Geisinger Health System: Achieving the Potential of System Integration Through Innovation, Leadership, Measurement, and Incentives

Presents a case study of a physician-led nonprofit healthcare group exhibiting the attributes of an ideal healthcare delivery system as defined by the Fund. Describes how its ProvenCare model improved clinical outcomes with reduced resource utilization

Involuntary social cue integration in patients with obsessive compulsive disorder

Objective Patients with obsessive compulsive disorder (OCD) have inferior social functioning compared to healthy controls, but the exact nature of these social deficits, and the underpinning mechanisms, are unknown. We sought to investigate social functioning in patients with OCD by measuring their involuntary/spontaneous processing of social cues using a specifically designed test, which might reveal deficits in these patients that explicit voluntary tasks do not detect. Methods The sample of the study consisted of an OCD group (n = 25) and a control group (n = 26). Both groups performed an adaptation of the Social Distance Judgment Task (SDJT; Jellema et al., 2009), in which participants have to judge the geometrical distance between two human cartoon figures presented on a computer screen. Head/gaze direction and body direction were manipulated to be either compatible, i.e. both directed to the left or to the right (Compatible condition) or incompatible, i.e. body directed toward the observer (frontal view) and head/gaze directed to the left or right (Incompatible condition). Results In the Compatible condition, controls nor OCD patients were influenced by the social cues in their judgments of the geometrical distances. However, in the Incompatible condition, where the attentional cue was more conspicuous, both groups were influenced by the cues, but the controls to a significantly larger extent than the OCD patients. Conclusions This study showed that patients with OCD are less likely, compared to controls, to automatically/spontaneously integrate the other’s direction of attention into their visual percept. This may have resulted in their judgments of the geometrical distances between the agents to be more accurate than those of controls. The suggested impairment in automatically integrating social cues may have important repercussions for the social functioning of OCD patients

Memory for Emotionally Provocative Words in Alexithymia: A Role for Stimulus Relevance

Alexithymia is associated with emotion processing deficits, particularly for negative emotional information. However, also common are a high prevalence of somatic symptoms and the perception of somatic sensations as distressing. Although little research has yet been conducted on memory in alexithymia, we hypothesized a paradoxical effect of alexithymia on memory. Specifically, recall of negative emotional words was expected to be reduced in alexithymia, while memory for illness words was expected to be enhanced in alexithymia. Eighty-five high or low alexithymia participants viewed and rated arousing illness-related ( pain ), emotionally positive ( thrill ), negative ( hatred ), and neutral words ( horse ). Recall was assessed 45 min later. High alexithymia participants recalled significantly fewer negative emotion words but also more illness-related words than low alexithymia participants. The results suggest that personal relevance can shape cognitive processing of stimuli, even to enhance retention of a subclass of stimuli whose retention is generally impaired in alexithymia

Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

Building Resilience through Culturally Grounded Practices in Clinical Psychology and Higher Education

There is no “one size fits all” approach when it comes to the process of healing, particularly for individuals who are continuously affected by the many barriers and impacts of systemic oppres- sion. This reality demands the sustained development of a praxis rooted in trauma-informed and culturally grounded care so that we may better serve our most-impacted communities (such as Black, Indigenous and People of Color [BIPOC], disability, queer, and survivor communities). As practitioners in the fields of Clinical Psychology and Higher Education, we engage in cross-disciplinary analysis so that we may amplify and share our tools for collective healing. We highlight the importance of sup- porting client and student development through multisystemic and resilience-oriented frameworks. Specifically, we discuss the implications of the Minority Stress Model (Meyer, 2003) and Bronfenbrenner’s Ecological Systems Theory (1979) in serving our communities more effectively to enhance positive clinical and academic outcomes

Emotion words and categories: evidence from lexical decision

We examined the categorical nature of emotion word recognition. Positive, negative, and neutral words were presented in lexical decision tasks. Word frequency was additionally manipulated. In Experiment 1, "positive" and "negative" categories of words were implicitly indicated by the blocked design employed. A significant emotion–frequency interaction was obtained, replicating past research. While positive words consistently elicited faster responses than neutral words, only low frequency negative words demonstrated a similar advantage. In Experiments 2a and 2b, explicit categories ("positive," "negative," and "household" items) were specified to participants. Positive words again elicited faster responses than did neutral words. Responses to negative words, however, were no different than those to neutral words, regardless of their frequency. The overall pattern of effects indicates that positive words are always facilitated, frequency plays a greater role in the recognition of negative words, and a "negative" category represents a somewhat disparate set of emotions. These results support the notion that emotion word processing may be moderated by distinct systems

Daily Stress Recognition from Mobile Phone Data, Weather Conditions and Individual Traits

Research has proven that stress reduces quality of life and causes many diseases. For this reason, several researchers devised stress detection systems based on physiological parameters. However, these systems require that obtrusive sensors are continuously carried by the user. In our paper, we propose an alternative approach providing evidence that daily stress can be reliably recognized based on behavioral metrics, derived from the user's mobile phone activity and from additional indicators, such as the weather conditions (data pertaining to transitory properties of the environment) and the personality traits (data concerning permanent dispositions of individuals). Our multifactorial statistical model, which is person-independent, obtains the accuracy score of 72.28% for a 2-class daily stress recognition problem. The model is efficient to implement for most of multimedia applications due to highly reduced low-dimensional feature space (32d). Moreover, we identify and discuss the indicators which have strong predictive power.Comment: ACM Multimedia 2014, November 3-7, 2014, Orlando, Florida, US