Wearable activity trackers and health awareness: Nursing implications

PurposeWearable devices are commonly used to measure physical activity. However, it remains unclear the effect of wearing these devices on health awareness. Our aim was to provide evidence related to wearing physical activity trackers and health awareness.MethodsA quantitative comparison study design was used comparing participants who wore physical activity tracking devices (n = 108) and those who did not (n = 112). A paper-based Physical Health Knowledge survey designed for the purpose of this research was used for data collection in 2018.ResultsA difference between participants who wore physical activity tracking devices and those that did not was identified in relation to activity levels and physical health awareness. Wearable devices are suggested as an opportunity for nurses to engage people in physical activity with the potential to improve their health awareness.ConclusionsNurses are well placed in the healthcare landscape to work with patients who own an activity tracker device concerning increasing activity self-monitoring. This information the patient has from the device can also form the basis of health discussions between nurses and the people in their care.     

The predictors and economic burden of early-, mid- and late-onset cardiac implantable electronic device infections: a retrospective cohort study in Ontario,Canada

The rate of cardiac implantable electronic device (CIED) infection is increasing with time. We sought to determine the predictors, relative mortality, and cost burden of early-, mid- and late-onset CIED infections. We conducted a retrospective cohort study of all CIED implantations in Ontario, Canada between April 2013 and March 2016. The procedures and infections were identified in validated, population-wide health-care databases. Infection onset was categorized as early (0–30 days), mid (31–182 days) and late (183–365 days). Cox proportional hazards regression was used to assess the mortality impact of CIED infections, with infection modelled as a time-varying covariate. A generalized linear model with a log-link and γ distribution was used to compare health-care system costs by infection status. Among 17 584 patients undergoing CIED implantation, 215 (1.2%) developed an infection, including 88 early, 85 mid, and 42 late infections. The adjusted hazard ratio (aHR) of death was higher for patients with early (aHR 2.9, 95% CI 1.7–4.9), mid (aHR 3.3, 95% CI 1.9–5.7) and late (aHR 19.9, 95% CI 9.9–40.2) infections. Total mean 1-year health costs were highest for late-onset (mean Can$113 778), followed by mid-onset (mean Can$85 302), and then early-onset (Can$75 415) infections; costs for uninfected patients were Can$25 631. After accounting for patient and procedure characteristics, there was a significant increase in costs associated with early- (rate ratio (RR) 3.1, 95% CI 2.3–4.1), mid- (RR 2.8, 95% CI 2.4–3.3) and late- (RR 4.7, 95% CI 3.6–6.2) onset infections. In summary, CIED infections carry a tremendous clinical and economic burden, and this burden is disproportionately high for late-onset infections.     

Promoting Health Literacy in the Inpatient Setting: Assessment and Interventions

Limited health literacy (LHL) is typically identified in the outpatient setting, at a physician’s office or clinic, and addressed through interventions designed to promote patient understanding of self-care and preventative measures. When a patient with limited health literacy is hospitalized, information needs shift to inpatient, discharge, and posthospitalization care. Hospitalized patients present unique challenges which may affect their abilities to ask questions and retain information. Hospital personnel may also face the challenges of identifying limited health literacy in inpatients and providing appropriate education, in addition to patient care. Implementing hospital-wide health literacy screening is a feasible solution to identifying LHL patients and providing interventions.     

100 Million Views of Electronic Cigarette YouTube Videos and Counting: Quantification,Content Evaluation,and Engagement Levels of Videos

BackgroundThe video-sharing website, YouTube, has become an important avenue for product marketing, including tobacco products. It may also serve as an important medium for promoting electronic cigarettes, which have rapidly increased in popularity and are heavily marketed online. While a few studies have examined a limited subset of tobacco-related videos on YouTube, none has explored e-cigarette videos’ overall presence on the platform.ObjectiveTo quantify e-cigarette-related videos on YouTube, assess their content, and characterize levels of engagement with those videos. Understanding promotion and discussion of e-cigarettes on YouTube may help clarify the platform’s impact on consumer attitudes and behaviors and inform regulations.MethodsUsing an automated crawling procedure and keyword rules, e-cigarette-related videos posted on YouTube and their associated metadata were collected between July 1, 2012, and June 30, 2013. Metadata were analyzed to describe posting and viewing time trends, number of views, comments, and ratings. Metadata were content coded for mentions of health, safety, smoking cessation, promotional offers, Web addresses, product types, top-selling brands, or names of celebrity endorsers.ResultsAs of June 30, 2013, approximately 28,000 videos related to e-cigarettes were captured. Videos were posted by approximately 10,000 unique YouTube accounts, viewed more than 100 million times, rated over 380,000 times, and commented on more than 280,000 times. More than 2200 new videos were being uploaded every month by June 2013. The top 1% of most-viewed videos accounted for 44% of total views. Text fields for the majority of videos mentioned websites (70.11%); many referenced health (13.63%), safety (10.12%), smoking cessation (9.22%), or top e-cigarette brands (33.39%). The number of e-cigarette-related YouTube videos was projected to exceed 65,000 by the end of 2014, with approximately 190 million views.ConclusionsYouTube is a major information-sharing platform for electronic cigarettes. YouTube appears to be used unevenly for promotional purposes by e-cigarette brands, and our analyses indicated a high level of user engagement with a small subset of content. There is evidence that YouTube videos promote e-cigarettes as cigarette smoking cessation tools. Presence and reach of e-cigarette videos on YouTube warrants attention from public health professionals and policymakers.     

Improving Hepatitis Vaccination Series Completion in Patients Awaiting Liver Transplantation

The aim of this quality improvement project was to improve hepatitis A and B vaccination rates by 20% in patients listed for liver transplant by improving vaccine tracking, ordering/scheduling practices, out-of-network vaccinations, and flagging electronic health records. We audited 101 records; 44 patients were vaccine-deficient. Combined vaccine completion rates improved 94.6% (44.7%-87.0%) after implementing the educational and health record interventions. We believe the results of this study have implications for improving survival and decreasing complication rates for patients with chronic liver disease.     

基于iBooksAuthor的电子教材研究

介绍了以微课程理念和贯通式学习思想为指导，基于iBooksAuthor制作电子教材的设计思想、设计过程及设计中需要注意的问题，同时分析了影响此类电子教材普及的因素。