The Australian general public's perceptions of having a personally controlled electronic health record (PCEHR)

Objective The move internationally by Governments and other health providers to encourage patients to have their own electronic personal health record (e-PHRs) is growing exponentially. In Australia the initiative for a personally controlled electronic health record (known as PCEHR) is directed towards the public at large. The first objective of this study then, is to examine how individuals in the general population perceive the promoted idea of having a PCEHR. The second objective is to extend research on applying a theoretically derived consumer technology acceptance model to guide the research. Method An online survey was conducted to capture the perceptions and beliefs about having a PCEHR identified from technology acceptance models and extant literature. The survey was completed by 750 Queensland respondents, 97% of whom did not have a PCEHR at that time. The model was examined using exploratory factor analysis, regressions and mediation tests. Results Findings support eight of the 11 hypothesised relationships in the model. Perceived value and perceived risk were the two most important variables explaining attitude, with perceived usefulness and compatibility being weak but significant. The perception of risk was reduced through partial mediation from trust and privacy concerns. Additionally, web-self efficacy and ease of use partially mediate the relationship between attitude and intentions. Conclusions The findings represent a snapshot of the early stages of implementing this Australian initiative and captures the perceptions of Queenslanders who at present do not have a PCEHR. Findings show that while individuals appreciate the value of having this record, they do not appear to regard it as particularly useful at present, nor is it particularly compatible with their current engagement with e-services. Moreover, they will need to have any concerns about the risks alleviated, particularly through an increased sense of trust and reduction of privacy concerns. It is noted that although the respondents are non-adopters, they do not feel that they lack the necessary web skills to set up and use a PCEHR. To the best of our knowledge this is one of a very limited number of studies that examines a national level implementation of an e-PHR system, where take-up of the PCEHR is optional rather than a centralised, mandated requirement.

Small and medium enterprises using software as a service : exploring the different roles of intermediaries

Software as a Service (SaaS) can provide significant benefits to small and medium enterprises (SMEs) due to advantages like ease of access, 7*24 availability, and utility pricing. However, underlying the SaaS delivery model is often the assumption that SMEs will directly interact with the SaaS vendor and use a self-service approach. In practice, we see the rise of SaaS intermediaries who can support SMEs with sourcing and leveraging SaaS. This paper reports on the roles of intermediaries and how they support SMEs with using SaaS. We conducted an empirical study of two SaaS intermediaries and analysed their business models, in particular their value propositions. We identified orientation (technology or customer) and alignment (operational or strategic) as themes for understanding their roles. The contributions of this paper include: (1) the identification and description of SaaS intermediaries for SMEs based on an empirical study and (2) understanding the different roles of SaaS intermediaries, in particular a more basic role based on technology orientation and operational alignment and a more value adding role based on customer orientation and strategic alignment. We propose that SaaS intermediaries can address SaaS adoption and implementation challenges of SMEs by playing a basic role and can also aim to support SMEs in creating business value with SaaS based solutions by playing an added value role.

Novel architecture to facilitate disassembly and reuse of electronic components and sub-assemblies

This paper advances the proposition that in many electronic products, the partitioning scheme adopted and the interconnection system used to interconnect the sub-assemblies or components are intimately related to the economic benefits, and hence the attractiveness, of reuse of these items. An architecture has been developed in which the residual values of the connectors, components and sub-assemblies are maximized, and opportunities for take-back and reuse of redundant items are greatly enhanced. The system described also offers significant manufacturing cost benefits in terms of ease of assembly, compactness and robustness.

Barriers to and facilitators of interventions to counter publication bias: thematic analysis of scholarly articles and stakeholder interviews.

