Women's voice: The case of nursing information systems

This paper looks at the cultural transformation of nursing. It argues that introducing computers in a female occupation is not simply a case of imposing male technology on female care-oriented practices and values. In order to understand current changes of nursing practice, three points of view have to be simultaneously kept in focus: 1) the differences between women's interests and ambitions; 2) the readings of a technology that have already been established through previous examples of design and use (in hospitals up to date primarily for the purpose of establishing discipline and management control); and 3) the social practices that dominate a field of work (in the case of health work the already technology-driven cure aspect).     

A GIS-based urban simulation model for environmental health analysis

This paper introduces an urban simulation model for environmental health analysis (SIENA). SIENA is a novel tool to explore urban interactions and processes with regard to exposure assessments. It is based on urban structures and relationships observed in real-world cities making it a realistic representation of a functioning city. The development of SIENA involved identifying and quantifying fundamental processes and similarities in urban areas in Great Britain and using those to guide the building of SIENA within a GIS. An internal validation confirmed SIENA's realism. Its generality, achieved through the pooling of information from different real-world cities, makes it particularly useful for developing and testing spatial epidemiological concepts and models; simulating processes and interactions relating to environmental exposure; and exploring theoretical and methodological problems in the spatial analysis of environmental health. SIENA ultimately provides a much needed tool in the form of a controlled, simplified urban simulation model.     

Online clinical decision support system using optimal deep neural networks

The Internet of Health things (IoHT) has numerous applications in healthcare by integrating health monitoring things like sensors and medical devices for remotely observe patient’s records to provide smarter and intelligent medicare services. To avail best healthcare services to the users using the e-health applications, in this paper, we propose an IoT with cloud based clinical decision support system for the prediction and observance of Chronic Kidney Disease (CKD) with its level of severity. The proposed framework collects the patient data using the IoT devices attached to the user which will be stored in the cloud along with the related medical records from the UCI repository. Furthermore, we employ a Deep Neural Network (DNN) classifier for the prediction of CKD and its level of severity. A Particle Swarm Optimization (PSO) based feature selection method is also used to improve the performance of DNN classifier. The proposed model is validated by employing the benchmark CKD dataset. Different classifiers are employed to compare the performance of the proposed model under several classification measures. The proposed DNN classifier alone predicts CKD with an accuracy of 98.25% and is further enhanced to 99.25 by PSO-FS method. At the same time, the improved classification performance is verified with higher values of 98.03 specificity, 99.25 accuracy, 99.39 F-score and 98.40 kappa value respectively.     

A Qualitative Design Approach for Exploring the Use of Medication and Health Care Devices among Elderly Persons

An academia–industry collaborative research project regarding design for elderly persons was initiated to investigate their living needs and potential design opportunities for new technologies and products. In the first year, a qualitative design approach for exploring their use of medication and health care devices was proposed. First, a user study was conducted using self‐reporting, observation, and interview methods. Four personas representing different lifestyle patterns of elderly persons were then derived from the user study data. Finally, four designers were invited to present and synthesize their design ideas for those personas. Results showed that the user study could reveal considerable information and that the persona method was effective for designers to communicate their ideas and concentrate on user requirements. The study findings suggested that, for design for elderly persons, social and affective factors can be considered with decline in age‐related abilities. © 2012 Wiley Periodicals, Inc.     

An approach for sub-ontology evolution in a distributed health care enterprise

In response to the changing nature of health issues, standardized health ontologies such as SNOMED CT and UMLS incline to change more frequently than most other domain ontologies. Yet, semantic interoperability shared among institutions within a distributed health care enterprise relies heavily on the availability of a valid and up-to-date standardized ontology. In this paper, we propose the creation and preservation of sub-ontologies to deal with the frequent changes in health ontologies. Our approach focuses on the nature and characteristics of standard health ontologies, however it can also be applied to other domain ontologies with similar characteristics. Our sub-ontology evolution approach defines ways to create valid sub-ontologies for each specific health application, and to effectively develop a series of propagation mechanism when the main ontology changes. Our approach will (i) isolate the required change propagation to the relevant health applications that utilized the changing concepts only, and (ii) optimize the propagation mechanism to include the minimum number of operations only. Since a sub-ontology should be a valid ontology by itself, the change propagation approach used in this process should contain the rules to assure the validity of the produced sub-ontology while keeping the consistency of the sub-ontology to the evolved base ontology. A change identification process, which considers the nature of the health ontology change logs, is conducted to identify the semantics of the changes. From the evaluation, it is shown that the content of the evolved sub-ontologies produced using our approach is consistent to the evolved base ontology. Moreover, the propagation process can be performed more efficiently because the number of operations required for our change propagation method is lower than the number of operations required for direct re-extraction from the evolved base ontology.     

