Search

Adolescent illicit drug, tobacco, and alcohol use can result in sudden and long-term negative health consequences. Primary care environments present the optimal opportunity for screening and brief interventions that target prevention and curtailing use. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a service delivery method that could potentially be well-integrated into primary care settings and used to serve a high volume of adolescents. Methods: This qualitative analysis of clinic staff interviews (N = 20), collected during a large cluster-randomized trial to implement two models of adolescent SBIRT, examined barriers and facilitating factors to overall acceptability of SBIRT. This study was conducted in a large, urban Federally Qualified Health Center (FQHC) at 7 sites throughout Baltimore City, Maryland, USA. Participants from each clinic included a range of various roles and responsibilities including: medical assistants (n = 3), nurses (n = 3), primary care providers (n = 4), behavioral health counselors (n = 4), and administrators (n = 6). Results: Results indicate both barriers and facilitating factors for acceptability of SBIRT in terms of (1) universal screening, (2) provider time demands, (3) behavioral health collaboration, and (4) behavioral health caseloads. Discussion: Universal screening was acceptable to participants across organizational roles, but brief interventions and referrals to treatment were found substantially less acceptable. [ABSTRACT FROM AUTHOR]

Using video recordings as data to study how dyads follow instructional videos to achieve practical tasks, this article focuses on how participants coordinate the temporality of the video with that of their task by pausing the video. We examine three types of pausing, each displaying participants' online understanding of the instructions and different articulations between demonstrations and practical task: pausing to raise a correspondence problem, to keep up with the video, and to turn to action. From this exemplar case, we discuss how ordinary people experience and make time with interactive media. [ABSTRACT FROM AUTHOR]

Background: Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic. Methods and findings: We conducted a retrospective cross-sectional study. All pregnant women admitted to the L&D Unit of Elmhurst Hospital from March 29, 2020 to April 22, 2020 were included for analysis. The primary outcomes of the study were: (1) SARS-CoV-2 positivity among universally screened pregnant women, stratified by demographic characteristics, maternal comorbidities, and delivery outcomes; and (2) Symptomatic or asymptomatic presentation at the time of testing among SARS-CoV-2 positive women. A total of 126 obstetric patients were screened for SARS-CoV-2 between March 29 and April 22. Of these, 37% were positive. Of the women who tested positive, 72% were asymptomatic at the time of testing. Patients who tested positive for SARS-CoV-2 were more likely to be of Hispanic ethnicity (unadjusted difference 24.4 percentage points, CI 7.9, 41.0) and report their primary language as Spanish (unadjusted difference 32.9 percentage points, CI 15.8, 49.9) than patients who tested negative. Conclusions: In this retrospective cross-sectional study of data from a universal SARS-Cov-2 screening program implemented in the L&D unit of a safety-net hospital in Queens, New York, we found over one-third of pregnant women testing positive, the majority of those asymptomatic. The rationale for universal screening at the L&D Unit at Elmhurst Hospital was to ensure safety of patients and staff during an acute surge in SARS-Cov-2 infections through appropriate identification and isolation of pregnant women with positive test results. Women were roomed by their SARS-CoV-2 status given increasing space limitations. In addition, postpartum counseling was tailored to infection status. We quickly established discharge counseling and follow-up protocols tailored to their specific social needs. The experience at Elmhurst Hospital is instructive for other L&D units serving vulnerable populations and for pandemic preparedness. [ABSTRACT FROM AUTHOR]

Although the vehicle horn is a minimal audible unit for communication, we will show that its uses are impressively varied. Drawing upon a corpus of video recordings from dashcams, we show how drivers use the horn for creating awareness; how they target particular vehicles; and how they use it for warnings, for complaints, and in instructing the seeing of an aspect of an ambiguous traffic object. Drivers' use of the horn involves, first, their sounding it in recognizable relations to past, current, and projected configurations of traffic on the road. Second, it involves drivers manipulating the vehicle horn to create sounds of shorter and longer durations that can then produce hearably distinct actions. Third, and finally, the driver can use the horn as an initiating or responsive action in relation to the actions of other members of traffic. The data are from road users in Chennai, India. [ABSTRACT FROM AUTHOR]

