Finding My Way: Protocol of a randomised controlled trial evaluating an internet self-help program for cancer-related distress

Background A cancer diagnosis elicits greater distress than any other medical diagnosis, and yet very few studies have evaluated the efficacy of structured online self-help therapeutic programs to alleviate this distress. This study aims to assess the efficacy over time of an internet Cognitive Behaviour Therapy (iCBT) intervention (‘Finding My Way’) in improving distress, coping and quality of life for individuals with a recent diagnosis of early stage cancer of any type. Methods/Design The study is a multi-site Randomised Controlled Trial (RCT) seeking to enrol 188 participants who will be randomised to either the Finding My Way Intervention or an attention-control condition. Both conditions are delivered online; with 6 modules released once per week, and an additional booster module released one month after program-completion. Participants complete online questionnaires on 4 occasions: at baseline (immediately prior to accessing the modules); post-treatment (immediately after program-completion); then three and six months later. Primary outcomes are general distress and cancer-specific distress, with secondary outcomes including Health-Related Quality of Life (HRQoL), coping, health service utilisation, intervention adherence, and user satisfaction. A range of baseline measures will be assessed as potential moderators of outcomes. Eligible participants are individuals recently diagnosed with any type of cancer, being treated with curative intent, aged over 18 years with sufficient English language literacy, internet access and an active email account and phone number. Participants are blinded to treatment group allocation. Randomisation is computer generated and stratified by gender. Discussion Compared to the few prior published studies, Finding My Way will be the first adequately powered trial to offer an iCBT intervention to curatively treated patients of heterogeneous cancer types in the immediate post-diagnosis/treatment period. If found efficacious, Finding My Way will assist with overcoming common barriers to face-to-face therapy in a cost-effective and accessible way, thus helping to reduce distress after cancer diagnosis and consequently decrease the cancer burden for individuals and the health system. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613000001​796 16.10.13

A Coalitional Game Framework for Cooperative Secondary Spectrum Access

We consider a framework in which several service providers offer downlink wireless data access service in a certain area. Each provider serves its end-users through opportunistic secondary spectrum access of licensed spectrum, and needs to pay primary license holders of the spectrum usage based and membership based charges for such secondary spectrum access. In these circumstances, if providers pool their resources and allow end-users to be served by any of the cooperating providers, the total user satisfaction as well as the aggregate revenue earned by providers may increase. We use coalitional game theory to investigate such cooperation among providers, and show that the optimal cooperation schemes can be obtained as solutions of convex optimizations. We next show that under usage based charging scheme, if all providers cooperate, there always exists an operating point that maximizes the aggregate revenue of providers, while presenting each provider a share of the revenue such that no subset of providers has an incentive to leave the coalition. Furthermore, such an operating point can be computed in polynomial time. Finally, we show that when the charging scheme involves membership based charges, the above result holds in important special cases.

A Coalition game model for spectrum pooling in wireless data access networks

We consider a setting in which several operators offer downlink wireless data access services in a certain geographical region. Each operator deploys several base stations or access points, and registers some subscribers. In such a situation, if operators pool their infrastructure, and permit the possibility of subscribers being served by any of the cooperating operators, then there can be overall better user satisfaction, and increased operator revenue. We use coalitional game theory to investigate such resource pooling and cooperation between operators.We use utility functions to model user satisfaction, and show that the resulting coalitional game has the property that if all operators cooperate (i.e., form a grand coalition) then there is an operating point that maximizes the sum utility over the operators while providing the operators revenues such that no subset of operators has an incentive to break away from the coalition. We investigate whether such operating points can result in utility unfairness between users of the various operators. We also study other revenue sharing concepts, namely, the nucleolus and the Shapely value. Such investigations throw light on criteria for operators to accept or reject subscribers, based on the service level agreements proposed by them. We also investigate the situation in which only certain subsets of operators may be willing to cooperate.

