Data collection challenges in community settings: Insights from two field studies of patients with chronic disease

Purpose Collecting information about health and disease directly from patients can be fruitfully accomplished using contextual approaches, ones that combine more and less structured methods in home and community settings. This paper's purpose is to describe and illustrate a framework of the challenges of contextual data collection. Methods A framework is presented based on prior work in community-based participatory research and organizational science, comprised of ten types of challenges across four broader categories. Illustrations of challenges and suggestions for addressing them are drawn from two mixed-method, contextual studies of patients with chronic disease in two regions of the US. Results The first major category of challenges was concerned with the researcher-participant partnership, for example, the initial lack of mutual trust and understanding between researchers, patients, and family members. The second category concerned patient characteristics such as cognitive limitations and a busy personal schedule that created barriers to successful data collection. The third concerned research logistics and procedures such as recruitment, travel distances, and compensation. The fourth concerned scientific quality and interpretation, including issues of validity, reliability, and combining data from multiple sources. The two illustrative studies faced both common and diverse research challenges and used many different strategies to address them. Conclusion Collecting less structured data from patients and others in the community is potentially very productive but requires the anticipation, avoidance, or negotiation of various challenges. Future work is necessary to better understand these challenges across different methods and settings, as well as to test and identify strategies to address them

The weak password problem: chaos, criticality, and encrypted p-CAPTCHAs

Vulnerabilities related to weak passwords are a pressing global economic and security issue. We report a novel, simple, and effective approach to address the weak password problem. Building upon chaotic dynamics, criticality at phase transitions, CAPTCHA recognition, and computational round-off errors we design an algorithm that strengthens security of passwords. The core idea of our method is to split a long and secure password into two components. The first component is memorized by the user. The second component is transformed into a CAPTCHA image and then protected using evolution of a two-dimensional dynamical system close to a phase transition, in such a way that standard brute-force attacks become ineffective. We expect our approach to have wide applications for authentication and encryption technologies.Comment: 5 pages, 6 figer

