A Content Analysis of Judicial Decision-Making: How Judges Use the Primary Caretaker Standard to Make a Custody Determination

This article expands upon Professor Mercer\u27s previous discussion of the efficacy of the primary caretaker standard in West Virginia

The Ethics of Judicial Decision-Making Regarding Custody of Minor Children: Looking at the Best Interests of the Child and the Primary Caretaker Standards as Utility Rules

This article will examine how a judge\u27s ethical framework can influence the outcome of a custody award, even where the same child-centered standard is ostensibly being used. This article uses three cases from the Supreme Court of Nebraska to demonstrate that the best interests of the child standard can be used: 1) to award a parent custody because parents have near absolute rights (an example of rule deontology); 2) to deny a parent custody because the par ent is unfit (an example of rule utilitarianism); or 3) to deny a parent custody because the child\u27s life needs stability (an example of act utilitarianism)

A vagrant Subantarctìc fur seal Arctocephalus tropicalis found in the Comores

A juvenile Subantarctic fur seal, Arctocephalus tropicalis was caught near the island of Anjouan, Comores, about 500 km off the east coast of Africa, on 20 August 1990. This record represents a northerly extension by some 1800 km of the recorded east coast range. The breeding colonies of this species are on temperate islands north of the Antarctic Polar Front. The dosest colonies are on Amsterdam Island and the Prince Edward islands, nearly 4000 km south-west and south, respectively of this sighting

Communicating health information in primary care: a multidisciplinary exploration of patient, pharmacist, and physician decision-making

Research has yet to clearly define how health care professionals’ (HCPs) use and sharing of information influences how health decisions are made, both independently and collaboratively. Similarly, the manner in which patients use, interact with, and find health information is not fully, and how external influencers impact patient decision-making about health. The overall goal of this thesis is to examine how and what information is being shared among patients, pharmacists, and physicians and how this information is used in decision making. Using a variety of methodologies, this research examined five areas of communication and decision-making: 1) How patients, pharmacists, and physicians currently make decisions as a healthcare team; how this information influences shared decision-making about patients’ medications and health; and how this process can be improved through the use of electronic health records (EHRs); 2) How information is communicated among HCPs and between HCPs and patients; 3) What information patients seek out, collect and communicate to their HCPs; 4) How relationships influence professional collaboration and communication in healthcare; and 5) The scope of existing knowledge around including the reason for use on a prescription and how that influences the ways in which pharmacists make decisions. This thesis consists of four papers that describe two studies. Three of the papers use data from a qualitative examination of ethnographic observations and structured or semi-structured interview methods to examine: 1) patients’ medication decision-making with their pharmacists and physicians; 2) pharmacist and physician medication decision-making; and 3) how relationships between pharmacists and physicians influence collaboration. The final paper is a scoping review of the literature that characterizes the current body of research on how including the reason for use on a prescription impacts pharmacist decision making. The first study examines how patients make decisions with their health care team, how information influences decision-making and how the process can be improved through EHRs. It revealed that different people play different roles when it comes to helping patients make decisions. The first of three papers emerging from the first study determined that while EHRs can support decision-making, more research is needed to further clarify perceptions of role and how to develop EHRs that are adaptive to varying user information needs. The second paper focuses on physician-pharmacists medication decision-making and examined how physician and pharmacist relationships influence collaboration and communication. It concluded that there is limited communication and collaboration between physicians and pharmacists around managing medications. Further, this research saw an emerging result about how relationships influence how and when collaboration and communication occur, resulting in the third paper which examined the relationships more closely. The fourth paper emerged from the need to better understand the current scope of research about including reason for use on a prescription that is sent to a pharmacist--an emerging area of interest from the original study. Taken together, the chapters provide an emerging picture of how and what information is and should be communicated in healthcare and the factors that influence how information is shared. The findings reveal important common elements that have yet to be fully explored when it comes to information sharing, and these ultimately influence decision-making in health. The findings describe a complex environment of differing information needs among pharmacists, physicians, and patients and emphasize the importance of understanding specific knowledge that must be communicated. Future research should be designed to accommodate a robust multidisciplinary approach that allows us to examine how sharing and communicating health information changes as the influence of technology and the number of stakeholders involved in care increases. Future research should focus on helping HCPs develop multidisciplinary strategies for collaboration and information sharing, based on a shared understanding of each other’s roles, priorities, and values

