Towards a Toolset for Intranet Evaluation

Usability is an important component of information systems acceptance. Independent consultants in the assessment of organisational intranets often perform heuristic appraisal, a common method of usability evaluation. However, there are alternative usability models that offer valuable analysis in the evaluation process. Using a government organisation’s intranet as a case study, this paper assesses the value of an independent heuristic-based intranet audit by providing a comparable approach to assessment realisable internally in the organisation using questionnaires. Using a single case study, we empirically apply the Technology Acceptance Model (TAM), together with some heuristic aspects, to provide an alternative tool for intranet usability and acceptance. We provide insight into the usability impact of intranet design changes, and compare the findings of an external usability audit with the approach outlined. An overall toolset for intranet evaluation is proposed as an initial step for further exploration and potential use

Fractional flow reserve guided stent optimisation in focal and diffuse coronary artery disease

Assessing coronary physiology after stent implantation facilitates the optimisation of percutaneous coronary intervention (PCI). Coronary artery disease (CAD) patterns can be characterised by the pullback pressure gradient (PPG) index. The impact of focal vs. diffuse disease on physiology-guided incremental optimisation strategy (PIOS) is unknown. This is a sub-study of the TARGET-FFR randomized clinical trial (NCT03259815). The study protocol directed that optimisation be attempted for patients in the PIOS arm when post-PCI FFR was <0.90. Overall, 114 patients (n = 61 PIOS and 53 controls) with both pre-PCI fractional flow reserve (FFR) pullbacks and post-PCI FFR were included. A PPG ≥ 0.74 defined focal CAD. The PPG correlated significantly with post-PCI FFR (r = 0.43; 95% CI 0.26 to 0.57; p-value < 0.001) and normalised delta FFR (r = 0.49; 95% CI 0.34 to 0.62; p-value < 0.001). PIOS was more frequently applied to vessels with diffuse CAD (6% focal vs. 42% diffuse; p-value = 0.006). In patients randomized to PIOS, those with focal disease achieved higher post-PCI FFR than patients with diffuse CAD (0.93 ± 0.05 vs. 0.83 ± 0.07, p < 0.001). There was a significant interaction between CAD patterns and the randomisation arm for post-PCI FFR (p-value for interaction = 0.004). Physiology-guided stent optimisation was applied more frequently to vessels with diffuse disease; however, patients with focal CAD at baseline achieved higher post-PCI FF

Developing Graduate Employability: The CareerEDGE Model and the Importance of Emotional Intelligence

This chapter discusses a model of graduate employability development, the CareerEDGE model (Dacre Pool and Sewell 2007) which includes Emotional Intelligence (EI) as a key component. Although previous models and theories of employability (e.g. Fugate et al. 2004; Knight and Yorke 2004) have alluded to adaptive emotional functioning as an aspect of employability, CareerEDGE was the first to give EI such prominence. There is scope for EI to have a direct impact on graduate employability but also an indirect impact via other aspects of employability development

Division of Short Gastric Vessels at Laparoscopic Nissen Fundoplication: A Prospective Double-Blind Randomized Trial With 5-Year Follow-Up

OBJECTIVE: To determine whether division of the short gastric vessels at laparoscopic fundoplication confers long-term clinical benefit to patients. SUMMARY BACKGROUND DATA: Dividing the short gastric vessels during surgery for gastroesophageal reflux is controversial. This prospective randomized study was designed to determine whether there is a benefit in terms of patient outcome at a minimum of 5 years after primary surgery. METHODS: Between May 1994 and October 1995, 102 patients undergoing a laparoscopic Nissen fundoplication were randomized to have their short gastric vessels either divided or left intact. By September 2000, 99 (50 no division, 49 division) patients were available for follow-up, and they all underwent a detailed telephone interview by an independent and masked investigator. RESULTS: There were no significant differences between the groups at 5 years of follow-up in terms of the incidence of epigastric pain, regurgitation, odynophagia, early satiety, inability to belch, anorexia, nausea, vomiting, nocturnal coughing, and nocturnal wheezing. There was also no difference between the groups in the incidence of heartburn when determined by either yes/no questioning or a 0-to-10 visual analog scale. There was no difference between the groups in terms of the incidence and severity of dysphagia determined by yes/no questioning, 0-to-10 visual analog scales, or a composite dysphagia score. There was a significantly increased incidence of flatus production and epigastric bloating and a decreased incidence of ability to relieve bloating in patients who underwent division of the short gastric vessels. CONCLUSIONS: Division of the short gastric vessels during laparoscopic Nissen fundoplication does not improve any measured clinical outcome at 5 years of follow-up and is associated with an increased incidence of “wind-related” problems

mechanisms

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