bluuebunny/crossref_metadata_2025 huggingface dataset:
The restoration of San Pedro cliff at La Alhambra
Authors: Justo J.L.  , Saura J.  , Vázquez N.  , Durand P.  , Justo E.  , Azañón M.
Published: February 2025

San Pedro cliff is a dihedral 65.5 m high, which has progressed to place itself at 23.8 m from the Alhambra wall-palace that is a heritage of the Humankind. A deep research on the Tectonics of the zone, and an insight into the topographic measurements taken during several years, has shown that active normal faults surrounding the cliff have created an extension tectonic regime that loosens the ground and activates the ground falls. One major fault coincides with one of the faces of the dihedral. The factor of safety of the cliff subject to the 100 years period earthquake is 0.73. The preservation solution proposed is a post-tensioned high elastic limit wire mesh and autochthonous vegetation. With this reinforcement, the factor of safety under that earthquake raises to a value around one. In this way, the environmental impact is negligible.
The measurement of K
Authors: Eliadorani Ali Akbar  , Vaid Yoginder P.
Published: February 2025

An experimental study of the K0of a loose reconstituted sand is presented. The experimental technique consists of drained vertical compression of a triaxial specimen using the strain path control, in which a positive control of the strain increments rather than the conventional stress increments is exercised. The method does not require the use of any lateral strain sensors as used in previous studies and is free from any side friction affects, typical of oedometer testing. Possible influence of stress/strain history the soil inevitably experiences during sampling or reconstitution together with the initial state of stress prior to initiating zero lateral strain loading on the measured K0are critically reviewed and evaluated experimentally. It is also shown that the requirement of absolute zero lateral strain may not be essential for obtaining credible estimates of K0as long as the ratio of radial to axial strain during vertical compression does not exceed about 3 to 5%.
The general principle of the authenticity and the foundations of monuments
Authors: Tsatsanifos C.
Published: February 2025

In general, authenticity in the restoration techniques has been considered only for the super-structures of historical monuments and not for their foundations. However, in some cases, the type of the foundation itself is a historical monument. In these cases, the type of the foundation might be preferred to keep its originalities. Hence, when we compare several methods of treating foundation system to conserve the historical structures, we recommend inclusion of the argument on the authenticity as well as those on cost, reliability, and technical difficulty.
Designing an Internet-Based Intervention Tailored to Psychological Factors for CVD Risk Reduction: Role of Stress and Anger
Authors: Kim Chun-Ja  , Park Na-Jin  , Choi JiYeon  , Shin Dong-Soo
Published: February 2025

Purpose: To examine the mediating role of occupational stress on the relationship of anger expression to cardiovascular disease (CVD) risk using Framingham risk score equation in Korean adults with metabolic syndrome.
Attitude Towards Health Information Privacy and Electronic Health Records Among Urban Sri Lankan Adults
Authors: Tissera Shaluni R.  , Silva S.N.
Published: February 2025

Sri Lanka is planning to move towards an Electronic Health Record (EHR) system. This research argues that the public preparedness should be considered in order to implement a functioning and an effective EHR system in a country. When asked about how concerned the participants were about the security of their health records, 40.5% stated they were concerned and 38.8% were very concerned. They were asked to rate the ‘level of trust’ they have on health institutes in Sri Lanka on a scale from 1 to 10 (1 lowest level of trust and 10 highest), 66.1% rated at level 5 or less.
Evaluation of Efficiency Improvement in Vital Documentation Using RFID Devices
Authors: Kimura Eizen  , Nakai Miho  , Ishihara Ken
Published: February 2025

We introduced medical devices with RFID tags and the terminal with RFID reader in our hospital. Time study was conducted in two phases. In phase I, nurses round as usual, and in phase II, the nurse round the ward with a terminal installed on a cart. This study concluded that RFID system shortens the time for vital sign documentation. However, deploying the terminals at every bedside did not contribute the more time reduction.
Implementation of Improvements in an Electronic Documentation Nursing Process System Structured on NANDA-I, NOC and NIC (NNN) Classification
Authors: Peres Heloísa  , Cruz Diná  , Tellez Michelle  , de Cássia Gengo e Silva Rita  , Ortiz Diley  , Diogo Regina  , Ortiz Dóris R.
Published: February 2025

The aim of this study was to present the experience of a teaching hospital with the implementation of improvements to an electronic documentation system of the nursing process (PROCEnf-USP®). The improvements were based on functional performance and technical quality of the system. It was adopted Scrum™method for version control PROCEnf-USP® by enabling agility, flexibility and possibility of integration between development and users. The PROCEnf-USP® has been used since 2009 and has professional and academic environments. The current version lets you generate reports and supports decisions about diagnoses, outcomes and interventions. It is provided the use of indicators to monitor results and registration at the point of care. The establishment of important.
Utilizing Health Analytics in Improving Emergency Room Performance
Authors: Khalifa Mohamed
Published: February 2025

