Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

Az integráció mérésének lehetőségei (Measuring the level of integration)

Az integrációt, mint folyamatot, valamint állapotot (integráltság), az integráció „intenzitását” az irodalomban nagyszámú mutatóval mérik. A mérési kísérletek a globális és regionális integrációk feltérképezésére és elemzésére egyaránt kiterjednek. A mérés kérdésének különös jelentősége van a gazdaságpolitikai kihívások és a hatékony válaszok kidolgozása szempontjából. / === / Many methods exist in the literature to measure the level and intensity of integration both as a process and as a state. These measurement exercises can be used to assess both global and regional integration. The most important goal of measurement is to provide inputs for effective policy making. The paper provides a review on the various approaches used in the context of the European Union.

Az európai villamosenergia-árak központi szabályozásának hatása a fogyasztói árakra (The impacts of the price regulation on the level of retail electricity prices in Europe)

Az Európai Unión belül az elmúlt időszakban megerősödött a vita arról, vajon a Közösség versenyképességének javításához milyen módon és mértékben járulhat hozzá az ipari és lakossági fogyasztók számára kedvező áron elérhető villamos energia. Az uniós testületek elsődlegesen a verseny feltételeinek további javításában látják a versenyképesség javításának fő eszközét, ám egyesek az aktívabb központi szabályozás mellett érvelnek. A jelenleg alkalmazott európai szabályozási gyakorlat áttekintése, a szabályozási modellek és a piaci árak alakulásának vizsgálata hozzásegíthet, hogy következtetéseket vonjunk le a tagállami gyakorlatok tekintetében, vajon sikeresebb-e a központi ármegállapításon alapuló szabályozói mechanizmus, mint a liberalizált piacmodell. ______ There is a strengthening debate within the European Union in recent years about the impact of the affordable industrial and household electricity prices on the general competitiveness of European economies. While the European Institutions argues for the further liberalization of the energy retail sector, there are others who believe in centralization and price control to achieve lower energy prices. Current paper reviews the regulatory models of the European countries and examines the connection between the regulatory regime and consumer price trends. The analysis can help to answer, whether the bureaucratic central regulation or the liberalized market model seems more successful in supporting the competitiveness goals. Although the current regulatory practice is heterogeneous within the EU member states, there is a clear trend to decrease the role of regulated tariffs in the end-user prices. Our study did not find a general causal relationship between the regulatory regime and the level of consumer electricity prices in a country concerned. However, the quantitative analysis of the industrial and household energy prices by various segments detected significant differences between the regulated and free-market countries. The first group of member states tends to decrease the prices in the low-consuming household segments through cross-financing technics, including increased network tariffs and/or taxes for the high-consuming segments and for industrial consumers. One of the major challenges of the regulatory authorities is to find the proper way of sharing these burdens proportionally with minimizing the market-distorting effects of the cross-subsidization between the different stakeholder groups.

Nurses' spiritual well-being: Its influence on attitudes and level of practice in providing spiritual care

The purpose of this study was to examine the relationship between the spiritual well-being of nurses and its influence on their attitudes toward providing spiritual care to patients. Two research instruments and a demographic data form were used for the survey. Using a descriptive design, tbe Spiritual Well-Being Scale, the Health Professional's Spiritual Role Scale, and the demographic data form were administered to 100 registered nurses from a large South Florida teaching hospital. The findings indicated a significantly positive correlation between the overall Spiritual Well-Being Scale and the Health Professional's Spiritual Role Scale (r = 0.52; p =.005). Significant differences were found between correlation of nurses' levels of spiritual well-being and all sociodemographic factors except for the three Age Groups and for religious affiliations. Findings have implications for how nurses should be trained in meeting patients total needs. ^

The relationship between the teacher's experience, the teacher's college major, and the teacher's level of education in predicting classroom attitudes in high school science students

