Truck drivers' perceptions on wearable devices and health promotion:A qualitative study

Professional truck drivers, as other shift workers, have been identified as a high-risk group for various health conditions including cardiovascular disease, obesity, diabetes, sleep apnoea and stress. Mobile health technologies can potentially improve the health and wellbeing of people with a sedentary lifestyle such as truck drivers. Yet, only a few studies on health promotion interventions related to mobile health technologies for truck drivers have been conducted. We aimed to explore professional truck drivers views on health promotion delivered via mobile health technologies such as wearable devices.We conducted a phenomenological qualitative study, consisting of four semi-structured focus groups with 34 full-time professional truck drivers in the UK. The focus groups were audio-taped, transcribed verbatim and analysed using thematic content analysis. We discussed drivers perceptions of their health, lifestyle and work environment, and their past experience and expectations from mobile health technologies.The participants viewed their lifestyle as unhealthy and were aware of possible consequences. They expressed the need and wish to change their lifestyle, yet perceived it as an inherent, unavoidable outcome of their occupation. Current health improvement initiatives were not always aligned with their working conditions. The participants were generally willing to use mobile health technologies such as wearable devices, as a preventive measure to avoid prospect morbidity, particularly cardiovascular diseases. They were ambivalent about privacy and the risk of their employers monitoring their clinical data.Wearable devices may offer new possibilities for improving the health and wellbeing of truck drivers. Drivers were aware of their unhealthy lifestyle. They were interested in changing their lifestyle and health. Drivers raised concerns regarding being continuously monitored by their employer. Health improvement initiatives should be aligned with the unique working conditions of truck drivers. Future research is needed to examine the impact of wearable devices on improving the health and wellbeing of professional drivers

Four Responses to Warning Systems: A Case Study of Clinical Reminders

This paper addresses theoretical aspects of human responses to warning systems and applies them to the responses to a clinical reminder system. The literature on warnings describes a number of responses, such as compliance and reliance, automation bias, and the “cry-wolf” effect. This paper suggests two complementary responses to compliance and reliance, named spillover and reactance, which can be placed within the framework of operators' responses to warning systems, and which altogether describe a complete set of possible responses to cues from warning systems. This set of responses is demonstrated on the example of a clinical reminder system, which mails reminders to primary care physicians regarding patients who require secondary prevention of clinical arteriosclerosis. The results mainly show evidence for compliance. Some theoretical conclusions are drawn. </jats:p

Physicians Bypass Enrollment Suggestions into a Clinical Reminders Intervention

While clinical reminders can promote adherence with evidence-based clinical guidelines, they may have unintended consequences such as alert fatigue, false alarms and increased workload, which cause clinicians to ignore them. We evaluated clinicians' response rates to suggestions to enroll patients in a nationwide clinical reminders intervention, aiming to promote prevention of clinical arthrosclerosis. Analysis of 203, 164 suggestions for 108, 636 patients showed that the clinicians mostly ignored suggestions from the system and followed only 21.4% of the inclusion suggestions. The data show that when physicians could choose for which patients the reminders will be generated, they mostly chose not to include patients in the clinical reminders intervention. It seems that they tried to abort the process as soon as possible, rather than complete the workflow orderly. Insights regarding the usability of clinical reminders are discussed. </jats:p

Second medical opinions

Second opinion is a decision-support tool for ratification or modification of a suggested treatment, by another physician. Second opinion may have a critical influence on the diagnosis, treatment and prognosis. The patient can benefit from treatment optimization and avoid unnecessary risks. The physician can benefit from less exposure to legal claims, and healthcare organizations can benefit from increased treatment, quality assurance and costs saving from unnecessary surgery and treatments. Nevertheless, injudicious use of this tool can provoke unnecessary medical costs. In recent years, many patients prefer to seek a second opinion on their disease and available treatments. Private and public insurance companies are trying to control surgery costs by urging and even demanding a second opinion before surgery. Although second opinions are common in medical practice, relatively little is known on this subject. Most of the studies reviewed in this article evaluated the clinical benefit of second opinions, the reasons patients seek a second opinion and the characteristics of these patients, as well as technological interventions to promote second opinions, and ethical or legal issues related to second opinions. Yet, there are opportunities for further studies about physicians attitudes and barriers towards second opinions, their effect on patient-physician communication and cost-effectiveness analyses of second opinions. Due to the relevance of second opinions for public heath, this review aims to summarize the current research on second opinions