceptance of selective contracting: the role of trust in the health insurer

PubMed Central

2013-01-01

Background In a demand oriented health care system based on managed competition, health insurers have incentives to become prudent buyers of care on behalf of their enrolees. They are allowed to selectively contract care providers. This is supposed to stimulate competition between care providers and both increase the quality of care and contain costs in the health care system. However, health insurers are reluctant to implement selective contracting; they believe their enrolees will not accept this. One reason, insurers believe, is that enrolees do not trust their health insurer. However, this has never been studied. This paper aims to study the role played by enrolees’ trust in the health insurer on their acceptance of selective contracting. Methods An online survey was conducted among 4,422 people insured through a large Dutch health insurance company. Trust in the health insurer, trust in the purchasing strategy of the health insurer and acceptance of selective contracting were measured using multiple item scales. A regression model was constructed to analyse the results. Results Trust in the health insurer turned out to be an important prerequisite for the acceptance of selective contracting among their enrolees. The association of trust in the purchasing strategy of the health insurer with acceptance of selective contracting is stronger for older people than younger people. Furthermore, it was found that men and healthier people accepted selective contracting by their health insurer more readily. This was also true for younger people with a low level of trust in their health insurer. Conclusion This study provides insight into factors that influence people’s acceptance of selective contracting by their health insurer. This may help health insurers to implement selective contracting in a way their enrolees will accept and, thus, help systems of managed competition to develop. PMID:24083663

Acceptance of selective contracting: the role of trust in the health insurer.

PubMed

Bes, Romy E; Wendel, Sonja; Curfs, Emile C; Groenewegen, Peter P; de Jong, Judith D

2013-10-02

In a demand oriented health care system based on managed competition, health insurers have incentives to become prudent buyers of care on behalf of their enrolees. They are allowed to selectively contract care providers. This is supposed to stimulate competition between care providers and both increase the quality of care and contain costs in the health care system. However, health insurers are reluctant to implement selective contracting; they believe their enrolees will not accept this. One reason, insurers believe, is that enrolees do not trust their health insurer. However, this has never been studied. This paper aims to study the role played by enrolees' trust in the health insurer on their acceptance of selective contracting. An online survey was conducted among 4,422 people insured through a large Dutch health insurance company. Trust in the health insurer, trust in the purchasing strategy of the health insurer and acceptance of selective contracting were measured using multiple item scales. A regression model was constructed to analyse the results. Trust in the health insurer turned out to be an important prerequisite for the acceptance of selective contracting among their enrolees. The association of trust in the purchasing strategy of the health insurer with acceptance of selective contracting is stronger for older people than younger people. Furthermore, it was found that men and healthier people accepted selective contracting by their health insurer more readily. This was also true for younger people with a low level of trust in their health insurer. This study provides insight into factors that influence people's acceptance of selective contracting by their health insurer. This may help health insurers to implement selective contracting in a way their enrolees will accept and, thus, help systems of managed competition to develop.

36 CFR 1010.2 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Purpose. 1010.2 Section 1010.2 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.2 Purpose. The regulations in this part incorporate and supplement the Council on Environmental Quality's (CEQ) regulations at 40 CFR parts 1500 through 1508 for...

36 CFR § 1010.1 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Policy. § 1010.1 Section § 1010.1 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.1 Policy. The..., available resources, and national policy, to protect and enhance the quality of the human environment; (b...

"Where did my data layer come from?" The semantics of data release

NASA Astrophysics Data System (ADS)

Leadbetter, Adam; Buck, Justin

2015-04-01

In his lecture, "Theory of Creative Fitting" (Margullis, Corner & Holt, 2006), Ian McHarg introduced his vision for cross-disciplinary data and information sharing networks with the end goal of producing detailed overlay maps for the purposes of ecological architectural planning. Within McHarg's networks, experts in various fields, such as hydrology or surface geology, would provide data layers to the final overlay map with full provenance, such that the users of the overlay maps would know the originator of the data, the "value systems" by which the data were created and could place their trust in the outcomes. In the light of McHarg's statements and in order to allow the encoding of value systems in a cyber-GIS, analyses of: data quality (Giarlo, 2013); data publication networks (Reinsfelder, 2012); trust in collaborative research networks (Leadbetter, 2015); and the metaphors of data publication, data release and data ecosystems (Parsons & Fox, 2013) have been synthesised into a logical model of the data release lifecycle. This model concerns the actors in the data release process; the data-information-knowledge ecosystem through the various stages of the data release process and the impact of data release on perceptions of trust through the data release lifecycle. The data-information-knowledge ecosystem described how the collection of data can be presented in new ways to form information products, and how these information products can inform conversations amongst information-consumers who integrate the information into new knowledge. The actors concerned in the process comprise: researchers data publishers academic publishers & academic administrators Finally, the lifecycle of data release involves the initial release of a data-layer, possibly with a Persistent Identifier (PID) more generic than a Digital Object Identifier (DOI). A data description paper can be written about the dataset, which then necessitates the assignment of a DOI to the datasets; the DOI can be seen as an indicator of trust through "benevolence". A technical document citing the dataset may then be informed by the dataset release or the dataset description paper. These citations may show the "competence" (in terms of a trust model) of the original datasets, and the dataset description papers or other technical articles show the integrity of the dataset. The synthesised logical model has been represented in freely available ontologies, such that data layers can be annotated with metadata about their provenance and stage within the data release lifecycle before incorporation into a cyber-GIS, in which distributed data providers provide for a collaborative research environment. References Giarlo, M. (2013). Academic libraries as data quality hubs. Journal of Librarianship and Scholarly Communication 1(3): eP1059. doi: 10.7710/2162-3309.1059 Leadbetter, A. (2015). Examining trust in collaborative research networks. In P. Diviacco, P. Fox, C. Pshenichny, and A. Leadbetter (Eds.) Collaborative Knowledge in Scientific Research Networks, Hershey, PA: IGI Global. doi: 10.4018/978-1-4666-6567-5.ch002 Margulis, L., Corner, J. and Hawthorne, B. (Editors), 2006. Ian McHarg: conversations with students. Dwelling with nature. New York, NY: Princeton Architectural Press. Parsons, M., and Fox, P. (2013). Is data publication the right metaphor? Data Science Journal 12, 32-46. doi:10.2481/dsj.WDS-042 Reinsfelder, T. (2012). Open access publishing practices in a complex environment: conditions, barriers and bases of power. Journal of Librarianship and Scholarly Communication 1(1): eP1029. doi: 10.7710/2162-3309.1029

Online Sellers’ Website Quality Influencing Online Buyers’ Purchase Intention

NASA Astrophysics Data System (ADS)

Shea Lee, Tan; Ariff, Mohd Shoki Md; Zakuan, Norhayati; Sulaiman, Zuraidah; Zameri Mat Saman, Muhamad

2016-05-01

The increase adoption of Internet among young users in Malaysia provides high prospect for online seller. Young users aged between 18 and 25 years old are important to online sellers because they are actively involved in online purchasing and this group of online buyers is expected to dominate future online market. Therefore, examining online sellers’ website quality and online buyers’ purchase intention is crucial. Based on the Theory of planned behavior (TPB), a conceptual model of online sellers’ website quality and purchase intention of online buyers was developed. E-tailQ instrument was adapted in this study which composed of website design, reliability/fulfillment, security, privacy & trust, and customer service. Using online questionnaire and convenience sampling procedure, primary data were obtained from 240 online buyers aged between 18 to 25 years old. It was discovered that website design, website reliability/fulfillment, website security, privacy & trust, and website customer service positively and significantly influence intention of online buyers to continuously purchase via online channels. This study concludes that online sellers’ website quality is important in predicting online buyers’ purchase intention. Recommendation and implication of this study were discussed focusing on how online sellers should improve their website quality to stay competitive in online business.

Does corruption undermine trust in health care? Results from public opinion polls in Croatia.

PubMed

Radin, Dagmar

2013-12-01

Health and health care provision are one of the most important topics in public policy, and often a highly debated topic in the political arena. The importance of considering trust in the health care sector is highlighted by studies showing that trust is associated, among others, with poor self-related health, and poorer health outcomes. Similarly, corruption has shown to create economic costs and inefficiencies in the health care sector. This is particularly important for a newly democratized country such as Croatia, where a policy responsive government indicates a high level of quality of democracy (Roberts, 2009) and where a legacy of corruption in the health care sector has been carried over from the previous regime. In this study, I assess the relationship between health care corruption and trust in public health care and hypothesize that experience with health care corruption as well as perception of corruption has a negative effect on trust in public care facilities. Data were collected in two surveys, administered in 2007 and 2009 in Croatia. Experience with corruption and salience with corruption has a negative effect on trust in public health care in the 2007 survey, but not in the 2009 survey. While the results are mixed, they point to the importance of further studying this relationship. Copyright © 2013 Elsevier Ltd. All rights reserved.

Trust in health care encounters and systems: a case study of British pensioners living in Spain.

PubMed

Legido-Quigley, Helena; McKee, Martin; Green, Judith

2014-11-01

Research on trust in health care faces two enduring challenges. Firstly, there are conceptual ambiguities in distinguishing trust from related concepts, such as confidence or dependence. Second, the tacit understandings which underpin the 'faith' element of trust are difficult to explicate. A case study of British pensioners who have moved to Spain provides an opportunity to explore trust in a setting where they often have a choice of where to access health care (UK or Spain), and are therefore not in a state of dependence, and in which the 'differences' of a new field generates reflection on their tacit expectations of providers and systems. In accounting for decisions to use (or not to use) Spanish health care, British pensioners cited experiential knowledge of symbolic indicators of trustworthy institutions (they were hygienic, modern, efficient), which contributed to background confidence in the system, and interpersonal qualities of practitioners (respect for older people, embodied empathy and reciprocity) which evoked familiar relations, within which faith is implicit. In contrast, with limited recent access to the British system, their background confidence had been compromised by reports of poor performance, with few opportunities to rebuild the interrelational bases of trust. © 2014 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for Sociology of Health and Illness (SHIL).

The impact of global health initiatives on trust in health care provision under extreme resource scarcity: presenting an agenda for debate from a case study of emergency obstetric care in Northern Tanzania

PubMed Central

2010-01-01

Background Through the nearly three decades that have passed since the Alma Ata conference on Primary Health Care, a wide range of global health initiatives and ideas have been advocated to improve the health of people living in developing countries. The issues raised in the Primary Health Care concept, the Structural Adjustment Programmes and the Health Sector Reforms have all influenced health service delivery. Increasingly however, health systems in developing countries are being described as having collapsed Do the advocated frameworks contribute to this collapse through not adequately including population trust as a determinant of the revival of health services, or are they primarily designed to satisfy the values of other actors within the health care system? This article argues there is an urgent need to challenge common thinking on health care provision under extreme resource scarcity. Methods This article sets out to discuss and analyze the described collapse of health services through a brief case study on provision of Emergency Obstetric Care in Northern Tanzania. Results The article argues that post the Alma Ata conference on Primary Health Care developments in global health initiatives have not been successful in incorporating population trust into the frameworks, instead focusing narrowly on expert-driven solutions through concepts such as prevention and interventions. The need for quantifiable results has pushed international policy makers and donors towards vertical programmes, intervention approaches, preventive services and quantity as the coverage parameter. Health systems have consequently been pushed away from generalized horizontal care, curative services and quality assurance, all important determinants of trust. Conclusions Trust can be restored, and to further this objective a new framework is proposed placing generalized services and individual curative care in the centre of the health sector policy domain. Preventive services are important, but should increasingly be handled by other sectors in a service focused health care system. To facilitate such a shift in focus we should acknowledge that limited resources are available and accept the conflict between population demand and expert opinion, with the aim of providing legitimate, accountable and trustworthy services through fair, deliberative, dynamic and incremental processes. A discussion of the acceptable level of quality, given the available resources, can then be conducted. The article presents for debate that an increased focus on quality and accountability to secure trust is an important precondition for enabling the political commitment to mobilize necessary resources to the health sector. PMID:20500857

Importance of relationship quality and communication on foodservice for the elderly.

PubMed

Seo, Sunhee; Back, Ki Joon; Shanklin, Carol W

2011-02-01

In order to promote foodservice for the elderly, foodservice managers in Continuing Care Retirement Communities (CCRCs) must identify the main factors to enhance the satisfaction and behavioral intentions with food service. The purpose of this study was to investigate the relationships between relationship quality (consisting of trust, commitment, and satisfaction) and communication in the formation of elderly's behavioral intentions with food services at CCRCs. A survey was administered to residents in two CCRCs and a total of 327 residents participated. A tested structural equation model exhibited good model fit and explanatory power of the study construct. Satisfaction directly influenced word-of-mouth and service quality has an influence on commitment. Commitment was a significant determinant of behavioral intentions to eat more often in the dining room. Also, communication showed positive association with trust. The results provided strong evidence for the importance of satisfaction and communication as a consequence of relationship marketing efforts. Suggestions for future research to better understand the elderly' behavioral intention judgments were given.

Importance of relationship quality and communication on foodservice for the elderly

PubMed Central

Back, Ki Joon; Shanklin, Carol W.

2011-01-01

In order to promote foodservice for the elderly, foodservice managers in Continuing Care Retirement Communities (CCRCs) must identify the main factors to enhance the satisfaction and behavioral intentions with food service. The purpose of this study was to investigate the relationships between relationship quality (consisting of trust, commitment, and satisfaction) and communication in the formation of elderly's behavioral intentions with food services at CCRCs. A survey was administered to residents in two CCRCs and a total of 327 residents participated. A tested structural equation model exhibited good model fit and explanatory power of the study construct. Satisfaction directly influenced word-of-mouth and service quality has an influence on commitment. Commitment was a significant determinant of behavioral intentions to eat more often in the dining room. Also, communication showed positive association with trust. The results provided strong evidence for the importance of satisfaction and communication as a consequence of relationship marketing efforts. Suggestions for future research to better understand the elderly' behavioral intention judgments were given. PMID:21487500

Helping doctors in training to STEP-UP: A leadership and quality improvement programme in the Belfast Health and Social Care Trust.

PubMed

Donaghy, Grainne; McKeever, Kris; Flanagan, Catherine; O'Kane, Donal; McQuillan, Bernie; Cash, Johnny; Jack, Cathy; Lundy, Claire

2018-05-01

Medical engagement in healthcare organisations can improve service development and patient experience. Doctors in training have limited opportunities to engage in service improvement work and develop leadership skills. We describe the Specialist Trainees Engaged in Leadership Programme (STEP) , a programme developed to introduce concepts of medical leadership and quality improvement skills in the Belfast Trust. STEP started in 2013 and over 140 trainees have now participated in the programme. Over 42 quality improvement projects have been completed with the support of the programme. Evaluation of STEP has demonstrated an improvement across all domains explored throughout the duration of the programme, with benefits for the individual trainee and the wider organisation. We describe the programme in detail. The STEP curriculum can easily be adapted to meet the needs of NHS trainees, allowing them to understand the objectives and strategy of their employers and improve their ability to plan and deliver safe, effective, patient-centred care.

Primary care units in Emilia-Romagna, Italy: an assessment of organizational culture.

PubMed

Pracilio, Valerie P; Keith, Scott W; McAna, John; Rossi, Giuseppina; Brianti, Ettore; Fabi, Massimo; Maio, Vittorio

2014-01-01

This study investigates the organizational culture and associated characteristics of the newly established primary care units (PCUs)-collaborative teams of general practitioners (GPs) who provide patients with integrated health care services-in the Emilia-Romagna Region (RER), Italy. A survey instrument covering 6 cultural dimensions was administered to all 301 GPs in 21 PCUs in the Local Health Authority (LHA) of Parma, RER; the response rate was 79.1%. Management style, organizational trust, and collegiality proved to be more important aspects of PCU organizational culture than information sharing, quality, and cohesiveness. Cultural dimension scores were positively associated with certain characteristics of the PCUs including larger PCU size and greater proportion of older GPs. The presence of female GPs in the PCUs had a negative impact on collegiality, organizational trust, and quality. Feedback collected through this assessment will be useful to the RER and LHAs for evaluating and guiding improvements in the PCUs. © 2013 by the American College of Medical Quality.

Braving a faceless new world? Conceptualizing trust in the pharmaceutical industry and its products.

PubMed

Brown, Patrick; Calnan, Michael

2012-01-01

Pharmaceutical products are commonly relied upon by professionals, and correspondingly patients, within a wide range of healthcare contexts. This dependence, combined with the inherent risk and uncertainty surrounding both medical practice and the drugs it harnesses, points towards the importance of trust in the pharmaceutical industry--a subject which has been much neglected by researchers. This article begins to address this deficiency by mapping out a conceptual framework which may form a useful basis for future research into this important topic. The often negative portrayal of the pharmaceutical industry in the public sphere belies a state of apparent confidence in its products. The role of prescribing professionals as 'mediators of trust' amid a faceless system of production and, alongside regulators, as bases of assurance in the quality of drugs goes some way towards explaining this contradiction. Recent policy moves towards fostering increased patient 'expertise' and responsibility for illness management, a widening of over-the-counter medication availability and a growing market of products (mainstream and illicit) via the Internet suggest this role of 'facework' in facilitating trust may be becoming more marginal. This heightened requirement for trusting amid the unfamiliar, and an apparent willingness to do so, underlines the need for further research into trust in the industry--both mainstream and underground--and its products. Within this discussion an agenda for furthering our understandings of the political-economy of the pharmaceutical industry becomes apparent, one which might be most effectively approached by way of a broader political-economy of hope and trust.

A follow-up evaluation of the impact of the Chief Nursing Officer's review of mental health nursing in Mental Health Trusts and Universities in England: comparisons of two e-surveys.

PubMed

Baker, John; Swarbrick, Caroline; Campbell, Malcolm; Playle, John; Lovell, Karina

2012-03-01

This article is a report of a study that aimed to establish a national picture of the implementation of Review recommendations over time in both Mental Health Trusts and Higher Education Institutions (Universities) in England. The 2006 Review of Mental Health Nursing in England by the Chief Nursing Officer made 17 key recommendations for Mental Health Trusts and Universities to improve mental health nursing. This article outlines key findings from a national survey of National Health Service Trusts and Universities in England with regard to prioritization and progress on implementation of these recommendations. An e-survey was carried out in 2008-2009 based on the Chief Nursing Officer review recommendations and guidance. Participants included all Trusts which delivered mental health services (n = 68) and Universities which delivered pre-registration mental health nursing education (n = 50) in England. There appears to be some evidence that the Chief Nursing Officer review of Mental Health Nursing in England continues to be implemented in both Mental Health Trusts and Universities. There is variety in levels of implementation, but Mental Health Trusts and Universities broadly agree on priority areas. The Chief Nursing Officer review has been influential in focusing the care and education of mental health nurses and services in England. There appears to be a range of barriers and facilitators which aid the implementation of healthcare policy. More attention is required from researchers to enhance and evaluate the impact of policy implementation on the quality of care provided. © 2011 Blackwell Publishing Ltd.

Death among children and adolescents

MedlinePlus

... and genetic conditions that were present at birth Homicide 5 to 14 years: Accidents (unintentional injuries) Cancer ... trust is very important for preventing teen suicide. HOMICIDE Homicide is a complex issue that does not ...

Complex Langevin method: When can it be trusted?

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

Aarts, Gert; Seiler, Erhard; Stamatescu, Ion-Olimpiu

2010-03-01

We analyze to what extent the complex Langevin method, which is in principle capable of solving the so-called sign problems, can be considered as reliable. We give a formal derivation of the correctness and then point out various mathematical loopholes. The detailed study of some simple examples leads to practical suggestions about the application of the method.

People's trust in health news disseminated by mass media in Tehran.

PubMed

Nedjat, Sima; Nedjat, Saharnaz; Majdzadeh, Reza; Farshadi, Mojgan

2014-01-01

People are increasingly interested in health news. As a mass media, the 'Islamic Republic of Iran Broadcasting' (IRIB) has the highest number of target audiences. In Iran, some people follow health news via health programs on satellites and other means of communication. However, all of these programs do not live up to the standards of scientific evidence. In this study, we examined Tehran people's trust in health news disseminated by the IRIB and other mass media outlets. A cross-sectional study was conducted in Tehran. Through multistage sampling, 510 households proportional to size were randomly selected from five regions of Tehran including northern, eastern, western, southern and central regions. One person from each household completed the questionnaire through interviews. The questionnaire included questions on people's level of trust in health news delivered by the IRIB, satellite programs, the internet and magazines. It also included demographic questions. The validity and reliability of the questionnaire was evaluated. Among the interviewees, 50.6% was female. The highest level of trust by the participants was observed in the IRIB (65.2%), and the lowest trust was observed in satellite news (43.4%); p< 0.001. The interviewees believed that the IRIB news broadcasters had more mastery over the subject than the ones in satellite channels (p< 0.001). The IRIB's coverage of important and relevant health topics was also significantly perceived to be better than that of satellite news (p< 0.001). According to 83.5% of interviewees, the quality of health news had improved in the past 10 years. Fifty nine point eight percent of participants believed the quality and accuracy of the IRIB health news was monitored. People's higher level of trust in domestic news as compared to foreign sources and the better status of domestic sources in other areas such as precision in reporting, coverage of more important news, its delivery in lay language, the news broadcasters' proficiency, and other cases - from the participants' point of view - can highlight the significance of designing interventions for changing health behavior among domestic health news producers. Therefore, the results of this study can prove useful to health news policy makers in the IRIB.

Human Connections.

ERIC Educational Resources Information Center

Sgroi, Angela; Saltiel, Iris M.

