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Selection biases in technology-based intervention research: patients\u27 technology use relates to both demographic and health-related inequities.
Get PDFOBJECTIVE: Researchers conduct studies with selection biases, which may limit generalizability and outcomes of intervention research. In this methodological reflection, we examined demographic and health characteristics of implantable cardioverter defibrillator patients who were excluded from an informatics intervention due to lack of access to a computer and/or the internet.
MATERIALS AND METHODS: Using information gathered from surveys and electronic health records, we compared the intervention group to excluded patients on demographic factors, computer skills, patient activation, and medical history.
RESULTS: Excluded patients were older, less educated, less engaged and activated in their health, and had worse health (ie, more medical comorbidities) than nonexcluded patients.
DISCUSSION: Although excluded from the intervention based solely on lack of access to a computer and/or internet, excluded patients may have needed the intervention more because they were sicker with more comorbidities.
CONCLUSION: Researchers must be mindful of enrollment biases and demographic and health-related inequities that may exist during recruitment for technology-based interventions
Online sexual harassment over anonymous social media in Bangladesh
No full textICTD \u2719: Proceedings of the Tenth International Conference on Information and Communication Technologies and Development.
Prior research on anonymous social media (ASM) has studied the issue of sexual harassment and has revealed its connections to stereotyping, aggression, interpersonal relationships, and mental health among others [16, 24, 60]. However, the characteristics of such harassment in the context of low and middle-income countries (LMICs) in the global south has not received enough attention in the literature. This paper presents our findings on the use of ASM in Bangladesh based on an anonymous online survey of (n= 291) participants and semi-structured interviews with (n= 27) participants. Our study shows a wide prevalence of sexual harassment on anonymous social networks in Bangladesh, the relationship between a closely-knitted communal culture and anonymous harassment, and the lack of infrastructural support for the victims. We also propose a set of design and policy recommendations for such anonymous social media to extend the current ICTD literature on ensuring a safer online environment for women, especially in an LMIC
Sirenomelia and maternal chlamydia trachomatis infection: a case report and review.
No full textBackground: Sirenomelia is a lethal congenital anomaly, presenting with fusion of lower extremities and malformed perineum. The pathogenesis is unclear, and defective blastogenesis is the proposed mechanism. Chlamydia trachomatis (CT) is an obligate intracellular pathogen which reportedly invades placenta and may result in fetal demise. It has documented cytopathogenic effects, specifically, cellular disruption, tissue dysgenesis, and genomic instability.
Case report: An infant with sirenomelia was born as a product of 30 weeks of pregnancy, which was normal except for a persistent maternal CT infection. The infant expired shortly after birth.
Conclusion: Fetal invasion by CT, conceivably, may induce structural anomalies, such as sirenomelia by virtue of its cytopathic effects. We intend to draw attention to such a possibility by reporting this case. This association, however, is speculative and more cases of sirenomelia with CT positive mothers need to be described in order to make definite conclusions about such a relationship
Implementation of a pharmacist-guided procalcitonin protocol in a community hospital
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Impact of clinical guideline implementation of adult ketamine dosing in the emergency department
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Implementation of a pilot program for medication-assisted treatment in the emergency department
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Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers: A Positive Deviance Approach.
No full textBackground: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These positive deviant practices translate into organizational policies to improve health care access and patient experience.
Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families.
Participants: Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States.
Methods: Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software.
Results: Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient-provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates.
Conclusion: We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access
Utilizing Pharmaceutical Precision: The journey from informative guessing to informative decision-making
No full textThe choice of medication for psychiatric conditions has historically been based uopon the clinician\u27s experience and intuitive judgment. Parkview Physicians Group - Mind-Body Medicine has created a psychopharmacological algorithm that allows for a systematic diagnostic assessment used by Mind-Body Medicine and review the rationale and treatment success of generic testing for individuals with such conditions as depression, bipolar disorder, anxiety conditions and attention deficit disorder
