Breast cancer on the world wide web: cross sectional survey of quality of information and popularity of websites.

OBJECTIVES: To determine the characteristics of popular breast cancer related websites and whether more popular sites are of higher quality. DESIGN: The search engine Google was used to generate a list of websites about breast cancer. Google ranks search results by measures of link popularity---the number of links to a site from other sites. The top 200 sites returned in response to the query "breast cancer" were divided into "more popular" and "less popular" subgroups by three different measures of link popularity: Google rank and number of links reported independently by Google and by AltaVista (another search engine). MAIN OUTCOME MEASURES: Type and quality of content. RESULTS: More popular sites according to Google rank were more likely than less popular ones to contain information on ongoing clinical trials (27% v 12%, P=0.01 ), results of trials (12% v 3%, P=0.02), and opportunities for psychosocial adjustment (48% v 23%, P<0.01). These characteristics were also associated with higher number of links as reported by Google and AltaVista. More popular sites by number of linking sites were also more likely to provide updates on other breast cancer research, information on legislation and advocacy, and a message board service. Measures of quality such as display of authorship, attribution or references, currency of information, and disclosure did not differ between groups. CONCLUSIONS: Popularity of websites is associated with type rather than quality of content. Sites that include content correlated with popularity may best meet the public's desire for information about breast cancer.

Perceived usefulness of RFID-enabled information services – a systematic approach

Even though RFID technology is currently gaining importance mainly in logistics, usage areas, such as shopping or after-sales enhancements beyond the supply chain are envisioned. Yet, while RFID hits the street it is questioned if it may undermine one’s privacy while providing few customer benefits. Meeting this criticism this paper investigates RFID-enabled information services and the drivers of their usefulness for consumers. The article claims that the more risk one associates with a product the more benefit from RFID-enabled information services is perceived. We show empirically that the nature of product risk provides a useful framework to decide on the types of RFID information services a marketer should offer to create RFID usefulness perceptions and increase technology acceptance.

Quality of feedback to e-mail requests - an explorative study in alpine tourism destinations

The central aim of our project is to explore the handling of e-mail request from customers by tourist organisations and to explain the perceived behaviour. For this purpose, we designed a qualitative empirical study which consists basically of two stages. The first stage consists of a black-box test where we employ the setting of a qualitative experiment to measure the behaviour of the organisation to an e-mail request. The second stage comprises a with-box test where we want to look into the tourist organizations and analyse the relevant information processes. This study should give as some insight in the internal processing of e-mail requests and thus should help to explain the reactions that we registered.

Cross-Layer Optimizations for Multimedia Distribution over Wireless Multimedia Sensor Networks and Flying Ad-Hoc Networks with Quality of Experience Support

The proliferation of multimedia content and the demand for new audio or video services have fostered the development of a new era based on multimedia information, which allowed the evolution of Wireless Multimedia Sensor Networks (WMSNs) and also Flying Ad-Hoc Networks (FANETs). In this way, live multimedia services require real-time video transmissions with a low frame loss rate, tolerable end-to-end delay, and jitter to support video dissemination with Quality of Experience (QoE) support. Hence, a key principle in a QoE-aware approach is the transmission of high priority frames (protect them) with a minimum packet loss ratio, as well as network overhead. Moreover, multimedia content must be transmitted from a given source to the destination via intermediate nodes with high reliability in a large scale scenario. The routing service must cope with dynamic topologies caused by node failure or mobility, as well as wireless channel changes, in order to continue to operate despite dynamic topologies during multimedia transmission. Finally, understanding user satisfaction on watching a video sequence is becoming a key requirement for delivery of multimedia content with QoE support. With this goal in mind, solutions involving multimedia transmissions must take into account the video characteristics to improve video quality delivery. The main research contributions of this thesis are driven by the research question how to provide multimedia distribution with high energy-efficiency, reliability, robustness, scalability, and QoE support over wireless ad hoc networks. The thesis addresses several problem domains with contributions on different layers of the communication stack. At the application layer, we introduce a QoE-aware packet redundancy mechanism to reduce the impact of the unreliable and lossy nature of wireless environment to disseminate live multimedia content. At the network layer, we introduce two routing protocols, namely video-aware Multi-hop and multi-path hierarchical routing protocol for Efficient VIdeo transmission for static WMSN scenarios (MEVI), and cross-layer link quality and geographical-aware beaconless OR protocol for multimedia FANET scenarios (XLinGO). Both protocols enable multimedia dissemination with energy-efficiency, reliability and QoE support. This is achieved by combining multiple cross-layer metrics for routing decision in order to establish reliable routes.