Pesquisa de satisfação dos usuários do Centro de Informática da Câmara dos Deputados : o índice de satisfação como indicador estratégico

Monitorar a percepção de qualidade sob a ótica do usuário é fundamental para se estabelecer mecanismos de melhoria dos produtos e serviços oferecidos. O planejamento estratégico do Centro de Informática da Câmara dos Deputados, CENIN, para o quadriênio 2010 a 2013, estabeleceu o indicador Índice de Satisfação do Usuário do CENIN com o objetivo de mensurar o objetivo estratégico "Aprimorar o atendimento aos parlamentares e órgãos da Câmara dos Deputados". O presente trabalho teve como objetivo realizar a primeira medição do referido indicador através de uma pesquisa de satisfação de usuário e, consequentemente, estabeleceu uma forma de cálculo para as demais medições do indicador. Além disso, esse trabalho deixa um legado de importantes informações que poderão subsidiar ações estratégicas no sentido de melhorar a qualidade dos serviços prestados pelo CENIN.

Práticas educativas de enfermeiros na Estratégia de Saúde da Família: reflexões desde a Educação Popular e Saúde

O estudo em questão teve como objetivo analisar a atuação do enfermeiro nas práticas educativas na Estratégia de Saúde da Família considerando os princípios da Educação Popular e Saúde. É um estudo descritivo com abordagem qualitativa e análise temático-categorial proposta por Bardin. O cenário foi o município do Rio de janeiro, em duas clínicas da família situadas na AP 3.1. Os sujeitos foram 17 enfermeiros. A coleta de dados foi realizada no mês de Agosto de 2012. As entrevistas foram gravadas e realizadas com ICD formulado previamente. Este foi dividido em: caracterização dos sujeitos com 5 questões fechadas e 3 abertas e um roteiro de entrevistas que foi composto por três tópicos e um total de 8 questões abertas. O projeto foi encaminhado ao Comitê de ética e pesquisa da Secretaria Municipal de Saúde do Rio de Janeiro, respeitando os preceitos éticos de pesquisas com seres humanos. Após a análise dos dados foi possível a construção de quatro categorias. A primeira trata das ações desenvolvidas pelos enfermeiros na ESF; foi possível verificar nesta categoria que o grande quantitativo de funções desempenhado pelo enfermeiro faz com que as práticas educativas sejam colocadas, em alguns casos, em segundo plano. A segunda aborda a dinâmica de realização da prática educativa; esta compreende duas subcategorias: o planejamento da prática educativa e as características destas práticas pelo enfermeiro. Com a mesma percebeu-se que as práticas são planejadas mensalmente em uma reunião de equipe com a presença de todos os profissionais onde eles opinam e decidem qual grupo será realizado e que temática será abordada. Na segunda subcategoria, verificou-se que diante das características extraídas das falas, as práticas educativas realizadas são focadas nos modelos tradicionais de transmissão de informações. A terceira categoria analisou alguns princípios da EPS, que emergiram das falas dos enfermeiros como escuta ativa e valorização do saber popular. Por fim, a quarta categoria, é subdividida em duas subcategorias que compreendem as facilidades e dificuldades atribuídas pelo enfermeiro para o desenvolvimento de práticas educativas. Nela, surgiram aspectos como o desinteresse da população na atividade e a grande quantidade de falta nos grupos educativos. Dentre as facilidades, está a satisfação do usuário, a divulgação que os indivíduos fazem na comunidade e a participação do ACS durante o desenvolvimento da prática. Portanto, percebe-se que há uma priorização das atividades educativas focada no processo saúde-doença, no qual o foco principal é a patologia e mudança de hábito. Desta forma, faz-se necessário que os profissionais se coloquem disponíveis para ouvir a população na construção de uma relação que considere o ser humano como um todo, a fim de respeitar sua cultura e sua crença, e saibam fazer deste espaço um campo para o desenvolvimento de práticas educativas que se aproximem do que é apresentado na EPS.

