Satisfaction and acceptance with learning management systems

More and more often, universities make the decision to implement integrated learning management systems. Nevertheless, these technological developments are not realized without any trouble, and are achieved with more or less success and user satisfaction (Valenduc, 2000). It is why the presented study aims at identifying the factors influencing learning management system satisfaction and acceptance among students. The Technology Acceptance model created by Wixom and Todd (2005) studies information system acceptance through user satisfaction, and has the benefit of incorporating several ergonomic factors. More precisely, the survey, based on this model, investigates behavioral attitudes towards the system, perceived ease of use, perceived usefulness, as well as system satisfaction, information satisfaction and also incorporates two groups of factors affecting separately the two types of satisfaction. The study was conducted on a representative sample of 593 students from a Brussels university which had recently implemented an integrated learning management system. The results show on one hand, the impact of system reliability, accessibility, flexibility, lay-out and functionalities offered on system satisfaction. And on the other hand, the impact of information accuracy, intelligibility, relevance, exhaustiveness and actualization on information satisfaction. In conclusion, the results indicate the applicability of the theoretical model with learning management systems, and also highlight the importance of each aforementioned factor for a successful implantation of such a system in universities.

Metastatic bone disease

The skeleton is the first and most common site of distant relapse in breast and prostate carcinomas. Tumor bone disease is responsible for a considerable morbidity, which also makes major demands on resources for healthcare provision. Increased bone resorption in tumor bone disease appears to be essentially mediated by the ostoclasts, explaining why bisphosphonates have been successfully used for the treatment of malignant ostolysis. Hypercalcemia occurs in 10-20% of the patients with advanced cancer, and the uncoupling between bone resorption and bone formation is easily demonstrated by the measurement of bone markers. The differential diagnosis between tumor-induced hypercalcemia and primary hyperparathyroidism is most often easy when using intact parathyroid hormone (PTH) assays; moreover, parathyroid hormone-related protein (PTHrP) determination can be useful in selected cases. The diagnosis of bone metastases is often easy when the patient is symptomatic. The diagnostic usefulness of bone markers is limited, and the available data indicate that bone markers are so far unsuitable for an early diagnosis of neoplastic skeletal involvement on an individual basis. However, by combining bone-specific alkaline phosphatase (BALP) or modern bone resorption markers with specific tumor markers, such as PSA or CA15.3, the diagnostic sensitivity of bone markers can be improved. Their degree of elevation correlates with the tumor burden and has been shown to be an independent prognostic factor for several tumors. On the other hand, biochemical markers of bone turnover have the unique potential to simplify and improve the monitoring of metastatic bone disease, which remains a continuous challenge for the oncologist. Peptide-bound cross-links could be quite useful to discriminate between patients progressing early on treatment from those with longer disease control. Also, the diagnostic efficiency of a 50% increase in these markers could identify imminent progression. © 2006 Elsevier Inc. All rights reserved.