A review of the literature reveals few research has attempted to demonstrate if a relationship exists between the type of teacher training a science teacher has received and the perceived attitudes of his/her students. Some of the teacher preparation factors examined in this study include the college major chosen by the science teacher, the highest degree earned, the number of years of teaching experience, the type of science course taught, and the grade level taught by the teacher. This study examined how the various factors mentioned, could influence the behaviors which are characteristic of the teacher, and how these behaviors could be reflective in the classroom environment experienced by the students.^ The instrument used in the study was the Classroom Environment Scale (CES), Real Form. The measured classroom environment was broken down into three separate dimensions, with three components within each dimension in the CES. Multiple Regression statistical analyses examined how components of the teachers' education influenced the perceived dimensions of the classroom environment from the students.^ The study occurred in Miami-Dade County Florida, with a predominantly urban high school student population. There were 40 secondary science teachers involved, each with an average of 30 students. The total number of students sampled in the study was 1200. The teachers who participated in the study taught the entire range of secondary science courses offered at this large school district. All teachers were selected by the researcher so that a balance would occur in the sample between teachers who were education major versus science major. Additionally, the researcher selected teachers so that a balance occurred in regards to the different levels of college degrees earned among those involved in the study.^ Several research questions sought to determine if there was significant difference between the type of the educational background obtained by secondary science teachers and the students' perception of the classroom environment. Other research questions sought to determine if there were significant differences in the students' perceptions of the classroom environment for secondary science teachers who taught biological content, or non-biological content sciences. An additional research question sought to evaluate if the grade level taught would affect the students' perception of the classroom environment. (Abstract shortened by UMI.) ^

Tobacco use prevention education (TUPE) programs in the state of Florida: Teachers' perceptions of program structure and effectiveness

This study described teacher perceptions of TUPE program effectiveness in Florida in an attempt to improve programs by identifying factors that might influence teacher motivation and performance. Very little work has been done to examine how teachers' perceptions are related to the effectiveness of TUPE programs. A statewide survey provided information about how teachers' perceptions of program effectiveness are affected by variables such as: program structure, barriers, tobacco use norms, and training variables. Data were obtained from a telephone survey conducted in Florida as part of the Tobacco Pilot Project (TPP). The sample included 296 middle school teachers and 282 high school teachers as well as 193 middle school principals and 190 high school principals. Correlational and hierarchical regression analyses identified correlates and predictors of teachers' ratings of effectiveness. Results suggest that use of peer leaders, more frequent evaluations, a higher degree of parent involvement, fewer barriers, greater student interest, and lower tolerance for tobacco use were correlated with higher ratings of program effectiveness. Furthermore, student interest, peer, staff, and community tolerance norms, peer leaders, program evaluation, and parent involvement predicted middle school teachers' perceptions. Parent tolerance, student interest, number of barriers, and more frequent program evaluation predicted high school teachers' perceptions. In addition, middle school teachers who reported a lower number of factors negatively associated with teacher receptivity were more likely to view TUPE programs more favorably than teachers who reported a greater number of these risk factors. This relationship was not as robust among the high school teacher sample. Differences between the middle and high school sample were found in the magnitude and number of significant correlations, the proportion of variance accounted for by predictor variables, and the strength of the relationship between the number of factors negatively associated with teacher receptivity and teachers' perceptions of TUPE effectiveness. These findings highlighted the importance of the timing, program features, and the external environment for enhancing or minimizing teachers' ratings of TUPE program effectiveness. In conclusion, significant increases in TUPE teachers' self-efficacy will occur through the participation of peers, parents, staff, and community leaders in different aspects of TUPE programs. ^

The Effects of Proper Implementation of Bilingual Programs in Elementary Schools in the United States

Americans’ support of bilingual education has been closely linked with the immigration sentiments of the times. Current anti-immigrant feelings on bilingualism have intensified its negative connotation and effectiveness in English language acquisition. Improper implementation of bilingual programs has also fueled this misconception. This literature will challenge these misconceptions.