1998-01-01

The power of collaborative learning partnerships is the synergy created through productive, meaningful activity. Key elements include trust, respect, self-selection, mutual goals, a belief that the sum is greater than the parts, and complementary qualities. (SK)

Why carers use adult day respite: a mixed method case study

PubMed Central

2014-01-01

Background We need to improve our understanding of the complex interactions between family carers’ emotional relationships with care-recipients and carers use of support services. This study assessed carer’s expectations and perceptions of adult day respite services and their commitment to using services. Methods A mixed-method case study approach was used with psychological contract providing a conceptual framework. Data collection was situated within an organisational case study, and the total population of carers from the organisation’s day respite service were approached. Fifty respondents provided quantitative and qualitative data through an interview survey. The conceptual framework was expanded to include Maslow’s hierarchy of needs during analysis. Results Carers prioritised benefits for and experiences of care-recipients when making day respite decisions. Respondents had high levels of trust in the service and perceived that the major benefits for care-recipients were around social interaction and meaningful activity with resultant improved well-being. Carers wanted day respite experiences to include all levels of Maslow’s hierarchy of needs from the provision of physiological care and safety through to the higher levels of belongingness, love and esteem. Conclusion The study suggests carers need to trust that care-recipients will have quality experiences at day respite. This study was intended as a preliminary stage for further research and while not generalizable it does highlight key considerations in carers’ use of day respite services. PMID:24906239

An analysis on the research ethics cases managed by the Committee on Publication Ethics (COPE) between 1997 and 2010.

PubMed

Foo, Jong Yong Abdiel; Wilson, Stephen James

2012-12-01

The growing emphasis on the importance of publishing scientific findings in the academic world has led to increasing prevalence of potentially significant publications in which scientific and ethical rigour may be questioned. This has not only hindered research progress, but also eroded public trust in all scientific advances. In view of the increasing concern and the complexity of research misconduct, the Committee on Publication Ethics (COPE) was established in 1997 to manage cases with ethical implications. In order to review the outcomes of cases investigated by COPE, a total of 408 cases that had been managed by COPE were successfully extracted and analysed with respect to 7 distinct criteria. The results obtained indicate that the number of ethical implications per case has not changed significantly (p > 0.01) since the year COPE was instigated. Interestingly, the number of ethical cases, and to some extent, research misconduct, is not diminishing. Therefore, journal editors and publishers need to work closely together with COPE to inculcate adoption of appropriate research ethics and values in younger researchers while discouraging others from lowering standards. It is hoped that with a more concerted effort from the academic community and better public awareness, there will be fewer incidences of ethically and scientifically challenged publications. The ultimate aim being to enhance the quality of published works with concomittant public trust in the results.

Incapacitated Surrogates: A New and Increasing Dilemma in Hospital Care.

PubMed

Smith, Karen L; Fedel, Patrice; Heitman, Jay

2017-01-01

A power of attorney for healthcare (POAHC) form gives designated individuals legal status to make healthcare decisions when patients are unable to convey their decisions to medical staff. Completion of a POAHC form is crucial in the provision of comprehensive healthcare, since it helps to ensure that patients' interests, values, and preferences are represented in decisions about their medical treatment. Because increasing numbers of people suffer from debilitating illness and cognitive deficits, healthcare systems may be called upon to navigate the complexities of patients' care without clear directives from the patients themselves. Hence, the healthcare industry encourages all individuals to complete a POAHC form to ensure that persons who have the patients' trust are able to act as their surrogate decision makers. However, sometimes POAHC agents, even when they are patients' trusted agents, lack the capacity to make fully informed decisions that are in the patients' best interests. We describe designated surrogate decision makers who have impaired or diminished judgment capacity as incapacitated surrogates. Decision making that is obviously flawed or questionable is a significant impediment to providing timely and appropriate care to patients. Moreover, failure to redress these issues in a timely and efficient manner can result in significant costs to an institution and a diminished quality of patient care. The authors offer a legal, ethical, and interdisciplinary framework to help navigate cases of incapacitated surrogates. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

Why carers use adult day respite: a mixed method case study.

PubMed

Stirling, Christine M; Dwan, Corinna A; McKenzie, Angela R

2014-06-06

We need to improve our understanding of the complex interactions between family carers' emotional relationships with care-recipients and carers use of support services. This study assessed carer's expectations and perceptions of adult day respite services and their commitment to using services. A mixed-method case study approach was used with psychological contract providing a conceptual framework. Data collection was situated within an organisational case study, and the total population of carers from the organisation's day respite service were approached. Fifty respondents provided quantitative and qualitative data through an interview survey. The conceptual framework was expanded to include Maslow's hierarchy of needs during analysis. Carers prioritised benefits for and experiences of care-recipients when making day respite decisions. Respondents had high levels of trust in the service and perceived that the major benefits for care-recipients were around social interaction and meaningful activity with resultant improved well-being. Carers wanted day respite experiences to include all levels of Maslow's hierarchy of needs from the provision of physiological care and safety through to the higher levels of belongingness, love and esteem. The study suggests carers need to trust that care-recipients will have quality experiences at day respite. This study was intended as a preliminary stage for further research and while not generalizable it does highlight key considerations in carers' use of day respite services.

Establishing Relationships and Navigating Boundaries When Caring for Children With Medical Complexity at Home.

PubMed

Nageswaran, Savithri; Golden, Shannon L

Children with medical complexity receive care from many healthcare providers including home healthcare nurses. The objective of our study, based on a conceptual framework, was to describe the relationships between parents/caregivers of children with medical complexity and home healthcare nurses caring for these children. We collected qualitative data in 20 semistructured in-depth interviews (15 English, 5 Spanish) with 26 primary caregivers of children with medical complexity, and 4 focus groups of 18 home healthcare nurses inquiring about their experiences about home healthcare nursing services for children with medical complexity. During an iterative analysis process, we identified recurrent themes related to caregiver-nurse relationships. Our study showed that: (1) caregiver-nurse relationships evolved over time and were determined by multiple factors; (2) communication and trust were essential to the establishment of caregiver-nurse relationships; (3) both caregivers and nurses described difficulties of navigating physical, professional, personal, and emotional boundaries, and identified strategies to maintain these boundaries; and (4) good caregiver-nurse relationships helped in the care of children with medical complexity, reduced caregiver burden, resulted in less stress for nurses, and was a factor in nurse retention. We conclude that trusted relationships between caregivers and nurses are important to the home care of children with medical complexity. Interventions to develop and maintain good caregiver-nurse relationships are necessary.

Millions in cash in your hospital halls. Calculating the cash value of employee engagement, Part II.

PubMed

Simon, Matthew

2003-01-01

Quality of care and the bottom line are often seen as trade-offs. But this can be a false dichotomy. As we shall see, many of the factors impacted by employee engagement--a term that encompasses trust, loyalty, motivation and cooperative spirit--contribute to both quality of care and financial performance.

Partners in quality: managing your suppliers.

PubMed

Conway, B A

1991-05-01

Just expecting more from your supplier is not what partnership is about. We have had the experience where the quality improvement and partnership banner has been waved but the tone and spirit of the meeting did not encourage or support a joint quality improvement effort. Benefits will not be achieved until the wall truly begins to come apart and the relationship is built on mutual respect and trust. Data collection and open answers to questions often reveal embarrassing errors and obvious needs for improvements. As stated before, blame and finger-pointing must be replaced with a mutual commitment to asking and answering the question, "How can we improve?" As Dr. W. Edwards Deming has stated, "End the practice of awarding business on the basis of price tag. Instead, minimize total cost. Move toward a single supplier for any one item on a long-term relationship of loyalty and trust." The structured approach of a quality improvement process and the application of quality methods and techniques has proven useful in removing emotion and helping the team focus on the process rather than the people and the issues involved. Quality improvement methods are focused on achieving both customer and supplier goals--customer satisfaction, employee satisfaction, and operational efficiency and effectiveness. Our experience with Partners in Quality as well as our experience with the quality leadership process supports a recent quote in the Harvard Business Review: "Quality is not just a slogan...(it is) the most profitable way to run a business."

Gaining trust from the scientific climate change community and increasing the visibility of their data

NASA Astrophysics Data System (ADS)

Pfeil, B.; Diepenbroek, M.

2017-12-01

Climate science has a major impact not just within the field, but also has immediate significant societal and economic implications. Scientists are well aware that their research results may be discussed by policy-makers and the media, sometimes with hostile intent from climate science deniers. Sustainable and scrutinized data management is the backbone for future scientific research and vital to maintain the integrity and reputation of the climate science community. In 2009 a lack of openness regarding data acquisition data treatment was one of the main factors in Climategate that severely damaged the community's image - and efficient data sharing and management can prevent this in the future. Data repositories can only operate effectively if they have the trust of their users: this includes both the data providers and data users. Both groups have to be assured that data treatment and quality control follows internationally agreed SOPs (standard operating procedures), is transparent, documented and traceable. Users want easy access to data and have to be assured that data is citable, allows reproducibility and can be used with confidence, which requires that both the data and accompanying metadata are of the highest possible quality. Building up trust from both communities takes time and requires collaboration, getting feedback from the community and addressing their needs. This presentation will show the basic needs and challenges for data repositories, and will illustrate how the marine carbon climate change community has successfully addressed these through the SOCAT (Surface Ocean CO2 Atlas) project. The project actively involves both data providers and users throughout the design and implementation of their infrastructures. Scientists are directly involved in quality control of the data and metadata, increasing trust in the data and encouraging international collaboration, which in turn increases the visibility of both the community and its data.

Trusted Spotter Network Austria - a new standard to utilize crowdsourced weather and impact observations

NASA Astrophysics Data System (ADS)

Krennert, Thomas; Kaltenberger, Rainer; Pistotnik, Georg; Holzer, Alois M.; Zeiler, Franz; Stampfl, Mathias

2018-05-01

Information from voluntary storm spotters has been an increasingly important part for the severe weather warning process at the Zentralanstalt für Meteorologie and Geodynamik (ZAMG), Austria's National Weather Service, for almost 15 years. In 2010 a collaboration was formalized and an annual training was established to educate voluntary observers into Trusted Spotters. The return of this investment is a higher credibility of their observations after these spotters have undergone a basic meteorological training and have become aware of their responsibility. The European Severe Storms Laboratory (ESSL) was included to this collaboration to adopt their successful quality control system of severe weather reports, which is employed in the European Severe Weather Database ESWD. That way, reports from Trusted Spotters automatically obtain a higher quality flag, which enables a faster processing by forecasters on duty for severe weather warnings, when time is a critical issue. The concept of combining training for voluntary storm spotters and a thorough quality management was recognized as a Best Practice Model by the European Meteorological Society. We propose to apply this concept also in other European countries and present its advancement into an even broader, pan-European approach. The European Weather Observer app EWOB, recently released by ESSL, provides a novel and easy-to-handle tool to submit weather and respective impact observations. We promote its use to provide better data and information for a further real-time improvement of severe weather warnings.

Trustworthy Research Institutions: The Challenging Case of Studying the Genetics of Intelligence.

PubMed

Johnston, Josephine; Banerjee, Mohini P; Geller, Gail

2015-01-01

It is simple enough to claim that academic research institutions ought to be trustworthy. Building the culture and taking the steps necessary to earn and preserve institutional trust are, however, complex processes. The experience motivating this special report--a request for the Center for Talented Youth at Johns Hopkins University to collaborate on research regarding the genetics of intelligence--illustrates how ensuring institutional trustworthiness can be in tension with a commitment to fostering research. In this essay, we explore the historical context for biomedical research institutions like Johns Hopkins that have worked to build local community trust. In so doing, we consider how the example under focus in this special report can lead to greater consideration of how research institutions balance fostering trust with their other commitments. © 2015 The Hastings Center.

The Expert and the Lay Public: Reflections on Influenza A (H1N1) and the Risk Society

PubMed Central

Williams-Jones, Bryn

2012-01-01

Trust between the lay public and scientific experts is a key element to ensuring the efficient implementation of emergency public health measures. In modern risk societies, the management and elimination of risk have become preeminent drivers of public policy. In this context, the protection of public trust is a complex task. Those actors involved in public health decision-making and implementation (e.g., mass vaccination for influenza A virus) are confronted with growing pressures and responsibility to act. However, they also need to accept the limits of their own expertise and recognize the ability of lay publics to understand and be responsible for public health. Such a shared responsibility for risk management, if grounded in participative public debates, can arguably strengthen public trust in public health authorities and interventions. PMID:22397338

In whom do cancer survivors trust online and offline?

PubMed

Shahrokni, Armin; Mahmoudzadeh, Sanam; Lu, Bryan Tran

2014-01-01

In order to design effective educational intervention for cancer survivors, it is necessary to identify most-trusted sources for health-related information and the amount of attention paid to each source. The objective of our study was to explore the sources of health information used by cancer survivors according to their access to the internet and levels of trust in and attention to those information sources. We analyzed sources of health information among cancer survivors using selected questions adapted from the 2012 Health Information National Trends Survey (HINTS). Of 357 participants, 239 (67%) had internet access (online survivors) while 118 (33%) did not (offline survivors). Online survivors were younger (p<0.001), more educated (p<0.001), more non-Hispanic whites (p<0.001), had higher income (p<0.001), had more populated households (p<0.001) and better quality of life (p<0.001) compared to offline survivors. Prevalence of some disabilities was higher among offline survivors including serious difficulties with walking or climbing stairs (p<0.001), being blind or having severe visual impairment (p=0.001), problems with making decisions (p<0.001), doing errands alone (p=0.001) and dressing or bathing (p=0.001). After adjusting for socio- demographic status, cancer survivors who were non-Hispanic whites (OR=3.49, p<0.01), younger (OR=4.10, p<0.01), more educated (OR=2.29, p=0.02), with greater income (OR=4.43, p<0.01), and with very good to excellent quality of life (OR=2.60, p=0.01) had higher probability of having access to the internet, while those living in Midwest were less likely to have access (OR=0.177, p<0.01). Doctors (95.5%) were the most and radio (27.8%) was the least trusted health related information source among all cancer survivors. Online survivors trusted internet much more compared to those without access (p<0.001) while offline cancer survivors trusted health-related information from religious groups and radio more than those with internet access (p<0.001 and p=0.008). Cancer survivors paid the most attention to health information on newsletters (63.8%) and internet (60.2%) and the least to radio (19.6%). More online survivors paid attention to internet than those without access (68.5% vs 39.1%, p<0.001) while more offline survivors paid attention to radio compared to those with access (26.8% vs 16.5%, p=0.03). Our findings emphasize the importance of improving the access and empowering the different sources of information. Considering that the internet and web technologies are continuing to develop, more attention should be paid to improve access to the internet, provide guidance and maintain the quality of accredited health information websites. Those without internet access should continue to receive health-related information via their most trusted sources.

Organization structure as a moderator of the relationship between procedural justice, interactional justice, perceived organizational support, and supervisory trust.

PubMed

Ambrose, Maureen L; Schminke, Marshall

2003-04-01

Organizational justice researchers recognize the important role organization context plays in justice perceptions, yet few studies systematically examine contextual variables. This article examines how 1 aspect of context--organizational structure--affects the relationship between justice perceptions and 2 types of social exchange relationships, organizational and supervisory. The authors suggest that under different structural conditions, procedural and interactional justice will play differentially important roles in determining the quality of organizational social exchange (as evidenced by perceived organizational support [POS]) and supervisory social exchange (as evidenced by supervisory trust). In particular, the authors hypothesized that the relationship between procedural justice and POS would be stronger in mechanistic organizations and that the relationship between interactional justice and supervisory trust would be stronger in organic organizations. The authors' results support these hypotheses.

A Model for Integrating Ambulatory Surgery Centers Into an Academic Health System Using a Novel Ambulatory Surgery Coordinating Council.

PubMed

Ishii, Lisa; Pronovost, Peter J; Demski, Renee; Wylie, Gill; Zenilman, Michael

2016-06-01

An increasing volume of ambulatory surgeries has led to an increase in the number of ambulatory surgery centers (ASCs). Some academic health systems have aligned with ASCs to create a more integrated care delivery system. Yet, these centers are diverse in many areas, including specialty types, ownership models, management, physician employment, and regulatory oversight. Academic health systems then face challenges in integrating these ASCs into their organizations. Johns Hopkins Medicine created the Ambulatory Surgery Coordinating Council in 2014 to manage, standardize, and promote peer learning among its eight ASCs. The Armstrong Institute for Patient Safety and Quality provided support and a model for this organization through its quality management infrastructure. The physician-led council defined a mission and created goals to identify best practices, uniformly provide the highest-quality patient-centered care, and continuously improve patient outcomes and experience across ASCs. Council members built trust and agreed on a standardized patient safety and quality dashboard to report measures that include regulatory, care process, patient experience, and outcomes data. The council addressed unintentional outcomes and process variation across the system and agreed to standard approaches to optimize quality. Council members also developed a process for identifying future goals, standardizing care practices and electronic medical record documentation, and creating quality and safety policies. The early success of the council supports the continuation of the Armstrong Institute model for physician-led quality management. Other academic health systems can learn from this model as they integrate ASCs into their complex organizations.

Reputation, relationships, risk communication, and the role of trust in the prevention and control of communicable disease: a review.

PubMed

Cairns, Georgina; de Andrade, Marisa; MacDonald, Laura

2013-01-01

Population-level compliance with health protective behavioral advice to prevent and control communicable disease is essential to optimal effectiveness. Multiple factors affect perceptions of trustworthiness, and trust in advice providers is a significant predeterminant of compliance. While competency in assessment and management of communicable disease risks is critical, communications competency may be equally important. Organizational reputation, quality of stakeholder relationships and risk information provision strategies are trust moderating factors, whose impact is strongly influenced by the content, timing and coordination of communications. This article synthesizes the findings of 2 literature reviews on trust moderating communications and communicable disease prevention and control. We find a substantial evidence base on risk communication, but limited research on other trust building communications. We note that awareness of good practice historically has been limited although interest and the availability of supporting resources is growing. Good practice and policy elements are identified: recognition that crisis and risk communications require different strategies; preemptive dialogue and planning; evidence-based approaches to media relations and messaging; and building credibility for information sources. Priority areas for future research include process and cost-effectiveness evaluation and the development of frameworks that integrate communication and biomedical disease control and prevention functions, conceptually and at scale.

CENTERA: A Centralized Trust-Based Efficient Routing Protocol with Authentication for Wireless Sensor Networks †

PubMed Central

Tajeddine, Ayman; Kayssi, Ayman; Chehab, Ali; Elhajj, Imad; Itani, Wassim

2015-01-01

In this paper, we present CENTERA, a CENtralized Trust-based Efficient Routing protocol with an appropriate authentication scheme for wireless sensor networks (WSN). CENTERA utilizes the more powerful base station (BS) to gather minimal neighbor trust information from nodes and calculate the best routes after isolating different types of “bad” nodes. By periodically accumulating these simple local observations and approximating the nodes' battery lives, the BS draws a global view of the network, calculates three quality metrics—maliciousness, cooperation, and compatibility—and evaluates the Data Trust and Forwarding Trust values of each node. Based on these metrics, the BS isolates “bad”, “misbehaving” or malicious nodes for a certain period, and put some nodes on probation. CENTERA increases the node's bad/probation level with repeated “bad” behavior, and decreases it otherwise. Then it uses a very efficient method to distribute the routing information to “good” nodes. Based on its target environment, and if required, CENTERA uses an authentication scheme suitable for severely constrained nodes, ranging from the symmetric RC5 for safe environments under close administration, to pairing-based cryptography (PBC) for hostile environments with a strong attacker model. We simulate CENTERA using TOSSIM and verify its correctness and show some energy calculations. PMID:25648712

CENTERA: a centralized trust-based efficient routing protocol with authentication for wireless sensor networks.

PubMed

Tajeddine, Ayman; Kayssi, Ayman; Chehab, Ali; Elhajj, Imad; Itani, Wassim

2015-02-02

In this paper, we present CENTERA, a CENtralized Trust-based Efficient Routing protocol with an appropriate authentication scheme for wireless sensor networks (WSN). CENTERA utilizes the more powerful base station (BS) to gather minimal neighbor trust information from nodes and calculate the best routes after isolating different types of "bad" nodes. By periodically accumulating these simple local observations and approximating the nodes' battery lives, the BS draws a global view of the network, calculates three quality metrics-maliciousness, cooperation, and compatibility-and evaluates the Data Trust and Forwarding Trust values of each node. Based on these metrics, the BS isolates "bad", "misbehaving" or malicious nodes for a certain period, and put some nodes on probation. CENTERA increases the node's bad/probation level with repeated "bad" behavior, and decreases it otherwise. Then it uses a very efficient method to distribute the routing information to "good" nodes. Based on its target environment, and if required, CENTERA uses an authentication scheme suitable for severely constrained nodes, ranging from the symmetric RC5 for safe environments under close administration, to pairing-based cryptography (PBC) for hostile environments with a strong attacker model. We simulate CENTERA using TOSSIM and verify its correctness and show some energy calculations.

