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Biblioteca integradora para ciegos y disminuidos visuales : Realidad y desafío

El objetivo de este trabajo ha sido el estudio de la actual situación de los servicios bibliotecarios para personas ciegas y disminuidas visuales en Argentina. Se realizó una encuesta a bibliotecas que prestan servicios a personas ciegas y disminuidas visuales de todo el país. La muestra quedó conformada por 20 bibliotecas públicas y especiales en Argentina. Se confeccionó un cuestionario de 114 preguntas basadas en estándares elaborados por American Library Association (ALA) los cuales fueron preparados y enviados vía correo electrónico. Asimismo, se llevaron a cabo visitas a 10 de estas bibliotecas con el objetivo de obtener información a través de entrevistas a sus respectivos directores así como también al personal y a los usuarios que en ese momento se encontraban presentes en el lugar. El análisis de la situación de las bibliotecas para ciegos y disminuidos visuales en Argentina revela que el 70de estas bibliotecas tienen menos de 1000 ejemplares, el 40depende de donaciones y canje y el 45carecen de tecnología especial. Además presentan severas deficiencias en sus edificios. El 35atienden menos de 100 usuarios y un 40no posee ningún tipo de registro de los usuarios. Se pudieron identificar: colecciones pequeñas, servicios limitados, procesos técnicos incompletos, estructura edilicia inadecuada, escasa tiflotecnología (tecnología especial para personas ciegas y disminuidas visuales) y falta de gestión bibliotecológica, entre otras falencias. Se considera que el presente modelo de biblioteca especial posiblemente contribuya al aislamiento y al confinamiento de la persona ciega y disminuida visual, por ello se debe tener en cuenta un nuevo modelo de biblioteca integradora basado en los Manifiestos de la Unesco para bibliotecas públicas y bibliotecas escolares. Se sugiere la aplicación de este modelo de biblioteca integradora capaz de garantizar eficazmente el acceso a la información para los ciegos y disminuidos visuales de acuerdo a las nuevas recomendaciones universales. En unas pocas palabras, una biblioteca pública para todos.

Biblioteca integradora para ciegos y disminuidos visuales : Realidad y desafío

El objetivo de este trabajo ha sido el estudio de la actual situación de los servicios bibliotecarios para personas ciegas y disminuidas visuales en Argentina. Se realizó una encuesta a bibliotecas que prestan servicios a personas ciegas y disminuidas visuales de todo el país. La muestra quedó conformada por 20 bibliotecas públicas y especiales en Argentina. Se confeccionó un cuestionario de 114 preguntas basadas en estándares elaborados por American Library Association (ALA) los cuales fueron preparados y enviados vía correo electrónico. Asimismo, se llevaron a cabo visitas a 10 de estas bibliotecas con el objetivo de obtener información a través de entrevistas a sus respectivos directores así como también al personal y a los usuarios que en ese momento se encontraban presentes en el lugar. El análisis de la situación de las bibliotecas para ciegos y disminuidos visuales en Argentina revela que el 70de estas bibliotecas tienen menos de 1000 ejemplares, el 40depende de donaciones y canje y el 45carecen de tecnología especial. Además presentan severas deficiencias en sus edificios. El 35atienden menos de 100 usuarios y un 40no posee ningún tipo de registro de los usuarios. Se pudieron identificar: colecciones pequeñas, servicios limitados, procesos técnicos incompletos, estructura edilicia inadecuada, escasa tiflotecnología (tecnología especial para personas ciegas y disminuidas visuales) y falta de gestión bibliotecológica, entre otras falencias. Se considera que el presente modelo de biblioteca especial posiblemente contribuya al aislamiento y al confinamiento de la persona ciega y disminuida visual, por ello se debe tener en cuenta un nuevo modelo de biblioteca integradora basado en los Manifiestos de la Unesco para bibliotecas públicas y bibliotecas escolares. Se sugiere la aplicación de este modelo de biblioteca integradora capaz de garantizar eficazmente el acceso a la información para los ciegos y disminuidos visuales de acuerdo a las nuevas recomendaciones universales. En unas pocas palabras, una biblioteca pública para todos.

