Social media applications within the NHS: role and impact of organisational culture, information governance, and communications policy

The paper focuses on health professionals’ attitudes to and use of Web 2.0 and social media within their practice and on the management of access to Web 2.0 and social media applications within NHS organisations. It discusses the following specific issues: 1) the nature and extent of restrictions on access to such applications within NHS organisations arising from organisational policies; 2) their impacts on professional information seeking and sharing, and working practices in general; 3) the attitudes, professional norms, presuppositions and practices which bear on how social media policy is implemented within NHS trusts, in relation to overall organisational strategies. There is a need to develop a better understanding of, on the one hand, a clear need for robust information governance and network security, with, on the other hand, systems and procedures that enable appropriate access to valid online resources to support professional information needs. Particular questions that need to be addressed include: Why are restrictions imposed on access to Web 2.0 or social media-based information resources, or technologies to support professional information seeking? What issues for the accessibility of information within the English NHS are posed by current approaches to information governance risk

Understanding the lived experiences of Mexican informal caregivers with Ambient Assisted Living Technologies

Ambient Assisted Living (AAL) Technologies, have the potential to support the people with dementia living in their homes for longer. Dementia is a major public health concern. It currently affects approximately 46.8 million people worldwide and by 2050 this figure will increase to 131.5 million. Low-and-middle income countries (LMIC) will be particularly affected by this situation as their poor health infrastructures and governmental support will mean that they have to rely on the informal caregiver (IC) sector. ICs are people who care for a dependent or disabled family member, commonly spouses or daughters. Mexico was the first Spanish speaking country in the world to recognise dementia as a public health priority. In-home technologies, such as AAL Technologies, are used in dementia care in order to improve patients’ and caregivers’ quality of life. This paper explores the way in which Mexican ICs of people with dementia (PWD) make sense of their lived experiences with AAL technologies

The use of classification and regression tree to predict 15-year survival in community-dwelling older people

Previous research has identified various risk factors for mortality in older people. The aim of this paper was to use Classification and Regression Tree to predict 15-year survival in community-dwelling older people. Data were obtained from a United Kingdom representative sample of 1042 community-dwelling people aged 65 and over. Outcome was time from 1985 interview to death or censorship on February 29, 2000. Classification and Regression Tree is a non-parametric technique widely used in medical domain classification. We applied CART to the set of risk-factors identified in a previous research. The selected CART model is based on age, dose of drug prescribed and handgrip measures. It predicts survival with a sensitivity rate of 76.3% and a specificity rate of 66.3%. The selection of variables are consistent with previous research. Finally, we observed the range of risk factors and their combination associated with increased and decreased mortality

Web-based system for assessing risk factors for falls in community-dwelling elderly people using the Analytic Hierarchy Process

Falls occur frequently among older people and represent the most common cause of injury-related morbidity and mortality in later life. Preventing falls is an important way to reduce injuries, hospitalizations, and injury-related morbidity and mortality among older people. The research literature has identified hundreds of risk factors for falls among elderly people. Prioritizing risk factors for falls is useful for designing effective and efficacious prevention programs. The aim of this study was to use the Analytic Hierarchy Process to develop a hierarchy of risk factors for falls based on the knowledge and experience of experts working in this field

The underlying career values of young adults' protean and traditional career orientations

Although young people espouse a range of career values, the extent to which traditional career values inter-mix with protean values is unclear. We interviewed a group of young university students in Australia (N = 24, MAge 19.4 years; 50% young men) and examined the full range of traditional and protean values held. Employing applied thematic analysis, we found that freedom/autonomy and fit to self were dominant in protean career themes, while they strongly expressed a desire for job security in a traditional career. The results inform theory development in the career development area and can assist university career counselors