Health-related quality of life in European women following myocardial infarction: A cross-sectional study

Background:Coronary heart disease is a major contributor to women's health problems.Design:Self-perceived social support, well-being and health-related quality of life (HRQL) were documented in the cross-sectional HeartQoL survey of European women one and six months after a myocardial infarction.Methods:European women were recruited in 18 European countries and grouped into four geographical regions (Southern Europe, Northern Europe, Western Europe and Eastern Europe). Continuous socio-demographic variables and categorical variables were compared by age and region with ANOVA and χ(2), respectively; multiple regression models were used to identify predictors of social support, well-being and HRQL.Results:Women living in the Eastern European region rated social support, well-being and HRQL significantly lower than women in the other regions. Older women had lower physical HRQL scores than younger women. Eastern European women rated social support, well-being and HRQL significantly lower than women in the other regions. Prediction of the dependent variables (social support, well-being and HRQL) by socio-demographic factors varied by total group, in the older age group, and by region; body mass index and managerial responsibility were the most consistent significant predictors.

Galileo Orbit and Clock Quality of the IGS Multi-GNSS Experiment

The Multi-GNSS Experiment (MGEX) of the International GNSS Service (IGS) aims at the data collection and analysis of all available satellite navigation systems. In particular the new global and regional satellite navigation systems are of interest, i.e., the European Galileo, the Chinese BeiDou, the Japanese QZSS as well as satellite based augmentation systems. This article analyzes the orbit and clock quality of the Galileo products of four MGEX analysis centers for a common time period of 20 weeks. Orbit comparisons of the individual analysis centers have a consistency at the 5–30 cm level. Day boundary discontinuities range from 4 to 28 cm whereas 2-day orbit fit RMS values vary between 1 and 7 cm. The accuracy evaluated by satellite laser ranging residuals is on the one decimeter level with a systematic bias of about −5 cm for all analysis centers. In addition, systematic errors on the decimeter level related to solar radiation pressure mismodeling are present in all orbit products. Due to the correlation of radial orbit errors with the clock parameters, these errors are also visible as a bump in the Allan deviation of the Galileo satellite clocks at the orbital frequency.

Quality of Life in Swiss Paediatric Inflammatory Bowel Disease Patients: Do Patients and Their Parents Experience Disease in the Same Way?

BACKGROUND AND AIMS Inflammatory bowel diseases (IBDs) may impair quality of life (QoL) in paediatric patients. We aimed to evaluate in a nationwide cohort whether patients experience QoL in a different way when compared with their parents. METHODS Sociodemographic and psychosocial characteristics were prospectively acquired from paediatric patients and their parents included in the Swiss IBD Cohort Study. Disease activity was evaluated by the Paediatric Crohn's Disease Activity Index (PCDAI) and the Paediatric Ulcerative Colitis Activity Index (PUCAI). We assessed QoL using the KIDSCREEN questionnaire. The QoL domains were analysed and compared between children and parents according to type of disease, parents' age, origin, education and marital status. RESULTS We included 110 children and parents (59 Crohn's disease [CD], 45 ulcerative colitis [UC], 6 IBD unclassified [IBDU]). There was no significant difference in QoL between CD and UC/IBDU, whether the disease was active or in remission. Parents perceived overall QoL, as well as 'mood', 'family' and 'friends' domains, lower than the children themselves, independently of their place of birth and education. However, better concordance was found on 'school performance' and 'physical activity' domains. Marital status and age of parents significantly influenced the evaluation of QoL. Mothers and fathers being married or cohabiting perceived significantly lower mood, family and friends domains than their children, whereas mothers living alone had a lower perception of the friends domain; fathers living alone had a lower perception of family and mood subscores. CONCLUSION Parents of Swiss paediatric IBD patients significantly underestimate overall QoL and domains of QoL of their children independently of origin and education.