Turnover and retention in the information technology workforce

Die Fluktuation von Mitarbeitern in der Computerbranche ist im Vergleich zu anderen Tätigkeitsbereichen besonders hoch; sie kann bis zu 20% pro Jahr betragen. Die Fluktuationsraten von Frauen sind dabei in der Regel höher als die von Männern. Der Anteil von Frauen in den USA, die in der Computerbranche arbeiten, ist dabei von 41% im Jahr 1996 auf 29% im Jahr 2004 zurückgegangen. Hohe Fluktuationsraten von gut ausgebildeten Mitarbeiter/innen können für Unternehmen sehr teuer und im Betriebsablauf sehr störend sein. Der Verlust von gut ausgebildeten Mitarbeiter/innen bedeutet, dass Unternehmen hohe Kosten für die Aufnahme bzw. Ausbildung von Personal aufbringen müssen. Dazu kommen versteckte Kosten, die z.B. entstehen, wenn Projekte nicht abgeschlossen werden können und sich Zusammensetzungen von Arbeitsteams verändern. Die Analyse von Ursachen von Fluktuation im Bereich von IT-Arbeitskräften und ihre Kontrolle durch entsprechende HR-Maßnahmen ist daher ausgesprochen wichtig für die Unternehmen. Das Ziel dieser Arbeit ist die Analyse von Ursachen von Fluktuation in der IT-Branche. In der vorliegenden Dissertation wird beschrieben, wie ein Fragebogen zur Erfassung der Ursachen von Fluktuation, arbeitsbezogenen Einstellungen und Fluktuationsintentionen entwickelt wurde (Beitrag 1). Es wird die Durchführung der Implementierung des Fragebogens als Online-Tool vorgestellt; dabei wird auf Überlegungen zum Fragebogendesign eingegangen, um den Rücklauf zu erhöhen (Beitrag 2). In weiterer Folge wird ein Modell zur Vorhersage von Fluktuation literaturbasiert entwickelt und pfadanalytisch überprüft. Zusätzlich wird dabei auf Geschlechtsunterschiede eingegangen (Beitrag 3). Im vierten Beitrag wird beschrieben, wie dieses Modell in einer transnationalen Vergleichstudie (mit Daten aus Österreich) überprüft wurde. Abschließend werden im fünften Beitrag Empfehlungen zur Verhinderung von hoher Fluktuation dargestellt. Im ersten Beitrages kann gezeigt werden, wie ein reliabler und valider Fragebogen entwickelt wurde. Vergleiche zwischen postalischer Versendung einer Papier/Bleistift-Version und einer Online-Version zeigen ähnliche und akzeptable Rücklaufraten; die Ergebnisse dieser Studie (Beitrag 1) können auf die gesamte IT-Branche übertragen werden (Beitrag 2). Die statistischen Analysen erbrachten einen guten Fit zwischen den Modellüberlegungen und dem Datensatz. Es konnte gezeigt werden, dass eine Reihe von Prädiktoren auf organisatorischer Ebene sowie im Bereich von Personal-entwicklungsmaßnahmen mit Fluktuationsintentionen einhergehen. Dazu gehören z.B. fehlende Herausforderung in der Tätigkeit, (zu) hohe Anforderungen, Arbeit/Familien-Konflikte, fehlende Karrieremöglichkeiten und die Wahrnehmung eines ungerechten Belohnungssystems. Die Analysen zeigen, dass die Beziehungen zwischen diesen Prädiktoren und der Zielgröße durch arbeitsbezogene Einstellungen (Arbeitszufriedenheit und Burnout) mediiert werden. Es kann weiters gezeigt werden, dass das Geschlecht als Moderatorvariable auf die Beziehungen zwischen den Prädiktoren, den arbeitsbezogenen Einstellungen und der Fluktuationsneigung einwirkt. Die Ergebnisse können herangezogen werden, um die Bereitschaft zum Verbleib zu erhöhen (Beitrag 3). Die Robustheit des postulierten Modells wurde in einer transnationalen Vergleichstudie mit österreichischen Daten überprüft und bestätigt (Beitrag 4). Die Ergebnisse der Vergleichsstudien zeigen, dass ein optimiertes Modell einen zufriedenstellenden Fit in beiden Datensätzen (USA und Österreich) erbringt. Die Stabilität des Modells kann so bestätigt werden. Zusätzlich konnte gezeigt werden, dass die postulierten Modellbeziehungen auch für Frauen und Männer, für Altersgruppen sowie unterschiedliche Gruppen in den Unternehmen (Betriebszugehörigkeit und Qualifikation) bestätigt werden können. Als Abschluss der Studienreihe konnte auf der Basis der amerikanischen Daten gezeigt werden, dass eine familien-freundliche Politik im Unternehmen sowohl bei weißen Mitarbeiter/innen als auch bei den unterrepräsentierten Minoritäten geeignet ist, um Bleiberaten im Unternehmen zu erhöhen (Beitrag 5). Die Ergebnisse zeigen aber auch, dass es keinen einheitlichen Ansatz für alle Unternehmen gibt. Um Fluktuationsraten möglichst gering zu halten, müssen die organisatorischen Praktiken an die jeweiligen Bedürfnisse der Unternehmen und Mitarbeiter/innen angepasst werden.Employee turnover in the Information Technology (IT) workforce is high: it can reach more than 20% on an annual basis. Turnover rates of women are higher than turnover of men, and the percentage of women working in IT fell from 41% in 1996 to 29% in 2004. Turnover of highly skilled employees can be very expensive and disruptive for firms. Losing highly skilled staff members means that companies incur substantial costs associated with recruiting and re-skilling, and hidden costs associated with difficulties completing projects and disruptions in team-based work environments. Determining the causes of turnover within the IT workforce and controlling it through human resource practices and work system design is imperative for organizations. The goal of this study is examine antecedents of turnover in IT. In this dissertation we describe how we developed a questionnaire to examine antecedents, work-related attitudes and turnover intention in IT (Paper 1); the process of questionnaire implementation through a web-based survey system and the survey design factors that play a role in achieving high response rates (Paper 2). Further, we describe the development of a turnover model for IT based on the literature, how we tested the model with path analysis, and how we tested the model for gender differences, using data collected in the USA (Paper 3). In the fourth paper we describe how the turnover model is tested with data collected in a transnational (Austrian) study. Finally, recommendations are made for retention of IT personnel (Paper 5). Results of the study show that we developed a reliable and valid questionnaire (Paper 1). Further, results of our comparison between postal mail and Internet surveys show that the web-based survey we used to collect the data in the American study generated response rates that are comparable to postal mail studies; and that the results --in principal-- can be generalized to the whole IT population (Paper 2). Results of our statistical analysis show that there is a good fit between the turnover model that we developed for IT, and the data. Results show that there are a number of job and organizational factors and human resources practices that are related to turnover intention, such as lack of challenge in the job, high job demands, work-family conflict, lack of career opportunities and the lack of fairness of the reward system. Results show that most of the relationship between the antecedents of turnover intention is mediated by work-related attitudes such as job satisfaction and burnout. Results also show that gender moderates the relationship between antecedents of turnover, work-related attitudes and turnover intention. These results have an impact on retention of IT personnel (paper 3). We tested the robustness of the turnover model in a transnational study, using data collected in Austria (Paper 4). Results of the transnational studies show that the optimized turnover model fits both databases (American and Austrian) and thus confirm the stability of the model. Moreover, the model relations were found to be similar not only in the two national samples, but also for gender, age groups, groups with different tenure at their organizations, and groups with different educational backgrounds. Finally, using the American sample, we examined what family-friendly practices are effective in retaining white men and women, and underrepresented minorities in IT (Paper 5). Results show that there is not a “one size fits all” approach for retaining IT personnel. Retention practices have to be tailor-made to in order to be effective