Emergency room performance improvement has been a major concern for healthcare professionals and researchers. ER patients' length of stay and percentage of patients leaving without treatment are two of the most important indicators for performance monitoring and improvement. The main objective of this study is to utilize health analytics methods in identifying areas of deficiency, potential improvements and recommending effective solutions to enhance ER performance. ER data of 2014 were retrospectively retrieved in January 2015 and analyzed for significant variables affecting inpatient admission rates. Patient Acuity Level was the significant variable on which the recommendations were based. A Fast-Track area was redesigned and dedicated for managing lower acuity level patients; CTAS levels 4 and 5. The performance of the ER has been monitored for the first six months of 2015 and compared to 2014. 29% improvement was achieved on shortening the total ER LOS and 30% improvement was achieved on the percentage of patients leaving ER without treatment.
Using Education Technology as a Proactive Approach to Healthy Ageing
Authors: Rodger Daragh  , Spencer Anne  , Hussey Pamela
Published: February 2025

Bone Health in the Park was created in Ireland and is an online health promotion education resource focussing on bone health, healthy ageing and falls prevention. The programme was designed by an Advanced Nurse Practitioner in collaboration with an Education Technologist and primarily uses storytelling to promote education specifically on bone health and falls risk prevention for health care professionals, clients, families and informal carers. This paper reports on core deliverables from this programme from 2010 to 2015, and provides insight into their development, in addition to details on its clinical effectiveness by using technology enhanced learning to underpin health promotion initiatives.
Implementing Innovation: The Creation of an iUnit and the Role of Nursing
Authors: Tiase Victoria L.  , Ventura Rosemary  , Sorbello Daniel  , Robinson Kenya
Published: February 2025

NewYork-Presbyterian Hospital took on the challenge of thinking about innovation differently with the implementation of an innovation unit or iUnit to create the patient care unit of the future. Goals were to understand more about the innovation process and to test new service models, technology platforms, devices, and deployment models. Key findings from the focus groups included the need for additional training and technical support. In general, the initiative was felt to improve overall communication and represents a starting point for further innovation programs.
Operationalizing the TANIC and NICA-L3/L4 Tools to Improve Informatics Competencies
Authors: Sipes Carolyn  , McGonigle Dee  , Hunter Kathy  , Hebda Toni  , Hill Taryn  , Lamblin Jean
Published: February 2025

Two tools were developed for nurses to self-assess different levels of informatics competencies. The TANIC is used for all nurses to self-assess; the NICA-L3/L4 is a tool for the informatics nurse specialist (INS) to self-assess skill levels. There are 167 informatics items in the TANIC and 178 advanced informatics items in the NICA-L3/L4. These tools were piloted; the results presented here. Based on the evaluation, the tools have been integrated into informatics courses at the BSN and MSN programs at Chamberlain College of Nursing, and presented in two AACN webinars and other national conferences. Numerous requests have been honored to provide the tools for other schools of nursing to use in their courses, including DNP programs. Other requests include those from CNIOs and managers to include in their job descriptions for informatics nurses.
Preparing the Next Generation of Advanced Practice Nurses for Connected Care
Authors: Skiba Diane J.  , Barton Amy J.  , Estes Krista  , Gilliam Eric  , Knapfel Sarah  , Lee Chanmi  , Moore Gina  , Trinkley Katy
Published: February 2025

The health care delivery system in the United States is transforming at a rapid pace. Several trends, including the emergence of a Connected Health care system, will require advanced nurse practitioners to have new knowledge, skills and competencies to practice in the future. This paper describes the redesign of coursework and the development of a Connected Care Framework to guide the learning needs of nurse practitioners. A Connected Care Quotient consisting of ten relevant questions and learning activities will serve as a guide for the future development of competencies for advanced practice nurses.
Checking the Quality of Detailed Clinical Models: Instrument Application
Authors: van Munster Denice  , Krediet Irene  , Goossen William
Published: February 2025

Background: The exchange of clinical data between electronic health records is a challenge and need flexible models that adapt to clinical needs. Detailed Clinical Models (DCM) are used for this purpose, however, what is their quality? This paper's objective is to report on the application of an existing instrument to determine DCM quality.
Usabilty Evaluation of a Prototype Mobile App for Health Management for Persons Living with HIV
Authors: Schnall Rebecca  , Bakken Suzanne  , Brown III William  , Carballo-Dieguez Alex  , Iribarren Sarah
Published: February 2025

