Cost analysis of opt-in consent procedures for the Texas statewide immunization information system, ImmTrac

Background. Childhood immunization programs have dramatically reduced the morbidity and mortality associated with vaccine-preventable diseases. Proper documentation of immunizations that have been administered is essential to prevent duplicate immunization of children. To help improve documentation, immunization information systems (IISs) have been developed. IISs are comprehensive repositories of immunization information for children residing within a geographic region. The two models for participation in an IIS are voluntary inclusion, or "opt-in," and voluntary exclusion, or "opt-out." In an opt-in system, consent must be obtained for each participant, conversely, in an opt-out IIS, all children are included unless procedures to exclude the child are completed. Consent requirements for participation vary by state; the Texas IIS, ImmTrac, is an opt-in system.^ Objectives. The specific objectives are to: (1) Evaluate the variance among the time and costs associated with collecting ImmTrac consent at public and private birthing hospitals in the Greater Houston area; (2) Estimate the total costs associated with collecting ImmTrac consent at selected public and private birthing hospitals in the Greater Houston area; (3) Describe the alternative opt-out process for collecting ImmTrac consent at birth and discuss the associated cost savings relative to an opt-in system.^ Methods. Existing time-motion studies (n=281) conducted between October, 2006 and August, 2007 at 8 birthing hospitals in the Greater Houston area were used to assess the time and costs associated with obtaining ImmTrac consent at birth. All data analyzed are deidentified and contain no personal information. Variations in time and costs at each location were assessed and total costs per child and costs per year were estimated. The cost of an alternative opt-out system was also calculated.^ Results. The median time required by birth registrars to complete consent procedures varied from 72-285 seconds per child. The annual costs associated with obtaining consent for 388,285 newborns in ImmTrac's opt-in consent process were estimated at $702,000. The corresponding costs of the proposed opt-out system were estimated to total $194,000 per year. ^ Conclusions. Substantial variation in the time and costs associated with completion of ImmTrac consent procedures were observed. Changing to an opt-out system for participation could represent significant cost savings. ^

HPV knowledge, HPV vaccine awareness and initiation among Hispanics: The role of language, information seeking, and information scanning

Background. Among Hispanics, the HPV vaccine has the potential to eliminate disparities in cervical cancer incidence and mortality but only if optimal rates of vaccination are achieved. Media can be an important information source for increasing HPV knowledge and awareness of the vaccine. Very little is known about how media use among Hispanics affects their HPV knowledge and vaccine awareness. Even less is known about what differences exist in media use and information processing among English- and Spanish-speaking Hispanics.^ Aims. Examine the relationships between three health communication variables (media exposure, HPV-specific information scanning and seeking) and three HPV outcomes (knowledge, vaccine awareness and initiation) among English- and Spanish-speaking Hispanics.^ Methods. Cross-sectional data from a survey administered to Hispanic mothers in Dallas, Texas was used for univariate and multivariate logistic regression analyses. Sample used for analysis included 288 mothers of females aged 8-22 recruited from clinics and community events. Dependent variables of interest were HPV knowledge, HPV vaccine awareness and initiation. Independent variables were media exposure, HPV-specific information scanning and seeking. Language was tested as an effect modifier on the relationship between health communication variables and HPV outcomes.^ Results. English-speaking mothers reported more media exposure, HPV-specific information scanning and seeking than Spanish-speakers. Scanning for HPV information was associated with more HPV knowledge (OR = 4.26, 95% CI = 2.41 - 7.51), vaccine awareness (OR = 10.01, 95% CI = 5.43 - 18.47) and vaccine initiation (OR = 2.54, 95% CI = 1.09 - 5.91). Seeking HPV-specific information was associated with more knowledge (OR = 2.27, 95% CI = 1.23 - 4.16), awareness (OR = 6.60, 95% CI = 2.74 - 15.91) and initiation (OR = 4.93, 95% CI = 2.64 - 9.20). Language moderated the effect of information scanning and seeking on vaccine awareness.^ Discussion. Differences in information scanning and seeking behaviors among Hispanic subgroups have the potential to lead to disparities in vaccine awareness.^ Conclusion. Findings from this study underscore health communication differences among Hispanics and emphasize the need to target Spanish language media as well as English language media aimed at Hispanics to improve knowledge and awareness.^

Source Language Categorization for improving a Speech into Sign Language Translation System

This paper describes a categorization module for improving the performance of a Spanish into Spanish Sign Language (LSE) translation system. This categorization module replaces Spanish words with associated tags. When implementing this module, several alternatives for dealing with non-relevant words have been studied. Non-relevant words are Spanish words not relevant in the translation process. The categorization module has been incorporated into a phrase-based system and a Statistical Finite State Transducer (SFST). The evaluation results reveal that the BLEU has increased from 69.11% to 78.79% for the phrase-based system and from 69.84% to 75.59% for the SFST.

A Tele-Health Communication and Information System for Underserved Children in Rural Areas of Nicaragua

Millennium Development Goals point out the necessity of actively promoting maternal-child health care status, especially in underserved areas. This article details the development actions carried out between 2008 and 2011 in some rural communities of Nicaragua with the aim to provide a low-cost tele-health communication service. The service is managed by the health care center of Cusmapa, which leads the program and maintains a communication link between its health staff and the health brigades of 26 distant communities. Local agents can use the system to report urgent maternal-child health care episodes to be assessed through WiMAX-WiFi voice and data communications attended by two physicians and six nurses located at the health care center. The health and nutritional status of the maternal-child population can be monitored to prevent diseases, subnutrition, and deaths. The action approach assumes the fundamentals of appropriate technology and looks for community- based, sustainable, replicable, and scalable solutions to ensure future deployments according to the strategies of the United Nations.

Patrol team language identification system for DARPA RATS P1 evaluation

This paper describes the language identification (LID) system developed by the Patrol team for the first phase of the DARPA RATS (Robust Automatic Transcription of Speech) program, which seeks to advance state of the art detection capabilities on audio from highly degraded communication channels. We show that techniques originally developed for LID on telephone speech (e.g., for the NIST language recognition evaluations) remain effective on the noisy RATS data, provided that careful consideration is applied when designing the training and development sets. In addition, we show significant improvements from the use of Wiener filtering, neural network based and language dependent i-vector modeling, and fusion.

Adapting a speech into sign language translation system to a new domain

This paper presents a methodology for adapting an advanced communication system for deaf people in a new domain. This methodology is a user-centered design approach consisting of four main steps: requirement analysis, parallel corpus generation, technology adaptation to the new domain, and finally, system evaluation. In this paper, the new considered domain has been the dialogues in a hotel reception. With this methodology, it was possible to develop the system in a few months, obtaining very good performance: good speech recognition and translation rates (around 90%) with small processing times.

Creating a Web-accessible, point-of-care, team-based information system (PoinTIS): the librarian as publisher*

The Internet has created new opportunities for librarians to develop information systems that are readily accessible at the point of care. This paper describes the multiyear process used to justify, fund, design, develop, promote, and evaluate a rehabilitation prototype of a point-of-care, team-based information system (PoinTIS) and train health care providers to use this prototype for their spinal cord injury and traumatic brain injury patient care and education activities. PoinTIS is a successful model for librarians in the twenty-first century to serve as publishers of information created or used by their parent organizations and to respond to the opportunities for information dissemination provided by recent technological advances.