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Without a doubt, the new technology must be better than the old technology in at least one dimension (e.g., usefulness). However, it is the users who actually use the technology and their attitudes are the most important in the TAM. So, proper change management is necessary in this kind of situation.
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To answer the reason of not using bednets, I’d use qualitative method: in-depth interviews with key informants and informants until data saturation is achieved. The interview questions might be semi-structured because it requires less experienced interviewer than unstructured ones while there is room for flexibility.
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Some specific external variables, in my opinion, are:
– sense of urgency: one who accepts it is the high time to accept the new technology might adopt it faster than the others regardless of other factors such as user-friendliness
– peer pressure
– presence or absence of the feedback and support system. -
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Population density might be a confounder here. Since more young adults reside in the urban area with more population than other age groups because of the presence of university, work, recreation places, etc., more contact patterns might be detected than those age groups who live in the loosely populated areas.
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Age-specific mortality rate
Definition
It is a measure of number of deaths in a particular population of a specific age during a particular time period.Calculation
The numerator is the number of deaths in a specific age group during a particular time period. The denominator is the number of persons in that population of specific age during that time period.Usefulness
For example, the crude mortality rate of Alzheimer’s disease might be very low, however, if we narrow down the age group to 60-90, this age-specific mortality rate might be able to reflect more on the severity of Alzheimer’s disease. -
No. 10, page 342
“If you reject the test hypothesis because P</= 0.05, the chance you are in error is 5%.”P </= 0.05 does not mean that the chance you are in error for rejecting the test hypothesis, which is actually true, is 5%. It means that you will reject it and be in error for 5 times if you apply the test across 100 different studies.
The same explanation can be used for No. 24, page 345.
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I work as a monitoring and evaluation officer at a DR-TB project. My day to day work relates a lot to data: collecting, data quality assurance and reporting, but not so much of analysis and statistics.
I have learned about basic biostatistics in my undergraduate program, and I’m willing to learn more from this course. -
Topic:
Effect of coup d’etat on drug-resistance tuberculosis (DR-TB) morbidity and mortalityRationale:
Myanmar is one of DR-TB high burden countries, and the control measures were implemented by the National TB control programme together with non-governmental partners. As a result of coup d’etat and subsequent health system breakdown nationwide, there have been disruption in both early diagnosis and treatment measures and adherence monitoring. It is needed to measure how large the negative impact of coup d’etat would be on DR-TB morbidity and mortality so that effective health planning can be made to cover the aftermath.Research question:
Can this model predict the effect of coup d’etat on DR-TB morbidity and mortality in Myanmar?Note:
Since this topic is politically related and there might be a huge variety of contributing factors, I have no idea if this question might be answerable. Thank you in advance for comments and recommendations. -
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It was a very interesting topic.
1. One of my instructors from med school once asked us that if we were to buy only one: oral rehydration salts for many people or one high-tech laparoscopy machine which would cost the same, which we would buy. The number of lives saved from the same amount of resource is the justification factor in my opinion.
2. Digitalizing vital statistics at all levels of the hospitals would solve the problem, if feasible.
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1. As discussed during seminar, for those refusing to use the system, encouraging by force or policy is initially required in my opinion. After that, we can change methods according to their response.
2. Continuous support for IT solutions and HR are needed to sustain the system. Listening and responding to the users’ feedback activity is also a key.
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Thank you for interesting presentation.
1. I would consider privacy and security and the app’s operability in low performance smartphones the most for smartphone tracking.
2. Highly infectious and severe diseases might benefit from smartphone tracking apps. For less infectious and severe diseases, risks and benefits of using this technology with the morbidity and mortality of the disease should be considered before adopting.
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I enjoyed your presentation a lot.
1. Like you discussed, there is much relying upon past personal experiences than what the data says in our organization. This issue needs to be addressed.
2. I would in my opinion involve all levels of staffs in recording and reporting design, and data collection steps to give them a sense of autonomy. This is a way to nurture the culture of information use.