Timeshare Owner Preferences - An Analysis of Program and Service Relationships during Recessionary Times

Since the 1970s various industry studies have indicated that the vacation ownership industry has enjoyed unprecedented growth in unit sales, resort growth, and the number of owners (American Resort Devleopment Association [ARDA], 2007; ARDA, 2009a; ARDA, 2009b). However, due to the recent economic downturn these growth metrics are no longer obtainable. This external impact has caused developers to retrench and therefore reflect upon their existing product and service offerings, financial metrics, and consumer markets (ARDA, 2010a; ARDA 2010b). The crux of these findings indicates that the industry has shifted to maintaining and enhancing product and service offerings as a reaction to changing economic conditions. The findings reported in the body of this manuscript represent product and service preferences as collected from a random data pull of their existing ownership base. The study also revealed current preferences of timeshare owners with relation to services provided and products/amenities offered. Management implications and limitations of the current study are discussed.

A Study of Satisfaction Level of Hong Kong Tourists with Hot Springs Hotels and Resorts in Guangdong, China

The research reported here aimed at examining Hong Kong tourists’ level of satisfaction with hot springs hotels and resorts in Guangdong, China. Primary data were collected and service quality and tourist satisfaction levels were measured using the SERVQUAL model. The empirical findings indicate that most tourists are satisfied with the service quality of these hotels and resorts. Among the different dimensions of service quality, empathy receives the highest score. Overall satisfaction receives a score only slightly better than average. The results also reveal significant relationships among customer satisfaction level, loyalty, and recommendation.

A study of the implementation of junior college *evaluation system in Taiwan

Since the establishment of the evaluation system in 1975, the junior colleges in the Republic of China (Taiwan), have gone through six formal evaluations. We know that evaluation in schooling, like quality control in businesses, should be a systematic, formal, and a continual process. It can doubtless serve as a strategy to refine the quality of education. The purpose of this research is to explore the current practice of junior college evaluation in Taiwan. This provides insight into the development of and quality of the current evaluation system. Moreover, this study also identified the source of problems with the current evaluation system and provided suggestion for improvements.^ In order to attain the above purposes, this research was undertaken in both theoretical and practical ways. First, theoretically, on the basis of a literature review, the theories of educational evaluation and, according to the course and principles of development, a view of the current practice in Taiwan. Secondly, in practice, by means of questionnaires, an analysis of the views of evaluation committeemen, junior college presidents, and administrators were obtained on evaluation models, methods, contents, organization, functions, criteria, grades reports, and others with suggestions for improvement. The summary of findings concludes that most evaluators and evaluatees think the purpose of evaluation can help the colleges explore their difficulties and problems. In addition, it was found that there is significant difference between the two groups regarding the evaluation methods, contents, organization, functions, criteria, grades reports and others, while analyzing these objective data forms the basis for an improved method of evaluation for Junior Colleges in Taiwan. ^

Undergraduate Students’ Perceptions of Study Abroad and Their Level of Achievement of Global Learning Outcomes

This study expanded on current research on study abroad and global learning, using the Global Perspective Inventory (GPI), and conducted at Florida International University (FIU) in Miami, FL. The GPI assesses the holistic development of a global perspective in higher education within three domains and their respective FIU-determined equivalents: cognitive (global awareness), intrapersonal (global perspective), and interpersonal (global engagement). The main purpose of this study was to assess FIU’s undergraduate students’ perceptions of study abroad on their level of achievement of global awareness, global perspective, and global engagement. The secondary purpose was to determine how the students described their study abroad experience and achievement of global learning. The research design for this study consisted of parallel mixed methods. The quantitative component was an ex post facto with hypothesis design, using a pretest/posttest nonequivalent group methodology. FIU undergraduates (N=147) who studied abroad for one semester or more completed the GPI pre- and post-tests. Descriptive statistics and paired t-tests were conducted to compare the means. The interviews included 10 students, and were analyzed through Structural coding, Saldaña’s In Vivo coding, and Value coding. Quantitative analyses indicated positive changes in the students’ global awareness and global perspective. These analyses also showed that the FIU students achieved higher post-test means on all the domains of the GPI compared to other studies. Qualitative analyses showed that the students’ experiences incorporated all three global learning outcomes, most notably global awareness and perspective.

