An App-Based Intervention to Support First Responders and Essential Workers During the COVID-19 Pandemic: Needs Assessment and Mixed Methods Implementation Study

The COVID-19 pandemic has created unprecedented challenges for first responders (eg, police, fire, and emergency medical services) and nonmedical essential workers (eg, workers in food, transportation, and other industries). Health systems may be uniquely suited to support these workers given their medical expertise, and mobile apps can reach local communities despite social distancing requirements. Formal evaluation of real-world mobile app–based interventions is lacking

Automatic measurement of propositional idea density from part-of-speech tagging

The original publication is available at www.springerlink.comThe Computerized Propositional Idea Density Rater (CPIDR, pronounced “spider”) is a computer program that determines the propositional idea density (P-density) of an English text automatically on the basis of partof-speech tags. The key idea is that propositions correspond roughly to verbs, adjectives, adverbs, prepositions, and conjunctions. After tagging the parts of speech using MontyLingua (Liu, 2004), CPIDR applies numerous rules to adjust the count, such as combining auxiliary verbs with the main verb. A “speech mode” is provided in which CPIDR rejects repetitions and a wider range of fillers. CPIDR is a user-friendly Windows .NET application distributed as open-source freeware under GPL. Tested against human raters, it agrees with the consensus of two human raters better than the team of five raters agree with each other [r(80) = .97 vs. r(10) = .82, respectively]

Medicine Plus Mindset: A Mixed-Methods Evaluation of a Novel Mindset-Focused Training for Primary Care Teams

Objectives Patient mindsets influence health outcomes; yet trainings focused on care teams’ understanding, recognizing, and shaping patient mindsets do not exist. This paper aims to describe and evaluate initial reception of the “Medicine Plus Mindset” training program. Methods Clinicians and staff at five primary care clinics (N = 186) in the San Francisco Bay Area received the Medicine Plus Mindset Training. The Medicine Plus Mindset training consists of a two-hour training program plus a one-hour follow-up session including: (a) evidence to help care teams understand patients’ mindsets’ influence on treatment; (b) a framework to support care teams in identifying specific patient mindsets; and (c) strategies to shape patient mindsets. Results We used a common model (Kirkpatrick) to evaluate the training based on participants’ reaction, learnings, and behavior. Reaction: Participants rated the training as highly useful and enjoyable. Learnings: The training increased the perceived importance of mindsets in healthcare and improved self-reported efficacy of using mindsets in practice. Behavior: The training increased reported frequency of shaping patient mindsets. Conclusions Development of this training and the study’s results introduce a promising and feasible approach for integrating mindset into clinical practice. Practice Implications Mindset training can add a valuable dimension to clinical care and should be integrated into training and clinical practice

Presence 5 for Racial Justice Workshop: Fostering Dialogue Across Medical Education to Disrupt Anti-Black Racism in Clinical Encounters

Introduction: Anti-Black racism has strong roots in American health care and medical education. While curricula on social determinants of health are increasingly common in medical training, curricula directly addressing anti-Black racism are limited. Existing frameworks like the Presence 5 framework for humanism in medicine can be adapted to develop a novel workshop that promotes anti-racism communication. Methods: We performed a literature review of anti-racism collections and categorized anti-racism communication practices using the Presence 5 framework to develop the Presence 5 for Racial Justice Workshop. Implementation included an introductory didactic, a small-group discussion, and a large-group debrief. Participants evaluated the workshop via an online survey, and we analyzed the resulting qualitative feedback. Results: A total of 17 participants took part in two workshops, with nine of the participants responding to the evaluation survey. Themes that emerged from survey responses included strengths of and improvements for the workshop structure (protected time for anti-racism discussion, dialogue between learners and faculty) and content (specific phrases and language, practicing self-reflection). Discussion: The workshop provides participants with a semistructured discussion around the five anti-racism communication practices. Barriers to implementation include incorporating the workshop into existing curricula and ensuring diverse learners. Barriers to evaluating the workshop include the low survey response rate. Recommendations to improve the workshop include using case-based discussion and varying the workshop structure according to institutional needs. Next steps include an implementation study to evaluate the acceptability, feasibility, and effectiveness of the workshop