BACKGROUND: When the nature and direction of research results affect their chances of publication, a distortion of the evidence base - termed publication bias - results. Despite considerable recent efforts to implement measures to reduce the non-publication of trials, publication bias is still a major problem in medical research. The objective of our study was to identify barriers to and facilitators of interventions to prevent or reduce publication bias. METHODS: We systematically reviewed the scholarly literature and extracted data from articles. Further, we performed semi-structured interviews with stakeholders. We performed an inductive thematic analysis to identify barriers to and facilitators of interventions to counter publication bias. RESULTS: The systematic review identified 39 articles. Thirty-four of 89 invited interview partners agreed to be interviewed. We clustered interventions into four categories: prospective trial registration, incentives for reporting in peer-reviewed journals or research reports, public availability of individual patient-level data, and peer-review/editorial processes. Barriers we identified included economic and personal interests, lack of financial resources for a global comprehensive trial registry, and different legal systems. Facilitators identified included: raising awareness of the effects of publication bias, providing incentives to make data publically available, and implementing laws to enforce prospective registration and reporting of clinical trial results. CONCLUSIONS: Publication bias is a complex problem that reflects the complex system in which it occurs. The cooperation amongst stakeholders to increase public awareness of the problem, better tailoring of incentives to publish, and ultimately legislative regulations have the greatest potential for reducing publication bias.

Acquisition of continuous plankton recorder data

The Continuous Plankton Recorder has been deployed on a seasonal basis in the north Pacific since 2000, accumulating a database of abundance measurements for over 290 planktonic taxa in over 3,500 processed samples. There is an additional archive of over 10,000 samples available for further analyses. Exxon Valdez Oil Spill Trustee Council financial support has contributed to about half of this tally, through four projects funded since 2002. Time series of zooplankton variables for sub-regions of the survey area are presented together with abstracts of eight papers published using data from these projects. The time series covers a period when the dominant climate signal in the north Pacific, the Pacific Decadal Oscillation (PDO), switched with unusual frequency between warm/positive states (pre-1999 and 2003-2006) and cool/negative states (1999-2002 and 2007). The CPR data suggest that cool negative years show higher biomass on the shelf and lower biomass in the open ocean, while the reverse is true in warm (PDO positive) years with lower shelf biomass (except 2005) and higher oceanic biomass. In addition, there was a delay in plankton increase on the Alaskan shelf in the colder spring of 2007, compared to the warmer springs of the preceding years. In warm years, smaller species of copepods which lack lipid reserves are also more common. Availability of the zooplankton prey to higher trophic levels (including those that society values highly) is therefore dependent on the timing of increase and peak abundance, ease of capture and nutritional value. Previously published studies using these data highlight the wide-ranging applicability of CPR data and include collaborative studies on; phenology in the key copepod species Neocalanus plumchrus, descriptions of distributions of decapod larvae and euphausiid species, the effects of hydrographic features such as mesoscale eddies and the North Pacific Current on plankton populations and a molecularbased investigation of macro-scale population structure in N. cristatus. The future funding situation is uncertain but the value of the data and studies so far accumulated is considerable and sets a strong foundation for further studies on plankton dynamics and interactions with higher trophic levels in the northern Gulf of Alaska.

The Effects of Several Paper Characteristics and Application Methods on the Sublimation Rate of Cyclododecane

Cyclododecane (CDD) is a waxy, solid cyclic hydrocarbon (C12H24) that sublimes at room temperature and possesses strong hydrophobicity. In paper conservation CDD is used principally as a temporary fixative of water-soluble media during aqueous treatments. Hydrophobicity, ease of reversibility, low toxicity, and absence of residues are reasons often cited for its use over alternative materials although the latter two claims continue to be debated in the literature. The sublimation rate has important implications for treatment planning as well as health and safety considerations given the dearth of reliable information on its toxicity and exposure limits. This study examined how the rate of sublimation is affected by fiber type, sizing, and surface finish as well as delivery in the molten phase and as a saturated solution in low boiling petroleum ether. The effect of warming the paper prior to application was also evaluated. Sublimation was monitored using gravimetric analysis after which samples were tested for residues with gas chromatography-flame ionization detection (GC-FID) to confirm complete sublimation. Water absorbency tests were conducted to determine whether this property is fully reestablished. Results suggested that the sublimation rate of CDD is affected minimally by all of the paper characteristics and application methods examined in this study. The main factors influencing the rate appear to be the thickness and mass of the CDD over a given surface area as well as temperature and ventilation. The GC-FID results showed that most of the CDD sublimed within several days of its disappearance from the paper surface regardless of the application method. Minimal changes occurred in the water absorbency of the samples following complete sublimation.

