Optimizing Postpartum Care: The Development of a Debriefing Tool and Guideline for Healthcare Providers

This capstone project was a quality improvement project to reinforce evidence based practice for the care of postpartum women and their infants. The aim of the project was to provide a guideline and tool to allow for assessment of needs, resources available, and ongoing support to promote well-being, improved quality of life, and physical and mental health needs. Research showed postpartum care in the United States has been found to be fragmented with communication deficits between healthcare providers including maternal and pediatric providers and patients (American Congress of Obstetricians and Gynecologists [ACOG], 2016). Patients who attended a scheduled postpartum visit reported not receiving enough information or education at their postpartum visit with regard to “postpartum depression, birth spacing, healthy eating, the importance of exercise, or changes in their sexual response and emotions” (AGOG, 2016, p. 2). This fragmented care results in the mother uncertain of her future healthcare needs, timing, and potential risk factors adversely affecting her health and future pregnancies. At the postpartum visit, providers should assist the patient to identify “who will assume primary responsibility for her ongoing care in her primary care medical home” (ACOG, 2016, p. 4). This should also include documentation for the patient or other healthcare providers iv including pregnancy complications, risks, timing, and intervals of future medical needs such as contraception or family planning, cervical cancer screening pap smear, diabetes screening, cholesterol screening, as well as any other ongoing treatments for health issues such as thyroid disorder or depression. This would allow the patient to be fully aware of her health conditions, ongoing health care needs, and care coordination. The project was developed with the use of a Delphi method and process to create the tool and practice guideline. Staff from Kaiser Permanente’s Obstetrics and Gynecology Departments within metro Denver were surveyed with the use of Delphi questionnaires. Once the tool and guideline were created, the quality department must approve the guideline and implementation shall occur within Kaiser Permanente’s Obstetrics and Gynecology Departments. Implementation was not accomplished by the completion of this capstone project due to the prolonged time of the quality department’s approval. Once implementation occurs, a brief survey will be conducted of healthcare providers within several weeks of use to determine effectiveness and changes that might need to be made. The Stetler (2001) model provided the framework of this project to assure appropriate evidence-based medicine was incorporated into nursing practice once determined effective

Computer Self-Efficacy: Finding the Right Construct, for the Right Job, using the Right Measurement

Computer self-efficacy is a commonly used construct to explore user behavior and adoption of IS systems. However, there has been limited and somewhat conflicting empirical evidence to support the theorizing about the construct. After conducting a multi-discipline literature review of self-efficacy and analyzing the IS field’s usage of computer self-efficacy, we offer a discussion about the challenges and opportunities we see for the construct’s use in IS research. We state 6 propositions in this article that are structured around: (1) the nomological network of computer self-efficacy and the opportunities to refocus theorizing around generative capability as a source of performance mechanisms and (2) the appropriate task context in which to consider computer self-efficacy as a predictor. Next, we offer a discussion and set of recommendations around the challenges and considerations associated with current computer self-efficacy scales

An analysis of the prevalence of musculoskeletal disorders in heavy, civil construction operations and the impact of job, age, and experience

Includes bibliographical references

Understanding Primary Appraisal in User Adoption: an Exploration case study of a Telehealth Project

Implementation of a new system typically results in significant change for users’ work processes who engage in adaptation processes to cope with the change. Coping theory explains how people choose adaptation behaviors after a series of appraisal processes. Primary appraisal results in the categorization of the IT artifact as a threat or an opportunity. Understanding these primary appraisals, specifically what antecedents produce various appraisal results, allows better prediction of user behaviors and ultimately of implementation success. Drawing on observations during a case study of a telehealth pilot project in six sites, we offer a theoretical model to better understand the antecedents of primary appraisal

The Eureka Effect: Exploring the Benefits of Struggling with Technology

This research in progress piece adds two interesting theoretical insights to traditional models of adoption. First, it introduces the Eureka effect, which suggests that some types of usage challenges can actually increase satisfaction with the system--even if they decrease the user\u27s perceived ease of use. Second, it expands on expectation-disconfirmation adoption models to carefully problematize when a user\u27s expectations of a system are confirmed or disconfirmed and builds theory in the various liminal states in between preadoption and postadoption. Specifically, this paper builds the foundational base of theory and grounds initial hypotheses to support its two contributions to IS theory

