Matching Items (6)
Filtering by
- All Subjects: Medical informatics
- All Subjects: Smartphones
- Genre: Doctoral Dissertation
- Creators: Greenes, Robert
- Creators: Forzani, Erica
- Status: Published
Description
A core principle in multiple national quality improvement strategies is the engagement of chronically ill patients in the creation and execution of their treatment plans. Numerous initiatives are underway to use health information technology (HIT) to support patient engagement however the use of HIT and other factors such as health literacy may be significant barriers to engagement for older adults. This qualitative descriptive study sought to explore the ways that older adults with multi-morbidities engaged with their plan of care. Forty participants were recruited through multiple case sampling from two ambulatory cardiology practices. Participants were English-speaking, without a dementia-related diagnosis, and between the ages of 65 and 86. The older adults in this study performed many behaviors to engage in the plan of care, including acting in ways to support health, managing health-related information, attending routine visits with their doctors, and participating in treatment planning. A subset of patients engaged in active decision-making because of the point they were at in their chronic disease. At that cross roads, they expressed uncertainly over which road to travel. Two factors influenced the engagement of older adults: a relationship with the provider that met the patient's needs, and the distribution of a Meaningful Use clinical summary at the conclusion of the provider visit. Participants described the ways in which the clinical summary helped and hindered their understanding of the care plan.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
ContributorsJiggins Colorafi, Karen (Author) / Lamb, Gerri (Thesis advisor) / Marek, Karen (Committee member) / Greenes, Robert (Committee member) / Evans, Bronwynne (Committee member) / Arizona State University (Publisher)
Created2015
Description
This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in forming the design of the current implementation at the Southern Nevada Health District (SNHD). The result of the system deployment at SNHD was considered as a basis for projecting the practical application and benefits of an enterprise architecture. This approach has resulted in a sustainable platform to enhance the practice of public health by improving the quality and timeliness of data, effectiveness of an investigation, and reporting across the continuum.
ContributorsKriseman, Jeffrey Michael (Author) / Dinu, Valentin (Thesis advisor) / Greenes, Robert (Committee member) / Johnson, William (Committee member) / Arizona State University (Publisher)
Created2012
Description
Text mining of biomedical literature and clinical notes is a very active field of research in biomedical science. Semantic analysis is one of the core modules for different Natural Language Processing (NLP) solutions. Methods for calculating semantic relatedness of two concepts can be very useful in solutions solving different problems such as relationship extraction, ontology creation and question / answering [1–6]. Several techniques exist in calculating semantic relatedness of two concepts. These techniques utilize different knowledge sources and corpora. So far, researchers attempted to find the best hybrid method for each domain by combining semantic relatedness techniques and data sources manually. In this work, attempts were made to eliminate the needs for manually combining semantic relatedness methods targeting any new contexts or resources through proposing an automated method, which attempted to find the best combination of semantic relatedness techniques and resources to achieve the best semantic relatedness score in every context. This may help the research community find the best hybrid method for each context considering the available algorithms and resources.
ContributorsEmadzadeh, Ehsan (Author) / Gonzalez, Graciela (Thesis advisor) / Greenes, Robert (Committee member) / Scotch, Matthew (Committee member) / Arizona State University (Publisher)
Created2016
Description
While various collision warning studies in driving have been conducted, only a handful of studies have investigated the effectiveness of warnings with a distracted driver. Across four experiments, the present study aimed to understand the apparent gap in the literature of distracted drivers and warning effectiveness, specifically by studying various warnings presented to drivers while they were operating a smart phone. Experiment One attempted to understand which smart phone tasks, (text vs image) or (self-paced vs other-paced) are the most distracting to a driver. Experiment Two compared the effectiveness of different smartphone based applications (app’s) for mitigating driver distraction. Experiment Three investigated the effects of informative auditory and tactile warnings which were designed to convey directional information to a distracted driver (moving towards or away). Lastly, Experiment Four extended the research into the area of autonomous driving by investigating the effectiveness of different auditory take-over request signals. Novel to both Experiment Three and Four was that the warnings were delivered from the source of the distraction (i.e., by either the sound triggered at the smart phone location or through a vibration given on the wrist of the hand holding the smart phone). This warning placement was an attempt to break the driver’s attentional focus on their smart phone and understand how to best re-orient the driver in order to improve the driver’s situational awareness (SA). The overall goal was to explore these novel methods of improved SA so drivers may more quickly and appropriately respond to a critical event.