Mobile health (mHealth) applications (apps) have the potential to support self-management and improve health outcomes in persons living with HIV (PLWH). In this paper, we report on the final step in a three-stage user-centered design process for the development of a mHealth app for PLWH. We conducted a usability evaluation with 10 targeted end-users and a heuristic evaluation with 5 persons with informatics expertise to assess the usability of a prototype mHealth app for PLWH to manage their health. At the end of our usability evaluation, we finalized a Design Document that included the user interface design and functional specifications of the mHealth app. The functional areas which were identified at the end of our iterative process included: Communication, Reminders, Medication Logs, Lab Reports, Pharmacy Info, Nutrition and Fitness, Resources and Settings.
TextWithSurgeryPatients – A Research Hypothesis in Enhancing Education and Physical Assessment for Abdominal Surgical Patients
Authors: Hansen Margaret
Published: February 2025

Medical surgical nurses may not have the time or resources to provide effective pre- and post-operative instructions for patients in today's healthcare system. And, making timely physical assessments following discharge from the hospital is not always straightforward. Therefore, the risk for readmission associated with post-surgical complications is a concern. At present, mobile healthcare technologies and patient care are precipitously evolving and may serve as a resource to enhance communication between the healthcare provider and patient. A mobile telephone text message (short message service [SMS]) intervention for abdominal surgical patients may foster effective education (communication) and timely self-reported physical assessment in the home environment hence preventing deleterious outcomes. The aim of this research proposal is to identify the feasibility of using a SMS intervention via smart phones to improve health outcomes via timely communication, reach large numbers of at-risk surgical patients and, establish and sustain uniform protocols in a cost-efficient manner.
Patient Participation in Chronic Pain Management Through Social Media: A Clinical Study
Authors: Merolli Mark  , Gray Kathleen  , Martin-Sanchez Fernando
Published: February 2025

Chronic pain places a significant burden on individuals as well as health services. Long wait lists to access public clinical pain management services can result, and health outcomes deteriorate. Innovative technologies, such as social media provide opportunities to support self-management within the participatory health framework. This paper aims to investigate patients' perceptions towards using social media while waiting for clinic access, with a particular focus on therapeutic affordances. Seventeen wait-listed patients underwent intervention using various social media resources as part of self-management. Thematic content analysis of semi-structured interviews examined patients' perceptions about social media use and participation. Three therapeutic affordances were most evident in the qualitative data: exploration, connection and narration. Barriers to participation were also identified, such as ‘specificity of the resources’. Findings suggest social media are perceived positively. However, there is also the need to balance a desire to deliver evidence-based practice with patient-preferences in shared-decision making about social media use.
Social Media as Catalyzer for Connected Health: Hype or Hope? Perspectives from IMIA Working Groups
Authors: Fernandez-Luque Luis  , Vilmarlund Vivian  , Borycki Elizabeth  , Schulz Stefan  , Kuziemsky Craig  , Marschollek Michael  , Kulikowski Casimir A.
Published: February 2025

The Internet and social media are becoming ubiquitous technologies that are transforming the health sector. Social media has become an avenue for accessing, creating and sharing health information among patients and healthcare professionals. Furthermore, social media has become a key feature in many eHealth solutions, including wearable technologies, Big Data solutions, eLearning systems, Serious Games, Medical imaging, etc. These hyper-connected technologies are facilitating a paradigm shift towards more connected health. In this panel, representatives of different IMIA Working Groups will explore how both hope and hype contribute to social media's catalyzing role in creating connected health solutions.
The Need for a Global Language – SNOMED CT Introduction
Authors: Millar Jane
Published: February 2025

SNOMED CT is the most comprehensive, multilingual clinical healthcare terminology in the world. It is a resource with comprehensive, scientifically validated clinical content. SNOMED CT enables consistent, processable representation of clinical content in electronic health records.
Intelligent Re-Use of Nursing Routine Data: Opportunities and Challenges
Authors: Hackl Werner O.
Published: February 2025

Secondary use of structured nursing routine data receives an increasing attention in healthcare and is supposed to bear huge potential for different purposes. However, building and analyzing such integrated nursing routine data repositories are nontrivial, challenging tasks. The workshop gives an insight in the state of the art of secondary data analysis in nursing and addresses possible opportunities as well as the main challenges when re-using nursing data for secondary analyses. The target audience of the workshop comprises all stakeholders who are interested in the intelligent re-use of nursing data (e.g. decision-makers, public health officials, nursing managers, nursing informatics/IT staff, scientists, data analysts as well as industry representatives).
Urgent Call for Nursing Big Data
Authors: Delaney Connie W.
Published: February 2025

The purpose of this panel is to expand internationally a National Action Plan for sharable and comparable nursing data for quality improvement and big data science. There is an urgent need to assure that nursing has sharable and comparable data for quality improvement and big data science. A national collaborative – Nursing Knowledge and Big Data Science includes multi-stakeholder groups focused on a National Action Plan toward implementing and using sharable and comparable nursing big data. Panelists will share accomplishments and future plans with an eye toward international collaboration. This presentation is suitable for any audience attending the NI2016 conference.
Facilitating eHealth for All Through Connecting Nurses and the Women Observatory for eHealth
Authors: Thouvenot Veronique Ines  , Hardiker Nicholas
Published: February 2025