Extent of non-publication in cohorts of studies approved by research ethics committees or included in trial registries

BACKGROUND: The synthesis of published research in systematic reviews is essential when providing evidence to inform clinical and health policy decision-making. However, the validity of systematic reviews is threatened if journal publications represent a biased selection of all studies that have been conducted (dissemination bias). To investigate the extent of dissemination bias we conducted a systematic review that determined the proportion of studies published as peer-reviewed journal articles and investigated factors associated with full publication in cohorts of studies (i) approved by research ethics committees (RECs) or (ii) included in trial registries. METHODS AND FINDINGS: Four bibliographic databases were searched for methodological research projects (MRPs) without limitations for publication year, language or study location. The searches were supplemented by handsearching the references of included MRPs. We estimated the proportion of studies published using prediction intervals (PI) and a random effects meta-analysis. Pooled odds ratios (OR) were used to express associations between study characteristics and journal publication. Seventeen MRPs (23 publications) evaluated cohorts of studies approved by RECs; the proportion of published studies had a PI between 22% and 72% and the weighted pooled proportion when combining estimates would be 46.2% (95% CI 40.2%-52.4%, I2 = 94.4%). Twenty-two MRPs (22 publications) evaluated cohorts of studies included in trial registries; the PI of the proportion published ranged from 13% to 90% and the weighted pooled proportion would be 54.2% (95% CI 42.0%-65.9%, I2 = 98.9%). REC-approved studies with statistically significant results (compared with those without statistically significant results) were more likely to be published (pooled OR 2.8; 95% CI 2.2-3.5). Phase-III trials were also more likely to be published than phase II trials (pooled OR 2.0; 95% CI 1.6-2.5). The probability of publication within two years after study completion ranged from 7% to 30%. CONCLUSIONS: A substantial part of the studies approved by RECs or included in trial registries remains unpublished. Due to the large heterogeneity a prediction of the publication probability for a future study is very uncertain. Non-publication of research is not a random process, e.g., it is associated with the direction of study findings. Our findings suggest that the dissemination of research findings is biased.

Analysis of Abstracts Presented at the Prosthodontic Research Section of IADR General Sessions 2004-2005: Demographics, Publication Rates, and Factors Contributing to Publication

Purpose: The purposes of this study were to describe the demographics of abstracts presented at the prosthodontics section of IADR General Sessions from 2004 to 2005, evaluate the publication rate of abstracts, and analyze the relationship between variables in abstracts and publication.Materials and Methods: Prosthodontics research section abstracts from the IADR General Session in 2004 and 2005 were evaluated for: number of authors, presentation type, origin, affiliation, topic, study design, statistics, study outcome, and funding. The publication rate was calculated following a PubMed search. The journal of publication, year of publication, and the length of time before publication were analyzed. Descriptive statistics were used for the data analysis; the relationships between presentation type, study design, study outcome, statistics, funding, and publication were analyzed using logistic regression (alpha = 0.05).Results: From 346 abstracts, 37.0% were published. For oral presentations, 40.7% were published; 35.8% of poster presentations were published. The mean duration before publicationwas 26.4months. North America had themost abstracts, and Europe had the most publications. Fixed prosthodontic research had the highest number and proportion for publication. A significant association with publication was noted for neutral study outcomes (p = 0.018), studies with funding (p = 0.035), and abstracts from Europe (p = 0.001).Conclusions: The majority of abstracts from the prosthodontics research section of IADR General Sessions from 2004 and 2005 remain unpublished. A significant association for publication was noted with neutral outcomes, funding, and abstracts from Europe.

