Producing computer-generated tailored written information for stroke patients and their carers: System development and preliminary evaluation

Purpose: The aim of this project was to design and evaluate a system that would produce tailored information for stroke patients and their carers, customised according to their informational needs, and facilitate communication between the patient and, health professional. Method: A human factors development approach was used to develop a computer system, which dynamically compiles stroke education booklets for patients and carers. Patients and carers are able to select the topics about which they wish to receive information, the amount of information they want, and the font size of the printed booklet. The system is designed so that the health professional interacts with it, thereby providing opportunities for communication between the health professional and patient/carer at a number of points in time. Results: Preliminary evaluation of the system by health professionals, patients and carers was positive. A randomised controlled trial that examines the effect of the system on patient and carer outcomes is underway. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Designing effective written health education materials: Considerations for health professionals

Purpose: Written health education materials can only be effective if they can be read, understood, and remembered by patients. The purpose of this article was to review the literature about features that should be incorporated into written health education materials to maximize their effectiveness, identify where there is consensus and debate about which features should be incorporated, and develop recommendations that health professionals can use when reviewing their existing materials and designing new materials. Method: Literature review of published research and education articles. Results: There is a large number of features that need to be considered when designing written health education materials so that they are suitable for the target audience and effective. Although there is consensus about the majority of features that should be included, further research is needed to explore the contribution of certain features, such as illustrations, to the effectiveness of written materials and the effect of well-designed written materials on patient outcomes. Conclusions: Health professionals need to provide their patients with written health education materials that are patient-orientated and designed according to the best practice principles in written health education material design.

Analysis of stroke patients' and carers' reading ability and the content and design of written materials: Recommendations for improving written stroke information

Objective: This study (a) evaluated the reading ability of patients following stroke and their carers and the reading level and content and design characteristics of the written information provided to them, (b) explored the influence of sociodemographic and clinical characteristics on patients' reading ability, and (c) described an education package that provides well-designed information tailored to patients' and carers' informational needs. Methods: Fifty-seven patients and 12 carers were interviewed about their informational needs in an acute stroke unit. Their reading ability was assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM). The written information provided to them in the acute stroke unit was analysed using the SMOG readability formula and the Suitability Assessment of Materials (SAM). Results: Thirteen (22.8%) patients and 5 (41.7%) carers had received written stroke information. The mean reading level of materials analysed was 11th grade while patients read at a mean of 7-8th grade. Most materials (89%) scored as only adequate in content and design. Patients with combined aphasia read significantly lower (4-6th grade) than other patients (p = 0.001). Conclusion: Only a small proportion of patients and carers received written materials about stroke and the readability level and content and design characteristics of most materials required improvement. Practice implications: When developing and distributing written materials about stroke, health professionals should consider the reading ability and informational needs of the recipients, and the reading level and content and design characteristics of the written materials. A computer system can be used to generate written materials tailored to the informational needs and literacy skills of patients and carers. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

The information specialist in the clinical team: Building expertise in evidence-based healthcare

The Clinician Development Program (CDP) is an initiative of Queensland Health’s Quality Improvement and Enhancement Program. At the Royal Brisbane & Royal Women's Hospital Health Service Districts, evidence-base practice (EBP) is an important CDP area in which several projects were carried out in 2002. This paper describes one such project. A medical librarian was invited to accompany the clinical team on morning rounds in the Medical Assessment & Planning Unit (MAPU). The librarian conducted information skills training in the ward and helped clinicians to answer questions directly related to patient care. Questions not answered during the round were followed-up, usually within 48 hours, and responses emailed to the consultant who led the rounds. At the project’s conclusion the librarian was invited to continue as a member of the MAPU clinical team, thus acknowledging the valuable role an information specialist can play in incorporating research evidence into patient care. Clinical librarianship (CL) creates a space, albeit a contentious one, for the health librarian at the bedside. This paper describes an Australian CL project and attempts to demystify the role of an information specialist in EBP. It also highlights some of the challenges facing librarians and clinicians attempting to embed EBP in clinical settings.

