Abstract
Background
Healthcare relies on health information systems (HISs) to support the care and receive reimbursement for the care provided. Healthcare providers experience many problems with ...their HISs due to improper architecture design. To support the design of a proper HIS architecture, a reference architecture (RA) can be used that meets the various stakeholder concerns of HISs. Therefore, the objective of this study is to develop and analyze an RA following well-established architecture design methods.
Methods
Domain analysis was performed to scope and model the domain of HISs. For the architecture design, we applied the views and beyond approach and designed the RA’s views based on the stakeholders and features from the domain analysis. We evaluated the RA with a case study.
Results
We derived the following four architecture views for HISs: The context diagram, decomposition view, layered view, and deployment view. Each view shows the architecture of the HIS from a different angle, suitable for various stakeholders. Based on a Japanese hospital information system study, we applied the RA and derived the application architecture.
Conclusion
We demonstrated that the methods of the software architecture design community could be used in the healthcare domain effectively and showed the applicability of the RA.
•Interdisciplinary measurement of sustainability in the TBL framework is near-unique.•Reports of interdisciplinary measurement models are often incomplete.•Low measurement levels occur in ...environmental, social and economic indicators.•Composite measures often combine different or unknown measurement levels.•Weighting schemes to reach composite measurements are often based on expert opinion.
Measurement in interdisciplinary research can be difficult due to incompatibility of measures used in the different disciplines. These difficulties arise when measurements from different disciplines need to be combined to quantify an attribute for an object of study. Sustainability is a fuzzy concept measured as an attribute of many different objects. Sustainability measurements are often a composition of environmental, economic and social sustainability measurements, which makes them interdisciplinary composite measurements. The present study aims to advance interdisciplinary sustainability research by a systematic review of the interdisciplinary measurement of the attribute sustainability using the Triple Bottom Line (TBL) framework and to investigate whether measurement issues differ between the environmental, economic and social dimension.
A systematic literature review was done based on a query, on Web of Science, that reflected the interdisciplinarity of sustainability science and the TBL framework. Abstracts were scanned for relevance and papers that passed the scan were downloaded and scrutinized for their measurement characteristics such as measurement level, aggregation of scores into composite measurements, and weighting methods. An iterative coding approach (top-down and bottom-up) was used until saturation was reached.
The search returned 467 papers, of which 77 contained sufficiently detailed information on the interdisciplinary measurement of sustainability, following the TBL framework. Not all papers in the final set contained sufficiently detailed information on the performed measurements, and if and how the distinct dimensions were combined into one interdisciplinary sustainability measurement. The 86 reported measurement models of sustainability were heterogeneous with respect to measurement levels used, the use of composite scores, weighting schemes and time synchronization between indicators. Two thirds of the measurement models presented composite scores of the attribute sustainability. The weights used in composite scores were in most cases determined using experts’ opinions.
Albeit all included papers used the TBL as a framework, their measurement models do not form a coherent set. Fuzzy measurement practices occurred in all three dimensions of sustainability. On closer inspection, and wherever reports were sufficiently specific, interdisciplinary measurement models of sustainability turned out to be near-unique.
Complex Adaptive Systems (CAS) is an interdisciplinary and dynamic modelling approach for the study of today’s global challenges. It is used for the explanation, description, and prediction of ...behaviours of system components and the system at large. To understand and assess the quality of research in which CAS models are designed and used, a thorough understanding of the meanings of ‘validity’ from social science research methodology and ‘validation’ from simulation modelling is needed. In this paper, we first describe the modelling process. Then, we analyse the concepts ‘validity’ and ‘validation’ as used in a set of research methodology textbooks and a set of modelling textbooks. We present one single map that integrates validity as characteristic of the model input, the modelling process, model validation, and the validity of the model built. The map is illustrated by means of one example. The terminology proposed in the map allows to describe and distinguish between the validity of primary research used for input in the model, how the quality of the modelling depends on structural and behavioural validation, and, how the assessment of the validity of the model is informed by these types of validation plus research with independent data.
Cultured meat is an unfamiliar emerging food technology that could provide a near endless supply of high quality protein with a relatively small ecological footprint. To understand consumer ...acceptance of cultured meat, this study investigated the influence of information provision on the explicit and implicit attitude toward cultured meat. Three experiments were conducted using a Solomon four-group design to rule out pretest sensitization effects. The first experiment (N = 190) showed that positive or negative information about cultured meat changed the explicit attitude in the direction of the information. This effect was smaller for participants who were more familiar with cultured meat. In the second experiment (N = 194) positive information was provided about solar panels, an attitude object belonging to the same sustainable product category as sustainable food products such as cultured meat. Positive information about solar panels was found to change the explicit attitude in the direction of the information. Using mood induction, the third experiment (N = 192) ruled out the alternative explanation that explicit attitude change in experiment 1 and 2 was caused by content free affect rather than category based inferences. The implicit attitude appeared insensitive to both information or mood state in all three experiments. These findings show that the explicit attitude toward cultured meat can be influenced by information about the sustainability of cultured meat and information about a positively perceived sustainable product. This effect was shown to be content based rather than merely affect based. Content based information in a relevant context could therefore contribute to the commercial success of cultured meat.
Abstract
Background
Care for people with an Intellectual Disability (ID) is complex: multiple health care professionals are involved and use different Health Information Systems (HISs) to store ...medical and daily care information on the same individuals. The objective of this study is to identify the HISs needs of professionals in ID care by addressing the obstacles and challenges they meet in their current HISs.
