1,721,081 research outputs found
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Primary Care Providers' Perspective on the Inclusion of Behavioral Risk Measures in the Electronic Health Record for Patient Engagement of Individuals with Multiple Chronic Conditions
No full textThesis (Master's)--University of Washington, 2013The Society of Behavioral Medicine issued a policy statement supporting inclusion of a "core set of behavioral and psychosocial measures in EHRs" in 2011. The core set of 17 screening measures cover nine domains: anxiety and depression, eating patterns, physical activity, quality of life, risky drinking, sleep quality, stress, substance use, and tobacco use. Addressing modifiable risk behaviors may facilitate positive health outcomes for individuals with multimorbidities; and, since care coordination for most patients with multimorbidities as well as assessment and counseling for modifiable risk behaviors occur in the primary care setting, primary care appears to be the most appropriate location to collect and use risk behavior information. However, primary care settings are currently under-resourced and lack sufficient time for additional initiatives. The aim of this study is to illuminate, through qualitative research methods, primary care providers' perspective to the Society of Behavioral Medicine's recommendation of including risk behaviors into the electronic health record (EHR). A secondary aim was to learn how information about these risk behaviors within an EHR might effectively be utilized within a primary care setting. Primary care providers acknowledge the importance of risk behaviors in general, and support many of the specific questions that is recommended though they counsel against mandating the inclusion of these risk behaviors into the EHR at this time based on five themes that emerged from this analysis: constriction on providers' time, importance of risk behavior information, balancing disease management with the patient's illness narrative, technology's contribution to care, and regulatory perspective
Design and Evaluation of Health Visualizations for Older Adults
No full textThesis (Ph.D.)--University of Washington, 2014Older adults, those 60 years and above, represent the quickest growing demographic group in the United States. Additionally, health related changes associated with aging make this population one of the primary consumers of health care resources. Innovative informatics solutions can assist older adults in maintaining health and independence. One such approach is through smart home technologies, residences with technology embedded within the infrastructure of the home to unobtrusively monitor and assist older adults with activities of daily living. To present data collected from home based monitoring including smart homes, and other informatics tools such as telehealth in a meaningful manner, I describe work in the development of health visualizations for older adults. Though a body of work has shown that older adults find utility in technology to support their health and wellness, there has been limited research examining how this would translate to data visualizations. I start by looking at potential differences in how older adults process graphical information compared to the general population through a set psychophysics experiments. I then apply a user-centered design approach to iterate on health visualizations from early mockups to fully interactive prototypes. I describe different approaches for evaluating visualizations with older adults, and report on the findings of the evaluations. Finally, I thematically analyze the evaluation sessions to extract themes associated with how older adults utilize health visualizations. Based on these themes, I provide a set of recommendations to assist other researchers and designers in this domain as they develop older adult focused visualizations. This work represents an end-to-end process from initially identifying older adult visualization needs through to the design and evaluation of interactive visualizations. The three primary contributions in this research are: 1) comparing graphical perceptual needs of older adults with that of the general population, 2) comparing different approaches towards evaluating health visualizations, and 3) providing a set of guidelines to inform the design of health visualizations for older adults
In-home Use of Home-based Sensor Technology for Monitoring Mobility in Community-Dwelling Korean American Older Adults
Full text linkThesis (Ph.D.)--University of Washington, 2014The growing population of older adults faces many health challenges, including mobility limitation. Mobility limitation leads to reduced participation in physical and social activities and threatens quality of life and well-being. However, the current understanding of mobility and the ability to assess mobility limitation in older adults are often restricted to a limited set of variables measured sporadically. An alternative approach is to bring monitoring through sensor-based technology into the home setting. This monitoring could be performed continuously with less intrusion on the daily lives of residents and reduced reliance on self-reporting and memory recall of past events. Recent developments in sensor technologies have shown that they could provide the key to early detection of mobility limitation and prompt intervention to prevent adverse health events due to mobility limitation. Despite demonstrated successes of sensor technologies, no attempts have been made to explore mobility and activity patterns of Asian American older adults. Also, there still remains a challenge in increasing acceptance and usage of these technologies among older adults, particularly in those from racial and ethnic minority groups, or who have lower income or poor literacy. The dissertation includes three papers that covered two areas, 1) mobility limitation in community-dwelling older adults and 2) home-based sensor technologies for continuously monitoring older adults' mobility and activity levels. The first paper is a systematic review of instruments to measure mobility limitation among community-dwelling older adults. A search of PubMed, CINAHL, and psycINFO databases identified studies that were published from 1990 to 2012 and included the topics of definitions of mobility limitation, empirical constructs of elderly mobility and types of mobility measurement tools (either self-report or performance-based). A total of 103 articles were included in this systematic review. The review provides a broader overview of what types of mobility measures are commonly used and included a thought discussion of the inconsistencies in mobility measurement, which limit the comparison across studies. The second paper seeks to understand perceptions of home-based monitoring technologies in the context of culture among older Korean immigrants