How Two Librarians Became Co-instructors For a First Year Course

In Spring 2014, two librarians co-instructed an undergraduate Pharmacy course at the University of Waterloo. Providing students with the skills to access medical/drug information, this course gave students the skills to critically appraise literature to support an evidence-based patient care model. This poster shares their experience co-instructing a required course co-taught with the School of Pharmacy’s Director, an expert in critical appraisal

Behavior Change Techniques Present in Wearable Activity Trackers: A Critical Analysis

Please cite as: Mercer K, Li M, Giangregorio L, Burns C, Grindrod K Behavior Change Techniques Present in Wearable Activity Trackers: A Critical Analysis JMIR Mhealth Uhealth 2016;4(2):e40 DOI: 10.2196/mhealth.4461 PMID: 27122452 PMCID: 4917727Background: Wearable activity trackers are promising as interventions that offer guidance and support for increasing physical activity and health-focused tracking. Most adults do not meet their recommended daily activity guidelines, and wearable fitness trackers are increasingly cited as having great potential to improve the physical activity levels of adults. Objective: The objective of this study was to use the Coventry, Aberdeen, and London-Refined (CALO-RE) taxonomy to examine if the design of wearable activity trackers incorporates behavior change techniques (BCTs). A secondary objective was to critically analyze whether the BCTs present relate to known drivers of behavior change, such as self-efficacy, with the intention of extending applicability to older adults in addition to the overall population. Methods: Wearing each device for a period of 1 week, two independent raters used CALO-RE taxonomy to code the BCTs of the seven wearable activity trackers available in Canada as of March 2014. These included Fitbit Flex, Misfit Shine, Withings Pulse, Jawbone UP24, Spark Activity Tracker by SparkPeople, Nike+ FuelBand SE, and Polar Loop. We calculated interrater reliability using Cohen's kappa. Results: The average number of BCTs identified was 16.3/40. Withings Pulse had the highest number of BCTs and Misfit Shine had the lowest. Most techniques centered around self-monitoring and self-regulation, all of which have been associated with improved physical activity in older adults. Techniques related to planning and providing instructions were scarce. Conclusions: Overall, wearable activity trackers contain several BCTs that have been shown to increase physical activity in older adults. Although more research and development must be done to fully understand the potential of wearables as health interventions, the current wearable trackers offer significant potential with regard to BCTs relevant to uptake by all populations, including older adults

Acceptance of Commercially Available Wearable Activity Trackers Among Adults Aged Over 50 and With Chronic Illness: A Mixed-Methods Evaluation

Please cite as: Mercer K, Giangregorio L, Schneider E, Chilana P, Li M, Grindrod K Acceptance of Commercially Available Wearable Activity Trackers Among Adults Aged Over 50 and With Chronic Illness: A Mixed-Methods Evaluation JMIR Mhealth Uhealth 2016;4(1):e7 DOI: 10.2196/mhealth.4225 PMID: 26818775 PMCID: 4749845Background: Physical inactivity and sedentary behavior increase the risk of chronic illness and death. The newest generation of “wearable” activity trackers offers potential as a multifaceted intervention to help people become more active. Objective: To examine the usability and usefulness of wearable activity trackers for older adults living with chronic illness. Methods: We recruited a purposive sample of 32 participants over the age of 50, who had been previously diagnosed with a chronic illness, including vascular disease, diabetes, arthritis, and osteoporosis. Participants were between 52 and 84 years of age (mean 64); among the study participants, 23 (72%) were women and the mean body mass index was 31 kg/m2 . Participants tested 5 trackers, including a simple pedometer (Sportline or Mio) followed by 4 wearable activity trackers (Fitbit Zip, Misfit Shine, Jawbone Up 24, and Withings Pulse) in random order. Selected devices represented the range of wearable products and features available on the Canadian market in 2014. Participants wore each device for at least 3 days and evaluated it using a questionnaire developed from the Technology Acceptance Model. We used focus groups to explore participant experiences and a thematic analysis approach to data collection and analysis. Results: Our study resulted in 4 themes: (1) adoption within a comfort zone; (2) self-awareness and goal setting; (3) purposes of data tracking; and (4) future of wearable activity trackers as health care devices. Prior to enrolling, few participants were aware of wearable activity trackers. Most also had been asked by a physician to exercise more and cited this as a motivation for testing the devices. None of the participants planned to purchase the simple pedometer after the study, citing poor accuracy and data loss, whereas 73% (N=32) planned to purchase a wearable activity tracker. Preferences varied but 50% felt they would buy a Fitbit and 42% felt they would buy a Misfit, Jawbone, or Withings. The simple pedometer had a mean acceptance score of 56/95 compared with 63 for the Withings, 65 for the Misfit and Jawbone, and 68 for the Fitbit. To improve usability, older users may benefit from devices that have better compatibility with personal computers or less-expensive Android mobile phones and tablets, and have comprehensive paper-based user manuals and apps that interpret user data. Conclusions: For older adults living with chronic illness, wearable activity trackers are perceived as useful and acceptable. New users may need support to both set up the device and learn how to interpret their data