The relationship between coping strategies and level of depression among spousal caregivers of elders with dementia

Caregivers are often under a great deal of stress while caring for their spouses with dementia. It is when the stress builds up and becomes overwhelming that the caregiver is at risk for developing depression. The primary objective of this study was to determine which cognitive and behavioral coping strategies are associated with lower levels of depression; once these strategies are identified, interventions can be established to educate these caregivers. Thirty-two spousal caregivers participated in this study. They each filled out a questionnaire, which contained three sections. The first section asked them for demographic information about themselves and their spouses; the second section consisted of a coping strategies scale; and, the third section contained a depression scale. Results of this study indicate that problem-focused coping strategies were associated with a lesser degree of depressive symptomatology, whereas most of the emotion-focused strategies were associated with a greater degree of depressive symptomatology among the present sample of spousal caregivers. In addition, no relationship was found between the length of time providing care to their spouses and their level of depression.

The relationship between the teacher's experience, the teacher's college major, and the teacher's level of education in predicting classroom attitudes in high school science students

A review of the literature reveals few research has attempted to demonstrate if a relationship exists between the type of teacher training a science teacher has received and the perceived attitudes of his/her students. Considering that a great deal of time and energy has been devoted by university colleges, school districts, and educators towards refining the teacher education process, it would be more efficient for all parties involved, if research were available that could discern if certain pathways in achieving that education, would promote the tendency towards certain teacher behaviors occurring in the classroom, while other pathways would lead towards different behaviors. Some of the teacher preparation factors examined in this study include the college major chosen by the science teacher, the highest degree earned, the number of years of teaching experience, the type of science course taught, and the grade level taught by the teacher. This study examined how the various factors mentioned, could influence the behaviors which are characteristic of the teacher, and how these behaviors could be reflective in the classroom environment experienced by the students. The instrument used in the study was the Classroom Environment Scale (CES), Real Form. The measured classroom environment was broken down into three separate dimensions, with three components within each dimension in the CES. Multiple Regression statistical analyses examined how components of the teachers' education influenced the perceived dimensions of the classroom environment from the students. The study occurred in Miami-Dade County Florida, with a predominantly urban high school student population. There were 40 secondary science teachers involved, each with an average of 30 students. The total number of students sampled in the study was 1200. The teachers who participated in the study taught the entire range of secondary science courses offered at this large school district. All teachers were selected by the researcher so that a balance would occur in the sample between teachers who were education major versus science major. Additionally, the researcher selected teachers so that a balance occurred in regards to the different levels of college degrees earned among those involved in the study. Several research questions sought to determine if there was significant difference between the type of the educational background obtained by secondary science teachers and the students' perception of the classroom environment. Other research questions sought to determine if there were significant differences in the students' perceptions of the classroom environment for secondary science teachers who taught biological content, or non-biological content sciences. An additional research question sought to evaluate if the grade level taught would affect the students' perception of the classroom environment. Analysis of the multiple regression were run for each of four scores from the CES, Real Form. For score 1, involvement of students, the results showed that teachers with the highest number of years of experience, with masters or masters plus degrees, who were education majors, and who taught twelfth grade students, had greater amounts of students being attentive and interested in class activities, participating in discussions, and doing additional work on their own, as compared with teachers who had lower experience, a bachelors degree, were science majors, and who taught a grade lower than twelfth. For score 2, task orientation, which emphasized completing the required activities and staying on-task, the results showed that teachers with the highest and intermediate experience, a science major, and with the highest college degree, showed higher scores as compared with the teachers indicating lower experiences, education major and a bachelors degree. For Score 3, competition, which indicated how difficult it was to achieve high grades in the class, the results showed that teachers who taught non-biology content subjects had the greatest effect on the regression. Teachers with a masters degree, low levels of experience, and who taught twelfth grade students were also factored into the regression equation. For Score 4, innovation, which indicated the extent in which the teachers used new and innovative techniques to encourage diverse and creative thinking included teachers with an education major as the first entry into the regression equation. Teachers with the least experience (0 to 3 years), and teachers who taught twelfth and eleventh grade students were also included into the regression equation.

Women officer workers meeting about banks that do not raise level of women employees

General note: Title and date provided by Bettye Lane.