Content validation for level of use of feature rich systems: a Delphi study of electronic medical records systems

Introduction. Feature usage is a pre-requisite to realising the benefits of investments in feature rich systems. We propose that conceptualising the dependent variable 'system use' as 'level of use' and specifying it as a formative construct has greater value for measuring the post-adoption use of feature rich systems. We then validate the content of the construct as a first step in developing a research instrument to measure it. The context of our study is the post-adoption use of electronic medical records (EMR) by primary care physicians. Method. Initially, a literature review of the empirical context defines the scope based on prior studies. Having identified core features from the literature, they are further refined with the help of experts in a consensus seeking process that follows the Delphi technique. Results.The methodology was successfully applied to EMRs, which were selected as an example of feature rich systems. A review of EMR usage and regulatory standards provided the feature input for the first round of the Delphi process. A panel of experts then reached consensus after four rounds, identifying ten task-based features that would be indicators of level of use. Conclusions. To study why some users deploy more advanced features than others, theories of post-adoption require a rich formative dependent variable that measures level of use. We have demonstrated that a context sensitive literature review followed by refinement through a consensus seeking process is a suitable methodology to validate the content of this dependent variable. This is the first step of instrument development prior to statistical confirmation with a larger sample.

Observations of the diurnal cycle of outgoing longwave radiation from the Geostationary Earth Radiation Budget instrument

The Geostationary Earth Radiation Budget instrument on Meteosat-8, located over Africa, provides unprecedented temporal sampling (~17 minutes) of the broadband emitted thermal and reflected solar radiances. We analyse the diurnal cycle of the outgoing longwave radiation (OLR) fluxes derived from the thermal radiances for July 2006. Principal component (PC) analysis separates the signals of the surface temperature response to solar heating and of the development of convective clouds. The first two PCs explain most of the OLR variations: PC1 (surface heating) explains 82.3% of the total variance and PC2 (cloud development) explains 12.8% of the variance. Convection is initiated preferentially over mountainous regions and the cloud then advects downstream in the ambient flow. Diurnal variations are much weaker over the oceans, but a coherent signal over the Gulf of Guinea suggests that the cloudiness is modulated by the diurnally varying contrast between the Gulf and the adjacent land mass.

Investigation of liquid MALDI and optimization for instrument tuning and quantitative measurements

The success of Matrix-assisted laser desorption / ionisation (MALDI) in fields such as proteomics has partially but not exclusively been due to the development of improved data acquisition and sample preparation techniques. This has been required to overcome some of the short comings of the commonly used solid-state MALDI matrices such as - cyano-4-hydroxycinnamic acid (CHCA) and 2,5-dihydroxybenzoic acid (DHB). Solid state matrices form crystalline samples with highly inhomogeneous topography and morphology which results in large fluctuations in analyte signal intensity from spot to spot and positions within the spot. This means that efficient tuning of the mass spectrometer can be impeded and the use of MALDI MS for quantitative measurements is severely impeded. Recently new MALDI liquid matrices have been introduced which promise to be an effective alternative to crystalline matrices. Generally the liquid matrices comprise either ionic liquid matrices (ILMs) or a usually viscous liquid matrix which is doped with a UV lightabsorbing chromophore [1-3]. The advantages are that the droplet surface is smooth and relatively uniform with the analyte homogeneously distributed within. They have the ability to replenish a sampling position between shots negating the need to search for sample hot-spots. Also the liquid nature of the matrix allows for the use of additional additives to change the environment to which the analyte is added.

Governing the clean development mechanism: global rhetoric versus local realities in carbon sequestration projects

Global agreements have proliferated in the past ten years. One of these is the Kyoto Protocol, which contains provisions for emissions reductions by trading carbon through the Clean Development Mechanism (CDM). The CDM is a market-based instrument that allows companies in Annex I countries to offset their greenhouse gas emissions through energy and tree offset projects in the global South. I set out to examine the governance challenges posed by the institutional design of carbon sequestration projects under the CDM. I examine three global narratives associated with the design of CDM forest projects, specifically North – South knowledge politics, green developmentalism, and community participation, and subsequently assess how these narratives match with local practices in two projects in Latin America. Findings suggest that governance problems are operating at multiple levels and that the rhetoric of global carbon actors often asserts these schemes in one light, while the rhetoric of those who are immediately involved locally may be different. I also stress the alarmist’s discourse that blames local people for the problems of environmental change. The case studies illustrate the need for vertical communication and interaction and nested governance arrangements as well as horizontal arrangements. I conclude that the global framing of forests as offsets requires better integration of local relationships to forests and their management and more effective institutions at multiple levels to link the very local to the very large scale when dealing with carbon sequestration in the CDM.