Interrelationships between the structural and functional aspects of social relationships, comorbidity and health related quality of life in breast cancer survivors

It is widely acknowledged in theoretical and empirical literature that social relationships, comprising of structural measures (social networks) and functional measures (perceived social support) have an undeniable effect on health outcomes. However, the actual mechanism of this effect has yet to be clearly understood or explicated. In addition, comorbidity is found to adversely affect social relationships and health related quality of life (a valued outcome measure in cancer patients and survivors). ^ This cross sectional study uses selected baseline data (N=3088) from the Women's Healthy Eating and Living (WHEL) study. Lisrel 8.72 was used for the latent variable structural equation modeling. Due to the ordinal nature of the data, Weighted Least Squares (WLS) method of estimation using Asymptotic Distribution Free covariance matrices was chosen for this analysis. The primary exogenous predictor variables are Social Networks and Comorbidity; Perceived Social Support is the endogenous predictor variable. Three dimensions of HRQoL, physical, mental and satisfaction with current quality of life were the outcome variables. ^ This study hypothesizes and tests the mechanism and pathways between comorbidity, social relationships and HRQoL using latent variable structural equation modeling. After testing the measurement models of social networks and perceived social support, a structural model hypothesizing associations between the latent exogenous and endogenous variables was tested. The results of the study after listwise deletion (N=2131) mostly confirmed the hypothesized relationships (TLI, CFI >0.95, RMSEA = 0.05, p=0.15). Comorbidity was adversely associated with all three HRQoL outcomes. Strong ties were negatively associated with perceived social support; social network had a strong positive association with perceived social support, which served as a mediator between social networks and HRQoL. Mental health quality of life was the most adversely affected by the predictor variables. ^ This study is a preliminary look at the integration of structural and functional measures of social relationships, comorbidity and three HRQoL indicators using LVSEM. Developing stronger social networks and forming supportive relationships is beneficial for health outcomes such as HRQoL of cancer survivors. Thus, the medical community treating cancer survivors as well as the survivor's social networks need to be informed and cognizant of these possible relationships. ^

Improving the Quality of Life of spousal caregivers of stroke survivors: A cost effectiveness analysis

Back ground and Purpose. There is a growing consensus among health care researchers that Quality of Life (QoL) is an important outcome and, within the field of family caregiving, cost effectiveness research is needed to determine which programs have the greatest benefit for family members. This study uses a multidimensional approach to measure the cost effectiveness of a multicomponent intervention designed to improve the quality of life of spousal caregivers of stroke survivors. Methods. The CAReS study (Committed to Assisting with Recovery after Stroke) was a 5-year prospective, longitudinal intervention study for 159 stroke survivors and their spousal caregivers upon discharge of the stroke survivor from inpatient rehabilitation to their home. CAReS cost data were analyzed to determine the incremental cost of the intervention per caregiver. The mean values of the quality-of-life predictor variables of the intervention group of caregivers were compared to the mean values of usual care groups found in the literature. Significant differences were then divided into the cost of the intervention per caregiver to calculate the incremental cost effectiveness ratio for each predictor variable. Results. The cost of the intervention per caregiver was approximately $2,500. Statistically significant differences were found between the mean scores for the Perceived Stress and Satisfaction with Life scales. Statistically significant differences were not found between the mean scores for the Self Reported Health Status, Mutuality, and Preparedness scales. Conclusions. This study provides a prototype cost effectiveness analysis on which researchers can build. Using a multidimensional approach to measure QoL, as used in this analysis, incorporates both the subjective and objective components of QoL. Some of the QoL predictor variable scores were significantly different between the intervention and comparison groups, indicating a significant impact of the intervention. The estimated cost of the impact was also examined. In future studies, a scale that takes into account both the dimensions and the weighting each person places on the dimensions of QoL should be used to provide a single QoL score per participant. With participant level cost and outcome data, uncertainty around each cost-effectiveness ratio can be calculated using the bias-corrected percentile bootstrapping method and plotted to calculate the cost-effectiveness acceptability curves.^

