Stressed Web Environments as Strategic Games: Risk Profiles and Weltanschauung

We consider the behaviour of a set of services in a stressed web environment where performance patterns may be difficult to predict. In stressed environments the performances of some providers may degrade while the performances of others, with elastic resources, may improve. The allocation of web-based providers to users (brokering) is modelled by a strategic non-cooperative angel-daemon game with risk profiles. A risk profile specifies a bound on the number of unreliable service providers within an environment without identifying the names of these providers. Risk profiles offer a means of analysing the behaviour of broker agents which allocate service providers to users. A Nash equilibrium is a fixed point of such a game in which no user can locally improve their choice of provider – thus, a Nash equilibrium is a viable solution to the provider/user allocation problem. Angel daemon games provide a means of reasoning about stressed environments and offer the possibility of designing brokers using risk profiles and Nash equilibria.

The Postmodernist Critique of Evidence-Based Practice

In this paper, we examine the postmodernist argument that evidence-based practice (EBP) should be rejected by nurses because it restricts the sources of knowledge used by practitioners. Three main postmodernist criticisms are identified and discussed. First, that the notion of ‘best evidence’ implies a hierarchical and exclusivist approach to knowledge. We accept this argument, noting that such a hierarchy is accepted and justified by many of its proponents. Second, that the hierarchy embraced by the evidence-based practice movement damages health care because it excludes other forms of evidence that are needed to understand the complexity of care. We accept that some manifestations of EBP, notably the Cochrane Collaboration, have devalued qualitative evidence. Using our previous experience of conducting Cochrane reviews (McGaughey et al. 2007), we argue that this limits explanatory scope. Third, that it fails to take account of individuals or their experience. Here, we use evidence of the use by midwives of EBP policies and protocols to the detriment of including women in decision-making processes (Porter et al. 2007) to accept that there is also some merit to this critique. We conclude that, while it is not necessary to concur with the total rejection of EBP that postmodernists advocate, it is necessary to address the issues they raise in order to ensure that EBP better fits the requirements of nursing.
McGaughey, J., Alderdice, F., Fowler, R., Kapila, A., Mayhew, A., Moutray, M., 2007. Outreach and Early Warning Systems (EWS) for the prevention of Intensive Care admission and death of critically ill adult patients on general hospital wards. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD005529. DOI: 10.1002/14651858.CD005529.pub2.
Porter, S., Crozier, K., Sinclair, M., Kernohan, W., 2007. New midwifery? A qualitative analysis of midwives’ decision-making strategies. Journal of Advanced Nursing 60 (6), 525-534.

Working with fathers to improve children's well-being: Results of a survey exploring service provision and intervention approach in the UK

Interventions for fathers are a recent growth area in family services. Although some specific approaches are beginning to be evaluated, there is little known about what kinds of interventions are more generally being used in practice. A web-based survey of practitioners was conducted in the UK, with contact being made via local authority service managers. Two hundred and twenty-one responses were received from 53% of local authorities. Both interventions specifically for fathers and services for both parents were targeted in the survey. Results are reported on organisational location; targeting of services; type of intervention; numbers and percentages of men attending services, recruitment of fathers; evaluation strategies; and ideological and theoretical approaches. Numbers of fathers engaged are relatively low - e.g. the median annual number of fathers attending structured parenting courses was eight and in courses for both parents, 21% of those attending were men. Responses on ideological and theoretical approaches suggest that overt gender politics play only a small part, but that the dominant views of practitioners are in line with mainstream approaches to parenting support. Cognitive and behavioral approaches were the most popular.

Web adoption by Irish credit unions: Performance implications

The purpose of this paper is to examine website adoption and its resultant effects on credit union performance in Ireland over the period 2002 to 2010. While there has been a steady increase in web adoption over the period a sizeable proportion (53%) of credit unions did not have a web-based facility in 2010. To gauge web functionality the researchers accessed all websites in 2010/2011 and it transpired that most sites were classified as informational with limited transactional options. Panel data techniques are then used to capture the dynamic nature of website diffusion and to investigate the effect of website adoption on cost and performance. The empirical analysis reveals that credit unions that have web-based functionality have a reduced spread between the loan and pay-out rate with this primarily caused by reduced loan rates. This reduced spread, although small, is found to both persist and increase over time.

