Original Paper
Who Uses Mobile Phone Health Apps and Does Use Matter? A
Secondary Data Analytics Approach
Jennifer K Carroll1, MPH, MD; Anne Moorhead2, MSc, MA, MICR, CSci, FNutr (Public Health), PhD; Raymond
Bond3, PhD; William G LeBlanc1, PhD; Robert J Petrella4, MD, PhD, FCFP, FACSM; Kevin Fiscella5, MPH, MD
1Department of Family Medicine, University of Colorado, Aurora, CO, United States
2School of Communication, Ulster University, Newtownabbey, United Kingdom
3School of Computing & Maths, University of Ulster, Newtownabbey, United Kingdom
4Lawson Health Research Institute, Family Medicine, Kinesiology and Cardiology, Western University, London, ON, Canada
5Family Medicine, Public Health Sciences and Community Health, University of Rochester Medical Center, Rochester, NY, United States
Corresponding Author:
Jennifer K Carroll, MPH, MD
Department of Family Medicine
University of Colorado
Mail Stop F496
12631 E. 17th Ave
Aurora, CO, 80045
United States
Phone: 1 303 724 9232
Fax: 1 303 724 9747
Email: [email protected]
Abstract
Background: Mobile phone use and the adoption of healthy lifestyle software apps (“health apps”) are rapidly proliferating.
There is limited information on the users of health apps in terms of their social demographic and health characteristics, intentions
to change, and actual health behaviors.
Objective: The objectives of our study were to (1) to describe the sociodemographic characteristics associated with health app
use in a recent US nationally representative sample; (2) to assess the attitudinal and behavioral predictors of the use of health
apps for health promotion; and (3) to examine the association between the use of health-related apps and meeting the recommended
guidelines for fruit and vegetable intake and physical activity.
Methods: Data on users of mobile devices and health apps were analyzed from the National Cancer Institute’s 2015 Health
Information National Trends Survey (HINTS), which was designed to provide nationally representative estimates for health
information in the United States and is publicly available on the Internet. We used multivariable logistic regression models to
assess sociodemographic predictors of mobile device and health app use and examine the associations between app use, intentions
to change behavior, and actual behavioral change for fruit and vegetable consumption, physical activity, and weight loss.
Results: From the 3677 total HINTS respondents, older individuals (45-64 years, odds ratio, OR 0.56, 95% CI 0.47-68; 65+
years, OR 0.19, 95% CI 0.14-0.24), males (OR 0.80, 95% CI 0.66-0.94), and having degree (OR 2.83, 95% CI 2.18-3.70) or less
than high school education (OR 0.43, 95% CI 0.24-0.72) were all significantly associated with a reduced likelihood of having
adopted health apps. Similarly, both age and education were significant variables for predicting whether a person had adopted a
mobile device, especially if that person was a college graduate (OR 3.30). Ind ...
This document discusses a study of consumer healthcare apps and barriers to their broader use. It finds that while there are tens of thousands of apps available, most focus on wellness and few do more than provide information. Fewer than 500 downloads is typical for over 50% of apps. Barriers to greater use include a lack of guidance for patients, lack of evidence demonstrating benefits, and lack of integration into healthcare systems. Moving apps mainstream will require recognition of their role by payers and providers, addressing privacy and security, evaluating apps to guide patients and doctors, and integrating apps with care delivery.
Running head APPLICATIONS OF THE PRECEDE-PROCEED MODEL 1.docxSUBHI7
This document discusses behavioral risk factors for lung cancer. The two main behavioral risk factors discussed are heavy alcohol consumption and cigarette smoking. Predisposing factors that contribute to these behaviors include gender and family history. Reinforcing factors include internal and external rewards, while enabling factors make the behaviors easier through conditions like wealth and living situation. The document also discusses advantages and disadvantages of different settings for addressing lung cancer risks, such as quitting smoking/drinking or improving nutrition.
This study investigated factors influencing older adults' intention to use mobile medical apps in the Netherlands. Data was collected through questionnaires administered both digitally and on paper to over 1000 community-dwelling older adults aged 65 and over. Logistic regression analysis identified several significant factors: a positive attitude towards use, perceived usefulness, perceived ease of use, availability of support services, sense of control, self-perceived effectiveness, access to technology, personal innovativeness, social relationships, subjective norms, and lower anxiety levels increased intention to use apps, whereas cost did not. The study provides insight into important factors for developing policies to advance older adults' adoption of medical apps.
Potential of social media as a tool to combat foodborne illnessMarcella Zanellato
Abstract
The use of social media platforms, such as Facebook and Twitter, has been increasing
substantially in recent years and has affected the way that people access information online.
Social media rely on high levels of interaction and user-generated context shared through
established and evolving social networks. Health information providers must know how to
successfully participate through social media in order to meet the needs of these online
audiences. This article reviews the current research on the use of social media for public health
communication and suggests potential frameworks for developing social media strategies. The
extension to food safety risk communication is explored, considering the potential of social
media as a tool to combat foodborne illness.
1) Home and specialty infusion professionals widely embrace mobile health technology, with 83% using apps to reference drug or clinical information and 40% using apps to communicate with coworkers.
2) Popular clinical apps used include Epocrates, Lexicomp, Medscape, and Micromedex for drug information, and effective app features include leveraging smartphone capabilities, linking to external sensors, and securely transmitting data.
3) While apps can help improve patient engagement and care delivery, barriers remain around evidence, integration, privacy, and reimbursement, though the mobile health market is expected to reach $31 billion by 2020.
The document describes a new mobile application called BOINK! that aims to provide sexual health education and safety information to address gaps in traditional sex education programs in the United States. It outlines topics to be covered in the app such as gender, anatomy, contraception, and STI prevention. It also discusses research conducted to develop comprehensive health resources for inclusion. The document recommends usability testing and continuous updates to content to ensure accuracy and relevance over time. The goal is to impact millions of people who may lack access to reliable sexual health information.
This document discusses a study of consumer healthcare apps and barriers to their broader use. It finds that while there are tens of thousands of apps available, most focus on wellness and few do more than provide information. Fewer than 500 downloads is typical for over 50% of apps. Barriers to greater use include a lack of guidance for patients, lack of evidence demonstrating benefits, and lack of integration into healthcare systems. Moving apps mainstream will require recognition of their role by payers and providers, addressing privacy and security, evaluating apps to guide patients and doctors, and integrating apps with care delivery.
Running head APPLICATIONS OF THE PRECEDE-PROCEED MODEL 1.docxSUBHI7
This document discusses behavioral risk factors for lung cancer. The two main behavioral risk factors discussed are heavy alcohol consumption and cigarette smoking. Predisposing factors that contribute to these behaviors include gender and family history. Reinforcing factors include internal and external rewards, while enabling factors make the behaviors easier through conditions like wealth and living situation. The document also discusses advantages and disadvantages of different settings for addressing lung cancer risks, such as quitting smoking/drinking or improving nutrition.
This study investigated factors influencing older adults' intention to use mobile medical apps in the Netherlands. Data was collected through questionnaires administered both digitally and on paper to over 1000 community-dwelling older adults aged 65 and over. Logistic regression analysis identified several significant factors: a positive attitude towards use, perceived usefulness, perceived ease of use, availability of support services, sense of control, self-perceived effectiveness, access to technology, personal innovativeness, social relationships, subjective norms, and lower anxiety levels increased intention to use apps, whereas cost did not. The study provides insight into important factors for developing policies to advance older adults' adoption of medical apps.
Potential of social media as a tool to combat foodborne illnessMarcella Zanellato
Abstract
The use of social media platforms, such as Facebook and Twitter, has been increasing
substantially in recent years and has affected the way that people access information online.
Social media rely on high levels of interaction and user-generated context shared through
established and evolving social networks. Health information providers must know how to
successfully participate through social media in order to meet the needs of these online
audiences. This article reviews the current research on the use of social media for public health
communication and suggests potential frameworks for developing social media strategies. The
extension to food safety risk communication is explored, considering the potential of social
media as a tool to combat foodborne illness.
1) Home and specialty infusion professionals widely embrace mobile health technology, with 83% using apps to reference drug or clinical information and 40% using apps to communicate with coworkers.
2) Popular clinical apps used include Epocrates, Lexicomp, Medscape, and Micromedex for drug information, and effective app features include leveraging smartphone capabilities, linking to external sensors, and securely transmitting data.
3) While apps can help improve patient engagement and care delivery, barriers remain around evidence, integration, privacy, and reimbursement, though the mobile health market is expected to reach $31 billion by 2020.
The document describes a new mobile application called BOINK! that aims to provide sexual health education and safety information to address gaps in traditional sex education programs in the United States. It outlines topics to be covered in the app such as gender, anatomy, contraception, and STI prevention. It also discusses research conducted to develop comprehensive health resources for inclusion. The document recommends usability testing and continuous updates to content to ensure accuracy and relevance over time. The goal is to impact millions of people who may lack access to reliable sexual health information.
A STUDY ON PHYSICAL ACTIVITY AND HEALTH LITERACY IN ADULT POPULATION WITH REF...IAEME Publication
The article a study on physical activity and health literacy in adult population with reference to Kanyakumari district. The present article shows the profile and awareness about physical activity and health literacy in Adults in the Study area. The health conditions prevailing in India is different. Usually the people care their children health only during childhood and after that when they become adults, they totally neglect about health aspects of their children. When children reach adolescence, they have to choose their career as professionals or non-professionals. Due to various environmental impacts and in the process of life circumstances, they forget about the concept and development of fitness or health-related activities. The major difference between physical activity and health-related physical fitness components are body composition, immunity, briskness, strength and ability. The present study is descriptive in nature using both primary data and secondary data. Primary data were collected through interview schedule from the respondents in the study area. Secondary data were collected from various journals, magazines, newspaper related website and records of etc. the collected primary data were analyzed by using appropriate Statistical tools like Simple percentage, ANOVA, Chi-square test. The study is based on simple random sampling technique. The researcher has collected the primary data through survey fact investigation impact of physical activity and health literacy in adult population with reference to Kanyakumari District. 10villages were selected in Kanyakumari district, 11 respondents from each village were selected on the basis of convenience sampling techniques. Hence, the total sample size is restricted to 110 respondents for the study.
Fattori - 50 abstracts of e patient. In collaborazione con Monica DaghioGiuseppe Fattori
This document contains summaries of 50 abstracts related to e-patients and social media. Some key points:
1) Participatory surveillance of hypoglycemia in an online diabetes social network found high rates of hypoglycemic events and related harms like daily worry and withdrawal from activities. Engagement was also high.
2) Analysis of self-reported Parkinson's disease symptom data from an online platform found short-term dynamics like fluctuations exceeding clinically important differences that add to understanding of disease progression.
3) Examination of influential cancer patients on Twitter found most tweets focused on support rather than medical information, indicating its role in online patient community and support.
Low Functional health literacy is a problem affecting 90 million residents of the United States. Among the 90 million, 36% are adults who have “below basic” health literacy skills. Assessing health literacy is important in improving health behaviors, health outcomes, and perceived communication barriers related to health. The Patient Protection and Affordable Care Act enacted in 2010 brought about changes that demand a more coordinated approach to manage health care services. This research focused on the efforts being made to promote health literacy at Medicaid health homes such as Greater Buffalo United Accountable Healthcare Network (GBUAHN). This research consisted of observation of Patient Health Navigator interactions with patients in order to identify best practices of health literacy initiatives within GBUAHN. Results suggest best practices include promoting and establishing relationship to effectively enhance patients understanding of all their healthcare needs. This study suggests that GBUAHN should continue making use of recommendations related health literacy promotion while exploring areas of improvement as noted on scorecard. Patient Health Navigators are engaging patient in manner that will establish adherence within patients.
This document summarizes research on mobile applications that promote healthy lifestyles. It reviews 8 sources that examine the design, features, effectiveness and challenges of such apps. The literature emphasizes using behavior change techniques, personalization, self-monitoring and feedback to engage users and facilitate long-term behavior change. While mobile apps show promise in health promotion, challenges remain around privacy, usability and integrating apps with healthcare systems. Emerging technologies may further impact app-based health promotion.
Running Head HEALTH NEEDS ASSESSMENT1HEALTH NEEDS ASSESSMEN.docxwlynn1
This document summarizes a health needs assessment that evaluated several measures used to assess public health, including mortality, morbidity, and disability rates. It discusses two completed needs assessments - the 2016 St. Mary's Community Health Needs Assessment and the 2015 Georgia Five Year Needs Assessment. The theories and approaches used in each assessment are described. The document also outlines how the results of needs assessments can be applied to health program planning and design.
The document discusses the health belief model, which is a theoretical framework used in healthcare to guide health promotion plans and disease prevention. It has five stages: precontemplation, contemplation, preparation, action, and maintenance. The model focuses on perceived susceptibility, severity, benefits, and confidence. It can be used to understand behaviors like substance abuse in youth. Barriers to implementing it include lack of resources. Benefits are improving health knowledge and behaviors.
This document discusses how consumers use the internet and social media for health information. About half of US adults own smartphones and 17% use them to look up health information. Social media allows for direct communication between patients and providers and the sharing of health experiences. However, privacy and unreliable information are concerns. The role of nurses includes disseminating effective health information online and enhancing provider-patient communication through technology.
Researchers analyzed large datasets on diet, physical activity, and stress to understand lifestyle habits and identify effective ways to promote healthy changes. One dataset contained 8 million photos of meals taken by mobile users to receive peer feedback on healthiness, which was found to be as accurate as experts. Another dataset contained heartbeat variations for 30,000 people, allowing analysis of actual exercise levels compared to recommendations. The goal is to combine such data insights to better understand morbidity and performance, and evaluate programs to encourage healthy lifestyles.
This document summarizes several studies on health information seeking online:
1) A 2002 study found 80% of online adults look for health information online, amounting to 110 million people. Most (53%) use search engines to find information across sites.
2) A 2006 study found 80% of online Americans search for health information daily, with 66% starting on search engines like Google. Many feel more confident in decisions after searching.
3) A 2005-2007 Europe-wide study found internet health users increased from 44% to 54%. The growth occurred across all countries. The internet will be important for future healthcare.
This paper examines the opportunities and benefits of using apps to help manage diabetes, as well as limitations and concerns. Apps can help patients track key areas of care, enable personalized self-management through data sharing with providers, and provide decision support. However, many apps focus only on parts of care and few use evidence-based practices or offer comprehensive education. After analyzing the top diabetes apps against criteria for effective features, the author concludes that Diabetes App is currently the best option due to its coverage of important data areas and education. Overall, apps show promise for improving outcomes but development needs to address gaps versus clinical guidelines.
A retrospective review of the Honduras AIN-C program guided by a community he...HFG Project
Factors that influence performance of community health workers (CHWs) delivering health services are not well understood. A recent logic model proposed categories of support from both health sector and communities influence CHW performance and program outcomes. This logic model has been used to review a growth monitoring program delivered by CHWs in Honduras, known as Atención Integral a la Niñez en la Comunidad (AIN-C). A retrospective review of AIN-C was conducted through a document desk review and supplemented with in-depth interviews. Documents were systematically coded using the categories from the logic model, and gaps were addressed through interviews. Authors reviewed coded data for each category to analyze program details and outcomes as well as identify potential issues and gaps in the logic model.