A sociotechnical systems approach toward tailored design for personal health information management

We used a sociotechnical systems approach—which conceptualizes a system of interacting people, technologies, and tasks, to identify individual differences in personal health information management (PHIM) that can inform the design of patient-friendly environments, tools, and technologies. We conducted a secondary thematic analysis of data collected as part of a parent project, vizHOME. The goal of vizHOME was to improve health and health outcomes through identifying key features in the environment that will inform the design of consumer health information technology HIT. We analyzed interview data collected from 20 individuals with diabetes. We found seven dimensions of PHIM: (1) level of privacy preferred for PHIM; (2) amount of engagement in PHIM; (3) extent of guidance preferred for PHIM; (4) level of documentation preferred for PHIM; (5) degree of physical distribution of PHIM; (6) amount of flexibility in PHIM routine; and (7) use of external cues to manage PHIM. Our results suggest that each dimension exists as a continuum, which are anchored from low to high. Exploring the interaction between PHIM and the sociotechnical system in which PHIM is performed revealed key dimensions of PHIM as well as individual differences in those PHIM dimensions. Identification of individual differences in PHIM can support the creation of human-centered design considerations for tailored environments, products, processes, and technologies that support PHIM. Future research will seek to validate PHIM dimensions in a larger population and develop a PHIM-typing measure to identify PHIM types toward tailoring processes, products, and to individual needs in context. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len

A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer: design and methodological challenges

<p>Abstract</p> <p>Background</p> <p>Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and encountered methodological challenges of a nationwide study in the Netherlands investigating the effects of treatment on reproductive function, ovarian reserve, premature menopause and pregnancy outcomes in female childhood cancer survivors (CCS), the DCOG LATER-VEVO study.</p> <p>Methods</p> <p>The study is a retrospective cohort study consisting of two parts: a questionnaire assessing medical, menstrual, and obstetric history, and a clinical assessment evaluating ovarian and uterine function by hormonal analyses and transvaginal ultrasound measurements. The eligible study population consists of adult female 5-year survivors of childhood cancer treated in the Netherlands, whereas the control group consists of age-matched sisters of the participating CCS. To date, study invitations have been sent to 1611 CCS and 429 sister controls, of which 1215 (75%) and 333 (78%) have responded so far. Of these responders, the majority consented to participate in both parts of the study (53% vs. 65% for CCS and sister controls respectively). Several challenges were encountered involving the study population: dealing with bias due to the differences in characteristics of several types of (non-) participants and finding an adequately sized and well-matched control group. Moreover, the challenges related to the data collection process included: differences in response rates between web-based and paper-based questionnaires, validity of self-reported outcomes, interpretation of clinical measurements of women using hormonal contraceptives, and inter- and intra-observer variation of the ultrasound measurements.</p> <p>Discussion</p> <p>The DCOG LATER-VEVO study will provide valuable information about the reproductive potential of paediatric cancer patients as well as long-term survivors of childhood cancer. Other investigators planning to conduct large cohort studies on late effects may encounter similar challenges as those encountered during this study. The solutions to these challenges described in this paper may be useful to these investigators.</p> <p>Trial registration</p> <p>NTR2922; <url>http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2922</url></p

Work system barriers and facilitators of a team health information technology.

Designing health IT aimed at supporting team-based care and improving patient safety is difficult. This requires a work system (i.e., SEIPS) evaluation of the technology by care team members. This study aimed to identify work system barriers and facilitators to the use of a team health IT that supports care transitions for pediatric trauma patients. We conducted an analysis on 36 interviews - representing 12 roles - collected from a scenario-based evaluation of T3. We identified eight dimensions with both barriers and facilitators in all five work system elements: person (experience), task (task performance, workload/efficiency), technology (usability, specific features of T3), environment (space, location), and organization (communication/coordination). Designing technology that meets every roles needs is challenging; in particular, when trade-offs need to be managed, e.g., additional workload for one role or divergent perspectives regarding specific features. Our results confirm the usefulness of a continuous work system approach to technology design and implementation

Effectiveness of interventions for preventing injuries in the construction industry: results of an updated Cochrane systematic review

