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Item Clinician-Patient Small Talk: Comparing Fourth-Year Dental Students and Practicing Dentists in a Standardized Patient Encounter(2016) Maupome, Gerardo; Holcomb, Christopher; Schrader, Stuart; Cariology, Operative Dentistry and Dental Public Health, School of DentistryThe aim of this study was to establish whether frequency of non-diagnostic, non-management exchanges between clinicians and patient (called “socioemotional communication,” SC) during a consultation differed between fourth-year dental students and dentists, controlling for clinically driven exchanges of information. Fifteen dentists and 17 fourth-year dental students were recorded in 2006 while undergoing a consultation with a live standardized patient and were subsequently interviewed by investigators in a separate room with the recording present for analysis. Their shared interpretations of cognitive strategies were recorded and compared for differences in the presence of SC. The results showed that most of the students and dentists engaged in SC throughout the consultation with a few exceptions. There were no significant differences between student and dentist cohorts for overall SC presence (p=0.62), time to first instance of SC from overall start of the consultation (p=0.73), and time to first instance of SC after first intraoral examination had taken place (p=0.76). Nonsignificant differences were also recorded for overall frequency at which SC occurred from overall start of the consultation (p=0.89) and after the first intraoral examination had taken place (p=0.12). The patterns showed SC interaction occurring throughout the consultation, not concentrated at the beginning or end. SC did not appear to differ between practitioners and students in terms of prevalence, frequency, or timing. Future research should examine the detailed association between SC and diagnostic thinking processes to further delineate the relationship and characterize possible pedagogical applications.Item A Comparison of the Sensitivity and Specificity of I-123 Whole body scan and Serum Thyroglobulin for Follow-up Thyroid Cancer Patients(Office of the Vice Chancellor for Research, 2016-04-08) Almomen, Fatimah F.; Nielsen, Cybil; Clifft, Monica; Thomas, PamalaAbstract Does the I-123 WBS have more sensitivity and specificity than Tg level test in follow-up for thyroid cancer? A comparison of the sensitivity & specificity between I-123 whole body scan (I-123 WBS) and serum thyroglobulin (Tg) for follow-up patients who were treated with I-131 for thyroid cancer was conducted. Methods & material: The design of this study is Null hypothesis: I-123 WBS has equal sensitivity or greater than Tg test when predicting recurrence of thyroid cancer. Alternate hypothesis: I-123 WBS has less sensitivity than Tg test. The population of this study is a convenience sample consisted of 28 patients who met the following criteria: 1) had follicular or papillary thyroid cancer or both, 2) between the period 2013 to 2015, and 3) had serum Tg results and had undergone I-123 WBS after one year of iodine therapy. Any detectable Tg value was considered positive. Tg and I-123 WBS results were compared with the final impression, which was the radiologist determination from the patient history and other tests (besides Tg and I-123 WBS), We compared Sensitivity and Specificity for both tests Results: Tg had a higher sensitivity than I-123 WBS. Tg has 75% sensitivity while I-123 WBS has 73.3 % sensitivity. I-123 WBS had a specificity of 100% and Tg had a specificity of 91.7%. Positive predictive Value (PPV) for Tg was 92.3%. and I-123 WBS was 100%. Negative Predictive Value (NPV) for Tg was 73.3% and I-123 WBS was 75%. Conclusions: I-123 WBS should not be replaced by Tg. I-123 WBS has higher specificity.Item Connecting Care – Empowering The Patient Through Their Waiting Experience(Office of the Vice Chancellor for Research, 2016-04-08) Sieferd, Edward J.; Hsu, Hsueh-Fen; Semidey, Lisa; Mohebbi, Mahdiyeh; Rong, Jiacheng; Chen, Linjun; Phillips, Milesha; Stevens, Madison; Jin, Siying; Hong, YoungbokWaiting at a hospital is a challenge for patients and their families. Many individuals go to the hospital, waiting for hours to receive their tests and results. This waiting experience places a burden on individuals and causes stress in a tense time in their lives. This research was a partnership between healthcare providers and graduate program of Design Thinking and Leadership, Department of Visual Communication Design, Herron School of Art and Design. The goal of this people-centered research was to examine and enhance the patient waiting experience at the Registration, Lab and Radiology service areas of a Carmel Hospital. To understand the patient experiences, we approached the project utilizing people-centered design methods. The design research team conducted ethnographic observations and interviews involving patients and staff within the Laboratory, Registration, and Radiology spaces at a hospital. In responding to defined problems within these spaces, the design team identified the desirable patient communication flow and developed an integrative communication system that aligned with the touch points of the patient journey. This communication system included wrist bands, digital message boards, an expanded pager system, as well as redesigned interior spaces. The two major findings from the research were: One, current communication levels between provider staff and patients resulted in negative patient perceptions of the service. Two, patients wanted more integrated ways to maintain communication between service providers and themselves. From these findings, it was recommended that service providers adapt a more integrated communication system to deliver an optimal patient experience.Item Daily Situational Brief, December 12, 2014(MESH Coalition, 12/12/14) MESH CoalitionItem Daily Situational Brief, December 25, 2014(MESH Coalition, 12/25/14) MESH CoalitionItem Daily Situational Brief, July 27, 2011(MESH Coalition, 2011-07-27) MESH CoalitionItem THE EFFECTIVENESS OF A HORTICULTURE THERAPY CLASS ON PERCEIVED EMOTIONS FOR COLLEGE NURSING STUDENTS: A PRELIMINARY STUDY(Office of the Vice Chancellor for Research, 2015-04-17) Chen, Shih-Ni; Sun, Jia-LingObjective: Horticultural therapy (HT) is a dynamic, guided therapeutic process that involves healthcare providers teaching patients to work with plants and natural materials. Through engaging in horticultural