Internet Interventions In Review, In Use, and Into the Future.docxmariuse18nolet
Internet interventions are behavioral treatments delivered via the Internet with the goal of symptom improvement. Several studies have found Internet interventions to be feasible and effective for issues like smoking cessation, weight loss, headaches, and body image. However, more research is still needed. Future Internet interventions may be more engaging through improved use of graphics, audio, and interactivity. Hybrid interventions address bandwidth limitations by storing large files locally while maintaining Internet connection.
Statistics For Health Science and Its ImpactsCashews
This document discusses the importance of statistics for health sciences and its impact. It provides examples of how statistical studies and computerized health programs have helped increase compliance with preventative health guidelines over time. Health statistics systems collectively provide data to understand national health and how to address areas for improvement. Challenges include having appropriate technical, operational and resource capacity to produce reliable health statistics.
Data is an essential commodity and various organizations today unlock data to allow them to make business decisions that are highly informed. Data in open source has become highly available and U.K Government has a wide range of available open data to analyse. The paper of this report lies in information extraction from data sets of health for supporting development for wide range of food products that are healthy. The scope of this paper lies in analysing and extracting information from distinct data sets using a specific tool of data analytics that is either SAS JMP or SAS Enterprise guide or base SAS. After this analysis, results for the data will be analysed for showing the requirement for a wide range of food products that are healthy.
Quantitative/Mixed-Methods
American InterContinental University
March 27, 2018
Running head: QUANTITATIVE/MIXED-METHODS
1
QUANTITATIVE/MIXED-METHODS
2
Quantitative/Mixed-Methods
Abstract
Case studies which are done in the field of medicine work towards improving the health of the population. There are some of the parts contained in case studies which are abstract, results, limitations of results, conclusions, and applications. The common statistical methods used in research are descriptive numerical and qualitative thematic analyses. The results of the studies show that equal participation of individuals in the health sector will help boost public health. Limitations of results are that although some strategies may work towards improving health sector, not all of them are effective.
Public health is an important sector in any country for it directly affects the economy of the nation. There need to be certain ways which should be employed with the aim of supporting and improving public health. In this paper, I am going to examine 4 contemporary peer-reviewed articles which employ quantitative or mixed-methods concerning ways on how to improve the health of the public. The interest of the paper is to aid in achieving the best impact in public health sector via using programs which will improve health outcomes drastically. Enhancement of public health will in return help to improve the well-being of populations across the world. Public health awareness on how to avoid unhealthy lifestyles should be created.
In the articles, samples and populations used were appropriate for it showed the real representative of the population at hand. All the samples used in the 4-contemporary peer-reviewed articles fulfilled the rule of thumb hence making them appropriate. The samples used were suitable for they were used to estimate the population parameters for it stood for the entire inhabitants. The samples used were larger but not too large to consume more resources of money and time. The larger sample has helped to produce accurate results making the samples valid and appropriate. The appropriateness of the samples used in these articles, it has been proved via usage of target variance. In using target variance an estimate to be derived from the model eventually attained.
Each article which has been used includes having results, limitations of results, conclusions, and applications. The first contemporary peer-reviewed article is entitled, Refugee women’s involvements of maternity-care facilities in Canada: a methodical review using a description synthesis written by Gina MA Higginbottom, Myfanwy Morgan, Miranda Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay and Rubina Barolia. The article was published 11 February 2015. The results show that there needs to have a healthier understanding of the aspects that produce discrepancies in availability, adequacy, and outcomes during parenthood care (Higginbottom, Morgan, Alexandre, Chiu, Forg ...
Effects of the Affordable Care Act MedicaidExpansion on Subj.docxgidmanmary
Effects of the Affordable Care Act Medicaid
Expansion on Subjective Well-Being in the US Adult
Population, 2010–2016
Lindsay C. Kobayashi, PhD, Onur Altindag, PhD, Yulya Truskinovsky, PhD, and Lisa F. Berkman, PhD
Objectives. To determine whether the 2014 Affordable Care Act Medicaid expansion
affected well-being in the low-income and general adult US populations.
Methods. We obtained data from adults aged 18 to 64 years in the nationally rep-
resentative Gallup-Sharecare Well-Being Index from 2010 to 2016 (n = 1 674 953). We
used a difference-in-differences analysis to compare access to and difficulty affording
health care and subjective well-being outcomes (happiness, sadness, worry, stress, and
life satisfaction) before and after Medicaid expansion in states that did and did not
expand Medicaid.
Results. Access to health care increased, and difficulty affording health care declined
following the Medicaid expansion. Medicaid expansion was not associated with changes
to emotional states or life satisfaction over the study period in either the low-income
population who newly gained health insurance or in the general adult population as a
spillover effect of the policy change.
Conclusions. Although the public health benefits of the Medicaid expansion are in-
creasingly apparent, improved population well-being does not appear tobe among them.
Public Health Implications. Subjective well-being indicators may not be informative
enough to evaluate the public health impact of expanded health insurance. (Am J Public
Health. 2019;109:1236–1242. doi:10.2105/AJPH.2019.305164)
See also Galea and Vaughan, p. 1169.
Akey component of the US AffordableCare Act (ACA) was the expansion of
Medicaid eligibility to nonelderly adults with
incomes up to 138% of the federal poverty
level.1 This policy resulted in 9.6 million
people becoming newly eligible for Medicaid
beginning in 2014.2 The rapidly growing
literature documents a range of beneficial
outcomes for the newly eligible population,
including higher rates of insurance coverage,
increased access to health care providers,
improved quality of care, increased use of
preventive health services, reduced likelihood
of emergency department visits, and reduced
financial difficulties.3–7 Public health spill-
over effects with relevance to the general
population also have been documented,
including lower rates of crime, higher
prescribing of opioid treatments, and reduced
socioeconomic disparities in access to health
care.8–11 Evidence of direct effects on health
outcomes is relatively scarce,5 whereas a
growing body of evidence shows mixed re-
sults for its effect on self-rated health.7,11–14
The effects of the ACA Medicaid expansion
on population well-being in the United States
are unknown.
Human well-being is gaining attention
from researchers and policymakers as a metric
of social welfare that goes beyond standard
indicators for health policy evaluation.15–18
Broadly defined, subjective w ...
The Internet and Information· One of the most effective strate.docxarnoldmeredith47041
"The Internet and Information"
· One of the most effective strategies for increasing the flow of information within a hospitality organization is to give all employees access to the company intranet and all corporate information. Describe three ways how allowing access to the company intranet could help communication and three ways how it could hinder communication within a hospitality organization.
"The
Internet
and
Information"
·
One of the most effective strategies for increasing the flow of information within
a hospitality organization is to give all employees access to the company
intranet and all corporate information. Describe three ways how
allowing
access to the company intranet could help communication and three ways how
it could hinder communication within a hospitality organization.
"The Internet and Information"
One of the most effective strategies for increasing the flow of information within
a hospitality organization is to give all employees access to the company
intranet and all corporate information. Describe three ways how allowing
access to the company intranet could help communication and three ways how
it could hinder communication within a hospitality organization.
Literature Evaluation Table
Student Name: Christiana Bona.
Summary of Clinical Issue (200-250 words):
Childhood obesity is one of the problems that affect the United States and other developed economies. Obesity among children and youths is widely recognized as an issue that generates a lot of adverse health impacts. For instance, childhood obesity is a major indicator of future mental and physical health problems. In spite of the highest rates of childhood obesity in the country in the last three decades, obesity has been linked to other more serious health problems such as cardiovascular diseases and diabetes. As nurses and other health professionals continue to grapple with this problem, there are still no clear treatment approaches. Health professionals usually do not have a comprehensive guideline on where to manage the nearly one-third of their populations who present the medical care with obesity that coexists with other medical conditions and problems. Numerous treatment models have been proposed to address this rising public health concern. These approaches often include use of the traditional interventions such as pharmacological interventions. However, overemphasis on one treatment intervention may fail to generate the desired objectives. While the traditional strategies to obesity prevention and management have placed emphasis on medications, wider attention to other dimensions of treatment is necessary. Such treatment interventions may include the multi-tiered or holistic strategies that incorporate both pharmacological and non-pharmacological interventions. For instance, a wider focus should incorporate practices such as assessing the mental health impacts of obesity on the patients. Thus, a public health multi-tiered .
The mission of the program is to sensitize the elderly about how they could get access to their medicine. The primary goal is to ensure that older adults are living well by getting access to their medicines when they want them depending on their condition
1. Primary sources2. Secondary sources3. La Malinche4. Bacon’s.docxvannagoforth
1. Primary sources
2. Secondary sources
3. La Malinche
4. Bacon’s rebellion
5. Robert Carter III
6. Mesoamerica
7. Middle Passage
8. Indentured servitude
9. The Jefferson-Hemings Controversy
10. Triangular trade
11. Saint Dominique Revolt
12. Syncretism
13. Olaudah Equiano
14. Christopher Columbus
15. Columbian Moment
16. Hernan Cortes
17. Florentine Codex
18. Master Narrative of American History
19. Reconquista
20. The Paradox of Slavery
21. Indian Removal Act 1830
22. Trail of Tears
23. Treaty of Guadalupe Hidalgo
24. Niños Heroes (Heroic Children)
25. Antonio López de Santa Anna y Pérez de Lebrón
26. The Royal Africa Company
27. John Locke
28. St. Patrick’s Battalion
29. Chilam Balam
30. Popol Vuh
31. El requerimiento (The Requirement)
32. Manifest Destiny
33. Moses and Stephen F. Austin
34. Colonialism
35. Colonial Legacy
.
1. Prepare an outline, an introduction, and a summary.docxvannagoforth
The document instructs the reader to prepare a 4 page double spaced report on an attached article, including an outline, introduction, and summary, and to prepare 4 PowerPoint slides summarizing the report.
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This document contains summaries of 50 abstracts related to e-patients and social media. Some key points:
1) Participatory surveillance of hypoglycemia in an online diabetes social network found high rates of hypoglycemic events and related harms like daily worry and withdrawal from activities. Engagement was also high.
2) Analysis of self-reported Parkinson's disease symptom data from an online platform found short-term dynamics like fluctuations exceeding clinically important differences that add to understanding of disease progression.
3) Examination of influential cancer patients on Twitter found most tweets focused on support rather than medical information, indicating its role in online patient community and support.
Low Functional health literacy is a problem affecting 90 million residents of the United States. Among the 90 million, 36% are adults who have “below basic” health literacy skills. Assessing health literacy is important in improving health behaviors, health outcomes, and perceived communication barriers related to health. The Patient Protection and Affordable Care Act enacted in 2010 brought about changes that demand a more coordinated approach to manage health care services. This research focused on the efforts being made to promote health literacy at Medicaid health homes such as Greater Buffalo United Accountable Healthcare Network (GBUAHN). This research consisted of observation of Patient Health Navigator interactions with patients in order to identify best practices of health literacy initiatives within GBUAHN. Results suggest best practices include promoting and establishing relationship to effectively enhance patients understanding of all their healthcare needs. This study suggests that GBUAHN should continue making use of recommendations related health literacy promotion while exploring areas of improvement as noted on scorecard. Patient Health Navigators are engaging patient in manner that will establish adherence within patients.
This document summarizes research on mobile applications that promote healthy lifestyles. It reviews 8 sources that examine the design, features, effectiveness and challenges of such apps. The literature emphasizes using behavior change techniques, personalization, self-monitoring and feedback to engage users and facilitate long-term behavior change. While mobile apps show promise in health promotion, challenges remain around privacy, usability and integrating apps with healthcare systems. Emerging technologies may further impact app-based health promotion.
Running Head HEALTH NEEDS ASSESSMENT1HEALTH NEEDS ASSESSMEN.docxwlynn1
This document summarizes a health needs assessment that evaluated several measures used to assess public health, including mortality, morbidity, and disability rates. It discusses two completed needs assessments - the 2016 St. Mary's Community Health Needs Assessment and the 2015 Georgia Five Year Needs Assessment. The theories and approaches used in each assessment are described. The document also outlines how the results of needs assessments can be applied to health program planning and design.
The document discusses the health belief model, which is a theoretical framework used in healthcare to guide health promotion plans and disease prevention. It has five stages: precontemplation, contemplation, preparation, action, and maintenance. The model focuses on perceived susceptibility, severity, benefits, and confidence. It can be used to understand behaviors like substance abuse in youth. Barriers to implementing it include lack of resources. Benefits are improving health knowledge and behaviors.
This document discusses how consumers use the internet and social media for health information. About half of US adults own smartphones and 17% use them to look up health information. Social media allows for direct communication between patients and providers and the sharing of health experiences. However, privacy and unreliable information are concerns. The role of nurses includes disseminating effective health information online and enhancing provider-patient communication through technology.
Researchers analyzed large datasets on diet, physical activity, and stress to understand lifestyle habits and identify effective ways to promote healthy changes. One dataset contained 8 million photos of meals taken by mobile users to receive peer feedback on healthiness, which was found to be as accurate as experts. Another dataset contained heartbeat variations for 30,000 people, allowing analysis of actual exercise levels compared to recommendations. The goal is to combine such data insights to better understand morbidity and performance, and evaluate programs to encourage healthy lifestyles.
This document summarizes several studies on health information seeking online:
1) A 2002 study found 80% of online adults look for health information online, amounting to 110 million people. Most (53%) use search engines to find information across sites.
2) A 2006 study found 80% of online Americans search for health information daily, with 66% starting on search engines like Google. Many feel more confident in decisions after searching.
3) A 2005-2007 Europe-wide study found internet health users increased from 44% to 54%. The growth occurred across all countries. The internet will be important for future healthcare.
This paper examines the opportunities and benefits of using apps to help manage diabetes, as well as limitations and concerns. Apps can help patients track key areas of care, enable personalized self-management through data sharing with providers, and provide decision support. However, many apps focus only on parts of care and few use evidence-based practices or offer comprehensive education. After analyzing the top diabetes apps against criteria for effective features, the author concludes that Diabetes App is currently the best option due to its coverage of important data areas and education. Overall, apps show promise for improving outcomes but development needs to address gaps versus clinical guidelines.
A retrospective review of the Honduras AIN-C program guided by a community he...HFG Project
Factors that influence performance of community health workers (CHWs) delivering health services are not well understood. A recent logic model proposed categories of support from both health sector and communities influence CHW performance and program outcomes. This logic model has been used to review a growth monitoring program delivered by CHWs in Honduras, known as Atención Integral a la Niñez en la Comunidad (AIN-C). A retrospective review of AIN-C was conducted through a document desk review and supplemented with in-depth interviews. Documents were systematically coded using the categories from the logic model, and gaps were addressed through interviews. Authors reviewed coded data for each category to analyze program details and outcomes as well as identify potential issues and gaps in the logic model.