Various interventions to prevent occupational injuries in the construction industry have been proposed and studied. This continuing updated Cochrane review systematically summarizes the most current scientific evidence on the effectiveness of interventions to prevent injuries associated with construction work. Search terms that covered the concepts of ‘construction workers’, ‘injury’, ’safety’ and ‘study design’ were used to identify intervention studies in five electronic databases up to April 2017. Acceptable study designs included randomized controlled trials (RCT), controlled before–after studies (CBA) and interrupted time series (ITS). In total 17 studies, 14 ITS and three CBA studies, from the US (6), UK (2), Italy (3), Denmark (1), Finland (1), Austria (1) Germany (1) Spain (1), Belgium (1) met the inclusion criteria. Most studies were at high risk of bias. There is very low-quality evidence that introducing regulations as such may or may not result in a decrease in fatal and non-fatal injuries. There is also very low-quality evidence that regionally oriented safety campaigns, training, inspections or the introduction of occupational health services may not reduce non-fatal injuries in construction companies. There is very low-quality evidence that company-oriented safety interventions such as a multifaceted safety campaign, a multifaceted drug workplace programme and subsidies for replacement of scaffoldings may reduce non-fatal injuries among construction workers

Supplier pre-qualification method for the Portuguese construction industry

The construction process is so dependent on supply chain partners that selecting the best ones has an impact on its performance. The literature on supplier selection in the construction industry is little explored and its proposals are complex using techniques that industry managers are unfamiliar. This work's purpose was to study a construction organization's needs and, thus, develop a method of supplier qualification, capable of matching best practices while responding to the company's specific needs, according to its context. Thereby, a case study was used in the metal construction industry. The paper describes the development of a simple and fast supply chain partner pre-qualification method, which corresponds to a questionnaire, an automatic assessment, and a classification method. The study' main conclusions are the managers' lack of familiarity with analysis and improvement techniques, the difficulty of defining “quality” in this industry and the need for further studies in this area.This work has been supported by FCT – Fundação para a Ciência e Tecnologia within the R&D Units Project Scope: UIDB/00319/2020

Interventions to prevent injuries in construction workers

Background Construction workers are frequently exposed to various types of injury-inducing hazards. A number of injury prevention interventions have been proposed, yet their effectiveness is uncertain. Objectives To assess the effects of interventions to prevent injuries in construction workers. Search methods We searched the Cochrane Injuries Group’s specialised register, CENTRAL,MEDLINE, EMBASE, PsycINFO,OSH-ROM(including NIOSHTIC and HSELINE), Scopus, Web of Science and EI Compendex to September 2011. The searches were not restricted by language or publication status. The reference lists of relevant papers and reviews were also searched. Selection criteria Randomised controlled trials, controlled before-after (CBA) studies and interrupted time series (ITS) of all types of interventions for preventing fatal and non-fatal injuries among workers at construction sites. Data collection and analysis Two review authors independently selected studies, extracted data and assessed study quality. For ITS, we re-analysed the studies and used an initial effect, measured as the change in injury-rate in the year after the intervention, as well as a sustained effect, measured as the change in time trend before and after the intervention

Tele-Neuro-Ophthalmology: Vision for 20/20 and Beyond

Background: Telehealth provides health care to a patient from a provider at a distant location. Prior to the COVID-19 pandemic adoption of telehealth modalities was increasing slowly but steadily. During the public health emergency rapid widespread telehealth implementation has been encouraged to promote patient and provider safety and preserve access to health care. Evidence acquisition: Evidence was acquired from English language Internet-searches of medical and business literature and following breaking news on the COVID-19 pandemic and responses from health care stakeholders including policy makers, payers, physicians and health care organizations, and patients. We also had extensive discussions with colleagues who are developing telehealth techniques relevant to neuro-ophthalmology. Results: Regulatory, legal, reimbursement and cultural barriers impeded the widespread adoption of telehealth prior to the COVID-19 pandemic. With the increased use of telehealth in response to the public health emergency, we are rapidly accumulating experience and an evidence base identifying opportunities and challenges related to the widespread adoption of tele-neuro-ophthalmology. One of the major challenges is the current inability to adequately perform funduscopy remotely. Conclusions: Telehealth is an increasingly recognized means of healthcare delivery. Tele-neuro-ophthalmology adoption is necessary for the sake of our patients, the survival of our subspecialty, and the education of our trainees and students. Telehealth does not supplant but supplements and complements in-person neuro-ophthalmologic care. Innovations in digital optical fundus photography, mobile vision testing applications, artificial intelligence and principles of channel management will facilitate further adoption of tele-neuro-ophthalmology and bring the specialty to the leading edge of healthcare delivery