The scale, scope and impact of alternative care for OVC in developing countries

This item is archived in the repository for materials published for the USAID supported Orphans and Vulnerable Children Comprehensive Action Research Project (OVC-CARE) at the Boston University Center for Global Health and Development.Over 145 million children worldwide have lost one or both parents due to various causes, 15 million of these are due to AIDS (1,2); and many more have been made vulnerable due to other causes. The global community has responded by putting in place various care arrangements for these children. However, the scale, scope and impact of these alternative care approaches have not been well summarized. The aim of this literature review is to synthesize and analyze available data on alternative care approaches and the impact of these placements on the lives of orphans and other vulnerable children. Both the short-term and long term wellbeing of a child depends a lot on where they live and the care they receive in those settings.The USAID | Project SEARCH, Orphans and Vulnerable Children Comprehensive Action Research (OVC-CARE) Task Order, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00023-00, beginning August 1, 2008. OVC-CARE Task Order is implemented by Boston University. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the funding agency

An evaluation of the economic impact of broadband in Lincolnshire: updated final report

The Lincolnshire Broadband Initiative, ‘onlincolnshire’, was launched in 2003 to bring a range of broadband supply and demand stimulation activities to businesses across the county. The initiative has used £15 million of European funding, together with matched funding from Lincolnshire County Council, to support a series of significant Information and Communication Technology (ICT) interventions to provide support and financial assistance to eligible Lincolnshire businesses. The ‘onlincolnshire’ initiative has four long term strategic objectives. By 2010: • Lincolnshire will be the foremost rural County in the UK, with regards to ICT usage and skills and will have a commercial environment that embraces ICT; • The main employment sites and premises will have attracted increased and more diverse investment; • ICT will have made a major contribution to business competitiveness, expansion and diversification of the economy – measured through an increase in ICT related employment and a range of ICT based activities; • To have engaged individuals and employers in improving ICT skills to increase local competitiveness, raise the standards, participation and achievement in ICT throughout the County

Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

The intention to use mobile digital library technology: A focus group study in the United Arab Emirates

IGI Global (“IGI”) granted Brunel University London the permission to archive this article in BURA (http://bura.brunel.ac.uk).This paper presents a qualitative study on student adoption of mobile library technology in a developing world context. The findings support the applicability of a number of existing constructs from the technology acceptance literature, such as perceived ease of use, social influence and trust. However, they also suggest the need to modify some adoption factors previously found in the literature to fit the specific context of mobile library adoption. Perceived value was found to be a more relevant overarching adoption factor than perceived usefulness for this context. Facilitating conditions were identified as important but these differed somewhat from those covered in earlier literature. The research also uncovered the importance of trialability for this type of application. The findings provide a basis for improving theory in the area of mobile library adoption and suggest a number of practical design recommendations to help designers of mobile library technology to create applications that meet user needs

PatientExploreR: an extensible application for dynamic visualization of patient clinical history from electronic health records in the OMOP common data model.

MotivationElectronic health records (EHRs) are quickly becoming omnipresent in healthcare, but interoperability issues and technical demands limit their use for biomedical and clinical research. Interactive and flexible software that interfaces directly with EHR data structured around a common data model (CDM) could accelerate more EHR-based research by making the data more accessible to researchers who lack computational expertise and/or domain knowledge.ResultsWe present PatientExploreR, an extensible application built on the R/Shiny framework that interfaces with a relational database of EHR data in the Observational Medical Outcomes Partnership CDM format. PatientExploreR produces patient-level interactive and dynamic reports and facilitates visualization of clinical data without any programming required. It allows researchers to easily construct and export patient cohorts from the EHR for analysis with other software. This application could enable easier exploration of patient-level data for physicians and researchers. PatientExploreR can incorporate EHR data from any institution that employs the CDM for users with approved access. The software code is free and open source under the MIT license, enabling institutions to install and users to expand and modify the application for their own purposes.Availability and implementationPatientExploreR can be freely obtained from GitHub: https://github.com/BenGlicksberg/PatientExploreR. We provide instructions for how researchers with approved access to their institutional EHR can use this package. We also release an open sandbox server of synthesized patient data for users without EHR access to explore: http://patientexplorer.ucsf.edu.Supplementary informationSupplementary data are available at Bioinformatics online

Designing an Adaptive Web Navigation Interface for Users with Variable Pointing Performance

