Troubling Vulnerability: Designing with LGBT Young People's Ambivalence Towards Hate Crime Reporting

HCI is increasingly working with ?vulnerable? people yet there is a danger that the label of vulnerability can alienate and stigmatize the people such work aims to support. We report our study investigating the application of interaction design to increase rates of hate crime reporting amongst Lesbian, Gay, Bisexual and Transgender young people. During design-led workshops participants expressed ambivalence towards reporting. While recognizing their exposure to hate crime they simultaneously rejected ascription as victim as implied in the act of reporting. We used visual communication design to depict the young people?s ambivalent identities and contribute insights on how these fail and succeed to account for the intersectional, fluid and emergent nature of LGBT identities through the design research process. We argue that by producing ambiguous designed texts, alongside conventional qualitative data, we ?trouble? our design research narratives as a tactic to disrupt static and reductive understandings of vulnerability within HCI

BATSE Observations of Gamma-Ray Burst Spectra. IV. Time-Resolved High-Energy Spectroscopy

We report on the temporal behavior of the high-energy power law continuum component of gamma-ray burst spectra with data obtained by the Burst and Transient Source Experiment. We have selected 126 high fluence and high flux bursts from the beginning of the mission up until the present. Much of the data were obtained with the Large Area Detectors, which have nearly all-sky coverage, excellent sensitivity over two decades of energy and moderate energy resolution, ideal for continuum spectra studies of a large sample of bursts at high time resolution. At least 8 spectra from each burst were fitted with a spectral form that consisted of a low-energy power law, a spectral break at middle energies and a high-energy continuum. In most bursts (122), the high-energy continuum was consistent with a power law. The evolution of the fitted high-energy power-law index over the selected spectra for each burst is inconsistent with a constant for 34% of the total sample. The sample distribution of the average value for the index from each burst is fairly narrow, centered on -2.12. A linear trend in time is ruled out for only 20% of the bursts, with hard-to-soft evolution dominating the sample (100 events). The distribution for the total change in the power-law index over the duration of a burst peaks at the value -0.37, and is characterized by a median absolute deviation of 0.39, arguing that a single physical process is involved. We present analyses of the correlation of the power-law index with time, burst intensity and low-energy time evolution. In general, we confirm the general hard-to-soft spectral evolution observed in the low-energy component of the continuum, while presenting evidence that this evolution is different in nature from that of the rest of the continuum.Comment: 30 pages, with 2 tables and 9 figures To appear in The Astrophysical Journal, April 1, 199

Temporal trends and risk factors for readmission for infections, gastrointestinal and immobility complications after an incident hospitalisation for stroke in Scotland between 1997 and 2005

Background: Improvements in stroke management have led to increases in the numbers of stroke survivors over the last decade and there has been a corresponding increase of hospital readmissions after an initial stroke hospitalisation. The aim of this study was to examine the one year risk of having a readmission due to infective, gastrointestinal or immobility (IGI) complications and to identify temporal trends and any risk factors.<p></p> Methods: Using a cohort of first hospitalised for stroke patients who were discharged alive, time to first event (readmission for IGI complications or death) within 1 year was analysed in a competing risks framework using cumulative incidence methods. Regression on the cumulative incidence function was used to model the risks of having an outcome using the covariates age, sex, socioeconomic status, comorbidity, discharge destination and length of hospital stay.<p></p> Results: There were a total of 51,182 patients discharged alive after an incident stroke hospitalisation in Scotland between 1997–2005, and 7,747 (15.1%) were readmitted for IGI complications within a year of the discharge. Comparing incident stroke hospitalisations in 2005 with 1997, the adjusted risk of IGI readmission did not increase (HR = 1.00 95% CI (0.90, 1.11). However, there was a higher risk of IGI readmission with increasing levels of deprivation (most deprived fifth vs. least deprived fifth HR = 1.16 (1.08, 1.26).<p></p> Conclusions: Approximately 15 in 100 patients discharged alive after an incident hospitalisation for stroke in Scotland between 1997 and 2005 went on to have an IGI readmission within one year. The proportion of readmissions did not change over the study period but those living in deprived areas had an increased risk

Informing the design of a randomised controlled trial of an exercise-based programme for long term stroke survivors: lessons from a before-and-after case series study

Background: To inform the design of a randomised controlled trial (RCT) of an exercise-based programme for long term stroke survivors, we conducted a mixed methods before-and-after case series with assessment at three time points. We evaluated Action for Rehabilitation from Neurological Injury (ARNI), a personalised, functionally-focussed programme. It was delivered through 24 hours of one-to-one training by an Exercise Professional (EP), plus at least 2 hours weekly unsupervised exercise, over 12- 14 weeks. Assessment was by patient-rated questionnaires addressing function, physical activity, confidence, fatigue and health-related quality of life; objective assessment of gait quality and speed; qualitative individual interviews conducted with participants. Data were collected at baseline, 3 months and 6 months. Fidelity and acceptability was assessed by participant interviews, audit of participant and EP records, and observation of training. Findings: Four of six enrolled participants completed the exercise programme. Quantitative data demonstrated little change across the sample, but marked changes on some measures for some individuals. Qualitative interviews suggested that small benefits in physical outcomes could be of great psychological significance to participants. Participant-reported fatigue levels commonly increased, and non-completers said they found the programme too demanding. Most key components of the intervention were delivered, but there were several potentially important departures from intervention fidelity. Discussion: The study provided data and experience that are helping to inform the design of an RCT of this intervention. It suggested the need for a broader recruitment strategy; indicated areas that could be explored in more depth in the qualitative component of the trial; and highlighted issues that should be addressed to enhance and evaluate fidelity, particularly in the preparation and monitoring of intervention providers. The experience illustrates the value of even small sample before-and-after studies in the development of trials of complex interventions.PenCLAHRC; NIH

Developing a Theoretical Model of Clinician Information Usage Propensity

Abstract. Based on qualitative research, we developed the theoretical construct "clinician information usage propensity" as a hypothetical indicator of attitudes and behaviour towards clinical information and systems. We devised a survey to validate the construct and had 146 responses. Principal components analysis extracted four factors accounting for 47.2% of the variance: beliefs about clinical judgement, beliefs about information quality, cultural resistance and cognitive approach. The components were reasonably consistent with the model but two factors (beliefs about information quality, cognitive approach) had low reliability (α < 0.6). Cultural resistance was the main factor and correlated with gender, grade and age group. Female clinicians showed significantly higher cultural resistance and preference for narrative; hospital doctors generally had higher cultural resistance than general practitioners. As only 47.2% of the variance was explained, further work.is needed to refine the instrument to remove redundancy, improve sensitivity on the identified components and allow the construct to be explored as a form of technology adoption model. We posit that beliefs about clinical judgement merit further attention in medical informatics research

Performance Measures Using Electronic Health Records: Five Case Studies

Presents the experiences of five provider organizations in developing, testing, and implementing four types of electronic quality-of-care indicators based on EHR data. Discusses challenges, and compares results with those from traditional indicators