ContributorsMcNabb, Jaimie Christine (Author) / Gray, Dr. Rob (Thesis advisor) / Branaghan, Dr. Russell (Committee member) / Becker, Dr. Vaughn (Committee member) / Arizona State University (Publisher)
Created2017
Description
Abnormally low or high blood iron levels are common health conditions worldwide and can seriously affect an individual’s overall well-being. A low-cost point-of-care technology that measures blood iron markers with a goal of both preventing and treating iron-related disorders represents a significant advancement in medical care delivery systems. Methods: A novel assay equipped with an accurate, storable, and robust dry sensor strip, as well as a smartphone mount and (iPhone) app is used to measure total iron in human serum. The sensor strip has a vertical flow design and is based on an optimized chemical reaction. The reaction strips iron ions from blood-transport proteins, reduces Fe(III) to Fe(II), and chelates Fe(II) with ferene, with the change indicated by a blue color on the strip. The smartphone mount is robust and controls the light source of the color reading App, which is calibrated to obtain output iron concentration results. The real serum samples are then used to assess iron concentrations from the new assay and validated through intra-laboratory and inter-laboratory experiments. The intra-laboratory validation uses an optimized iron detection assay with multi-well plate spectrophotometry. The inter-laboratory validation method is performed in a commercial testing facility (LabCorp). Results: The novel assay with the dry sensor strip and smartphone mount, and App is seen to be sensitive to iron detection with a dynamic range of 50 - 300 µg/dL, sensitivity of 0.00049 µg/dL, coefficient of variation (CV) of 10.5%, and an estimated detection limit of ~15 µg/dL These analytical specifications are useful for predicting iron deficiency and overloads. The optimized reference method has a sensitivity of 0.00093 µg/dL and CV of 2.2%. The correlation of serum iron concentrations (N=20) between the optimized reference method and the novel assay renders a slope of 0.95, and a regression coefficient of 0.98, suggesting that the new assay is accurate. Lastly, a spectrophotometric study of the iron detection reaction kinetics is seen to reveal the reaction order for iron and chelating agent. Conclusion: The new assay is able to provide accurate results in intra- and inter- laboratory validations and has promising features of both mobility and low-cost.
ContributorsSerhan, Michael (Author) / Forzani, Erica (Thesis advisor) / Raupp, Gregory (Committee member) / Acharya, Abhinav (Committee member) / Hu, Tony (Committee member) / Smith, Barbara (Committee member) / Arizona State University (Publisher)
Created2020
Description
Parkinson's disease, the most prevalent movement disorder of the central nervous system, is a chronic condition that affects more than 1000,000 U.S. residents and about 3% of the population over the age of 65. The characteristic symptoms include tremors, bradykinesia, rigidity and impaired postural stability. Current therapy based on augmentation or replacement of dopamine is designed to improve patients' motor performance but often leads to levodopa-induced complications, such as dyskinesia and motor fluctuation. With the disease progress, clinicians must closely monitor patients' progress in order to identify any complications or decline in motor function as soon as possible in PD management. Unfortunately, current clinical assessment for Parkinson's is subjective and mostly influenced by brief observations during patient visits. Thus improvement or decline in patients' motor function in between visits is extremely difficult to assess. This may hamper clinicians while making informed decisions about the course of therapy for Parkinson's patients and could negatively impact clinical care. In this study we explored new approaches for PD assessment that aim to provide home-based PD assessment and monitoring. By extending the disease assessment to home, the healthcare burden on patients and their family can be reduced, and the disease progress can be more closely monitored by physicians. To achieve these aims, two novel approaches have been designed, developed and validated. The first approach is a questionnaire based self-evaluation metric, which estimate the PD severity through using self-evaluation score on pre-designed questions. Based on the results of the first approach, a smart phone based approach was invented. The approach takes advantage of the mobile computing technology and clinical decision support approach to evaluate the motor performance of patient daily activity and provide the longitudinal disease assessment and monitoring. Both approaches have been validated on recruited PD patients at the movement disorder program of Barrow Neurological Clinic (BNC) at St Joseph's Hospital and Medical Center. The results of validation tests showed favorable accuracy on detecting and assessing critical symptoms of PD, and shed light on promising future of implementing mobile platform based PD evaluation and monitoring tools to facilitate PD management.
ContributorsPan, Di (Author) / Petitti, Diana (Thesis advisor) / Greenes, Robert (Committee member) / Johnson, William (Committee member) / Dhall, Rohit (Committee member) / Arizona State University (Publisher)
Created2013