Parkview Health Research Repository
Not a member yet
774 research outputs found
Sort by
Parent distraction with phones, reasons for use, and impacts on parenting and child outcomes: A review of the emerging research
No full textArticle Free to Read through Link.
The current article reviews the emerging research related to parent distraction with phones and mobile devices. From this review, it is clear that parent distraction with phones and mobile devices while around children has become common. This is concerning, as the evidence suggests links with parenting and child outcomes—such as lower awareness and sensitivity, fewer verbal and nonverbal interactions, less coordinated parenting and coparenting, dissatisfaction with time spent together, and negative child reactions (e.g., problem behaviors). The issue is complex, however, as many reasons may drive parents to use devices around children, such as strong habits, device notifications, work/social pressures, parenting stress, and boredom or loneliness. Ultimately, parenting is affected due to displacement of time with children, difficulty of multitasking between device and child, and the emotions and stresses that can come from device use. Research gaps are found and future directions are proposed. Most findings come from self-reports or observations. More longitudinal and experimental work is needed to establish causation. Furthermore, as parents and children are concerned about phone use during family time, it is important for evidence-based programs to be developed to address healthy device habits specifically during family time and social interactions
Improving Implanted Device Remote Monitoring Adherence Through Data Sharing
No full textSESSION TITLE: EMERGING TECHNOLOGIES AND DISEASE MARKERS
Abstract 13109
Introduction: Congestive heart failure (CHF) patients with cardiac resynchronization therapy (CRT) devices do not always adhere to remote monitoring (RM). Utilization of RM has been found to improve health outcome while the lack thereof can delay clinical interventions to maintain optimum therapy.
Hypothesis: CRT patients currently do not have access to their own RM data. We assessed the hypothesis that CRT patients will become more adherent with RM if they are given access to their device data. We build an interactive report that engages patients by sharing their RM data. The goal was to improve RM adherence and empower patients to contact the clinic appropriately for low CRT pacing.
Methods: We applied a patient-centered design approach to create an interactive patient-facing RM report (Figure 1) in collaboration with CHF patients living with a CRT device and their informal caregivers. The iterative design process utilized participatory design and usability testing methods prior to enrolling a different group of patients in a 6-month pilot study. The study examined the impact of delivering this report via Epic’s patient portal, MyChart®. We collected MyChart® activity, calls to the clinic, report review frequency, healthcare utilization and RM adherence. Participant experience was gathered during exit interviews.
Results: 10 patients with an age range of 35-80 (mean 60) years participated in the study. The average adherence to RM prior to enrollment was 75% and increased to 91% by the end of the study. Participants on average accessed their report once every three weeks. Two participants received warning for low CRT pacing and appropriately contacted the clinic. At study exit all participants expressed realizing value from having access to the device data and wished to continue receiving reports.
Conclusion: Providing RM data to CRT patients had a positive impact on engagement and improved RM adherence
Free Access through Lin
Connecting ACEs to in-patient behavioral health treatment associated with bullying/cyberbullying
Get PDFDepression, Smart Phone Dependence, and Social Media Cyberbullying Among Youth and Young Adults Wyatt Meriwether, PhD, Quality, Safety, & Value, Kansas City VA Medical Center, Independence, MO APHA\u27s 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)
Abstract: Connecting ACEs to in-patient behavioral health treatment associated with bullying/cyberbullying.
Bullying/cyberbullying are pervasive for today’s youth – 28% report being bullied and 30% report having been a bully themselves. Involvement with cyberbullying is linked to depression, suicidal ideation, and attempted or completed suicide. In addition to bullying/cyberbullying, adverse childhood experiences (ACEs) impact future violence victimization and perpetration. The CDC estimates that 64% of the population have at least one adverse child experience, with 12.5% having four or more. To understand the impacts of these issues within our health system, the inpatient behavioral health unit changed its standard of care to include a bullying/cyberbullying survey at intake and discharge to identify the depth of this problem in the youth patient population. This survey assesses aspects of perceived safety, how the bullying took place, the impact on the patient, and if bullying/cyberbullying contributed to their admission. This project evaluates the outcomes of the surveys. The dataset is comprised of patients who were admitted between June 2018 and January 2019. In addition to the survey data, for each patient we collected specific health data including: diagnosis, reason for admission, admission/discharge notes, and duration of stay. We utilized diagnoses and admission/discharge notes to retroactively screen patients for aspects related to ACEs. These include abuse (emotional, physical, sexual) and household issues (substance abuse, mental illness, incarceration, parental separation/divorce). Initial data analysis indicates that out of 733 patients, 31.1% indicated that bullying/cyberbullying contributed to their admission or was found in their chart. Of this subset, 45.8% had an indication of an ACE within their diagnosis or admission comments, compared to 31.8% for patients with no indication of bullying/cyberbullying. Of the personal ACEs, 18.9% indicated abuse and 3.9% neglect. From the household perspective, 11.4% indicated substance abuse, 14.0% divorce/separation, 5.3% incarceration and 4.4% mental illness. Our analysis shows that ACEs are prevalent in patients who indicated that bullying/cyberbullying contributed to their admission. In addition to the need for increased education for our patients, their families and the community-at-large about ACEs, bullying/cyberbullying and how to address them, further research is needed to understand the deeper connections between ACEs and bullying/cyberbullying from a clinical perspective
Perspectives on facilitating whole exome sequencing for international patients at Mayo Clinic.
