Hospital clinicians information behaviour and attitudes towards the 'Clinical Informationist': an Irish survey

Background: Hospital clinicians are increasingly expected to practice evidence-based medicine (EBM) in order to minimize medical errors and ensure quality patient care, but experience obstacles to information-seeking. The introduction of a Clinical Informationist (CI) is explored as a possible solution. Aims:  This paper investigates the self-perceived information needs, behaviour and skill levels of clinicians in two Irish public hospitals. It also explores clinicians perceptions and attitudes to the introduction of a CI into their clinical teams. Methods: A questionnaire survey approach was utilised for this study, with 22 clinicians in two hospitals. Data analysis was conducted using descriptive statistics. Results: Analysis showed that clinicians experience diverse information needs for patient care, and that barriers such as time constraints and insufficient access to resources hinder their information-seeking. Findings also showed that clinicians struggle to fit information-seeking into their working day, regularly seeking to answer patient-related queries outside of working hours. Attitudes towards the concept of a CI were predominantly positive. Conclusion: This paper highlights the factors that characterise and limit hospital clinicians information-seeking, and suggests the CI as a potentially useful addition to the clinical team, to help them to resolve their information needs for patient care.

The utility of survey and administrative data to generate information for research and outcomes-based oral health services development

The aim of this research, which focused on the Irish adult population, was to generate information for policymakers by applying statistical analyses and current technologies to oral health administrative and survey databases. Objectives included identifying socio-demographic influences on oral health and utilisation of dental services, comparing epidemiologically-estimated dental treatment need with treatment provided, and investigating the potential of a dental administrative database to provide information on utilisation of services and the volume and types of treatment provided over time. Information was extracted from the claims databases for the Dental Treatment Benefit Scheme (DTBS) for employed adults and the Dental Treatment Services Scheme (DTSS) for less-well-off adults, the National Surveys of Adult Oral Health, and the 2007 Survey of Lifestyle Attitudes and Nutrition in Ireland. Factors associated with utilisation and retention of natural teeth were analysed using count data models and logistic regression. The chi-square test and the student’s t-test were used to compare epidemiologically-estimated need in a representative sample of adults with treatment provided. Differences were found in dental care utilisation and tooth retention by Socio-Economic Status. An analysis of the five-year utilisation behaviour of a 2003 cohort of DTBS dental attendees revealed that age and being female were positively associated with visiting annually and number of treatments. Number of adults using the DTBS increased, and mean number of treatments per patient decreased, between 1997 and 2008. As a percentage of overall treatments, restorations, dentures, and extractions decreased, while prophylaxis increased. Differences were found between epidemiologically-estimated treatment need and treatment provided for those using the DTBS and DTSS. This research confirms the utility of survey and administrative data to generate knowledge for policymakers. Public administrative databases have not been designed for research purposes, but they have the potential to provide a wealth of knowledge on treatments provided and utilisation patterns.

PARTAKE survey of public knowledge and perceptions of clinical research in India.

BACKGROUND: A public that is an informed partner in clinical research is important for ethical, methodological, and operational reasons. There are indications that the public is unaware or misinformed, and not sufficiently engaged in clinical research but studies on the topic are lacking. PARTAKE - Public Awareness of Research for Therapeutic Advancements through Knowledge and Empowerment is a program aimed at increasing public awareness and partnership in clinical research. The PARTAKE Survey is a component of the program. OBJECTIVE: To study public knowledge and perceptions of clinical research. METHODS: A 40-item questionnaire combining multiple-choice and open-ended questions was administered to 175 English- or Hindi-speaking individuals in 8 public locations representing various socioeconomic strata in New Delhi, India. RESULTS: Interviewees were 18-84 old (mean: 39.6, SD ± 16.6), 23.6% female, 68.6% employed, 7.3% illiterate, 26.3% had heard of research, 2.9% had participated and 58.9% expressed willingness to participate in clinical research. The following perceptions were reported (% true/% false/% not aware): 'research benefits society' (94.1%/3.5%/2.3%), 'the government protects against unethical clinical research' (56.7%/26.3%/16.9%), 'research hospitals provide better care' (67.2%/8.7%/23.9%), 'confidentiality is adequately protected' (54.1%/12.3%/33.5%), 'participation in research is voluntary' (85.3%/5.8%/8.7%); 'participants treated like 'guinea pigs'' (20.7%/53.2%/26.0%), and 'compensation for participation is adequate' (24.7%/12.9%/62.3%). CONCLUSIONS: Results suggest the Indian public is aware of some key features of clinical research (e.g., purpose, value, voluntary nature of participation), and supports clinical research in general but is unaware of other key features (e.g., compensation, confidentiality, protection of human participants) and exhibits some distrust in the conduct and reporting of clinical trials. Larger, cross-cultural surveys are required to inform educational programs addressing these issues.