Evaluation of multi-sensory feedback on the usability of a virtual assembly environment

Virtual assembly environment (VAE) technology has the great potential for benefiting the manufacturing applications in industry. Usability is an important aspect of the VAE. This paper presents the usability evaluation of a developed multi-sensory VAE. The evaluation is conducted by using its three attributes: (a) efficiency of use; (b) user satisfaction; and (c) reliability. These are addressed by using task completion times (TCTs), questionnaires, and human performance error rates (HPERs), respectively. A peg-in-a-hole and a Sener electronic box assembly task have been used to perform the experiments, using sixteen participants. The outcomes showed that the introduction of 3D auditory and/or visual feedback could improve the usability. They also indicated that the integrated feedback (visual plus auditory) offered better usability than either feedback used in isolation. Most participants preferred the integrated feedback to either feedback (visual or auditory) or no feedback. The participants' comments demonstrated that nonrealistic or inappropriate feedback had negative effects on the usability, and easily made them feel frustrated. The possible reasons behind the outcomes are also analysed. © 2007 ACADEMY PUBLISHER.

Uptake and use of electronic information services: trends in UK higher education from the JUSTEIS project

Urquhart, C., Lonsdale, R.,Thomas, R., Spink, S., Yeoman, A., Armstrong, C. & Fenton, R. (2003). Uptake and use of electronic information services: trends in UK higher education from the JUSTEIS project. Program, 37(3), 167-180. Sponsorship: JISC

STAR 3 randomized controlled trial to compare sensor-augmented insulin pump therapy with multiple daily injections in the treatment of type 1 diabetes: research design, methods, and baseline characteristics of enrolled subjects.

BACKGROUND: Sensor-augmented pump therapy (SAPT) integrates real-time continuous glucose monitoring (RT-CGM) with continuous subcutaneous insulin infusion (CSII) and offers an alternative to multiple daily injections (MDI). Previous studies provide evidence that SAPT may improve clinical outcomes among people with type 1 diabetes. Sensor-Augmented Pump Therapy for A1c Reduction (STAR) 3 is a multicenter randomized controlled trial comparing the efficacy of SAPT to that of MDI in subjects with type 1 diabetes. METHODS: Subjects were randomized to either continue with MDI or transition to SAPT for 1 year. Subjects in the MDI cohort were allowed to transition to SAPT for 6 months after completion of the study. SAPT subjects who completed the study were also allowed to continue for 6 months. The primary end point was the difference between treatment groups in change in hemoglobin A1c (HbA1c) percentage from baseline to 1 year of treatment. Secondary end points included percentage of subjects with HbA1c < or =7% and without severe hypoglycemia, as well as area under the curve of time spent in normal glycemic ranges. Tertiary end points include percentage of subjects with HbA1c < or =7%, key safety end points, user satisfaction, and responses on standardized assessments. RESULTS: A total of 495 subjects were enrolled, and the baseline characteristics similar between the SAPT and MDI groups. Study completion is anticipated in June 2010. CONCLUSIONS: Results of this randomized controlled trial should help establish whether an integrated RT-CGM and CSII system benefits patients with type 1 diabetes more than MDI.

Multi-touch accceptance: perceived disorientation and consequences on task engagement