activities, patients achieve specific goals such as improved physical strength, memory, cognitive abilities, task initiation, language skills, and socialization. The aim of the study was to evaluate the efficacy of a horticultural therapy (HT) class for college nursing students who perceive high levels of stress in their academic and clinical nursing studies. Method: The study was conducted at a health science university in an urban city of northern Taiwan. After explaining the procedure to and receiving consent from participants, a total of 116 college, nursing students, aged 20-39 years, mean age 26.90 (4.72), all females were recruited into the study. One group pretest and posttest design and convenient sampling were adopted. Participants received a pretest one week prior to the three-week HT class. The three-week HT class was conducted once per week with two hours for each section. Learning was evaluated with a posttest one week after the end of the HT class. Personal characteristics and outcome data was collected by a constructed questionnaire including five parts: the demographic section, the attitude towards HT, the knowledge of HT, the perceived emotional status, and the Chinese State-Trait Anxiety Inventory (C-STAI). Results: After the three-week HT class, student-perceived emotional management and status significantly improved. While students perceived greater HT knowledge, there was no significant difference in the HT knowledge pre and post-test scores. While a decrease in anxiety was found, it failed to reach a 0.05 level of significance. It showed relationships between pretest emotional status and previous experience with the decreased level of anxiety in the results of the multiple regression analysis. Conclusion: Engaging students in experiencing HT during an academic class could improve college nursing students' emotional status. Further refinement of the HT class and research design are suggested, such as adding a control group and involving more therapeutic activities into the class.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.Item A Qualitative Study Exploring Why Individuals Opt Out of Lung Cancer Screening(Oxford, 2017-04) Carter-Harris, Lisa; Brandzel, Susan; Wernli, Karen J.; Roth, Joshua; Buist, Diana S. M.; School of NursingBackground. Lung cancer screening with annual low-dose computed tomography is relatively new for long-term smokers in the USA supported by a US Preventive Services Task Force Grade B recommendation. As screening programs are more widely implemented nationally and providers engage patients about lung cancer screening, it is critical to understand behaviour among high-risk smokers who opt out to improve shared decision-making processes for lung cancer screening. Objective. The purpose of this study was to explore the reasons for screening-eligible patients’ decisions to opt out of screening after receiving a provider recommendation. Methods. Semi-structured qualitative telephone interviews were performed with 18 participants who met lung cancer screening criteria for age, smoking and pack-year history in Washington State from November 2015 to January 2016. Two researchers with cancer screening and qualitative methodology expertise conducted data analysis using thematic content analytic procedures from audio-recorded interviews. Results. Five primary themes emerged for reasons of opting out of lung cancer screening: (i) Knowledge Avoidance; (ii) Perceived Low Value; (iii) False-Positive Worry; (iv) Practical Barriers; and (v) Patient Misunderstanding. Conclusion. The participants in our study provided insight into why some patients make the decision to opt out of low-dose computed tomography screening, which provides knowledge that can inform intervention development to enhance shared decision-making processes between long-term smokers and their providers and decrease decisional conflict about screening.Item “The RESPECT (Research in Palliative and End-of-Life Communication and Training) Center”(Office of the Vice Chancellor for Research, 2011-04-08) Hickman, Susan E.; Sachs, Greg A.; Haase, Joan E.; Stickler, Molly DonovanCommunication is crucial to decision-making and high-quality care for patients with serious illness, but there are significant gaps in communication among patients, families, and clinicians. The Research in Palliative and End-of-Life Communication and Training (RESPECT) Center was funded in July 2010 under the IUPUI Signature Center Initiative to advance the science of palliative and end-of-life communication. The mission of the RESPECT Center is to build a collaborative, interdisciplinary scientific community of researchers and clinicians to work together to advance the science of communication in palliative and end-of-life care across the lifespan. The Center capitalizes on the complementary and expanding expertise at IU to support the advancement of research on communication in populations with serious illness that is lifethreatening, debilitating, or terminal. The Center is working to achieve its mission through three primary activities. First, the Center convenes researchers with shared expertise to utilize the collective wisdom of the interdisciplinary group in grant development and submission. The RESPECT Center uses a peer review meeting model to provide a forum for students, trainees, and faculty to develop and refine their grant writing activities focused on palliative and end-of-life care from idea development to grant revision. Second, research development is augmented by funding opportunities for peerreviewed pilot studies. Pilot funding is designed to attract new researchers to this area of study and to facilitate the generation of pilot data for more experienced researchers who are carving a new path in the field. Finally, several outreach activities are being undertaken with the goal of fostering new partnerships for translational science. The RESPECT Visiting Scholar series brings in external experts to present as part of a conference series and to meet with research faculty, clinicians, and administration to discuss issues related to advancing palliative and endof-life care research at IU. Additionally, a city-wide conference will be convened in year 3 to bring together members of the health care professional community with an interest in evidencebased practice in palliative and end-of-life care. The long-term goal of the RESPECT Center is to secure funding to permit the continued operation and expansion of Center activities.