Biblioteca integradora para ciegos y disminuidos visuales : Realidad y desafío

El objetivo de este trabajo ha sido el estudio de la actual situación de los servicios bibliotecarios para personas ciegas y disminuidas visuales en Argentina. Se realizó una encuesta a bibliotecas que prestan servicios a personas ciegas y disminuidas visuales de todo el país. La muestra quedó conformada por 20 bibliotecas públicas y especiales en Argentina. Se confeccionó un cuestionario de 114 preguntas basadas en estándares elaborados por American Library Association (ALA) los cuales fueron preparados y enviados vía correo electrónico. Asimismo, se llevaron a cabo visitas a 10 de estas bibliotecas con el objetivo de obtener información a través de entrevistas a sus respectivos directores así como también al personal y a los usuarios que en ese momento se encontraban presentes en el lugar. El análisis de la situación de las bibliotecas para ciegos y disminuidos visuales en Argentina revela que el 70de estas bibliotecas tienen menos de 1000 ejemplares, el 40depende de donaciones y canje y el 45carecen de tecnología especial. Además presentan severas deficiencias en sus edificios. El 35atienden menos de 100 usuarios y un 40no posee ningún tipo de registro de los usuarios. Se pudieron identificar: colecciones pequeñas, servicios limitados, procesos técnicos incompletos, estructura edilicia inadecuada, escasa tiflotecnología (tecnología especial para personas ciegas y disminuidas visuales) y falta de gestión bibliotecológica, entre otras falencias. Se considera que el presente modelo de biblioteca especial posiblemente contribuya al aislamiento y al confinamiento de la persona ciega y disminuida visual, por ello se debe tener en cuenta un nuevo modelo de biblioteca integradora basado en los Manifiestos de la Unesco para bibliotecas públicas y bibliotecas escolares. Se sugiere la aplicación de este modelo de biblioteca integradora capaz de garantizar eficazmente el acceso a la información para los ciegos y disminuidos visuales de acuerdo a las nuevas recomendaciones universales. En unas pocas palabras, una biblioteca pública para todos.

Information interventions for orienting patients and their carers to cancer care facilities (Protocol)

To assess the effects of information interventions which orient patients and their carers/family to a cancer care facility and the services available in the facility.

Information interventions for orienting patients and their carers to cancer care facilities

Background: Cancer patients experience distress and anxiety related to their diagnosis, treatment and the unfamiliar cancer centre. Strategies with the aim of orienting patients to a cancer care facility may improve patient outcomes. Although meeting patients' information needs at different stages is important, there is little agreement about the type of information and the timing for information to be given. Orientation interventions aim to address information needs at the start of a person's experience with a cancer care facility. The extent of any benefit of these interventions is unknown. Objectives: To assess the effects of information interventions which orient patients and their carers/family to a cancer care facility, and to the services available in the facility. Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2); MEDLINE (OvidSP) (1966 to Jun 2011), EMBASE (Ovid SP) (1966 to Jun 2011), CINAHL (EBSCO) (1982 to Jun 2011), PsycINFO (OvidSP) (1966 to Jun 2011), review articles and reference lists of relevant articles. We contacted principal investigators and experts in the field. Selection Criteria: Randomised controlled trials (RCTs), cluster RCTs and quasi-RCTs evaluating the effects of information interventions that orient patients and their carers/family to a cancer care facility. Data collection and analysis: Results of searches were reviewed against the pre-determined criteria for inclusion by two review authors. The primary outcomes were knowledge and understanding; health status and wellbeing, evaluation of care, and harms. Secondary outcomes were communication, skills acquisition, behavioural outcomes, service delivery, and health professional outcomes. We pooled results of RCTs using mean differences (MD) and 95% confidence intervals (CI). Main results: We included four RCTs involving 610 participants. All four trials aimed to investigate the effects of orientation programs for cancer patients to a cancer facility. There was high risk of bias across studies. Findings from two of the RCTs demonstrated significant benefits of the orientation intervention in relation to levels of distress (mean difference (MD) -8.96 (95% confidence interval (CI) -11.79 to -6.13), but non-significant benefits in relation to state anxiety levels (MD -9.77 (95% CI -24.96 to 5.41). Other outcomes for participants were generally positive (e.g. more knowledgeable about the cancer centre and cancer therapy, better coping abilities). No harms or adverse effects were measured or reported by any of the included studies. There were insufficient data on the other outcomes of interest. Authors conclusion: This review has demonstrated the feasibility and some potential benefits of orientation interventions. There was a low level of evidence suggesting that orientation interventions can reduce distress in patients. However, most of the other outcomes remain inconclusive (patient knowledge recall/ satisfaction). The majority of studies were subject to high risk of bias, and were likely to be insufficiently powered. Further well conducted and powered RCTs are required to provide evidence for determining the most appropriate intensity, nature, mode and resources for such interventions. Patient and carer-focused outcomes should be included.

