Parkview Health Research Repository
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Noninvasive Hemoglobin Level Prediction in a Mobile Phone Environment: State of the Art Review and Recommendations.
Get PDFBACKGROUND: There is worldwide demand for an affordable hemoglobin measurement solution, which is a particularly urgent need in developing countries. The smartphone, which is the most penetrated device in both rich and resource-constrained areas, would be a suitable choice to build this solution. Consideration of a smartphone-based hemoglobin measurement tool is compelling because of the possibilities for an affordable, portable, and reliable point-of-care tool by leveraging the camera capacity, computing power, and lighting sources of the smartphone. However, several smartphone-based hemoglobin measurement techniques have encountered significant challenges with respect to data collection methods, sensor selection, signal analysis processes, and machine-learning algorithms. Therefore, a comprehensive analysis of invasive, minimally invasive, and noninvasive methods is required to recommend a hemoglobin measurement process using a smartphone device.
OBJECTIVE: In this study, we analyzed existing invasive, minimally invasive, and noninvasive approaches for blood hemoglobin level measurement with the goal of recommending data collection techniques, signal extraction processes, feature calculation strategies, theoretical foundation, and machine-learning algorithms for developing a noninvasive hemoglobin level estimation point-of-care tool using a smartphone.
METHODS: We explored research papers related to invasive, minimally invasive, and noninvasive hemoglobin level measurement processes. We investigated the challenges and opportunities of each technique. We compared the variation in data collection sites, biosignal processing techniques, theoretical foundations, photoplethysmogram (PPG) signal and features extraction process, machine-learning algorithms, and prediction models to calculate hemoglobin levels. This analysis was then used to recommend realistic approaches to build a smartphone-based point-of-care tool for hemoglobin measurement in a noninvasive manner.
RESULTS: The fingertip area is one of the best data collection sites from the body, followed by the lower eye conjunctival area. Near-infrared (NIR) light-emitting diode (LED) light with wavelengths of 850 nm, 940 nm, and 1070 nm were identified as potential light sources to receive a hemoglobin response from living tissue. PPG signals from fingertip videos, captured under various light sources, can provide critical physiological clues. The features of PPG signals captured under 1070 nm and 850 nm NIR LED are considered to be the best signal combinations following a dual-wavelength theoretical foundation. For error metrics presentation, we recommend the mean absolute percentage error, mean squared error, correlation coefficient, and Bland-Altman plot.
CONCLUSIONS: We addressed the challenges of developing an affordable, portable, and reliable point-of-care tool for hemoglobin measurement using a smartphone. Leveraging the smartphone\u27s camera capacity, computing power, and lighting sources, we define specific recommendations for practical point-of-care solution development. We further provide recommendations to resolve several long-standing research questions, including how to capture a signal using a smartphone camera, select the best body site for signal collection, and overcome noise issues in the smartphone-captured signal. We also describe the process of extracting a signal\u27s features after capturing the signal based on fundamental theory. The list of machine-learning algorithms provided will be useful for processing PPG features. These recommendations should be valuable for future investigators seeking to build a reliable and affordable hemoglobin prediction model using a smartphone
Improved Patient Safety and Quality Outcomes With Amiodarone Infusions.
No full textBACKGROUND: Amiodarone is a common intravenous medication and a known irritant to the vessel wall when administered peripherally.
LOCAL PROBLEM: Nurses identified an increase in phlebitis associated with peripheral amiodarone leading to multiple catheter replacements and interruptions in drug therapy. Central venous access is recommended by the manufacturer but not practical for a short-term infusion based on the risk to the patient, time, and cost.
METHODS: A 4-phased approach was used to identify a more suitable peripheral intravenous catheter.
INTERVENTIONS: A collaborative effort between bedside nurses and the vascular access team evolved to look at alternative products for peripheral intravenous catheters.
RESULTS: The extended dwell peripheral catheter decreased phlebitis from 54% to 5%. It also decreased interruptions in drug therapy and improved patient comfort and satisfaction.
CONCLUSIONS: A practice change was implemented utilizing extended dwell peripheral catheters for intravenous amiodarone and disseminated to other units
How Parkview Created a Holistic Response Team to Improve Workforce Well-Being: Case study for health care providers worldwide
No full textOverview: How Parkview Created a Holistic Response Team to Improve Workforce Well-Being
The challenge: Health care staff across all levels find it challenging to prioritize their own wellbeing, both during and outside of an immediate crisis. The stigma associated with accessing emotional support resources, a health care culture that idolizes stoicism, and competing priorities for time leave many prone to burnout.
The organization: Parkview Health is a not-for-profit, community-based health system serving northeast Indiana and northwest Ohio. The system includes an extensive network of primary care and specialty physicians and 10 hospitals, with more than 13,000 employees.
The approach: Parkview has a robust holistic nursing program that provides an opportunity for nurses to achieve certification. They created a workforce-facing Holistic Response Team (HRT) to “take care of the people who take care of our patients.” The HRT is made up of clinical staff who are dedicated to improving their peers’ well-being.