The paradox of openness revisited: Collaborative innovation and patenting by UK innovators

© 2016 The Authors.We revisit the "paradox of openness" in the literature which consists of two conflicting views on the link between patenting and open innovation-the spillover prevention and the organizational openness views. We use the data from the Survey of Innovation and Patent Use and the Community Innovation Survey (CIS6) in the UK to assess the empirical support for the distinct predictions of these theories. We argue that both patenting and external sourcing (openness) are jointly-determined decisions made by firms. Their relationship is contingent upon whether the firms are technically superior to their rivals and lead in the market or not. Leading firms are more vulnerable to unintended knowledge spillovers during collaboration as compared to followers, and consequently, the increase in patenting due to openness is higher for leaders than for followers. We develop a simple framework that allows us to formally derive the empirical implications of this hypothesis and test it by estimating whether the reduced form relationship between patenting and collaboration is stronger for leaders than for followers.

Complexity of mixed shop scheduling problems: A survey

We survey recent results on the computational complexity of mixed shop scheduling problems. In a mixed shop, some jobs have fixed machine orders (as in the job shop), while the operations of the other jobs may be processed in arbitrary order (as in the open shop). The main attention is devoted to establishing the boundary between polynomially solvable and NP-hard problems. When the number of operations per job is unlimited, we focus on problems with a fixed number of jobs.

A survey of teaching and assessment methods employed in UK higher education programmes for HCI course

A survey of teaching and assessment methods employed in UK Higher Education programmes for Human-Computer Interaction (HCI) courses was conducted in April 2003. The findings from this survey are presented, and conclusions drawn.

The AASK database V4.0: aircraft accident statistics and knowledge. A database to record human experience of evacuation in aviation accidents

This paper describes the AASK database. The AASK database is unique as it is a record of human behaviour during survivable aviation accidents. The AASK database is compiled from interview data compiled by agencies such as the NTSB and the AAIB. The database can be found on the website http://fseg.gre.ac.uk

CAA paper 2006/01: a database to record human experience of evacuation in aviation accidents: the aircraft accident statistics and knowledge database (AASK)

This report concerns the development of the AASK V4.0 database (CAA Project 560/SRG/R+AD). AASK is the Aircraft Accident Statistics and Knowledge database, which is a repository of survivor accounts from aviation accidents. Its main purpose is to store observational and anecdotal data from interviews of the occupants involved in aircraft accidents. The AASK database has wide application to aviation safety analysis, being a source of factual data regarding the evacuation process. It is also key to the development of aircraft evacuation models such as airEXODUS, where insight into how people actually behave during evacuation from survivable aircraft crashes is required. With support from the UK CAA (Project 277/SRG/R&AD), AASK V3.0 was developed. This was an on-line prototype system available over the internet to selected users and included a significantly increased number of passenger accounts compared with earlier versions, the introduction of cabin crew accounts, the introduction of fatality information and improved functionality through the seat plan viewer utility. The most recently completed AASK project (Project 560/SRG/R+AD) involved four main components: a) analysis of the data collected in V3.0; b) continued collection and entry of data into AASK; c) maintenance and functional development of the AASK database; and d) user feedback survey. All four components have been pursued and completed in this two-year project. The current version developed in the last year of the project is referred to as AASK V4.0. This report provides summaries of the work done and the results obtained in relation to the project deliverables.

Fifty years of scheduling: a survey of milestones

Scheduling has become a major field within operational research with several hundred publications appearing each year. This paper explores the historical development of the subject since the mid-1950s when the landmark publications started to appear. A discussion of the main topics of scheduling research for the past five decades is provided, highlighting the key contributions that helped shape the subject. The main topics covered in the respective decades are combinatorial analysis, branch and bound, computational complexity and classification, approximate solution algorithms and enhanced scheduling models.