Nurses are at the forefront of health care delivery and are key to health improvements across populations worldwide. They play vital role in the treatment of communicable diseases and in maintaining optimal quality of life for those living with long-term conditions. A number of factors such as an ageing population, a shrinking nursing workforce, inequity and variable access to health services naturally point towards technology-focused solutions. However the uptake of eHealth tools and techniques by nurses and their integration with nursing practice remain patchy, not least because of nurses simply ‘not knowing’ that good solutions exist. The purpose of this panel is to describe initiatives that seek to identify and showcase good practice in the use of eHealth in nursing.
Making Patient Risk Visible: Implementation of a Nursing Document Information System to Improve Patient Safety
Authors: Wang Panfeng  , Zhang Hongjun  , Li Baohua  , Lin Keke
Published: February 2025

Objectives: The aims of this study were to develop a nursing information system (NIS), enhance the visibility of patient risk, and identify challenges and facilitators to adoption of the NIS risk assessment system for nurse leaders.
Classification of Patient Care Complexity: Cloud Technology
Authors: de Oliveira Riboldi Caren  , Macedo Andrea Barcellos Teixeira  , Mergen Thiane  , Dias Vera Lúcia Mendes  , da Costa Diovane Ghignatti  , Malvezzi Maria Luiza Falsarella  , Magalhães Ana Maria Muller  , Silveira Denise Tolfo
Published: February 2025

Presentation of the computerized structure to implement, in a university hospital in the South of Brazil, the Patients Classification System of Perroca, which categorizes patients according to the care complexity. This solution also aims to corroborate a recent study at the hospital, which evidenced that the increasing workload presents a direct relation with the institutional quality indicators. The tools used were the Google applications with high productivity interconnecting the topic knowledge on behalf of the nursing professionals and information technology professionals.
Nursing Activities Score: Cloud Computerized Structure
Authors: Moraes Kátia Bottega  , Martins Fabiana Zerbieri  , de Camargo Maximiliano Dutra  , Vieira Débora Feijó  , Magalhães Ana Maria Muller  , Silveira Denise Tolfo
Published: February 2025

This study objective to describe the cloud Nursing Activities Score implementation process in the Intensive Care Unit of the Post-Anesthesia Recovery Room. It is a case study. The tools used were the Google applications with high productivity interconnecting the topic knowledge on behalf of the nursing professionals and information technology professionals. As partial results, it was determined that the average nursing staff workload in the ICU/PARR during the first 24 hours, according to the score on the scale, was 91.75 ± 18.2. Each point of NAS is converted into 14.4 minutes, which is equivalent to an average of 22 working hours. Currently the instrument is implemented in the institution, reinforcing the need to update and raise awareness concerning the need to maintain the new routine.
Nurses' Actual Usage of EMRs: An Access Log-Based Analysis
Authors: Kajimura Ayako  , Takemura Tadamasa  , Hikita Tomoko  , Fujita Kenichiro  , Yoshihara Waon  , Hashiya Akane  , Kuroda Tomohiro
Published: February 2025

Access logs for electronic medical records (EMRs) are a useful source of data for understanding how nurses' perform their duties. The purpose of this study was to understand how nurses' used an EMR system, by inspecting and analyzing from one week EMR access logs (394,708) of accessing ‘outcome Input’ screen. Anytime day and night, nurses accessed ‘outcome Input’ screen. Viewing and information input obtained from observations, in order to monitor patients' conditions over tasks such as keeping nursing records.
An Efficient User Interface Design for Nursing Information System Based on Integrated Patient Order Information
Authors: Chu Chia-Hui  , Kuo Ming-Chuan  , Weng Shu-Hui  , Lee Ting-Ting
Published: February 2025

A user friendly interface can enhance the efficiency of data entry, which is crucial for building a complete database. In this study, two user interfaces (traditional pull-down menu vs. check boxes) are proposed and evaluated based on medical records with fever medication orders by measuring the time for data entry, steps for each data entry record, and the complete rate of each medical record. The result revealed that the time for data entry is reduced from 22.8 sec/record to 3.2 sec/record. The data entry procedures also have reduced from 9 steps in the traditional one to 3 steps in the new one. In addition, the completeness of medical records is increased from 20.2% to 98%. All these results indicate that the new user interface provides a more user friendly and efficient approach for data entry than the traditional interface.
Use and Acceptance of Mobile Technology by Hospital Nurses in Germany
Authors: Schmeer Regina  , Behrends Marianne  , Kupka Thomas  , Meyenburg-Altwarg Iris  , Marschollek Michael
Published: February 2025

Introduction: The aim of the study was to measure and describe user behavior, information and communication technology (ICT) competence and technology acceptance of hospital nurses.
Development of an Open Source Educational Resource: “Clinical Procedures for Safer Patient Care”
Authors: Doyle Glynda  , McCutcheon Jodie
Published: February 2025

