Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application : a cross sectional exploratory study

Background New patient-centric integrated care models are enabled by the capability to exchange the patient’s data amongst stakeholders, who each specialise in different aspects of the patient’s care. This requires a robust, trusted and flexible mechanism for patients to offer consent to share their data. Furthermore, new IT technologies make it easier to give patients more control over their data, including the right to revoke consent. These characteristics challenge the traditional paper-based, single-organisation-led consent process. The Dovetail digital consent application uses a mobile application and blockchain based infrastructure to offer this capability, as part of a pilot allowing patients to have their data shared amongst digital tools, empowering patients to manage their condition within an integrated care setting. Objective To evaluate patient perceptions towards existing consent processes, and the Dovetail blockchain based digital consent application as a means to manage data sharing in the context of diabetes care. Method Patients with diabetes at a General Practitioner practice were recruited. Data were collected using focus groups and questionnaires. Thematic analysis of the focus group transcripts and descriptive statistics of the questionnaires was performed. Results There was a lack of understanding of existing consent processes in place, and many patients did not have any recollection of having previously given consent. The digital consent application received favourable feedback, with patients recognising the value of the capability offered by the application. Patients overwhelmingly favoured the digital consent application over existing practice. Conclusions Digital consent was received favourably, with patients recognising that it addresses the main limitations of the current process. Feedback on potential improvements was received. Future work includes confirmation of results in a broader demographic sample and across multiple conditions

Is the propensity to emit alarm calls associated with health status?

This work was supported by the National Geographic Society, UCLA (Faculty Senate and the Division of Life Sciences), a RMBL research fellowship, and by the National Science Foundation (NSF) (IDBR-0754247, and DEB-1119660 and 1557130 to D.T.B., as well as DBI-0242960, 0731346, and 1226713 to the RMBL).Peer reviewedPublisher PD

Recent advances in Omega-3: Health benefits, sources, products and bioavailability

The joint symposium of The Omega-3 Centre and the Australasian Section American Oil Chemists Society; Recent Advances in Omega-3: Health Benefits, Sources, Products and Bioavailability, was held November 7, 2013 in Newcastle, NSW, Australia. Over 115 attendees received new information on a range of health benefits, aquaculture as a sustainable source of supply, and current and potential new and novel sources of these essential omega-3 long-chain (LC, ≥C20) polyunsaturated fatty acid nutrients (also termed LC omega-3). The theme of “Food versus Fuel” was an inspired way to present a vast array of emerging and ground breaking Omega-3 research that has application across many disciplines. Eleven papers submitted following from the Omega-3 Symposium are published in this Special Issue volume, with topics covered including: an update on the use of the Omega-3 Index (O3I), the effects of dosage and concurrent intake of vitamins/minerals on omega-3 incorporation into red blood cells, the possible use of the O3I as a measure of risk for adiposity, the need for and progress with new land plant sources of docosahexaenoic acid (DHA, 22:6ω3), the current status of farmed Australian and New Zealand fish, and also supplements, in terms of their LC omega-3 and persistent organic pollutants (POP) content, progress with cheap carbon sources in the culture of DHA-producing single cell organisms, a detailed examination of the lipids of the New Zealand Greenshell mussel, and a pilot investigation of the purification of New Zealand hoki liver oil by short path distillation. The selection of papers in this Special Issue collectively highlights a range of forward looking and also new and including positive scientific outcomes occurring in the omega-3 field

Plasmodium falciparum:Rosettes do not protect merozoites from invasion-inhibitory antibodies

Rosetting is a parasite adhesion phenotype associated with severe malaria in African children. Why parasites form rosettes is unknown, although enhanced invasion or immune evasion have been suggested as possible functions. Previous work showed that rosetting does not enhance parasite invasion under standard in vitro conditions. We hypothesised that rosetting might promote invasion in the presence of host invasion-inhibitory antibodies, by allowing merozoites direct entry into the erythrocytes in the rosette and so minimising exposure to plasma antibodies. We therefore investigated whether rosetting influences invasion in the presence of invasion-inhibitory antibodies to MSP-1. We found no difference in invasion rates between isogenic rosetting and non-rosetting lines from two parasite strains, R29 and TM284, in the presence of MSP-1 antibodies (P=0.62 and P=0.63, Student's t test, TM284 and R29, respectively). These results do not support the hypothesis that rosettes protect merozoites from inhibitory antibodies during invasion. The biological function of rosetting remains unknown