System dynamics (SD) modeling is used to compare and contrast strategies for effective implementation of an evidence-based adolescent behavioral health treatment in primary care settings. With qualitative and quantitative data from an on-going cluster-randomized trial in 7 federally qualified health center sites, two implementation conditions were compared: generalist vs. specialist. In the generalist approach, the primary care provider (PCP) delivered brief intervention (BI) for substance misuse (n = 4 clinics). In the specialist approach, BIs were delivered by behavioral health counselors (BHCs) (n = 3 clinics). The resultant SD model compared 'basecase' dynamics to strategic approaches to deploying continuous technical assistance (TA) and performance feedback reporting (PFR). The basecase effectively represented the SBIRT intervention, which reflected actual monthly volume of adolescent primary care visits (N = 9639), screenings (N = 5937), positive screenings (N = 246), and brief interventions (BIs; N = 50) over the 20-month implementation period. Insights gained suggest that implementation outcomes are sensitive to frequency of PFR, with bimonthly events generating the most rapid and sustained screening results. Simulated trends indicated that availability of the BHC directly impacts success of the specialist model. Similarly, understanding PCPs' perception of severity of need for intervention is key to outcomes in either condition. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses article in the issue on research on collocated interaction topics including research agenda for HCI research; observational study by Luigina Ciolfi and Marc McLoughlin on heritage site; and combining collocation research topic.

Background: Obesity is part of the established risk factors for breast cancer (BC) in postmenopausal females. Circulating leptin increases in parallel with the increase of body weight and fat reservoir.Methods: This research investigated the link between leptin phenotype and the clinicopathological factors in BC. A large set of breast cancer cases (449), and 27 non-cancerous tissue samples of breast were employed for leptin expression recognition using immunohistochemistry staining.Results: Cytoplasmic immunohistochemical staining of leptin was recognized in 376 (83.7%) and 25 (92.6%) of BC and control cases respectively. Leptin immunostaining were significantly associated with age, histotypes, grade, stage, lymph node involvement, tumor recurrence, hormone receptor phenotypes, ER and HER2 expressions, and p-values were (P = 0.0233), (P = 0.0001), (P = 0.050), (P = 0.0291), (P = 0.0300), (P = 0.0023), (P = 0.0021), (P = 0.0279) respectively. Reasonable proportion of cases with low staining score was more prevalent in all subgroups of clinicopathological parameters except ER- PR+ HER2- hormone receptor phenotype and mucinous carcinoma which showed high level of leptin immunoreactivity. Tumor recurrence is less prevailing in high score leptin immunostaining cases. Furthermore, Log Rank (Mantel-Cox) test findings revealed considerably different survival distributions were observed for the different categories of leptin immunostaining scores (P = 0.032). Negative leptin immunostaining is related to poor survival.Conclusions: Our preliminary findings support leptin clinical value in confirming BC diagnosis as well as prognosis. These results suggest that leptin molecule is an important biomarker that could identify type, grade, stage, lymph node involvement, relapse and prognosis in breast cancer. [ABSTRACT FROM AUTHOR]

Until the day comes when all vehicles are fully autonomous, self-driving cars must be more than safe and efficient--they must also understand and interact naturally with human drivers. The web extras include videos demonstrating "rude" behavior by Tesla's Autopilot system, www.youtube.com/watch?v=el4OdwtgzNk; a human driver confused by self-driving technology, www.youtube.com/watch?v=Uj-rK8V-rik; and aggressive driving prompted by self-driving technology, www.youtube.com/watch?v=FbSQm3YaAzA. [ABSTRACT FROM AUTHOR]

While walking has always been mediated, the arrival of smartphones with multiple apps has changed how we walk and how we use apps. In this study, we investigate the relationships of pedestrian-in-the-street and app-user-on-screen actions. We display and describe a series of intersubjective practices constituted by, and with, walking while using a mobile device. The video data used are from a larger study of pedestrians using smartphones in urban settings, with our analysis here turning on how a smartphone is used and interacted around to accomplish walking together. Our approach draws upon ethnomethodological conversation analytic studies of the sequential and category-based organisation of mobile and on-screen actions. The analysis shows how walking actions (such as unilateral-stopping, turning, restarting) are connected to map actions such as displaying the map, manipulating the scale and monitoring the movement of the you-are-here dot. We conclude with remarks on the collaborative inter-subjective nature of walking with apps. [ABSTRACT FROM AUTHOR]