Hospital Trusts productivity in the English NHS: Uncovering possible drivers of productivity variations

PubMed Central

Aragon Aragon, María Jose; Gaughan, James

2017-01-01

Background Health care systems in OECD countries are increasingly facing economic challenges and funding pressures. These normally demand interventions (political, financial and organisational) aimed at improving the efficiency of the health system as a whole and its single components. In 2009, the English NHS Chief Executive, Sir David Nicholson, warned that a potential funding gap of £20 billion should be met by extensive efficiency savings by March 2015. Our study investigates possible drivers of differential Trust performance (productivity) for the financial years 2010/11-2012/13. Methods Following accounting practice, we define Productivity as the ratio of Outputs over Inputs. We analyse variation in both Total Factor and Labour Productivity using ordinary least squares regressions. We explicitly included in our analysis factors of differential performance highlighted in the Nicholson challenge as the sources were the efficiency savings should come from. Explanatory variables include efficiency in resource use measures, Trust and patient characteristics, and quality of care. Results We find that larger Trusts and Foundation Trusts are associated with lower productivity, as are those treating a greater proportion of both older and/or younger patients. Surprisingly treating more patients in their last year of life is associated with higher Labour Productivity. PMID:28767731

Erosion of Trust in the Medical Profession in India: Time for Doctors to Act

PubMed Central

Kane, Sumit; Calnan, Michael

2017-01-01

In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction. PMID:28005537

If you come from a well-known organisation, I will trust you: Exploring and understanding the community's attitudes towards healthcare research in Cambodia.

PubMed

Pol, Sreymom; Fox-Lewis, Shivani; Neou, Leakhena; Parker, Michael; Kingori, Patricia; Turner, Claudia

2018-01-01

To explore Cambodian community members' understanding of and attitudes towards healthcare research. This qualitative study generated data from semi-structured interviews and focus group discussions. This study was conducted at a non-governmental paediatric hospital and in nearby villages in Siem Reap province, Cambodia. A total of ten semi-structured interviews and four focus group discussions were conducted, involving 27 participants. Iterative data collection and analysis were performed concurrently. Data were analysed by thematic content analysis and the coding structure was developed using relevant literature. Participants did not have a clear understanding of what activities related to research compared with those for routine healthcare. Key attitudes towards research were responsibility and trust: personal (trust of the researcher directly) and institutional (trust of the institution as a whole). Villagers believe the village headman holds responsibility for community activities, while the village headman believes that this responsibility should be shared across all levels of the government system. It is essential for researchers to understand the structure and relationship within the community they wish to work with in order to develop trust among community participants. This aids effective communication and understanding among all parties, enabling high quality ethical research to be conducted.

Finance organizations, decisions and emotions.

PubMed

Pixley, Jocelyn

2002-03-01

Analyses of global financial markets are dominated by atomized models of decision-making and behavioural psychology ('exuberance' or 'panic'). In contrast, this paper argues that overwhelmingly, finance organizations rather than 'individuals' make decisions, and routinely use emotions in formulating expectations. Keynes introduced emotion (business confidence and animal spirits) but in economics, emotion remains individualistic and irrational. Luhmann's system theory lies at the other extreme, where emotions like trust and confidence are central variables, functional in the reduction of complexity in sub-systems like the economy. The gap between irrational emotions aggregated to 'herd' behaviour in economics, and 'system trust' applied to finance and money as a 'medium of communication' in sociology, remains largely unfilled. This paper argues that while organizations cannot be said to 'think' or 'feel', they are rational and emotional, because impersonal trust, confidence and their contrary emotions are unavoidable in decision-making due to fundamental uncertainty. These future-oriented emotions are prevalent within and between organizations in the financial sector, primarily in generating expectations. The dynamic of corporate activities of tense and ruthless struggle is a more plausible level of analysis than either financial 'manias' in aggregate or 'system trust'.

Surrogate Motherhood: A Trust-Based Approach.

PubMed

Beier, Katharina

2015-12-01

Because it is often argued that surrogacy should not be treated as contractual, the question arises in which terms this practice might then be couched. In this article, I argue that a phenomenology of surrogacy centering on the notion of trust provides a description that is illuminating from the moral point of view. My thesis is that surrogacy establishes a complex and extended reproductive unit--the "surrogacy triad" consisting of the surrogate mother, the child, and the intending parents--whose constituents are bound together by mutual trustful commitments. Even though a trust-based approach does not provide an ultimate answer to whether surrogacy should be sanctioned or prohibited, it allows for at least some practical suggestions. In particular, I will argue that, under certain conditions, surrogacy is tenable within familial or other significant relationships, and I will stress the necessity of acknowledging the new relationships and moral commitments that result from this practice. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Data-centric protection in DICOM

NASA Astrophysics Data System (ADS)

Künzi, Julien; Petkovic, M.; Koster, Paul

2009-02-01

In this paper we address the problem of privacy protection and trust enhancement in a distributed healthcare eco system. Increased trust in other parties of the eco system encourages medical entities to share data. This increases the availability of data and consequently improves the general quality of health care. We present two different solutions to the above described problem, both being developed using the DICOM standard (Digital Imaging and Communications in Medicine). The first approach, which is partially relying on legislation, uses sticky policies and commitment protocols to enhance trust. We propose to attach the access control policies to the data in the DICOM files. Furthermore, the source of data disclosure makes sure that the destination commits to enforce the policies by obtaining a signature on the policies and thus providing a proof of the commitment by the destination. The second approach aims at increasing trust by technical enforcement. For this purpose, digital rights management (DRM) technology is used. We demonstrate that it is possible to create a DICOM DRM container using the tools provided by this standard, hence still guaranteeing backward compatibility.

Disparate British Breast Reconstruction Utilization: Is Universal Coverage Sufficient to Ensure Expanded Care?

PubMed Central

Offodile, Anaeze C.

2016-01-01

Summary: Our intent is to improve the understanding of the ability of healthcare providers to deliver high-quality care as we approach an era of universal coverage. We adopted 2 unique vantage points in this article: (1) the mandated coverage for immediate breast reconstruction (IBR) surgery as a microcosmic surrogate for universal coverage overall and (2) we then scrutinized the respective IBR utilization rates in a contemporaneous system of 2 healthcare delivery models in the United Kingdom, that is, the public National Health Service trust versus private-sector hospitals. A literature review was performed for IBR rates across public trust and private-sector hospitals in the United Kingdom. The IBR rate among public trust hospitals was 17% compared with 43% in the private sector. In the trust hospital setting, the enactment of 2 government mandates, intended to increase the access to cancer care, seemed to fall short in maximizing the ability of surgical practitioners to deliver quality care to patients. Among women who did not receive IBR, 65% felt that they had received the sufficient amount of information to appropriately inform their decision. In addition, only 46% of this same cohort reported a consultation with a reconstructive surgeon preoperatively. Private-sector hospitals delivered better IBR care because of the likely presence of infrastructure and financial incentives for physicians. These results serve as a call for a better alignment between policy initiatives designed to expand care access and the perogatives of physicians to ensure an optimized delivery of the expanded care such policy mandates. PMID:27482486

Hospital board oversight of quality and safety: a stakeholder analysis exploring the role of trust and intelligence.

PubMed

Millar, Ross; Freeman, Tim; Mannion, Russell

2015-06-16

Hospital boards, those executive members charged with developing appropriate organisational strategies and cultures, have an important role to play in safeguarding the care provided by their organisation. However, recent concerns have been raised over boards' ability to enact their duty to ensure the quality and safety of care. This paper offers critical reflection on the relationship between hospital board oversight and patient safety. In doing so it highlights new perspectives and suggestions for developing this area of study. The article draws on 10 interviews with key informants and policy actors who form part of the 'issue network' interested in the promotion of patient safety in the English National Health Service. The interviews surfaced a series of narratives regarding hospital board oversight of patient safety. These elaborated on the role of trust and intelligence in highlighting the potential dangers and limitations of approaches to hospital board oversight which have been narrowly focused on a risk-based view of organisational performance. In response, a need to engage with the development of trust based organisational relationships is identified, in which effective board oversight is built on 'trust' characterised by styles of leadership and behaviours that are attentive to the needs and concerns of both staff and patients. Effective board oversight also requires the gathering and triangulating of 'intelligence' generated from both national and local information sources. We call for a re-imagination of hospital board oversight in the light of these different perspectives and articulate an emerging research agenda in this area.

Embedding X.509 Digital Certificates in Three-Dimensional Models for Authentication, Authorization, and Traceability of Product Data.

PubMed

Hedberg, Thomas D; Krima, Sylvere; Camelio, Jaime A

2017-03-01

Exchange and reuse of three-dimensional (3D)-product models are hampered by the absence of trust in product-lifecycle-data quality. The root cause of the missing trust is years of "silo" functions (e.g., engineering, manufacturing, quality assurance) using independent and disconnected processes. Those disconnected processes result in data exchanges that do not contain all of the required information for each downstream lifecycle process, which inhibits the reuse of product data and results in duplicate data. The X.509 standard, maintained by the Telecommunication Standardization Sector of the International Telecommunication Union (ITU-T), was first issued in 1988. Although originally intended as the authentication framework for the X.500 series for electronic directory services, the X.509 framework is used in a wide range of implementations outside the originally intended paradigm. These implementations range from encrypting websites to software-code signing, yet X.509 certificate use has not widely penetrated engineering and product realms. Our approach is not trying to provide security mechanisms, but equally as important, our method aims to provide insight into what is happening with product data to support trusting the data. This paper provides a review of the use of X.509 certificates and proposes a solution for embedding X.509 digital certificates in 3D models for authentication, authorization, and traceability of product data. This paper also describes an application within the Aerospace domain. Finally, the paper draws conclusions and provides recommendations for further research into using X.509 certificates in product lifecycle management (PLM) workflows to enable a product lifecycle of trust.

Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala.

PubMed

Hitziger, Martin; Berger Gonzalez, Mónica; Gharzouzi, Eduardo; Ochaíta Santizo, Daniela; Solis Miranda, Regina; Aguilar Ferro, Andrea Isabel; Vides-Porras, Ana; Heinrich, Michael; Edwards, Peter; Krütli, Pius

2017-08-08

Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration. We developed a collaborative, patient-centered boundary mechanism to overcome these challenges and to foster intercultural partnerships in health care. To assess its impact on the quality of intercultural patient care in a medically pluralistic developing country, we conducted and evaluated a case study. The case study took place in Guatemala, since previous efforts to initiate intercultural medical partnerships in this country were hampered by intense historical and societal conflicts. It was designed by a team from ETH Zurich's Transdisciplinarity Lab, the National Cancer Institute of Guatemala, two traditional Councils of Elders and 25 Mayan healers from the Kaqchikel and Q'eqchi' linguistic groups. It was implemented from January 2014 to July 2015. Scientists and traditional political authorities collaborated to facilitate workshops, comparative diagnoses and patient referrals, which were conducted jointly by biomedical and traditional practitioners. The traditional medical practices were thoroughly documented, as were the health-seeking pathways of patients, and the overall impact was evaluated. The boundary mechanism was successful in discerning barriers of access for indigenous patients in the biomedical health system, and in building trust between doctors and healers. Learning outcomes included a reduction of stereotypical attitudes towards traditional healers, improved biomedical procedures due to enhanced self-reflection of doctors, and improved traditional health care due to refined diagnoses and adapted treatment strategies. In individual cases, the beneficial effects of traditional treatments were remarkable, and the doctors continued to collaborate with healers after the study was completed. Comparison of the two linguistic groups illustrated that the outcomes are highly context-dependent. If well adapted to local context, patient-centered boundary mechanisms can enable intercultural partnerships by creating access, building trust and fostering mutual learning, even in circumstances as complex as those in Guatemala. Creating multilateral patient-centered boundary mechanisms is thus a promising approach to improve health care in medically pluralistic developing countries.

The Complex Learning Difficulties and Disabilities Research Project: Developing Meaningful Pathways to Personalised Learning. Executive Summary

ERIC Educational Resources Information Center

Schools Network, 2011

2011-01-01

The Specialist Schools and Academies Trust (SSAT) was commissioned by the Department for Education (DfE) to research ways to improve outcomes for children and young people with the most complex educational needs and disabilities through the development of evidence-based teaching and learning strategies. The programme of research brought together a…

77 FR 38821 - Final Environmental Impact Statement for the Menominee Indian Tribe of Wisconsin's Proposed Fee...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... Menominee Indian Tribe of Wisconsin's Proposed Fee-to-Trust Transfer and Casino-Hotel Project in the City of... casino-hotel complex. This notice also announces the FEIS is now available for public review. Hard copies... develop a casino-hotel complex. The proposed project is located at the site of the existing Dairyland...

The consumer-provider relationship in the dental industry.

PubMed

Griffith, Andrew S; Abratt, Russell

2013-01-01

This article explains how a consumer's level of trust and commitment to his or her dental service provider factors into the relationship between the consumer and the dental professional. Very little research has been done that describes the complexity of this relationship. This article documents the complexity of and influences on that relationship by providing an interaction model of this relationship.

Deploying Team Science Principles to Optimize Interdisciplinary Lung Cancer Care Delivery: Avoiding the Long and Winding Road to Optimal Care.

PubMed

Osarogiagbon, Raymond U; Rodriguez, Hector P; Hicks, Danielle; Signore, Raymond S; Roark, Kristi; Kedia, Satish K; Ward, Kenneth D; Lathan, Christopher; Santarella, Scott; Gould, Michael K; Krasna, Mark J

2016-11-01

The complexity of lung cancer care mandates interaction between clinicians with different skill sets and practice cultures in the routine delivery of care. Using team science principles and a case-based approach, we exemplify the need for the development of real care teams for patients with lung cancer to foster coordination among the multiple specialists and staff engaged in routine care delivery. Achieving coordinated lung cancer care is a high-priority public health challenge because of the volume of patients, lethality of disease, and well-described disparities in quality and outcomes of care. Coordinating mechanisms need to be cultivated among different types of specialist physicians and care teams, with differing technical expertise and practice cultures, who have traditionally functioned more as coactively working groups than as real teams. Coordinating mechanisms, including shared mental models, high-quality communication, mutual trust, and mutual performance monitoring, highlight the challenge of achieving well-coordinated care and illustrate how team science principles can be used to improve quality and outcomes of lung cancer care. To develop the evidence base to support coordinated lung cancer care, research comparing the effectiveness of a diverse range of multidisciplinary care team approaches and interorganizational coordinating mechanisms should be promoted.

2015 National Agenda for Digital Stewardship

DTIC Science & Technology

2014-09-01

tool and framework that explores the aspects of “benefit,” “risk,” “value,”’ “ quality ,” and “sustainability.” It is analyzing previous work on cost...evidence of the value of digital stewardship activities is needed. Improved and sharable metrics about the quality and success of digital stewardship...Significant Properties .................................. 38 5.3.4 Policy Research on Trust Frameworks

Farmers, Trust, and the Market Solution to Water Pollution: The Role of Social Embeddedness in Water Quality Trading

ERIC Educational Resources Information Center

Mariola, Matt J.

2012-01-01

Water quality trading (WQT) is a market arrangement in which a point-source water polluter pays farmers to implement conservation practices and claims the resulting benefits as credits toward meeting a pollution permit. Success rates of WQT programs nationwide are highly variable. Most of the literature on WQT is from an economic perspective…

Developing effective feedback on quality of anaesthetic care: what are its most valuable characteristics from a clinical perspective?

PubMed

D'Lima, Danielle M; Moore, Joanna; Bottle, Alex; Brett, Stephen J; Arnold, Glenn M; Benn, Jonathan

2015-01-01

Research suggests that better feedback from quality and safety indicators leads to enhanced capability of clinicians and departments to improve care and change behaviour. The aim of the current study was to investigate the characteristics of feedback perceived by clinicians to be of most value. Data were collected using a survey designed as part of a wider evaluation of a data feedback initiative in anaesthesia. Eighty-nine consultant anaesthetists from two English NHS acute Trusts completed the survey. Multiple linear regression with hierarchical variable entry was used to investigate which characteristics of feedback predict its perceived usefulness for monitoring variation and improving care. The final model demonstrated that the relevance of the quality indicators to the specific service area (β=0.64, p=0.01) and the credibility of the data as coming from a trustworthy, unbiased source (β=0.55, p=0.01) were the significant predictors, having controlled for all other covariates. For clinicians to engage with effective quality monitoring and feedback, the perceived local relevance of indicators and trust in the credibility of the resulting data are paramount. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Effect of communication style and physician-family relationships on satisfaction with pediatric chronic disease care.

PubMed

Swedlund, Matthew P; Schumacher, Jayna B; Young, Henry N; Cox, Elizabeth D

2012-01-01

Over 8% of children have a chronic disease and many are unable to adhere to treatment. Satisfaction with chronic disease care can impact adherence. We examine how visit satisfaction is associated with physician communication style and ongoing physician-family relationships. We collected surveys and visit videos for 75 children ages 9-16 years visiting for asthma, diabetes, or sickle cell disease management. Raters assessed physician communication style (friendliness, interest, responsiveness, and dominance) from visit videos. Quality of the ongoing relationship was measured with four survey items (parent-physician relationship, child-physician relationship, comfort asking questions, and trust in the physician), while a single item assessed satisfaction. Correlations and chi square were used to assess association of satisfaction with communication style or quality of the ongoing relationship. Satisfaction was positively associated with physician to parent (p < 0.05) friendliness. Satisfaction was also associated with the quality of the ongoing parent-physician (p < 0.001) and child-physician relationships (p < 0.05), comfort asking questions (p < 0.001), and trust (p < 0.01). This shows that both the communication style and the quality of the ongoing relationship contribute to pediatric chronic disease visit satisfaction.

Power and the Association with Relationship Quality in South African Couples: Implications for HIV/AIDS Interventions

PubMed Central

Conroy, Amy A.; McGrath, Nuala; van Rooyen, Heidi; Hosegood, Victoria; Johnson, Mallory O.; Fritz, Katherine; Marr, Alexander; Ngubane, Thulani; Darbes, Lynae A.

2016-01-01

Introduction Power imbalances within sexual relationships have significant implications for HIV prevention in sub-Saharan Africa. Little is known about how power influences the quality of a relationship, which could be an important pathway leading to healthy behavior around HIV/AIDS. Methods This paper uses data from 448 heterosexual couples (896 individuals) in rural KwaZulu-Natal, South Africa who completed baseline surveys from 2012–2014 as part of a couples-based HIV intervention trial. Using an actor-partner interdependence perspective, we assessed: (1) how both partners’ perceptions of power influences their own (i.e., actor effect) and their partner’s reports of relationship quality (i.e., partner effect); and (2) whether these associations differed by gender. We examined three constructs related to power (female power, male equitable gender norms, and shared power) and four domains of relationship quality (intimacy, trust, mutually constructive communication, and conflict). Results For actor effects, shared power was strongly and consistently associated with higher relationship quality across all four domains. The effect of shared power on trust, mutually constructive communication, and conflict were stronger for men than women. The findings for female power and male equitable gender norms were more mixed. Female power was positively associated with women’s reports of trust and mutually constructive communication, but negatively associated with intimacy. Male equitable gender norms were positively associated with men’s reports of mutually constructive communication. For partner effects, male equitable gender norms were positively associated with women’s reports of intimacy and negatively associated with women’s reports of conflict. Conclusions Research and health interventions aiming to improving HIV-related behaviors should consider sources of shared power within couples and potential leverage points for empowerment at the couple level. Efforts solely focused on empowering women should also take the dyadic environment and men’s perspectives into account to ensure positive relationship outcomes. PMID:26859436

Power and the association with relationship quality in South African couples: Implications for HIV/AIDS interventions.

PubMed

Conroy, Amy A; McGrath, Nuala; van Rooyen, Heidi; Hosegood, Victoria; Johnson, Mallory O; Fritz, Katherine; Marr, Alexander; Ngubane, Thulani; Darbes, Lynae A

2016-03-01

Power imbalances within sexual relationships have significant implications for HIV prevention in sub-Saharan Africa. Little is known about how power influences the quality of a relationship, which could be an important pathway leading to healthy behavior around HIV/AIDS. This paper uses data from 448 heterosexual couples (896 individuals) in rural KwaZulu-Natal, South Africa who completed baseline surveys from 2012 to 2014 as part of a couples-based HIV intervention trial. Using an actor-partner interdependence perspective, we assessed: (1) how both partners' perceptions of power influences their own (i.e., actor effect) and their partner's reports of relationship quality (i.e., partner effect); and (2) whether these associations differed by gender. We examined three constructs related to power (female power, male equitable gender norms, and shared power) and four domains of relationship quality (intimacy, trust, mutually constructive communication, and conflict). For actor effects, shared power was strongly and consistently associated with higher relationship quality across all four domains. The effect of shared power on trust, mutually constructive communication, and conflict were stronger for men than women. The findings for female power and male equitable gender norms were more mixed. Female power was positively associated with women's reports of trust and mutually constructive communication, but negatively associated with intimacy. Male equitable gender norms were positively associated with men's reports of mutually constructive communication. For partner effects, male equitable gender norms were positively associated with women's reports of intimacy and negatively associated with women's reports of conflict. Research and health interventions aiming to improving HIV-related behaviors should consider sources of shared power within couples and potential leverage points for empowerment at the couple level. Efforts solely focused on empowering women should also take the dyadic environment and men's perspectives into account to ensure positive relationship outcomes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Toward designing for trust in database automation

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

Duez, P. P.; Jamieson, G. A.