Understanding the information dynamics of medication administration in residential aged care facilities (RACFs): A prerequisite for design of effective ICT systems

Medication information is a critical part of the information required to ensure residents' safety in the highly collaborative care context of RACFs. Studies report poor medication information as a barrier to improve medication management in RACFs. Research exploring medication work practices in aged care settings remains limited. This study aimed to identify contextual and work practice factors contributing to breakdowns in medication information exchange in RACFs in relation to the medication administration process. We employed non-participant observations and semi-structured interviews to explore information practices in three Australian RACFs. Findings identified inefficiencies due to lack of information timeliness, manual stock management, multiple data transcriptions, inadequate design of essential documents such as administration sheets and a reliance on manual auditing procedures. Technological solutions such as electronic medication administration records offer opportunities to overcome some of the identified problems. However these interventions need to be designed to align with the collaborative team based processes they intend to support.

Coping with information silos: An examination of the medication management process in residential aged care facilities (RACFs)

The aim of this study was to examine the actions of geographically dispersed process stakeholders (doctors, community pharmacists and RACFs) in order to cope with the information silos that exist within and across different settings. The study setting involved three metropolitan RACFs in Sydney, Australia and employed a qualitative approach using semi-structured interviews, non-participant observations and artefact analysis. Findings showed that medication information was stored in silos which required specific actions by each setting to translate this information to fit their local requirements. A salient example of this was the way in which community pharmacists used the RACF medication charts to prepare residents' pharmaceutical records. This translation of medication information across settings was often accompanied by telephone or face-to-face conversations to cross-check, validate or obtain new information. Findings highlighted that technological interventions that work in silos can negatively impact the quality of medication management processes in RACF settings. The implementation of commercial software applications like electronic medication charts need to be appropriately integrated to satisfy the collaborative information requirements of the RACF medication process.

Complexity of collaborative work in residential aged care facilities: An analysis of information exchange for medication management

Information exchange (IE) is a critical component of the complex collaborative medication process in residential aged care facilities (RACFs). Designing information and communication technology (ICT) to support complex processes requires a profound understanding of the IE that underpins their execution. There is little existing research that investigates the complexity of IE in RACFs and its impact on ICT design. The aim of this study was thus to undertake an in-depth exploration of the IE process involved in medication management to identify its implications for the design of ICT. The study was undertaken at a large metropolitan facility in NSW, Australia. A total of three focus groups, eleven interviews and two observation sessions were conducted between July to August 2010. Process modelling was undertaken by translating the qualitative data via in-depth iterative inductive analysis. The findings highlight the complexity and collaborative nature of IE in RACF medication management. These models emphasize the need to: a) deal with temporal complexity; b) rely on an interdependent set of coordinative artefacts; and c) use synchronous communication channels for coordination. Taken together these are crucial aspects of the IE process in RACF medication management that need to be catered for when designing ICT in this critical area. This study provides important new evidence of the advantages of viewing process as a part of a system rather than as segregated tasks as a means of identifying the latent requirements for ICT design and that is able to support complex collaborative processes like medication management in RACFs. © 2012 IEEE.

Medication errors in residential aged care facilities: A distributed cognition analysis of the information exchange process

Background Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. Methods The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May–September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. Results The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Conclusions Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding the dynamics of the cognitive process can inform the design of interventions to manage errors and improve residents’ safety.