Internet Interventions In Review, In Use, and Into the Future.docxmariuse18nolet
Internet interventions are behavioral treatments delivered via the Internet with the goal of symptom improvement. Several studies have found Internet interventions to be feasible and effective for issues like smoking cessation, weight loss, headaches, and body image. However, more research is still needed. Future Internet interventions may be more engaging through improved use of graphics, audio, and interactivity. Hybrid interventions address bandwidth limitations by storing large files locally while maintaining Internet connection.
Statistics For Health Science and Its ImpactsCashews
This document discusses the importance of statistics for health sciences and its impact. It provides examples of how statistical studies and computerized health programs have helped increase compliance with preventative health guidelines over time. Health statistics systems collectively provide data to understand national health and how to address areas for improvement. Challenges include having appropriate technical, operational and resource capacity to produce reliable health statistics.
Data is an essential commodity and various organizations today unlock data to allow them to make business decisions that are highly informed. Data in open source has become highly available and U.K Government has a wide range of available open data to analyse. The paper of this report lies in information extraction from data sets of health for supporting development for wide range of food products that are healthy. The scope of this paper lies in analysing and extracting information from distinct data sets using a specific tool of data analytics that is either SAS JMP or SAS Enterprise guide or base SAS. After this analysis, results for the data will be analysed for showing the requirement for a wide range of food products that are healthy.
Quantitative/Mixed-Methods
American InterContinental University
March 27, 2018
Running head: QUANTITATIVE/MIXED-METHODS
1
QUANTITATIVE/MIXED-METHODS
2
Quantitative/Mixed-Methods
Abstract
Case studies which are done in the field of medicine work towards improving the health of the population. There are some of the parts contained in case studies which are abstract, results, limitations of results, conclusions, and applications. The common statistical methods used in research are descriptive numerical and qualitative thematic analyses. The results of the studies show that equal participation of individuals in the health sector will help boost public health. Limitations of results are that although some strategies may work towards improving health sector, not all of them are effective.
Public health is an important sector in any country for it directly affects the economy of the nation. There need to be certain ways which should be employed with the aim of supporting and improving public health. In this paper, I am going to examine 4 contemporary peer-reviewed articles which employ quantitative or mixed-methods concerning ways on how to improve the health of the public. The interest of the paper is to aid in achieving the best impact in public health sector via using programs which will improve health outcomes drastically. Enhancement of public health will in return help to improve the well-being of populations across the world. Public health awareness on how to avoid unhealthy lifestyles should be created.
In the articles, samples and populations used were appropriate for it showed the real representative of the population at hand. All the samples used in the 4-contemporary peer-reviewed articles fulfilled the rule of thumb hence making them appropriate. The samples used were suitable for they were used to estimate the population parameters for it stood for the entire inhabitants. The samples used were larger but not too large to consume more resources of money and time. The larger sample has helped to produce accurate results making the samples valid and appropriate. The appropriateness of the samples used in these articles, it has been proved via usage of target variance. In using target variance an estimate to be derived from the model eventually attained.
Each article which has been used includes having results, limitations of results, conclusions, and applications. The first contemporary peer-reviewed article is entitled, Refugee women’s involvements of maternity-care facilities in Canada: a methodical review using a description synthesis written by Gina MA Higginbottom, Myfanwy Morgan, Miranda Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay and Rubina Barolia. The article was published 11 February 2015. The results show that there needs to have a healthier understanding of the aspects that produce discrepancies in availability, adequacy, and outcomes during parenthood care (Higginbottom, Morgan, Alexandre, Chiu, Forg ...
Effects of the Affordable Care Act MedicaidExpansion on Subj.docxgidmanmary
Effects of the Affordable Care Act Medicaid
Expansion on Subjective Well-Being in the US Adult
Population, 2010–2016
Lindsay C. Kobayashi, PhD, Onur Altindag, PhD, Yulya Truskinovsky, PhD, and Lisa F. Berkman, PhD
Objectives. To determine whether the 2014 Affordable Care Act Medicaid expansion
affected well-being in the low-income and general adult US populations.
Methods. We obtained data from adults aged 18 to 64 years in the nationally rep-
resentative Gallup-Sharecare Well-Being Index from 2010 to 2016 (n = 1 674 953). We
used a difference-in-differences analysis to compare access to and difficulty affording
health care and subjective well-being outcomes (happiness, sadness, worry, stress, and
life satisfaction) before and after Medicaid expansion in states that did and did not
expand Medicaid.
Results. Access to health care increased, and difficulty affording health care declined
following the Medicaid expansion. Medicaid expansion was not associated with changes
to emotional states or life satisfaction over the study period in either the low-income
population who newly gained health insurance or in the general adult population as a
spillover effect of the policy change.
Conclusions. Although the public health benefits of the Medicaid expansion are in-
creasingly apparent, improved population well-being does not appear tobe among them.
Public Health Implications. Subjective well-being indicators may not be informative
enough to evaluate the public health impact of expanded health insurance. (Am J Public
Health. 2019;109:1236–1242. doi:10.2105/AJPH.2019.305164)
See also Galea and Vaughan, p. 1169.
Akey component of the US AffordableCare Act (ACA) was the expansion of
Medicaid eligibility to nonelderly adults with
incomes up to 138% of the federal poverty
level.1 This policy resulted in 9.6 million
people becoming newly eligible for Medicaid
beginning in 2014.2 The rapidly growing
literature documents a range of beneficial
outcomes for the newly eligible population,
including higher rates of insurance coverage,
increased access to health care providers,
improved quality of care, increased use of
preventive health services, reduced likelihood
of emergency department visits, and reduced
financial difficulties.3–7 Public health spill-
over effects with relevance to the general
population also have been documented,
including lower rates of crime, higher
prescribing of opioid treatments, and reduced
socioeconomic disparities in access to health
care.8–11 Evidence of direct effects on health
outcomes is relatively scarce,5 whereas a
growing body of evidence shows mixed re-
sults for its effect on self-rated health.7,11–14
The effects of the ACA Medicaid expansion
on population well-being in the United States
are unknown.
Human well-being is gaining attention
from researchers and policymakers as a metric
of social welfare that goes beyond standard
indicators for health policy evaluation.15–18
Broadly defined, subjective w ...
The Internet and Information· One of the most effective strate.docxarnoldmeredith47041
"The Internet and Information"
· One of the most effective strategies for increasing the flow of information within a hospitality organization is to give all employees access to the company intranet and all corporate information. Describe three ways how allowing access to the company intranet could help communication and three ways how it could hinder communication within a hospitality organization.
"The
Internet
and
Information"
·
One of the most effective strategies for increasing the flow of information within
a hospitality organization is to give all employees access to the company
intranet and all corporate information. Describe three ways how
allowing
access to the company intranet could help communication and three ways how
it could hinder communication within a hospitality organization.
"The Internet and Information"
One of the most effective strategies for increasing the flow of information within
a hospitality organization is to give all employees access to the company
intranet and all corporate information. Describe three ways how allowing
access to the company intranet could help communication and three ways how
it could hinder communication within a hospitality organization.
Literature Evaluation Table
Student Name: Christiana Bona.
Summary of Clinical Issue (200-250 words):
Childhood obesity is one of the problems that affect the United States and other developed economies. Obesity among children and youths is widely recognized as an issue that generates a lot of adverse health impacts. For instance, childhood obesity is a major indicator of future mental and physical health problems. In spite of the highest rates of childhood obesity in the country in the last three decades, obesity has been linked to other more serious health problems such as cardiovascular diseases and diabetes. As nurses and other health professionals continue to grapple with this problem, there are still no clear treatment approaches. Health professionals usually do not have a comprehensive guideline on where to manage the nearly one-third of their populations who present the medical care with obesity that coexists with other medical conditions and problems. Numerous treatment models have been proposed to address this rising public health concern. These approaches often include use of the traditional interventions such as pharmacological interventions. However, overemphasis on one treatment intervention may fail to generate the desired objectives. While the traditional strategies to obesity prevention and management have placed emphasis on medications, wider attention to other dimensions of treatment is necessary. Such treatment interventions may include the multi-tiered or holistic strategies that incorporate both pharmacological and non-pharmacological interventions. For instance, a wider focus should incorporate practices such as assessing the mental health impacts of obesity on the patients. Thus, a public health multi-tiered .
The mission of the program is to sensitize the elderly about how they could get access to their medicine. The primary goal is to ensure that older adults are living well by getting access to their medicines when they want them depending on their condition
Similar to Original PaperWho Uses Mobile Phone Health Apps and Does U.docx (20)
1. Primary sources2. Secondary sources3. La Malinche4. Bacon’s.docxvannagoforth
1. Primary sources
2. Secondary sources
3. La Malinche
4. Bacon’s rebellion
5. Robert Carter III
6. Mesoamerica
7. Middle Passage
8. Indentured servitude
9. The Jefferson-Hemings Controversy
10. Triangular trade
11. Saint Dominique Revolt
12. Syncretism
13. Olaudah Equiano
14. Christopher Columbus
15. Columbian Moment
16. Hernan Cortes
17. Florentine Codex
18. Master Narrative of American History
19. Reconquista
20. The Paradox of Slavery
21. Indian Removal Act 1830
22. Trail of Tears
23. Treaty of Guadalupe Hidalgo
24. Niños Heroes (Heroic Children)
25. Antonio López de Santa Anna y Pérez de Lebrón
26. The Royal Africa Company
27. John Locke
28. St. Patrick’s Battalion
29. Chilam Balam
30. Popol Vuh
31. El requerimiento (The Requirement)
32. Manifest Destiny
33. Moses and Stephen F. Austin
34. Colonialism
35. Colonial Legacy
.
1. Prepare an outline, an introduction, and a summary.docxvannagoforth
The document instructs the reader to prepare a 4 page double spaced report on an attached article, including an outline, introduction, and summary, and to prepare 4 PowerPoint slides summarizing the report.
1. Normative moral philosophy typically focuses on the determining t.docxvannagoforth
According to Aristotle, virtues are traits of character that are good for a person to have and that are developed through habitual actions over time. Acting virtuously leads to morally correct actions. The document discusses Aristotle's view of virtue ethics and how it differs from normative moral philosophy by focusing on the character of the moral agent rather than just determining the right action. It asks how virtue ethics would analyze two different medical ethical dilemmas.
1. Paper should be 5-pages min. + 1 page works cited2. Should have.docxvannagoforth
1. Paper should be 5-pages min. + 1 page works cited
2. Should have at least 10 annotated sources (copy article onto word, highlight main point, write a few sentences about how it'll help you in writing the paper at the bottom of page)
3
. Should have an INTRO, NARRATION, ARGUMENTS, REFUTATION, CONCUSION
4. Use in-text citations and have organized mla format works cited page
SAMPLE OUTLINE
Research Paper Outline
Title: Rebellious Libya
Thesis: The United States should not get involved with Libya’s conflicts.
I.
Introduction:
A.
Start with the question, what is war? Explain briefly.
B.
Talk about the wars of the United States.
C.
What were the outcomes of some of those wars?
II.
Narration:
A.
Give some background on Libya.
B.
Explain how Col. Muammar Gaddafi became the leader of Libya
C.
Talk about why the citizens of Libya want to overthrow Gaddafi.
D.
Explain why the people feel that the United States should get involved in Libya’s conflicts.
III.
Partition:
A.
Thesis: I believe that the United States should not get involve with Libya’s conflicts.
B.
Essay Map.
1.
Cost of war.
2.
Using money in other Departments other defense.
3.
Killing innocent civilians and soldiers.
4.
Helping unknown rebels
5.
Involvement of foreign wars
IV.
Arguments:
A.
The cost of war is rising by the minute. The Obama Administration proposed a budget of $553 billion dollars for the department.
B.
Instead of spending all that money on war, we should be investing that money on health care and education.
C.
This conflict has caused the lives of many innocent civilians. NATO openly admitted to have killed innocent civilians, due to misguidance.
D.
The rebels fighting against Gaddafi are in need of military supplies. I don’t think that it is a good idea to help unknown rebels. We helped the Afghanistan rebels when they were fighting Russia. After they were victorious, they later became the “Taliban” and used those weapons to attack the US.
E.
Getting involved in foreign wars is not a good idea. The US has been involved in many foreign wars lately. These wars have been in foreign countries where Islam is the prominent religion. Libya is one of these countries. The involvement of the US in these places, builds a bad reputation worldwide and among the Muslim community.
V.
Refutation:
A.
Gaddafi’s actions against the civilians of Libya are totally wrong. Killing your own people is bad and therefore, we should help the rebels overthrow him.
B.
Gaddafi has been in power for many years. In fact, he holds the record for most years in power in a single country. This type of power can potentially lead to corruption and mistreatment of civilians.
C.
The people of Libya deserve to have democracy. They should have the right to elect their own leader.
D.
If Al Qaeda is threatening NATO and Libyan mercenaries then we should help them fight terrorism.
VI.
Conclusion:
A.
Summarize my arguments.
B.
State why we should not get involve with Libya’s conf.
1. Name and describe the three steps of the looking-glass self.2.docxvannagoforth
1. Name and describe the three steps of the 'looking-glass self'.
2. List and describe the three stages in George Mead's model of human development.
3. Piaget developed a four-stage process to explain how children develop reasoning skills. List each and give an example of one of the stages.
4. Briefly summarize the three elements of Freud's theory of personality and explain why sociologist have negative reactions to his analysis.
5. How does the mass media reinforce society's expectations of gender?
.
1. Provide an example of a business or specific person(s) that effec.docxvannagoforth
1. Provide an example of a business or specific person(s) that effectively use social media. What tools does the business or person use? How do they apply the tools effectively? Describe areas of improvement.
This assignment has to be 4 pages long, then it needs a cover page and reference page however that can not be a part of the four pages. So it would be 6 pages if you count the cover page and reference page!
.
1. Mexico and Guatemala. Research the political and economic situati.docxvannagoforth
1. Mexico and Guatemala. Research the political and economic situation of these countries and write about their peculiar circumstances.
2. Honduras, El Salvador and Panama. Research the political and economic situation of these countries and write about their peculiar circumstances.
3. Costa Rica and Nicaragua. Research the ecological and political situation of these countries and write about their peculiar circumstances.
4. Colombia and Ecuador. Research about the truths and myths about this two countries and write about your impressions on these stereotypes.
.
1. Many scholars have set some standards to judge a system for taxat.docxvannagoforth
1. Many scholars have set some standards to judge a system for taxation for its validity. How can you decide if a tax is good or bad?
You can consider these five following principles for your Discussion. What do these issues mean? How do you think they matter?
Adequacy Equity Exportability Neutrality Simplicity
What other tax revenue systems could you consider? How do you think they would be better or worse?
2. What role do taxes play in political issues?
3. What is your opinion of a flat tax as some politicians have proposed?
.
1. List and (in 1-2 sentences) describe the 4 interlocking factors t.docxvannagoforth
1. List and (in 1-2 sentences) describe the 4 interlocking factors that led to the ourbreak of world war 1
2. Explain the difference between and authoritarian regime and a totalitarian regime.
3. List and (in 1-2 sentences) describe the 5 factors that led to the ourbreak of world war 2.
.
