Supporting Special-Purpose Health Care Models via Web Interfaces

The potential of the Web, via both the Internet and intranets, to facilitate development of clinical information systems has been evident for some time. Most Web-based clinical workstations interfaces, however, provide merely a loose collection of access channels. There are numerous examples of systems for access to either patient data or clinical guidelines, but only isolated cases where clinical decision support is presented integrally with the process of patient care, in particular, in the form of active alerts and reminders based on patient data. Moreover, pressures in the health industry are increasing the need for doctors to practice in accordance with ¿best practice¿ guidelines and often to operate under novel health-care arrangements. We present the Care Plan On-Line (CPOL) system, which provides intranet-based support for the SA HealthPlus Coordinated Care model for chronic disease management. We describe the interface design rationale of CPOL and its implementation framework, which is flexible and broadly applicable to support new health care models over intranets or the Internet

Understanding Consumers’ Inferences from Price and Nonprice Information in the Online Lodging Purchase Decision

The sustained success of variable pricing for revenue management (RM) is dependent on the creation of appropriate price points at which to sell a given product offering. To date, few studies have considered the impact of nonprice information on consumer reaction to price, and none have investigated the relative weights that consumers assign to price and the nonprice information available to them during different phases of the purchase choice process. This exploratory study uses a combination of eye tracking and retrospective think-aloud (RTA) interviews to examine how consumers consider the price and nonprice content generated by the firm and the nonprice information generated by other consumers during two distinct phases of the online choice process: browsing and deliberation. This study’s findings suggest that during browsing, firm-generated content appears to be very influential, particularly the image selected to represent the property in search results. Both firm-generated and user-generated content play a role in hotel choice during deliberation, with the interplay among several types of information being an important indication of value for consumers

Show Me What You See, Tell Me What You Think: Using Eye Tracking for Hospitality Research

Identifying precisely what consumers are looking at (and by implication what they are thinking) when they consider a web page, an image, or a hospitality environment could provide tremendous insights to the hospitality industry. By using eye tracking technology, one can almost literally see through the eyes of the customer to find out what information is examined at various points during the hotel search process or to assess which property design features attract guests’ attention. When eye tracking is immediately followed by interviews that review a graphical representation of the consumer’s eye movements, the thought processes behind consumers’ visual activity can be uncovered and explored. In this paper we explain how eye tracking works and how it could apply to hospitality research. Today’s eye tracking systems are easy for researchers to set up and use and are virtually transparent to the participant during use, making eye tracking a valuable method for examining consumer choice or facility design, or to develop employee training procedures. We argue that eye tracking would provide rich results and deserves to be considered for a wide range of hospitality applications

Single particle analysis of ice crystal residuals observed in orographic wave clouds over Scandinavia during INTACC experiment

International audienceIndividual ice crystal residual particles collected over Scandinavia during the INTACC (INTeraction of Aerosol and Cold Clouds) experiment in October 1999 were analyzed by Scanning Electron Microscopy (SEM) equipped with Energy-Dispersive X-ray Analysis (EDX). Samples were collected onboard the British Met Office Hercules C-130 aircraft using a Counterflow Virtual Impactor (CVI). This study is based on six samples collected in orographic clouds. The main aim of this study is to characterize cloud residual elemental composition in conditions affected by different airmasses. In total 609 particles larger than 0.1 ?m diameter were analyzed and their elemental composition and morphology were determined. Thereafter a hierarchical cluster analysis was performed on the signal detected with SEM-EDX in order to identify the major particle classes and their abundance. A cluster containing mineral dust, represented by aluminosilicates, Fe-rich and Si-rich particles, was the dominating class of particles, accounting for about 57.5% of the particles analyzed, followed by low-Z particles, 23.3% (presumably organic material) and sea salt (6.7%). Sulfur was detected often across all groups, indicating ageing and in-cloud processing of particles. A detailed inspection of samples individually unveiled a relationship between ice crystal residual composition and airmass origin. Cloud residual samples from clean airmasses (that is, trajectories confined to the Atlantic and Arctic Oceans and/or with source altitude in the free troposphere) were dominated primarily by low-Z and sea salt particles, while continentally-influenced airmasses (with trajectories that originated or traveled over continental areas and with source altitude in the continental boundary layer) contained mainly mineral dust residuals. Comparison of residual composition for similar cloud ambient temperatures around ?27°C revealed that supercooled clouds are more likely to persist in conditions where low-Z particles represent significant part of the analyzed cloud residual particles. This indicates that organic material may be poor ice nuclei, in contrast to polluted cases when ice crystal formation was observed at the same environmental conditions and when the cloud residual composition was dominated by mineral dust. The presented results suggest that the chemical composition of cloud nuclei and airmass origin have a strong impact on the ice formation through heterogeneous nucleation in supercooled clouds

Profiles of CH_4, HDO, H_2O, and N_2O with improved lower tropospheric vertical resolution from Aura TES radiances