An Open Education Resource (OER) has been developed by two nurse educators to address inconsistencies in how clinical health care skills are taught and practiced in the clinical setting, and to ensure best practice and quality care based on the latest evidence. A checklist approach aims to provide clear steps and rationale for procedures, standardized processes for clinical skills and to assist nursing schools and clinical practice partners in teaching clinical skills, and keeping procedural practice current. The format is logical, organized and focused on patient safety, and will provide information retrieval opportunities at the point of care to support decisions and plan patient care. This poster discusses the development of this resource, the framework used, and the process from conception to distribution.
Using Clinical Decision Support and Dashboard Technology to Improve Heart Team Efficiency and Accuracy in a Transcatheter Aortic Valve Implantation (TAVI) Program
Authors: Clarke Sarah  , Wilson Marisa L.  , Terhaar Mary
Published: February 2025

Heart Team meetings are becoming the model of care for patients undergoing transcatheter aortic valve implantations (TAVI) worldwide. While Heart Teams have potential to improve the quality of patient care, the volume of patient data processed during the meeting is large, variable, and comes from different sources. Thus, consolidation is difficult. Also, meetings impose substantial time constraints on the members and financial pressure on the institution. We describe a clinical decision support system (CDSS) designed to assist the experts in treatment selection decisions in the Heart Team. Development of the algorithms and visualization strategy required a multifaceted approach and end-user involvement. An innovative feature is its ability to utilize algorithms to consolidate data and provide clinically useful information to inform the treatment decision. The data are integrated using algorithms and rule-based alert systems to improve efficiency, accuracy, and usability. Future research should focus on determining if this CDSS improves patient selection and patient outcomes.
Geo-spatial Informatics in International Public Health Nursing Education
Authors: Kerr Madeleine J.  , Honey Michelle L.L.  , Krzyzanowski Brittany
Published: February 2025

This poster describes results of an undergraduate nursing informatics experience. Students applied geo-spatial methods to community assessments in two urban regions of New Zealand and the United States. Students used the Omaha System standardized language to code their observations during a brief community assessment activity and entered their data into a mapping program developed in Esri ArcGIS Online, a geographic information system. Results will be displayed in tables and maps to allow comparison among the communities. The next generation of nurses can employ geo-spatial informatics methods to contribute to innovative community assessment, planning and policy development.
Converting Text to Structured Models of Healthcare Services
Authors: Despotou George  , Matragkas Nicholas  , Arvanitis Theodoros N.
Published: February 2025

The paper presents a concise method for transforming textual representations of healthcare services, to a structured, semantically unambiguous modelling language. The method is designed based on literature, as well as trial and error by the authors, using text descriptions of healthcare services. Employing the method can convert textual descriptions to structured graphical models, facilitating stakeholder collaboration on requirements analysis and simulation.
mHealth Apps and Their Risks – Taking Stock
Authors: Albrecht Urs-Vito  , von Jan Ute
Published: February 2025

Despite the popularity of health related apps and the great potential they hold for improving health care, the risks as well as potential hazards posed by such apps are often not adequately appreciated by users. Based on an analysis of scientific literature as well as anecdotal evidence, this contribution addresses the most common risks and pitfalls of health related apps (e.g. related to physical integrity as well as bodily and mental wellbeing) that users may encounter and sketches some remedies. While certainly not exhaustive, the mentioned aspects may serve as a starting point to raise awareness about potential risks of health related apps.
Identifying Dyscalculia Symptoms Related to Magnocellular Reasoning Using Smartphones
Authors: Knudsen Greger Siem  , Babic Ankica
Published: February 2025

This paper presents a study that has developed a mobile software application for assisting diagnosis of learning disabilities in mathematics, called dyscalculia, and measuring correlations between dyscalculia symptoms and magnocellular reasoning. Usually, software aids for dyscalculic individuals are focused on both assisting diagnosis and teaching the material. The software developed in this study however maintains a specific focus on the former, and in the process attempts to capture alleged correlations between dyscalculia symptoms and possible underlying causes of the condition. Classification of symptoms is performed by k-Nearest Neighbor algorithm classifying five parameters evaluating user's skills, returning calculated performance in each category as well as correlation strength between detected symptoms and magnocellular reasoning abilities. Expert evaluations has found the application to be appropriate and productive for its intended purpose, proving that mobile software is a suitable and valuable tool for assisting dyscalculia diagnosis and identifying root causes of developing the condition.
Improving Utilization of Clinical Decision Support Systems by Reducing Alert Fatigue: Strategies and Recommendations
Authors: Khalifa Mohamed  , Zabani Ibrahim
Published: February 2025