Methods
We distributed an online questionnaire amongst Dutch ID care professionals via different professional associations and care providers. 328 respondents answered questions on their HISs. An inventory was made of HIS usage purposes, problems, satisfaction and desired features, with and without stratification on type of HIS and care professional.
Results
Typical in ID care, two types of HISs are being used that differ with respect to their features and users: Electronic Client Dossiers (ECDs) and Electronic Patient Dossiers (EPDs). In total, the respondents mentioned 52 unique HISs. Groups of care professionals differed in their satisfaction with ECDs only. Both HIS types present users with difficulties related to the specifics of care for people with an ID. Particularly the much needed communication between the many unique HISs was reported a major issue which implies major issues with inter-operability. Other problems seem design-related as well.
Conclusion
This study can be used to improve current HISs and design new HISs that take ID care professionals requirements into account.
Research that addresses complex challenges often requires contributions from the social, life and natural sciences. The disciplines that contribute subject response data, and more specifically ...qualitative analyses of subject response data, to interdisciplinary studies are characterised by low consensus with respect to methods they use a diversity of terms to describe those methods and they often work from assumptions that are foreign to readers in the natural and life sciences. The first contribution this paper makes is to demonstrate that the forms of reporting that may be adequate for communicating quantitative analysis do not provide teams that include members from natural, life and social sciences with useful accounts of qualitative analysis. Our second contribution is to discuss and model how to report four methods appropriate for qualitative contributions to interdisciplinary projects.
Interdisciplinary higher education aims to develop boundary-crossing skills, such as interdisciplinary thinking. In the present review study, interdisciplinary thinking was defined as the capacity to ...integrate knowledge of two or more disciplines to produce a cognitive advancement in ways that would have been impossible or unlikely through single disciplinary means. It was considered as a complex cognitive skill that constituted of a number of subskills. The review was accomplished by means of a systematic search within four scientific literature databases followed by a critical analysis. The review showed that, to date, scientific research into teaching and learning in interdisciplinary higher education has remained limited and explorative. The research advanced the understanding of the necessary subskills of interdisciplinary thinking and typical conditions for enabling the development of interdisciplinary thinking. This understanding provides a platform from which the theory and practice of interdisciplinary higher education can move forward.
•A methodology for assessing rankings based on an indicator system is proposed.•This methodology was applied to six European green city rankings.•The rankings varied greatly although all showed ...methodological weaknesses.•None of the city rankings clearly defined their ranking attribute.•Developers of city rankings ought to be more transparent towards end-users.
City rankings that aim to measure the environmental sustainability of European cities may contribute to the evaluation and development of environmental policy of European cities. The objective of this study is to identify and evaluate the methodological characteristics of these city rankings. First, a methodology was developed to systematically identify methodological characteristics of city rankings within different steps of the ranking development process. Second, six city rankings (European Energy Award, European Green Capital Award, European Green City Index, European Soot-free City Ranking, RES Champions League, Urban Ecosystem Europe) were examined. Official websites and any methodological documents found on those websites were content analyzed using the developed methodology. Interviews with representatives of the city rankings were conducted to acquire any additional information. Results showed that the city rankings varied greatly with respect to their methodological characteristics and that all city rankings had methodological weaknesses. Developers of city rankings are advised to use the methodology developed in this study to find methodological weaknesses and improve their ranking. In addition, developers ought to be more transparent about the methodological characteristics of their city rankings. End-users of city rankings are advised to use the developed methodology to identify and evaluate the methodological characteristics of city rankings before deciding to act on ranking results.
The lack of suitable and reliable scales to measure self-reported health and health behaviour among people with intellectual disabilities (ID) is an important methodological challenge in health ...research. This study, which was undertaken together with co-researchers with ID, explores possibilities for self-reported health scales by adjusting, testing, and reflecting on three self-reported health scales.
In an inclusive process, the researchers and co-researchers with ID adjusted the SBQ (sedentary behaviour), SQUASH (physical activity), and SRH (self-reported health) scales, after which a test-retest study among adults with ID was performed. Test outcomes were analysed on suitability and test-retest reliability, and discussed with the co-researchers with ID to reflect on outcomes and to make further recommendations.
Main adjustments made to the scales included: use easy words, short sentences, and easy answer formats. Suitability (N = 40) and test-retest reliability (N = 15) was higher for the adjusted SQUASH (SQUASH-ID), in which less precise time-based judgements are sought, than in the adjusted SBQ (SBQ-ID). Suitability and test-retest reliability were fair to moderate for the SRH-ID and CHS-ID. The main outcome from the reflection was the recommendation to use SQUASH-ID answer options, in which less precise time-based judgements were sought, in the SBQ-ID as well.
This study served as a pilot of an inclusive process in which people with ID collaborated in adjusting, testing, and reflecting on self-reported health scales. Although the adjusted self-reported measurements may be reliable and suitable to the target group, the adjustments needed may impair measurement precision. This study's results contribute to informed decision making on the adaptation and use of self-reported health scales for people with ID.
Medical care for people with intellectual and developmental disabilities (IDD) is organized differently across the globe and interpretation of the concept of medical care for people with IDD may vary ...across countries. Existing models of medical care are not tailored to the specific medical care needs of people with IDD. This study aims to provide an improved understanding of which aspects constitute medical care for people with IDD by exploring how international researchers and practitioners describe this care, using concept mapping. Twenty-five experts (researchers and practitioners) on medical care for people with IDD from 17 countries submitted statements on medical care in their country in a brainstorming session, using an online concept mapping tool. Next, they sorted all collected statements and rated them on importance. The themes, clusters and statements identified through this explorative study provide additional content and context for the specific patient group of people with IDD to the dimensions of previous models of medical care.
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