1. Please explain how the Constitution provides for a system of sepa.docxvannagoforth
1. Please explain how the Constitution provides for a system of separation of powers and checks and balances. Provide a fully developed essay of at least 500 words, and cite sources used.
2. Describe how a bill becomes a law at the national level, in a fully developed essay of at least 500 words. Support your work with cited sources, references to Lecture Notes, or URLs where you obtained your information.
.
1. Please watch the following The Diving Bell & The Butterfly, Amel.docxvannagoforth
1. Please watch the following: The Diving Bell & The Butterfly, Amelie, The Lookout, A Single Man, Her, Little Children, and An Education and
Please respond to the films. In particular, respond to how the film develops the identity of a single character for an audience, and which you responded to (either the characters themselves or the way the film constructed the character) the most, or the least please , 10 sentence min and no plagiariasm also it has to be
followowed exactly whats written here.
PS: please dont waste my time if you will do a messy assigment, just dont send me a msg.
.
1. Most sociologists interpret social life from one of the three maj.docxvannagoforth
1. Most sociologists interpret social life from one of the three major theoretical frameworks/perspectives (conflict theory, functionalism, symbolic interactionism). Describe the major points of each one. List at least one sociologist who has been identified with each of these three theories.
2. What is the difference between basic sociology and applied sociology?
3. List and describe the eight steps of the scientific research model.
4. Discuss the importance of ethics in social research. Define what is meant by ethics.
.
1. Members of one species cannot successfully interbreed and produc.docxvannagoforth
1. Members of one species cannot successfully interbreed and produce fertile offspring with members of other species. This idea is known as
a. reproductive success.
b. punctuated evolution.
c. adaptive radiation.
d. the biological species concept.
e. geographic isolation.
2. The origin of new species, the extinction of species, and the evolution of major new features of living things are all changes that result from
a. macroevolution.
b. fitness.
c. speciation.
d. the biological species concept.
e. convergent evolution.
3. Which is a barrier that can contribute to reproductive isolation?
a. timing
b. behavior
c. habitat
d. incompatible reproductive structures
e. all of the above
4. Which of the following statements is false?
a. Horses and donkeys are separate species.
b. Two mules can mate and produce fertile offspring.
c. A horse and a donkey can mate and produce offspring.
d. Two donkeys can mate and produce fertile offspring.
e. Two horses can mate and produce fertile offspring.
5. The evolution of the penguin’s wing from a wing suited for flying to a “flipper-wing” used for swimming is an example of
a. refinement of existing adaptations.
b. reproductive isolation.
c. adaptation of existing structures to new functions.
d. inheritance of acquired characteristics.
e. the biological species concept.
6. Which of the following have been preserved as fossils?
a. dinosaur footprints
b. insects preserved in amber
c. petrified plant remains
d. animal bones
e. all of the above
7. The mass extinctions that included the dinosaurs took place during which period?
a. Cambrian (543–510 million years ago)
b. Devonian (409–363 million years ago)
c. Carboniferous (363–290 million years ago)
d. Jurassic (206–144 million years ago)
e. Cretaceous (144–65 million years ago)
8. The development of the complex, camera-like eye of a mammal is an example of
a. refinement of existing adaptations.
b. reproductive isolation.
c. adaptation of existing structures to new functions.
d. inheritance of acquired characteristics.
e. the biological species concept.
9. Which of the following statements is true?
a. Carbon-14 dating is useful for studying the age of early dinosaur fossils.
b. Carbon-14 has a half-life of 5,730 years.
c. Uranium-238 has a very short half-life.
d. Uranium-238 is present in all organisms.
e. Carbon-12 is not found in living plants.
10. Which of the following provides the best explanation for why Australia has so many organisms unique to that continent?
a. punctuated equilibrium
b. the biological species concept
c. convergent evolution
d. continental drift
e. cladistics
11. Scientists think that a meteor that fell in ____________________ may have led to the extinction of the dinosaurs.
a. Australia
b. the Yucatán peninsula
c. The Galápagos Islands
d. Pangaea
e. India
12. The great diversit.
1. Of the three chemical bonds discussed in class, which of them is .docxvannagoforth
1. Of the three chemical bonds discussed in class, which of them is simultaneously the weakest and most important for life on this planet as we know it?
2.Carbohydrates are very important sources of energy for life. Plants and arthropods also use carbohydrates as components of structures that are very important for their existence. Provide the names of the two most important carbohydrate based structures (one for plants and one for arthropods) and the carbohydrate components that are used to form them.
3._____________ _____________ are joined by ______________ bonds to form proteins.
4.Proteins can be used for several functions. Provide examples of structural and metabolic functions of proteins.
5.Describe the phosholipid bilayer of the plasma membrane. Why is this bilayer important for the formation of cells and the sequestration of chemical reactions within the cell?
.
1. Look at your diagrams for hydrogen, lithium, and sodium. What do .docxvannagoforth
1. Look at your diagrams for hydrogen, lithium, and sodium. What do they all have in common? What group are these elements in on the periodic table?
2. Look at your diagrams for fluorine and chlorine. What do they have in common?
Picture is in the link. Put answers on the word document and re-submit
.
1. Name the following molecules2. Sketch the following molecules.docxvannagoforth
1. Name the following molecules:
2. Sketch the following molecules:
3-cyclohexenone
4-ethyl 2,2,5-trimethyl 3-hexanone
ethyl butyrate
pentanoic acid
2-chloro 4-methyl 2,5-heptadienal
3,4-dichloro 4-ethyl octanal
p-chloro phenol
3-bromo 2-chloro 4-methyl hexane
3-cyclopropyl 1,2-cyclopentanediol
methyl phenyl ether
3,5-dimethyl 2-heptene-4,5-diol
3. Give two different uses for ethanol.
4. Name two categories of organic compounds (alkanes, aldehydes…) that have very strong characteristic odours.
.
1. List the horizontal and vertical levels of systems that exist in .docxvannagoforth
1. List the horizontal and vertical levels of systems that exist in organizations.
2.
Describe at least five steps involved in systems integration
3.
What is the role of ERP systems in system integration?
4. Why do you think functional silos are not appropriate for today's organization? Discuss your answer from organizational and technical perspectives.
5. Pick an organization that you know of or where you are/were working and provide examples of logical and physical integration issues that were faced by the organization when they broke the functional silos and moved to integrated systems.
.
1. Kemal Ataturk carried out policies that distanced the new Turkish.docxvannagoforth
1. Kemal Ataturk carried out policies that distanced the new Turkish republic of the 1920s from the Ottoman past. Why? What specific policies did Ataturk pursue? 2. Why many Arabs felt betrayed by the British (and the French) after the First World War? 3. Discuss at least three features of patrimonial leadership. List three or more Middle Eastern states where such type of political leadership persists 4. Describe the key processes (both internal and external) that initiated political and economic disintegration of the Ottoman Empire in the nineteenth century. 5. European military superiority in the late eighteenth century prompted Ottoman rulers to respond with what specific political measures? 6. The Zionist political movement originated in Europe rather than in the Middle East. Explain why and how. 7. After the Second World War, several Arab countries went through the process of transition from constitutional monarchies to republics. Identify three such countries and describe the course of events that brought about this transition. 8. How is religious Zionism different from secular Zionism? What is the relevance of this difference for the creation of the state of Israel? Has the relative influence of the two remained stable since the creation of the Israeli state? 9. What was the principle source of political legitimacy of the Ottoman Empire? 10. While most Ottoman European provinces, riding the tide of the nineteenth century nationalism, sought and won independence from Istanbul, Ottoman Arab provinces maintained their political loyalty to the Ottomans. What explains this difference between Arab and European provinces? 11. Social and political forces in favor of a constitutional reform in Iran (1905-1911) were markedly different from the groups that promoted constitutional limitations on executive powers of the sultan in the Ottoman Empire prior to the First World War? Explain this difference. 12. What are some of the key features of Arab socialisms? Which Arab leaders adopted socialist ideology? Which Arab leaders were opposed to it? 13. After the First World War, the new Middle Eastern protectorates (e.g., Syria, Lebanon, Iraq) were expected to develop into modern secular states. What specific policies did France and Britain try to implement? How successful have theses policies been? 14. The 1967 war was a watershed event for all major actors in the Middle East. Explain the consequences of the war for domestic politics in Israel and Egypt respectively.
.
1. If we consider a gallon of gas as having 100 units of energy, and.docxvannagoforth
1. If we consider a gallon of gas as having 100 units of energy, and 25 of those units are used to move the car, what law of thermodynamics accounts for the other 75 units of energy? (Points : 2)
the first law
the second law
2. Which of these is not a component of a molecule of adenosine triphosphate (ATP)? (Points : 3)
adenosine
phosphate
deoxyribose sugar
ribose sugar
3. Glycolysis is a sequence of ______ chemical reactions. (Points : 3)
nine
six
five
ten
4. Exergonic reactions produce products with a ___ energy level than that of the initial reactants. (Points : 3)
lower
higher
the same
5. When chemical X is reduced, which of these expressions would be an accurate representation of its reduced state? (Points : 3)
XO
XH
X
HX
6. Most enzymes are which kind of organic compound? (Points : 3)
carbohydrates
lipids
proteins
none of the above
7. The area on an enzyme where the substrate attaches is called the: (Points : 3)
active site
allosteric site
anabolic site
inactive site
8. Which of the following creatures would not be an autotroph? (Points : 3)
cactus
cyanobacteria
fish
palm tree
9. The process by which most of the world's autotrophs make their food is known as: (Points : 3)
glycolysis
photosynthesis
chemosynthesis
herbivory
10. Plants are the only organisms that use ATP for the transfer and storage of energy. (Points : 2)
True
False
11. The colors of light in the visible range (from longest wavelength to shortest) are: (Points : 3)
ROYGBIV
VIBGYOR
GRBIYV
ROYROGERS
12. Chlorophyll is a green pigment because it absorbs only the green part of the visible light spectrum. (Points : 2)
True
False
13. The photosynthetic pigment that is essential for the process to occur is: (Points : 3)
chlorophyll a
chlorophyll b
beta carotene
xanthocyanin
14. A photosystem is: (Points : 3)
a collection of hydrogen-pumping proteins
a series of electron-accepting proteins arranged in the thylakoid membrane
a collection of photosynthetic pigments arranged in a thylakoid membrane
found only in prokaryotic organisms
15. Which of these molecules is NOT a product of the Electron Transport System? (Points : 3)
ATP
Water
Pyruvate
NAD+
16. The dark reactions require all of these chemicals to proceed except: (Points : 3)
ATP
NADPH
carbon dioxide
oxygen
17. The structural unit of photosynthesis, where the photosystems are located, are called: (Points : 3)
chlorophylls
eukaryotes
stroma
thylakoids
18. Which of the following does NOT occur during the light independent process? (Points : 3)
CO2 is used to form carbohydrates
NADPH converts to NADP
ADP converts to ATP
ATP converts to ADP
19. The production of ATP that occurs in the presence of oxygen is called: (Points : 3)
aerobic respiration
anaerobic respiration
chemiosmosis
photosynthesis
20. The first stable chemical formed by the Calvin Cycle is: (Points :.
1. In 200-250 words, analyze the basic issues of human biology as th.docxvannagoforth
1. In 200-250 words, analyze the basic issues of human biology as they relate to chronic conditions and describe the interaction between disability, disease, and behavior. Examine and discuss the impact of biological health or illness on social, psychological, and physical problems from the micro, mezzo, and macro perspectives. Choose a chronic condition from those provided in your text and consider how you might feel, think, and behave differently if the condition were affecting you versus if the condition were affecting a stranger. How might you think differently about this chronic condition if it were affecting someone close to you, your neighbor, or someone in your community? Please include at least two supporting scholarly resources.
2.Our stage of life, intellectual/cognitive abilities, and sociocultural position in life, affect our perspectives and resultant behaviors about a number of conditions including cancer. Consider the information provided in the
“Introduction to the Miller Family”
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Original PaperWho Uses Mobile Phone Health Apps and Does U.docx
1. Original Paper
Who Uses Mobile Phone Health Apps and Does Use Matter? A
Secondary Data Analytics Approach
Jennifer K Carroll1, MPH, MD; Anne Moorhead2, MSc, MA,
MICR, CSci, FNutr (Public Health), PhD; Raymond
Bond3, PhD; William G LeBlanc1, PhD; Robert J Petrella4,
MD, PhD, FCFP, FACSM; Kevin Fiscella5, MPH, MD
1Department of Family Medicine, University of Colorado,
Aurora, CO, United States
2School of Communication, Ulster University, Newtownabbey,
United Kingdom
3School of Computing & Maths, University of Ulster,
Newtownabbey, United Kingdom
4Lawson Health Research Institute, Family Medicine,
Kinesiology and Cardiology, Western University, London, ON,
Canada
5Family Medicine, Public Health Sciences and Community
Health, University of Rochester Medical Center, Rochester, NY,
United States
Corresponding Author:
Jennifer K Carroll, MPH, MD
Department of Family Medicine
University of Colorado
Mail Stop F496
12631 E. 17th Ave
Aurora, CO, 80045
United States
Phone: 1 303 724 9232
2. Fax: 1 303 724 9747
Email: [email protected]
Abstract
Background: Mobile phone use and the adoption of healthy
lifestyle software apps (“health apps”) are rapidly proliferating.
There is limited information on the users of health apps in terms
of their social demographic and health characteristics,
intentions
to change, and actual health behaviors.
Objective: The objectives of our study were to (1) to describe
the sociodemographic characteristics associated with health app
use in a recent US nationally representative sample; (2) to
assess the attitudinal and behavioral predictors of the use of
health
apps for health promotion; and (3) to examine the association
between the use of health-related apps and meeting the
recommended
guidelines for fruit and vegetable intake and physical activity.
Methods: Data on users of mobile devices and health apps were
analyzed from the National Cancer Institute’s 2015 Health
Information National Trends Survey (HINTS), which was
designed to provide nationally representative estimates for
health
information in the United States and is publicly available on the
Internet. We used multivariable logistic regression models to
assess sociodemographic predictors of mobile device and health
app use and examine the associations between app use,
intentions
to change behavior, and actual behavioral change for fruit and
vegetable consumption, physical activity, and weight loss.
Results: From the 3677 total HINTS respondents, older
individuals (45-64 years, odds ratio, OR 0.56, 95% CI 0.47-68;
3. 65+
years, OR 0.19, 95% CI 0.14-0.24), males (OR 0.80, 95% CI
0.66-0.94), and having degree (OR 2.83, 95% CI 2.18-3.70) or
less
than high school education (OR 0.43, 95% CI 0.24-0.72) were
all significantly associated with a reduced likelihood of having
adopted health apps. Similarly, both age and education were
significant variables for predicting whether a person had
adopted a
mobile device, especially if that person was a college graduate
(OR 3.30). Individuals with apps were significantly more likely
to report intentions to improve fruit (63.8% with apps vs 58.5%
without apps, P=.01) and vegetable (74.9% vs 64.3%, P<.01)
consumption, physical activity (83.0% vs 65.4%, P<.01), and
weight loss (83.4% vs 71.8%, P<.01). Individuals with apps
were
also more likely to meet recommendations for physical activity
compared with those without a device or health apps (56.2%
with
apps vs 47.8% without apps, P<.01).