The research project takes place within the technology acceptability framework which tries to understand the use made of new technologies, and concentrates more specifically on the factors that influence multi-touch devices’ (MTD) acceptance and intention to use. Why be interested in MTD? Nowadays, this technology is used in all kinds of human activities, e.g. leisure, study or work activities (Rogowski and Saeed, 2012). However, the handling or the data entry by means of gestures on multi-touch-sensitive screen imposes a number of constraints and consequences which remain mostly unknown (Park and Han, 2013). Currently, few researches in ergonomic psychology wonder about the implications of these new human-computer interactions on task fulfillment.This research project aims to investigate the cognitive, sensori-motor and motivational processes taking place during the use of those devices. The project will analyze the influences of the use of gestures and the type of gesture used: simple or complex gestures (Lao, Heng, Zhang, Ling, and Wang, 2009), as well as the personal self-efficacy feeling in the use of MTD on task engagement, attention mechanisms and perceived disorientation (Chen, Linen, Yen, and Linn, 2011) when confronted to the use of MTD. For that purpose, the various above-mentioned concepts will be measured within a usability laboratory (U-Lab) with self-reported methods (questionnaires) and objective indicators (physiological indicators, eye tracking). Globally, the whole research aims to understand the processes at stakes, as well as advantages and inconveniences of this new technology, to favor a better compatibility and adequacy between gestures, executed tasks and MTD. The conclusions will allow some recommendations for the use of the DMT in specific contexts (e.g. learning context).

Specializing pedestrian maps to address the needs of people using wheelchairs: a case study in community-sustainable information systems

Gemstone Team FASTR (Finding Alternative Specialized Travel Routes)

ThermoSpots to detect hypothermia in children with severe acute malnutrition

INTRODUCTION: Hypothermia is a risk factor for increased mortality in children with severe acute malnutrition (SAM). Yet frequent temperature measurement remains unfeasible in under-resourced units in developing countries. ThermoSpot is a continuous temperature monitoring sticker designed originally for neonates. When applied to skin, its liquid crystals are designed to turn black with hypothermia and remain green with normothermia.

AIMS: To (i) estimate the diagnostic accuracy of ThermoSpots for detecting WHO-defined hypothermia (core temperature <35.5°C or peripheral temperature <35.0°C) in children with SAM and (ii) determine their acceptability amongst mothers.

METHODS: Children with SAM in a malnutrition unit in Malawi were enrolled during March-July 2010. The sensitivity and specificity of ThermoSpots were calculated by comparing the device colour against 'gold standard' rectal temperatures taken on admission and follow up peripheral temperatures taken until discharge. Guardians completed a questionnaire to assess acceptability.

RESULTS: Hypothermia was uncommon amongst the 162 children enrolled. ThermoSpot successfully detected the one rectal temperature and two peripheral temperatures recorded that met the WHO definition of hypothermia. Overall, 3/846 (0.35%) temperature measurements were in the WHO-defined hypothermia range. Interpreting the brown transition colour (between black and green) as hypothermia improved sensitivities. For milder hypothermia definitions, sensitivities declined (<35.4°C, 50.0%; <35.9°C, 39.2%). Specificity was consistently above 94%. From questionnaires, 40/43 (93%) mothers reported they were 90-100% happy with the device overall. Free-text answers revealed themes of "Skin Rashes", "User-satisfaction" and "Empowerment".

CONCLUSION: Although hypothermia was uncommon in this study, ThermoSpots successfully detected these episodes in malnourished children and were acceptable to mothers. Research in settings where hypothermia is common is needed to determine performance with certainty. Instructing users to act when the device's transition colour appears could improve accuracy. If reliable, ThermoSpots may offer simple, acceptable and continuous temperature measurement for high-burden areas and reduce the workload of over-stretched staff.

Messung der Zufriedenheit von Studierenden der Fakultät Wirtschaft und Informatik der Hochschule Hannover mit der Hochschul-Zentralbibliothek