Health literacy and the internet: An exploratory study on the 2013 HINTS survey

Health literacy rates among American and European adults remain low, with almost half of adults having only basic levels in 2012. In this digital era, the Internet has been recognized as an important medium for improving health literacy. However, little is known about the mechanisms that underlie its impact on health literacy. With a general basis in the Cognitive Mediation Model, this study empirically tested a model that included motivation for health-related Internet use, health-related Internet use, perceived health information overload, and health literacy. Structural equation modeling was used to analyze the US-based Health Information National Trends Survey (HINTS) 2013 dataset. The results support for all the paths in our posited model. The effects of motivation for health-related Internet use on health literacy were completely mediated by health-related Internet use and perceived health information overload. The findings extend the Cognitive Mediation Model to the context of health literacy and provide significant implications for the design and dissemination of online health information. Recommendations are made for future research, including further validation of the five-item scale of health literacy.     

Evaluating the impact of a cloud-based serious game on obese people

This paper describes the process of monitoring obese people through a cloud-based serious game that promotes them to engage in physical exercises in a playful manner. The monitoring process focuses on obtaining various health and exercise-related parameters of obese during game-play, such as heart rate, weight, step count and calorie burn, which contributes to their weight loss. While the obese are engaged in the game session, therapists/caregivers can access their health data anytime, anywhere and from any device to change the game complexity level and accordingly provide on the spot recommendation. In our study, we evaluate how the different physical activities performed through this game impact their cognitive behavior in terms of attention, relevance, confidence and satisfaction. The evaluation was based on the participation of 150 undergraduate obese and overweight students who were asked to play the game and fill a questionnaire after game-play. The data analysis conducted on their feedback showed that they were self-aware and motivated to play the game for weight loss.     

Peer Review: An Overview.

In the context of professional psychology, peer review refers to an organized system of assessing quality of services and requires analysis and judgment of professional practice by other practitioners within the profession. This special issue on peer review and quality assurance represents a report on the status of developments in quality assurance within the mental health professions and emphasizes the major role of groups within the American Psychological Association (APA). The first set of articles discusses general issues in quality assessment. The next set of articles is specifically relevant to the progress and development of the Defense Department's Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) Project. The third section comprises a series of articles that describe the application of quality assurance methodology to a variety of service delivery settings. Other approaches to quality assessment and quality assurance are described in the final section. The editors hope that the articles in this special issue can assist the profession in achieving greater and more consistent effectiveness with the public it serves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Roles for knowledge-based computer systems: Case studies in maternity care

The design of medical knowledge-based computer systems requires effective interdisciplinary communication for the development of a community sharing common goals and a common language for design. Over the past 9 years the Perinatal Research Group, an interdisciplinary team of computer scientists, engineers and clinicians, have developed a prototype knowledge-based computer system to aid clinicians in the care of women in labour. The group were uncertain which approach to adopt to progress this system from a prototype to a useful clinical tool to support decision making. A case study and activity theory analysis, of an existing clinical knowledge-based computer system in routine use, helped to resolve a number of communication and methodological issues that the design team encountered. Sharing of backgrounds and perspectives caused the design team to question previous assumptions and to explore alternative functions and roles for knowledge-based computer systems in maternity care. We are now undertaking a longitudinal case study and activity theory analysis of obstetric teams and women in labour to analyse the relationships between clinicians, patients and technology. This work will inform the development of our knowledge-based computer system to place the patient at the centre of the decision-making process.