A EDUCAÇÃO A DISTÂNCIA E A FORMAÇÃO DO SUJEITO: Estudo realizado sobre o professor tutor nos cursos de graduação, na modalidade a distância da Umesp, sob a ótica da multirreferencialidade

A educação a distância (EAD) é uma modalidade de ensino antiga que se renova com as novas tecnologias de informação e comunicação (NTIC). O momento presente é promissor para o desenvolvimento de pesquisas neste âmbito, visto o crescimento desta modalidade de ensino no Brasil. Universidades brasileiras (públicas, privadas, comunitárias e confessionais) têm investido em projetos de educação a distância; percebe-se que os modelos utilizados carecem precisão na configuração das funções exercidas pelos vários atores presentes na EAD. Por esta razão, o trabalho tutorial é pe squisado tendo como objetivo o desvelar das relações entre a formação do sujeito e o papel do professor tutor, considerando o Projeto Pedagógico Institucional e o projeto pedagógico dos cursos a distância, bem como suas proposituras sobre a concepção antropológica (homem), a concepção gnosiológica (conhecimento) e a concepção política (relações político-sociais). As hipóteses que sustentaram a pesquisa consideraram a tutoria como: mediadora no processo de construção do conhecimento e desenvolvimento do sujeito e como uma das responsáveis pela articulação da equipe de EAD, nas relações com o corpo discente, da Universidade Metodista de São Paulo. O texto, a seguir, é fruto do desejo de corroborar com o desenvolvimento desta modalidade de ensino no Brasil.(AU)

Educating future IS professionals through real-world integration

We report on teaching Information Systems Analysis (ISA) in a way that takes the classroom into the real world to enrich students' understanding of the broader role of being an IS professional. Through exposure to less controllable and more uncomfortable issues (e.g., client deadlines; unclear scope; client expectations; unhelpful colleagues, complexity about what is the problem never mind the solution) we aim to better prepare students to respond to the complex issues surrounding deployment of systems analysis methodologies in the real world. In this paper we provide enough detail on what these classes involve to allow a reader to replicate appealing elements in their own teaching. This paper is a reflection on integrating in the real world when teaching ISA – a reflection from the standpoint of students who face an unstructured and complex world and of lecturers who aim to prepare students to hit the floor running when they encounter that world.

Stepping Stones to Information Literacy: a PebblePad case study

Aston University has recently made PebblePad, an e-portfolio or personal learning system, available to all students within the University. The customisable Profiles within PebblePad allow students to self-declare their skills in particular areas, attaching evidence of their skills or an action plan for improvement to each statement. Formal Information Literacy (IL) teaching within Aston University is currently limited to Library & Information Services (LIS) Information Specialists delivering a maximum of one session to each student during each level of their degree. However, many of the skills are continually developed by students during the course of their academic studies. For this project, an IL skills profile was created within PebblePad, which was then promoted to groups of staff and students to complete during the academic session 2009-10. Functionality within PebblePad allowed students to share their IL skills profile, evidence, action plans or any other items they felt were appropriate with an LIS Information Specialist who was able to add comments and offer suggestions for activities to help the student to develop further. Activities were closely related to students’ coursework where possible: suggesting a student kept a short reflective log of their information searching and evaluating process for an upcoming essay, for example. Feedback on the usefulness of the IL Profile will be sought from students through focus groups and the communication tools in PebblePad. In this way, we hope to make students more aware of their IL skills and to offer IL skills support over a longer period of time than a single session can provide. We will present preliminary conclusions about the practicalities and benefits of a self-declaration approach to developing IL skills in students at Aston University.