Humanism in telemedicine: Connecting through virtual visits during the COVID-19 pandemic

The COVID-19 pandemic is spurring the massive deployment of telemedicine to prevent risk of infection and address healthcare workforce demands. In primary care, many visits have shifted from in-person to telemedicine, introducing a potential barrier to the human connection that is central to clinical care. We adapted existing frameworks that seek to foster humanism in clinical care-the Four Habits Model and Presence 5-to the virtual care context. Reconceptualizing these frameworks to video visits in particular yields strategies for four phases of the visit - (1) Before the Visit: Set up for Success, (2) Beginning the Visit: Establish a Connection, (3) Throughout the Visit: Invest in the Relationship and the Patient's Story, and (4) Completing the Visit: End on a Meaningful Note. Adopting explicit humanistic practices can help clinicians foster meaningful connections with patients through video visits amidst this challenging pandemic and in the future as telemedicine becomes more widely integrated into clinical care.This study was supported by a grant from the Gordon and Betty Moore Foundation (#6382; PIs Donna Zulman and Abraham Verghese). Megha Shankar is supported by a VA Office of Academic Affairs Advanced Fellowship in Health Services Research. The views expressed herein are those of the authors and do not necessarily reflect the views of the Department of Veterans Affairs, the Gordon and Betty Moore Foundation, or Stanford University School of Medicine.https://deepblue.lib.umich.edu/bitstream/2027.42/154738/1/Shankar article file.pdfDescription of Shankar article file.pdf : Main articl

Physical activity and nutrition program for seniors (PANS): protocol of a randomized controlled trial

Background Along with reduced levels of physical activity, older Australian's mean energy consumption has increased. Now over 60% of older Australians are considered overweight or obese. This study aims to confirm if a low-cost, accessible physical activity and nutrition program can improve levels of physical activity and diet of insufficiently active 60-70 year-olds. Methods/Design This 12-month home-based randomised controlled trial (RCT) will consist of a nutrition and physical activity intervention for insufficiently active people aged 60 to 70 years from low to medium socio-economic areas. Six-hundred participants will be recruited from the Australian Federal Electoral Role and randomly assigned to the intervention (n = 300) and control (n = 300) groups. The study is based on the Social Cognitive Theory and Precede-Proceed Model, incorporating voluntary cooperation and self-efficacy. The intervention includes a specially designed booklet that provides participants with information and encourages dietary and physical activity goal setting. The booklet will be supported by an exercise chart, calendar, bi-monthly newsletters, resistance bands and pedometers, along with phone and email contact. Data will be collected over three time points: pre-intervention, immediately post-intervention and 6-months post-study. Discussion This trial will provide valuable information for community-based strategies to improve older adults' physical activity and dietary intake. The project will provide guidelines for appropriate sample recruitment, and the development, implementation and evaluation of a minimal intervention program, as well as information on minimising barriers to participation in similar programs

Analysing political discourse: Toward a cognitive approach

Original article can be found at: http://www.informaworld.com/smpp/title~content=t713695016 Copyright Informa / Taylor and Francis --DOI : 10.1080/17405900500283706The critical study of political discourse has up until very recently rested solely within the domain of the social sciences. Working within a linguistics framework, Critical Discourse Analysis (CDA), in particular Fairclough (Fairclough 1989, 1995a, 1995b, 2001; Fairclough and Wodak 1997), has been heavily influenced by Foucault.2 The linguistic theory that CDA and critical linguistics especially (which CDA subsumes) has traditionally drawn upon is Halliday‟s Systemic-Functional Grammar, which is largely concerned with the function of language in the social structure3 (Fowler et al. 1979; Fowler 1991; Kress and Hodge 1979).[opening paragraph]Peer reviewe