Exploring strategies for promoting the use of research findings in practice

Following the integration of nurse and midwifery education into institutions of higher education in the United Kingdom, a number of studies have shown that a defined clinical framework for nursing and midwifery lecturers in practice areas is lacking. The aim of this study was to explore strategies that nurse and midwifery lecturers from one higher education institution in south east England can use to work collaboratively with nurses and midwives to promote the utilization of research findings in practice. A cross-sectional survey using a structured questionnaire was sent to a sample of 60 nurse and midwifery lecturers and 90 clinical managers. Response rates of 67% (40) and 69% (62) respectively were obtained. The main strategies suggested were to make clinical staff more aware of what research exist in their specialties; to help them to access research information from research databases; and to critically appraise this information. Other strategies were for teachers to run research workshops on site; to undertake joint research projects with clinical staff; to set up journal clubs or research interest groups; and to help formulate clinical guidelines and protocols which are explicitly research-based.

The feedback we give: university student perceptions and preferences

This paper reports the results of a study on higher education student perceptions of and preferences for feedback on their performance. The issue of feedback to students is becoming increasingly important in higher education, not only because it is an important element of learning, but also as a significant component of the student experience and its evaluation. Within a mass education context, written feedback on coursework may be an important opportunity available to students for individualised attention. The current research explored perceptions of feedback by participants who were studying in undergraduate business degrees in a UK university (N=175). The survey instrument asked participants to evaluate the feedback they receive at university in terms of its impact and influence, as well as their understanding of feedback received and preferences. Analysis of the data indicates that students generally find feedback provided to them helpful and encouraging in improving their work but they also indicate that they would prefer to discuss their work directly with their tutor instead of receiving written feedback. They comment on the illegibility of some hand written feedback received. They also report that, generally, they act on the feedback received in order to improve their work and say that it helps them to reflect on their learning. Students comment that negative feedback received does not make them angry or demotivate them. The survey found considerable variability in the students' understanding of 'typical' feedback comments. The majority of students (79%) also reported that they prefer a structured feedback matrix to general comments because they consider it more specific and easier to understand. The implications of these findings for feedback and assessment practices are discussed and suggestions for improvements developed.

When deterrence works - and when it doesn't: a comparison of Sweden's prostitution law and UK's Dangerous Dogs Act

Many pieces of legislation have been implemented with the anticipation - or justification - that they will have a deterrent effect. Deterrence was clearly argued in the debate preceding the Swedish prostitution law prohibiting the purchase of sexual services, but less so regarding the Dangerous Dogs Act, which was a very rapid response to a particular moral panic. As it turned out, the Swedish law has had a deterrent effect on street prostitution in that 'respectable' buyers were deterred. It will be argued that it is this very 'respectability' that makes deterrence work in this case. Regarding the Dangerous Dogs Act, the owners of Pit Bulls and other banned breeds are not considered 'respectable' and the banning might have had the reversed effect - increasing the attraction of these dogs, rather than deterring the ownership. Apart from deterrence and its consequences, the rendering invisible of key actors - buyers and owners respectively - and the use of symbolic legislation to promote moral messages will also be considered. [From the Author]

Law in the community: the University of Greenwich/Greenwich Association of Disabled People Centre for Independent Living (GAD) research project

The GAD Advocacy Service is funded by the London Borough of Greenwich Directorate of Neighbourhood Services; its remit to support disabled people experiencing Hate Crime, Domestic Violence and Harassment. Run by disabled personnel and giving advice to all disabled people it is unique in London. Since its inception in 2004, the Advocacy Service has been stretched to its limit - there is a need to extend the remit of the Advocacy Service to give specialist legal advice on other issues. In 2003, the CEDRM-UK project was set up in the University of Greenwich Law Department as part of the Disability Rights Promotion International Legal Education and Research Project; its objectives were firstly, to facilitate the collection of data on the effectiveness of legislation in promoting the rights of disabled persons; and secondly, to pilot new methods in teaching and training in Human Rights Law – students acquire an expertise in Human Rights Law through research into the practical application of legislation relating to civil and human rights in the daily life of the community. In July 2007, GAD and CEDRM-UK embarked on a joint project to report on the work of the Advocacy Service and to create a database to support its caseload. The 2008-9 Project team will report on their work and findings relating to facilitating equality in the workplace; the inclusion of cancer, HIV and multiple sclerosis within the legal definition of disability and the implications of the statutory duty to promote disability equality for the provision of extracurricular activities for schoolchildren. [From the Author]

