Information Presentation Features and Comprehensibility of Hospital Report Cards: Design Analysis and Online Survey Among Users

Background: Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented. Objective: We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature. Methods: The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents’ hospital choices were associated with particular information design elements. Results: Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data (“N/A” as a value). When investigating the RAMR in a sample of 10 hospitals’ report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature. Conclusions: To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a “good quality” range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.

Modelling the development of an online learning resource by health care professionals

The aim of this study was to model the process of development for an Online Learning Resource (OLR) by Health Care Professionals (HCPs) to meet lymphoedema-related educational needs, within an asset-based management context. Previous research has shown that HCPs have unmet educational needs in relation to lymphoedema but details on their specific nature or context were lacking. Against this background, the study was conducted in two distinct but complementary phases. In Phase 1, a national survey was conducted of HCPs predominantly in community, oncology and palliative care services, followed by focus group discussions with a sample of respondents. In Phase 2, lymphoedema specialists (LSs) used an action research approach to design and implement an OLR to meet the needs identified in Phase 1. Study findings were analysed using descriptive statistics (Phase 1), and framework, thematic and dialectic analysis to explore their potential to inform future service development and education theory. Unmet educational need was found to be specific to health care setting and professional group. These resulted in HCPs feeling poorly-equipped to diagnose and manage lymphoedema. Of concern, when identified, lymphoedema was sometimes buried for fear of overwhelming stretched services. An OLR was identified as a means of addressing the unmet educational needs. This was successfully developed and implemented with minimal additional resources. The process model created has the potential to inform contemporary leadership theory in asset-based management contexts. This doctoral research makes a timely contribution to leadership theory since the resource constraints underpinning much of the contribution has salience to current public services. The process model created has the potential to inform contemporary leadership theory in asset-based management contexts. Further study of a leadership style which incorporates cognisance of Cognitive Load Theory and Self-Determination Theory is suggested. In addition, the detailed reporting of process and how this facilitated learning for participants contributes to workplace education theory

Active Data Collection Techniques to Understand Online Scammers and Cybercriminals

Nigerian scam, also known as advance fee fraud or 419 scam, is a prevalent form of online fraudulent activity that causes financial loss to individuals and businesses. Nigerian scam has evolved from simple non-targeted email messages to more sophisticated scams targeted at users of classifieds, dating and other websites. Even though such scams are observed and reported by users frequently, the community’s understanding of Nigerian scams is limited since the scammers operate “underground”. To better understand the underground Nigerian scam ecosystem and seek effective methods to deter Nigerian scam and cybercrime in general, we conduct a series of active and passive measurement studies. Relying upon the analysis and insight gained from the measurement studies, we make four contributions: (1) we analyze the taxonomy of Nigerian scam and derive long-term trends in scams; (2) we provide an insight on Nigerian scam and cybercrime ecosystems and their underground operation; (3) we propose a payment intervention as a potential deterrent to cybercrime operation in general and evaluate its effectiveness; and (4) we offer active and passive measurement tools and techniques that enable in-depth analysis of cybercrime ecosystems and deterrence on them. We first created and analyze a repository of more than two hundred thousand user-reported scam emails, stretching from 2006 to 2014, from four major scam reporting websites. We select ten most commonly observed scam categories and tag 2,000 scam emails randomly selected from our repository. Based upon the manually tagged dataset, we train a machine learning classifier and cluster all scam emails in the repository. From the clustering result, we find a strong and sustained upward trend for targeted scams and downward trend for non-targeted scams. We then focus on two types of targeted scams: sales scams and rental scams targeted users on Craigslist. We built an automated scam data collection system and gathered large-scale sales scam emails. Using the system we posted honeypot ads on Craigslist and conversed automatically with the scammers. Through the email conversation, the system obtained additional confirmation of likely scam activities and collected additional information such as IP addresses and shipping addresses. Our analysis revealed that around 10 groups were responsible for nearly half of the over 13,000 total scam attempts we received. These groups used IP addresses and shipping addresses in both Nigeria and the U.S. We also crawled rental ads on Craigslist, identified rental scam ads amongst the large number of benign ads and conversed with the potential scammers. Through in-depth analysis of the rental scams, we found seven major scam campaigns employing various operations and monetization methods. We also found that unlike sales scammers, most rental scammers were in the U.S. The large-scale scam data and in-depth analysis provide useful insights on how to design effective deterrence techniques against cybercrime in general. We study underground DDoS-for-hire services, also known as booters, and measure the effectiveness of undermining a payment system of DDoS Services. Our analysis shows that the payment intervention can have the desired effect of limiting cybercriminals’ ability and increasing the risk of accepting payments.

Raising concerns and reporting poor care in practice

This article considers the issue of poor care and how nurses should respond when they encounter it. Several reports and inquiries into failings in care have called into question the standards of care provided by nurses. Of equal concern is the observation that in some instances, poor care is unreported. While there may be underlying structural and organisational reasons for this, it is contended that nurses have a legal, moral and professional obligation to report poor care when they become aware of it.

Determinants of Sustainability e-reporting in Portuguese municipalities: an institutional and legitimacy theoretical framewor

This study aims to analyse the extent of online social responsibility (SR) information disclosure by Portuguese municipalities and to identify related determinant factors, based on Institutional Theory and Legitimacy Theories. A content analysis was performed on webpages from 60 sampled municipalities, and an information disclosure index was created.Descriptive statistics obtained indicate the Total Disclosure Index (TDI) value was 0.46. The Economic Information sub-category exhibits the highest value (0.66), followed by the Social and Environmental Information categories (0.61 and 0.36, respectively). The multivariate analysis results indicate that LA21 implementation the existence of tax burdens, the characterisation of a municipality as urban and environmental/SR certification application positively influence SR information disclosure. TDI is negatively affected by the existence of an inactive population (i.e. by the percentage of individuals ≤19 and ≥65 years of age).

Evolutions of an Online Generation: Education, Industry and IMC

This paper traces the evolutions of a new generation of students who are predominantly the ‘online generation’; explores the emerging impact of this generation on industry; identifies the changing role of education from traditional classroom to an online environment; and explores the contribution related to integrated marketing communications (IMC). Educational requirements from a business perspective must incorporate global business demands; virtual learning environments progress the online generation towards a post-modern learning state. The central proposition of this paper is that the emergence of IMC in evolving industry practices is influenced by student generations who are producing a new paradigm of alignment between education and industry. This is purely a conceptual exploration using limited examples to provide some context and illustrate the questions raised for consideration.