Parkview Health Research Repository
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Tailored, theory-based strategies for engaging low-income populations with a personal health record
Get PDFThere remain significant barriers to the use of personal health records (PHRs), which limit potential benefits in underserved patient populations. Novel strategies must be developed to achieve the desired impact of PHRs on patient engagement and health outcomes. This paper describes the health information needs and technology preferences of adults seeking care in Community Health Centers (CHCs), which provide care to low-income, uninsured and underinsured patients. We offer design suggestions emerging from interviews with 43 CHC patients and 49 CHC staff members that explored many themes including: patient barriers to accessing health care, health information needs of patients between clinic visits, patient and clinic staff preferences for technology use, and PHR implementation approaches used in CHCs. Our findings provide a roadmap to greater engagement of patients via PHRs by expanding functionality, providing tailored patient messaging, and incorporating adult learning strategies
One Hospital\u27s Path to Develop an IVC Filter Registry
Get PDFBackground- Inferior Vena Cava (IVC) filters are small cage like devices placed percutaneously into the inferior vena cava to prevent propagation of thrombus into the pulmonary arteries. Currently there are two available types of filters, permanent filters and retrievable filters. In 2014, the FDA initiated a comprehensive analysis of filter placement and issued a statement recommending implanting physicians and clinicians responsible for the ongoing care of patients with retrievable IVC filters consider removing the filter as soon as protection from pulmonary embolism is no longer needed. Prior to the hospital’s structured system, there was a low rate of follow-up. The hospital had three separate databases involving two different implanting groups. Therefore, Parkview Health felt it was imperative to develop a comprehensive approach to IVC filter placement and follow-up to ensure good patient outcomes and comply with FDA recommendations.
Objective- Develop a single hospital process for following IVC filter patients to ensure proper indication for procedure order, short term, long term follow-up, and outcomes of IVC filters implantation and removal
Multimodal Classification of Moderated Online Pro-Eating Disorder Content
No full textCHI \u2717: Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems
Free Access to Full Text & Video Presentation through Link.
Social media sites are challenged by both the scale and variety of deviant behavior online. While algorithms can detect spam and obscenity, behaviors that break community guidelines on some sites are difficult because they have multimodal subtleties (images and/or text). Identifying these posts is often regulated to a few moderators. In this paper, we develop a deep learning classifier that jointly models textual and visual characteristics of pro-eating disorder content that violates community guidelines. Using a million Tumblr photo posts, our classifier discovers deviant content efficiently while also maintaining high recall (85%). Our approach uses human sensitivity throughout to guide the creation, curation, and understanding of this approach to challenging, deviant content. We discuss how automation might impact community moderation, and the ethical and social obligations of this area
Changing Guidelines for Preoperative Fasting
No full textAsk the Experts - reply by Jan Powers
What are the best practices or current guidelines regarding proper length of time and what patients can eat before being given NPO status
Impact of an aseptic procedure for breaking the integrity of the urinary drainage system on the development of catheter-associated urinary tract infections in the intensive care unit
No full textBACKGROUND:
Catheter associated urinary tract infections (CAUTI) are a common complication in the hospital, especially in intensive care units (ICU). These infections are directly linked to the use of an indwelling urinary catheter. One commonly identified factor related to the development of CAUTI has been thought to be violating the integrity of the closed drainage system. However, a paucity of research exists to support or refute this practice. OBJECTIVE:
The primary purpose of this observational study was to assess if there is a relationship between CAUTI incidence and breaking the closed drainage system using an aseptic procedure. METHOD:
A process improvement effort was developed to ensure an aseptic technique was utilised when there was a need to break the integrity of the urinary drainage system. Because this was a new practice and not supported by the Centres for Disease Control (CDC) recommendations, this change in practice was evaluated as an observational study. RESULTS:
In an eight month period there were 53 documented breaks in the urinary drainage system. There were 28 total cases of CAUTI overall during this same time period. Only four patients with a system break developed a CAUTI (7.5%). In almost 93% of the patients where aseptic technique was used for breaks in the drainage system, there was no occurrence of CAUTI. A follow-up evaluation was performed after a year of this practice in three adult ICUs. During this three month evaluation period, there were 47 documented cases of breaking this system using aseptic technique. Of the patients who had a documented break in their drainage system, none developed subsequent CAUTIs. CONCLUSION:
One commonly identified factor related to the development of CAUTI has been thought to be violating the integrity of the closed drainage system. However, a paucity of research exists to support or refute this practice. This observational study found that utilising an aseptic technique to break the integrity system did not result in an associated increase in CAUTI
#thyghgapp: Instagram Content Moderation and Lexical Variation in Pro-Eating Disorder Communities
Get PDFCSCW \u2716, FEBRUARY 27–MARCH2, 2016, SAN FRANCISCO, CA, USA
In Proceedings of the 19th ACM conference on computer-supported cooperative work & social computing.
