Attitudes and beliefs among anesthesia provides regarding smartphone use for intraoperative anesthetic management

Background: Smartphone technology has evolved at the same accelerated pace as healthcare technological innovation. The literature shows that healthcare providers already utilize Smartphone technology to bridge gaps in knowledge and provide quality care to patients. Critics of these advancements are leery about Smartphone use in the operating room (OR) because it may be a source of distraction for anesthesia providers; however, supporters argue that their use is also recognized as a potential aid in learning. Objectives: This study was conducted to assess workplace attitudes and beliefs regarding the use of Smartphones in the operating room in order to establish policies that promote patient safety in conjunction with accessibility to valuable technology. Method: An investigator-developed questionnaire on Smartphone uses in the OR was sent to the anesthesiology staff of a large, academic medical center in Illinois. The study enrolled 28 participants who are anesthesiologist physicians, CRNAs and SRNAs. Results: The findings revealed that over 95% of study participants believe that Smartphones in the OR are very useful for accessing medical information during anesthesia care. The majority of participants (92.9%) indicated that they never use Smartphones during critical times of anesthesia and 57.1% of participants do not believe that Smartphone use should be restricted in the OR. Fisher exact tests revealed that there was no statistically significant association between the participants’ beliefs and attitudes on intraoperative Smartphone use and the participants’ sociodemographic variables such as age (40 years and younger versus 41 years and older), years of experience (1 to 10 years versus 11 years and greater), or provider type (physician anesthesiologist versus nurse anesthetist). A large discrepancy was noted between the Employee Handbook policy on Smartphone use and the beliefs, attitudes, and actions of anesthesia providers. Conclusion: There is a need for a policy review on Smartphone use in the OR in order to correct inconsistencies, remove obsolete rules, update outdated policies, and build consensus on ways in which anesthesia providers may use Smartphones effectively and safely in the OR. Keywords: Smartphones, Anesthesia, Medical Apps, Patient Safety, Hospital Polic

A Phenomenological Study of Teachers\u27 Lived Experiences with Cell Phones in the Classroom

The purpose of this phenomenological study was to discover high school teachers\u27 experiences with cell phones in the classrooms during instructional time at Quaker High School. The theory guiding this study is Jean Piaget\u27s constructivism theory, as it argues that knowledge is produced, and meaning is formed through the experiences of one\u27s physical or mental actions in their environment. The methodology for this dissertation includes a study design that utilizes a phenomenological study method and consists of thirteen teachers from various backgrounds and locations. The setting for the study is a high school in Pittsburgh, PA. The data collection and analysis approach includes semi-structured interviews, focus group interviews, and document analysis. The data were analyzed using coding methods consisting of initial coding and NVivo coding practices. The data were searched for patterns, insights, or concepts. The approaches high school teachers use for instructing students with cell phones during teaching periods were the focus of this dissertation. Notably, the findings illuminate how cell phone usage in classrooms impacts the scope of teachers\u27 autonomy in regulating such use and how it changes instructional methods. The research contributes to understanding how high school teachers navigate the challenges and opportunities presented by cell phones during instructional time

Tripod of Requirements in Horizontal Heterogeneous Mobile Cloud Computing

Recent trend of mobile computing is emerging toward executing resource-intensive applications in mobile devices regardless of underlying resource restrictions (e.g. limited processor and energy) that necessitate imminent technologies. Prosperity of cloud computing in stationary computers breeds Mobile Cloud Computing (MCC) technology that aims to augment computing and storage capabilities of mobile devices besides conserving energy. However, MCC is more heterogeneous and unreliable (due to wireless connectivity) compare to cloud computing. Problems like variations in OS, data fragmentation, and security and privacy discourage and decelerate implementation and pervasiveness of MCC. In this paper, we describe MCC as a horizontal heterogeneous ecosystem and identify thirteen critical metrics and approaches that influence on mobile-cloud solutions and success of MCC. We divide them into three major classes, namely ubiquity, trust, and energy efficiency and devise a tripod of requirements in MCC. Our proposed tripod shows that success of MCC is achievable by reducing mobility challenges (e.g. seamless connectivity, fragmentation), increasing trust, and enhancing energy efficiency