Conclusions: The main users of health apps were individuals
who were younger, had more education, reported excellent
health,
and had a higher income. Although differences persist for
gender, age, and educational attainment, many individual
sociodemographic factors are becoming less potent in
influencing engagement with mobile devices and health app use.
App use
was associated with intentions to change diet and physical
activity and meeting physical activity recommendations.
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(J Med Internet Res 2017;19(4):e125) doi: 10.2196/jmir.5604
KEYWORDS
smartphone; cell phone; Internet; mobile applications; health
promotion; health behavior
Introduction
As of 2015, nearly two-thirds (64%) of the American public
owned a mobile phone, which is an increase from 35% in 2011
[1]. It is estimated that 90% of the worldwide population will
own a mobile phone by 2020 [1]. Current UK data reveals that
mobile phone usage is increasing as 66% adults aged more than
18 years owned a mobile phone in 2015, up from 61% in 2014
[2]. Mobile phone ownership is higher among younger people,
with 77% ownership for those aged 16-24 years [3]. Although
mobile phone ownership is especially high among younger
persons and those with higher educational attainment and
income [4], those with lower income and educational attainment
are now likely to be “mobile phone dependent,” meaning that
they do not have broadband access at home and have few other
options for Web-based access other than via mobile phone.
As mobile phone ownership rapidly proliferates, so does the
number of mobile phone software apps grown in the
5. marketplace
[5]. Apps focused on health promotion are quite common: more
than 100,000 health apps are available in the iTunes and Google
Play stores [6]. This staggering number speaks to both the huge
market and ongoing demand for new tools to help the public
manage their diet, fitness, and weight-related goals, and the
limitations of the current health care system to provide such
resources. A recent study found that 53% of cell phone users
owned a smartphone—this translates to 45% of all American
adults—and that half of those (or about 1 in 4 Americans) have
used their phone to look up health information [7]. There is
increasing usage of health apps among health care
professionals,
patients and general public [8], and apps can play a role in
patient education, disease self-management, remote monitoring
of patients, and collection of dietary data [9-12]. Using mobile
phones and apps, social media also can be easily accessed, and
increasing numbers of individuals are using social media for
health information with reported benefits and limitations [8].
Despite the massive uptake in mobile phone ownership and
health app usage and their potential for improving health,
important limitations of health apps are the lack of evidence of
clinical effectiveness, lack of integration with the health care
delivery system, the need for formal evaluation and review, and
potential threats to safety and privacy [6,13-17]. Although
previous studies have described the sociodemographic factors
associated with mobile health and app use [7,18,19], it is a
rapidly changing field with the most recent published reports
reflecting data at least four to five years old. Additionally, there
is a lack of information on the users of health apps in terms of
their sociodemographic and health characteristics and health
behaviors. Furthermore, to our knowledge, there have been no
previous publications reporting on the association between the
use of health apps, behavioral or attitudinal factors (ie,
readiness
6. or intentions to change), and health outcomes. This information
is important for future health-improving initiatives and for
identifying appropriate use of health apps among population
groups.
Therefore, the aim for our study was 3-fold: (1) to describe the
sociodemographic characteristics associated with health app
use in a recent US nationally representative sample; (2) to
assess
the attitudinal and behavioral predictors of the use of health
apps for health promotion; and (3) to examine the association
between the use of health-related apps and meeting the
recommended guidelines for fruit and vegetable intake and
physical activity. Given the increasing focus on new models
for integrating technology into health care and the need to
expand the evidence base on the role of health apps for health
and wellness promotion, these research questions are timely
and relevant to inform the development of health app
interventions.
Methods
Data Source
The National Cancer Institute’s Health Information National
Trends Survey (HINTS) is a national probability sample of US
adults that assesses usage and trends in health information
access
and understanding. HINTS was first administered in 2002-2003
as a cross-sectional survey of US civilians and
noninstitutionalized adults. It has since been iteratively
administered in 2003, 2005, 2008, 2011, 2012, 2013, and 2014.
We used data from HINTS 4 Cycle 4 data released in June 2015,
which corresponded to surveys administered in
August-November, 2014. Publicly available datasets and
information about methodology are available at the HINTS
7. website [20]. The 2014 iteration reported herein contained
questions about whether participants used mobile phone or
tablet
technology and software apps for health-related reasons. The
overall response rate was 34.44%. This study was reviewed and
qualified for an Exemption by the American Academy of Family
Physicians Institutional Review Board.
Participants
A total of 3677 individuals completed the 2014 HINTS survey.
From this sample, 148 respondents were considered partial
completers, in that they completed 50%-79% of the questions
in Sections A and B. We included all 3677 respondents in our
analysis. We used sampling weights from the HINTS dataset
that were incorporated into the regression analyses.
Measures
Demographics
We used participants’ self-report of their age, sex, race,
ethnicity, income, level of education, English proficiency,
height, and weight. We converted height and weight into body
mass index (BMI), using weight (kg)/height (m2)×10,000, and
classified participants as obese (≥30), overweight (29.9-26), or
normal weight or underweight (<26).
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Usage of Mobile Devices and Health Apps
We used participants’ responses to the 3 questions to
characterize the distribution of subjects who used health-related
software apps on their mobile devices. The participants were
asked whether they had a tablet computer, smartphone, basic
cell phone only, or none of the above. We examined factors for
those with and without mobile devices, since previous studies
have shown differences in seeking health information on the
Internet related to access (eg, availability of a computer)
[21,22],
HINTS dataset is a nationally representative sample, and we
wished to put our findings on app use in the larger population
context. We categorized participants who had a mobile phone
or a tablet device under the label “Device+.” Similarly,
participants who did not report having a mobile phone or a
tablet
device were labeled “Device-.” Of the Device+ group, we also
categorized them according to whether they had health apps on
their device (Device+/App+) or did not have health apps on
their device (Device+/App-).
Fruit and Vegetable Intake
We assessed fruit and vegetable intake using the 2 questions:
amount of fruit consumed per day and amount of vegetables
consumed per day (7 response options for each ranging from
none to >4 cups per day). We reclassified the response options
for both questions into a single dichotomous outcome variable,
that is, the subject either (1) meets recommendations for fruit
or vegetables (4 or more cups for each) or (2) does not meet
recommendations for fruit or vegetables (all other response
options). Fruit and vegetable scores were analyzed separately.
9. Physical Activity
We assessed physical activity using the 2 questions: (1) in a
typical week how many days do you do any physical activity
or exercise of at least moderate intensity, such as brisk walking,
bicycling at a regular pace, and swimming at a regular pace? (8
response options ranging from none to 7 days per week) and
(2) on the days that you do any physical activity or exercise of
at least moderate intensity how long do you do these activities?
(2 response options for minutes and hours). We reclassified the
response options into a single dichotomous outcome variable
for physical activity, that is, whether the subject (1) met
physical
activity recommendations (≥150 minutes per week) or did not
meet the physical activity recommendations (<150 minutes per
week).
Intentions to Change Behavior
We examined participants’ intentions to change behavior based
on the 5 questions (all with yes or no responses): At any time
in the last year, have you intentionally tried to (1) increase the
amount of fruit or 100% fruit juice you eat or drink, (2) increase
the amount of vegetables or 100% vegetable juice you eat or
drink, (3) decrease the amount of regular soda or pop you
usually drink in a week, (4) lose weight, and (5) increase the
amount of exercise you get in a typical week?
Statistical Analysis
The outcome variable (OUTCOME) was a composite derived
from 3 survey variables: (1) own a smartphone (an
Internet-enabled mobile phone “such as iPhone android
BlackBerry or Windows phone” differentiated from a “basic
cell phone,” hereafter referred to as “mobile phone”) or device,
(2) have health apps on mobile phone or device, and (3) use of
health apps. Own a mobile phone or device was a
10. system-supplied derived variable to categorize responses given
to question B4 (possession of a mobile phone or tablet device).
Have health apps on mobile phone or device (question B5)
asked about health apps on a tablet or mobile phone. Use of
health apps (question B6a) asked whether the apps on a mobile
phone or tablet helped in achieving a health-related goal.
OUTCOME consisted of 3 levels: Device-/App- (33.2% of
respondents), Device+/App- (44% of respondents), and
Device+/App+ (22.77% of respondents). Device referred to
having a tablet or mobile phone, and App referred to having a
health-related app that ran on a tablet or mobile phone. A total
of 93 of 3677 respondents were unable to be classified due to
missing data. These people were not used in the analyses. To
assess the relationship between OUTCOME and the
demographic or health behavior variables, simple unweighted
2-way crosstab tables were generated and tested with a
chi-square test of association. We used a cutoff of P<.05 to
determine statistical significance for all analyses.
We used the R programming language (R-Studio) and SPSS
(SPSS Inc) for all data modeling and analysis carried out in this
study.
Results
Principal Findings
From the 3677 total HINTS respondents, 3584 answered
questions about whether or not they had a tablet computer or
mobile phone, or used apps. Figure 1 shows the participants in
this study.
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Figure 1. Health Information National Trends Survey (HINTS)
respondents’ use of mobile phones, tablets, and apps.
Demographic Variables Associated With App Use
Table 1 compares respondents grouped into Device+/App+,
Device+/App-, and Device-, according to sociodemographic
characteristics. As shown in Table 1, those who used health
apps (compared with those who either did not have apps or did
not have the necessary equipment) were more likely to be
younger, live in metropolitan areas, have more education, have
higher income, speak English well, be Asian, and report
excellent health. There was no significant association between
both BMI and smoking status and app use.
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12. Table 1. Demographic variables associated with app usage.
P valueDevice-
n (%)
Device+/App-
n (%)
Device+/App+
nb,c (%)d
Demographic variables
.391156 (55.29)1555 (50.23)808 (51.62)Sex (female vs male;
na,c=3519)
<.0011111 (21.92)1552 (52.25)782 (65.62)Age (18-44 years vs
45+ years; n=3415)
<.011121 (51.82)1535 (27.95)788 (12.72)Education (high
school or less vs some college or college graduate, n=3444)
<.0011162 (75.12)1560 (42.20)808 (31.72)Income (US $0-
49,999 vs 50,000 or greater; n=3530)
<.011057 (83.68)1453 (78.52)763 (71.85)Race or ethnicity
(white vs other; n=3273)
.491114 (33.82)1524 (36.98)782 (33.71)BMI (normal vs
overweight, obese; n=3420)
<.0011191 (78.93)1577 (85.67)816 (92.10)Metro vs nonmetro
(n=3584)
13. <.0011089 (90.37)1497 (97.13)759 (99.37)Speak English (very
well or well vs not well or not at all; n=3584)
<.0011138 (74.99)1544 (89.74)795 (92.85)Self-rated health
(excellent, very good, good vs fair or poor; n=3477)
aThe sample sizes (n’s) listed for each variable in the far left
column represent the total number of respondents across all
app-usage categories
(Device+/App+, Device +/App-, Device-) who answered that
question.
bThe sample sizes (n’s) listed for each variable within each cell
represent the total number of respondents within a given app-
usage category (either
Device+/App+, Device +/App-, or Device-) who answered that
question.
cSample sizes vary for each variable due to missing values.
dPopulation estimates were used for the numerators and
denominators in the calculation of percentages. Row
percentages do not add to 100%, as the
table shows percentages within a given app-usage category
(Device+/App+, Device +/App-, or Device-).
Association Between the Use of Apps and Intentions
to Change Diet, Perform Physical Activity, and Lose
Weight
Table 2 shows the association between the use of apps (versus
Device+/App- or Device-) with intentions to change diet,
perform physical activity, or lose weight. As Table 2 shows,
participants with apps were significantly more likely to report
intentions to improve fruit (P=.01) and vegetable consumption
(P<.01), physical activity (P<.01), and weight loss (P<.01)
compared with those in the Device+/App- or Device- groups.
14. Table 2. Association between the usage of apps for health-
related goal and intentions to change diet, physical activity, or
lose weight.
P valueaDevice-
n (%)
Device+/App-
n (%)
Device+/App+
n (%)
Health-related intention
.01654 (48.94)885 (58.50)545 (63.76)Increase fruit
<.01717 (50.02)1023 (64.26)621 (74.92)Increase vegetables
.06754 (77.36)1135 (82.76)630 (84.96)Decrease soda
<.01769 (49.94)1237 (65.42)707 (82.99)Increase physical
activity
<.01881 (60.02)1259 (71.75)692 (83.36)Lose weight
aSignificance between participants with apps (Device+/App+)
compared with those not using apps or devices (Device+/App-
or Device- groups).
Association Between the Use of Apps and Meeting
Recommendations for Fruit and Vegetable Intake and
Physical Activity
15. Table 3 shows the association between the use of apps (versus
Device+/App- or Device-) and meeting the recommendations
for fruit and vegetable intake and physical activity. Participants
in the Device+/App+ group were not significantly more likely
to meet recommendations for fruit and vegetables compared
with those in the Device+/App- or Device- groups; however,
they were significantly more likely to exercise more than 2
hours per week.
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Table 3. Association between the use of apps for health-related
goal and meeting recommendations for fruit and vegetables and
physical activity.
P valueaDevice-
n (%)
Device+/App-
n (%)
Device+/App+
16. n (%)
Percent respondents meeting recommendations
.251161 (5.43)1560 (7.96)804 (8.87)Fruit
.271155 (3.48)1557 (3.01)809 (4.81)Vegetables
<.011144 (37.69)1552 (47.79)801 (56.23)Physical activity
aSignificance between participants with apps (Device+/App+)
compared with those not using apps or devices (Device+/App-
or Device- groups).
Predicting Health App Adoption Only (Binary
Classification)
Table 4 presents the statistically significant odds ratios (ORs)
as derived using multivariate logistic regression when applied
to the entire dataset. As expected, those aged 45-64 years (OR
0.56) or 65+ years (OR 0.19) had a reduced likelihood of having
adopted health apps relative to younger persons. It also showed
that males were slightly less likely (OR 0.80) to have a health
app compared with females. The most significant finding was
the confirmation that graduates had significantly higher odds
(OR 2.83) of having a health app especially when compared
with those who had attained an education that was considered
“less than high school” (OR 0.43). The results also indicated
that the category “completed high school only” had no
predictive
ability for estimating whether a person had adopted a health
app.
Table 4. Statistically significant odds ratios derived using
multivariate logistic regression when applied to the entire
17. dataset for predicting health app
adoption only.
