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Item Advice Regarding Alcohol Use by Individuals With Nonalcoholic Fatty Liver Disease: Primum non nocere(Wiley, 2018) Dunn, Winston; Chalasani, Naga; Medicine, School of MedicineIndividuals with nonalcoholic fatty liver disease (NAFLD) often ask their health care providers about routinely consuming non‐heavy amounts of alcohol for pleasure and potential health benefits. According to the American Association for the Study of Liver Diseases (AASLD) Practice Guidance published in 2018, there are insufficient data to make a recommendation with regard to non‐heavy alcohol consumption by individuals with NAFLD.(1) Although several cross‐sectional studies have suggested that light alcohol consumption (on average, <1 drink per day) may have a beneficial effect on the presence and severity of NAFLD, a large meta‐regression analysis suggested that lower body mass index among light and moderate drinkers is a potential confounder and thus casts doubt on the rigor of those studies.Item Making a Shared Decision on Meningococcal B Vaccine: Provider Feedback on an Educational Tool Developed for Use With Patients(Elsevier, 2022-05) Middleman, Amy B.; Zimet, Gregory D.; Srivastava, Amit K.; Auslander, Beth A.; Pediatrics, School of MedicineBackground In 2015, the Advisory Committee on Immunization Practices recommended Meningococcal B vaccination for healthy 16- to 23-year-olds based on shared clinical decision-making between the patient and the provider. There has been some confusion regarding how to implement this recommendation. Methods Through discussions among the authors, a review of relevant literature, and consultation with vaccine experts, we developed educational materials for providers that included a patient handout to help initiate and guide conversations leading to shared clinical decision-making for the Meningococcal B vaccine. Materials were distributed to 88 health care providers who subsequently completed surveys to evaluate their impressions of the materials and the utility of the materials for clinical practice. Results The survey results from the 88 providers revealed that they valued the materials; 93% percent indicated they would share these materials with colleagues, and 95% agreed or strongly agreed that they would share these materials with patient families. Responses to an open-ended question indicate that some providers initiated discussions regarding the Meningococcal B vaccine in ways that truncated conversation rather than encouraging a shared decision-making process. Conclusions Overall, the materials developed and implemented for this project support the initiation of, and help standardize provider conversations regarding, Meningococcal B vaccination for healthy adolescents.Item Person-Centered Health Records(Office of the Vice Chancellor for Research, 2016-04-08) King, ZacharyCurrent Personal Health Records (PHRs) have been in existence for more than a decade. However, to date, they have not been able to attract the attention of mainstream patients. This limited widespread adoption may possibly be due to a lack of support of the users in efficiently and effectively managing their health records. The exiting PHRs seem to be even less useful to health care providers in support of their decision-making process. Most PHRs include an emergency profile which is entered by the user and can be accessed by emergency care providers. This information is useful and in critical situation may be the only information available to health care providers. However, the PHRs also often rely on the user to enter other health-related information instead of facilitating a user-friendly automated and personalized data integration model with external data sources. User-entered data can make health records lack reliability and render the underlying application difficult to manage for layman users. Furthermore, current PHRs are organized to facilitate data acquisition rather than based on ease of access and of management by mainstream users. In this paper, we propose a new architecture for PHRs that we believe can overcome the lack of personalization and data integration in current systems thereby leading to a more user-friendly PHR model that may be able to gain active mainstream engagement. The architecture of the proposed PHR is patient-centric and socially-driven. It allows the users to customize their health records and make these records more available to health care providers for tracking, review, and editing. The proposed system will also encourage large scale community engagement and participation in health related research.