Workplace violence and intentions to quit: results from a survey of London nurses

Study Objective: Work-place violence, harassment and abuse is an increasing feature of nurses’ experience of work in many countries. There is some evidence that the experience of workplace violence affects levels of job satisfaction (Hesketh et al 2003) and career decisions (e.g. Mayer et al 1999, Fernandes et al 1999). This paper reports on verbal and physical abuse by patients, relatives and carers, as well as racial and sexual harassment in Acute Hospitals in London and investigates whether workplace violence affects nurses’ intentions to leave either their current job or the nursing profession, controlling for a number of other factors that are known to affect career decisions, such as workload, pay and own health. Method: A questionnaire designed by two of the authors (Reeves and West) to assess many different aspects of nurses work life was used in a postal survey of nurses grades A to I practising in twenty London acute trusts in 2002. A total of 6,160 clinical nurses were mailed the questionnaires and 2,880 returned completed questionnaires, resulting in an overall response rate of 47%, discounting undelivered questionnaires. Respondents worked in a wide variety of clinical settings but mainly in acute medical and surgical wards. In addition to descriptive statistics, results were analysed using logistic regression with robust standard errors: the appropriate test when the dependent variable is dichotomous and the individual respondents clustered within units (nurses working within hospitals are not statistically independent). Results: Our results show high levels of racial (%), sexual (%) and other, unspecified forms of harassment (%), as well as verbal and physical abuse (14% had been physically assaulted with 5% being assaulted more than once), over the previous 6 months. A very small number (1%) reported experiencing all three forms of harassment; 12% two forms and 29% one form. Only 45% of this sample intended to stay in nursing for at least 3 years; 40% were undecided and 15% intended to leave. Logistic regression estimates showed that reported levels of abuse and harassment had a significant impact on respondents’ career intentions, even in models that controlled for known factors affecting career decisions. About 70% of our respondents reported that they had had too little training in dealing with aggressive behaviour—or none at all—but there was no statistical relationship between lack of training and reported assaults. Conclusions: The international shortage of health care workers is due at least in part to low retention rates. It is crucial to investigate nurses’ experiences of work to identify the factors that shape their career decisions. Workplace violence is increasingly acknowledged as an international, service-wide, health care problem. This paper adds to the literature that shows that workplace violence has an impact on nurses’ career decisions. The implications for managers and policy makers are that strengthening systems of security and providing nurses with training in interpersonal relationships including dealing with aggressive patients could slow nurse turnover.

Exploration of the student experience of e-learning: beginning to bridge the learning divide

Introduction This proposal aims, through debate within symposium to explore the student experience of e-learning. The team facilitating the discussion will draw upon their experience of an HEA funded pathfinder project, the main aim of which was to collect learner stories about their experience of using technology in their everyday learning activities at the University of Greenwich across a range of programmes, levels, locations and student groups. Method The project design responded to the growing body of student voice literature and then utilised and built upon the JISC-funded studies that focussed on understanding the learner perspectives on the role of technology in learning, namely: • the LEX study which investigated a broad spectrum of technology use by eliciting rich data about learners’ feelings, beliefs and intentions towards e-learning (Creanor et al, 2006); • the LXP studies which explored disciplinary differences in uses of technology by university students through a variety of methodologies (Conole et al, 2006). Results The symposium will be organised as a round table discussion that will be structured into three sections: • Designing an online survey tool, and the results of our survey. • Exploring student stories. • What can learned from the project and taking the findings back to enhance learning. To stimulate discussion each section will start by asking the participants to discuss and debate a particular question, this will be followed by an interactive presentation by the respective member of the project team who will share the findings of the project and invite contributions to the resulting discussion from personal perspectives. The questions are: • What is effective learning within a context of digital technology? • What are the myths and truths about the identity of today's learners? • What practical changes need to happen in order to see real change? Conclusion The final section of the symposium will invite contributions from the participants in order to collate the views and perspectives of all the participants in order to focus the discussion on the following: • The issues that have arisen as a result of the round table debates. • New speculative approaches to enhancing the student experience. • A controversial stand to the future of Higher Education teaching and learning and the role and integration of technology within that education. The symposium will provide an opportunity to explore the predictive value of Student Experience of E-Learning Laboratory (SEEL) project.