Protocol for a pilot randomised controlled trial of an intervention to increase the use of traffic light food labelling in UK shoppers (the FLICC trial)

Background: Traffic light labelling of foods—a system that incorporates a colour-coded assessment of the level of total fat, saturated fat, sugar and salt on the front of packaged foods—has been recommended by the UK Government and is currently in use or being phased in by many UK manufacturers and retailers. This paper describes a protocol for a pilot randomised controlled trial of an intervention designed to increase the use of traffic light labelling during real-life food purchase decisions.

Methods/design: The objectives of this two-arm randomised controlled pilot trial are to assess recruitment, retention and data completion rates, to generate potential effect size estimates to inform sample size calculations for the main trial and to assess the feasibility of conducting such a trial. Participants will be recruited by email from a loyalty card database of a UK supermarket chain. Eligible participants will be over 18 and regular shoppers who frequently purchase ready meals or pizzas. The intervention is informed by a review of previous interventions encouraging the use of nutrition labelling and the broader behaviour change literature. It is designed to impact on mechanisms affecting belief and behavioural intention formation as well as those associated with planning and goal setting and the adoption and maintenance of the behaviour of interest, namely traffic light label use during purchases of ready meals and pizzas. Data will be collected using electronic sales data via supermarket loyalty cards and web-based questionnaires and will be used to estimate the effect of the intervention on the nutrition profile of purchased ready meals and pizzas and the behavioural mechanisms associated with label use. Data collection will take place over 48 weeks. A process evaluation including semi-structured interviews and web analytics will be conducted to assess feasibility of a full trial.

Discussion: The design of the pilot trial allows for efficient recruitment and data collection. The intervention could be generalised to a wider population if shown to be feasible in the main trial.

Impact of an evidence-based online module on best practice in physical therapy for children with developmental coordination disorder: a mixed methods study

Aims : This study evaluates the impact of a Developmental Coordination Disorder (DCD) evidence-based online module including synthesized resources, practical strategies, and interactive component on self-reported physical therapist (PT) knowledge, skills, and practice. Methods : PTs from across Canada completed questionnaires before, immediately after, and 2 months following completion of the module. Questionnaires used 7-point Likert scale items and short open-ended questions; analyzes used paired t-tests and a thematic approach. Results : Fifty PTs completed both pre- and post-questionnaires; 41 of these completed the follow-up questionnaire. Most items (79%) evaluating self-reported knowledge and skills increased significantly following module completion and this increase was maintained two months later. Most participants (92%) reported an increase in their confidence to provide DCD evidence-based services. Participants plan to modify their evaluative practices (e.g., involving children in goal setting) and their management of DCD (e.g., using best practice principles, providing resources to families and physicians). At the 2- month follow-up, 46% of participants had returned to the module to review information (e.g., video, resources) or to download handouts. Conclusion : An online module developed collaboratively with PTs has the potential not only to increase PTs’ knowledge, but also to support them in implementing evidence-based services for children with DCD.

Working with physical therapists to develop and evaluate an evidence-based online module for Developmental Coordination Disorder (DCD): bridging the knowledge-to-practice gap

Aims: Developmental Coordination Disorder (DCD) is a chronic condition with potential negative health consequences. Clinicians working with children with DCD need access to tailored, synthesized, evidence-based DCD information; however a knowledge-to-practice gap exists. The aim of this study was to develop and evaluate an evidence-based online DCD module tailored to physical therapists’ (PTs) identified needs. Methods: Guided by the Knowledge to Action framework, we interviewed PTs working with children with DCD (n=9) to identify their information needs. Their recommendations, along with synthesized DCD research evidence, informed module development. PTs (n=50) responded to scaled items and open-ended questions to evaluate module usefulness. Results: The module incorporated important PT DCD content areas including: 1) Identification; 2) Planning Interventions and Goals; 3) Evidence-Based Practice; 4) Management; and, 5) Resources. Case scenarios, clinical applications, interactive media, links to resources, and interactive learning opportunities were also embedded. PTs perceived the module to be comprehensive and useful and provided feedback to improve module navigation. Conclusions: Involving end-users throughout the development and evaluation of an online PT DCD module contributed to its relevance, applicability, and utility. The ongoing clinical use of this module may have the potential to improve the quality of PT DCD services.