Clinical decision support systems (CDSS) are designed to help making clinical decisions regarding the management of patients. CDS alerts can save lives but frequent insignificant ones might cause alert fatigue. Studies discuss that 33% to 96% of clinical alerts are ignored. We categorized best evidence based strategies, to reduce alert fatigue and improve CDSS utilization, into five major areas. Classify alerts in to three main levels; severe, moderate and minor then develop a core set of critical drug to drug interactions. Classify alerts into active and passive groups, where only critical alerts should be interruptive actively while less critical alerts should be non-interruptive to the user. Conduct regular user training on new improvements. Keep monitoring alert response rates and keep ongoing research and improvement efforts. Provide systems with automated feedback and learning mechanisms where frequently ignored and justified alerts could be moved automatically from the active interruptive to the passive non-interruptive model.
Predicting Unpanned Return to Hospital for Chronic Disease Patients
Authors: Khanna Sankalp  , Good Norm  , Boyle Justin
Published: February 2025

Preventing unplanned returns, including readmissions and representations to the emergency department is increasingly becoming a performance target for hospitals across the globe. Significant successes have been reported from interventions put in to place by hospitals to reduce their incidence. However, despite several risk stratification algorithms being proposed in recent years, there is limited use of these algorithms in hospital services to identify patients for enrolment into these intervention programs. This study identifies constraints limiting the practical use of such algorithms. We also develop and validate models that focus on clinically relevant patient cohorts and are thus better suited to practical deployment in hospitals, while still offering good predictive ability.
Security and Privacy in a DACS
Authors: Delgado Jaime  , Llorente Silvia  , Pàmies Martí  , Vilalta Josep
Published: February 2025

The management of electronic health records (EHR), in general, and clinical documents, in particular, is becoming a key issue in the daily work of Healthcare Organizations (HO). The need for providing secure and private access to, and storage for, clinical documents together with the need for HO to interoperate, raises a number of issues difficult to solve. Many systems are in place to manage EHR and documents. Some of these Healthcare Information Systems (HIS) follow standards in their document structure and communications protocols, but many do not. In fact, they are mostly proprietary and do not interoperate. Our proposal to solve the current situation is the use of a DACS (Document Archiving and Communication System) for providing security, privacy and standardized access to clinical documents.
Large Scale eHealth Deployment in Europe: Insights from Concurrent Use of Standards
Authors: Eichelberg Marco  , Chronaki Catherine
Published: February 2025

Large-scale eHealth deployment projects face a major challenge when called to select the right set of standards and tools to achieve sustainable interoperability in an ecosystem including both legacy systems and new systems reflecting technological trends and progress. There is not a single standard that would cover all needs of an eHealth project, and there is a multitude of overlapping and perhaps competing standards that can be employed to define document formats, terminology, communication protocols mirroring alternative technical approaches and schools of thought. eHealth projects need to respond to the important question of how alternative or inconsistently implemented standards and specifications can be used to ensure practical interoperability and long-term sustainability in large scale eHealth deployment. In the eStandards project, 19 European case studies reporting from R&D and large-scale eHealth deployment and policy projects were analyzed. Although this study is not exhaustive, reflecting on the concepts, standards, and tools for concurrent use and the successes, failures, and lessons learned, this paper offers practical insights on how eHealth deployment projects can make the most of the available eHealth standards and tools and how standards and profile developing organizations can serve the users embracing sustainability and technical innovation.
Co-Design of a Computer-Assisted Medical Decision Support System to Manage Antibiotic Prescription in an ICU Ward
Authors: Gil Miguel  , Pinto Pedro  , Simões Alexandra S.  , Póvoa Pedro  , Da Silva Miguel Mira  , Lapão Luís Velez
Published: February 2025

About 37 thousand people die per year in Europe due to infections by resistant bacteria. Fighting antimicrobial resistances (AR) is a top priority to save lives and reduce costs. AR is triggered mostly by uncritical antibiotic prescription. This paper presents HAITool, a decision-making information system to support antibiotic prescription. The system was co-developed together with health professionals using Design Science Research Methodology, empowered with innovative data visualization techniques to improve AR management. HAITool includes integrated visualizations of patient, microbiology, and pharmacy data, facilitating clinical decision support, antibiotic prescriptions quality and antibiotic-resistant bacteria monitoring. It also includes an alert module that monitors conformance of antibiotic prescriptions with norms and guidelines. HAITool is evaluated using both the Österle principles and interviews with physicians and infection control team from three participant hospitals.
Care Professionals' Perceived Usefulness of eHealth for Post-Discharge Stroke Patients
Authors: Davoody Nadia  , Hägglund Maria
Published: February 2025