The evolving role of information specialists:change agents in process redesign

The research investigates the past, present and potential future role of Information Specialists (ISps) in process oriented companies. It tests the proposition that ISps in companies that have undertaken formal process reengineering exercises are likely to become more proactive and more business oriented (as opposed to technically oriented) than they had previously been when their organisations were organised along traditional, functional lines. A review of existing literature in the area of Business Process Reengineering and Information Management reveals a lack of consensus amongst researchers concerning the appropriate role for ISps during and after BPR. Opinion is divided as to whether IS professionals should reactively support BPR or whether IT/IS developments should be driving these initiatives. A questionnaire based ‘Descriptive Survey’ with 60 respondents is used as a first stage of primary data gathering. This is followed by follow-up interviews with 20 of the participating organisations to gather further information on their experiences. The final stage of data collection consists of further in-depth interview with four case study companies to provide an even richer picture of their experiences. The results of the questionnaire are analysed and displayed in the form of simple means, frequencies and bar graphs. The ‘NU-DIST’ computer based discourse analysis package was tried in relation to summarising the interview findings, but this proved cumbersome and a visual collation method is preferred. Overall, the researcher contends that the supposition outlined above is proven, and she concludes the research by suggesting the implications of these findings. In particular she offers a ‘Framework for Understanding and Action’ which is deemed to be relevant to both practitioners and future researchers.

Patients’ and health professionals’ views and experiences of atrial fibrillation and oral-anticoagulant therapy:a qualitative meta-synthesis

Objective - Atrial fibrillation (AF) patients are prescribed oral-anticoagulant (OAC) therapy, often warfarin, to reduce stroke risk. We explored existing qualitative evidence about patients’ and health professionals’ experiences of OAC therapy. Methods - Systematic searches of eight bibliographic databases were conducted. Quality was appraised using the Critical Appraisal Skills Programme tool and data from ten studies were synthesised qualitatively. Results - Four third-order constructs, emerged from the final step in the analysis process: (1) diagnosing AF and the communication of information, (2) deciding on OAC therapy, (3) challenges revolving around patient issues, and (4) healthcare challenges. Synthesis uncovered perspectives that could not be achieved through individual studies. Conclusion - Physicians’ and patients’ experiences present a dichotomy of opinion on decision-making, which requires further exploration and changes in practice. Outcomes of workload pressure on both health professionals and patients should be investigated. The need for on-going support and education to patients and physicians is critical to achieve best practice and treatment adherence. Practice implications - Such research could encourage health professionals to understand and attend better to the needs and concerns of the patient. Additionally these findings can be used to inform researchers and healthcare providers in developing educational interventions with both patients and health professionals.

Community accessibility of health information and the consequent impact for translation into community languages

This paper reports on a research project that investigated the accessibility of health information and the consequent impact for translation into community languages. This is a critical aspect of the mediation of intercultural and interlingual communication in the domain of public health information and yet very little research has been undertaken to address such issues. The project was carried out in collaboration with the New South Wales Multicultural Health Communication Service (MHCS), which provides advice and services to state-based health professionals aiming to communicate with non-English speaking communities. The research employed a mixed-method and action research based approach involving two phases. The primary focus of this paper is to discuss major quantitative findings from the first pilot phase, which indicated that there is much room to improve the way in which health information is written in English for effective community-wide communication within a multilingual society.

Information and behavioural instruction along the health-care pathway:the perspective of people undergoing hernia repair surgery and the role of formal and informal information sources

Provision of information and behavioural instruction has been demonstrated to improve recovery after surgery. However, patients draw on a range of information sources and it is important to establish which sources patients use and how this influences perceptions and behaviour as they progress along the surgical pathway. In this qualitative, exploratory and longitudinal study, the use of information and instruction were explored from the perspective of people undergoing inguinal hernia repair surgery. Seven participants undergoing inguinal hernia repair surgery were interviewed using semi-structured interviews 2 weeks before surgery and 2 weeks and 4 months post-surgery. Nineteen interviews were conducted in total. Topic guides included sources of knowledge, reasons for help-seeking and opting for surgery and factors influencing return to activity. Data were analysed thematically according to Interpretative Phenomenological Analysis. Participants sought information from a range of sources, focusing on informal information sources before surgery and using information and instruction from health-care professionals post-surgery. This information influenced behaviours including deciding to undergo surgery, use of pain medication and returning to usual activity. Anxiety and help-seeking resulted when unexpected post-surgical events occurred such as extensive bruising. Findings were consistent with psychological and sociological theories. Overall, participants were positive about the information and instruction they received but expressed a desire for more timely information on post-operative adverse events.

