Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

The Service Profit Chain Customer Value Equation – an application to Health Care

The assessment of value in health care is most often considered from a population perspective, using techniques such as burden of illness and economic evaluation. While necessary, such techniques are not sufficient to maximise health benefits from the perspective of the individual. The Service Profit Chain is a model by which better outcomes for both service providers and customers can be achieved. A core component, the Customer Value Equation, describes the perceived value of a service to an individual as: outcomes plus perceptions of the quality of service delivery (process quality) / monetary fees plus access costs (such as time). Based on a series of studies using real-world data, this thesis discusses applicability of these ideas to the health care environment, focusing on process quality and the relationship between clinicians and their consulting patients. Patients must be equal partners in the decision-making process; where this occurred, outcomes were generally better. Engagement, empathy and good communication between clinician and patient were shown to be necessary factors to maximise outcomes. Disconnects between clinical and patient regarding disease severity, recognition of symptoms and side-effects, and perceived lack of communication were all associated with worse quality of life, lower satisfaction and lower adherence to treatment plans. Policy implications arising from the research findings are discussed, including equipping clinicians to better understand the objectives and needs of their patients, improving clinical-patient communication, more widespread use of models of care such as Shared Decision Making, and developing tools to measure satisfaction with the care process. This thesis demonstrates the advantages of real-world data regarding the measurement of process activity and outcomes, highlighting the value of any data source able to capture both clinician and patient perspectives of the same health care encounter. This allows assessment of value from the individual patient perspective which, together with population measures of value, will enable the maximisation of value of health care interventions

Saliva continine levels of babies and mothers living with smoking fathers under different housing types in Hong Kong: a cross-sectional study

Paper Session 15 - The Challenge of Second-Hand Smoke: PA15-3BACKGROUND: After the Smoking Ordinance enacted in HK since 1/2007, shifting of smoking from outdoor to home was found, home becomes a major source of secondhand smoke (SHS) exposure of nonsmokers. OBJECTIVES: It aimed to assess the SHS exposure of babies and mothers living with smoking fathers of two housing types by using a biomarker. METHODS: Trios of smoking father, non-smoking mother and a baby under 18-months were recruited from Maternal and Child Health Centres (MCHCs) from 6/2008 to 10/2009. Consented couples completed the baseline survey including demographic data, fathers’ household smoking behaviors and mothers’ actions in protecting babies from household SHS exposure. Saliva samples from baby and mother were collected and then sent to the National University of Singapore for cotinine analyses. Log-transformations were used for the saliva cotinine due to skewed data. There were 2 housing types (public/private) and father was asked if they smoked at home (yes/no). MANOVA was used to compare the babies’ and mothers’ cotinine levels when fathers smoked at home under the 2 housing types. RESULTS: 1,158 trios were consented. 1,142 mothers’ and 1,058 babies’ samples were assayed. The mean age of the fathers and mothers was 35.5(±7.0) and 31.2(±4.9). The mean mothers’ cotinine level was 12.15ng/ml (±61.20) while babies’ was 2.38ng/ml (±6.01). 606 and 501 trios were living in public and private housing. Fathers’ smoked at home led to higher mothers’ and babies’ saliva cotininary (mean log of mothers’ cotininary: 0.14±0.62 vs. 0.05±0.55, p=0.06; babies: 0.16±0.38 vs. 0.07±0.34, p=0.003). Housing types influenced babies’ cotinine level (public: 0.17±0.37; private: 0.10±0.36, p=0.01). MANOVA showed that fathers smoked at home (Λ=0.99, p=0.01) and housing types (Λ=0.99, p=0.01) were positively related to the saliva cotinine levels. CONCLUSIONS: Father smoked at home and the housing types have greater impact on babies’ saliva cotininary, showing that they were highly exposed at home and in public housing environment. HK government should promote smoke-free homes and to provide more smoking cessation services to minimize the household SHS exposure to babiespublished_or_final_versio

Annual Report of the University, 2005-2006, Volumes 1-7

PROPOSED POLICIES The Office of Government & Community Relations is in charge of advancing the University\u27s interests at all levels of federal, state and local government. The following policy guidelines for working with University units will achieve a coordinated and effective institutional advancement program. • To inform the Office of Government & Community Relations of all planned contacts and correspondence with elected officials and policy-making employees of federal, state and local government, including those who are alumni or friends of the University. Those items which pertain to sponsored research should be coordinated with the Vice President for Research. • To consult the Office of Government & Community Relations on any verbal or written statements made on behalf of the University that concern federal, state or local policies, legislation or regulations. • To advise the Office of Government & Community Relations on any activities, conferences, seminars, lectures or projects that involve the community and/or impact the University area. • Faculty or staff members who contact federal, state or local policy-making employees as experts in a specific field, or who act on behalf of themselves or another organization, should include a disclaimer which clearly states that they are not acting on behalf of the University

Investigating summer thermal stratification in Lake Ontario

Summer thermal stratification in Lake Ontario is simulated using the 3D hydrodynamic model Environmental Fluid Dynamics Code (EFDC). Summer temperature differences establish strong vertical density gradients (thermocline) between the epilimnion and hypolimnion. Capturing the stratification and thermocline formation has been a challenge in modeling Great Lakes. Deviating from EFDC's original Mellor-Yamada (1982) vertical mixing scheme, we have implemented an unidimensional vertical model that uses different eddy diffusivity formulations above and below the thermocline (Vincon-Leite, 1991; Vincon-Leite et al., 2014). The model is forced with the hourly meteorological data from weather stations around the lake, flow data for Niagara and St. Lawrence rivers; and lake bathymetry is interpolated on a 2-km grid. The model has 20 vertical layers following sigma vertical coordinates. Sensitivity of the model to vertical layers' spacing is thoroughly investigated. The model has been calibrated for appropriate solar radiation coefficients and horizontal mixing coefficients. Overall the new implemented diffusivity algorithm shows some successes in capturing the thermal stratification with RMSE values between 2-3°C. Calibration of vertical mixing coefficients is under investigation to capture the improved thermal stratification

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

The effects of homophobia, biphobia and transphobia in high school physical education classes, school sports and community sports on future sports and physical activity participation: a retrospective study

LGBTQ2-S-phobia is still present within physical education (PE) classes, school sports and community sports. According to Denison and Kitchen (2015), one in five participants reported that PE classes are the most homophobic sporting environment. This mixed method retrospective survey seeks to examine the effects of LGBTQ2-S-phobia in high school PE classes, school and community sports on future sports and physical activity participation along with identifying whether gender and geographical locations are factors in the experiences in which individuals witnessed or had LGBTQ2-S-phobic events in these environments. Results show that PE classes in high schools represent a higher proportion of LGBTQ2-S-phobia than school sports and community sports. Furthermore, those who identify as male and that attended high school in Northern Ontario were faced with higher levels of LGBT2-S-phobia. Some experiences in these specific geographical areas discouraged some individuals to pursue physical activity and sports participation.Maitrise en Kinésie Humaine (MKH

Tattooed Skin and Health

With about 10–20% of the adult population in Europe being tattooed, there is a strong demand for publications discussing the various issues related to tattooed skin and health. Until now, only a few scientific studies on tattooing have been published. This book discusses different aspects of the various medical risks associated with tattoos, such as allergic reactions from red tattoos, papulo-nodular reactions from black tattoos as well as technical and psycho-social complications, in addition to bacterial and viral infections. Further sections are dedicated to the composition of tattoo inks, and a case is made for the urgent introduction of national and international regulations. Distinguished authors, all specialists in their particular fields, have contributed to this publication which provides a comprehensive view of the health implications associated with tattooing