Argument is made for the importance of conducting a national treatment evaluation to permit understanding of the nature and effectiveness of typical treatment programming. Only through such study can we hope to learn areas of success and failure of normative programming relative to population characteristics and treatment strategies, and the extent to which research-based initiatives have been adopted by the field. That information is central to efforts to draw up a research agenda appropriate to the needs of clients and the staffs responsible for their treatment, and to clarify and respond to gaps in the application of potentially useful treatment components. In spite of such need, our understanding of typical treatment programming and of its effectiveness is based on data collected from a treatment cohort of 20 years ago, although patterns of drug use, characteristics of clients, and the treatment components available have all undergone substantial change. The responsibility taken to provide such information to the field, once seen as a central task of research, needs to be reasserted to strengthen and support our treatment efforts. [ABSTRACT FROM PUBLISHER]

While there is a rich collection of studies of consumption and identity, the role of buying practices in ordinary conversations has been largely neglected. Minor items and major purchases regularly play a key role in furnishing our talk with topics, news, jokes and formulations of what kind of people we are. This paper unpacks the idea of post-purchase conversations contained within the common phrase “word of mouth.” What happens when products are examined in ordinary talk is pursued through the close analysis of a series of conversations around a significant purchase (a mountain bike). Drawing on the work of Harvey Sacks, and conversation analysis more broadly, this paper documents how products as a topic provide not only resources for small talk, but also an opportunity to consider our identity and its transformation. In conclusion, this paper argues that the knowledge and experience that circulate outside of the actual marketplace or point of purchase are part of a domain of economics as ordinary practice. [ABSTRACT FROM PUBLISHER]

Online review Web sites have enabled new interactions between companies and their customers. In this article we draw on interviews with users, reviewers, and establishments to explore how local review Web sites can change interactions around local places. Review Web sites such as Yelp and Tripadvisor allow customers to "previsit" establishments and areas of a city before an actual visit. The collection of a large numbers of user-generated reviews has also created a new genre of writing, with reviewers gaining considerable pleasure from passing on word of mouth and influencing others' choices. Reviews also offer a new channel of communication between establishments, customers, and competitors. We discuss how review Web sites can be designed to cater for a broader range of interactions around reviews beyond a focus on recommendations. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this phase 1/2 study, the authors tested the hypothesis that single-fraction stereotactic body radiotherapy (SBRT) for previously unirradiated spinal metastases is a safe, feasible, and efficacious treatment approach. METHODS: All patients were evaluated by a multidisciplinary team. Spinal magnetic resonance imaging studies were obtained before treatment and at regular intervals to define both target volume and response to treatment. SBRT was delivered to a peripheral dose of 16 to 24 grays in a single fraction while limiting the dose to the spinal cord. Higher doses were used for renal cell histology. The National Cancer Institute Common Toxicity Criteria 2.0 and McCormick neurologic function score were used as toxicity assessment tools. RESULTS: In total, 61 patients who had 63 tumors of the noncervical spine were enrolled and received SBRT between 2005 and 2010 on a prospective, phase 1/2 trial at The University of Texas M. D. Anderson Cancer Center. The mean follow-up was 20 months. The actuarial 18-month imaging local control rate for all patients was 88%, the actuarial 18-month overall survival rate for all patients was 64%, and the median survival for all patients was 30 months. No significant differences in outcomes were noted with respect to tumor histology or SBRT dose. Two patients experienced radiation adverse events (grade 3 or higher). The actuarial rate of 18-month freedom from neurologic deterioration from any cause was 82%. CONCLUSIONS: Data from this phase 1/2 trial supported an expanded indication for SBRT as first-line treatment of spinal metastases in selected patients. The authors concluded that additional studies that can prospectively identify predictive factors for spinal cord toxicity after SBRT are warranted to minimize the incidence of this serious yet rare complication. Cancer 2012. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

In this paper we investigate how the sequential organization and settlement of disagreements comes to shape, and be shaped by, navigation. Using extracts of in-car interaction, we examine the gestalt of projectable aspects of road travel, car movements, and driver-navigator talk. Navigation when accomplished with-out maps relies on making sense of streets, landmarks, and signs, activities that are displayed through passengers and drivers giving directions to each other, alongside embodied references to passing roadside features and the movement of the vehicle. More broadly, "finding the way" is bound up with the social relation-ships between passengers -- in particular families caring for one another and showing their epistemic and emotional stance on particular matters. To examine this we draw on existing conversation analytic work on epistemics, stance, and emotion to explore the potentially argumentative character of direction-giving and direction-receiving and how this comes to be combined with the task at hand. [ABSTRACT FROM AUTHOR]