Appropriate reliance on system automation is imperative for safe and productive work, especially in safety-critical systems. It is unsafe to rely on automation beyond its designed use; conversely, it can be both unproductive and unsafe to manually perform tasks that are better relegated to automated tools. Operator trust in automated tools mediates reliance, and trust appears to affect how operators use technology. As automated agents become more complex, the question of trust in automation is increasingly important. In order to achieve proper use of automation, we must engender an appropriate degree of trust that is sensitive to changes in operatingmore » functions and context. In this paper, we present research concerning trust in automation in the domain of automated tools for relational databases. Lee and See have provided models of trust in automation. One model developed by Lee and See identifies three key categories of information about the automation that lie along a continuum of attributional abstraction. Purpose-, process-and performance-related information serve, both individually and through inferences between them, to describe automation in such a way as to engender r properly-calibrated trust. Thus, one can look at information from different levels of attributional abstraction as a general requirements analysis for information key to appropriate trust in automation. The model of information necessary to engender appropriate trust in automation [1] is a general one. Although it describes categories of information, it does not provide insight on how to determine the specific information elements required for a given automated tool. We have applied the Abstraction Hierarchy (AH) to this problem in the domain of relational databases. The AH serves as a formal description of the automation at several levels of abstraction, ranging from a very abstract purpose-oriented description to a more concrete description of the resources involved in the automated process. The connection between an AH for an automated tool and a list of information elements at the three levels of attributional abstraction is then direct, providing a method for satisfying information requirements for appropriate trust in automation. In this paper, we will present our method for developing specific information requirements for an automated tool, based on a formal analysis of that tool and the models presented by Lee and See. We will show an example of the application of the AH to automation, in the domain of relational database automation, and the resulting set of specific information elements for appropriate trust in the automated tool. Finally, we will comment on the applicability of this approach to the domain of nuclear plant instrumentation. (authors)« less

Neophyte experiences of football (soccer) match analysis: a multiple case study approach.

PubMed

McKenna, Mark; Cowan, Daryl Thomas; Stevenson, David; Baker, Julien Steven

2018-03-05

Performance analysis is extensively used in sport, but its pedagogical application is little understood. Given its expanding role across football, this study explored the experiences of neophyte performance analysts. Experiences of six analysis interns, across three professional football clubs, were investigated as multiple cases of new match analysis. Each intern was interviewed after their first season, with archival data providing background information. Four themes emerged from qualitative analysis: (1) "building of relationships" was important, along with trust and role clarity; (2) "establishing an analysis system" was difficult due to tacit coach knowledge, but analysis was established; (3) the quality of the "feedback process" hinged on coaching styles, with balance of feedback and athlete engagement considered essential; (4) "establishing effect" was complex with no statistical effects reported; yet enhanced relationships, role clarity, and improved performances were reported. Other emic accounts are required to further understand occupational culture within performance analysis.

Tailored expectant management in couples with unexplained infertility does not influence their experiences with the quality of fertility care.

PubMed

Kersten, F A M; Hermens, R P G M; Braat, D D M; Tepe, E; Sluijmer, A; Kuchenbecker, W K; Van den Boogaard, N; Mol, B W J; Goddijn, M; Nelen, W L D M

2016-01-01

Do couples who were eligible for tailored expectant management (TEM) and did not start treatment within 6 months after the fertility work-up, have different experiences with the quality of care than couples that were also eligible for TEM but started treatment right after the fertility work-up? Tailored expectant management of at least 6 months in couples with unexplained infertility is not associated with the experiences with quality of care or trust in their physician. In couples with unexplained infertility and a good prognosis of natural conception within 1 year, expectant management for 6-12 months does not compromise ongoing birth rates and is equally as effective as starting medically assisted reproduction immediately. Therefore, TEM is recommended by various international clinical guidelines. Implementation of TEM is still not optimal because of existing barriers on both patient and professional level. An important barrier is the hesitance of professionals to counsel their patients for TEM because they fear that patients will be dissatisfied with care. However, if and how adherence to TEM actually affects the couples' experience with care is unknown. Experiences with the quality care can be measured by evaluating the patient-centredness of care and the patients' trust in their physician. This is a retrospective cross-sectional study. A survey with written questionnaires was performed among all couples who participated in the retrospective audit of guideline adherence on TEM in 25 Dutch clinics. Couples were eligible to participate if they were diagnosed with unexplained infertility and had a good prognosis (>30%) of natural conception within 1 year based on the Hunault prediction model. We used patient's questionnaires to collect data on the couples' experience with the quality of care and possible confounders for their experiences other than having undergone TEM or not. Multilevel regression analyses were performed to investigate case-mix adjusted association of TEM with the patient-centredness of care (PCQ-Infertility) and the patients' trust in their physician (Wake Forest Trust Scale). Couples who adhered to TEM experienced the quality of care on the same level as couples who were exposed to early treatment, i.e. started fertility treatment within 6 months after fertility work-up. There were no associations between adherence to TEM and the patient-centredness of care or the patients' trust in their physician. Because this study is retrospective, recall bias might occur. Furthermore, we were unable to measure the difference in experience with care over time. Therefore, our results have to be interpreted carefully. Prospective research on couples undergoing TEM have to be performed to provide more detailed insight in the patients' experiences with the decision making process and subsequently the expectant period. Tackling the barriers surrounding TEM, i.e. better counselling and more patient information material, could further improve patient experiences with the quality of care for couples who are advised TEM. Supported by Netherlands Organisation for Health Research and Development (ZonMW). ZonMW had no role in designing the study, data collection, analysis and interpretation of data or writing of the report. Competing interests: none. www.trialregister.nl NTR3405. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Is the jury still out on PFI contracts?

PubMed

Baillie, Jonathan

2012-02-01

Last September Andrew Lansley claimed that some NHS Trusts occupying PFI healthcare facilities had been 'landed with deals they could not afford', seemingly attributing much of the blame for a scenario where the Department of Health said 22 Trusts in England alone could be at significant financial risk to Labour, which, in the 1990s, greatly expanded a public/private funding partnership originally introduced by the Tories a decade earlier. Two key factors critics claim have put such Trusts 'at risk' are the 'inflexibility' of some PFI contracts, which makes varying terms difficult mid-contract, and the fact that many of the earlier deals were inexpertly negotiated by the 'public sector side'. HEJ editor Jonathan Baillie sought the views of Malcolm Austwick, a partner at top commercial law firm, DAC Beachcroft (see panel below), with extensive experience in the legal complexities of PFI, on whether or not the initiative's 'pros' do indeed outweigh the 'cons'.

Trauma-focused CBT for youth with complex trauma

PubMed Central

Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

2013-01-01

Objectives Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with complex trauma. Methods TF-CBT treatment phases are described and modifications of timing, proportionality and application are described for youth with complex trauma. Practical applications include a) dedicating proportionally more of the model to the TF-CBT coping skills phase; b) implementing the TF-CBT Safety component early and often as needed throughout treatment; c) titrating gradual exposure more slowly as needed by individual youth; d) incorporating unifying trauma themes throughout treatment; and e) when indicated, extending the TF-CBT treatment consolidation and closure phase to include traumatic grief components and to generalize ongoing safety and trust. Results Recent data from youth with complex trauma support the use of the above TF-CBT strategies to successfully treat these youth. Conclusions The above practical strategies can be incorporated into TF-CBT to effectively treat youth with complex trauma. Practice implications Practical strategies include providing a longer coping skills phase which incorporates safety and appropriate gradual exposure; including relevant unifying themes; and allowing for an adequate treatment closure phase to enhance ongoing trust and safety. Through these strategies therapists can successfully apply TF-CBT for youth with complex trauma. PMID:22749612

Perceptions of work-time and leisure-time among managers and field staff in a UK primary health care trust.

PubMed

Brown, Reva Berman; Adebayo, Shirley A

2004-09-01

The aims of the research were to explore the issues around the perception of District Nurses in an inner London Primary Health Care Trust of their use of work-time and leisure-time, and to reveal how the boundaries between these two aspects can become blurred and impinge on each other. Time use is helpful in considerations of wider issues such as satisfaction at work and work-life balance. The data were collected by a questionnaire to seek the views of managers and field staff on issues such as the impact on the quality of patient care of the nurses' perception of work-time and leisure-time. The research identified the different perception of "work-time" that employees have in relation to their place within the hierarchical structure. The findings answered the question of whether time is perceived differently, dependent on one's occupation within the Trust.

Perceptions of the authority of health information. Case study: digital interactive television and the Internet.

PubMed

Nicholas, David; Huntington, Paul; Williams, Peter; Gunter, Barrie

2003-12-01

As part of a Department of Health funded project nearly 2000 people were surveyed as to their use of two digital health information services, one on the Web and the other on digital interactive television (DiTV). The website was of a commercial company-Surgerydoor-and the DiTV service NHS based. This paper concentrates on the issue of trust in digital health information. Two of the main findings were that advertising was found to have an effect on trust, though the quality and type of advertising will impact in different ways on trustworthiness. DiTV subscribers who had either used the Living Health channel which carried NHS branded health information or had heard of the service, were more likely to say that the NHS was a symbol of trust for them compared with DiTV subscribers who had not used the service.

How improving practice relationships among clinicians and nonclinicians can improve quality in primary care.

PubMed

Lanham, Holly J; McDaniel, Reuben R; Crabtree, Benjamin F; Miller, William L; Stange, Kurt C; Tallia, Alfred F; Nutting, Paula

2009-09-01

Understanding the role of relationships health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Data were drawn from four large National Institutes of Health (NIH)-funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties.

The potential contribution of the Queensland wet tropics region natural resource plan to river improvement and water quality.

PubMed

McDonald, G; Weston, N; Dorrington, B

2003-01-01

This paper reports on work in progress on the new Wet Tropics Regional Natural Resource Management Plan and its potential to deliver river management and water quality outcomes. The plan is being prepared in accordance with the guidelines of the Nation Action Plan for Salinity and Water Quality/Natural Heritage Trust (NAP/NHT2). In particular the paper discusses the technical basis for priorities, target setting and implementation and the most effective instruments for achieving river improvement and water quality outcomes in the region.

Capturing Trust in Social Web Applications

NASA Astrophysics Data System (ADS)

O'Donovan, John

The Social Web constitutes a shift in information flow from the traditional Web. Previously, content was provided by the owners of a website, for consumption by the end-user. Nowadays, these websites are being replaced by Social Web applications which are frameworks for the publication of user-provided content. Traditionally, Web content could be `trusted' to some extent based on the site it originated from. Algorithms such as Google's PageRank were (and still are) used to compute the importance of a website, based on analysis of underlying link topology. In the Social Web, analysis of link topology merely tells us about the importance of the information framework which hosts the content. Consumers of information still need to know about the importance/reliability of the content they are reading, and therefore about the reliability of the producers of that content. Research into trust and reputation of the producers of information in the Social Web is still very much in its infancy. Every day, people are forced to make trusting decisions about strangers on the Web based on a very limited amount of information. For example, purchasing a product from an eBay seller with a `reputation' of 99%, downloading a file from a peer-to-peer application such as Bit-Torrent, or allowing Amazon.com tell you what products you will like. Even something as simple as reading comments on a Web-blog requires the consumer to make a trusting decision about the quality of that information. In all of these example cases, and indeed throughout the Social Web, there is a pressing demand for increased information upon which we can make trusting decisions. This chapter examines the diversity of sources from which trust information can be harnessed within Social Web applications and discusses a high level classification of those sources. Three different techniques for harnessing and using trust from a range of sources are presented. These techniques are deployed in two sample Social Web applications—a recommender system and an online auction. In all cases, it is shown that harnessing an increased amount of information upon which to make trust decisions greatly enhances the user experience with the Social Web application.

Applying Semantic Web technologies to improve the retrieval, credibility and use of health-related web resources.

PubMed

Mayer, Miguel A; Karampiperis, Pythagoras; Kukurikos, Antonis; Karkaletsis, Vangelis; Stamatakis, Kostas; Villarroel, Dagmar; Leis, Angela

2011-06-01

The number of health-related websites is increasing day-by-day; however, their quality is variable and difficult to assess. Various "trust marks" and filtering portals have been created in order to assist consumers in retrieving quality medical information. Consumers are using search engines as the main tool to get health information; however, the major problem is that the meaning of the web content is not machine-readable in the sense that computers cannot understand words and sentences as humans can. In addition, trust marks are invisible to search engines, thus limiting their usefulness in practice. During the last five years there have been different attempts to use Semantic Web tools to label health-related web resources to help internet users identify trustworthy resources. This paper discusses how Semantic Web technologies can be applied in practice to generate machine-readable labels and display their content, as well as to empower end-users by providing them with the infrastructure for expressing and sharing their opinions on the quality of health-related web resources.

How Do Acquired Political Identities Influence Our Neural Processing toward Others within the Context of a Trust Game?

PubMed

Wu, Chien-Te; Fan, Yang-Teng; Du, Ye-Rong; Yang, Tien-Tun; Liu, Ho-Ling; Yen, Nai-Shing; Chen, Shu-Heng; Hsung, Ray-May

2018-01-01

Trust is essential for mutually beneficial human interactions in economic exchange and politics and people's social identities notably have dramatic effects on trust behaviors toward others. Previous literature concerning social identities generally suggests that people tend to show in-group favoritism toward members who share the same identity. However, how our brains process signals of identity while facing uncertain situations in interpersonal interactions remains largely unclear. To address this issue, we performed an fMRI experiment with 54 healthy adults who belonged to two identity groups of opposing political orientations. The identity information of participants was extracted from a large-scale social survey on the 2012 Taiwan presidential election. Accordingly, participants were categorized as either the Kuomintang (KMT) or the Democratic Progressive Party (DPP) supporters. During the experiment, participants played trust games with computer agents with labels of the same or the opposing political identity. Interestingly, our results suggest that the behaviors of the two groups cannot be equally attributed to in-group favoritism. Behaviorally, only the DPP supporter group showed a significant trust preference toward in-group members, which did not hold for the KMT supporter group. Consistently, neurophysiological findings further revealed that only the DPP supporter group showed neuronal responses to both unexpected negative feedback from in-group members in anterior insula, temporoparietal junction, and dorsal lateral prefrontal cortex, as well as to unexpected rewards from out-group members in caudate. These findings therefore suggest that acquired identities play a more complex role in modulating people's social expectation in interpersonal trust behaviors under identity-relevant contexts.

Implications of Aggregated DoD Information Systems for Information Assurance Certification and Accreditation

DTIC Science & Technology

2010-01-01

offshoring, or producing major software components overseas (Defense Science Board, 2009). These trends raise concerns about the level of trust that...7 Software Complexity...7 Increasing Software Vulnerabilities and Malware Population . . . . . . . . . . . . . . . . 9 Limitations of

Presidential address: adjusting the art and the science of surgery.

PubMed

Traverso, L William

2007-10-01

Why are there so many opinions for surgical treatments? Why do surgeons not agree on the same definitions? To adjust the art and science of surgery, we should understand the reason behind this Tower of Babel and ourselves by grasping the three biological lessons of history. These lessons are instincts of man--our instincts have not changed for as long as there has been recorded history. The lessons were elucidated by Will and Ariel Durant and these are competition, selection, and reproduction. How might they be applied to improving our surgical science? First, competition has always forced individuals or small groups to strengthen themselves with cooperation. Cooperate or not survive. Cooperation increases with social development and technology. Next, we must realize that nature relishes diversity. We are all born unequal and diverse. The second biological lesson is selection; which individual among a diverse group of individuals will succeed (by improving)? Therefore, by nature, man's instincts provide diverse opinions and bias. This creates a myopic view when surgeons try to discern the truth. The results are the trendy bandwagons that divert us, like tonsillectomy. Too much diversity is bad, and a balance is required. Man's third lesson of history is reproduction. Better stated is that nature loves quantity. We naturally give priority to quantity over quality. To obtain quality rather than just quantity, we need the antidotes for competition and diversity--that would be cooperation using the Deming guidelines of leadership, profound knowledge, and technology. One example of this urge for quantity and diversity is our lack of standardized definitions. These three biological lessons can be summarized by viewing competition as an impediment for quality improvement in the complex challenges of modern healthcare. Cooperation (trust) is the antidote to the bandwagon effect of unproven treatments. Cooperation and technology can be joined to establish a successful team using the global technology of the internet ("Club Web"). To improve, we must measure real cases in a registry and generate a standard set of definitions and benchmarks. A focus group that trusts each other through the common interest of a disease or organ could succeed. Only then does comparison (and improvement) become possible.

Clostridium difficile multidisciplinary team root cause analysis: impact on clinical care and circumvention of financial penalties posed by clinical commissioning groups, but at what cost?

PubMed

Saeed, Kordo; Petridou, Christina; Gray, Hazel; Dryden, Matthew; Davis-Blues, Karen; Lucero, Sheryl; Parker, Natalie; Keyser, Taryn; Matthews, Tanya; Cortes, Nick; Kidd, Stephen; Thomas, Claire; Peacock, Heather; Hornzee, Joanna; Wake, Bruce

2018-03-01

In Hampshire Hospitals NHS Foundation Trust, in addition to an on-the-spot investigation into hospital-onset Clostridium difficile infection (CDI) by the infection prevention team, a multidisciplinary team root cause analysis (MDT-RCA) forum has been developed. The MDT-RCA aims to deliver a more thorough investigation into individual cases and the recommendation of cases to the clinical commissioning groups (CCG) appeals panel against potential financial penalties (£10,000 per breached case). We mainly aimed to investigate the financial impact of MDT-RCAs to the Trust. Over two years, 84 cases of hospital-onset CDI cases were reviewed by the MDT-RCA forum. Among this cohort, no additional learning outcomes were identified by the MDT-RCAs over those that were found by on-the-spot investigations. In total, 543 staff members attended the MDT-RCAs at a potential cost to the Trust of £23,795.74-£51,670.10. The Trust appealed against financial penalties for 27 cases and 14 were successful, i.e. £140,000 would have been avoided had targets been breached by 14 cases. However, targets were only breached by two cases, meaning only £20,000 in fines was avoided. Deducting this from the total costs of the MDT-RCA meant the Trust lost £3,795.74-£31,670.10. Over the two years reviewed, the MDT-RCA proved to be costly to the Trust, with no additional learning or quality improvement measures identified.

Coaching Quality and Teachers' Implementation of the 4Rs Social-Emotional and Literacy Curriculum: Testing the Link between Two Levels of Intervention Fidelity

ERIC Educational Resources Information Center

Downer, Jason; Brown, Josh; Herrera, Manuela Jimenez; Stuhlman, Megan; Bourassa, Kyle; Gologor, Ben; Wong, Pamela

2013-01-01

Teacher-educators and policy-makers recognize that ongoing training and support for high quality implementation of curricula can be a vital component of systems that ensure the value of education experiences, particularly for students at-risk of school failure (Meisels, 2007; Pew Charitable Trusts, 2007; Pianta, 2005). In particular, there is…

A values-based approach to medical leadership.

PubMed

Moen, Charlotte; Prescott, Patricia

2016-11-02

Integrity, trust and authenticity are essential characteristics of an effective leader, demonstrated through a values-based approach to leadership. This article explores whether Covey's (1989) principle-centred leadership model is a useful approach to developing doctors' leadership qualities and skills.

Trust-Based Service Composition and Binding for Tactical Networks with Multiple Objectives

DTIC Science & Technology

2013-12-01

services, then it will have a set of four-tuple records for each abstract service that it can provide. We assume that the service quality of a SP in...user (i.e., a SR) does not have knowledge of the “best” service quality , so its satisfaction level with services received is based on what has been...hand, when USRm is less than USTm, identifies the culprits with low performance (by comparing the advertised service quality profile with the

Healthy eating in Ukraine: attitudes, barriers and information sources.

PubMed

Biloukha, O; Utermohlen, V

2001-04-01

To identify the major perceived influences on food choice, to examine the use of and trust in information sources concerning healthy eating, and to assess attitudes towards and barriers to adopting healthy eating practices in a post-USSR country (Ukraine). A survey of an urban adult population. The questions were adopted from the Pan-European Union (EU) Survey of Consumer Attitudes to Food, Nutrition and Health (1995-1996). Lviv city, Ukraine. The survey included 296 adults (84 males, 212 females) aged 18-55 years; they were primarily college students and subjects with tertiary education--the groups most likely to be both interested in healthy eating and affected by current socioeconomic downturns. The major factors in food choice were: 'quality/freshness' (cited by 80%), 'price' (58%) and 'taste' (47%); only 34% cited 'trying to eat healthily'. More older people cited 'price' than 'quality/freshness', and men were more likely than women to cite 'taste'. Sources of healthy eating information included: 'relatives/friends' (cited by 65%, trusted by 85%) and health professionals (trusted by 92%, but used by only 35%); while advertising was the least trusted source (cited by 28%). Fifty-three per cent of respondents considered their diet to be healthy enough without further changes; 50% thought of the nutritional aspects of the food they ate; fewer women than men considered their diet healthy, and more women than men thought about nutrition. Barriers to healthy eating included: 'cost' (cited by 65%), 'lack of time' (55%), 'self-control' (54%), 'selection influences' (41%), 'lack of knowledge' (32%), 'unpleasant foods' and 'resistance to change' (both 30%). Strategies to encourage healthy eating in this population should involve word-of-mouth nutrition education concerning low-cost healthy alternatives.

Embedding X.509 Digital Certificates in Three-Dimensional Models for Authentication, Authorization, and Traceability of Product Data

PubMed Central

Hedberg, Thomas D.; Krima, Sylvere; Camelio, Jaime A.

2016-01-01

Exchange and reuse of three-dimensional (3D)-product models are hampered by the absence of trust in product-lifecycle-data quality. The root cause of the missing trust is years of “silo” functions (e.g., engineering, manufacturing, quality assurance) using independent and disconnected processes. Those disconnected processes result in data exchanges that do not contain all of the required information for each downstream lifecycle process, which inhibits the reuse of product data and results in duplicate data. The X.509 standard, maintained by the Telecommunication Standardization Sector of the International Telecommunication Union (ITU-T), was first issued in 1988. Although originally intended as the authentication framework for the X.500 series for electronic directory services, the X.509 framework is used in a wide range of implementations outside the originally intended paradigm. These implementations range from encrypting websites to software-code signing, yet X.509 certificate use has not widely penetrated engineering and product realms. Our approach is not trying to provide security mechanisms, but equally as important, our method aims to provide insight into what is happening with product data to support trusting the data. This paper provides a review of the use of X.509 certificates and proposes a solution for embedding X.509 digital certificates in 3D models for authentication, authorization, and traceability of product data. This paper also describes an application within the Aerospace domain. Finally, the paper draws conclusions and provides recommendations for further research into using X.509 certificates in product lifecycle management (PLM) workflows to enable a product lifecycle of trust. PMID:27840596

Antecedents of hospital nurses' intention to leave the organization: A cross sectional survey.