In der vorliegenden Arbeit wird die Zufriedenheit von Studierenden mit der Hochschul-Zentralbibliothek (HZB) der Hochschule Hannover untersucht. Es wird überprüft, inwieweit Alter, Semesteranzahl und Geschlecht der Befragten einen Einfluss auf die Zufriedenheit mit der HZB haben. Des Weiteren besteht ein Aspekt der Untersuchung aus der Einschätzung der Wichtigkeit einzelner Faktoren aus Sicht der Studierenden, welcher bei den praktischen Implikationen zum Tragen kommt. Die Literaturrecherche machte deutlich, dass bereits diverse Umfragen von Bibliotheken zur Zufriedenheit der Nutzer stattgefunden haben. Wenige Umfragen richten sich jedoch direkt an Studierende. Da der Leistungskatalog von Bibliothek zu Bibliothek variiert, muss der Fragebogen an die konkreten Rahmenbendingungen der HZB angepasst werden. Mit der vorliegenden Arbeit werden Aussagen über die Zufriedenheit und Wichtigkeit der einzelnen Faktoren aus Studierendensicht getroffen. Mittels eines elektronischen Fragebogens werden die Studierenden der Fakultät IV – Wirtschaft und Informatik, hierunter die Abteilungen Betriebswirtschaft und Wirtschaftsinformatik, der Hochschule Hannover befragt, von denen 116 den Fragebogen beantwortet haben. Zusammenfassend lässt sich sagen, dass die Ergebnisse die aufgestellten Hypothesen nicht unterstützen. Es liegen keine signifikanten Ergebnisse vor und es bestehen keine Zusammenhänge zwischen Alter, Geschlecht oder Semesterzahl mit der Zufriedenheit der Studierenden. Die Auswertung der Wichtigkeit verdeutlicht, dass keines der abgefragten Kriterien besonders negativ beurteilt wurde während es gleichzeitig für die Studierenden von großer Wichtigkeit ist.

Optimal strategies for marine wildlife tourism in small islands

Tese de Doutoramento, Ciências Económicas e Empresariais (especialidade de Economia), 18 de Junho de 2015, Universidade dos Açores

Avaliação da satisfação do utente na comunicação com os profissionais de saúde construção e validação de um instrumento

A satisfação do utente na comunicação com profissionais de saúde é um indicador de qualidade dos serviços ou instituições. Na literatura não encontramos instrumentos padronizados e validados, que avaliem a satisfação do utente na comunicação com os profissionais de saúde. O presente estudo tem como objetivo construir e validar um instrumento para avaliar a satisfação do utente na comunicação com os profissionais de saúde. Desenvolvemos este estudo em três ciclos. Um primeiro, revisão da literatura, para identificar dimensões e itens da comunicação interpessoal na saúde. No segundo ciclo, conduzimos um método de Delphi modificado em três rondas, com recurso à plataforma informática de questionários Survey Monkey, no qual participou um painel de 25 peritos; estabelecemos como critério mínimo de retenção para a ronda seguinte os itens que recebessem 70% do consenso por parte do painel. Após as três rondas, obtivemos um instrumento com seis dimensões comunicacionais (comunicação verbal, comunicação não verbal, empatia, respeito, resolução de problemas e material de apoio), vinte e cinco itens específicos, e mais seis dimensões genéricas, que avaliam cada uma das dimensões. No terceiro ciclo avaliamos as características psicométricas, em termos de sensibilidade, validade do construto e fidelidade, numa amostra de 348 participantes. Os resultados mostram que todas as categorias de resposta estavam representadas em todos os itens. Validade do construto- a análise fatorial identificou uma solução de seis componentes que explicam 71% da variância total. Fiabilidade - os valores da correlação item-total variam entre 0,387 e 0,722, existindo uma correlação positiva moderada a forte. O valor de alfa de Cronbach (α=0,928) indica que a consistência interna é excelente. O instrumento construído apresenta boas propriedades psicométricas. Fica assim disponível uma nova ferramenta para auxiliar na gestão e no processo de planeamento necessários ao incremento da qualidade nos serviços e instituições de saúde.

O impacto do controlo interno nas instituições particulares de Solidariedade Social - a qualidade dos serviços prestados na área da segurança alimentar IPSS: estudo do caso das IPSS do concelho de Vale de Cambra

Dissertação apresentada ao Instituto Superior de Contabilidade e Administração do Porto para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Auditoria, realizada sob a orientação científica do Mestre Carlos Mendes, Equiparado a Professor Adjunto do Instituto Superior de Contabilidade e Administração do Porto. Orientada por Mestre Carlos Mendes Porto, abril 2014