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1. EA is essential for comprehensive healthcare IT solutions in long-term. However, it’s quite difficult in my opinion to persuade stakeholders not to look for short-term solutions only.
2. Since healthcare industry is always evolving, the EA design should be adaptable to changes in the future. Continuous research is needed to know future demands.
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I gained useful knowledge from your presentation.
Since the knowledge of blockchain technology is new to me, I haven’t heard of any use of it in my country’s healthcare system. I think budget availability would be a challenge.
For its use in health, maybe it could also be integrated in public health fields like epidemiological surveillance.
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It was an interesting presentation.
The nature of EWARS itself is easy to be implemented and used, as it comes readily in a box, and so the installation process is very quick which is advantageous especially in such emergency conditions.
A concern that occurred to me concerning EWARS evaluation is that there was no comparison of effectiveness between EWARS and existing surveillance systems (due to lack of the latter). If it could be shown that EWARS was more effective, it could be of use in the future, not only in emergency response.
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Please check my wrap-up.
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Please check my wrap-up.
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Please follow this link for my wrap-up assignment.
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In case, the image cannot be viewed, please go to this link: https://prnt.sc/12qc32d -
It is a very well done CRF with neat design. I like how month is recorded so that it cannot be misread as day. Having investigator’s signature space, instruction for filling out physical examination, degree of severity of solicited reactions included and being able to choose which visit in solicited reactions page are what I find significantly good in this CRF design.
Eligibility criteria questions are easy to understand for investigator, however, most of them can be written shorter in my opinion. As for adding 2 identifiers (screening no. and participant no.), I get the point that some subjects might be screened but not enrolled because of ineligibility. But, I think only 1 identifier might do the work since unenrolled subjects might not be entered into the database. Other small findings are:
– QIV and TIV for vaccination arm (instead of right and left)
– 3 boxes for age (only 2 required)
– unit for respiratory rate being bpm
– being not sure if we can match solicited symptoms on AE page as you mentioned because all of the AEs might not be written in the AE page. -
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Benefits of having data standards are enormous, and to state one, I would say ease of data sharing. Data sharing, consequently can lead to better healthcare through evidence based medicine. It is obvious that clinical research results are more reliable when there are more data collected across different studies.
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I haven’t experienced study projects, however, recording TB cases for treatment monitoring and reporting is my daily practice. In this practice, case recording is done in web application developed by our team. It has been integrated with:
– User authentication and access control: each user has his/her own username and password. Features accessible are not the same among levels of different users.
– Edit checks and logical checks: eg., the conclusion of the investigated presumptive case being “No TB” with sputum examination result “positive” triggers a prompt box for manual query.
– Data backup and recovery: All the data on the app are backed up in a purchased virtual server.We have yet to discuss about adding audit trail in the app since I just started to realize its importance.
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I have only experienced some of the steps in the data management process missing most of the important ones such as protocol discussion, data quality assurance, data coding and data sharing.
If I were to be able to go back and make improvements, I would choose web-based electronic data capture from the beginning to reduce workload. Data management plan would be well written not only with minimum requirements but in the best possible practice. And also, enough time would be given for data entry screen test to reduce entry errors and boost confidence. Apart from data quality control, quality assurance will be performed in accordance with protocols. -
1. I once assisted my senior in her PhD research project in the data collection process. The project is about child nutrition, and it was field-based study.
2. There were 3 phases of data collection in the project: 1st is qualitative study to validate survey questions to be used in the last phase, followed by anthropometric measurements of children which is quantitative data. The last step involved both quantitative and qualitative data by interviewing parents’ of the children. So, all the data collected in all 3 steps are primary data.
3. Data were collected in papers and interviewer-administered. Interviews were audio recorded and transcribed later.
4. During focus group discussions, both note taking and audio recording were done, but there was some confusion on who said the certain sentence, and blurred sentences while transcribing. And also, there were some minor misinterpretation of interviewer’s questions. Apart from those, it was a smooth process.