Conceptual Building Information Modelling Framework for Whole‐house Refurbishment based on LCC and LCA

The UK government aims at achieving 80% CO2 emission reduction by 2050 which requires collective efforts across all the UK industry sectors. In particular, the housing sector has a large potential to contribute to achieving the aim because the housing sector alone accounts for 27% of the total UK CO2 emission, and furthermore, 87% of the housing which is responsible for current 27% CO2 emission will still stand in 2050. Therefore, it is essential to improve energy efficiency of existing housing stock built with low energy efficiency standard. In order for this, a whole‐house needs to be refurbished in a sustainable way by considering the life time financial and environmental impacts of a refurbished house. However, the current refurbishment process seems to be challenging to generate a financially and environmentally affordable refurbishment solution due to the highly fragmented nature of refurbishment practice and a lack of knowledge and skills about whole‐house refurbishment in the construction industry. In order to generate an affordable refurbishment solution, diverse information regarding costs and environmental impacts of refurbishment measures and materials should be collected and integrated in right sequences throughout the refurbishment project life cycle among key project stakeholders. Consequently, various researchers increasingly study a way of utilizing Building Information Modelling (BIM) to tackle current problems in the construction industry because BIM can support construction professionals to manage construction projects in a collaborative manner by integrating diverse information, and to determine the best refurbishment solution among various alternatives by calculating the life cycle costs and lifetime CO2 performance of a refurbishment solution. Despite the capability of BIM, the BIM adoption rate is low with 25% in the housing sector and it has been rarely studied about a way of using BIM for housing refurbishment projects. Therefore, this research aims to develop a BIM framework to formulate a financially and environmentally affordable whole‐house refurbishment solution based on the Life Cycle Costing (LCC) and Life Cycle Assessment (LCA) methods simultaneously. In order to achieve the aim, a BIM feasibility study was conducted as a pilot study to examine whether BIM is suitable for housing refurbishment, and a BIM framework was developed based on the grounded theory because there was no precedent research. After the development of a BIM framework, this framework was examined by a hypothetical case study using BIM input data collected from questionnaire survey regarding homeowners’ preferences for housing refurbishment. Finally, validation of the BIM framework was conducted among academics and professionals by providing the BIM framework and a formulated refurbishment solution based on the LCC and LCA studies through the framework. As a result, BIM was identified as suitable for housing refurbishment as a management tool, and it is timely for developing the BIM framework. The BIM framework with seven project stages was developed to formulate an affordable refurbishment solution. Through the case study, the Building Regulation is identified as the most affordable energy efficiency standard which renders the best LCC and LCA results when it is applied for whole‐house refurbishment solution. In addition, the Fabric Energy Efficiency Standard (FEES) is recommended when customers are willing to adopt high energy standard, and the maximum 60% of CO2 emissions can be reduced through whole‐house fabric refurbishment with the FEES. Furthermore, limitations and challenges to fully utilize BIM framework for housing refurbishment were revealed such as a lack of BIM objects with proper cost and environmental information, limited interoperability between different BIM software and limited information of LCC and LCA datasets in BIM system. Finally, the BIM framework was validated as suitable for housing refurbishment projects, and reviewers commented that the framework can be more practical if a specific BIM library for housing refurbishment with proper LCC and LCA datasets is developed. This research is expected to provide a systematic way of formulating a refurbishment solution using BIM, and to become a basis for further research on BIM for the housing sector to resolve the current limitations and challenges. Future research should enhance the BIM framework by developing more detailed process map and develop BIM objects with proper LCC and LCA Information.