and older adults living in Korea. This study is a qualitative analysis of three focus groups and four individual interviews (N = 21) and focuses on cross-national differences in perceptions and intention to use of home-based monitoring technologies among the Korean ethnic group. We identified several cultural and contextual factors affected the acceptability of home-based monitoring technologies among participants, such as weakened filial tradition, immigration, cultural norms around the living situation of an older adult, health insurance system, and national policy initiatives for technology adoption for older adults. Results of the study indicates the need for considering cultural differences to better understand the complexity embedded in the construction of perceptions of and preferences for home-based monitoring technologies among older adults from various ethnic groups. The third paper is a feasibility study to test an integrated home-based monitoring system that utilizes innovative sensor technologies to assess aspects of Korean American older adults' daily activities with an emphasis on mobility. An exploratory multiple case-study methodology was used. The sensor system was deployed in four homes of Korean American older adults (N = 6). Study procedures included 1) data collection from the sensors, 2) administration of self-report instruments to measure mobility and health, and 3) individual interviews at midpoint and study completion. Sequence plots for every area of the home show variable natural fluctuation in activity trends. Most participants did not have any decrease or increase, but one participant's overall activity in each area was increased after her granddaughter's visit. Participants had different 24-hour occupancy patterns in the bathroom, bedroom, kitchen, and living room. Interview data indicated that the home-based sensor system was acceptable for all participants. However, some participants reported privacy concerns related to a motion sensor in the bathroom at an initial stage. Results from these papers suggest that sensor technologies could lead to understanding of aging, allowing for identification of patterns in elder mobility. Despite some challenges related to sensor deployment and data analysis, continuous sensor-based monitoring of activity patterns in the home will provide a useful tool to detect deviations from normal activity and mobility patterns that could be an early sign of functional decline. Finally, findings from the dissertation indicate that technology applications could be successfully performed in the minority population of older adults. Future efforts are necessary to develop linguistically and culturally appropriate technology-based interventions to prevent functional limitation and enhance healthy aging among older adults from racial and ethnic minority groups
Examining the Feasibility and Acceptability of a Fall Detection Device
Full text linkThesis (Ph.D.)--University of Washington, 2015Falls are an incredibly complex problem in people over the age of 65 with a third of older adults falling at least once each year. This problem is ever increasing as the population of older adults continues to grow rapidly. Falls are dangerous in that they have the ability to damage the individual during the fall and also may leave them unable to get up from a fall independently. This "long lie" has been shown to be almost as damaging as the fall itself and has the ability to affect not only the fallen individual's physical health but also their mental health. Current technology designed to detect these falls are often inappropriately designed for the older adult population and thus go unused or improperly used. This dissertation includes 3 studies that cover various aspects of older adults' use of fall detection technology. The first study is a systematic review which assesses the current state of design and implementation of fall detection devices. A search of PubMed, CINAHL, and PsycINFO databases identified studies published up to 2013 involving a system with the purpose of detecting a fall in adults. A total of 125 articles were included in this systematic review providing a broad overview of the types of fall detection devices being researched and to what extent these devices have been tested in the real world with older adults The second study seeks to more clearly understand older adults' perceptions of fall detection technology. This study is a qualitative analysis of 5 focus groups (n = 27) which centers on the opinions of older adults regarding fall detection devices. We identified 2 main themes of interest: 1) personal influences on the participants' desire to have a fall detection device and 2) participant recommendations regarding specific features and functionalities of these devices. Together, these themes suggest ways in which fall detection devices may be improved so that they are suitable for their intended population. The third study is a feasibility study investigating the usability of a fall detection device that employs innovative GPS and automatic detection technologies. This device was deployed to older adults (n=18) to use on their own for a period of up to 4 months. Study procedures included 1) data collection from the device, 2) phone calls to or from participants at specific times during the study, and 3) individual interviews at baseline, midpoint and study completion. Eight participants completed the full trial while the other 10 left the study early. Over the course of the study participants experienced 84 false alarms and only 1 alarm that accurately identified a fall. This discrepancy suggests poor accuracy, sensitivity and specificity results from the device. Participant adherence was also measured as well as the participants' opinions on the device. In general, most participants had some complaints about the device while also suggesting some additional feature they thought was useful. This feedback points to a need for device customization based on the user as well as overall improvement in various aspects of the device. Results from these three studies help to better understand the current research being conducted on these devices as well as the overall thoughts and usability concerns of older adults towards these devices. There are many challenges associated with these devices including usability issues, the lack of real world testing, and the lack of perceived need from older adults. It appears that fall detection technology needs to be improved greatly before achieving acceptance in the older adult community. Improvements could include less obtrusive technology, more accurate technology, technology developed to prevent a person from falling and a cultural change affecting how older adults perceive these devices
Using personal health records to promote patient activation in the homebound older adult population