Factors Influencing Publication Rates of Abstracts Presented at the ADEA Annual Session & Exhibition

Factors related to the path of abstracts from presentation at a conference to publication as a full article have been analyzed in the medical field, but only a few studies have been performed in dentistry. This study investigated the rate of publication of articles based on abstracts presented at the American Dental Education Association (ADEA) Annual Session & Exhibition in 2002 and 2003 and the time lag to publication. This study also aimed to characterize the abstracts and subsequent articles and determine if there were any significant factors related to expansion of an abstract into a full manuscript. A total of 370 abstracts met the inclusion criteria and were examined for this study. Subsequent published articles were located using a standard PubMed search. Descriptive statistics and bivariate analyses were used to analyze the data collected (alpha=0.05). Results suggest that there was a low (19 percent) publication rate for articles based on abstracts presented at the meetings studied. The median time between abstract presentation and article publication was ten months. Factors that showed significant correlation to likelihood of article publication were multiple affiliations, presence of analytical statistics, and, to a lesser extent, funding. We suggest that presenters at these meetings should expand their abstracts into full manuscripts and seek to publish them in peer-reviewed journals for the benefit of the profession.

Initiation and continuation of randomized trials after the publication of a trial stopped early for benefit asking the same study question: STOPIT-3 study design

BACKGROUND Randomized control trials (RCTs) stopped early for benefit (truncated RCTs) are increasingly common and, on average, overestimate the relative magnitude of benefit by approximately 30%. Investigators stop trials early when they consider it is no longer ethical to enroll patients in a control group. The goal of this systematic review is to determine how investigators of ongoing or planned RCTs respond to the publication of a truncated RCT addressing a similar question. METHODS/DESIGN We will conduct systematic reviews to update the searches of 210 truncated RCTs to identify similar trials ongoing at the time of publication, or started subsequently, to the truncated trials ('subsequent RCTs'). Reviewers will determine in duplicate the similarity between the truncated and subsequent trials. We will analyze the epidemiology, distribution, and predictors of subsequent RCTs. We will also contact authors of subsequent trials to determine reasons for beginning, continuing, or prematurely discontinuing their own trials, and the extent to which they rely on the estimates from truncated trials. DISCUSSION To the extent that investigators begin or continue subsequent trials they implicitly disagree with the decision to stop the truncated RCT because of an ethical mandate to administer the experimental treatment. The results of this study will help guide future decisions about when to stop RCTs early for benefit.

Full-text publication of abstracts presented at European Orthodontic Society congresses.

INTRODUCTION Empirical evidence has indicated that only a subsample of studies conducted reach full-text publication and this phenomenon has become known as publication bias. A form of publication bias is the selectively delayed full publication of conference abstracts. The objective of this article was to examine the publication status of oral abstracts and poster-presentation abstracts, included in the scientific program of the 82nd and 83rd European Orthodontic Society (EOS) congresses, held in 2006 and 2007, and to identify factors associated with full-length publication. METHODS A systematic search of PubMed and Google Scholar databases was performed in April 2013 using author names and keywords from the abstract title to locate abstract and full-article publications. Information regarding mode of presentation, type of affiliation, geographical origin, statistical results, and publication details were collected and analyzed using univariable and multivariable logistic regression. RESULTS Approximately 51 per cent of the EOS 2006 and 55 per cent of the EOS 2007 abstracts appeared in print more than 5 years post congress. A mean period of 1.32 years elapsed between conference and publication date. Mode of presentation (oral or poster), use of statistical analysis, and research subject area were significant predictors for publication success. LIMITATIONS Inherent discrepancies of abstract reporting, mainly related to presentation of preliminary results and incomplete description of methods, may be considered in analogous studies. CONCLUSIONS On average 52.2 per cent of the abstracts presented at the two EOS conferences reached full publication. Abstracts presented orally, including statistical analysis, were more likely to get published.