Autonomous interactive intermediaries : social intelligence for mobile communication agents

Thesis (Ph. D.)--Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, 2005.Includes bibliographical references (p. 151-167).Today's cellphones are passive communication portals. They are neither aware of our conversational settings, nor of the relationship between caller and callee, and often interrupt us at inappropriate times. This thesis is about adding elements of human style social intelligence to our mobile communication devices in order to make them more socially acceptable to both user and local others. I suggest the concept of an Autonomous Interactive Intermediary that assumes the role of an actively mediating party between caller, callee, and co-located people. In order to behave in a socially appropriate way, the Intermediary interrupts with non-verbal cues and attempts to harvest 'residual social intelligence' from the calling party, the called person, the people close by, and its current location. For example, the Intermediary obtains the user's conversational status from a decentralized network of autonomous body-worn sensor nodes. These nodes detect conversational groupings in real time, and provide the Intermediary with the user's conversation size and talk-to-listen ratio. The Intermediary can 'poll' all participants of a face-to-face conversation about the appropriateness of a possible interruption by slightly vibrating their wirelessly actuated finger rings.(cont.) Although the alerted people do not know if it is their own cellphone that is about to interrupt, each of them can veto the interruption anonymously by touching his/her ring. If no one vetoes, the Intermediary may interrupt. A user study showed significantly more vetoes during a collaborative group-focused setting than during a less group oriented setting. The Intermediary is implemented as a both a conversational agent and an animatronic device. The animatronics is a small wireless robotic stuffed animal in the form of a squirrel, bunny, or parrot. The purpose of the embodiment is to employ intuitive non-verbal cues such as gaze and gestures to attract attention, instead of ringing or vibration. Evidence suggests that such subtle yet public alerting by animatronics evokes significantly different reactions than ordinary telephones and are seen as less invasive by others present when we receive phone calls. The Intermediary is also a dual conversational agent that can whisper and listen to the user, and converse with a caller, mediating between them in real time.(cont.) The Intermediary modifies its conversational script depending on caller identity, caller and user choices, and the conversational status of the user. It interrupts and communicates with the user when it is socially appropriate, and may break down a synchronous phone call into chunks of voice instant messages.by Stefan Johannes Walter Marti.Ph.D

Modeling Cost of Interruption (COI) to Manage Unwanted Interruptions for Mobile Devices

Unwanted and untimely interruptions have been a major cause in the loss of productivity in recent years. It has been found that they are mostly detrimental to the immediate task at hand. Multiple approaches have been proposed to address the problem of interruption by calculating cost of it. The Cost Of Interruption (COI) gives a measure of the probabilistic value of harmfulness of an inopportune interruption. Bayesian Inference stands as the premier model so far to calculate this COI. However, Bayesian-based models suffer from not being able to model context accurately in situations where a priori, conditional probabilities and uncertainties exist while utilizing context information. Hence, this thesis introduces the Dempster-Shafer Theory of Evidence to model COI. Along the way, it identifies specific contexts that are necessary to take into account. Simulation results and performance evaluation suggest that this is a very good approach to decision making. The thesis also discusses an illustrative example of a mobile interruption management application where the Dempster-Shafer theory is used to get a better measurement of whether or not to interrupt

Mitigations to Reduce the Law of Unintended Consequences for Autonomy and Other Technological Advances