PubMed

Bobbio, Andrea; Manganelli, Anna Maria

2015-07-01

Leadership and perceived organizational support inspire trust in the leader and in the organization. Consequently, these aspects may contribute to a reduction in job burnout among nurses and, in the end, of the intention on their part to leave the hospital. It is crucial to develop models in order to simultaneously test the correlations between these relevant psychosocial variables, so that complexity of the nursing work environment may be better understood. We expected to give support to and to further corroborate results in the literature linking perceived leadership style – and particularly servant leadership – perceived organizational support, trust in the leader and in the organization, job burnout among nurses and their subsequent intention to leave the hospital. Cross-sectional study. Two Italian large size public hospitals. Two samples including both graduates and non-graduates members of the nursing staff. Overall mean age was equal to 42.06 years while the general mean for tenure was 12.99 years. Data were collected in 2012. A regression model with latent variables was tested via structural equation modeling using LISREL. The multi-sample procedure was also applied in order to test invariance of results between the two samples. Servant leadership was positively associated with trust in the leader and perceived organizational support was positively associated with trust in the organization. Trust in the leader and trust in the organization displayed a negative correlation with the emotional exhaustion and cynicism factors of job burnout, and a positive correlation with the professional efficacy factor. Furthermore, trust scores mediated the effects of servant leadership and perceived organizational support on job burnout factors. The cynicism factor was negatively associated with intention to leave the organization and it also mediated the effects of both trust in the leader and servant leadership on intention to leave. On the other hand, trust in the organization turned out to be directly and negatively related to intention to leave. Servant leadership and perceived organizational support showed their relevance in the nursing setting. The role of trust in the leader, trust in the organization and job burnout factors as mediating variables received support. Interestingly enough, the higher the cynicism score the higher the intention to leave the hospital. The results achieved may have practical implications not only for recruitment and training of nurse managers but also for hospital management. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hospital nurses' lived experiences of intelligent resilience: A phenomenological study.

PubMed

Imani, Behzad; Kermanshahi, Sima Mohamad Khan; Vanaki, Zohreh; Kazemnejad Lili, Anoshiravan

2018-05-01

To explore Iranian hospital nurses' lived experiences of intelligent resilience. Nurses do high levels of emotional work when fulfilling patients' and their family members' complex needs. Intelligent resilience can alleviate nurses' stress and enhance their endurance. This study was based on the Husserlian descriptive phenomenology. A purposive sample of ten hospital nurses was drawn from hospitals affiliated with Hamadan University of Medical Sciences, Hamadan, Iran. In-depth semi-structured interviews were held to collect data. The seven-step data analysis approach proposed by Colaizzi was used for the data analysis. In this study, the adherence to consolidated criteria for reporting qualitative guidelines has been followed. The participating hospital nurses' lived experiences of intelligent resilience came into four main themes of patience and wisdom, reverence, situational self-control and appealing to religiosity. Each of the four main themes included two subthemes which were having peace and wise quietness, reverence for the patients, physicians and nurses, distancing themselves from stressful situations and displacing staff who cause stress, and the nurse's trust in God as well as the patient and his family`s trust in God, respectively. Nurses with intelligent resilience are able to bring peace, reverence for others and situational self-control to stressors thereby providing higher quality of care to their patients. Nurses work in unstable and stressful conditions. The findings of this study provide better understanding about the concept of nurses' intelligent resilience and its indicators and attributes. © 2018 John Wiley & Sons Ltd.

Community action against asthma: examining the partnership process of a community-based participatory research project.

PubMed

Parker, Edith A; Israel, Barbara A; Williams, Melina; Brakefield-Caldwell, Wilma; Lewis, Toby C; Robins, Thomas; Ramirez, Erminia; Rowe, Zachary; Keeler, Gerald

2003-07-01

Community Action Against Asthma (CAAA) is a community-based participatory research (CBPR) project that assesses the effects of outdoor and indoor air quality on exacerbation of asthma in children, and tests household- and neighborhood-level interventions to reduce exposure to environmental asthma triggers. Representatives of community-based organizations, academia, an integrated health system, and the local health department work in partnership on CAAA's Steering Committee (SC) to design and implement the project. To conduct a process evaluation of the CAAA community-academic partnership. In-depth interviews containing open-ended questions were conducted with SC members. Analysis included established methods for qualitative data, including focused coding and constant comparison methods. Community setting in Detroit, Michigan. Twenty-three members of the CAAA SC. Common themes identified by SC members relating to the partnership's ability to achieve project goals and the successes and challenges facing the partnership itself. Identified partnership accomplishments included: successful implementation of a complex project, identification of children with previously undiagnosed asthma, and diverse participation and community influence in SC decisions. Challenges included ensuring all partners' influence in decision-making, the need to adjust to "a different way of doing things" in CBPR, constraints and costs of doing CBPR felt by all partners, ongoing need for communication and maintaining trust, and balancing the needs of science and the community through intervention. CBPR can enhance and facilitate basic research, but care must be given to trust issues, governance issues, organizational culture, and costs of participation for all organizations involved.

Foundation Trusts: economics in the 'postmodern hospital'.

PubMed

Newbold, David

2005-09-01

Foundation Trust Hospitals are community-controlled health care providers which have increased autonomy about how they produce outcomes for the British National Health Service. Although there is a literature on hospital economics it is unclear how these innovative providers will behave, if they have to compete for scarce resources with other hospitals. This paper reviews some of the earlier theories, such as the neoclassical theory of the firm, and discusses their relevance along with 'newer' economic theories such as the transaction costs and evolutionary theory of the firm, plus organizational and human resources theory, to the performance of Foundation Trusts. Much contemporary health care provision is shaped along modernist lines, using scientific endeavour to maximize the impact on health outcomes and technical and social efficiency. However, there is an increasingly postmodern standpoint--critical of modernity--being taken by both patients and hospital staff, to deconstruct processes in the organizations that serve them. Foundation Trusts are postmodern hospitals insomuch as they (to attract scarce resources in a competitive environment), need to marshal the diverse theories of the firm together in order to provide a mass-customized, quality experience, transparently and at least cost--whilst maintaining a stable organizational culture for staff.

Self-reported and employer-recorded sickness absence in doctors.

PubMed

Murphy, I J

2014-09-01

Doctors' sickness absence reduces the quality and continuity of patient care and is financially costly. Doctors have lower rates of sickness absence than other healthcare workers. To compare self-reported with recorded sickness absence in doctors in a UK National Health Service hospital trust. A retrospective questionnaire study. The main outcome measures were self-reported and trust-recorded sickness absence episodes of 4 days or more in two consecutive 6-month periods. The response rate was 82% (607/736). Self-reported sickness absence rates were 1.2% compared with a rate of 0.6% from trust-recorded data. There were 38 matched pairs of self-reported (mean duration: 18 days, standard deviation: 22 days) and trust-recorded (mean duration: 10 days, standard deviation: 17 days) sickness absence episodes of 4 days or more in the 12 months studied. A matched pairs t-test determined that the difference between the two means was significant (t = 2.57, P < 0.05). Doctors' sickness absence was significantly under-recorded in this study population. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Who regulates food? Australians' perceptions of responsibility for food safety.

PubMed

Henderson, Julie; Coveney, John; Ward, Paul

2010-01-01

Food scares have diminished trust in public institutions to guarantee food safety. Food governance after the food scare era is concerned with institutional independence and transparency leading to a hybrid of public and private sector management and to mechanisms for consumer involvement in food governance. This paper explores Australian consumers' perceptions of who is, and should be responsible for food safety. Forty-seven participants were interviewed as part of a larger study on trust in the food system. Participants associate food governance with government, industry, and the individual. While few participants can name the national food regulator, there is a strong belief that the government is responsible for regulating the quality and safety of food. Participants are wary of the role of the food industry in food safety, believing that profit motives will undermine effective food regulation. Personal responsibility for food safety practices was also identified. While there are fewer mechanisms for consumer involvement and transparency built into the food governance system, Australian consumers display considerable trust in government to protect food safety. There is little evidence of the politicisation of food, reflecting a level of trust in the Australian food governance system that may arise from a lack of exposure to major food scares.

Overview of the TriBITS Lifecycle Model: Lean/Agile Software Lifecycle Model for Research-based Computational Science and Engineering Software

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

Bartlett, Roscoe A; Heroux, Dr. Michael A; Willenbring, James

2012-01-01

Software lifecycles are becoming an increasingly important issue for computational science & engineering (CSE) software. The process by which a piece of CSE software begins life as a set of research requirements and then matures into a trusted high-quality capability is both commonplace and extremely challenging. Although an implicit lifecycle is obviously being used in any effort, the challenges of this process--respecting the competing needs of research vs. production--cannot be overstated. Here we describe a proposal for a well-defined software lifecycle process based on modern Lean/Agile software engineering principles. What we propose is appropriate for many CSE software projects thatmore » are initially heavily focused on research but also are expected to eventually produce usable high-quality capabilities. The model is related to TriBITS, a build, integration and testing system, which serves as a strong foundation for this lifecycle model, and aspects of this lifecycle model are ingrained in the TriBITS system. Indeed this lifecycle process, if followed, will enable large-scale sustainable integration of many complex CSE software efforts across several institutions.« less

Scepticism and Trust: Two Counterpoint Essentials in Science Education for Complex Socio-Scientific Issues

ERIC Educational Resources Information Center

Fensham, Peter J.

2014-01-01

In this response to Tom G. K. Bryce and Stephen P. Day's ("Cult Stud Sci Educ." doi:10.1007/s11422-013-9500-0, 2013) original article, I share with them their interest in the teaching of climate change in school science, but I widen it to include other contemporary complex socio-scientific issues that also need to be discussed. I…

Trust, emotion, sex, politics, and science: surveying the risk-assessment battlefield.

PubMed

Slovic, P

1999-08-01

Risk management has become increasingly politicized and contentious. Polarized views, controversy, and conflict have become pervasive. Research has begun to provide a new perspective on this problem by demonstrating the complexity of the concept "risk" and the inadequacies of the traditional view of risk assessment as a purely scientific enterprise. This paper argues that danger is real, but risk is socially constructed. Risk assessment is inherently subjective and represents a blending of science and judgment with important psychological, social, cultural, and political factors. In addition, our social and democratic institutions, remarkable as they are in many respects, breed distrust in the risk arena. Whoever controls the definition of risk controls the rational solution to the problem at hand. If risk is defined one way, then one option will rise to the top as the most cost-effective or the safest or the best. If it is defined another way, perhaps incorporating qualitative characteristics and other contextual factors, one will likely get a different ordering of action solutions. Defining risk is thus an exercise in power. Scientific literacy and public education are important, but they are not central to risk controversies. The public is not irrational. Their judgments about risk are influenced by emotion and affect in a way that is both simple and sophisticated. The same holds true for scientists. Public views are also influenced by worldviews, ideologies, and values; so are scientists' views, particularly when they are working at the limits of their expertise. The limitations of risk science, the importance and difficulty of maintaining trust, and the complex, sociopolitical nature of risk point to the need for a new approach--one that focuses upon introducing more public participation into both risk assessment and risk decision making in order to make the decision process more democratic, improve the relevance and quality of technical analysis, and increase the legitimacy and public acceptance of the resulting decisions.

Trusts' forward-thinking approach recognised.

PubMed

Herring, Phillip

2017-05-01

It is often said that the quality of the parking experience at a hospital or other healthcare facility makes one of the most lasting impressions on visitors. HEJ editor, Jonathan Baillie, spoke to Phillip Herring, managing director at Indigo, the UK arm of one of Europe's leading 'bespoke parking solution' providers, to discover how, harnessing first-class customer service, the latest technology, and the ability to offer anything from simple car park management to 30-year Design Build Finance Operate (DBFO) packages, the company is looking to extend a UK healthcare parking contract portfolio which already sees it work with 11 NHS Trusts across England, Scotland, and Wales.

From pamphlets to podcasts: health information at Great Ormond Street Hospital for Children NHS trust.

PubMed

Moult, Beki; Stephenson, Paula; Geddes, Nicholas; Webb, Jo

2009-06-01

This paper outlines the development of information for children and families at Great Ormond Street Hospital for Children NHS Trust. Starting in 1995, guidelines for producing written information have been developed and a regular audit programme carried out, resulting in information of consistently high quality being produced. The 'rules' set out for the provision of written information have now been developed to cover multimedia information, so that technology can be harnessed to develop podcasts and other non-written information materials. Technical processes are explained both for production and delivery. Future plans for multimedia information are also outlined.

UK National Data Guardian for Health and Care's Review of Data Security: Trust, better security and opt-outs.

PubMed

Chan, Tom; Di Iorio, Concetta Tania; De Lusignan, Simon; Lo Russo, Daniel; Kuziemsky, Craig; Liaw, Siaw-Teng

2016-12-20

Sharing health and social care data is essential to the delivery of high quality health care as well as disease surveillance, public health, and for conducting research. However, these societal benefits may be constrained by privacy and data protection principles. Hence, societies are striving to find a balance between the two competing public interests. Whilst the spread of IT advancements in recent decades has increased the demand for an increased privacy and data protection in many ways health is a special case. UK are adopting guidelines, codes of conduct and regulatory instruments aimed to implement privacy principles into practical settings and enhance public trust. Accordingly, in 2015, the UK National Data Guardian (NDG) requested to conduct a further review of data protection, referred to as Caldicott 3.  The scope of this review is to strengthen data security standards and confidentiality. It also proposes a consent system based on an "opt-out" model rather than on "opt-in.Across Europe as well as internationally the privacy-health data sharing balance is not fixed.  In Europe enactment of the new EU Data Protection Regulation in 2016 constitute a major breakthrough, which is likely to have a profound effect on European countries and beyond.  In Australia and across North America different ways are being sought to balance out these twin requirements of a modern society - to preserve privacy alongside affording high quality health care for an ageing population.  Whilst in the UK privacy legal framework remains complex and fragmented into different layers of legislation, which may negatively impact on both the rights to privacy and health the UK is at the forefront in the uptake of international and EU privacy and data protection principles. And, if the privacy regime were reorganised in a more comprehensive manner, it could be used as a sound implementation model for other countries.

Healthcare quality improvement -- policy implications and practicalities.

PubMed

Esain, Ann Elizabeth; Williams, Sharon J; Gakhal, Sandeep; Caley, Lynne; Cooke, Matthew W

2012-01-01

This article aims to explore quality improvement (QI) at individual, group and organisational level. It also aims to identify restraining forces using formative evaluation and discuss implications for current UK policy, particularly quality, innovation, productivity and prevention. Learning events combined with work-based projects, focusing on individual and group responses are evaluated. A total of 11 multi-disciplinary groups drawn from NHS England healthcare Trusts (self-governing operational groups) were sampled. These Trusts have different geographic locations and participants were drawn from primary, secondary and commissioning arms. Mixed methods: questionnaires, observations and reflective accounts were used. The paper finds that solution versus problem identification causes confusion and influences success. Time for problem solving to achieve QI was absent. Feedback and learning structures are often not in place or inflexible. Limited focus on patient-centred services may be related to past assumptions regarding organisational design, hence assumptions and models need to be understood and challenged. The authors revise the Plan, Do, Study; Act (PDSA) model by adding an explicit problem identification step and hence avoiding solution-focused habits; demonstrating the need for more formative evaluations to inform managers and policy makers about healthcare QI processes. - Although UK-centric, the quality agenda is a USA and European theme, findings may help those embarking on this journey or those struggling with QI.

Implementing clinical governance in English primary care groups/trusts: reconciling quality improvement and quality assurance.

PubMed

Campbell, S M; Sheaff, R; Sibbald, B; Marshall, M N; Pickard, S; Gask, L; Halliwell, S; Rogers, A; Roland, M O

2002-03-01

To investigate the concept of clinical governance being advocated by primary care groups/trusts (PCG/Ts), approaches being used to implement clinical governance, and potential barriers to its successful implementation in primary care. Qualitative case studies using semi-structured interviews and documentation review. Twelve purposively sampled PCG/Ts in England. Fifty senior staff including chief executives, clinical governance leads, mental health leads, and lay board members. Participants' perceptions of the role of clinical governance in PCG/Ts. PCG/Ts recognise that the successful implementation of clinical governance in general practice will require cultural as well as organisational changes, and the support of practices. They are focusing their energies on supporting practices and getting them involved in quality improvement activities. These activities include, but move beyond, conventional approaches to quality assessment (audit, incentives) to incorporate approaches which emphasise corporate and shared learning. PCG/Ts are also engaged in setting up systems for monitoring quality and for dealing with poor performance. Barriers include structural barriers (weak contractual levers to influence general practices), resource barriers (perceived lack of staff or money), and cultural barriers (suspicion by practice staff or problems overcoming the perceived blame culture associated with quality assessment). PCG/Ts are focusing on setting up systems for implementing clinical governance which seek to emphasise developmental and supportive approaches which will engage health professionals. Progress is intentionally incremental but formidable challenges lie ahead, not least reconciling the dual role of supporting practices while monitoring (and dealing with poor) performance.

Introduction of clerking pro forma for surgical spinal patients at the Royal National Orthopaedic Hospital NHS Trust (London): an audit cycle.

PubMed

Pace, Valerio; Farooqi, Omar; Kennedy, James; Park, Chang; Cowan, Joseph

2018-05-01

As a tertiary referral centre of spinal surgery, the Royal National Orthopaedic Hospital (RNOH) handles hundreds of spinal cases a year, often with complex pathology and complex care needs. Despite this, issues were raised at the RNOH following lack of sufficient documentation of preoperative and postoperative clinical findings in spinal patients undergoing major surgery. This is not in keeping with guidelines provided by the Royal College of Surgeons. The authors believe that a standardised clerking pro forma for surgical spinal patients admitted to RNOH would improve the quality of care provided. Therefore, the use of a standard clerking pro forma for all surgical spinal patients could be a useful tool enabling improvements in patients care and safety in keeping with General Medical Council/National Institute for Health and Care Excellence guidelines. An audit (with closure of loop) looking into the quality of the preoperative and postoperative clinical documentation for surgical spinal patients was carried out at the RNOH in 2016 (retrospective case note audit comparing preintervention and postintervention documentation standards). Our standardised pro forma allows clinicians to best utilise their time and standardises examination to be compared in a temporal manner during the patients admission and care. It is the authors understanding that this work is a unique study looking at the quality of the admission clerking for surgical spinal patients. Evidently, there remains work to be done for the widespread utilisation of the pro forma. Early results suggest that such a pro forma can significantly improve the documentation in admission clerking with improvements in the quality of care for patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Technology Acceptance Model for Wireless Internet.

ERIC Educational Resources Information Center

Lu, June; Yu, Chun-Sheng; Liu, Chang; Yao, James E.

2003-01-01

Develops a technology acceptance model (TAM) for wireless Internet via mobile devices (WIMD) and proposes that constructs, such as individual differences, technology complexity, facilitating conditions, social influences, and wireless trust environment determine user-perceived short and long-term usefulness, and ease of using WIMD. Twelve…

How Do Acquired Political Identities Influence Our Neural Processing toward Others within the Context of a Trust Game?

PubMed Central

Wu, Chien-Te; Fan, Yang-Teng; Du, Ye-Rong; Yang, Tien-Tun; Liu, Ho-Ling; Yen, Nai-Shing; Chen, Shu-Heng; Hsung, Ray-May

2018-01-01

Trust is essential for mutually beneficial human interactions in economic exchange and politics and people’s social identities notably have dramatic effects on trust behaviors toward others. Previous literature concerning social identities generally suggests that people tend to show in-group favoritism toward members who share the same identity. However, how our brains process signals of identity while facing uncertain situations in interpersonal interactions remains largely unclear. To address this issue, we performed an fMRI experiment with 54 healthy adults who belonged to two identity groups of opposing political orientations. The identity information of participants was extracted from a large-scale social survey on the 2012 Taiwan presidential election. Accordingly, participants were categorized as either the Kuomintang (KMT) or the Democratic Progressive Party (DPP) supporters. During the experiment, participants played trust games with computer agents with labels of the same or the opposing political identity. Interestingly, our results suggest that the behaviors of the two groups cannot be equally attributed to in-group favoritism. Behaviorally, only the DPP supporter group showed a significant trust preference toward in-group members, which did not hold for the KMT supporter group. Consistently, neurophysiological findings further revealed that only the DPP supporter group showed neuronal responses to both unexpected negative feedback from in-group members in anterior insula, temporoparietal junction, and dorsal lateral prefrontal cortex, as well as to unexpected rewards from out-group members in caudate. These findings therefore suggest that acquired identities play a more complex role in modulating people’s social expectation in interpersonal trust behaviors under identity-relevant contexts. PMID:29456496

Sensing risk, fearing uncertainty: systems science approach to change

PubMed Central

Janecka, Ivo P.