Empirical study on the maintainability of Web applications: Model-driven Engineering vs Code-centric

Model-driven Engineering (MDE) approaches are often acknowledged to improve the maintainability of the resulting applications. However, there is a scarcity of empirical evidence that backs their claimed benefits and limitations with respect to code-centric approaches. The purpose of this paper is to compare the performance and satisfaction of junior software maintainers while executing maintainability tasks on Web applications with two different development approaches, one being OOH4RIA, a model-driven approach, and the other being a code-centric approach based on Visual Studio .NET and the Agile Unified Process. We have conducted a quasi-experiment with 27 graduated students from the University of Alicante. They were randomly divided into two groups, and each group was assigned to a different Web application on which they performed a set of maintainability tasks. The results show that maintaining Web applications with OOH4RIA clearly improves the performance of subjects. It also tips the satisfaction balance in favor of OOH4RIA, although not significantly. Model-driven development methods seem to improve both the developers’ objective performance and subjective opinions on ease of use of the method. This notwithstanding, further experimentation is needed to be able to generalize the results to different populations, methods, languages and tools, different domains and different application sizes.

A demonstration of mobile phone deployment to support the treatment of acutely ill children under five in Bushenyi district, Uganda.

Background: Benefits of mobile phone deployment for children <5 in low-resource settings remain unproven. The target population of the current demonstration study in Bushenyi District, Uganda, presented with acute fever, pneumonia, or diarrhoea and were treated by community health workers (CHWs) providing integrated community case management (iCCM). Methods: An observational study was conducted in five parishes (47 villages) served by CHWs well versed in iCCM with supplemental training in mobile phone use. Impact was assessed by quantitative measures and qualitative evaluation through household surveys, focus group discussions, and key informant interviews. Results: CHWs in targeted sites improved child healthcare through mobile phone use coupled with iCCM. Of acutely ill children, 92.6% were correctly managed. Significant improvements in clinical outcomes compared to those obtained by CHWs with enhanced iCCM training alone were unproven in this limited demonstration. Nonetheless, qualitative evaluation showed gains in treatment planning, supply management, and logistical efficiency. Provider confidence and communications were enhanced as was ease and accuracy of record keeping. Conclusion: Mobile phones appear synergistic with iCCM to bolster basic supportive care for acutely ill children provided by CHWs. The full impact of expanded mobile phone deployment warrants further evaluation prior to scaling up in low-resource settings.

Experiences of patients undergoing chemotherapy - a qualitative study of adults attending Uganda Cancer Institute

Background: Cancer is a global public health challenge and how patients in countries with poor healthcare infrastructure experience cancer treatment is largely unknown. Purpose: The objective of this study was to describe adult Ugandan cancer patients’ experiences of undergoing chemotherapy treatment. Methodology: Using a qualitative descriptive design, seven in-patients with varying cancer diagnoses at the Uganda Cancer Institute were interviewed about their experiences of undergoing chemotherapy treatment; the interviews were transcribed and analysed thematically. Results: The analysis resulted in nine subthemes, which were categorized under three main themes: ‘experiences related to the body’, with the subthemes dry and sensitive skin, changes in eating and bowel habits, fever and feelings of abnormal body sensation; ‘thoughts and feelings’, with four subthemes reflecting the psychosocial impact of chemotherapy; and ‘actively dealing with discomfort’, with three subthemes describing how patients dealt with side effects, such as by sticking to a diet. Conclusion: Receiving chemotherapy treatment is difficult, and the side effects negatively influenced patients’ bodies and moods. Dealing actively with discomfort and accepting negative impacts in hope of a cure helped the participants manage the acute complications related to the treatment. We recommend the development of interventions to ease discomfort due to chemotherapy.