The United Nations states that Earths population is expected to reach just under 10 billion people (9.7) by the year 2050. To meet the demands of 10 billion people, governments, multinational corporations and global leaders are relying on autonomy and technological advances to augment and/or accommodate human efforts to meet the required needs of daily living. Genetically modified organisms (GMOs), Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) gene-edited plants and cloning will be utilized to expand human food supply. Biomimetic implants are expected to improve life expectancy with 3D printed body parts. Human functioning will be extended with wearables and cybernetic implants continuing humanitys path toward transhumanism. Families will be strengthened with 3 parent households. Disease will surely be eradicated using the CRISPR-CAS9 genetic engineering revolution to design out undesirable human traits and to design in new capabilities. With autonomous cars, trucks and buses on our roads and on-demand autonomous aircraft delivering pizzas, medical prescriptions and groceries in the air and multi-planet vehicles traversing space, utopia will finally arrive! Or will it? All of these powerful, man-made, technological systems will experience unintended consequences with certainty. Instead of over-reacting with hysteria and fear, we should be seeking answers to the following questions - What skills are required to architect socially-healthy technological systems for 2050? What mindsets should we embody to ameliorate hubris syndrome and to build our future technological systems with deliberation, soberness and social responsibility

Bring Your Own Mobile Device (BYOD) to the Hospital: Layered Boundary Barriers and Divergent Boundary Management Strategies

This study examined how one US hospital implemented a mobile communication app to improve workplace communication. The hospital did not provide the technology, instead they asked their workers to use their own personal mobiles at work, through a permissive bring your own device to work (BYOD) policy. Using boundary theory, we conducted a constant-comparative analysis to examine the layers of boundary management issues. At the organizational level, the key issues were policy legacy, communicating the policy, control, dead zones, and mobile costs. At the group level, different hospital units created their own formal and informal policies. At the individual level, themes included personal mobile device use, job role expectations, and decision-making autonomy. The discussion presents examples of how healthcare workers enacted segregator and integrator boundaries. Our findings explain why it is not easy to tell hospital employees, “Go ahead and use your mobiles for patient care,” and have them embrace this practice

Design of Integral Reminder for Collaborative Appointment Management

Reminder systems have great potential to enhance healthcare outcome, but there is a big space for improvement to facilitate the collaborative appointment management with accessible mobile communication technology. This study proposes a design of integral reminder systems that automates the process of appointment rescheduling for patients and physicians in addition to confirmation and cancellation. Based on the premises of patient-centered care of media synchronicity theory, design principles are proposed to cater to the different requirements of healthcare providers and patient users on appointment management. The design provides useful guidelines for building integral reminder systems that enhance medical compliance

Role of the Physical Environment on Team-Based Primary Care in the Military Health System

Primary care in the United States has shifted from a physician-centered care approach to a multidisciplinary, team-based care approach. This shift has resulted in many day-to-day changes in the care delivery process including how clinical staff collaborate; interact with patients; and use space, equipment, and various technologies. Team-based approaches, such as the Patient-Centered Medical Home (PCMH) model, are demonstrating improvements in patient health outcomes. The U.S. Military Health System, one of the largest healthcare organizations in the world, has adopted the PCMH model for primary care clinics. To support this new care model, a team-based clinical module is emerging as a spatial concept that colocates the resources staff need for delivering care. Several different design configurations of team-based clinical modules exist in MHS clinics despite the organization’s emphasis on clinic standardization. The purpose of this dissertation is to understand staff perceptions concerning the environmental factors that best support team-based care in the MHS. Using a qualitative approach and a case study research strategy along with ethnographic data collection techniques, this study investigates how six team-based clinical module configurations in three different clinics influence the delivery of team-based care. Data collection included 58 semi-structured interviews with primary care providers, registered nurses, licensed practical nurses, and specialty care providers. Additionally, 11 hours of observations in team rooms provided insight on how the staff use space. Findings were translated into a set of design recommendations for planning team-based clinical modules aimed at improving staff workflow, functionality, and workspaces to facilitate both team collaboration and focused work. This study provides initial evidence that can directly support the MHS in updating design guidance criteria to support team-based primary care