Effects of Patient Aggression on Pediatric Healthcare Workers

Healthcare workers are injured at high rates, even those who work in pediatric settings. The source of these injuries may be overexertion, slips/trips/falls, or needle sticks, but one source of injuries that has not been studied as extensively is patient aggression. Our study looked at possible effects of experiencing “patient behavioral events” (or PBEs), which are defined as physical aggression toward an employee, whether or not there was an intention to harm. Surveys of employees at three children’s hospitals across the U.S. showed that increased frequency of PBEs is associated with decreased well-being and worse job/organization attitudes. One key finding from this study is that the same negative effects were shown when the frequency of witnessing or hearing about PBEs was higher, which suggests that one need not be the target of the aggression to experience negative effects. If this causal path holds in future research, it would mean that PBEs have ripple effects in the unit, beyond just the person who is targeted by the patient aggression. Ongoing data analyses will examine whether there are any mitigating factors that might reduce the harm caused by PBEs

Psychosocial stress induction in vivo vs. in virtuo and the influence of a health app on the acute stress reaction in youths: a study protocol for a randomized controlled trial

Background Acute and everyday stress is substantial for the development of mental and physical diseases, therefore it is crucial to get a better understanding of its pathogenesis. Different methods (e.g., Ambulatory Assessment) and stress reactivity paradigms (e.g., Trier Social Stress Test / TSST) in laboratory settings are often used to investigate basic mechanisms of this process. Due to the technological progress of the last years and especially due to children and adolescents growing up with it, the application of these developments in clinical research is reasonable. The aim of this project is to successfully transfer the TSST for children and adolescents into the virtual world, which will be compared to a real TSST situation. Physiological and psychological stress reactions will be analyzed in order to assess similarities and differences. Moreover, it will be investigated whether a Heart Coherence Exercise (HCE) has a stronger influence on coping with acute stress compared to Natural Relaxation (NR). Methods This single-center experimental study will examine acute and everyday stress and coping processes in eighty-four healthy children and adolescents between the ages of 11 and 17. For everyday stress, different parameters (e.g., hormonal profiles and mood ratings) as well as a history of stressful life events and utilized coping methods will be recorded and a relaxation exercise will be practiced on a smartphone over 2 days. Regarding the acute stress reaction, the participants will be confronted either with the virtual or the real version of the TSST, followed by the trained relaxation exercise (HCE vs. NR). Physiological (e.g., cortisol and heart rate) and psychological stress markers (e.g., mood and gaze behavior) will be recorded continuously. Discussion Studies are sparse using a virtual version of the TSST in children and adolescents. A successful virtual TSST would constitute an economical variant, which would also make it easier to administer it in clinical or population-based samples. Effective ambulatory relaxation exercises would be a useful addition to clinical treatment approaches

An interdisciplinary knowledge translation intervention in long-term care: Study protocol for the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial

BACKGROUND: Knowledge translation (KT) research in long-term care (LTC) is still in its early stages. This protocol describes the evaluation of a multifaceted, interdisciplinary KT intervention aimed at integrating evidence-based osteoporosis and fracture prevention strategies into LTC care processes. METHODS AND DESIGN: The Vitamin D and Osteoporosis Study (ViDOS) is underway in 40 LTC homes (n = 19 intervention, n = 21 control) across Ontario, Canada. The primary objectives of this study are to assess the feasibility of delivering the KT intervention, and clinically, to increase the percent of LTC residents prescribed ≥800 IU of vitamin D daily. Eligibility criteria are LTC homes that are serviced by our partner pharmacy provider and have more than one prescribing physician. The target audience within each LTC home is the Professional Advisory Committee (PAC), an interdisciplinary team who meets quarterly. The key elements of the intervention are three interactive educational sessions led by an expert opinion leader, action planning using a quality improvement cycle, audit and feedback reports, nominated internal champions, and reminders/point-of-care tools. Control homes do not receive any intervention, however both intervention and control homes received educational materials as part of the Ontario Osteoporosis Strategy. Primary outcomes are feasibility measures (recruitment, retention, attendance at educational sessions, action plan items identified and initiated, internal champions identified, performance reports provided and reviewed), and vitamin D (≥800 IU/daily) prescribing at 6 and 12 months. Secondary outcomes include the proportion of residents prescribed calcium supplements and osteoporosis medications, and falls and fractures. Qualitative methods will examine the experience of the LTC team with the KT intervention. Homes are centrally randomized to intervention and control groups in blocks of variable size using a computer generated allocation sequence. Randomization is stratified by home size and profit/nonprofit status. Prescribing data retrieval and analysis are performed by blinded personnel. DISCUSSION: Our study will contribute to an improved understanding of the feasibility and acceptability of a multifaceted intervention aimed at translating knowledge to LTC practitioners. Lessons learned from this study will be valuable in guiding future research and understanding the complexities of translating knowledge in LTC. TRIAL REGISTRATION: ClinicalTrials.gov NCT01398527