Quality evaluation of the available Internet information regarding pain during orthodontic treatment

OBJECTIVE To investigate the quality of the data disseminated via the Internet regarding pain experienced by orthodontic patients. MATERIALS AND METHODS A systematic online search was performed for 'orthodontic pain' and 'braces pain' separately using five search engines. The first 25 results from each search term-engine combination were pooled for analysis. After excluding advertising sites, discussion groups, video feeds, and links to scientific articles, 25 Web pages were evaluated in terms of accuracy, readability, accessibility, usability, and reliability using recommended research methodology; reference textbook material, the Flesch Reading Ease Score; and the LIDA instrument. Author and information details were also recorded. RESULTS Overall, the results indicated a variable quality of the available informational material. Although the readability of the Web sites was generally acceptable, the individual LIDA categories were rated of medium or low quality, with average scores ranging from 16.9% to 86.2%. The orthodontic relevance of the Web sites was not accompanied by the highest assessment results, and vice versa. CONCLUSIONS The quality of the orthodontic pain information cited by Web sources appears to be highly variable. Further structural development of health information technology along with public referral to reliable sources by specialists are recommended.

Educational Technology-Benefits and Barriers

Statement of Problem: The second background paper for the Medical School Objective Project (MSOP), defined Educational Technology (ET) as the use of information technology to facilitate student’s learning.1 Medical schools as a group have made limited progress in accomplishing the recommended educational technology goals and there had been much greater use of such technology in basic sciences courses than in clinical clerkships. We will explore the positive and negative implications of incorporating ET into the educational experience of TMC schools. [See PDF for complete abstract]

Clinical decision support capabilities of commercially-available clinical information systems.

BACKGROUND: The most effective decision support systems are integrated with clinical information systems, such as inpatient and outpatient electronic health records (EHRs) and computerized provider order entry (CPOE) systems. Purpose The goal of this project was to describe and quantify the results of a study of decision support capabilities in Certification Commission for Health Information Technology (CCHIT) certified electronic health record systems. METHODS: The authors conducted a series of interviews with representatives of nine commercially available clinical information systems, evaluating their capabilities against 42 different clinical decision support features. RESULTS: Six of the nine reviewed systems offered all the applicable event-driven, action-oriented, real-time clinical decision support triggers required for initiating clinical decision support interventions. Five of the nine systems could access all the patient-specific data items identified as necessary. Six of the nine systems supported all the intervention types identified as necessary to allow clinical information systems to tailor their interventions based on the severity of the clinical situation and the user's workflow. Only one system supported all the offered choices identified as key to allowing physicians to take action directly from within the alert. Discussion The principal finding relates to system-by-system variability. The best system in our analysis had only a single missing feature (from 42 total) while the worst had eighteen.This dramatic variability in CDS capability among commercially available systems was unexpected and is a cause for concern. CONCLUSIONS: These findings have implications for four distinct constituencies: purchasers of clinical information systems, developers of clinical decision support, vendors of clinical information systems and certification bodies.

Re-Conceptualizing the Global Digital Divide

The article seeks a re-conceptualization of the global digital divide debate. It critically explores the predominant notion, its evolution and measurement, as well as the policies that have been advanced to bridge the digital divide. Acknowledging the complexity of this inequality, the article aims at analyzing the disparities beyond the connectivity and skills barriers. Without understating the first two digital divides, it is argued that as the Internet becomes more sophisticated and more integrated into economic, social, and cultural processes, a “third” generation of divides becomes critical. These divides are drawn not at the entry to the net but within the net itself, and limit access to content. The increasing barriers to content, though of a diverse nature, all relate to some governance characteristics inherent in cyberspace, such as global spillover of local decisions, regulation through code, and proliferation of self- and co-regulatory models. It is maintained that as the practice of intervention intensifies in cyberspace, multiple and far-reaching points of control outside formal legal institutions are created, threatening the availability of public goods and making the pursuit of public objectives difficult. This is an aspect that is rarely addressed in the global digital divide discussions, even in comprehensive analyses and political initiatives such as the World Summit on the Information Society. Yet, the conceptualization of the digital divide as impeded access to content may be key in terms of ensuring real participation and catering for the long-term implications of digital technologies.