Pro-eating disorder (pro-ED) communities on social media encourage the adoption and maintenance of disordered eating habits as acceptable alternative lifestyles rather than threats to health. In particular, the social networking site Instagram has reacted by banning searches on several proED tags and issuing content advisories on others. We present the first large-scale quantitative study investigating pro-ED communities on Instagram in the aftermath of moderation – our dataset contains 2.5M posts between 2011 and 2014. We find that the pro-ED community has adopted nonstandard lexical variations of moderated tags to circumvent these restrictions. In fact, increasingly complex lexical variants have emerged over time. Communities that use lexical variants show increased participation and support of proED (15-30%). Finally, the tags associated with content on these variants express more toxic, self-harm, and vulnerable content. Despite Instagram’s moderation strategies, pro-ED communities are active and thriving. We discuss the effectiveness of content moderation as an intervention for communities of deviant behavior
Exploring Ethics and Obligations for Studying Digital Communities
No full textFree Full text through Link
GROUP \u2716: Proceedings of the 2016 ACM International Conference on Supporting Group Work
Many of the most prominent and unanswered ethical questions within HCI and social computing involve our ethical obligation to the communities that we study. Some of these questions fall under the purview of more traditional human subjects research ethics, but others hinge on when, for example, studies of public data trigger similar obligations. Basic rules to do no harm are complicated in digital communities by issues of consent and privacy, and ethics review boards are struggling to keep up even as research communities are similarly struggling to form appropriate norms. The goals of this workshop are to continue seeding conversations about research ethics within the SIGCHI community, to work towards norm setting, and in the meantime, to collectively help community members make good ethical decisions about research into sociotechnical systems and digital communities
Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning
No full textOBJECTIVE:
To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. METHODS:
Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura\u27s Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. RESULTS:
Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. CONCLUSION:
Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students\u27 skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations
Characterizations of Online Harassment: Comparing Policies Across Social Media Platforms
No full textFree Full text through Link.
Harassment in online spaces is increasingly part of public debate and concern. Pervasive problems like cyberbullying, hate speech, and the glorification of self-harm have highlighted the breadth and depth of harassment taking place online. In this study we conduct a content analysis of the governing policies for fifteen social media platforms as they relate to harassment (of oneself and/or of community members) and other associated behaviors. We find that there is a striking inconsistency in how platform-specific policies depict harassment. Additionally, how these policies prescribe responses to harassment vary from mild censuring to the involvement of law enforcement. Finally, based on our analysis and findings, we discuss the potential for harnessing the power of the online communities to create norms around problematic behaviors
Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: a quasi-experimental study
No full textOBJECTIVES:
To determine the impact of tethered personal health record (PHR) use on patient engagement and intermediate health outcomes among patients with coronary artery disease (CAD). METHODS:
Adult CAD patients (N = 200) were enrolled in this prospective, quasi-experimental observational study. Each patient received a PHR account and training on its use. PHRs were populated with information from patient electronic medical records, hosted by a Health Information Exchange. Intermediate health outcomes including blood pressure, body mass index, and hemoglobin A1c (HbA1c) were evaluated through electronic medical record review or laboratory tests. Trends in patient activation measure® (PAM) were determined through three surveys conducted at baseline, 6 and 12 months. Frequency of PHR use data was collected and used to classify participants into groups for analysis: Low, Active, and Super users. RESULTS:
There was no statistically significant improvement in patient engagement as measured by PAM scores during the study period. HbA1c levels improved significantly in the Active and Super user groups at 6 months; however, no other health outcome measures improved significantly. Higher PAM scores were associated with lower body mass index and lower HbA1c, but there was no association between changes in PAM scores and changes in health outcomes. Use of the PHR health diary increased significantly following PHR education offered at the 6-month study visit and an elective group refresher course. CONCLUSIONS:
The study findings show that PHR use had minimal impact on intermediate health outcomes and no significant impact on patient engagement among CAD patients