P valueOdds ratio
(95% CI)
Variable
<.0010.56
(0.47-0.68)
Age (45-64 years)
<.0010.19
(0.14-0.24)
Age (65+ years)
<.010.80
(0.66-0.94)
Sex (male)
<.0012.83
(2.18-3.70)
Education (college graduate or higher)
<.010.43
(0.24-0.72)
18. Education (less than high school)
<.011.70
(1.30-2.26)
Education (some college)
.051.25
(0.99-1.55)
Race (black)
Predicting Mobile Technology Adoption Only (Binary
Classification)
Table 5 presents the statistically significant ORs that increased
or decreased the likelihood that a person had adopted mobile
technology (tablet or mobile phone). Interestingly, there were
no statistically significant ORs for gender or racial categories.
However, similar to predicting health app adoption, both age
and education were significant variables for predicting whether
a person had adopted a mobile device, especially if that person
was a college graduate (OR 3.30). In addition, the results
indicated that the category “completed high school only” had
no predictive ability for estimating whether a person had
adopted
a mobile device.
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Table 5. Statistically significant odds ratios derived using
multivariate logistic regression when applied to the entire
dataset for predicting mobile device
adoption only.
P valueOdds ratio (95% CI)Variable
<.0010.35 (0.28-0.45)Age (45-64 years)
<.0010.09 (0.07-0.12)Age (65+ years)
<.0013.30 (2.65-4.11)Education (college graduate or higher)
<.0010.51 (0.37-0.70)Education (less than high school)
<.0011.87 (1.50-2.32)Education (some college)
Discussion
Principal Findings
Our first objective was to describe the sociodemographic and
health behavior characteristics associated with health app use
in a recent US nationally representative sample. Consistent with
previous findings [7], we found that those who were younger,
had more education, reported excellent health, and had a higher
income were more likely to use health apps. Our predictive
modeling using multivariate logistic regression showed that
education, sex, gender, and race were only mildly to moderately
20. potent in predicting mobile technology adoption.
Our second objective was to assess the behavioral and
attitudinal
predictors of the use of health apps for health promotion. We
found that participants with apps were also more likely to report
intentions to improve fruit and vegetable consumption, physical
activity, and weight loss. Finally, the third objective was to
examine the association between the use of health-related apps
and meeting the recommended guidelines for fruit and vegetable
intake and physical activity. We found that participants in the
health apps group were significantly more likely to meet
recommendations for physical activity compared with those
without a device or health apps.
Comparison With Prior Work
This study shares some similarities with previous HINTS
analyses. For example, McCully et al [19] reported that users
of the Internet for diet, weight, and physical activity tended to
be younger and more educated and that Internet use for these
purposes was more likely to be associated with higher fruit and
vegetable intake and moderate exercise. However in that study,
women were no more likely than men to use the Internet for
diet, weight, and physical activity, which was different from
our findings. In that study, minorities were more likely to use
the Internet; in our study, we found no such association.
Consistent with our findings, Kontos et al found that males,
those with lower education, and older US adults were less likely
to engage in a number of eHealth activities [18]. Similar to their
findings 3 years ago, our findings pointed to differences by
education for app use for health promotion.
The association between app use, intention to change lifestyle
behaviors, and actually meeting recommendations for healthy
lifestyle factors is interesting and could be due to several
reasons. First, it is possible that there are preexisting
21. differences
in individuals who engage with health apps compared with those
who do not. Users of health apps may have greater motivation
and interest in changing their diet, weight, or physical activity.
A recent review found that very few available apps provided
evidence-based support to meet lifestyle recommendations [13].
It could also be that app users are engaging with health apps to
help them simply track or self-manage differently than their
counterparts; thus, there could be differences in preferences or
needs. Due to the correlational nature of the data, we cannot
draw conclusions about the relationships or causal pathways.
Similar observations have been reported in a study of users of
the Internet for diet, weight, and physical activity promotion
[19].
The prevalence of app usage in our study was 22% (816/3677).
This is a doubling from the Kontos study in which 11.7%
downloaded info onto a mobile device. Although the questions
in these 2 HINTS datasets were worded differently (eg,
“downloaded” is broader and not referring exclusively to
downloading an app), it suggests that demand for apps continues
to rise and offers potential for reaching a growing segment of
the US population.
Our findings provide evidence for educational, age, and gender
differences in the use of mobile devices and health apps.
Educational attainment, age, and gender have been previously
shown to be important predictors of adoption of mobile devices
and apps [18]. Educational attainment appears more important
than other variables commonly used as proxies for
socioeconomic position (eg, income, race or ethnicity). The
reasons for the educational differences are unclear, but may
reflect skills and confidence with the use of devices and
possibly
social norms related to perceived value. Similarly, age likely
22. reflects both social norms and cohort effects, that is, exposure
during younger ages to these devices and apps. The reasons for
gender differences are less clear, but may reflect differences in
health-seeking behavior, and interest and participation in
healthy
lifestyle interventions generally.
Limitations
This study had limitations that should be kept in mind when
interpreting results. First, HINTS is a cross-sectional survey;
although it is a nationally representative cohort of individuals,
we were not able to evaluate the trends in an individual’s health
app use over time. There is the possibility of unmeasured
confounding, that is, unidentified factors that might be
associated with app use and intentions or health behaviors,
which could influence the interpretation of results. Although
the results showed association, it did not indicate a causal
relationship. This study could not answer the question of
whether more motivated individuals sought out apps, or whether
J Med Internet Res 2017 | vol. 19 | iss. 4 | e125 | p.
7http://www.jmir.org/2017/4/e125/
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Carroll et alJOURNAL OF MEDICAL INTERNET RESEARCH
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app use improved motivation and health outcomes. Furthermore,
some of the cells for subgroups were small, thereby limiting
the generalizability of some of the subanalyses. As with all
23. cross-sectional surveys, this was a study of association, not
causation. Finally, we were limited by the questions that were
asked in the HINTS survey. For example, we did not have
details
about specific health apps or features of apps used, the intensity
of use, whether the apps were interactive and linked to other
health promotion supports (eg, telehealth), and other strategies
used for health behavior change. Despite these limitations, the
results did identify areas for future research and add to the
knowledge base about predictors of the use of health apps.
Conclusions
Compared with previous studies, many individual
sociodemographic factors are becoming less important in
influencing engagement with mobile devices and health app
use; however, differences persist for gender, age, and
educational attainment. As health care undergoes technological
transformation with its electronic health records systems and
individuals’ access to their records, there are many
opportunities
for clinical care models to be expanded and improved, perhaps
through the use of apps as a means for sharing data, although
this remains an unanswered question. This study contributes to
the literature by providing up-to-date information on
populations
most and least likely to use health apps to guide clinical
interventions, commercial developers, and public health
programs when designing eHealth technology.
Conflicts of Interest
None declared.
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Abbreviations
HINTS: Health Information National Trends Survey
Edited by G Eysenbach; submitted 04.02.16; peer-reviewed by J
Updegraff, A Burls, B Fuemmeler; comments to author
06.04.16;
revised version received 18.05.16; accepted 21.06.16; published
19.04.17
Please cite as:
Carroll JK, Moorhead A, Bond R, LeBlanc WG, Petrella RJ,
Fiscella K
32. TODAY’S
HEALTH
INFORMATION
MANAGEMENT
AN INTEGRATED APPROACH, SECOND EDITION
by Dana C. McWay,
JD, RHIA
Australia Brazil Japan Korea Mexico Singapore Spain
United Kingdom United States
92471_fm_ptg01.indd 1 2/1/13 9:12 AM
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34. ISBN-10: 1-133-59247-1
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Today’s Health Information Management:
An Integrated Approach, Second Edition
Dana C. McWay
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37. time if subsequent rights restrictions require it.
BRIEF CONTENTS
iii
P A R T 1 INTRODUCTION TO HEALTH INFORMATION
MANAGEMENT
1 Health Care Delivery Systems 3
2 The Health Information Management Profession 29
3 Legal Issues 47
4 Ethical Standards 87
CLINICAL DATA MANAGEMENT
5 Health Care Data Content and Structures 121
6 Nomenclatures and Classification Systems 147
7 Quality Health Care Management 169
8 Health Statistics 199
9 Research 231
TECHNOLOGY
10 Database Management 259
11 Information Systems and Technology 279
12 Informatics 299
MANAGEMENT
13 Management Organization 321
14 Human Resource Management 355
15 Financial Management 387
16 Reimbursement Methodologies 405
38. Appendix A Common HIM Abbreviations 423
Appendix B Web Resources 433
Appendix C Sample HIPPA Notices of Privacy practices 443
Appendix D Selected Laws Affecting HIM 451
Appendix E Selected HIPAA Regulations 455
Glossar y 499
Index 527
P A R T 2
P A R T 3
P A R T 4
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CONTENTS
v
1
Preface xv
PART INTRODUCTION TO HEALTH INFORMATION
MANAGEMENT 1
Health Care Delivery Systems 3
Introduction 5
Historical Development 5
Early History 5
Health Care in the United States 6
Public Health 11
Mental Health 12
Occupational Health 14
Health Care Delivery Systems 15
Professional Associations 15
Voluntary Health Agencies 16
Philanthropic Foundations 17
International Health Agencies 17
Variety of Delivery Systems 17
Settings 17
40. Health Care Professionals 20
Medical Staff 22
Medical Staff Organization 22
Bylaws, Rules, and Regulations 23
Privileges and Credentialing 23
Conclusion 25
Chapter Summary 25
Case Study 25
Review Questions 25
Enrichment Activity 26
Web Sites 26
References 26
Notes 26
C H A P T E R 1
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vi C O N T E N T S
The Health Information Management Profession 29
Introduction 31
Health Information 31
41. Historical Development of the Profession 31
Educational and Certification Requirements 33
Careers 37
Traditional Settings 39
Nontraditional Settings 41
Direct Patient Care Settings 42
Settings Not Involving Direct Patient Care 43
Conclusion 44
Chapter Summary 44
Case Study 44
Review Questions 44
Enrichment Activities 45
Web Sites 45
References 45
Notes 45
Legal Issues 47
Introduction 49
Overview of External Forces 49
Roles of Governmental Entities 50
Roles of Nongovernmental Entities 52
Role Application 53
Understanding the Court System 53
The Court System 53
Administrative Bodies 55
Health Records as Evidence 58
Hearsay 58
Privilege 59
Exclusions 60
42. Legal Procedures 60
e-Discovery 61
Additional Steps in Litigation 63
Principles of Liability 64
Intentional Torts 64
Nonintentional Torts 65
Social Media 67
Legal Issues in HIM 67
HIPAA 68
Administrative Simplification 68
Fraud and Abuse 71
Privacy and Confidentiality 71
Access to Health Care Data 73
Ownership and Disclosure 73
Identity Theft 75
Informed Consent 76
Judicial Process 77
Fraud and Abuse 78
Fraud and Abuse Laws 79
Resources to Combat Fraud and Abuse 80
C H A P T E R 2
C H A P T E R 3
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C O N T E N T S vii
Conclusion 82
Chapter Summary 82
Case Study 83
Review Questions 83
Enrichment Activities 83
Web Sites 83
References 84
Notes 84
Ethical Standards 87
Introduction 89
Ethical Overview 89
Ethical Models 90
Ethical Concepts 90
Ethical Theories 93
Ethical Decision Making 94
Influencing Factors 95
Codes of Ethics 95
Patient Rights 103
Other Factors 104
Decision-Making Process 104
Bioethical Issues 106
44. Related to the Beginning of Life 106
Family Planning 106
Abortion 107
Perinatal Ethics 108
Eugenics 108
Related to Sustaining or Improving the Quality of Life 108
HIV/AIDS 109
Organ Transplantation 109
Genetic Science 110
Related to Death and Dying 110
Planning for End of Life 111
Euthanasia 111
Withholding/Withdrawing Treatment 111
Ethical Challenges 112
General Challenges 112
Role of Ethics in Supervision 113
Health Care Challenges 114
Health Information Management Challenges 115
Conclusion 116
Chapter Summary 116
Case Study 116
Review Questions 116
Enrichment Activities 116
Web Sites 117
References 117
Notes 117
C H A P T E R 4
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45. to electronic rights, some third party content may be suppressed
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viii C O N T E N T S
2
PART CLINICAL DATA MANAGEMENT 119
Health Care Data Content and Structures 121
Introduction 123
Types, Users, Uses, and Flow of Data 123
Types of Data 123
Users and Uses of Data 127
Patient Users 128
Data Flow 129
Forms Design and Control 131
Data Storage, Retention, and Destruction 132
Data Storage 134
Data Retention and Destruction 136
Indices and Registries 139
Indices 139
Registries 140
Registry Types 142
46. Conclusion 143
Chapter Summary 143
Case Study 143
Review Questions 143
Enrichment Activities 144
Web Sites 144
References 144
Notes 144
Nomenclatures and Classification Systems 147
Introduction 149
Languages, Vocabularies, and Nomenclatures 149
Nomenclature Development 150
Classification Systems 152
History and Application of Classification Systems 152
Diagnosis-Related Groups 155
HIM Transformation 157
Other Classification Systems 163
Emerging Issues 164
Conclusion 166
Chapter Summary 166
Case Study 166
Review Questions 167
Enrichment Activity 167
Web Sites 167
References 167
Notes 168
C H A P T E R 6
viii C O N T E N T S
47. C H A P T E R 5
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C O N T E N T S ix
Quality Health Care Management 169
Introduction 171
Data Quality 171
Historical Development 171
Federal Efforts 175
Private Efforts 176
Tools 178
Performance Improvement and Risk Management 187
Performance Improvement 187
Risk Management 189
Utilization Management 191
Utilization Review Process 192
Conclusion 195
Chapter Summary 195
48. Case Study 196
Review Questions 196
Enrichment Activity 196
Web Sites 197
References 197
Notes 197
Health Statistics 199
Introduction 201
Overview 201
Statistical Types 202
Statistical Literacy 203
Statistical Basics 204
Measures of Central Tendency 205
Other Mathematical Concepts 206
Data Collection 208
Statistical Formulas 209
Data Presentation 212
Regression Analysis 215
Regression Analysis Models 217
Health Information Management Statistics 221
Productivity 221
Statistical Tools 223
Conclusion 226
Chapter Summary 226
Case Studies 226
Review Questions 229
Enrichment Activities 229
Web Sites 230
49. References 230
Notes 230
C H A P T E R 7
C H A P T E R 8
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x C O N T E N T S
3
x C O N T E N T S
Research 231
Introduction 233
Research Principles 233
Historical Overview 233
Methodology 234
Qualitative and Quantitative Research 234
Study Types 235
Research Study Process 239
50. Research Design 239
Publication Process 240
Institutional Review Boards 241
Historical Overview 241
Review Process 243
Review of Research on Animals 246
Emerging Trends 247
Epidemiology 248
Historical Overview 249
Epidemiological Basics 250
Disease Progression 251
Types of Epidemiology 252
Descriptive Epidemiology 252
Analytic and Experimental Epidemiology 253
Conclusion 254
Chapter Summary 254
Case Study 254
Review Questions 254
Enrichment Activities 255
Web Sites 255
References 255
Notes 255
PART TECHNOLOGY 257
Database Management 259
Introduction 261
Concepts and Functions 261
Database Design 263
51. Controls 265
Data Standards 265
Retrieval and Analysis Methods 267
Data Sets 268
Data Exchange 272
State and Local Data Exchange Efforts 274
Conclusion 275
Chapter Summary 276
Case Study 276
Review Questions 276
Enrichment Activities 276
Web Sites 276
References 277
Notes 277
C H A P T E R 9
C H A P T E R 1 0
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C O N T E N T S xi
Information Systems and Technology 279
52. Introduction 281
Information Systems 281
Computer Concepts 281
Hardware 282
Software 285
Units of Measure and Standards 285
Information Systems Life Cycle 286
Communication Technologies 288
Security 290
HIPAA Security Rule 291
Systems Architecture 293
Systems Architecture Specifics 293
Conclusion 295