Achieving effective biosurveillance with the Nationwide Health Information Network

The federal government is currently developing the Nationwide Health Information Network (NHIN). Described as a “network of networks,” the NHIN seeks to provide a nationwide, interoperable health information infrastructure that will securely connect consumers with those involved in health care. As part of the national health information technology (HIT) agenda, the NHIN aims to improve individual and population health by enabling health information to follow the consumer, be available for clinical decision-making, and support important public health measures such as biosurveillance. While the NHIN promises to improve clinical care to individuals and to reduce U.S. health care system costs overall, this electronic environment presents novel challenges for protecting individually identifiable health information. A major barrier to achieving public trust in the NHIN is the development of, and adherence to, a consistent and coordinated approach to privacy and security of health information. This paper will analyze the policy framework for electronic health information exchange with the NHIN. This exercise will demonstrate that the current policy is an effective framework for achieving effective biosurveillance with the NHIN. ^

Assessing the impact of electronic health record technology adoption on hospital labor efficiency

Information technology (IT) in the hospital organization is fast becoming a key asset, particularly in light of recent reform legislation in the United States calling for expanding the role of IT in our health care system. Future payment reductions to hospitals included in current health reform are based on expected improvements in hospital operating efficiency. Since over half of hospital expenses are for labor, improved efficiency in use of labor resources can be critical in meeting this challenge. Policy makers have touted the value of IT investments to improve efficiency in response to payment reductions. ^ This study was the first to directly examine the relationship between electronic health record (EHR) technology and staffing efficiency in hospitals. As the hospital has a myriad of outputs for inpatient and outpatient care, efficiency was measured using an industry standard performance metric – full time equivalent employees per adjusted occupied bed (FTE/AOB). Three hypotheses were tested in this study.^ To operationalize EHR technology adoption, we developed three constructs to model adoption, each of which was tested by separate hypotheses. The first hypothesis that a larger number of EHR applications used by a hospital would be associated with greater staffing efficiency (or lower values of FTE/AOB) was not accepted. Association between staffing efficiency and specific EHR applications was the second hypothesis tested and accepted with some applications showing significant impacts on observed values for FTE/AOB. Finally, the hypothesis that the longer an EHR application was used in a hospital would be associated with greater labor efficiency was not accepted as the model showed few statistically significant relationships to FTE/AOB performance. Generally, there does not appear a strong relationship between EHR usage and improved labor efficiency in hospitals.^ While returns on investment from EHR usage may not come from labor efficiencies, they may be better sought using measures of quality, contribution to an efficient and effective local health care system, and improved customer satisfaction through greater patient throughput.^

Efficiency from pharmacy inventory technology: A means to improving quality in non-profit hospitals

Hospitals, like all organizations, have both a mission and a finite supply of resources with which to accomplish that mission. Because the inventory of therapeutic drugs is among the more expensive resources needed by a hospital to achieve its mission, a conceptual model of structure plus process equals outcome posits that adequate emphasis should be placed on optimization of the organization's investment in this important structural resource to provide highest quality outcomes. Therefore emphasis should be placed on the optimization of pharmacy inventory because lowering the financial investment in drug inventory and associated costs increases productive efficiency, a key element of quality. ^ In this study, a post-intervention analysis of a hospital pharmacy inventory management technology implementation at The University of Texas M.D. Anderson Cancer Center was conducted to determine if an intervention which reduced a hospital's financial investment in pharmaceutical inventory provided an opportunity to incrementally optimize the organization's mix of structural resources thereby improving quality of care. The results suggest that hospital pharmacies currently lacking technology to support automated purchasing logistics and perpetual, real-time inventory management for drugs may achieve measurable benefits from the careful implementation of such technology, enabling the hospital to lower its investment in on-hand inventory and, potentially, to reduce overall purchasing expenditures. ^ The importance of these savings to the hospital and potentially to the patient should not be underestimated for their ability to generate funding for previously unfunded public health programs or in their ability to provide financial relief to patients in the form of lower drug costs given the current climate of escalating healthcare costs and tightening reimbursements.^