A follow-up study on the quality of alcohol dependence-related information on the web.

ABSTRACT: In order to evaluate the one-year evolution of web-based information on alcohol dependence, we re-assessed alcohol-related sites in July 2007 with the same evaluating tool that had been used to assess these sites in June 2006. Websites were assessed with a standardized form designed to rate sites on the basis of accountability, presentation, interactivity, readability, and content quality. The DISCERN scale was also used, which aimed to assist persons without content expertise in assessing the quality of written health publications. Scores were highly stable for all components of the form one year later (r = .77 to .95, p < .01). Analysis of variance for repeated measures showed no time effect, no interaction between time and scale, no interaction between time and group (affiliation categories), and no interaction between time, group, and scale. The study highlights lack of change of alcohol-dependence-related web pages across one year.

Les campagnes sociales destinées aux jeunes adultes québécois sur Internet : pistes pour l'optimisation des sites Web

Avec la montée en popularité d’Internet et des médias sociaux, de plus en plus d’organismes sociaux et publics, notamment, intègrent des plateformes Web à leurs volets traditionnels. La question d’Internet demeure toutefois peu étudiée eu égard à la publicité sociale. Ce mémoire porte donc sur la question du Web en relation avec les campagnes sociales adressées aux jeunes Québécois de 18 à 25 ans, une population particulièrement réceptive aux nouvelles technologies. Plus exactement, dans cette étude, nous avons analysé trois sites Web rattachés à des campagnes sociales (La vitesse, ça coûte cher de la SAAQ, Les ITSS se propagent du MSSS et 50 000 adeptes, 5 000 toutous de la Fondation CHU Sainte-Justine) dans l’objectif de déterminer leurs forces et leurs faiblesses pour ensuite proposer des pistes pour leur optimisation. C’est à l’aide d’une analyse critique de contenu suivie d’entrevues et d’observations individuelles auprès de 19 participants que nous sommes parvenue à suggérer des pistes pour l’optimisation des sites Web de campagnes sociales destinées aux jeunes adultes québécois. Une des plus grandes difficultés en ce qui a trait à leur conception consiste à choisir les stratégies les plus appropriées pour provoquer un changement d’attitude ou de comportement, a fortiori chez ceux qui adoptent des comportements à risque (fumer, conduire en état d’ébriété, avoir des relations sexuelles non protégées); des stratégies qui, pour être plus efficaces, devraient être adaptées en fonction des caractéristiques propres aux publics cibles et aux médias de diffusion. Afin d’analyser adéquatement les campagnes sociales, nous avons fait appel aux théories de la persuasion et aux théories sur l’influence des médias jugées pertinentes dans notre contexte puisqu’elles sont propres à ce type d’étude. Ces approches combinées nous ont permis d’intégrer à l’analyse d’une campagne donnée les contextes qui l’entourent et les pratiques dans lesquelles elle s’inscrit. Cette étude nous a, entre autres, permis de démontrer qu’il existait d’importants écarts entre les attentes et les besoins des internautes et l’offre des sites Web étudiés.