Chapter Summary 295
Case Study 295
Review Questions 296
Enrichment Activity 296
Web Sites 296
References 296
Notes 297
Informatics 299
Introduction 301
Overview 301
Electronic Health Records 302
Meaningful Use 305
Legal Health Record 310
Technology Applications and Trends 311
Role of Social Media in Health Care 313
53. Conclusion 316
Chapter Summary 316
Case Study 316
Review Questions 317
Enrichment Activity 317
Web Sites 317
References 317
Notes 317
C H A P T E R 1 1
C H A P T E R 1 2
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xii C O N T E N T S
4C H A P T E R 1 3
PART MANAGEMENT 319
Management Organization 321
Introduction 323
Principles of Management 323
Planning 323
54. Strategic Planning 323
Management Planning 325
Operational Planning 326
Disaster Planning 326
Planning Tools 329
Organizing 329
Design and Structure 330
Organizing People 331
Organizing the Type of Work 335
Organizing Work Performance 335
Organizing the Work Environment 335
Directing 336
Decision Making 336
Instructing Others 337
Work Simplification 338
Controlling 338
Types of Controls 338
Setting Standards 339
Monitoring Performance 339
Leading 340
Motivating 340
Directing Others 341
Resolving Conflicts 342
Effective Communication 342
Management Theories 343
Historical Overview 343
Specialized Management Theories 344
Change Management 344
Project Management 345
Process Improvement 346
55. Knowledge Management 348
Effective Meeting Management 351
Conclusion 351
Chapter Summary 352
Case Study 352
Review Questions 352
Enrichment Activities 352
Web Sites 353
References 353
Notes 353
xii C O N T E N T S
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C O N T E N T S xiii
Human Resource Management 355
Introduction 357
Employment 357
Staffing 358
Recruitment 358
Selection 358
Compensation 364
56. Orientation and Training 364
Retention 365
Separation 366
Employee Rights 367
Overview 367
Employment Law Application 368
Discrimination 368
Sex Discrimination 368
Racial, Religious, and National Origin Discrimination 369
Age Discrimination 370
Disability Discrimination 370
Genetic Discrimination 372
Workplace Protections 372
Social Media 375
Supervision 376
Performance Evaluations 376
Problem Behaviors 377
Discipline and Grievance 378
Developing Others 379
Career Development 379
Coaching 379
Mentoring 380
Team Building 380
Telework 381
Workforce Diversity 383
Conclusion 384
Chapter Summary 384
Case Study 384
Review Questions 384
Enrichment Activities 384
57. Web Sites 385
References 385
Notes 385
C H A P T E R 1 4
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xiv C O N T E N T S
Financial Management 387
Introduction 389
Overview 389
Accounting 391
Managerial Accounting 391
Financial Accounting 393
Budgets 395
Procurement 399
Procurement Requests 400
Conclusion 402
Chapter Summary 402
Case Study 402
Review Questions 402
58. Enrichment Activities 402
Web Sites 403
References 403
Reimbursement Methodologies 405
Introduction 407
Third-Party Payers 407
Governmental Payers 408
Nongovernmental Payers 409
Managed Care Organizations 411
Health Insurance Exchanges 413
Payment Methodologies 414
Fee for Service 414
Prospective Payment Systems 415
Resource-Based Relative Value Systems 416
Capitation 416
Revenue Cycle Management 417
Conclusion 419
Chapter Summary 419
Case Study 420
Review Questions 420
Enrichment Activities 420
Web Sites 420
References 421
Notes 421
Common HIM Abbreviations 423
Web Resources 433
Sample HIPPA Notices of Privacy Practices 443
59. Selected Laws Affecting HIM 451
Selected HIPAA Regulations 455
Glossary 499
Index 527
C H A P T E R 1 5
C H A P T E R 1 6
A P P E N D I X A
A P P E N D I X B
A P P E N D I X C
A P P E N D I X D
A P P E N D I X E
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xv
60. BRIEF CONTENTS
Over the past quarter century, new developments in technology,
law, and organizational management have changed the
profession
of health information management (HIM). Once seen as the
guardian of a paper-based health record, the health information
management profession has evolved as health care has evolved,
expanding to include the development and implementation of
the
electronic health record and management of the data contained
within it. As the need for health information has grown, so has
the
need to manage that information. The health information profes-
sional plays a more central role in the delivery of health care
than
ever before.
For those interested in learning about health information
management, this text provides a comprehensive discussion of
the
principles and practices presented in a user-friendly manner. It
is
designed to serve as a broad text for the health information
man-
agement discipline and does not presume that the learner is
already versed in the subject matter. The text is designed to
incor-
porate the model curriculum of the American Health
Information
Management Association for both the health information admin-
istrator and health information technician programs. Although
differences exist in curricula between the programs, it is my
belief
that the content of this book is applicable to students in both
groups because it is written with multiple levels of detail.
61. Instruc-
tors may determine the emphasis level of each chapter as it is
taught during the semester. This text also serves as a reference
point for professionals in the health care field who need to
acquire a general understanding of health information manage-
ment, and as a research tool for other allied health and medical
disciplines.
Although this text is intended to be comprehensive, one text-
book could not possibly encompass all of the details of the
broad
discipline of health information management. Long past is the
time when one textbook could cover all matters and issues
associ-
ated with a single discipline—the evolution of the HIM
profession
is such that other specialized texts are needed to complement
this
text. Every effort has been made to capture the significant
changes
and trends that the HIM field and profession have undergone in
recent years.
Two things set this text apart from others in the field. First,
the book is authored by only one person, allowing for a
consistent
voice and tone across the chapters. It also means that one
chapter
will not contradict the contents of another chapter within the
same
book, and that the difficulty level will not vary from one
chapter to
the next. Second, the text integrates into each chapter, as
applica-
ble, five areas that are significant to health information manage-
62. ment: the American Recovery and Reinvestment Act (ARRA),
including HITECH; the Health Insurance Portability and
Account-
ability Act (HIPAA); electronic health information management
(e-HIM); the Genetic Information Nondiscrimination Act
(GINA); and informatics. This approach is taken so that while
the
student is learning the substantive matter, he or she can also
understand the interplay between these three areas and the sub-
stantive matter. Boxes for each of these five areas are found
near
the text discussion to highlight this interplay.
BOOK STRUCTURE
This text offers a comprehensive, sequential approach to the
study
of health information management. Although each chapter is
designed to stand alone, it is grouped with related chapters to
form units of study. Four major units of study are presented in
this text:
Part 1 serves as an introduction to health information man-
agement. This unit of study comprises four chapters, beginning
with a discussion of health care delivery systems, both
historically
and in the present day, and the health information management
profession, including various career paths. These chapters are
fol-
lowed by a discussion of legal issues, including an overview of
the
court systems, the principles of liability, HIPAA, and health
care
fraud and abuse. The last chapter addresses ethical standards,
PREFACE
63. Copyright 2013 Cengage Learning. All Rights Reserved. May
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to electronic rights, some third party content may be suppressed
from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does
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time if subsequent rights restrictions require it.
xvi C O N T E N T S
outlining the basis for ethical concepts and theories and their
role
in decision making, explaining various ethical challenges, and
highlighting bioethics issues.
Part 2 serves as an overview of clinical data management.
This unit of study consists of six chapters and begins with a dis-
cussion of health data content and structures, including types
and uses; forms design and control; data storage, retention, and
destruction; and indices and registries. Nomenclatures and
classification systems make up the next chapter, and a discus-
sion of emerging issues completes the chapter. Quality manage-
ment, performance improvement, risk management, and
utilization management form the basis of the next chapter.
Health statistics is the focus of the next chapter, addressing sta-
tistical literacy in general, and regression analysis and HIM sta-
tistics in particular. Research issues complete the unit, with
sections addressing research principles, the research study pro-
cess, the role of institutional review boards, and the discipline
of epidemiology.
Part 3 serves as an overview of information technology
issues. This unit of study is comprised of three chapters and
64. begins with a discussion of database management, including
con-
cepts and functions, data sets, and data exchange efforts.
Informa-
tion systems and technology is the subject of the next chapter,
including a discussion of various information systems and sys-
tems architecture. New to this edition, informatics completes
the
unit, with sections addressing electronic health records and
tech-
nological applications and trends, including the role of social
media in health care.
Part 3 serves as an overview of management issues. This unit
of study consists of four chapters, beginning with management
principles and theories, including change, project, and
knowledge
management. A discussion of human resource management
follows, focusing on staffing, employee rights, supervision, and
workforce diversity. The financial management chapter
addresses
the fundamental concepts that drive financial management,
including accounting, budgets, and procurement. The last
chapter
provides a basis in reimbursement methodologies, including
how
third-party payers and the revenue cycle function in the health
care world.
Wherever the term health information manager is used in this
text, I refer to both registered health information administrators
(RHIA) and registered health information technicians (RHIT). I
make this choice consciously, because the experience of the
health
information management profession during the last two decades
has shown that professionals at both levels hold a variety of
65. posi-
tions within the discipline. Additionally, care has been
exercised to
use the terms health record and health information management
in
lieu of medical record and medical record management, because
these are the terms in use in the 21st century. Each chapter
alter-
nates in the use of the male and female pronouns. Information
contained in the text boxes within the chapter provides a quick
grasp of concepts that may be new to the learner.
PEDAGOGICAL FEATURES
Each chapter contains:
An integration of ARRA, HIPAA, e-health information
management, GINA, and informatics throughout the
subject matter as appropriate
Learning objectives
A listing of key concepts that are further explained in
the text
Figures and tables that provide details to illustrate the
content of the text
Case studies to apply concepts learned
Review questions designed to test comprehension
Enrichment activities designed to assist critical
thinking
A list of Web sites that relate to the chapter’s subject
matter for the learner’s easy reference
66. Additionally, appendices contain:
An extensive glossary of terms
A list of abbreviations commonly used in HIM
Web site resources, organized by subject matter and in
alphabetical order
Sample HIPAA privacy notices
A table of selected federal laws applicable to HIM
Selected HIPAA regulations
TEACHING AND LEARNING
RESOURCES FOR TODAY’S
HEALTH INFORMATION
MANAGEMENT
Additional textbook resources for students and instructors can
be
found online by going to www.cengagebrain.com and typing in
the
book’s ISBN. The available resources are also listed as follows
for your
convenience. Please note: all instructor resources can be
accessed by
going to www.cengagebrain.com. You will need to create a
unique
login. If you need assistance, please contact your sales
representative.
Student Workbook
The Student Workbook contains additional application-based
exer-
67. cises to help reinforce the essential concepts presented in the
textbook.
Test your knowledge through activities such as abbreviations
and key
terms review, chapter quiz material, case explorations, and
more.
ISBN: 9781133592495
xvi P R E F A C E
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not be copied, scanned, or duplicated, in whole or in part. Due
to electronic rights, some third party content may be suppressed
from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does
not materially affect the overall learning experience. Cengage
Learning reserves the right to remove additional content at any
time if subsequent rights restrictions require it.
C O N T E N T S xvii
CourseMate
Go beyond the textbook and complement your text and course
content with study and practice materials through CourseMate.
CourseMate includes:
Interactive eBook with highlighting, note taking, and an
interactive glossary
Additional assignable chapter quizzes, flashcards, and
games
Engagement Tracker tool that monitors student engage-
68. ment in the course
Want to give CourseMate a try? Go to www.cengagebrain.com,
enter the ISBN of this textbook (978-1-1335-9247-1), and you
can access a free sample of the CourseMate available with this
textbook.
ISBN: 9781133595243
Instructor’s Manual
The Instructor’s Manual provides answer keys for the text and
workbook; a curriculum crosswalk for each chapter with links to
the AHIMA domains, subdomains, and knowledge clusters; and
additional enrichment activities.
ISBN: 9781133592488
Instructor Resources (Online)
All instructor resources can be accessed by going to
www.cengagebrain.com to create a unique user login. Contact
your sales representative for more information. Online instruc-
tor resources are password-protected and include all resources
found on the Instructor Resources CD-ROM, including the test
bank, PowerPoint presentations, and the electronic Instructor’s
Manual.
Use the electronic Instructor’s Manual files to
help prepare for class.
Customizable instructor support slide presentations in
PowerPoint® format focus in on key points for each
chapter.
The testbank written In ExamView® makes generating
tests and quizzes a snap.
69. ISBN: 9781133595786
Web Tutor™ Course Cartridges
WebTutor™ is a course management and delivery sys-
tem designed to accompany this textbook. It is available
to supplement on-campus course delivery or to serve as
the course management platform for an online course.
The WebTutor for this title contains:
Online quizzes for each chapter
Discussion topics and learning links
Online glossary
Instructor support slides using PowerPoint™
Computerized test bank
Communication tools, including a course calendar,
chat, e-mail, and threaded discussions
Web Tutor on Blackboard ISBN: 9781133595861
Web Tutor on Angel ISBN: 9781133595878
InfoHealth Connect Community Site
InfoHealth Connect is a Cengage Learning community Web site
that
gathers resources for educators, professionals, and students
working
in the Health Information and Insurance, Billing & Coding
arenas.
Need a research topic? Get news from the cutting
edge via our Healthcare news links and video
70. newsfeed
Have a burning question? Post your question to our dis-
cussion board
Looking for pearls of wisdom? Read blogs from sea-
soned professionals
Want to network? Create a member profile to connect
with other members
Too busy to visit regularly? Add the site RSS
feed to your reader or follow us on Twitter
@infohlthconnect
Go to http://community.cengage.com/Site/infohealthconnect/ to
join our community today!
P R E F A C E xvii
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not be copied, scanned, or duplicated, in whole or in part. Due
to electronic rights, some third party content may be suppressed
from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does
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Learning reserves the right to remove additional content at any
time if subsequent rights restrictions require it.
xviii C O N T E N T S
ACKNOWLEDGMENTS
Many persons have played a role in the creation of this text-
book, including family, friends, and colleagues. A special thank
71. you is warranted for my family, who showed patience, under-
standing, and support for the long hours spent on this, my sec-
ond textbook. My children, Conor, William, and Ryan, spent
many hours at libraries, learning the intricacies of research
and authorship. My husband, Patrick, whose patience and
encouragement sustained me throughout the development of
this text, deserves my unending love. Two HIM professionals,
Sharon Farley, RHIA, and Patt Petersen, MA, RHIA, provided
valuable assistance in the subjects of quality management and
statistics, respectively. My appreciation is extended to the
reviewers of my manuscript. Your comments aided in strength-
ening this text.