Should we adjudicate outcomes in stroke trials? A systematic review

BACKGROUND: Central adjudication of outcomes is common in randomized clinical trials in stroke. The rationale for adjudication is clear; centrally adjudicated outcomes should have less random and systematic errors than outcomes assessed locally by site investigators. However, adjudication brings added complexities to a clinical trial and can be costly. AIM: To assess the evidence for outcome adjudication in stroke trials. SUMMARY OF REVIEW: We identified 12 studies evaluating central adjudication in stroke trials. The majority of these were secondary analyses of trials, and the results of all of these would have remained unchanged had central adjudication not taken place, even for trials without sufficient blinding. The largest differences between site-assessed and adjudicator-assessed outcomes were between the most subjective outcomes, such as causality of serious adverse events. We found that the cost of adjudication could be upward of £100,000 for medium to large prevention trials. These findings suggest that the cost of central adjudication may outweigh the advantages it brings in many cases. However, through simulation, we found that only a small amount of bias is required in site investigators’ outcome assessments before adjudication becomes important. CONCLUSION: Central adjudication may not be necessary in stroke trials with blinded outcome assessment. However, for open-label studies, central adjudication may be more important

Protean career processes in young adults: Relationships with perceived future employability, educational performance, and commitment

Protean career processes of vocational identity awareness, career adaptability, and career agency have been hypothesized to mediate the relationships between protean career orientation and career-related outcomes. To date, the role of these process mechanisms has not been assessed directly in young adults, and little attention has been paid to educational outcomes, which are important career-related goals for young people on the way to their desired career. To address this gap, we tested this indirect-effects model in a sample of young adult undergraduates (N=396; Mage=20.19, SD=2.99; 72.2% women) and included career-related goals (perceived future employability, educational performance, and commitment) as outcomes. Identity awareness and career adaptability partially explained the relationship between protean career orientation and perceived future employability and completely explained the relationships with educational performance and commitment. Contrary to protean career theory, there were no significant indirect paths via career agency to any of the outcomes

Social media applications within the NHS: role and impact of organisational culture, information governance, and communications policy

The paper focuses on health professionals’ attitudes to and use of Web 2.0 and social media within their practice and on the management of access to Web 2.0 and social media applications within NHS organisations. It discusses the following specific issues: 1) the nature and extent of restrictions on access to such applications within NHS organisations arising from organisational policies; 2) their impacts on professional information seeking and sharing, and working practices in general; 3) the attitudes, professional norms, presuppositions and practices which bear on how social media policy is implemented within NHS trusts, in relation to overall organisational strategies. There is a need to develop a better understanding of, on the one hand, a clear need for robust information governance and network security, with, on the other hand, systems and procedures that enable appropriate access to valid online resources to support professional information needs. Particular questions that need to be addressed include: Why are restrictions imposed on access to Web 2.0 or social media-based information resources, or technologies to support professional information seeking? What issues for the accessibility of information within the English NHS are posed by current approaches to information governance risk

Short email with attachment versus long email without attachment when contacting authors to request unpublished data for a systematic review: a nested randomised trial

Objective: Systematic reviews often rely on the acquisition of unpublished analyses or data. We carried out a nested randomised trial comparing two different approaches for contacting authors to request additional data for a systematic review. Participants: Participants were authors of published reports of prevention or treatment trials in stroke in which there was central adjudication of events. A primary and secondary research active author were selected as contacts for each trial. Interventions: Authors were randomised to be sent either a short email with a protocol of the systematic review attached (“Short”), or a longer email that contained detailed information and without the protocol attached (“Long”). A maximum of two emails were sent to each author to obtain a response. The unit of analysis was trial, accounting for clustering by author.Primary and secondary outcome measures: The primary outcome was whether a response was received from authors. Secondary outcomes included time to response, number of reminders needed before a response was received and whether authors agreed to collaborate.Results: 88 trials with 76 primary authors were identified in the systematic review, and of these, 36 authors were randomised to Short [trials=45], and 40 to Long [trials=43]. Responses were received for 69 trials. There was no evidence of a difference in response rate between trial arms (Short vs Long, odds ratio 1.10, 95% C.I: [0.36, 3.33]). There was no evidence of a difference in time to response between trial arms (Short vs Long, hazard ratio 0.91, 95% C.I: [0.55, 1.51]). In total, 27% of authors responded within a day and 22% of authors never responded. Conclusions: There was no evidence to suggest that email format had an impact on the number of responses received when acquiring data for a systematic review involving stroke trials, or the time taken to receive these responses