Designing context-aware adaptive units of learning based on IMS-LD standard

Learning contents adaptation has been a subject of interest in the research area of the adaptive hypermedia systems. Defining which variables and which standards can be considered to model adaptive content delivery processes is one of the main challenges in pedagogical design over e-learning environments. In this paper some specifications, architectures and technologies that can be used in contents adaptation processes considering characteristics of the context are described and a proposal to integrate some of these characteristics in the design of units of learning using adaptation conditions in a structure of IMS-Learning Design (IMS-LD) is presented. The key contribution of this work is the generation of instructional designs considering the context, which can be used in Learning Management Systems (LMSs) and diverse mobile devices

Curriculum sequencing for an e-learning system based on learning styles

This work shows the use of adaptation techniques involved in an e-learning system that considers students' learning styles and students' knowledge states. The mentioned e-learning system is built on a multiagent framework designed to examine opportunities to improve the teaching and to motivate the students to learn what they want in a user-friendly and assisted environment

UX Theory - Web Design

This lecture introduces UX theory and focusses on applying this to web based design.

Teleconsultation in sexual and reproductive health for young adults through mobile devices: Experience in Colombia

Background: Sexual risk behaviors associated with poor information on sexuality have contributed to major public health problems in the area of sexual and reproductive health in teenagers and young adults in Colombia. Objective: To measure the perception of changes in sexual and reproductive risk behavior after the use of a teleconsultation service via mobile devices in a sample of young adults. Methods: A before and after observational study was designed, where a mobile application to inquire about sexual and reproductive health was developed. The perception of changes in sexual and reproductive health risk behaviors in a sample of young adults after the use of the application was measured using the validated survey “Family Health International (FHI) – Behavioral Surveillance Survey (BSS) – Survey for Adults between 15 to 40 Years”. Non-probabilistic convenience recruitment was undertaken through the study´s web page. Participants answered the survey online before and after the use of the mobile application for a six month period (intervention). For the inferential analysis, data was divided into three groups (dichotomous data, discrete quantitative data, and ordinal data), to compare the results of the questions between the first and the second survey. For all tests, a confidence interval of 95% was established. For dichotomous data, the Chi-squared test was used. For quantitative data, we used the Student’s t-test, and for ordinal data, the Mann-Whitney-Wilcoxon test. Results: A total of 257 subjects were registered in the study and met the selection criteria. The pre-intervention survey was answered by 232 subjects, and 127 completely answered the post-intervention survey, of which 54.3% did not use the application, leaving an effective population of 58 subjects for analysis. 53% (n=31) were female, and 47% (n=27) were male. The mean age was 21 years, ranging between 18 and 40 years. The differences between the answers on the first and the second survey were not statistically significant. The main risk behaviors identified in the population were homosexual relations, non-use of condoms, sexual relations with non-regular and commercial partners, the use of psychoactive substances, and ignorance about the symptoms of sexually transmitted diseases and HIV transmission. Conclusions: Although there were no differences between the pre- and post-intervention results, the study revealed different risk behaviors among the participating subjects. These findings highlight the importance of promoting educational strategies on this matter and the importance of providing patients with easily accessible tools with reliable health information.

The use of computer-based learning tools for teaching and clinical purposes: Interactive computing strategy for Iraq

Medical universities and teaching hospitals in Iraq are facing a lack of professional staff due to the ongoing violence that forces them to flee the country. The professionals are now distributed outside the country which reduces the chances for the staff and students to be physically in one place to continue the teaching and limits the efficiency of the consultations in hospitals. A survey was done among students and professional staff in Iraq to find the problems in the learning and clinical systems and how Information and Communication Technology could improve it. The survey has shown that 86% of the participants use the Internet as a learning resource and 25% for clinical purposes while less than 11% of them uses it for collaboration between different institutions. A web-based collaborative tool is proposed to improve the teaching and clinical system. The tool helps the users to collaborate remotely to increase the quality of the learning system as well as it can be used for remote medical consultation in hospitals.

Web services enhanced interoperable construction products catalogue

This paper presents a new approach to achieving interoperability between Web-based construction products catalogues. It first introduces the current development of electronic catalogues of construction products. The common system architecture of Web-based electronic products catalogues is discussed, which is followed by a discussion on construction products information standardization and the latest distributed-systems technologies for the communication and exchange of construction products information. The latter part of this paper presents a model of interoperable Web-based construction products catalogue and an implementation of Web services in E-commerce systems to enable the sharing of construction products information.