2014-01-01

Background: Medicine devotes its primary focus to understanding change, from cells to network relationships; observations of non-linearity are inescapable. Recent events provide extraordinary examples of major non-linear surprises within the societal system: human genome-from anticipated 100,000+ genes to only 20,000+; junk DNA-initially ignored but now proven to control genetic processes; economic reversals-bursting of bubbles in technology, housing, finance; foreign wars; relentless rise in obesity, neurodegenerative diseases. There are two attributes of systems science that are especially relevant to this research: One—it offers a method for creating a structural context with a guiding path to pragmatic knowledge; and, two—it gives pre-eminence to sensory input capable to register, evaluate, and react to change. Materials/Methods: Public domain records of change, during the last 50 years, have been studied in the context of systems science, the dynamic systems model, and various cycles. Results/Conclusions: Change is dynamic, ever-present, never isolated, and of variable impact; it reflects innumerable relationships among contextual systems; change can be perceived as risk or uncertainty depending upon how the assessment is made; risk is quantifiable by sensory input and generates a degree of rational optimism; uncertainty is not quantifiable and evokes fear; trust is key to sharing risk; the measurable financial credit can be a proxy for societal trust; expanding credit dilutes trust; when a credit bubble bursts, so will trust; absence of trust paralyzes systems' relationships leading to disorganized complexity which prevents value creation and heightens the probability of random events; disappearance of value, accompanied by chaos, threatens all systems. From personal health to economic sustainability and collective rationality, most examined components of the societal system were found not to be optimized and trust was not in evidence. PMID:24744723

Sensing risk, fearing uncertainty: systems science approach to change.

PubMed

Janecka, Ivo P

2014-01-01

Medicine devotes its primary focus to understanding change, from cells to network relationships; observations of non-linearity are inescapable. Recent events provide extraordinary examples of major non-linear surprises within the societal system: human genome-from anticipated 100,000+ genes to only 20,000+; junk DNA-initially ignored but now proven to control genetic processes; economic reversals-bursting of bubbles in technology, housing, finance; foreign wars; relentless rise in obesity, neurodegenerative diseases. There are two attributes of systems science that are especially relevant to this research: One-it offers a method for creating a structural context with a guiding path to pragmatic knowledge; and, two-it gives pre-eminence to sensory input capable to register, evaluate, and react to change. Public domain records of change, during the last 50 years, have been studied in the context of systems science, the dynamic systems model, and various cycles. Change is dynamic, ever-present, never isolated, and of variable impact; it reflects innumerable relationships among contextual systems; change can be perceived as risk or uncertainty depending upon how the assessment is made; risk is quantifiable by sensory input and generates a degree of rational optimism; uncertainty is not quantifiable and evokes fear; trust is key to sharing risk; the measurable financial credit can be a proxy for societal trust; expanding credit dilutes trust; when a credit bubble bursts, so will trust; absence of trust paralyzes systems' relationships leading to disorganized complexity which prevents value creation and heightens the probability of random events; disappearance of value, accompanied by chaos, threatens all systems. From personal health to economic sustainability and collective rationality, most examined components of the societal system were found not to be optimized and trust was not in evidence.

A model for (re)building consumer trust in the food system.

PubMed

Wilson, Annabelle M; Withall, Elizabeth; Coveney, John; Meyer, Samantha B; Henderson, Julie; McCullum, Dean; Webb, Trevor; Ward, Paul R

2017-12-01

The article presents a best practice model that can be utilized by food system actors to assist with (re)building trust in the food system, before, during and after a food incident defined as 'any situation within the food supply chain where there is a risk or potential risk of illness or confirmed illness or injury associated with the consumption of a food or foods' (Commonwealth of Australia. National Food Incident Response Protocol. Commonwealth of Australia, Canberra, 2012). Interviews were undertaken with 105 actors working within the media, food industry and food regulatory settings across Australia, New Zealand (NZ) and the United Kingdom (UK). Interview data produced strategy statements, which indicated participant views on how to (re)build consumer trust in the food system. These included: (i) be transparent, (ii) have protocols and procedures in place, (iii) be credible, (iv) be proactive, (v) put consumers first, (vi) collaborate with stakeholders, (vii) be consistent, (viii) educate stakeholders and consumers, (ix) build your reputation and (x) keep your promises. A survey was designed to enable participants to indicate their agreement/disagreement with the ideas, rate their importance and provide further comment. The five strategies considered key to (re)building consumer trust were used to develop a model demonstrating best practice strategies for (re)building consumer trust in the food system before, during and after a food incident. In a world where the food system is increasingly complex, strategies for (re)building and fostering consumer trust are important. This study offers a model to do so which is derived from the views and experiences of actors working across the food industry, food regulation and the media. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

36 CFR 1010.1 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... an impact on the human environment; (d) Develop and utilize ecological, cultural, and other..., available resources, and national policy, to protect and enhance the quality of the human environment; (b... the participation, where appropriate, of Federal, State, and local authorities and the public in Trust...

Understanding Command and Control

DTIC Science & Technology

2006-01-01

and may be stereotyped by role or function. For example, differing degrees of trust may be an initial default depending on whether the relationship is...quality and authenticity become extremely important. Indeed, this type of information sharing allows the users to pull information, which is a genu

32 CFR 651.36 - Public involvement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... to open decision-making and builds the necessary community trust that sustains the Army in the long... National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY... information on public involvement requirements). (b) Environmental agencies and the public will be involved to...

Social capital and active membership in the Ghana National Health Insurance Scheme - a mixed method study.

PubMed

Fenenga, Christine J; Nketiah-Amponsah, Edward; Ogink, Alice; Arhinful, Daniel K; Poortinga, Wouter; Hutter, Inge

2015-11-02

People's decision to enroll in a health insurance scheme is determined by socio-cultural and socio-economic factors. On request of the National health Insurance Authority (NHIA) in Ghana, our study explores the influence of social relationships on people's perceptions, behavior and decision making to enroll in the National Health Insurance Scheme. This social scheme, initiated in 2003, aims to realize accessible quality healthcare services for the entire population of Ghana. We look at relationships of trust and reciprocity between individuals in the communities (so called horizontal social capital) and between individuals and formal health institutions (called vertical social capital) in order to determine whether these two forms of social capital inhibit or facilitate enrolment of clients in the scheme. Results can support the NHIA in exploiting social capital to reach their objective and strengthen their policy and practice. We conducted 20 individual- and seven key-informant interviews, 22 focus group discussions, two stakeholder meetings and a household survey, using a random sample of 1903 households from the catchment area of 64 primary healthcare facilities. The study took place in Greater Accra Region and Western Regions in Ghana between June 2011 and March 2012. While social developments and increased heterogeneity seem to reduce community solidarity in Ghana, social networks remain common in Ghana and are valued for their multiple benefits (i.e. reciprocal trust and support, information sharing, motivation, risk sharing). Trusting relations with healthcare and insurance providers are, according healthcare clients, based on providers' clear communication, attitude, devotion, encouragement and reliability of services. Active membership of the NHIS is positive associated with community trust, trust in healthcare providers and trust in the NHIS (p-values are .009, .000 and .000 respectively). Social capital can motivate clients to enroll in health insurance. Fostering social capital through improving information provision to communities and engaging community groups in health care and NHIS services can facilitate peoples' trust in these institutions and their active participation in the scheme.

Improving the implementation of NICE public health workplace guidance: an evaluation of the effectiveness of action-planning workshops in NHS trusts in England.

PubMed

Jones, Sarah; Sloan, David; Evans, Hannah E R; Williams, Sian

2015-08-01

There is evidence that health and well-being of the National Health Service (NHS) workforce affects organizational and patient outcomes. A Cochrane review of the effectiveness of clinical audit to improve quality of care has shown great variation between studies, depending on the design and intensity of support offered. This study evaluates the effectiveness of an organizational audit methodology with (1) action-planning workshops and follow-up and (2) audit feedback alone, to support the implementation of the National Institute for Health and Care Excellence (NICE) workplace guidance. Two rounds of audit using a self-administered online questionnaire were conducted. An overall implementation score was devised for each trust. Following round 1, interviews were conducted with a cohort of trusts with high scores. The interviews used a theory-based framework to identify predictors of and barriers to successful implementation. From this, the content for action-planning workshops was devised and workshops held with lower scoring trusts. The remaining trusts received only written feedback on their audit results. Changes in the implementation score between rounds 1 and 2 were compared within and between cohorts. The median improvement in scores between rounds 1 and 2 was statistically significant except where baseline score was high. The improvement for trusts who received workshops was very much better than those who did not (P < 0.001). This difference remained after adjustment using stratification by baseline score (P = 0.001). Audit, combined with action-planning workshops and follow-up, appears to be more effective in improving implementation of NICE workplace health and well-being guidance than audit with feedback alone. © 2015 John Wiley & Sons, Ltd.

Older people and falls: health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fall.

PubMed

Roe, Brenda; Howell, Fiona; Riniotis, Konstantinos; Beech, Roger; Crome, Peter; Ong, Bie Nio

2009-08-01

This study has investigated older people's experiences of a recent fall, its impact on their health, lifestyle, quality of life, care networks, prevention and their views on service use. Falls are common in older people and prevalence increases with age. Falls prevention is a major policy and service initiative. An exploratory, qualitative design involving two time points. A convenience sample of 27 older people from two primary care trusts who had a recent fall. Taped semi structured qualitative interviews were conducted and repeated at follow up to detect change over time and repeat falls. Data were collected on their experience of falls, health, activities of living, lifestyle, quality of life, use of services, prevention of falls, informal care and social networks. Content analysis of transcribed interviews identified key themes. The majority of people fell indoors (n = 23), were repeat fallers (n = 22) with more than half alone when they fell (n = 15). For five people it was their first ever fall. Participants in primary care trust 1 had a higher mean age than those in primary care trust 2 and had more injurious falls (n = 12, mean age 87 years vs. n = 15, mean age 81 years). The majority of non-injurious falls went unreported to formal services. Falls can result in a decline in health status, ability to undertake activities of living, lifestyle and quality of life. Local informal care and support networks are as important as formal care for older people at risk of falls or who have fallen. Access to falls prevention programmes and services is limited for people living in more rural communities. Falls prevention initiatives and services should work with local communities, agencies and informal carers to ensure equitable access and provision of information, resources and care to meet the needs of older people at risk or who have fallen.

Ward round template: enhancing patient safety on ward rounds.

PubMed

Gilliland, Niall; Catherwood, Natalie; Chen, Shaouyn; Browne, Peter; Wilson, Jacob; Burden, Helena

2018-01-01

Concerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety. These parameters were based on Trust patient safety guidance and CQUIN targets. The quality improvement technique of plan-do-study-act (PDSA) was used in this project. We retrospectively reviewed ward round entries to record baseline measurements, based on the above described parameters, prior to making any changes. Following this, the change applied was the introduction of a ward round template to include the highlighted important baseline parameters. Monthly PDSA cycles are performed, and baseline measurements are re-examined, then relevant changes were made to the ward round template. Documentation of baseline measurements was poor prior to introduction of the ward round template; this improved significantly following introduction of a standardised ward round template. Following three cycles, documentation of VTE risk assessments increased from 14% to 92%. Antibiotic stewardship documentation went from 0% to 100%. Use of the TEP form went from 29% to 78%. Following introduction of the ward round template, compliance improved significantly in all safety parameters. Important safety measures being discussed on ward rounds will lead to enhanced patient safety and will improve compliance to Trust guidance and comissioning for quality and innovation (CQUIN) targets. Ongoing change implementation will focus on improving compliance with usage of the template on all urology ward rounds.

The influence of power dynamics and trust on multidisciplinary collaboration: a qualitative case study of type 2 diabetes mellitus

PubMed Central

2012-01-01

Background Ongoing care for chronic conditions such as diabetes is best provided by a range of health professionals working together. There are challenges in achieving this where collaboration crosses organisational and sector boundaries. The aim of this article is to explore the influence of power dynamics and trust on collaboration between health professionals involved in the management of diabetes and their impact on patient experiences. Methods A qualitative case study conducted in a rural city in Australia. Forty five health service providers from nineteen organisations (including fee-for-service practices and block funded public sector services) and eight patients from two services were purposively recruited. Data was collected through semi-structured interviews that were audio-taped and transcribed. A thematic analysis approach was used using a two-level coding scheme and cross-case comparisons. Results Three themes emerged in relation to power dynamics between health professionals: their use of power to protect their autonomy, power dynamics between private and public sector providers, and reducing their dependency on other health professionals to maintain their power. Despite the intention of government policies to support more shared decision-making, there is little evidence that this is happening. The major trust themes related to role perceptions, demonstrated competence, and the importance of good communication for the development of trust over time. The interaction between trust and role perceptions went beyond understanding each other's roles and professional identity. The level of trust related to the acceptance of each other's roles. The delivery of primary and community-based health services that crosses organisational boundaries adds a layer of complexity to interprofessional relationships. The roles of and role boundaries between and within professional groups and services are changing. The uncertainty and vulnerability associated with these changes has affected the level of trust and mistrust. Conclusions Collaboration across organisational boundaries remains challenging. Power dynamics and trust affect the strategic choices made by each health professional about whether to collaborate, with whom, and to what level. These decisions directly influenced patient experiences. Unlike the difficulties in shifting the balance of power in interprofessional relationships, trust and respect can be fostered through a mix of interventions aimed at building personal relationships and establishing agreed rules that govern collaborative care and that are perceived as fair. PMID:22413897

The influence of power dynamics and trust on multidisciplinary collaboration: a qualitative case study of type 2 diabetes mellitus.

PubMed

McDonald, Julie; Jayasuriya, Rohan; Harris, Mark Fort

2012-03-13

Ongoing care for chronic conditions such as diabetes is best provided by a range of health professionals working together. There are challenges in achieving this where collaboration crosses organisational and sector boundaries. The aim of this article is to explore the influence of power dynamics and trust on collaboration between health professionals involved in the management of diabetes and their impact on patient experiences. A qualitative case study conducted in a rural city in Australia. Forty five health service providers from nineteen organisations (including fee-for-service practices and block funded public sector services) and eight patients from two services were purposively recruited. Data was collected through semi-structured interviews that were audio-taped and transcribed. A thematic analysis approach was used using a two-level coding scheme and cross-case comparisons. Three themes emerged in relation to power dynamics between health professionals: their use of power to protect their autonomy, power dynamics between private and public sector providers, and reducing their dependency on other health professionals to maintain their power. Despite the intention of government policies to support more shared decision-making, there is little evidence that this is happening. The major trust themes related to role perceptions, demonstrated competence, and the importance of good communication for the development of trust over time. The interaction between trust and role perceptions went beyond understanding each other's roles and professional identity. The level of trust related to the acceptance of each other's roles. The delivery of primary and community-based health services that crosses organisational boundaries adds a layer of complexity to interprofessional relationships. The roles of and role boundaries between and within professional groups and services are changing. The uncertainty and vulnerability associated with these changes has affected the level of trust and mistrust. Collaboration across organisational boundaries remains challenging. Power dynamics and trust affect the strategic choices made by each health professional about whether to collaborate, with whom, and to what level. These decisions directly influenced patient experiences. Unlike the difficulties in shifting the balance of power in interprofessional relationships, trust and respect can be fostered through a mix of interventions aimed at building personal relationships and establishing agreed rules that govern collaborative care and that are perceived as fair.

Putting the ‘patient’ in patient safety: a qualitative study of consumer experiences

PubMed Central

Rathert, Cheryl; Brandt, Julie; Williams, Eric S.

2011-01-01

Abstract Background  Although patient safety has been studied extensively, little research has directly examined patient and family (consumer) perceptions. Evidence suggests that clinicians define safety differently from consumers, e.g. clinicians focus more on outcomes, whereas consumers may focus more on processes. Consumer perceptions of patient safety are important for several reasons. First, health‐care policy leaders have been encouraging patients and families to take a proactive role in ensuring patient safety; therefore, an understanding of how patients define safety is needed. Second, consumer perceptions of safety could influence outcomes such as trust and satisfaction or compliance with treatment protocols. Finally, consumer perspectives could be an additional lens for viewing complex systems and processes for quality improvement efforts. Objectives  To qualitatively explore acute care consumer perceptions of patient safety. Design and methods  Thirty‐nine individuals with a recent overnight hospital visit participated in one of four group interviews. Analysis followed an interpretive analytical approach. Results  Three basic themes were identified: Communication, staffing issues and medication administration. Consumers associated care process problems, such as delays or lack of information, with safety rather than as service quality problems. Participants agreed that patients need family caregivers as advocates. Conclusions  Consumers seem acutely aware of care processes they believe pose risks to safety. Perceptual measures of patient safety and quality may help to identify areas where there are higher risks of preventable adverse events. PMID:21624026

[Meaningful words? Cancer screening communication in Italy].

PubMed

Cogo, Carla; Petrella, Marco

2012-01-01

Over the last ten years, Italian work groups of communication within The National Centre for Screening Monitoring have been working on various aspects of communication in screening: quality surveys, information materials, guidelines, websites, and training. This has been done taking into account that good quality information must be clear, accessible, up to date, evidence based, clear about its limitations and capable of indicating further sources of information. Whenever possible, information has been developed in collaboration with the target groups: citizens but also health professionals. However, if good quality information must be clear about benefits and harms, the communication of quantitative information is particularly complex in cancer screening. Moreover, receiving more information on risks and benefits does not seem to modify participation. In addition, more balanced information does not entail that a person will include it in the decision process.Throughout several focus groups, citizens have made it clear that the information received from the programmes was only a part of the decisional process in which other elements were just as, if not more, important: trust in doctors, family and friends, perception of health authority efficiency, personal experiences, inconsistencies in information or public disagreements with other credible sources. Such elements can be seen as an opportunity to strengthen partnerships with professional and advocacy groups and to cooperate more efficiently with media and specialists from different fields.

Physicians' acceptance of electronic medical records exchange: an extension of the decomposed TPB model with institutional trust and perceived risk.

PubMed

Hsieh, Pi-Jung

2015-01-01

Electronic medical records (EMRs) exchange improves clinical quality and reduces medical costs. However, few studies address the antecedent factors of physicians' intentions to use EMR exchange. Based on institutional trust and perceived risk integrated with the decomposed theory of planned behavior (TPB) model, we propose a theoretical model to explain the intention of physicians to use an EMR exchange system. We conducted a field survey in Taiwan to collect data from physicians who had experience using the EMR exchange systems. A valid sample of 191 responses was collected for data analysis. To test the proposed research model, we employed structural equation modeling using the partial least squares method. The study findings show that the following five factors have a significant influence on the physicians' intentions to use EMR exchange systems: (a) attitude; (b) subjective norm; (c) perceived behavior control; (d) institutional trust; and (e) perceived risk. These five factors are predictable by perceived usefulness, perceived ease of use, and compatibility, interpersonal and governmental influence, facilitating conditions and self-efficacy, situational normality and structural assurance, and institutional trust, respectively. The results also indicate that institutional trust and perceived risk integrated with the decomposed TPB model improve the prediction of physician's intentions to use EMR exchange. The results of this study indicate that our research model effectively predicts the intention of physicians to use EMR exchange, and provides valuable implications for academics and practitioners. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Participatory Ethnographic Evaluation and Research: Reflections on the Research Approach Used to Understand the Complexity of Maternal Health Issues in South Sudan

PubMed Central

Elmusharaf, Khalifa; Byrne, Elaine; Manandhar, Mary; Hemmings, Joanne; O’Donovan, Diarmuid

2016-01-01

Many methodological approaches have been used to understand cultural dimensions to maternal health issues. Although a well-designed quantitative survey with a representative sample can provide essential information on trends in behavior, it does not necessarily establish a contextualized understanding of the complexity in which different behaviors occur. This article addresses how contextualized data can be collected in a short time and under conditions in which participants in conflict-affected zones might not have established, or time to establish, trust with the researchers. The solution, the Participatory Ethnographic Evaluation and Research (PEER) approach, is illustrated through a study whereby South Sudanese marginalized women were trained to design research instruments, and collect and analyze qualitative data. PEER overcomes the problem that many ethnographic or participatory approaches face—the extensive time and resources required to develop trusting relationships with the community to understand the local context and the social networks they form. PMID:27811290

Participatory Ethnographic Evaluation and Research: Reflections on the Research Approach Used to Understand the Complexity of Maternal Health Issues in South Sudan.

PubMed

Elmusharaf, Khalifa; Byrne, Elaine; Manandhar, Mary; Hemmings, Joanne; O'Donovan, Diarmuid

2017-07-01

Many methodological approaches have been used to understand cultural dimensions to maternal health issues. Although a well-designed quantitative survey with a representative sample can provide essential information on trends in behavior, it does not necessarily establish a contextualized understanding of the complexity in which different behaviors occur. This article addresses how contextualized data can be collected in a short time and under conditions in which participants in conflict-affected zones might not have established, or time to establish, trust with the researchers. The solution, the Participatory Ethnographic Evaluation and Research (PEER) approach, is illustrated through a study whereby South Sudanese marginalized women were trained to design research instruments, and collect and analyze qualitative data. PEER overcomes the problem that many ethnographic or participatory approaches face-the extensive time and resources required to develop trusting relationships with the community to understand the local context and the social networks they form.

A Hybrid Authentication and Authorization Process for Control System Networks

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

Manz, David O.; Edgar, Thomas W.; Fink, Glenn A.