A GIS (geographical information system)-based spatial data mining approach for optimal location and capacity planning of distributed biomass power generation facilities: A case study of Tumkur district, India

This paper primarily intends to develop a GIS (geographical information system)-based data mining approach for optimally selecting the locations and determining installed capacities for setting up distributed biomass power generation systems in the context of decentralized energy planning for rural regions. The optimal locations within a cluster of villages are obtained by matching the installed capacity needed with the demand for power, minimizing the cost of transportation of biomass from dispersed sources to power generation system, and cost of distribution of electricity from the power generation system to demand centers or villages. The methodology was validated by using it for developing an optimal plan for implementing distributed biomass-based power systems for meeting the rural electricity needs of Tumkur district in India consisting of 2700 villages. The approach uses a k-medoid clustering algorithm to divide the total region into clusters of villages and locate biomass power generation systems at the medoids. The optimal value of k is determined iteratively by running the algorithm for the entire search space for different values of k along with demand-supply matching constraints. The optimal value of the k is chosen such that it minimizes the total cost of system installation, costs of transportation of biomass, and transmission and distribution. A smaller region, consisting of 293 villages was selected to study the sensitivity of the results to varying demand and supply parameters. The results of clustering are represented on a GIS map for the region.

Construction of facilities under asymmetric information: do constitutional constraints matter?

This paper studies construction of facilities in a federal state under asymmetric information. A country consists of two regions, each ruled by a local authority. The federal government plans to construct a facility in one of the regions. The facility generates a local value in the host region and has spillover effects in the other region. The federal government does not observe the local value because it is the local authority's private information. 80 the federal governrnent designs an incentive-compatible mechanism, specifying if the facility should be constructed and a balanced scheme of interregional transfers to finance its cost. The federal governrnent is constitutionally constrained to respect a given leveI of each region's welfare. We show that depending upon the facility's local value and the spillover effect, the governrnent faces different incentive problems. Moreover, their existence depends crucially on how stringent constitutional constraints are. Therefore, the optimal mechanism will also depend upon these three features of the model.

Toxics Release Inventory facilities and childhood cancer: Geographic information systems based approach

Purpose. To examine the association between living in proximity to Toxics Release Inventory (TRI) facilities and the incidence of childhood cancer in the State of Texas. ^ Design. This is a secondary data analysis utilizing the publicly available Toxics release inventory (TRI), maintained by the U.S. Environmental protection agency that lists the facilities that release any of the 650 TRI chemicals. Total childhood cancer cases and childhood cancer rate (age 0-14 years) by county, for the years 1995-2003 were used from the Texas cancer registry, available at the Texas department of State Health Services website. Setting: This study was limited to the children population of the State of Texas. ^ Method. Analysis was done using Stata version 9 and SPSS version 15.0. Satscan was used for geographical spatial clustering of childhood cancer cases based on county centroids using the Poisson clustering algorithm which adjusts for population density. Pictorial maps were created using MapInfo professional version 8.0. ^ Results. One hundred and twenty five counties had no TRI facilities in their region, while 129 facilities had at least one TRI facility. An increasing trend for number of facilities and total disposal was observed except for the highest category based on cancer rate quartiles. Linear regression analysis using log transformation for number of facilities and total disposal in predicting cancer rates was computed, however both these variables were not found to be significant predictors. Seven significant geographical spatial clusters of counties for high childhood cancer rates (p<0.05) were indicated. Binomial logistic regression by categorizing the cancer rate in to two groups (<=150 and >150) indicated an odds ratio of 1.58 (CI 1.127, 2.222) for the natural log of number of facilities. ^ Conclusion. We have used a unique methodology by combining GIS and spatial clustering techniques with existing statistical approaches in examining the association between living in proximity to TRI facilities and the incidence of childhood cancer in the State of Texas. Although a concrete association was not indicated, further studies are required examining specific TRI chemicals. Use of this information can enable the researchers and public to identify potential concerns, gain a better understanding of potential risks, and work with industry and government to reduce toxic chemical use, disposal or other releases and the risks associated with them. TRI data, in conjunction with other information, can be used as a starting point in evaluating exposures and risks. ^