Many online services and products require users to point and interact with user interface elements. For individuals who experience variable pointing ability due to physical impairments, environmental issues or age, using an input device (e.g., a computer mouse) to select elements on a website can be difficult. Adaptive user interfaces dynamically change their functionality in response to user behavior. They can support individuals with variable pointing abilities by 1) adapting dynamically to make element selection easier when a user is experiencing pointing difficulties, and 2) informing users about these pointing errors. While adaptive interfaces are increasingly prevalent on the Web, little is known about the preferences and expectations of users with variable pointing abilities and how to design systems that dynamically support them given these preferences. We conducted an investigation with 27 individuals who intermittently experience pointing problems to inform the design of an adaptive interface for web navigation. We used a functional high-fidelity prototype as a probe to gather information about user preferences and expectations. Our participants expected the system to recognize and integrate their preferences for how pointing tasks were carried out, preferred to receive information about system functionality and wanted to be in control of the interaction. We used findings from the study to inform the design of an adaptive Web navigation interface, PINATA that tracks user pointing performance over time and provides dynamic notifications and assistance tailored to their specifications. Our work contributes to a better understanding of users' preferences and expectations of the design of an adaptive pointing system

Functional decline in residents living in nursing homes : a systematic review of the literature

Objectives To describe the functional dependence progression over time in older people living in nursing homes (NHs). Design A systematic review of the literature was performed. Studies involving individuals 65 years and older living in NHs, describing their functional decline, improvement or stability in activities of daily living (ADLs), were eligible. The search strategy was applied in MedLine, Cochrane, CINAHL, and SCOPUS databases; aimed at identifying an unbiased and complete list of studies, searching by hand was also performed. The methodological quality of the 27 studies included was assessed. Results Functional trajectories were documented mainly through multicenter study design including sample size ranging from 2 to 9336 NHs, from 1983 to 2011 throughout a single or multiple follow-ups (>20). The average rate of decline was expressed in different metrics and periods of time: from 3 months with a decline of −0.13 points of 28, to 6 months (−1.78 points of 2829) to 1.85 years (−0.5 points of 6). Eating and toileting were the most documented ADLs and the decline is approximately 0.4 points and 0.2 to 0.4 points of 5 a year, respectively. Among the covariates, individual factors, such as cognitive status, were mainly considered, whereas only 13 studies considered facility-level factors. Conclusions Findings report the slow functional decline mainly in women living in US NHs, in years when residents were admitted with a low or medium degree of functional dependence. Considering that in recent years residents have been admitted to NHs with higher-level functional dependence, studies measuring each single ADL, using standardized instruments capable of capturing the signs of decline, stability, or improvement are strongly recommended. Among the covariates, evaluation of both individual and facility-level factors, which may affect functional decline, is also suggested

The Mediation Effect of Trusting Beliefs on the Relationship Between Expectation-Confirmation and Satisfaction with the Usage of Online Product Recommendation

Online Product Recommendations (OPRs) are increasingly available to onlinecustomers as a value-added self-service in evaluating and choosing a product.Research has highlighted several advantages that customers can gain from usingOPRs. However, the realization of these advantages depends on whether and towhat extent customers embrace and fully utilise them. The relatively low OPR USAgerate indicates that customers have not yet developed trust in OPRs’ performance.Past studies also have established that satisfaction is a valid measure of systemperformance and a consistent significant determinant of users’ continuous systemusage. Therefore, this study aimed to examine the mediation effect of trustingbeliefs on the relationship between expectation-confirmation and satisfaction. Theproposed research model is tested using data collected via an online survey from626 existing users of OPRs. The empirical results revealed that social-psychologicalbeliefs (perceived confirmation and trust) are significant contributors to customersatisfaction with OPRs. Additionally, trusting beliefs partially mediate the impactof perceived confirmation on customer satisfaction. Moreover, this study validatesthe extensions of the interpersonal trust construct to trust in OPRs and examinesthe nomological validity of trust in terms of competence, benevolence, andintegrity. The findings provide a number of theoretical and practical implications.&nbsp

Patient characteristics associated with objective measures of digital health tool use in the United States: A literature review.

The study sought to determine which patient characteristics are associated with the use of patient-facing digital health tools in the United States.We conducted a literature review of studies of patient-facing digital health tools that objectively evaluated use (eg, system/platform data representing frequency of use) by patient characteristics (eg, age, race or ethnicity, income, digital literacy). We included any type of patient-facing digital health tool except patient portals. We reran results using the subset of studies identified as having robust methodology to detect differences in patient characteristics.We included 29 studies; 13 had robust methodology. Most studies examined smartphone apps and text messaging programs for chronic disease management and evaluated only 1-3 patient characteristics, primarily age and gender. Overall, the majority of studies found no association between patient characteristics and use. Among the subset with robust methodology, white race and poor health status appeared to be associated with higher use.Given the substantial investment in digital health tools, it is surprising how little is known about the types of patients who use them. Strategies that engage diverse populations in digital health tool use appear to be needed.Few studies evaluate objective measures of digital health tool use by patient characteristics, and those that do include a narrow range of characteristics. Evidence suggests that resources and need drive use