No full textThesis (Ph.D.)--University of Washington, 2017-12Patient activation, or an individual’s willingness and ability to take actions to maintain their health and wellness, is a primary component of the patient-centered health system. Activated patients are more likely to report positive experiences with their medical providers, have better health outcomes, and spend less on healthcare services. Homebound older adults face more barriers to patient activation than their non-homebound peers. Because people who are homebound are unable to leave their homes without significant assistance, regularly accessing clinic-based medical services is difficult. In addition, as a population, homebound older adults have more chronic diseases, physical and cognitive impairments, and challenges with activities of daily living than non-homebound older adults. The number of older adults who are homebound is on the rise, and they are a growing proportion of the older adult patient population. Therefore, more research is needed to understand how consumer health information tools can be used with this population to support activation and improve health outcomes. This dissertation explores the usability, feasibility, and preliminary effectiveness of personal health records with the homebound older adult patient population. In a series of studies, I outline the benefits of using personal health records with this population, assess how current personal health records meet the needs of homebound older adult users, and describe considerations for health systems and researchers who are interested in exploring personal health records for the homebound older adult population. This work furthers our understanding of the application of personal health records in homebound older adult patient populations. In addition, I provide design recommendations on how future systems can better meet needs of homebound older adult users. Finally, I offer suggestions to help future researchers maximize the effectiveness of homebound older adult personal health record evaluations
Pain Management Concerns from the Family Caregivers’ Perspective: An Exploratory Study and Utility Test of an Educational Tool to Support Pain Management
Full text linkThesis (Ph.D.)--University of Washington, 2017-06Approximately 1.6 to 1.7 million Americans received hospice care in 2014 and about 60% of them received care at their place of residence. Family caregivers play a pivotal role in supporting patient care and symptom management in home hospice care. More than 50% of the patients with terminal illness experience pain and pain is highly undertreated in the end-of-life stage. Pain management has been identified as one of the most challenging tasks for family caregivers and this burden often has a negative impact on family caregivers’ well-being and quality of life. There are limited studies focused on exploring family caregivers’ concerns regarding pain management in home hospice care and on designing supportive interventions for family caregivers. My dissertation aimed to identify the challenges related to pain management faced by family caregivers in home hospice care and develop an educational tool for healthcare clinicians to support caregivers’ pain management. This work is organized in three papers. In the first paper, I conducted a systematic review to understand family caregivers’ pain management in end-of-life care based on a search of CINAHL, Embase, PubMed, and Cochrane Library electronic databases. Fourteen research papers focused on family caregivers’ pain management experience and strategies in end-of-life care were included. Nine were observational studies, three were case studies, and two were experimental studies. This review identified themes similar to previous studies on family caregivers of patients with cancer or in palliative care: inadequate knowledge and assessment skills in pain management, misunderstanding of pain medications, and poor communication with the care team. However, the level of scientific evidence is low and the quantity is scarce. More research is needed to explore family caregivers’ pain management in end-of-life care and to design interventions to support family caregivers in pain management. The first paper has been published in the American Journal of Hospice and Palliative Medicine. In the second paper, I conducted a secondary data analysis of hospice family caregivers’ interviews from a recently completed five-year NIH/NINR R01 (Grant Nr. R01NR012213; PI: Demiris) randomized clinical trial to identify family caregivers’ concerns in pain management. The analysis was a theory-driven, deductive content analysis based on an existing hospice pain management framework called “Informal hospice caregiver pain management concerns”. The analysis identified most of the themes in the framework and confirmed that family caregivers faced a variety of challenges when managing patients’ pain: caregiver-centric issues, caregiver’s medication skills and knowledge, communication and teamwork, organizational skill, and patient-centric issues. In the third paper, I designed an educational tool and conducted an evaluation study to test the utility of the tool. The pain management educational tool consists of five modules and some pain management strategies and assessment scales. Each module includes a clinical scenario of caregivers’ challenges in pain management (based on the findings in the second paper) and guidelines (based on the Assessing Caregivers for Team Interventions model) for hospice providers to support family caregivers. The educational tool was vetted through five experts in cancer pain management and caregiving research. Fifteen hospice providers including physicians, nurses, pharmacists, social workers, and chaplains from several hospice agencies in the Seattle were interviewed to solicit their feedback on the utility of the educational tool. The interview data were transcribed verbatim and analyzed using thematic analysis. The hospice providers commented the utility of the tool and suggested improvements of the tool. They commented that the scenarios were realistic and the suggested guidelines were effective. They believed it could be a great reference for hospice providers to use in their clinical practice and a resource for providers’ continuing education. They suggested adding additional pain education content and some common pain management challenges into the tool to enhance the utility. They advised creating more than one platform for the tool such as a printed booklet, website, video, or mobile application in order to accommodate different user needs and experiences. The study showed that the educational tool holds promise to be effective and practical in the context of hospice care. The tool also has potential to improve communication in pain management and be integrated into hospice providers’ routine care
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