Differences in performance for quality of care indicators for acute myocardial infarction (AMI) across various hospital categories in Texas

The study analyzed Hospital Compare data for Medicare Fee-for-service patients at least 65 years of age to determine whether hospital performance for AMI outcome and processes of care measures differ amongst Texas hospitals with respect to ownership status (for profit vs. not-for-profit), academic status (teaching vs. non-teaching) and geographical setting (rural vs. urban). ^ The study found a statistically significant difference between for-profit and not-for-profit hospitals in four process-of-care measures (aspirin at discharge, P=0.028; ACE or ARB inhibitor for LSVD, P=0.048; Smoking cessation advice: P=0.034; outpatients who got aspirin with 24 hours of arrival in the ED, P=0.044). No significant difference in performance was found between COTH-member teaching and non-teaching hospitals for any of the eight process-of-care measures or the two outcome measures for AMI. The study was unable to compare performance based on geographic setting of hospitals due to lack of sufficient data for rural hospitals. ^ The results of the study suggest that for-profit Texas hospitals might be slightly better than not-for –profit hospitals at providing possible heart attack patients with certain processes of care.^

Baseline quality of life as a predictor of exercise intervention adherence among endometrial cancer survivors

Background: The objective of this analysis is to test whether baseline quality of life (QOL) measurements, body mass index (BMI) and prior exercise behavior are significantly associated with (1) telephone counseling adherence, and (2) activity at the final assessment, in a physical activity promoting intervention among endometrial cancer survivors.^ Methods: One hundred endometrial cancer survivors not currently meeting physical activity guidelines completed baseline QOL and anthropometric assessments to measure general physical and mental health [Medical Outcomes Survey (SF-36)], sleep patterns and sleep quality [Pittsburgh Sleep Quality Index (PSQI)], perceived stress [Perceived Stress Scale (PSS)], cancer-specific concerns of long-term survivors [Quality of Life in Adult Cancer Survivors (QLACS)], and psychological distress [Brief Symptom Inventory-18 (BSI-18)]. Survivors were counseled by telephone during the 6-month intervention and their completion rate determined their adherence. The primary variables of interest included age, baseline BMI, baseline activity level, time since diagnosis, education, treatment received, and the SF-36 physical and mental component scores.^ Results: Final activity was most closely linked with baseline activity (p<.001) and less invasive surgery, being leaner and older, and experiencing less pain and more vitality. Telephone counseling was also predicted well by baseline activity, working less and having better overall cancer-related functioning.^ Conclusion: Above and beyond the QOL measures, baseline activity was the strongest predictor of both final activity and telephone counseling adherence. While education, surgery treatment type and bodily pain were important predictors for final exercise and employment status and cancer-related quality of life were important predictors for telephone counseling adherence, considering adaptive exercise interventions that focus heavily on engaging inactive participants may be a way to produce better exercise-related outcomes in the endometrial cancer survivor population.^