2010-08-25

Convergence of control system and IT networks require that security, privacy, and trust be addressed. Trust management continues to plague traditional IT managers and is even more complex when extended into control system networks, with potentially millions of entities, a mission that requires 100% availability. Yet these very networks necessitate a trusted secure environment where controllers and managers can be assured that the systems are secure and functioning properly. We propose a hybrid authentication management protocol that addresses the unique issues inherent within control system networks, while leveraging the considerable research and momentum in existing IT authentication schemes. Our hybridmore » authentication protocol for control systems provides end device to end device authentication within a remote station and between remote stations and control centers. Additionally, the hybrid protocol is failsafe and will not interrupt communication or control of vital systems in a network partition or device failure. Finally, the hybrid protocol is resilient to transitory link loss and can operate in an island mode until connectivity is reestablished.« less

Trust, autonomy and relationships: the help-seeking preferences of young people in secondary level schools in London (UK).

PubMed

Leavey, Gerard; Rothi, Despina; Paul, Rini

2011-08-01

Help-seeking among young people is complicated, often determined vicariously by the ability of adults, family or professionals, to recognize, and respond to, their difficulties. We know very little about the complex concerns of teenage young people and how they impact on help-seeking preferences. We aimed to ascertain the help-seeking preferences for a range of mental health problems among adolescents attending schools in an inner-city area of London. In particular we sought to examine the relationship between such adolescents and their family doctor. Using a mixed methods approach we explored help-seeking attitudes of young people. Emotional and mental health problems are not seen by young people as the domain of General practitioners. Moreover, there is a worrying lack of confidence and trust placed in family doctor and other professionals by young people. Young people do not tend easily to trust adults to help them with emotional difficulties. Copyright © 2010 The Foundation for Professionals in Services for Adolescents. All rights reserved.

The next step in health data exchanges: trust and privacy in exchange networks.

PubMed

Gravely, Steve D; Whaley, Erin S

2009-01-01

The rapid development of health information exchanges (HIE), regional health information organizations (RHIO), the Nationwide Health Information Network (NHIN) and other data exchange platforms for health records creates complex and multifaceted challenges for protecting the privacy and security of health information. Often these issues are addressed in a contractual agreement between two parties seeking to exchange data. Until recently, this point-to-point approach has been acceptable because there were few operational HIEs or RHIOs that were ready, willing and able to actually exchange data. With the proliferation of HIEs and RHIOs that are either operational or on the cusp of being operational, the utility of point-to-point is diminishing. It is no longer efficient for a RHIO to negotiate a separate data exchange agreement with every one of its exchange partners. The evolving model for data exchange agreements is a multi-party trust agreement. This article will examine the crucial components of a multi-party trust agreement.

How Improving Practice Relationships Among Clinicians and Nonclinicians Can Improve Quality in Primary Care

PubMed Central

Lanham, Holly J.; McDaniel, Reuben R.; Crabtree, Benjamin F.; Miller, William L.; Stange, Kurt C.; Tallia, Alfred F.; Nutting, Paul A.

2010-01-01

Background Understanding the role of relationships in health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Methods Data were drawn from four large National Institutes of Health (NIH)–funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Findings Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Discussion Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties. PMID:19769206

Quality circles in a department of dietetics.

PubMed

Treadwell, D D; Klein, J A

1984-06-01

Quality circles can be an excellent approach to managerial effectiveness in the 1980s. For the Department of Dietetics at Miami Valley Hospital, Dayton , Ohio, quality circles have demonstrated excellent return on investment. Their many benefits include increased productivity, improved employee satisfaction and morale, and cost savings. In order to ensure success, the team needs to be selected carefully and trained thoroughly in problem-solving techniques. Initial meetings should be directed to defining the objectives and code of conduct as well as establishing a trusting environment in which to grow and develop.

Quality improvement collaborative: A novel approach to improve infection prevention and control. Perceptions of lead infection prevention nurses who participated.

PubMed

Adams, Debra; Hine, Victoria; Bucior, Helen; Foster, Wendy; Mukombe, Nyarayi; Ryan, Jane; Smirthwaite, Sandra; Winfield, Jodie

2018-03-01

In response to the ongoing infection prevention (IP) challenges in England, a 90-day quality improvement (QI) collaborative programme was developed. The paper discusses the approach, benefits, challenges and evaluation of the programme. The objective of the collaborative was to develop new approaches to enable sustainable and effective IP. Six trusts in the region participated in the collaborative. Each defined their bespoke IP focus. There was no expectation that statistically significant measurable improvements would be identified during the short time frame. The experiences of the participants were sought both during the programme to facilitate its constant review and at the end of the programme to evaluate its effectiveness. The feedback focused on achievements, barriers to change and benefits of participating in a QI collaborative. To measure the potential success of the projects, participants completed the Model for Understanding Success in Quality framework. (MUSIQ; Kaplan et al., 2012). Since each trusts IP focus was bespoke commonalities of success were not evaluated. Participants identified a positive outcome from their QI interventions. The MUSIQ score identified the projects had the potential for success. The feedback from the participants demonstrated that it is worthy of further development.

Research on the impact of LMX leadership theory on mutual trust and organisational commitment of employees in Bosnia and Herzegovina

NASA Astrophysics Data System (ADS)

Strukan, E.; Nikolić, M.

2017-05-01

The paper presents the theoretical foundations of leadership based on the LMX exchange leader-member theory which essentially involves leadership process where a continuous and creative interaction between leaders and followers is at the centre of attention, during which the leader, among other things, affects the degree of mutual trust and organisational commitment and the quality of relationships in his/her organisation, which actually has a direct impact on organisational performances, effectiveness of the organisation’s business and its market positioning. Also, the paper presents the results of research conducted in organisations in Bosnia and Herzegovina, which undoubtedly point to the fact that the dimensions of leadership based on the LMX exchange leader-member theory, is strongly correlated with the dimensions of mutual trust and organisational commitment, and to have a significant positive impact on them, and therefore on organisational performances and effectiveness of business organisations that were included in this study.

Disentangling the effects of promised and delivered inducements: relational and transactional contract elements and the mediating role of trust.

PubMed

Montes, Samantha D; Irving, P Gregory

2008-11-01

Psychological contracts contain both relational and transactional elements, each of which is associated with unique characteristics. In the present research, the authors drew on these distinct qualities to develop and test hypotheses regarding differential employee reactions to underfulfillment, fulfillment, and overfulfillment of relational and transactional promises. Further, the authors extended their test of the theoretical distinctions between relational and transactional contracts by assessing the relevance of trust as a key underlying mechanism of relational and transactional psychological contract breach effects. Participants in this 3-wave longitudinal study included 342 full-time temporary employees. In support of existing theoretical distinctions, results indicated that employees reacted differently to varying levels of fulfillment of their relational and transactional contracts and that trust is a more central mechanism of relational, as opposed to transactional, psychological contract breach effects. These findings underscore L.S. Lambert, J. R. Edwards, and D. M. Cable's (2003) recent recommendation that the traditional conceptualization and study of psychological contract breach requires expansion.

Higher Ambitions Summit. Rapporteur Report

ERIC Educational Resources Information Center

Nash, Ian

2014-01-01

The Sutton Trust and Pearson two-day summit on higher ambitions in apprenticeships and vocational education drew more than 120 leaders in education, training and employment, policy makers, academics, and researchers to London. Delegates heard from political leaders stressing the importance they attach to high-quality apprenticeships. Presentations…

In Defense of Teacher Professionalism as a Policy Choice.

ERIC Educational Resources Information Center

Sykes, Gary

1991-01-01

Whereas democracy institutionalizes distrust, professionalism relies on trust. Responding to Berbules and Densmore, this article identifies strong normative reasons, grounded in the interests of children, for promoting teacher professionalism. Exorcising the evils of classic professionalism will eliminate neither equity nor quality problems.…

Scale indicators of social exchange relationships: a comparison of relative content validity.

PubMed

Colquitt, Jason A; Baer, Michael D; Long, David M; Halvorsen-Ganepola, Marie D K

2014-07-01

Although social exchange theory has become one of the most oft-evoked theories in industrial and organizational psychology, there remains no consensus about how to measure its key mechanism: social exchange relationships (Blau, 1964). Drawing on Cropanzano and Byrne's (2000) review of contemporary social exchange theorizing, we examined the content validity of perceived support, exchange quality, affective commitment, trust, and psychological contract fulfillment as indicators of social exchange relationships. We used Hinkin and Tracey's (1999) quantitative approach to content validation, which asks participants to rate the correspondence between scale items and definitions of intended (and unintended) constructs. Our results revealed that some of the most frequently utilized indicators of social exchange relationships--perceived support and exchange quality--were significantly less content valid than rarely used options like affect-based trust. Our results also revealed that 2 direct measures--Bernerth, Armenakis, Feild, Giles, and Walker's (2007) scale and a scale created for this study--were content valid. We discuss the implications of these results for future applications of social exchange theory.

Understanding social and behavioral drivers and impacts of air quality sensor use.

PubMed

Hubbell, Bryan J; Kaufman, Amanda; Rivers, Louie; Schulte, Kayla; Hagler, Gayle; Clougherty, Jane; Cascio, Wayne; Costa, Dan

2018-04-15

Lower-cost air quality sensors (hundreds to thousands of dollars) are now available to individuals and communities. This technology is undergoing a rapid and fragmented evolution, resulting in sensors that have uncertain data quality, measure different air pollutants and possess a variety of design attributes. Why and how individuals and communities choose to use sensors is arguably influenced by social context. For example, community experiences with environmental exposures and health effects and related interactions with industry and government can affect trust in traditional air quality monitoring. To date, little social science research has been conducted to evaluate why or how sensors, and sensor data, are used by individuals and communities, or how the introduction of sensors changes the relationship between communities and air quality managers. This commentary uses a risk governance/responsible innovation framework to identify opportunities for interdisciplinary research that brings together social scientists with air quality researchers involved in developing, testing, and deploying sensors in communities. Potential areas for social science research include communities of sensor users; drivers for use of sensors and sensor data; behavioral, socio-political, and ethical implications of introducing sensors into communities; assessing methods for communicating sensor data; and harnessing crowdsourcing capabilities to analyze sensor data. Social sciences can enhance understanding of perceptions, attitudes, behaviors, and other human factors that drive levels of engagement with and trust in different types of air quality data. New transdisciplinary research bridging social sciences, natural sciences, engineering, and design fields of study, and involving citizen scientists working with professionals from a variety of backgrounds, can increase our understanding of air sensor technology use and its impacts on air quality and public health. Published by Elsevier B.V.

A Swedish interview study: parents' assessment of risks in home births.

PubMed

Lindgren, Helena; Hildingsson, Ingegerd; Rådestad, Ingela

2006-03-01

to describe home-birth risk assessment by parents. interviews using a semi-structured interview guide. Data were analysed using a phenomenological approach. independent midwifery practices in Sweden. five couples who had had planned home births. the parents had a fundamental trust that the birth would take place without complications, and they experienced meaningfulness in the event itself. Risks were considered to be part of a complex phenomenon that was not limited to births at home. This attitude seems to be part of a lifestyle that has a bearing on how risks experienced during the birth were handled. Five categories were identified as counterbalancing the risk of possible complications: (1) trust in the woman's ability to give birth; (2) trust in intuition; (3) confidence in the midwife; (4) confidence in the relationship; and (5) physical and intellectual preparation. although the parents were conscious of the risk of complications during childbirth, a fundamental trust in the woman's independent ability to give birth was central to the decision to choose a home birth. Importance was attached to the expected positive effects of having the birth at home. knowledge of parents' assessment can promote an increased understanding of how parents-to-be experience the risks associated with home birth.

Engagement in community activities and trust in local leaders as concomitants of psychological distress among Israeli civilians exposed to prolonged rocket attacks.

PubMed

Zanbar, Lea; Kaniasty, Krzysztof; Ben-Tzur, Navit

2018-07-01

Present study, conducted in the aftermath of the 2014 Israel-Gaza conflict, investigated psychological toll of exposure to rockets attacks in a sample of residents of central and southern Israel. Analyses focused on the distress-protective functions of collectively grounded resources: engagement in community activities and trust in local leadership. This cross-sectional study was conducted between 2 and 3 months after the hostilities. Participants (N = 764) were recruited by an online survey company that distributed a questionnaire assessing, in addition to focal predictors, sociodemographic factors and prior exposure to trauma. The outcome variables were post-traumatic stress disorder (PTSD) and nonspecific distress symptoms. Conservative regression analyses revealed that greater exposure to rocket attacks was predictive of higher levels of posttraumatic stress symptoms. Higher engagement in community activities exhibited a partial trauma-buffering function. However, higher levels of trust in local leaders appeared to exacerbate, rather than diminish, negative impact of rocket exposure on PTSD. Symptoms of psychological distress were not influenced neither by trauma exposure nor by stressor interactions with resources. Trust in local leadership exerted a beneficial main effect on distress. Collectively based resources are important for coping in times of community-wide stressors, yet their role is complex.

Analysis of public responses to preparedness policies: the cases of H1N1 influenza vaccination and gas mask distribution

PubMed Central

2013-01-01

Background During several months in 2009–2010, the Israeli population was asked to take part in two preparedness programs: Acquisition of gas masks against a potential chemical-warfare attack, and vaccination against the A/H1N1 influenza pandemics. Compliance with the first request was moderate and did not attract much attention, whereas compliance with the second request was very low and was accompanied by significant controversy. The aims of this study are to compare the public’s attitudes towards these two preparedness campaigns, and to explore the roles of trust, reasoned assessment, and reflexive reactions in the public’s response to governmental preparedness policies. Methods The comparative analysis was based on a telephone survey of 2,018 respondents representing a cross-section of the adult Israeli population. Univariate analysis to describe associations of public response and attitude was performed by Chi-square tests. Findings A set of queries related to actual compliance, trust in credibility of authorities, personal opinions, reasons for non-compliance, and attitudes towards uncertainties was used to characterize the response to mask-acquisition and vaccination. In the case of mask-acquisition, the dominant response profile was of trusting compliance based on non-conditional belief in the need to adhere to the recommendation (35.6% of respondents). In the case of vaccination, the dominant response profile was of trusting non-compliance based on a reflective belief in the need for adherence (34.8% of respondents). Among the variables examined in the study, passivity was found to be the major reason for non-compliance with mask-acquisition, whereas reasoned assessment of risk played a major role in non-compliance with vaccination. Realization of the complexity in dealing with uncertainty related to developing epidemics and to newly-developed vaccines was identified in the public’s response to the H1N1 vaccination campaign. Conclusions The newly identified profile of “trusting-reflective-non-complier” individuals should be of concern to policy makers. The public is not accepting governmental recommendations in an unconditional manner. This is not driven by lack of trust in authorities, but rather by the perception of the responsibility of individuals in confronting forthcoming risks. Nevertheless, under certain conditions the public may respond in a non-reflective way and delegate this responsibly to authorities in an uncontested manner. This leaves the policy makers with the complex challenge of interacting with a passive non-involved public or alternatively with an opinionated, reflexive public. PMID:23537171

Partnerships for Improving Schools. Contributions to the Study of Education, Number 24.

ERIC Educational Resources Information Center

Jones, Byrd L.; Maloy, Robert W.

Building organizational linkages between schools and other organizations requires many levels of support, trust, volunteered efforts, and complex understandings of social realities. Drawing on documented accounts and the authors' experiences, this volume presents definitions of interactive partnerships, barriers to school improvement and the…

A qualitative case study in the social capital of co-professional collaborative co-practice for children with speech, language and communication needs.

PubMed

McKean, Cristina; Law, James; Laing, Karen; Cockerill, Maria; Allon-Smith, Jan; McCartney, Elspeth; Forbes, Joan

2017-07-01

Effective co-practice is essential to deliver services for children with speech, language and communication needs (SLCN). The necessary skills, knowledge and resources are distributed amongst professionals and agencies. Co-practice is complex and a number of barriers, such as 'border disputes' and poor awareness of respective priorities, have been identified. However social-relational aspects of co-practice have not been explored in sufficient depth to make recommendations for improvements in policy and practice. Here we apply social capital theory to data from practitioners: an analytical framework with the potential to move beyond descriptions of socio-cultural phenomena to inform change. Co-practice in a local authority site was examined to understand: (1) the range of social capital relations extant in the site's co-practice; (2) how these relations affected the abilities of the network to collaborate; (3) whether previously identified barriers to co-practice remain; (4) the nature of any new complexities that may have emerged; and (5) how inter-professional social capital might be fostered. A qualitative case study of SLCN provision within one local authority in England and its linked NHS partner was completed through face-to-face semi-structured interviews with professionals working with children with SLCN across the authority. Interviews, exploring barriers and facilitators to interagency working and social capital themes, were transcribed, subjected to thematic analysis using iterative methods and a thematic framework derived. We identified a number of characteristics important for the effective development of trust, reciprocity and negotiated co-practice at different levels of social capital networks: macro-service governance and policy; meso-school sites; and micro-intra-practitioner knowledge and skills. Barriers to co-practice differed from those found in earlier studies. Some negative aspects of complexity were evident, but only where networked professionalism and trust was absent between professions. Where practitioners embraced and services and systems enabled more fluid forms of collaboration, then trust and reciprocity developed. Highly collaborative forms of co-practice, inherently more complex at the service governance, macro-level, bring benefits. At the meso-level of the school and support team network there was greater capacity to individualize co-practice to the needs of the child. Capacity was increased at the micro-level of knowledge and skills to harness the overall resource distributed amongst members of the inter-professional team. The development of social capital, networks of trust across SLCN support teams, should be a priority at all levels-for practitioners, services, commissioners and schools. © 2016 Royal College of Speech and Language Therapists.

Anonymity-preserving Reputation Management System for health sector

PubMed Central

Hamid, Zara; Abdul, Wadood; Ghouzali, Sanaa; Khan, Abid; Malik, Saif Ur Rehman; Shaukat Khan, Mansoor; Nawaz, Sarfraz

2018-01-01

In health sector, trust is considered important because it indirectly influences the quality of health care through patient satisfaction, adherence and the continuity of its relationship with health care professionals and the promotion of accurate and timely diagnoses. One of the important requirements of TRSs in the health sector is rating secrecy, which mandates that the identification information about the service consumer should be kept secret to prevent any privacy violation. Anonymity and trust are two imperative objectives, and no significant explicit efforts have been made to achieve both of them at the same time. In this paper, we present a framework for solving the problem of reconciling trust with anonymity in the health sector. Our solution comprises Anonymous Reputation Management (ARM) protocol and Context-aware Trustworthiness Assessment (CTA) protocol. ARM protocol ensures that only those service consumers who received a service from a specific service provider provide a recommendation score anonymously with in the specified time limit. The CTA protocol computes the reputation of a user as a service provider and as a recommender. To determine the correctness of the proposed ARM protocol, formal modelling and verification are performed using High Level Petri Nets (HLPN) and Z3 Solver. Our simulation results verify the accuracy of the proposed context-aware trust assessment scheme. PMID:29649267

Back-to-basics with a surgical rotation programme.

PubMed

Hall, Catherine L

This article describes the development and implementation of a rotation programme for Band 5 nurses within the surgical directorate at Heart of England NHS Foundation Trust. The article highlights the challenges raised for nurses with health service modernization and develops the rationale for the need for a different way of thinking. At Heart of England NHS Foundation Trust, the authors evaluation has led to the development of the surgical rotation programme for Band 5 nurses. This rotation programme challenged basic clinical practice and traditional modes of staff placement. Indications, so far, are that quality of care for patients has improved and nurses satisfaction has increased as a result of the implementation of the Band 5 surgical rotation programme.

Vantage point - Prudent health care.

PubMed

Ellis, Gemma

2014-09-25

DESPITE PRODUCTIVITY improvement programmes in the NHS, the Nuffield Trust warns us that the NHS in Wales is likely to face a funding gap of £2.5 billion by 2025. Obviously then, we need to keep searching for ways to ensure long-term sustainability that does not compromise quality.

Improving Learning and Reducing Costs: New Models for Online Learning.

ERIC Educational Resources Information Center

Twigg, Carol A.

2003-01-01

Describes five course redesign models (supplemental, replacement, emporium, fully online, and buffet) used by grantees of the Program in Course Redesign sponsored by the Pew Charitable Trusts. The grants helped colleges redesign instruction using technology to achieve quality enhancements as well as cost savings. (EV)

Social Security's Surpluses: An Update.

ERIC Educational Resources Information Center

Dattalo, Patrick

1992-01-01

Notes that deliberation over how to manage social security's large trust fund balances is expected to continue. Urges social workers to participate in this debate because surpluses have implications for increasing quality of life of low- and moderate-income families. Continues earlier discussion (Dattalo, 1990) by assessing two recent proposals…

Hispanic Graduate Students' Mentoring Themes: Gender Roles in a Bicultural Context

ERIC Educational Resources Information Center

Rudolph, Bonnie A.; Castillo, Carlos P.; Garcia, Vanessa G.; Martinez, Alina; Navarro, Fernando

2015-01-01

Male and female focus groups at a Hispanic Serving Institution (HSI) discussed mentoring of Hispanic graduate students. Using Thematic Analysis, investigators identified three main themes: Relationship Initiation and Development, Valued Relationship Qualities, and Context and Barriers. Relationship themes included mentor openness, trust,…

Mission-Centered Network Models: Defending Mission-Critical Tasks From Deception

DTIC Science & Technology

2015-09-29

celebrities ). In military applications, networked operations offer an effective way to reduce the footprint of a force, but become a center of gravity...from,-used-by-trust-algorithms-to-assess-quality-and- trustworthiness - •  Technical&challenge:-Developing-standard-representa3ons-for-provenance-that

Understanding couples' relationship quality and contraceptive use in Kumasi, Ghana.