A parentally-administered cognitive development assessment for children from 10 to 24 months

The Cognitive Development Questionnaire (CDQ) allows accurate assessment of cognitive development of children from 10 to 24 months by parents and caregivers in the home. It takes between one and two hours to complete over about a week. Three phases of work are described, in which the instrument is progressively refined to improve its validity and reliability. This resulting version of the CDQ shows excellent correlation with age, and with the Mental Scale of the Bayley Scales of Infant Development (Bayley, 1993). The CDQ thus offers researchers and clinicians a useful alternative to professionally-administered cognitive assessment in infancy.

The influence of vegetation and building morphology on shadow patterns and mean radiant temperatures in urban areas: model development and evaluation

The solar and longwave environmental irradiance geometry (SOLWEIG) model simulates spatial variations of 3-D radiation fluxes and mean radiant temperature (T mrt) as well as shadow patterns in complex urban settings. In this paper, a new vegetation scheme is included in SOLWEIG and evaluated. The new shadow casting algorithm for complex vegetation structures makes it possible to obtain continuous images of shadow patterns and sky view factors taking both buildings and vegetation into account. For the calculation of 3-D radiation fluxes and T mrt, SOLWEIG only requires a limited number of inputs, such as global shortwave radiation, air temperature, relative humidity, geographical information (latitude, longitude and elevation) and urban geometry represented by high-resolution ground and building digital elevation models (DEM). Trees and bushes are represented by separate DEMs. The model is evaluated using 5 days of integral radiation measurements at two sites within a square surrounded by low-rise buildings and vegetation in Göteborg, Sweden (57°N). There is good agreement between modelled and observed values of T mrt, with an overall correspondence of R 2 = 0.91 (p < 0.01, RMSE = 3.1 K). A small overestimation of T mrt is found at locations shadowed by vegetation. Given this good performance a number of suggestions for future development are identified for applications which include for human comfort, building design, planning and evaluation of instrument exposure.

Development and validation of a parent report measure for detection of cognitive delay in infancy

Aim To develop a brief, parent-completed instrument (‘ERIC’) for detection of cognitive delay in 10-24 month-olds born preterm, or with low birth weight, or with perinatal complications, and to establish its diagnostic properties. Method Scores were collected from parents of 317 children meeting ≥1 inclusion criteria (birth weight <1500g; gestational age <34 completed weeks; 5-minute Apgar <7; presence of hypoxic-ischemic encephalopathy) and meeting no exclusion criteria. Children were assessed for cognitive delay using a criterion score on the Bayley Scales of Infant and Toddler Development Cognitive Scale III1 <80. Items were retained according to their individual associations with delay. Sensitivity, specificity, Positive and Negative Predictive Values were estimated and a truncated ERIC was developed for use <14 months. Results ERIC detected 17 out of 18 delayed children in the sample, with 94.4% sensitivity (95% CI [confidence interval] 83.9-100%), 76.9% specificity (72.1-81.7%), 19.8% positive predictive value (11.4-28.2%); 99.6% negative predictive value (98.7-100%); 4.09 likelihood ratio positive; and 0.07 likelihood ratio negative; the associated Area under the Curve was .909 (.829-.960). Interpretation ERIC has potential value as a quickly-administered diagnostic instrument for the absence of early cognitive delay in preterm or premature infants of 10-24 months, and as a screen for cognitive delay. Further research may be needed before ERIC can be recommended for wide-scale use.

Multi-instrument ground-based observations of a travelling convection vortices event

A coordinated ground-based observational campaign using the IMAGE magnetometer network, EISCAT radars and optical instruments on Svalbard has made possible detailed studies of a travelling convection vortices (TCV) event on 6 January 1992. Combining the data from these facilities allows us to draw a very detailed picture of the features and dynamics of this TCV event. On the way from the noon to the drawn meridian, the vortices went through a remarkable development. The propagation velocity in the ionosphere increased from 2.5 to 7.4 km s−1, and the orientation of the major axes of the vortices rotated from being almost parallel to the magnetic meridian near noon to essentially perpendicular at dawn. By combining electric fields obtained by EISCAT and ionospheric currents deduced from magnetic field recordings, conductivities associated with the vortices could be estimated. Contrary to expectations we found higher conductivities below the downward field aligned current (FAC) filament than below the upward directed. Unexpected results also emerged from the optical observations. For most of the time there were no discrete aurora at 557.7 nm associated with the TCVs. Only once did a discrete form appear at the foot of the upward FAC. This aurora subsequently expanded eastward and westward leaving its centre at the same longitude while the TCV continued to travel westward. Also we try to identify the source regions of TCVs in the magnetosphere and discuss possible generation mechanisms.