Constraint-based runtime prediction of SLA violations in service orchestrations

Service compositions put together loosely-coupled component services to perform more complex, higher level, or cross-organizational tasks in a platform-independent manner. Quality-of-Service (QoS) properties, such as execution time, availability, or cost, are critical for their usability, and permissible boundaries for their values are defined in Service Level Agreements (SLAs). We propose a method whereby constraints that model SLA conformance and violation are derived at any given point of the execution of a service composition. These constraints are generated using the structure of the composition and properties of the component services, which can be either known or empirically measured. Violation of these constraints means that the corresponding scenario is unfeasible, while satisfaction gives values for the constrained variables (start / end times for activities, or number of loop iterations) which make the scenario possible. These results can be used to perform optimized service matching or trigger preventive adaptation or healing.

Key quality factors and travellers profiles at interurban interchanges

La planificación y las políticas de transporte no pueden descuidar la calidad del servicio, considerando que influye notablemente en el cambio modal del coche hacia otros medios de transporte más sostenibles. El concepto se aplica también a los intercambiadores de transporte público, los nodos del sistema donde se cruzan las distintas redes del transporte público y privado. Aunque se han logrado numerosos avances para medir y evaluar la calidad en el sector del transporte público, se han dedicado relativamente pocos esfuerzos a investigar estos aspectos relacionados con la calidad de los intercambiadores del transporte público. Este trabajo de investigación se concentra en la calidad del servicio de la transferencia modal en los intercambiadores interurbanos, según la perspectiva de los viajeros. Su objetivo es identificar los factores clave de la calidad del servicio y los perfiles de los viajeros en los intercambiadores. La investigación es exploratoria y ofrece información acerca de la percepción de los viajeros intermodales relacionada con los aspectos de la calidad, aportando nuevos elementos y datos para adentrarse en estudios más detallados. La metodología del trabajo combina técnicas de análisis estadístico multivariante para analizar los datos de las encuestas sobre la satisfacción de los clientes y se subdivide en tres etapas. En primer lugar, se ha implementado el análisis de correspondencias múltiples para explorar los constructos latentes relacionados con la satisfacción de las características cualitativas de los intercambiadores interurbanos, identificando así los factores clave de la calidad. En segundo lugar, se ha aplicado un análisis de conglomerados de k-medias sobre los factores clave de calidad para clasificar a los viajeros en grupos de usuarios de transportes homogéneos, de acuerdo con su percepción de satisfacción, identificando de este modo los perfiles de los viajeros. Por último, se han formulado sugerencias y recomendaciones sobre la calidad para respaldar la formulación de políticas, estableciendo las prioridades para los intercambiadores interurbanos. La metodología se aplicó en cuatro intercambiadores interurbanos (estaciones de ferrocarriles o de autobuses ) en Madrid, Zaragoza, Gothenburg y Lion, analizando los datos recogidos mediante una encuesta de satisfacción del cliente llevada a cabo en 2011 en los cuatro casos de estudio, donde se interconectan distintos medios de transporte público y privado, de corta y larga distancia. Se recogieron datos sobre la satisfacción de los viajeros con 26 criterios de calidad, así como información sobre aspectos socio-económicos y pautas de comportamiento de viajes. Mediante el análisis de correspondencias múltiples se identificaron 4-5 factores clave de calidad en cada intercambiador, que se asocian principalmente con el sistema de emisión de billetes, el confort y la interconexión, mientras que los viajeros no perciben los temas clásicos como la información. Mediante el análisis de conglomerados se identificaron 2-5 perfiles de viajeros en cada intercambiador. Se reconocieron dos grupos de viajeros en casi todos los casos de estudio: viajeros de cercanía/trabajadores y turistas. Por lo que concierne a las prioridades para apoyar a las partes interesadas en la formulación de políticas, la expedición de billetes es el factor clave para los intercambiadores interurbanos españoles, mientras que la interconexión y los aspectos temporales se destacan en los intercambiadores de Francia y Suecia. Quality of Service can not be neglected in public transport planning and policy making, since it strongly influences modal shifts from car to more sustainable modes. This concept is also related to Public Transport interchanges, the nodes of the transport system where the different sub-systems of public passenger transport and personal vehicles meet. Although a lot of progress has been generally done to measure and assess quality in public transport sector, relatively little investigation has been conducted on quality at PT interchanges. This research work focusses on Quality of Service in the use of transfer facilities at interurban interchanges, according to current travellers’ perspective. It aims at identifying key quality factors and travellers profiles at interurban interchanges. The research is exploratory and offers insight into intermodal travellers’ perception on quality aspects, providing new elements and inputs for more definitive investigation. The methodology of the work combines multivariate statistical techniques to analyse data from customer satisfaction surveys and is subdivided in three steps. Firstly, multiple correspondence analysis was performed to explore latent constructs as concern satisfaction of quality attributes at interurban interchanges, thus identifying the so-called Key Quality Factor. Secondly, k-means cluster analysis was implemented on the key quality factors to classify travellers in homogeneous groups of transport users, according to their perception of satisfaction, thus identifying the so-called Travellers Profiles. Finally, hints and recommendations on quality were identified to support policy making, setting priorities for interurban interchanges. The methodology was applied at four interurban interchanges in Madrid, Zaragoza, Gothenburg and Lyon, analysing the data collected through a customer satisfaction survey carried out in 2011 at the four railway or bus stations where different modes of public and private transport are interconnected covering both short and long trips. Data on travellers’ satisfaction with 26 quality attributes were collected, as well as information on socio-economical and travel patterns. Through multiple correspondence analysis were identified 4-5 key quality factors per interchange. They are mainly related to ticketing, comfort and connectivity, while classical issues, as information, are not perceived as important by travellers’. Through cluster analysis were identified 2-5 travellers profiles per interchange. Two groups of travellers can be found in almost all case studies: commuter / business travellers and holiday travellers. As regards the priorities to support stakeholders in policy making, ticketing is the key-issue for the Spanish interurban interchanges, while connectivity and temporal issues emerge in the French and Swedish case studies.