Thermal infrared (IR) radiances measured near 8 microns contain information about the vertical distribution of water vapor (H_2O), the water isotopologue HDO, and methane (CH_4), key gases in the water and carbon cycles. Previous versions (Version 4 or less) of the TES profile retrieval algorithm used a "spectral-window" approach to minimize uncertainty from interfering species at the expense of reduced vertical resolution and sensitivity. In this manuscript we document changes to the vertical resolution and uncertainties of the TES version 5 retrieval algorithm. In this version (Version 5), joint estimates of H_2O, HDO, CH_4 and nitrous oxide (N_2O) are made using radiances from almost the entire spectral region between 1100 cm^(−1) and 1330 cm^(−1). The TES retrieval constraints are also modified in order to better use this information. The new H_2O estimates show improved vertical resolution in the lower troposphere and boundary layer, while the new HDO/H_2O estimates can now profile the HDO/H_2O ratio between 925 hPa and 450 hPa in the tropics and during summertime at high latitudes. The new retrievals are now sensitive to methane in the free troposphere between 800 and 150 mb with peak sensitivity near 500 hPa; whereas in previous versions the sensitivity peaked at 200 hPa. However, the upper troposphere methane concentrations are biased high relative to the lower troposphere by approximately 4% on average. This bias is likely related to temperature, calibration, and/or methane spectroscopy errors. This bias can be mitigated by normalizing the CH_4 estimate by the ratio of the N_2O estimate relative to the N_2O prior, under the assumption that the same systematic error affects both the N_2O and CH_4 estimates. We demonstrate that applying this ratio theoretically reduces the CH4 estimate for non-retrieved parameters that jointly affect both the N_2O and CH_4 estimates. The relative upper troposphere to lower troposphere bias is approximately 2.8% after this bias correction. Quality flags based upon the vertical variability of the methane and N_2O estimates can be used to reduce this bias further. While these new CH_4, HDO/H_2O, and H_2O estimates are consistent with previous TES retrievals in the altitude regions where the sensitivities overlap, future comparisons with independent profile measurement will be required to characterize the biases of these new retrievals and determine if the calculated uncertainties using the new constraints are consistent with actual uncertainties

European principles of care for physiotherapy provision for persons with inherited bleeding disorders: Perspectives of physiotherapists and patients

Introduction: In their Chronic Care Model, the World Health Organisation states that people with chronic disorders and their families should be informed about the expected course, potential complications, and effective strategies to prevent complications and manage symptoms. Physiotherapists are a key professional group involved in the triage, assessment and management of musculoskeletal conditions of persons with a bleeding disorder (PWBD). Nevertheless, recent reports describe access to physiotherapy for those with these conditions is only sometimes available. Aim: Access to high quality individualised physiotherapy should be ensured for all PWBD, including those with mild and moderate severities, male and female, people with von Willebrand Disease (vWD) and other rare bleeding disorders. Physiotherapy should be viewed as a basic requisite in their multidisciplinary care. Methods/ results: Following a series of meetings with physiotherapists representing the European Association for Haemophilia and Allied Disorders (EAHAD) and PWBD representing the European Haemophilia Consortium (EHC) and a review of publications in the field, eight core principles of physiotherapy care for persons with a bleeding disorder have been co-produced by EAHAD and EHC. Conclusion: These eight principles outline optimum standards of practice in order to advocate personalised patient-centred care for physical health in which both prevention and interventions include shared decision making, and supported self-management

Relating tropical ocean clouds to moist processes using water vapor isotope measurements

We examine the co-variations of tropospheric water vapor, its isotopic composition and cloud types and relate these distributions to tropospheric mixing and distillation models using satellite observations from the Aura Tropospheric Emission Spectrometer (TES) over the summertime tropical ocean. Interpretation of these process distributions must take into account the sensitivity of the TES isotope and water vapor measurements to variations in cloud, water, and temperature amount. Consequently, comparisons are made between cloud-types based on the International Satellite Cloud Climatology Project (ISSCP) classification; these are clear sky, non-precipitating (e.g., cumulus), boundary layer (e.g., stratocumulus), and precipitating clouds (e.g. regions of deep convection). In general, we find that the free tropospheric vapor over tropical oceans does not strictly follow a Rayleigh model in which air parcels become dry and isotopically depleted through condensation. Instead, mixing processes related to convection as well as subsidence, and re-evaporation of rainfall associated with organized deep convection all play significant roles in controlling the water vapor distribution. The relative role of these moisture processes are examined for different tropical oceanic regions

Ultrathin Tropical Tropopause Clouds (UTTCs) : I. Cloud morphology and occurrence

Subvisible cirrus clouds (SVCs) may contribute to dehydration close to the tropical tropopause. The higher and colder SVCs and the larger their ice crystals, the more likely they represent the last efficient point of contact of the gas phase with the ice phase and, hence, the last dehydrating step, before the air enters the stratosphere. The first simultaneous in situ and remote sensing measurements of SVCs were taken during the APE-THESEO campaign in the western Indian ocean in February/March 1999. The observed clouds, termed Ultrathin Tropical Tropopause Clouds (UTTCs), belong to the geometrically and optically thinnest large-scale clouds in the Earth´s atmosphere. Individual UTTCs may exist for many hours as an only 200--300 m thick cloud layer just a few hundred meters below the tropical cold point tropopause, covering up to 105 km2. With temperatures as low as 181 K these clouds are prime representatives for defining the water mixing ratio of air entering the lower stratosphere

Arctic system on trajectory to new state

The Arctic system is moving toward a new state that falls outside the envelope of glacial-interglacial fluctuations that prevailed during recent Earth history. This future Arctic is likely to have dramatically less permanent ice than exists at present. At the present rate of change, a summer ice-free Arctic Ocean within a century is a real possibility, a state not witnessed for at least a million years. The change appears to be driven largely by feedback-enhanced global climate warming, and there seem to be few, if any processes or feedbacks within the Arctic system that are capable of altering the trajectory toward this “super interglacial” state