Technology Choice, Change of Trade Structure, and A Case of Hungarian Economy

In the IT industry, there has been a remarkable increase in the demand for system LSI. A system LSI must be tailor-designed for each electrical appliance, and then produced. It is said that in recent years, this production method has made the IC cycle ambiguous. It can be sought that the choice of whether the economy pursues a development path centering on technology which is tradable or technology which is embodied in labor, depends on the historical background. In this paper, the economic background is explained in order to analyze and capture movements in the IT industry and technology. Then, an econometric model for Hungary has been constructed to estimate the effect of technological progress on the economy.

Technology Choice in the IT Industry and Changes of the Trade Structure

In the IT industry, there has been a remarkable increase in the demand for system LSI. A system LSI must be produced, tailor-designed for each electrical appliance. It is said that this production method has made the IC cycle ambiguous in recent years. It can be sought that the choice of whether the economy pursues a development path centering on technology which is tradable or technology which is embodied in labor, depends on the historical background. The relationship between these two types of technologies is changing rapidly every one or two years. In this background, the analysis is focused on the new trend of technology. In the section 2, the newest trend of technology in the field of system LSI is explained. Then, which kind of technology will be developed and how it will have an affect in the near future, is considered.

Marco de Gobernanza de TI para empresas PyMEs – SMEsITGF

La tecnología de la información y su utilización en las empresas ha sido y es un elemento de debate ya que las organizaciones cuentan con grandes éxitos y grandes fracasos. Gran parte de estos últimos asociados a una falta de visión estratégica integral en relación a la utilización de TI en la organización lo que ha dado lugar al área del conocimiento llamada Gobernanza de TI y a la publicación de numerosos marcos y estándares. Un campo sensible y económicamente muy importante tanto para Uruguay como a nivel mundial son las empresas medianas y pequeñas (PyMEs), las que no logran aplicar de manera efectiva los marcos y estándares, es por esta razón que el objetivo final de esta tesis es el de construir un marco que permita a las PyMEs incorporar un marco efectivo para gobernar y gestionar TI adecuadamente obteniendo el valor esperado de las inversiones realizadas. Para alcanzar este objetivo general se ha realizado un estudio de campo que permita conocer la situación de la gobernanza y la gestión de TI en PyMEs del Uruguay; a partir de este estudio se pudo analizar cuáles son los factores más significativos que no permiten la correcta aplicación de buenas prácticas de gobernanza de TI en éstas empresas. Los resultados encontrados llevaron a la construcción de un marco de gobernanza de TI con foco en PyMEs, a la definición de un modelo de madurez asociado al marco y a una guía de implantación. En el marco de gobernanza propuesto, compatible con el estándar ISO/IEC 38500:2008, se han fortalecido los procesos que, por las características propias de las PyMEs presentan debilidades estructurales y se han reducido o eliminado aquellos que por las mismas razones no son aplicables a este tipo de organización. Finalmente se validaron los resultados en un entorno empresarial definiendo un estudio de caso. Los resultados obtenidos con una mejora porcentual consolidada del 46% en el conjunto de indicadores definidos llevan a considerar que la aplicación del marco fue exitosa. Por ser un estudio de caso único, los resultados no deben ser generalizados y una oportunidad de trabajo futuro es replicar el mismo estudio en otras empresas. ABSTRACT Information technology (IT) and its use in the enterprise context is a discussion element because organizations have numerous successes and failures using it. Most of the IT failed projects have a lack of integral strategic vision in relation with IT use in the organization. This fact has resulted in the IT Governance (ITG) area of knowledge. A large number of standards and frameworks have been published in relation with it. Small and medium enterprises (SMEs) are an important and sensible field in all economies around the world, particularly in Uruguay, an underdeveloped country of South America. Commonly, SMEs cannot apply successfully ITG frameworks because of the intrinsic complexity or because a lack of knowledge and culture respect this field, so the objective of this thesis is build a framework that allows SMEs to incorporate an effective framework to govern and manage IT properly, helping enterprises get the expected value of its IT investments. In a first place, has been conducted a field study to know the quality of actual practices relatively to the ITG and IG management in Uruguayan SMEs. With the obtained results in the study we can make a diagnostic of the most significant factors that prevent the proper application of good IT governance practices in these companies. The obtained results were the inputs to the definition of a IT governance framework with focus in SMEs, a maturity model associated with it and a implementation guide. The proposed framework is ISO/IEC 38500 standard compatible always with an SME vision so, sensible and weak processes have been strengthened and other ones have been eliminated because have no application in these type of organization. Finally the results were validated in a business environment by defining a case study. The results obtained with a consolidated percentage improvement of 46% in the defined set of indicators suggest that the implementation of the framework was successful. As a single case study, the results should not be generalized and an opportunity for future work is to replicate the same study in other companies.