Understanding Undergraduate Engineering Student Information Access and Needs: Results from a Scoping Review

To the authors knowledge this is the first review to examine the current body of research on how engineering students access, use, and understand information; identify gaps in the literature, and how this can be used to support information literacy education in the engineering disciplines. Engineering students are required to create, problem solve, and improve, using engineering principles to develop their skills in technical, environmental, socioeconomic and political aspects of the engineering process. They are increasingly faced with the availability of rapidly shifting information types, which are gathered from sources like Google and Reddit. Finding and interpreting such information, even when found correctly through sources outside traditional research boundaries (technical documents found online vs. peer review articles through a library catalog), creates a disconnect between students and the desire of librarians or faculty to teach traditional research and information seeking skills. A scoping review was conducted using the Arksey and O’Malley modified framework. Six databases focusing on information, education, and engineering research were searched (LISA, ERIC full-text, ASEE, ScienceDirect, EducationSource, and Scopus). Papers were included if they addressed engineering student information seeking behaviors or needs. Studies that focused on social science or humanities students were excluded. The data were examined to find methodological trends, research areas, gaps in knowledge, and key findings. This review included 44 articles in the final review. Analysis grouped research into four emerging themes: Student information behavior mirrors that of professionals; Design thinking as a guiding force for information behavior; Design work requires the use of a specialized information sources; Methodological and Theoretical approaches. Results demonstrate a significant gap in knowledge around information seeking behavior specific to engineering students. Research into this area should be developed to be more inclusive and diverse, which will help increase recruitment and support of underrepresented groups, and overall will improve student success in engineering. Additional research should be conducted to validate or confirm previous findings, build on existing assessment protocols, develop new protocols and methodologies, and explore the application of new theoretical frameworks. There should be a focus in engaging cross-disciplinary stakeholders in the research process

Critical Reading Across the Engineering Disciplines

Engineering students spend a significant amount of time discovering, evaluating, and reading/interpreting information. This book chapter discusses the existing knowledge around undergraduate engineering student information and critical reading practices and presents a case study that provides a successful pedagogical strategy to address these salient issues in the classroom

Transcending Academic Power Structures: Navigating STEM Misinformation for Undergraduate Learning

When students enter university, they learn that there are two types of information: information that can be found using library resources and the information that is found using Google. Sources are often framed in opposition to one another, with the library’s resources representing good and authoritative information, while other sources are considered risky and inferior. Librarians have started to question the usefulness of privileging certain types of information over others, acknowledging that highly useful and reliable information does exist outside of the confines of library resources. Specifically, by inherently devaluing sources found outside of the traditional academic context, how are we unintentionally perpetuating a power system that devalues non-academic voices, experiences, and contexts. Further, individuals with alternative viewpoints must first learn to act, think, and excel on academia’s terms before their worldviews and the information they have to share will be granted legitimacy by the academy. This poster uses critical theory to help position information as an element within the broader academic power structure. We are advocating for a more inclusive approach used in library instruction that encourages students to critically evaluate information on an individual basis