A Lazy User Perspective to the Voluntary Adoption of Electronic Personal Health Records (PHRs)

Personal Health Records (PHRs) have been imbued with the potential to improve health outcomes for individual healthcare consumers, providers, and the broader healthcare system. With Meaningful Use Stage 2 now mandating the implementation of tethered PHRs, tethered to provider electronic health records (patient portals), will healthcare consumers voluntarily use PHRs and contribute to safety, quality, efficiency and reduced health disparities through engagement? Or will PHR use remain low? In this qualitative study, using grounded theory, we asked users how they currently managed their personal health information (PHI) and why. Using the lazy user model, we found that letting physicians manage healthcare consumers PHI is the least effort-based solution and thus the predominant and preferred solution. Providers as guardians of patient PHI suggests the low use rates may persist yet. We should do more to make these technologies usable and accessible to those with irregular contact with a primary care physician

Healthcare Consumers’ Voluntary Adoption and Non-Adoption of Electronic Personal Health Records

The use and ready availability of electronic health records is broadly purported to have the potential to improve health outcomes for individual healthcare consumers, providers and the healthcare system as a whole. Unlike electronic health records that are created and managed by providers, personal health records (PHR) are controlled by the individual consumer and the persons/entities to which they choose to grant access. Studies show while more healthcare consumers have access to PHRs, their voluntary adoption is lagging. Yet, our understanding of adoption lag is also lacking. In this qualitative study, we investigate: (1) how individual healthcare users in Connecticut currently manage their personal health information, (2) whether they have adopted an electronic PHR and the considerations that influenced the volitional adoption or non-adoption of a PHR. Initial findings casts new and surprising understandings including how healthcare consumers would like to use PHRs

The Role of Negotiation in Privacy-Enhanced E-Commerce Transactions

Online vendors use personal information to deliver customized services efficiently to their customers. Both users and vendors value the relationship building made possible using personal data. However, the use of personally identifying data gives rise to the potential for privacy invasion. When consumers must disclose personal information, they are forced to perform a risk-benefit analysis in which the risks of disclosing one\u27s personal information are weighted against the potential benefits of the disclosure. While some researchers note that consumers maximize benefits in deciding whether to disclose personal information, others argue that consumers lack sufficient information and power to make educated, balanced decisions regarding disclosing their private information. We add to the privacy discussion by arguing that a real negotiation position for both parties can help realize the full benefits of online personalization. We propose a model for mitigating the tension between the benefits of personalization and the risks to privacy invasion. This framework informs our future work which seeks to develop rich and deep understandings of negotiated, privacy-concerned personalization

The Integration of HIV/AIDS Care and Support into Primary Health Care in Gauteng Province

The information contained in this publication may be freely distributed and reproduced, as long as the source is acknowledged, and it is used for non-commercial purposes.This study aimed to assess the integration of HIV/AIDS care and support in Gauteng’s primary health care (PHC) services. With this aim in mind, the research sought to provide answers to three main sets of questions. Firstly, are care and support services for people with HIV/AIDS being provided at PHC clinics, what is the quality of these services, and to what extent are these services being utilised? Secondly, are the inputs (e.g. staff knowledge and attitudes) and support systems (e.g. drug supplies), necessary for good quality, accessible HIV/AIDS care, present in the PHC infrastructure? Thirdly, what if any, systems changes are required to improve the access and quality of PHC services for people living with HIV/AIDS? This research was conducted in collaboration with, and partly funded by, the Gauteng Provincial Department of Health which is in the process of disseminating primary health care clinical guidelines in the Province.Funders of the Health Systems Trust include : Department of Health (South Africa) Department for International Development (UK) Henry J. Kaiser Family Foundation (USA) Commission of the European Union Rockefeller Foundatio

Development of solar powered water purification systems

Abstract: In this paper, we highlight the effects of contaminated water on humans as well as the crisis of water supply and distribution of potable water in many areas of developing countries. Water is the most important substance on earth. While water is a primary human need, contaminated water can cause and spread diseases. It is, therefore, necessary to ensure that water is purified and decontaminated for daily use at a low-cost. Therefore, the design of solar-powered water purification systems is considered to produce clean water. Solar energy poses no polluting effect; thus, has become a dependable energy source for usage. The design of a solar-powered water purification system is based totally on the thermal method by using the thermal heating system principle. This principle converts sunlight rays into heat. The most vital aspect is the absorption of heat to induce evaporation of water. Research shows that flat plate collectors produce heat at relatively low temperatures (27°C to 60°C) and are commonly used to heat liquids. A solar-powered water purification system consists of a solar collector that absorbs sunlight to ensure vaporisation which is the first stage of purifying and a filter that removes contaminants. Four different concepts have been developed. A detailed description of the components and the operation of the systems constitute the main contribution of this paper

Nets, Spray or Both? The Effectiveness of Insecticide-Treated Nets and Indoor Residual Spraying in Reducing Malaria Morbidity and Child Mortality in sub-Saharan Africa.