A versatile test for equality of two survival functions based on weighted differences of Kaplan-Meier curves

With censored event time observations, the logrank test is the most popular tool for testing the equality of two underlying survival distributions. Although this test is asymptotically distribution-free, it may not be powerful when the proportional hazards assumption is violated. Various other novel testing procedures have been proposed, which generally are derived by assuming a class of specific alternative hypotheses with respect to the hazard functions. The test considered by Pepe and Fleming (1989) is based on a linear combination of weighted differences of two Kaplan-Meier curves over time and is a natural tool to assess the difference of two survival functions directly. In this article, we take a similar approach, but choose weights which are proportional to the observed standardized difference of the estimated survival curves at each time point. The new proposal automatically makes weighting adjustments empirically. The new test statistic is aimed at a one-sided general alternative hypothesis, and is distributed with a short right tail under the null hypothesis, but with a heavy tail under the alternative. The results from extensive numerical studies demonstrate that the new procedure performs well under various general alternatives. The survival data from a recent cancer comparative study are utilized for illustrating the implementation of the process

Greenway Medical Technologies: The Pace-Setting David of Electronic Health Records

This teaching case updates a previous study of Greenway Medical Technologies, a software company delivering electronic healthcare record (EHR) solutions to physicians. The current EHR marketplace is considered, including global trends as well as the impact of U.S. government funded monetary incentives. Greenway continues to build on its best-in-class software application and find ways to provide new enticements to medical practices and improvements to the broader medical community. The case also describes the EHR systems industry and explores the reasons for Greenway’s continued success and growth that surpasses its competitors

The homeodomain protein PAL-1 specifies a lineage-specific regulatory network in the C. elegans embryo

Maternal and zygotic activities of the homeodomain protein PAL-1 specify the identity and maintain the development of the multipotent C blastomere lineage in the C. elegans embryo. To identify PAL-1 regulatory target genes, we used microarrays to compare transcript abundance in wild-type embryos with mutant embryos lacking a C blastomere and to mutant embryos with extra C blastomeres. pal-1-dependent C-lineage expression was verified for select candidate target genes by reporter gene analysis, though many of the target genes are expressed in additional lineages as well. The set of validated target genes includes 12 transcription factors, an uncharacterized wingless ligand and five uncharacterized genes. Phenotypic analysis demonstrates that the identified PAL-1 target genes affect specification, differentiation and morphogenesis of C-lineage cells. In particular, we show that cell fate-specific genes (or tissue identity genes) and a posterior HOX gene are activated in lineage-specific fashion. Transcription of targets is initiated in four temporal phases, which together with their spatial expression patterns leads to a model of the regulatory network specified by PAL-1

Self-Reliant and Deferred Privacy Stances: A Natural Quasi-Experiment of iOS Users’ Acceptance of Privacy Offerings

We often assume that technology users are concerned about their privacy and will readily take steps to protect it. But while there is clear evidence that users harbor serious privacy concerns, it is increasingly unclear whether users actually accept offers to improve their privacy. This study brings to light two strategies—a self-reliant privacy stance and a deferred privacy stance—that many users take to cope with their increasing loss of control over privacy. We argue that the two privacy stances help users envision positive future outcomes regarding their privacy but can paradoxically cause users to hesitate in accepting new privacy offerings from technology firms. We conduct a natural quasi- experiment studying how iPhone users under some mixture of the two privacy stances respond to a major privacy offering from Apple, in the form of an iOS update to that helps users control the tracking behavior of mobile apps like Facebook. We find that users taking a deferred privacy stance are less likely to accept the privacy offering than users with less staunch privacy stances. This hesitance on part of technology users is an underexamined challenge to privacy measures. By modeling privacy stances, information systems researchers can gain a more nuanced understanding of how people deal with the complex mix of threats to their privacy and the offers to manage their privacy. And by understanding privacy stances, firms might better calibrate their messaging to users holding out from technology offerings that genuinely seek to address privacy or security threats