When staff handle staph : user-driven versus expert-driven communication of infection control guidelines

Health care-associated infections cause thousands of preventable deaths each year. Therefore, it is crucial that health care workers (HCWs) adhere to infection control guidelines. Although most HCWs are aware of the rationale for guidelines, adherence is generally poor, which might be caused by the guidelines’ expert-driven character. Whereas traditional, paper-based guidelines have a strong focus on scientific validation, regulation, and legislation, HCWs’ information need is rather action-oriented.\ud \ud Based on extensive user-centered research involving HCWs (comprised of eight studies including Card Sort, scenario testing with thinking aloud, prototyping, interviewing, etc), a multimodal website was developed that presents evidence-based guidelines as answers to questions that reflect HCWs’ practical informational needs. \ud \ud Evaluation studies showed that the website outperformed the traditional, paper-based guidelines with regard to efficiency (time for task completion decreased significantly from six to two minutes), effectiveness (successful task completion rate increased significantly from 50% to 90%), and user satisfaction. The website appeared to ‘empower’ HCWs since it allowed them to take decisions for daily work practice, and thereby reduced infection control professionals’ workload. \ud \ud Since a website in itself is not enough to change HCWs’ behavioral intention to adhere to the guidelines, the factors that affect adoption of the website in daily work practice were investigated next to the determinants of intention to adhere. These factors were considered during the implementation phase of the website. \ud \ud The studies that together composed the user-centered design process of the website are described in a dissertation (thesis defense October 2nd, 2009). This dissertation provides the methodological steps and design principles necessary to communicate user-driven guidelines via a website and suggests how to optimally implement this website in daily work practice, in order to enhance effective and efficient risk- and crisis communication. Methicillin Resistant Staphylococcus aureus (also known as “hospital bacteria”) served as a case study for this dissertation research, but the thesis might also serve as a manual for the communication of guidelines regarding all types of infectious diseases, such as Mexican flu (H1N1)). This is subject of future research.\ud \ud Furthermore, future studies will concentrate on the development of e-learning strategies for HCWs and incorporating an advanced dialogue system into the website

Ramp Type HTS Josephson Junctions with PrBaCuGaO Barriers

Ramp type Josephson junctions have been fabricated using DyBa/sub 2/Cu/sub 3/O/sub 7-/spl delta// as electrode material and PrBa/sub 2/Cu/sub 3-x/Ga/sub x/O/sub 7-/spl delta// with x=0, 0.10 and 0.40 as junction barriers. Barrier thickness lie between 6-30 nm. Several junctions without barrier were made in order to find ways to minimize the damage of the ramp interface. In total about 40 chips were fabricated each containing several junctions and their I-V characteristics measured for various temperatures down to 4.2 K. Only those junctions showing clear RSJ-like curves were selected to be analyzed. In some cases we also measured I/sub c/ as a function of a small applied field and obtained a clear Fraunhofer pattern, but there is a tendency to flux trapping as evidenced by LTSEM. It was found at 4.2 K that the critical current density J/sub c/ scales with the specific resistance R/sub n/A as J/sub c/=C/sub bar/(R/sub n/A)/sup -m/ (m=1.8/spl plusmn/0.5). The barrier material dependent constant C/sub bar/ increases with x, whereas, for a given d, J/sub c/ is constant and R/sub n/A increase

An iterative algorithm for sparse and constrained recovery with applications to divergence-free current reconstructions in magneto-encephalography

We propose an iterative algorithm for the minimization of a $\ell_1$-norm penalized least squares functional, under additional linear constraints. The algorithm is fully explicit: it uses only matrix multiplications with the three matrices present in the problem (in the linear constraint, in the data misfit part and in penalty term of the functional). None of the three matrices must be invertible. Convergence is proven in a finite-dimensional setting. We apply the algorithm to a synthetic problem in magneto-encephalography where it is used for the reconstruction of divergence-free current densities subject to a sparsity promoting penalty on the wavelet coefficients of the current densities. We discuss the effects of imposing zero divergence and of imposing joint sparsity (of the vector components of the current density) on the current density reconstruction.Comment: 21 pages, 3 figure

Trying to break new ground in aerial archaeology

Aerial reconnaissance continues to be a vital tool for landscape-oriented archaeological research. Although a variety of remote sensing platforms operate within the earth’s atmosphere, the majority of aerial archaeological information is still derived from oblique photographs collected during observer-directed reconnaissance flights, a prospection approach which has dominated archaeological aerial survey for the past century. The resulting highly biased imagery is generally catalogued in sub-optimal (spatial) databases, if at all, after which a small selection of images is orthorectified and interpreted. For decades, this has been the standard approach. Although many innovations, including digital cameras, inertial units, photogrammetry and computer vision algorithms, geographic(al) information systems and computing power have emerged, their potential has not yet been fully exploited in order to re-invent and highly optimise this crucial branch of landscape archaeology. The authors argue that a fundamental change is needed to transform the way aerial archaeologists approach data acquisition and image processing. By addressing the very core concepts of geographically biased aerial archaeological photographs and proposing new imaging technologies, data handling methods and processing procedures, this paper gives a personal opinion on how the methodological components of aerial archaeology, and specifically aerial archaeological photography, should evolve during the next decade if developing a more reliable record of our past is to be our central aim. In this paper, a possible practical solution is illustrated by outlining a turnkey aerial prospection system for total coverage survey together with a semi-automated back-end pipeline that takes care of photograph correction and image enhancement as well as the management and interpretative mapping of the resulting data products. In this way, the proposed system addresses one of many bias issues in archaeological research: the bias we impart to the visual record as a result of selective coverage. While the total coverage approach outlined here may not altogether eliminate survey bias, it can vastly increase the amount of useful information captured during a single reconnaissance flight while mitigating the discriminating effects of observer-based, on-the-fly target selection. Furthermore, the information contained in this paper should make it clear that with current technology it is feasible to do so. This can radically alter the basis for aerial prospection and move landscape archaeology forward, beyond the inherently biased patterns that are currently created by airborne archaeological prospection

Lessons Learnt From WASH Action Research With Practitioners in Four Countries

This is the final report from the Action Research for Learning programme, a three-year initiative (2013 -- 2015), led by IRC, to improve the effectiveness of existing hygiene promotion and community empowerment programmes of selected local Dutch WASH Alliance partners in Bangladesh, Ethiopia, Ghana and Uganda. In Ethiopia and Bangladesh, the focus was on hygiene promotion, while in Ghana and Uganda the focus was on community empowerment interventions