Information systems offshore outsourcing: managerial conclusions from academic research

In the light of the growing interest raised by Information Systems Offshore Outsourcing both in the managerial world and in the academic arena, the present work carries out a revision of the research in this area. We have analysed 89 research articles on this topic published in 17 prestigious journals. The analysis deals with aspects such as research methodologies, level of analysis in the studies, data perspective, economic theories used or location of vendors and clients of these services; and it additionally identifies the most frequent topics in this field as well as the most prolific authors and countries. Although other reviews about the research in this area have been published, the present paper achieves a greater level of detail than previous works. The review of the literature in the area could have interesting implications not only for academics but also for business practice.

Gestión turística y tecnologías de la información y la comunicación (TIC): El nuevo enfoque de los destinos inteligentes

Este artículo analiza el nuevo enfoque de los destinos inteligentes para la gestión turística a escala local. Se estudia su génesis y se realiza una propuesta de conceptualización desde una perspectiva sistémica, que se contrasta con la gestión turística actual mediante una encuesta a municipios turísticos de la Comunidad Valenciana. Los resultados ponen de relieve que no se ha asumido como objetivo de gestión el enfoque de los destinos inteligentes, el cual requiere un proyecto global que incorpore cinco ámbitos fundamentales: gobernanza, sostenibilidad, conectividad, sistema de información e innovación. No obstante, la complejidad asociada a este enfoque hace aconsejable un desarrollo de tipo flexible, escalable y adaptado a cada entorno territorial.

The Determinants of Investment in Information and Communication Technologies. Bruges European Economic Research (BEER) Papers 16/March 2010

In this paper we investigate the determinants of ICT investment at the macro level for a panel of ten countries over the period 1992-2005. We argue that, since ICT is a General Purpose Technology, its diffusion can be understood only considering the interaction with institutional and structural factors. The empirical results are in line with this view: facilitating factors such as changes in regulation, human capital and the sectoral composition of the economy are relevant determinants for increasing ICT investment.

Offshoring of Information-intensive Services: Structural Breaks in Industry Life Cycles. ACES Working Papers, August 2010

The emergence of widespread offshoring of information-intensive services is arguably one of the more impactful phenomena to transform business in the last ten years. A growing body of research has examined the firm-level drivers andlocation factors (i.e., the why's and where's) of services offshoring. However, little empirical research has examined the maturation sequencing (or when's) of services offshoring. Adopting industry life cycle theory as a framework, the key research questions examined in the paper are: when do different categories of offshoring services provision change from being emergent sectors to more mature ones, and how does the timing of this sequence relate to the type of service offshored. Using a database of 1420 offshore services FDI projects, we find that the value-add as well as the information sensitivity of the service category are related to when the service categories progress through the industry life cycle. Implications for future waves of service offshoring are discussed.

Optical Technology Division.

Mode of access: Internet.