No full textWhole exome sequencing (WES) has become a fundamental component of genetic evaluation and diagnosing rare genetic diseases. This test is now offered to patients from a wide variety of cultural backgrounds and in various clinical and research settings. This commentary is a reflection of one group of clinical genetic counselors\u27 experiences in facilitating WES for patients who come from outside the United States for genetic evaluation and pursue WES. This patient population in our clinic primarily consists of individuals from the Middle East and presents recurrent logistical and counseling challenges. We aim to describe our international patient population, illuminate the challenges we have faced and illustrate how we have addressed these challenges
Evaluation of an adjusted body weight based heparin protocol
No full textPoster Presentation
2019 ASHP Midyear Clinical Meeting/ Las Vegas, Nevada/ Poster 11-136
Objective: Determine the efficacy and safety of a pharmacist-driven adjusted body weight protocol for therapeutic intravenous (IV) heparin dosing in patients of all weights in a community health system
Contemporary Management of Appendicular Skeletal Metastasis by Primary Tumor Type.
No full textSkeletal metastases exert a profound effect on patients and society, and will be encountered by most orthopedic surgeons. Once a primary malignancy is diagnosed, multidisciplinary management should focus on maximizing the quality of life while minimizing disease- and treatment-related morbidity. This may be best achieved with discerning attention to the unique characteristics of primary cancer types, including pathologic fracture healing rates, longevity, and efficacy of adjuvant therapies. Some lesions may respond well to nonsurgical measures, whereas others may require surgery. A single surgical intervention should allow immediate unrestricted activity and outlive the patient. In certain scenarios, a therapeutic benefit may be provided by excision with a curative intent. In these scenarios, or when endoprosthetic reconstruction is necessary, patients may be best referred to an orthopedic oncologist
Daily Technology Interruptions and Emotional and Relational Well-Being.
Get PDFThe current abundance of technology in daily life creates opportunities for interruptions in couple interactions, termed technoference or phubbing. The current study examined reports from both partners in 173 romantic relationships who completed daily surveys on technoference and relational well-being measures across 14 days. By using daily diary data, we were able to examine within-person associations and more closely approximate everyday life. Utilizing multilevel modeling, we found that on days when participants rated more technoference than usual, they felt worse about their relationship, perceived more conflict over technology use, rated their face-toface interactions as less positive, and experienced more negative mood. These relationships existed even after controlling for general feelings of relationship dissatisfaction, depression, and attachment anxiety, and there were no significant differences between women and men in these associations. This suggests that regardless of an individual’s or a couple’s current level of wellbeing, if individuals perceive technology use as interfering in their interactions with their partner, these perceptions may affect their daily assessments of their relationship and mood
Evaluation of Prescribing Patterns of Long-Acting Injectable Antipsychotics Within a Community Health System.
No full textPURPOSE/BACKGROUND: Long-acting injectable antipsychotics (LAIAs) are used in the management of schizophrenia, bipolar disorder, and related psychiatric conditions. The efficacy of LAIAs has been established in randomized controlled trials; however, usage of LAIAs outside of randomized controlled trials may not correlate to naturalistic prescribing habits. The purpose of this analysis was to evaluate the prescribing patterns of LAIAs within our health system and identify any inconsistencies between medications\u27 published labeling information and clinical practice.
METHODS/PROCEDURES: All patients who received a LAIA at the time of the analysis were included for review. Areas of inconsistency between the prescribed LAIA and each medication\u27s published labeling information were targeted and assessed. Frequency statistics were used to review the following areas for inconsistencies: indication, trial of oral therapy, dose, frequency, and titration method.
FINDINGS/RESULTS: This analysis included 427 patient cases who received a combined 1480 injections during the analysis period. Overall consistency rates between labeling information and prescribed LAIAs within the analysis period were as follows: 71.2% for indication, 67.4% for trial of oral therapy, 94.4% for dose of LAIA, 84.5% for injection frequency, and 93.9% for titration method.
IMPLICATIONS/CONCLUSIONS: Inconsistencies were observed between labeling information and clinical practice for LAIAs prescribed within the community health system. Patients who are more symptomatic and have additional psychological comorbidities are commonly excluded from clinical trials. Alternative dosing may be clinically necessary to obtain an adequate response, and this may have been captured in this review. This analysis may be hypothesis generating for future studies on LAIAs
Impact of atypical antipsychotics on sedation requirements in mechanically ventilated, critically ill patients
No full text2019 ASHP Midyear Clinical Meeting / Las Vegas, Nevada
Objective: To determine if atypical antipsychotics lower continuous infusion sedation requirements while also assessing ris