A survey on service quality description

Quality of service (QoS) can be a critical element for achieving the business goals of a service provider, for the acceptance of a service by the user, or for guaranteeing service characteristics in a composition of services, where a service is defined as either a software or a software-support (i.e., infrastructural) service which is available on any type of network or electronic channel. The goal of this article is to compare the approaches to QoS description in the literature, where several models and metamodels are included. consider a large spectrum of models and metamodels to describe service quality, ranging from ontological approaches to define quality measures, metrics, and dimensions, to metamodels enabling the specification of quality-based service requirements and capabilities as well as of SLAs (Service-Level Agreements) and SLA templates for service provisioning. Our survey is performed by inspecting the characteristics of the available approaches to reveal which are the consolidated ones and which are the ones specific to given aspects and to analyze where the need for further research and investigation lies. The approaches here illustrated have been selected based on a systematic review of conference proceedings and journals spanning various research areas in computer science and engineering, including: distributed, information, and telecommunication systems, networks and security, and service-oriented and grid computing.

Key quality factors at urban interchanges.

Quality of service should not be overlooked in public transport planning and policy making, as it influences modal shift from car use to more sustainable means. Little research has been conducted on the quality of public transport interchanges from the perspective of current travellers (i.e. perceived quality). This work is thus aimed at identifying key quality factors in urban interchanges, through an exploratory approach (multiple correspondence analysis) that provides novel elements for further research. The methodology was applied at interchanges in Madrid and Gothenburg and the data used in the analysis were collected through customer satisfaction surveys conducted in 2011. The analysis identified five key quality factors per interchange. Ticketing plays a key role at both interchanges while physical and environmental issues emerged at Avenida de America in Madrid, and services, temporal issues and interconnectivity characterise Gothenburg central station. Compared with other quality aspects, classical issues such as safety/security and information are not perceived as important by intermodal travellers.