The result: The HRT creates space and time for staff to address their emotional needs. This fosters a culture that normalizes and encourages the prioritization of well-being as an ongoing goal—not exclusively during times of crisis. In addition, Parkview has seen a positive impact on the engagement and retention of their overall nursing staff. Clinical staff who serve with the HRT report a significant reconnection to purpose and mission
1-Day vs 3-Day Low Residue Diet for Colonoscopy Bowel Cleansing: A Systematic Review
No full textIntroduction: Colonoscopy is the best method for colon cancer screening and to evaluate bowel abnormalities, including cancer. However, good bowel preparation is essential for a successful colonoscopy. Several studies have shown Low Residue Diet (LRD) to be better tolerated without any negative effects on bowel cleansing compared to Clear Liquid Diet. Several studies have compared 1-day vs. 3-day LRD for bowel cleansing. This study aims to compare the impact of the duration of LRD for colonoscopy bowel cleansing in adult patients. Methods: We studied the Cochrane and MEDLINE/Ovid databases from inception to November 2020 with keywords “colonoscopy,” “bowel preparation,” “bowel cleaning,” “1-day,” and “3-day”. Initially, 107 studies were identified, which were further screened with title and abstracts. Seven studies were selected for full-text review. Two studies were also excluded as one of them had included pediatric patients, and another was a post-doc analysis. Four studies were included in the final analysis. Results: All studies were single-institution studies conducted in Spain (2), Portugal (1), and Turkey (1) on elective patients only. Patients with significant comorbidities were excluded from all 4 studies, with 2 specifically excluding inflammatory bowel disease patients and one excluding patients with a history of poor bowel preparation in the past. Two studies included only morning colonoscopies, one from 8AM-4PM, and one did not specify the timing. Experienced endoscopists performed the procedure in 3 studies. All studies showed that 1-day LRD was not inferior to 3-day LRD to achieve adequate bowel cleansing, polyp detections, adenoma detection, and cecal intubations. Patients reported tolerating the 1-day LRD significantly better in 2 studies, with the other 2 showing equivalence between the groups (Table 1). Conclusion: 1-day LRD is not inferior to 3-day LRD for a select population of patients undergoing elective outpatient screening colonoscopies. However, there is no data to support or negate this finding in patients with significant comorbidities, specifically in patients with IBD who need serial screening colonoscopies. This group requires specific investigation in future studies
Social media activity: its impact on career-related perceptions
No full textAbstract Purpose
The purpose of this exploratory study is to examine individual perceptions about the impact that social media use has on career satisfaction and perceived career benefits. We examined whether informal online learning through “typical” types of social media behaviors (e.g. liking a post or messaging another user) and “networking” types of social media behaviors (e.g. endorsing another user, writing recommendations, going “live,” or looking for a job) impacted career-related perceptions. Design/methodology/approach
In this study, we analyzed Amazon Mechanical Turk survey data gathered from adult participants (n = 475). We focused our inquiry specifically on two social media sites, Facebook and LinkedIn. We asked participants about their social media use and behaviors, as well as their perceptions of career satisfaction and career benefits related to social media. Findings
We found that both typical and networking types of social media behaviors positively predicted the “knowing whom” career competency (defined as career relevant networks and contacts that individuals use to develop their careers) and career satisfaction. Only networking behaviors were positively associated with perceived career benefits of social media use. We further found that LinkedIn users’ career satisfaction was lower compared to non-LinkedIn users. Originality/value
This study adds to the small, but growing body of career research focusing on social capital and social media. Our results suggest that informal online learning via social media may have a positive impact on employees’ career-related perceptions
Work-related technoference at home and feelings of work spillover, overload, life satisfaction and job satisfaction
No full textThe purpose of this study is to examine whether work-related technology use outside of work and around family members could produce technoference or phubbing, where time spent with family members is interrupted by or intruded upon by technology use. The authors also examined its impact on work-to-family spillover, feelings of overload, life satisfaction and job satisfaction for workers.Via an online survey, the authors assessed the frequency of technoference due to work, work-to-family spillover, feelings of overload, life satisfaction and job satisfaction. The authors’ analytic sample included US parents (95 fathers and 88 mothers) who worked for pay and experienced technoference in their relationships, which was at least sometimes due to work.Results reveal possible impacts of technoference related to work on employee feelings of work-to-family spillover, greater feelings of overload, lower life satisfaction and lower job satisfaction.Data are from a cross-sectional online survey, and results are correlational. Although the authors have theoretical/conceptual evidence for the impacts of technoference, it is possible that the direction of effects could be reversed or even bidirectional. Experimental/intervention work could further examine whether changes in technology use at home due to work improve employee well-being.The authors’ findings suggest that organizational policies which promote healthy boundaries and work-life balance are likely fundamental to employee well-being and that employers should be mindful of employees\u27 work-related technology use at home.This study examines technoference and phubbing due to work while at home, as opposed to focusing on the at-work context
The impact of parent and child media use on parent-child attachment in early childhood
No full textAbstract
With the rise in affordability of digital media and mobile devices, children under age 2 on average spend significantly more time with digital media than is recommended. Although concerns have been expressed about how parent and child media use might negatively impact parent–child attachment, there continues to be a scarcity of research on the topic. The current study assessed both the amount and the way in which children (11–26 months) and their parents engage with digital media and the impact on early attachment after controlling for temperament, parent income, parent age, marital status, and access to support. The study utilizes data from a diverse sample: 248 parents of infants completed an attachment q-sort and surveys assessing the amount of media use, parental absorption in media, types of parental mediation, temperament, and demographics. Results showed that for both parent and child, time using digital media and co-viewing was not predictive of attachment insecurity. Parental absorption in media was found to significantly predict attachment insecurity. Greater child TV media use was associated with poorer attachment security when there was limited to no parental active mediation. Active mediation served as a protective factor for attachment while parental absorption in media serves as a risk factor for attachment
Rasburicase Utilization After Protocol Implementation Focused on Fixed Dosing by Limiting Use of Weight-Based Dosing to Oncology Providers
No full textDec 2021 ASHP Midyear Clinical Meeting / Poster
Objective: Evaluate the change in rasburicase use pre- and post-implementation of dosing restriction protocol