PubMed

Cox, Carie Muntifering; Hindin, Michelle J; Otupiri, Easmo; Larsen-Reindorf, Roderick

2013-12-01

A wealth of data exist on knowledge, attitudes and practice related to contraceptive use; however, emotional aspects of relationships that may influence reproductive decision making are often overlooked. Data from the 2010 Family Health and Wealth Survey were used in bivariate and multinomial logistic regression analyses to identify associations between relationship quality and current contraceptive use among 698 married or cohabiting couples in Kumasi, Ghana. Four scales measuring commitment, trust, constructive communication and destructive communication, as well as a question about relationship satisfaction, were the indicators of relationship quality. Current contraceptive use was divided into three categories: no use, reliance on a method that can be used without the partner's awareness (the injectable, pill, IUD, implant and diaphragm) and use of a method that both partners are typically aware of (periodic abstinence, withdrawal, condoms and spermicide). Overall contraceptive use was low--22% of women said they were currently using any method. In general, respondents reported high levels of relationship quality. Women's relationship satisfaction scores were positively associated with use of awareness methods rather than nonuse (relative risk ratio, 1.2). Men's trust scores were positively associated with use of nonawareness methods rather than nonuse (1.1), and men's constructive communication scores were associated with use of both types of method rather than nonuse (1.1 for each). Couples' relationship quality appears to be an important element in their decision making regarding contraceptive use, and should be taken into consideration in the design and implementation of family planning programs and policy.

The Five 'R's' for Developing Trusted Software Frameworks to increase confidence in, and maximise reuse of, Open Source Software.

NASA Astrophysics Data System (ADS)

Fraser, Ryan; Gross, Lutz; Wyborn, Lesley; Evans, Ben; Klump, Jens

2015-04-01

Recent investments in HPC, cloud and Petascale data stores, have dramatically increased the scale and resolution that earth science challenges can now be tackled. These new infrastructures are highly parallelised and to fully utilise them and access the large volumes of earth science data now available, a new approach to software stack engineering needs to be developed. The size, complexity and cost of the new infrastructures mean any software deployed has to be reliable, trusted and reusable. Increasingly software is available via open source repositories, but these usually only enable code to be discovered and downloaded. As a user it is hard for a scientist to judge the suitability and quality of individual codes: rarely is there information on how and where codes can be run, what the critical dependencies are, and in particular, on the version requirements and licensing of the underlying software stack. A trusted software framework is proposed to enable reliable software to be discovered, accessed and then deployed on multiple hardware environments. More specifically, this framework will enable those who generate the software, and those who fund the development of software, to gain credit for the effort, IP, time and dollars spent, and facilitate quantification of the impact of individual codes. For scientific users, the framework delivers reviewed and benchmarked scientific software with mechanisms to reproduce results. The trusted framework will have five separate, but connected components: Register, Review, Reference, Run, and Repeat. 1) The Register component will facilitate discovery of relevant software from multiple open source code repositories. The registration process of the code should include information about licensing, hardware environments it can be run on, define appropriate validation (testing) procedures and list the critical dependencies. 2) The Review component is targeting on the verification of the software typically against a set of benchmark cases. This will be achieved by linking the code in the software framework to peer review forums such as Mozilla Science or appropriate Journals (e.g. Geoscientific Model Development Journal) to assist users to know which codes to trust. 3) Referencing will be accomplished by linking the Software Framework to groups such as Figshare or ImpactStory that help disseminate and measure the impact of scientific research, including program code. 4) The Run component will draw on information supplied in the registration process, benchmark cases described in the review and relevant information to instantiate the scientific code on the selected environment. 5) The Repeat component will tap into existing Provenance Workflow engines that will automatically capture information that relate to a particular run of that software, including identification of all input and output artefacts, and all elements and transactions within that workflow. The proposed trusted software framework will enable users to rapidly discover and access reliable code, reduce the time to deploy it and greatly facilitate sharing, reuse and reinstallation of code. Properly designed it could enable an ability to scale out to massively parallel systems and be accessed nationally/ internationally for multiple use cases, including Supercomputer centres, cloud facilities, and local computers.

Implementing clinical governance in English primary care groups/trusts: reconciling quality improvement and quality assurance

PubMed Central

Campbell, S; Sheaff, R; Sibbald, B; Marshall, M; Pickard, S; Gask, L; Halliwell, S; Rogers, A; Roland, M

2002-01-01

Objectives: To investigate the concept of clinical governance being advocated by primary care groups/trusts (PCG/Ts), approaches being used to implement clinical governance, and potential barriers to its successful implementation in primary care. Design: Qualitative case studies using semi-structured interviews and documentation review. Setting: Twelve purposively sampled PCG/Ts in England. Participants: Fifty senior staff including chief executives, clinical governance leads, mental health leads, and lay board members. Main outcome measures: Participants' perceptions of the role of clinical governance in PCG/Ts. Results: PCG/Ts recognise that the successful implementation of clinical governance in general practice will require cultural as well as organisational changes, and the support of practices. They are focusing their energies on supporting practices and getting them involved in quality improvement activities. These activities include, but move beyond, conventional approaches to quality assessment (audit, incentives) to incorporate approaches which emphasise corporate and shared learning. PCG/Ts are also engaged in setting up systems for monitoring quality and for dealing with poor performance. Barriers include structural barriers (weak contractual levers to influence general practices), resource barriers (perceived lack of staff or money), and cultural barriers (suspicion by practice staff or problems overcoming the perceived blame culture associated with quality assessment). Conclusion: PCG/Ts are focusing on setting up systems for implementing clinical governance which seek to emphasise developmental and supportive approaches which will engage health professionals. Progress is intentionally incremental but formidable challenges lie ahead, not least reconciling the dual role of supporting practices while monitoring (and dealing with poor) performance. PMID:12078380

Use of quality information in decision-making about health and social care services--a systematic review.

PubMed

Turnpenny, Agnes; Beadle-Brown, Julie

2015-07-01

User choice and personalisation have been at the centre of health and social care policies in many countries. Exercising choice can be especially challenging for people with long-term conditions (LTC) or disabilities. Information about the quality, cost and availability of services is central to user choice. This study used systematic review methods to synthesise evidence in three main areas: (i) how people with LTC or disabilities and their family carers find and access information about the quality of services; (ii) how quality information is used in decision-making; and (iii) what type of quality information is most useful. Quality information was defined broadly and could include formal quality reports (e.g. inspection reports, report cards, etc.), information about the characteristics of a service or provider (e.g. number and qualifications of staff, facilities, etc.) and informal reports about quality (e.g. personal experience, etc.). Literature searches were carried out using electronic databases in January 2012. Thirteen papers reporting findings from empirical studies published between 2001 and 2012 were included in the review. The majority of papers (n = 9) had a qualitative design. The analysis highlighted the use of multiple sources of information in decision-making about services and in particular the importance of informal sources and extended social networks in accessing information. There is limited awareness and use of 'official' and online information sources. Service users or family carers place greater emphasis on general information and structural indicators. Clinical or quality-of-life outcomes are often difficult to interpret and apply. Trust emerged a key issue in relation to quality information. Experiential and subjective information is highly valued and trusted. Various barriers to the effective use of quality information in making choices about services are identified. Implications for policy and future research are discussed. © 2014 John Wiley & Sons Ltd.

Patients' satisfaction: customer relationship management as a new opportunity for quality improvement in thoracic surgery.

PubMed

Rocco, Gaetano; Brunelli, Alessandro

2012-11-01

Clinical and nonclinical indicators of performance are meant to provide the surgeon with tools to identify weaknesses to be improved. The World Health Organization's Performance Evaluation Systems represent a multidimensional approach to quality measurement based on several categories made of different indicators. Indicators for patient satisfaction may include overall perceived quality, accessibility, humanization and patient involvement, communication, and trust in health care providers. Patient satisfaction is included among nonclinical indicators of performance in thoracic surgery and is increasingly recognized as one of the outcome measures for delivered quality of care. Copyright © 2012 Elsevier Inc. All rights reserved.

Developing effective messages about potable recycled water: The importance of message structure and content

NASA Astrophysics Data System (ADS)

Price, J.; Fielding, K. S.; Gardner, J.; Leviston, Z.; Green, M.

2015-04-01

Community opposition is a barrier to potable recycled water schemes. Effective communication strategies about such schemes are needed. Drawing on social psychological literature, two experimental studies are presented, which explore messages that improve public perceptions of potable recycled water. The Elaboration-Likelihood Model of information processing and attitude change is tested and supported. Study 1 (N = 415) premeasured support for recycled water, and trust in government information at Time 1. Messages varied in complexity and sidedness were presented at Time 2 (3 weeks later), and support and trust were remeasured. Support increased after receiving information, provided that participants received complex rather than simple information. Trust in government was also higher after receiving information. There was tentative evidence of this in response to two-sided messages rather than one-sided messages. Initial attitudes to recycled water moderated responses to information. Those initially neutral or ambivalent responded differently to simple and one-sided messages, compared to participants with positive or negative attitudes. Study 2 (N = 957) tested the effectiveness of information about the low relative risks, and/or benefits of potable recycled water, compared to control groups. Messages about the low risks resulted in higher support when the issue of recycled water was relevant. Messages about benefits resulted in higher perceived issue relevance, but did not translate into greater support. The results highlight the importance of understanding people's motivation to process information, and need to tailor communication to match attitudes and stage of recycled water schemes' development.

The importance of the patient voice in vaccination and vaccine safety-are we listening?

PubMed

Holt, D; Bouder, F; Elemuwa, C; Gaedicke, G; Khamesipour, A; Kisler, B; Kochhar, S; Kutalek, R; Maurer, W; Obermeier, P; Seeber, L; Trusko, B; Gould, S; Rath, B

2016-12-01

Much has been written about the patient-physician relationship over the years. This relationship is essential in maintaining trust in the complex arena of modern diagnostic techniques, treatment and prevention, including vaccines and vaccine safety. However, a great deal of this material was written from the viewpoint of clinicians and academics. The patient voice may be positive or negative, fragmented or complex. Information sources are weighed and treated differently, according to the value system and risk perceptions of the individual. In post-trust societies, when people have less confidence in health authorities, communication needs to be more than a paternalistic top-down process. Notions of empowerment and individual patient choice are becoming crucial in medical care. The 'voice of the patient', which includes healthy individuals receiving vaccines, needs to be heard, considered and addressed. With respect to childhood immunizations, this will be the voice of the parent or caregiver. The key to addressing any concerns could be to listen more and to develop a communication style that is trust-based and science-informed. Regulatory agencies are encouraging clinical and patient-reported outcomes research under the umbrella of personalized medicine, and this is an important step forward. This paper attempts to reflect the paradigm shift towards increasing attention to the patient voice in vaccination and vaccine safety. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

The intersection of trust and recreation management

Treesearch

Patricia L. Winter; George T. Cvetkovich

2013-01-01

The management of public land as venues for a wide variety of outdoor recreation interests is a highly complex professional field. Understanding of the relationship between the visitor, general public values, the natural resource base and the politics of management policies requires training, experience and savvy. Recreation planning for forest, park, preserve,...

Medical decision and patient's preference: 'much ethics' and more trust always needed.

PubMed

Anyfantakis, Dimitrios; Symvoulakis, Emmanouil K

2011-01-01

There is much discussion on medical ethics literature regarding the importance of the patients' right for self-determination. We discuss some of the limitations of patient's autonomy with the aim to draw attention to the ethical complexity of medical decision making in the everyday clinical practice.

School Leader Relationships: The Need for Explicit Training on Rapport, Trust, and Communication

ERIC Educational Resources Information Center

Lasater, Kara

2016-01-01

An important aspect of school leadership is relationship development, but developing meaningful relationships as a school leader is challenging. School leader relationships are challenged by diverse stakeholder groups, varied contexts, and difficult situations. The complex nature of school leader relationships necessitates explicit training for…

Virtual Team Effectiveness: An Empirical Examination of the Use of Communication Technologies on Trust and Virtual Team Performance

ERIC Educational Resources Information Center

Thomas, Valerie Brown

2010-01-01

Ubiquitous technology and agile organizational structures have enabled a strategic response to increasingly competitive, complex, and unpredictable challenges faced by many organizations. Using cyberinfrastructure, which is primarily the network of information, computers, communication technologies, and people, traditional organizations have…

Fostering Integrity in Research

NASA Astrophysics Data System (ADS)

McNutt, M. K.

2017-12-01

The responsible conduct of research requires that all involved in the research enterprise - researchers, sponsors, reviewers, publishers, and communicators - adhere to a set of integrity principles to protect the public's investment. Given the increasing complexity and globalization of the research enterprise, the National Academies recently re-examined and updated its integrity recommendations for researchers in the report Fostering Integrity in Research, with sponsorship from the National Science Foundation. Major departures from the previous recommendations 25-years earlier are the recognition that practices that were previously classified as merely questionable are indeed detrimental to the responsible conduct of research. Furthermore, the report concludes that there has been insufficient effort to respond to the threats that lapses in research integrity pose to the quality of research products and the reputation of researchers as deserving of the public trust. It recommends the creation of an independent, non-profit entity dedicated to promoting research integrity by serving as a resource and clearing house for expertise, advice, materials, and best practices on fostering research integrity and responding to allegations of research misconduct.

Designing e-Health Interventions for Low-Health-Literate Culturally Diverse Parents: Addressing the Obesity Epidemic

PubMed Central

Kahlor, LeeAnn; Tyler, Diane; Gustafson, Jamie

2009-01-01

Abstract Child and adolescent obesity is a significant problem contributing to long-term trends in adult obesity. Educating parents about strategies for raising healthy children is complicated by the problem of low health literacy. E-health provides new opportunities to educate low-health-literate audiences, and this project was intended as formative research to guide design of interventions for low-health-literate parents. Focus groups were conducted with African American, Hispanic, and white parents (n = 43), 18 years of age or older, and at or below median income for the region. Each focus group included the following: a discussion of parents' general use of the Internet for health information, the demonstration of a Web site designed specifically for low-health-literate users, and asking participants about ideas under consideration for future interventions. Participants use search engines to look for health information and use heuristics, such as position in search results, to evaluate Web site quality. Some participants avoid information from .edu and .gov domains due to perceived complexity, and there was an almost-universal lack of trust in the government for health information. University researchers, by contrast, were trusted sources as information providers. Content and usability that meet the needs of extremely low-literate audiences may be perceived as slow and lacking depth by more literate and Internet-savvy users. E-health can be used to educate low-health-literate audiences, but interventions designed for these users must be layered in terms of content and usability to meet varying levels of functional and media literacy. PMID:19694596

Designing e-health interventions for low-health-literate culturally diverse parents: addressing the obesity epidemic.

PubMed

Mackert, Michael; Kahlor, LeeAnn; Tyler, Diane; Gustafson, Jamie

2009-09-01

Child and adolescent obesity is a significant problem contributing to long-term trends in adult obesity. Educating parents about strategies for raising healthy children is complicated by the problem of low health literacy. E-health provides new opportunities to educate lowhealth-literate audiences, and this project was intended as formative research to guide design of interventions for low-health-literate parents. Focus groups were conducted with African American, Hispanic, and white parents (n = 43), 18 years of age or older, and at or below median income for the region. Each focus group included the following: a discussion of parents' general use of the Internet for health information, the demonstration of a Web site designed specifically for low-health-literate users, and asking participants about ideas under consideration for future interventions. Participants use search engines to look for health information and use heuristics, such as position in search results, to evaluate Web site quality. Some participants avoid information from .edu and .gov domains due to perceived complexity, and there was an almost-universal lack of trust in the government for health information. University researchers, by contrast, were trusted sources as information providers. Content and usability that meet the needs of extremely low-literate audiences may be perceived as slow and lacking depth by more literate and Internet-savvy users. E-health can be used to educate low-health-literate audiences, but interventions designed for these users must be layered in terms of content and usability to meet varying levels of functional and media literacy.

Community Action Against Asthma

PubMed Central

Parker, Edith A; Israel, Barbara A; Williams, Melina; Brakefield-Caldwell, Wilma; Lewis, Toby C; Robins, Thomas; Ramirez, Erminia; Rowe, Zachary; Keeler, Gerald

2003-01-01

BACKGROUND Community Action Against Asthma (CAAA) is a community-based participatory research (CBPR) project that assesses the effects of outdoor and indoor air quality on exacerbation of asthma in children, and tests household- and neighborhood-level interventions to reduce exposure to environmental asthma triggers. Representatives of community-based organizations, academia, an integrated health system, and the local health department work in partnership on CAAA's Steering Committee (SC) to design and implement the project. OBJECTIVE To conduct a process evaluation of the CAAA community–academic partnership. DESIGN In-depth interviews containing open-ended questions were conducted with SC members. Analysis included established methods for qualitative data, including focused coding and constant comparison methods. SETTING Community setting in Detroit, Michigan. PARTICIPANTS Twenty-three members of the CAAA SC. MEASUREMENTS Common themes identified by SC members relating to the partnership's ability to achieve project goals and the successes and challenges facing the partnership itself. MAIN RESULTS Identified partnership accomplishments included: successful implementation of a complex project, identification of children with previously undiagnosed asthma, and diverse participation and community influence in SC decisions. Challenges included ensuring all partners' influence in decision-making, the need to adjust to “a different way of doing things” in CBPR, constraints and costs of doing CBPR felt by all partners, ongoing need for communication and maintaining trust, and balancing the needs of science and the community through intervention. CONCLUSIONS CBPR can enhance and facilitate basic research, but care must be given to trust issues, governance issues, organizational culture, and costs of participation for all organizations involved. PMID:12848839

The Presidential Image: Key to Effective Leadership.

ERIC Educational Resources Information Center

Whisnant, W. Terry

1990-01-01

Discusses the use of the community college president's image (e.g., behavior, dress, and mannerisms) to enhance leadership in times of limited resources and declining enrollments. Describes the qualities of trust, good judgement, and expertise as keys to an image that effectively involves followers and constituents in implementing presidential…

Why self-care is key to providing high-quality care to others.

PubMed

McCormick, Jo; Hayes, Sally

2017-06-22

Jo McCormick, Consultant Nurse and Associate Director of Nursing, Belfast Health and Social Care Trust, Joanna.McCormick@belfasttrust.hscni.net , and Sally Hayes, Director of Strategy, Planning and Resources at the Open University, share their insights from undertaking a Florence Nightingale Leadership Scholarship.

The Role of Individual Differences in Employee Adoption of TQM Orientation.

ERIC Educational Resources Information Center

Coyle-Shapiro, Jacqueline A. -M.; Morrow, Paula C.

2003-01-01

Employee surveys before and 9 and 32 months after total quality management (TQM) implementation (n=186, 166, 118) identified three individual characteristics that collectively explained the variance in and better predicted TQM adoption: organizational commitment, trust in colleagues, and importance of higher-order needs for achievement and…

Improving Principal Leadership through Feedback and Coaching

ERIC Educational Resources Information Center

Bickman, Leonard; Goldring, Ellen; De Andrade, Ana Regina; Breda, Carolyn; Goff, Peter

2012-01-01

The purpose of this study is to evaluate the efficacy of a feedback and coaching intervention designed to improve the quality of principal leadership. Principals received feedback from teachers on their instructional leadership, and their teachers' trust of them. Principals also provided self-ratings and they compared their teachers' ratings to…

Can I Trust ORE Reports?

ERIC Educational Resources Information Center

Feedback, 1984

1984-01-01

This issue of FEEDBACK, a newsletter produced by the the Austin Independent School District Office of Research and Evaluation (ORE), illustrates the accuracy, validity, and fairness of ORE reports. The independence of the reports is explained. Internal and external quality controls are used to ensure reliability and accuracy of the reports.…

The Role of the Principal's Emotional Intelligence in Primary Education Leadership

ERIC Educational Resources Information Center

Brinia, Vasiliki; Zimianiti, Lina; Panagiotopoulos, Konstantinos

2014-01-01

The development of emotional intelligence skills offers sufficient leadership qualities for advancing the organization and for achieving its objectives. In particular, the emotionally intelligent leader--principal is able to inspire and facilitate a self-conscious and organizational culture by adopting the values of understanding, trust, prospect,…

Assumptions Commonly Underlying Government Quality Assessment Practices

ERIC Educational Resources Information Center

Schmidtlein, Frank A.

2004-01-01

The current interest in governmental assessment and accountability practices appears to result from:(1) an emerging view of higher education as an "industry"; (2) concerns about efficient resource allocation; (3) a lack of trust ade between government institutional officials; (4) a desire to reduce uncertainty in government/higher education…

Modeling Antecedents of Student Loyalty in Higher Education

ERIC Educational Resources Information Center

Perin, Marcelo Gattermann; Sampaio, Claudio Hoffmann; Simoes, Claudia; de Polvora, Rosiane Polvora

2012-01-01

The purpose of this investigation is to understand the antecedents of student loyalty in the Brazilian context. In particular we address the impact of student trust, commitment and quality perception on loyalty. A quantitative study was conducted among business management student majors from two private Brazilian Higher Education Institutions…

Empowering Employees for a New Century.

ERIC Educational Resources Information Center

Wilkinson, Tom

In January 1986, the Learning Resource Center (LRC) of New River Community College in Virginia initiated efforts to increase the level, quality, responsiveness, and adaptability of LRC services. Central to these efforts was an emphasis on employee involvement and empowerment intended to create an atmosphere of trust and teamwork; enhance employee…

Read Them Now

ERIC Educational Resources Information Center

Tour, Rachel

2008-01-01

University presses have largely abdicated the job of substantive editing to outside readers, who write reports evaluating the quality of the work and offering both major and minor editing suggestions. Editors develop a cadre of readers they know they can trust, who will be fair, rigorous, and prompt with their reports. The author particularly…