Despite many attempts to provide appropriate tools for supporting stroke patients in their care and rehabilitation processes, there is still room for improvement. We propose an online care and rehabilitation planning tool as a potential eHealth service for stroke patients. The aim is to study the care professionals' perceived usefulness of the planning tool. We developed and presented a functional prototype to a neurology team in Stockholm. Three focus groups were performed with the care professionals in the team and the data were analysed based on the unified theory of acceptance and use of technology. Although care professionals mentioned challenges such as time limitation for using the tool and issues related to the responsibility of the system, they were positive towards the tool and its potential usefulness in ease of understanding the rehabilitation process and support for collaboration.
An Iterative Methodology for Developing National Recommendations for Nursing Informatics Curricula
Authors: Egbert Nicole  , Thye Johannes  , Schulte Georg  , Liebe Jan-David  , Hackl Werner O.  , Ammenwerth Elske  , Hübner Ursula
Published: February 2025

The increasing importance of IT in nursing requires educational measures to support its meaningful application. However, many countries do not yet have national recommendations for nursing informatics competencies. We thus developed an iterative triple methodology to yield validated and country specific recommendations for informatics core competencies in nursing. We identified relevant competencies from national sources (step 1), matched and enriched these with input from the international literature (step 2) and fed the resulting 24 core competencies into a survey (120 invited experts from which 87 responded) and two focus group sessions with a total of 48 experts (steps 3a/3b). The subsequent focus group sessions confirmed and expanded the findings. As a result, we were able to define role specific informatics core competencies for three countries.
The Use of Tools, Modelling Methods, Data Types, and Endpoints in Systems Medicine: A Survey on Projects of the German e:Med-Programme
Authors: Gietzelt Matthias  , Höfer Thomas  , Knaup-Gregori Petra  , König Rainer  , Löpprich Martin  , Poos Alexandra  , Ganzinger Matthias
Published: February 2025

Systems medicine is the consequent continuation of research efforts on the road to an individualized medicine. Thereby, systems medicine tries to offer a holistic view on the patient by combining different data sources to highlight different perspectives on the patient's health. Our research question was to identify the main data types, modelling methods, analysis tools, and endpoints currently used and studied in systems medicine. Therefore, we conducted a survey on projects with a systems medicine background. Fifty participants completed this survey. The results of the survey were analyzed using histograms and cross tables, and finally compared to results of a former literature review with the same research focus. The data types reported in this survey were widely diversified. As expected, genomic and phenotype data were used most frequently. In contrast, environmental and behavioral data were rarely used in the projects. Overall, the cross tables of the data types in the survey and the literature review showed overlapping results.
The Genomic Medicine Game
Authors: Tran Elvis  , de Andrés-Galiana Enrique J.  , Benitez Sonia  , Martin-Sanchez Fernando  , Lopez-Campos Guillermo H.
Published: February 2025

With advancements in genomics technology, health care has been improving and new paradigms of medicine such as genomic medicine have evolved. The education of clinicians, researchers and students to face the challenges posed by these new approaches, however, has been often lagging behind. From this the Genomic Medicine Game, an educational tool, was created for the purpose of conceptualizing the key components of Genomic Medicine. A number of phenotype-genotype associations were found through a literature review, which was used to be a base for the concepts the Genomic Medicine Game would focus on. Built in Java, the game was successfully tested with promising results.
Universal Design Criteria in Standards and Codes About Accessibility of Built Environments in Brazil
Authors: Guimarães Marcelo Pinto
Published: February 2025

This paper includes some criticism in analysis of the development and implementation of the national standards for accessibility of the built environment in Brazil, i.e., the NBR9050. Currently, the 2015 version of it resembles an encyclopaedia including a variety of exotic contributions gathered historically from different sources; however, that characteristic makes it work like a puzzle that keeps alive prejudices about users' needs and disabilities. Besides, there are conflicts between recommended ideas and previous requirements from older versions. The definition of Universal Design has been published since 2004, but there is still no indication of how to make the principles work in practice. Therefore, it is very hard for city officials to assess quality of environments, and professionals have serious constraints to explore their skills further while addressing users' diversified needs. Certainly, the current NBR9050 requires further editorial work. Nevertheless, an important decision is necessary: it is important to organize information so that readers may identify in each topic whether Universal Design application can be achieved or whether the proposed technical solution may lead to construction of limited spatial adaptation and reach only some poor accommodation of users with uncommon needs. Presenting some examples in context of socially inclusive environments, the newer revised version of NBR9050 is necessary to explain about pitfalls of bad design of accessibility for discriminated disabled users. Readers should be able to establish conceptual links between the best ideas so that Universal Design could be easily understood.
Developing Inclusive Teaching and Learning Through the Principles of Universal Design
Authors: Knarlag Kjetil  , Olaussen Elinor
Published: February 2025

For decades, the term reasonable accommodations has been the lead strategy and praxis in addressing diversity and disabilities in Higher Education. Universal Design for Learning (UDL) is a well-known theory and a practical approach which challenges these traditions in order to improve inclusive teaching and learning in the American school system. A European funded project, UDLL, has transferred these theories to a European context, and developed best practice guidelines for key stakeholders in European Higher Education Institutions. This universal approach challenges established traditions, methods and mindsets in addressing the diverse student population.
A Conceptual Framework for Inclusive Digital Storytelling to Increase Diversity and Motivation for Cultural Tourism in Thailand
Authors: Kasemsarn Kittichai  , Nickpour Farnaz
Published: February 2025

