Using HIT to deliver integrated care for the frail elderly in the UK: current barriers and future challenges

In this paper we briefly describe the results of a 3 year project examining the use of Health Information Technologies (e.g., electronic patient record systems) to deliver integrated care. In particular, we focus on one group of patient (the frail elderly) and efforts to design an e-health supported healthcare pathway (the frail elderly pathway--FEP). The aim of FEP is to bring together clinicians and staff from health and social care and allow them to share patient information. Our findings show that progress in delivering a fully-supported and working FEP has been slow, not least because of the difficulties experienced by healthcare staff in using current IT systems. In addition, there are many strategic and technical issues which remain unresolved (e.g., systems interoperability).     

Predicting long-term absenteeism from work in construction industry: a longitudinal study

In this study we examine whether the Work Ability Index (WAI) has additional value in predicting long-term absenteeism in construction industry. Results of the study show that the WAI has additional value in predicting absenteeism, but that the amount of explained variance is low. This is partly due to the definition of absenteeism in The Netherlands, where this study took place.     

Shared services centers and work sustainability: which contributions from ergonomics?

This study examines the way in which Shared Services Centers (SSCs) were implemented in a French multinational company. It aims to characterize the change according to the capabilities model developed by Amartya Sen: what are the effects of SSCs in terms of capabilities development and developmental quality of work, i.e. in the enabling potential of work? A 3-step methodology has been used: first, an investigation was conducted in a pay service of a local entity moving into SSC in 2013; second, two investigations were conducted in another pay service of a SSC: first, a few months after the change, and then, one year after the change (the same operators were interviewed). Results show a tendency to the decrease of the enabling potential. Additionally, it was noted that administrators are kept away from the design process and have to struggle with inappropriate rules. The efficiency and sustainability of the SSC are questioned; in this context, the human factor specialist has an important role to play.     

Systems approaches to risk assessing healthcare, how far have we come?

Systems approaches and their relevance to risk assessment are considered through an examination of a number of recent applications in England. The importance of visual mapping of systems is emphasised. This approach encourages participation from those within the system with less technical knowledge but with important information to add to a risk assessment. Other advantages outlined include the ability to readily identify system boundaries, map processes and record both strengths and weaknesses of existing or planned system changes. The use of risk assessment methods with this approach should be cautious, as any one method may only identify a sub-set of all risks.     

Managing unforeseen events in anesthesia: collective trade-off between "understanding" and "doing"

This study aims to describe how anesthesia teams handle unforeseen events that may affect the patients' health. More precisely, it investigates the mechanisms of decisions made by anesthesia teams to manage unthought-of situations, i.e. situations that have not been foreseen as "possible" ones before their occurrence. An empirical study, based on the analysis of simulated situations, was conducted in a pediatric anesthesia service of a university hospital in France. The results highlighted three ways of managing unthought-of situations (determined management, cautious management and overwhelmed management). They support the hypothesis of a collective cognitive trade-off, whereby teams would behave as virtual operators, with their own collective trade-off between "understanding" and "doing". The discussion of the results questions the assessment criteria, the safety perspectives we adopt and the possible ways to improve the management of unforeseen situations.     

The amount of ergonomics and user involvement in 151 design processes

Ergonomics, usability and user-centered design are terms that are well known among designers. Yet, products often seem to fail to meet the users' needs, resulting in a gap between expected and experienced usability. To understand the possible causes of this gap the actions taken by the designer during the design process are studied in this paper. This can show whether and how certain actions influence the user-friendliness of the design products. The aim of this research was to understand whether ergonomic principles and methods are included in the design process, whether users are involved in this process and whether the experience of the designer (in ergonomics/user involvement) has an effect on the end product usability. In this study the design processes of 151 tangible products of students in design were analyzed. It showed that in 75% of the cases some ergonomic principles were applied. User involvement was performed in only 1/3 of the design cases. Hardly any correlation was found between the designers' experience in ergonomic principles and the way they applied it and no correlations were found between the designers' experience in user involvement and the users' involvement in the design process.     

News coverage of child sexual abuse and prevention, 2007-2009

News media coverage of child sexual abuse can help policymakers and the public understand what must be done to prevent future abuse, but coverage tends to focus on extreme cases. This article presents an analysis of newspaper coverage from 2007 to 2009 to describe how the daily news presents and frames day-to-day stories about child sexual abuse. When child sexual abuse receives news attention, the stories focus primarily on the criminal justice details of a specific incident rather than contextual information about causes of and solutions to child sexual abuse, and prevention is rarely addressed. We offer suggestions for strategies that advocates can use to help reporters improve news coverage so that it better contextualizes child sexual abuse and links it to prevention policies.     

政府旅游开发方式评析——以土耳其为例

提起旅游,人们脑海里首先浮现的必然是"阳光与海滩"。土耳其是地中海地区的一个主要国家,在历史、文化、自然风光、美食、民俗等方面都具有巨大潜力,并且土耳其人民也非常热情友善。土耳其拥有21世纪的游客所寻求的异国风情。为使土耳其的这种潜力在继续服务于旅游业的同时保持其延续性,就需要认真的自省与科学的研究和规划。旅游业对于一国的社会福利和经济发展有着举足轻重的影响,但也存在毁灭当地资源的可能。理性运用旅游资产、增加游客数量和提高旅游收入,这些都可以通过有效的旅游规划来实现。在此问题上,中央政府、地方政府和非政府组织在相互协作的框架下各司其职显得至关重要。本文通过揭示当前土耳其旅游业的现状,对中央和地方政府扮演的角色做出评析,希望从国家管理的风格和方式角度出发,使土耳其的旅游规划和政策取得实际效果。