Dana C. McWay, JD, RHIA
CONTRIBUTORS
The author and publisher would like to acknowledge the
following
health information management educators for their contributions
to the content of this text:
Sharon Farley, RHIA
Contributing material to Chapter 7
Patt Peterson, MA, RHIA
Contributing material to Chapter 9
REVIEWERS
The following health information management educators
provided
invaluable feedback and suggestions during the development of
this text:
Julie Alles, RHIA
Adjunct Instructor
Health Administration Programs
72. Ferris State University
Big Rapids, MI 49307
Marie A. Janes, MEd, RHIA
Associate Lecturer
University of Toledo
Toledo, OH
Rachel Minatee, MBA, RHIA
Professor of Health Information Technology
Rose State College
Midwest City, OK
Kelly Rinker, MA, RHIA, CPHIMS
Faculty
Regis University
Denver, CO
Jeanne Sands, MBA, RHIT
Adjunct Professor
Herzing University Online
Milwaukee, WI
xviii P R E F A C E
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to electronic rights, some third party content may be suppressed
from the eBook and/or eChapter(s).
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time if subsequent rights restrictions require it.
73. C O N T E N T S xix
ABOUT THE AUTHOR
Dana C. McWay, JD, RHIA, is both a lawyer and a health
informa-
tion management professional. With training and experience in
both disciplines, experience as a member of the Institutional
Review Board at Washington University Medical School from
1992
to present, and experience in converting a paper-based record
management system to an electronic record management system,
she brings a wide-ranging perspective to this textbook.
Ms. McWay serves as the Court Executive/Clerk of Court for
the U.S. Bankruptcy Court for the Eastern District of Missouri,
an
executive position responsible for all operational,
administrative,
financial, and technological matters of the court. In this
capacity,
she organized the court’s conversion to an electronic case filing
system, resulting in widespread acceptance by end users. This
suc-
cess led to her appointment as member and, later, chair of the
Case
Management/Electronic Case Filing (CM/ECF) Working Group,
an entity within the federal judiciary responsible for providing
guidance and assistance in all phases of the development of
bank-
ruptcy CM/ECF software releases. She serves on numerous
national committees and working groups within the judiciary,
including those involved in identifying the impact of new
legisla-
tion upon judicial operations and those involved in advising on
the education and training needs of court staff. Prior to this
posi-
74. tion, she worked as the Chief Deputy Clerk of Court for the
U.S.
Court of Appeals for the Eighth Circuit, responsible for daily
operations of the court.
Ms. McWay began her legal career as a judicial law clerk to
the Honorable Myron H. Bright of the U.S. Court of Appeals for
the Eighth Circuit. She then became an associate with the law
firm
of Peper, Martin, Jensen, Maichel, & Hetlage, a multi-specialty
firm located in St. Louis, Missouri. Ms. McWay’s legal practice
encompassed a variety of health law topics, including contracts,
medical records, and physician practice issues. She is admitted
to
practice in both Illinois and Missouri.
Prior to her legal career, Ms. McWay worked in health infor-
mation management as both a director and assistant director of
medical records in a large teaching hospital and a for-profit
psy-
chiatric and substance abuse facility. She continues to
participate
in the HIM profession, having served as a project manager for
the Missouri Health Information Management Association
(MHIMA) and as a member of MHIMA’s Legislative
Committee.
On the national level, she serves as a director on the Board of
Directors of AHIMA and has served as faculty for AHIMA con-
tinuing education seminars, a peer reviewer of AHIMA book
pro-
posals and texts, a contributing author to AHIMA’s HIM
Practice
Standards, chair and former member of the Professional Ethics
Committee, and a member of both the Committee for Profes-
sional Development and the Triumph Awards Committee
75. of AHIMA.
Ms. McWay is both an author and an editor. Her textbook,
Legal Aspects of Health Information Management, is in its
second
edition. With the Peper Martin law firm, she revised The Legal
Manual to Medical Record Practice in Missouri in 1991. She has
authored numerous other publications and served as coeditor of
several online continuing education modules presented by the
American Health Information Management Association. She has
also presented numerous seminars, serving as faculty and panel
presenter. She has served as an adjunct faculty member in a
mas-
ter’s program in health informatics and a pre-law studies
program,
and as a guest lecturer at several area colleges and universities,
focusing on the intersection of legal issues and health care
practices.
Ms. McWay is a magna cum laude graduate of the St. Louis
University School of Allied Health Professions, with a degree in
medical record administration, and a cum laude graduate of the
St.
Louis University School of Law. While in law school, Ms.
McWay
served as the health law editor of the St. Louis University Law
Jour-
nal and as a faculty research fellow. She is a recipient of the
Alumni
Merit Award from the School of Allied Health Professions and a
Triumph Award (the Legacy Award) from the American Health
Information Management Association for her textbook, Legal
Aspects of Health Information Management. She is one of three
recipients of the 2010 Outstanding Leadership Award from the
Federal Judiciary.
76. P R E F A C E xix
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to electronic rights, some third party content may be suppressed
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HOW TO USE THE TEXTBOOK
Learning Objectives at the beginning
of each chapter list the theoretical and
practical goals of the chapter. The
Certification Connection ties the chapter
material to the RHIA and RHIT exam
outlines.
Important terms, ideas, and acro-
nyms are presented in the Key
Concepts list, and they are high-
lighted the first time they appear in
the chapter content. The Outline
lists major headings to provide a
roadmap for the chapter content.
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to electronic rights, some third party content may be suppressed
from the eBook and/or eChapter(s).
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At the end of each chapter, reinforce your understanding of the
covered concepts using the Summary and Review Questions.
Enrichment Activities and Case Studies provide opportunities to
use critical thinking
skills to reflect on the material and relate the concepts to real-
life situations.
The book highlights the interplay of informatics, electronic
health information (e-HIM), the Health Insurance
Portability and Accountability Act (HIPAA), American
Recovery & Reimbursement Act (ARRA), and Genetic
Information Nondiscrimination Act (GINA) with the sub-
ject matter of each chapter in special boxes.
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not be copied, scanned, or duplicated, in whole or in part. Due
to electronic rights, some third party content may be suppressed
from the eBook and/or eChapter(s).
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not materially affect the overall learning experience. Cengage
Learning reserves the right to remove additional content at any
time if subsequent rights restrictions require it.
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to electronic rights, some third party content may be suppressed
from the eBook and/or eChapter(s).
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78. not materially affect the overall learning experience. Cengage
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time if subsequent rights restrictions require it.
P A R T 1
1 Health Care Delivery Systems
2 The Health Information
Management Profession
3 Legal Issues
4 Ethical Standards
INTRODUCTION TO HEALTH
INFORMATION MANAGEMENT
iStock.com
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to electronic rights, some third party content may be suppressed
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to electronic rights, some third party content may be suppressed
79. from the eBook and/or eChapter(s).
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3
Health Care Delivery Systems
LEARNING OBJECTIVES
After reading this chapter, the learner should be able to:
1. Trace the historical development of the health
care delivery system in early times.
2. Describe the four-stage progression of the
health care delivery system in the United
States.
3. Describe the increase in stature of hospitals
after World War II.
4. Explain the standardization movement of the
early 20th century.
5. Define the term accreditation and explain its
significance to health care organizations.
6. Compare and contrast the federal government’s
role in health care during stages three and four.
7. Define the concept of managed care and dif-
ferentiate between the three main types.
80. 8. Trace the historical development of public,
mental, and occupational health.
9. Compare and contrast professional associa-
tions, voluntary health agencies, philan-
thropic foundations, and international health
agencies.
10. Differentiate between the variety of settings
where health care is delivered.
11. Compare and contrast physicians, dentists, chiro-
practors, podiatrists, optometrists, physician as-
sistants, nurses, and allied health professionals.
12. Understand the organization of a hospital’s
medical staff, the importance of its bylaws,
and the use of the credentialing process in
granting clinical privileges.
1C H A P T E R > >
CERTIFICATION
CONNECTION
RHIA
Accreditation, licensure, and certification
Continuum of health care services
Health care delivery systems
Organizational compliance
Regulatory and licensure requirements
RHIT
Accreditation, licensure, and certification
81. Health care delivery systems
Health care organizations and structure
Provider roles and disciplines
Public health
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T H E H E A L T H I N F O R M A T I O N M A N A G E M
E N T P R O F E S S I O N
Outline Key ConceptsOutline Key Concepts
Accountable care
organization
Accreditation
Adult day care
services
Allied health
professional
Ambulatory health
care
Block grants
83. Home health agency
Hospice care
Hospital
IPA
International health
agencies
Licensing
Long-term care facility
Managed care
Medicaid
Medicare
Medical staff
Medical staff
coordinator
Mental health
Mental illness
Mobile diagnostic
services
Nurse
85. Respite care
Rules
Secondary care
Specialists
Surgical assistant
Tertiary care
Tracer methodology
Voluntary health
agencies
Historical Development
Early History
Health Care in the United States
Public Health
Mental Health
Occupational Health
Health Care Deliver y Systems
Professional Associations
Voluntary Health Agencies
Philanthropic Foundations
86. International Health Agencies
Variety of Delivery Systems
Medical Staff
Medical Staff Organization
Bylaws, Rules, and Regulations
Privileges and Credentialing
4 P A R T 1 I N T R O D U C T I O N T O H E A L T H I
N F O R M A T I O N M A N A G E M E N T
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time if subsequent rights restrictions require it.
INTRODUCTION
C H A P T E R 1 H E A L T H C A R E D E L I V E R Y S Y
S T E M S 5
HISTORICAL DEVELOPMENT
The number and quality of professionals, organizations, and
enti-
ties involved in health care has varied significantly over time.
In
large measure, this variety is attributable to the knowledge of
87. dis-
eases and their causes possessed by individuals and
communities.
With the advent of technology and advancements in medicine,
an
ever-expanding knowledge base has resulted in more, rather
than
less, complexity in health care.
Early History
To understand the development of health care in the United
States,
one must first look to the development of health care in earlier
times and in other regions of the world. Anthropological studies
have helped to trace health care back thousands of years. Table
1-1
illustrates the early history of health care.
In primitive times, human society responded to disease in one
of three ways. First, humans looked to nature for answers,
determin-
ing that disease was a result of offended forces of nature such
as
storms, volcanic eruptions, and earthquakes. Second, they
looked to
the supernatural for answers, determining that disease may be a
way
of “possessing” human beings. Third, they looked to the
offended
spirits of gods or the dead, concluding that disease was a logical
result of any offense incurred. In response to any of these three
ways,
primitive peoples treated disease with prayers, offerings,
religious
ceremonies, diet, or medicinal herbs. Furthermore, they
88. attempted
to frighten demons—and, therefore, disease—away with
dancing,
drumming, and fearful masks. They employed resources such as
amulets, charmed stones, and songs in efforts to banish disease.
As humans made the connection between cause and effect,
treatments evolved to improve or cure disease. A medicine man
or
shaman employed methods such as applying warm ashes to
induce
sweating, applying a tight band around the head to treat a head-
ache, and bandaging the chest to the point of partial
immobiliza-
tion to treat tuberculosis. Man incised wounds to remove
foreign
bodies such as stones and splinters, doing so by sucking out the
foreign body. Fractured bones were splinted with stiffened mud
bandages or tree branches. Midwives became recognized figures
among primitive peoples.
As civilization emerged, instructions relating to health care
were
written down. The earliest known written materials—stone
tablets,
papyri, and inscriptions on monuments and tombs—have been
found
in Egypt, dating to 2700 b.c. These materials recognize the
existence
INTRODUCTION
The health care delivery system of the 21st century is both
varied and complex. No one organization or entity is respon-
sible for delivering all health care in the United States. It is
important to understand the origins of the health care delivery
89. system in the United States so that the relationships between
organizations, entities, and health care professionals be-
comes clear. This chapter provides that understanding through
an overview of the historical development of the health
care delivery system, both in the United States and other
regions of the world. Some focus is given to specified areas of
health care, including public health, mental health, and
occupational health. A discussion of the organizations, entities,
and professionals who deliver health care services and the
settings in which they work follows, allowing the learner to
better understand the complexity of health care. A section
concerning a hospital’s medical staff explains its organization,
its governing mechanisms, and the credentialing process.
Integrated as appropriate within the entire chapter is a discus-
sion of the influences of technology, financing concerns, and
the role of the federal government in the health care
delivery system.
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6 P A R T 1 I N T R O D U C T I O N T O H E A L T H I
N F O R M A T I O N M A N A G E M E N T
of physicians and dentists working under the authority of gods.
As
such, physicians were considered priests who received training
in
90. temple schools in areas such as diagnosis and treatment. Priests
fol-
lowed the case approach beginning with a preliminary
diagnosis,
examination of the patient, diagnosis and prognosis, and
indication of
treatment measures to be employed. An example of such an
approach
can be found in the famous Ebers Papyrus illustrated in Figure
1-1.
Although this description speaks to a rational approach to med-
icine, a magical approach to medicine was involved as well.
Because
of the prevailing belief that disease was caused by demons and
evil
spirits, curing of disease could only occur through the
intervention
of the gods. Accordingly, physicians in ancient Egypt
recognized one
god over all others as the most important with regard to
healing—
Imhotep, who they referred to as the god of medicine.
As Egyptian civilization declined, other civilizations adopted
and expanded the Egyptians’ knowledge of medicine. Arabians
refined the concept of pharmacology, and, in another part of the
world, the Chinese did the same. The Jewish people became pre-
eminent in the area of public hygiene. The Babylonians codified
fees for physician practice and punishments for malpractice in
the
Hammurabi Code. Eventually, each of these civilizations
declined
or dispersed.
The next notable civilization to make an impact on medicine
91. was the Greeks, the forerunners of modern Western medicine.
The
Greeks were the first to reduce and then shed the supernatural
view of disease and approach medicine from a rational and
scien-
tific point of view. Among the greatest Greek physicians was
Hippocrates, from whom the famous oath originates (see
Figure 1-2). Hippocrates is famous for codifying medicine
through
the publication of numerous books, promoting medicine as one
of
the highest ethical and spiritual endeavors, and establishing the
principle that knowledge of disease can be obtained from
careful
observation and notation of symptoms.
Between the 6th century and the 16th century, little advance-
ment in medicine occurred. Alchemy, magic, and astronomy
were
prominently identified with medicine. To the extent that
medicine
existed as we now understand it, the clergy were its
practitioners.
Religious orders established hospitals to offer hospitality and
refuge
to old, disabled, and homeless pilgrims. Soon a vast network of
hos-
pitals emerged, mainly offering rest and shelter rather than
treatment.
Toward the end of the 16th century, a renaissance occurred in
many areas of culture, including medicine. Advancements were
made in understanding the anatomy of the human body, clinical
observations of diseases, and bedside teaching methods. Efforts
were made to not only identify disease but to discover specific
remedies that could be applied to the patient. The concept of