Cultural tourism is considered to be a niche market and little attention has been paid to it, as compared with mass tourism. Moreover, visitors have little motivation to visit actual historical sites and read the story displayed behind the exhibitions. These issues highlight a good opportunity to increase further potential extended tourism and increase the motivation of visitors. To broaden and increase the potential market, this study applies inclusive design principles as ‘understanding and designing for diversity’ and presents reports on the first study. To increase the motivation of tourists, this study adopts digital storytelling as ‘the guideline to increase motivation’ and illustrates this in the second study.
Barriers to Banking – Towards an Inclusive Banking Environment in South Africa
Authors: Martinson Estelle  , Martinson Johannes
Published: February 2025

A recent study in South Africa on the barriers to banking which involved customers in three disability groups namely mobility, hearing and vision has highlighted that currently banking in South Africa is not accessible. Customers with a disability are unable to independently use banking services across a wide range of channels. Exclusion from something as fundamental as managing their own financial affairs raise serious human rights concerns and requires committed action from decision-makers to address this. The fact that solutions to all of the identified barriers have been successfully implemented in banks in other parts of the world for many years emphasize that this is not a technical challenge. While some solutions require complex or expensive changes such as removing physical access barriers and ensuring that digital channels meet internationally accepted standards of accessibility, there are many simple and low-cost solutions which can be implemented immediately and would make a world of difference to these customers and their experience of banking. One key barrier which emerged in all the focus groups and surveys is attitudinal barriers – staff who are unwilling to assist, impatient, interact with the customer's assistant instead of directly with them and lack basic skills on how to interact with someone who has a disability. A comprehensive framework of banking was used to identify a wide range of barriers. The barriers were classified as attitudinal, barriers to physical access, digital access barriers, barriers to information, communication barriers and some generic concerns such as safe evacuation during emergencies and alternative authentication. Both the barriers and the solutions where ranked by participants. From a theoretical perspective, the benefit of a customer-centric approach to understanding these barriers and the innovation potential of a Universal Design approach is affirmed by this study.
A South African Municipality Mapping the Way Forward for Social Inclusion Through Universal Design
Authors: Aalbers Michelle
Published: February 2025

Since becoming a democracy, South African legislation has changed. The South African Constitution and legislation governing the structures and mandate of the different spheres of government aim towards municipalities needing to become more developmental in the way it serves the community with a specific focus on the poor and vulnerable. It sets ideals to overcome the inheritance of the past. However, how to do this is sometimes still unclear. This paper is a case study illustrating how Stellenbosch Municipality overcame obstacles of perceived legislative restrictions, silo operations and antiquated thinking, working towards social inclusion for all its citizens. In moving away from disability accessibility and embracing universal access as a way in which to deliver basic services, Stellenbosch discovered the beginning of the process of overcoming the negative legacy of the past. Understanding the Universal Design principles and approach illustrated how South African municipalities can promote the concept of our rainbow nation as envisioned in the Constitution.
Exploring Intrinsic and Extrinsic Motivations to Participate in a Crowdsourcing Project to Support Blind and Partially Sighted Students
Authors: Layas Fatma  , Petrie Helen
Published: February 2025

There have been a number of crowdsourcing projects to support people with disabilities. However, there is little exploration of what motivates people to participate in such crowdsourcing projects. In this study we investigated how different motivational factors can affect the participation of people in a crowdsourcing project to support visually disabled students. We are developing “DescribeIT”, a crowdsourcing project to support blind and partially students by having sighted people describe images in digital learning resources. We investigated participants' behavior of the DescribeIT project using three conditions: one intrinsic motivation condition and two extrinsic motivation conditions. The results showed that participants were significantly intrinsically motivated to participate in the DescribeIT project. In addition, participants' intrinsic motivation dominated the effect of the two extrinsic motivational factors in the extrinsic conditions.
Resource Discovery and Universal Access: Understanding Enablers and Barriers from the User Perspective
Authors: Beyene Wondwossen Mulualem
Published: February 2025

Resource discovery tools are the keys to explore, find, and retrieve resources from multitudes of collections hosted by library and information systems. Modern resource discovery tools provide facet-rich interfaces that provide multiple alternatives to expose resources for their potential users and help them navigate to the resources they need. This paper examines one of those tools from the perspective of universal access, utilizing the experience of users with print disability. It aimed at exploring the way print disabled users use library search tools, the barriers they might face in the process, and what needs to be considered in order to implement discovery tools that incorporate the needs of users with print disability. Interviews that involved user testing were made with selected group of users. The data obtained in the process was analyzed and compared against the existing body of knowledge to forward design recommendations for future endeavors.