Malaria control programmes currently face the challenge of maintaining, as well as accelerating, the progress made against malaria with fewer resources and uncertain funding. There is a critical need to determine what combination of malaria interventions confers the greatest protection against malaria morbidity and child mortality under routine conditions. This study assesses intervention effectiveness experienced by children under the age of five exposed to both insecticide-treated nets (ITNs) and indoor residual spraying (IRS), as compared to each intervention alone, based on nationally representative survey data collected from 17 countries in sub-Saharan Africa. Living in households with both ITNs and IRS was associated with a significant risk reduction against parasitaemia in medium and high transmission areas, 53% (95% CI 37% to 67%) and 31% (95% CI 11% to 47%) respectively. For medium transmission areas, an additional 36% (95% CI 7% to 53%) protection was garnered by having both interventions compared with exposure to only ITNs or only IRS. Having both ITNs and IRS was not significantly more protective against parasitaemia than either intervention alone in low and high malaria transmission areas. In rural and urban areas, exposure to both interventions provided significant protection against parasitaemia, 57% (95% CI 48% to 65%) and 39% (95% CI 10% to 61%) respectively; however, this effect was not significantly greater than having a singular intervention. Statistically, risk for all-cause child mortality was not significantly reduced by having both ITNs and IRS, and no additional protectiveness was detected for having dual intervention coverage over a singular intervention. These findings suggest that greater reductions in malaria morbidity and health gains for children may be achieved with ITNs and IRS combined beyond the protection offered by IRS or ITNs alone

Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study

<p>Abstract</p> <p>Background</p> <p>Understanding the strategies that health care providers employ in order to invite men to participate in maternal health care is very vital especially in today's dynamic cultural environment. Effective utilization of such strategies is dependent on uncovering the salient issues that facilitate male participation in maternal health care. This paper examines and describes the strategies that were used by different health care facilities to invite husbands to participate in maternal health care in rural and urban settings of southern Malawi.</p> <p>Methods</p> <p>The data was collected through in-depth interviews from sixteen of the twenty health care providers from five different health facilities in rural and urban settings of Malawi. The health facilities comprised two health centres, one district hospital, one mission hospital, one private hospital and one central hospital. A semi-structured interview guide was used to collect data from health care providers with the aim of understanding strategies they used to invite men to participate in maternal health care.</p> <p>Results</p> <p>Four main strategies were used to invite men to participate in maternal health care. The strategies were; health care provider initiative, partner notification, couple initiative and community mobilization. The health care provider initiative and partner notification were at health facility level, while the couple initiative was at family level and community mobilization was at village (community) level. The community mobilization had three sub-themes namely; male peer initiative, use of incentives and community sensitization. The sustainability of each strategy to significantly influence behaviour change for male participation in maternal health care is discussed.</p> <p>Conclusion</p> <p>Strategies to invite men to participate in maternal health care were at health facility, family and community levels. The couple strategy was most appropriate but was mostly used by educated and city residents. The male peer strategy was effective and sustainable at community level. There is need for creation of awareness in men so that they sustain their participation in maternal health care activities of their female partners even in the absence of incentives, coercion or invitation.</p

El Conocimiento Didáctico del Contenido en ciencias: estado de la cuestión

This paper gives a descriptive overview of the literature related to Pedagogical Content Knowledge - PCK - in the sciences. It is expected that this review can contribute to a better understanding of PCK, pointing out what has been investigated about this concept. Specifically, we analyze: a) how PCK is defined, what are its main features and how it has been appropriated by teachers; b) the relationship between PCK, knowledge of the contents to be taught and students learning; c) how PCK was actually used in teachers' training and teachers' evaluation; and, d) the scientific areas in which PCK has been studied. It concludes that PCK is an essential tool for improving the quality of teacher training

Thromboxane biosynthesis in cancer patients and its inhibition by aspirin: a sub-study of the Add-Aspirin trial

BACKGROUND: Pre-clinical models demonstrate that platelet activation is involved in the spread of malignancy. Ongoing clinical trials are assessing whether aspirin, which inhibits platelet activation, can prevent or delay metastases. METHODS: Urinary 11-dehydro-thromboxane B2 (U-TXM), a biomarker of in vivo platelet activation, was measured after radical cancer therapy and correlated with patient demographics, tumour type, recent treatment, and aspirin use (100 mg, 300 mg or placebo daily) using multivariable linear regression models with log-transformed values. RESULTS: In total, 716 patients (breast 260, colorectal 192, gastro-oesophageal 53, prostate 211) median age 61 years, 50% male were studied. Baseline median U-TXM were breast 782; colorectal 1060; gastro-oesophageal 1675 and prostate 826 pg/mg creatinine; higher than healthy individuals (~500 pg/mg creatinine). Higher levels were associated with raised body mass index, inflammatory markers, and in the colorectal and gastro-oesophageal participants compared to breast participants (P < 0.001) independent of other baseline characteristics. Aspirin 100 mg daily decreased U-TXM similarly across all tumour types (median reductions: 77-82%). Aspirin 300 mg daily provided no additional suppression of U-TXM compared with 100 mg. CONCLUSIONS: Persistently increased thromboxane biosynthesis was detected after radical cancer therapy, particularly in colorectal and gastro-oesophageal patients. Thromboxane biosynthesis should be explored further as a biomarker of active malignancy and may identify patients likely to benefit from aspirin