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To my little knowledge, I have seen much less informatician than IT specialist/developer and clinician/public health specialist taking place in the practice. Even my department only has doctors and IT specialists for developing health informatics projects. To lessen the gap of communication between us, the doctors have to self-learn IT basics, and the developers, basic medical terms. Still, the gap exists. The cons of the lack of informaticians are significant in both private and public sectors, which might take a number of pages to describe in words.
The challenges, in my opinion, lie in the resources, or the lack thereof. Limited availability of man: trainers, money: budget on informatics, materials: training resources and infrastructure for informatics projects to properly operate upon are the barriers to the graduates who are willing to become informaticians. Policies to support informaticians such as adding health informatics subjects in medical undergraduate curriculum would help increase the workforce to a certain extent. -
As discussed in the lecture videos, data sharing has many benefits, not only financially but also in reliability of research results. In this way, quality of care can be improved. If I were to share a data set which is under my responsibility, I would consider:
– data sharing policies of my country
– if data sharing has been consented during initial data collection
– the individual/organization which the requester represents
– types of data requested (sensitive data or not)
– the potential impacts of the research results on the community.
The decision will be made based on the above considerations, and also, I would ask for the opinion of other responsible persons if I am not the only one in charge of the data set. -
For the same treatment, US charges much more than any other countries. And also, higher medical expenses do not mean higher life expectancy there according to the statistics. With complex health insurance systems in the US, to my little knowledge, the US government does not control drug prices and charges by healthcare professionals. It’s lack of simpler insurance system and the implemented multiple systems what increase out-of-pocket costs for healthcare. While hospitals are non-profit in Japan, those in the US are profit centers.
Government has the whole responsible to make all of its people to be able to access healthcare without financial burden regardless of the development status of the country. -
According to the lecture videos, I find Net Pracharat to be a big step towards digital equity. The benefits to the people in the country, and the nation as a whole are immense with proper use of the internet.
However, I agree with the article provided about current/potential problems with Net Pracharat.
1. Number of Wi-Fi spots and weak signals: the download/upload speed being less than that stated in the project description is a a big problem to be considered. Checking the capacity of infrastructure, and setting a proper feedback mechanism from the users might solve this.
2. Benefits to private telecoms: as described in the article, issuing a policy to private telecoms to lower their charge to rural customers might be able to prevent the free rides.
3. Risk to user data: with new cyber law coming into effect, this risk is not negligible. To lessen this risk, we can educate the users about the law and its potential usage in politics, minimum set of skills for cybersecurity. -
The health setting I’m working at is the care of drug-resistant tuberculosis patients. I would like to briefly describe the functions of my project before listing pros and cons of the implemented EMR in the process.
The main functions of the DR-TB patient care project is providing money support, supervising regular taking of drugs, monitoring disease progress, drug side effects and infection control practices, and regular screening of close contacts. The following pros and cons of EMR are stated in relation to the functions mentioned above.Pros: Alert features, proper recording of patient’s demographics, increased accessibility (indirectly reduced cost of transportation), and timeliness provided by the EMR can lead to:
– decrease in loss to follow up rates
– improved regularity of drug taking and consequently, less change into worse drug-resistant forms of TB
– improved outcomes
– early catchup of side effects and therefore no unnecessary morbidity and mortality
– better infection control practice and reduced transmission
– early diagnosis and prompt treatment.Cons:
– increased workload during transition period
– Initial setup and training cost
– Burden to users with less IT knowledge might lead to reduced work satisfaction
– Potential security and privacy threats. -
Dear, thank you for your encouragement. I’m sorry for the confusing research question. What I meant with “this model” is the model which I would be working on later in the project, not a pre-existing model. Yeah, it looks confusing even to me now 😀
Thank you again for pointing out. I think it’d be better to update the research question to “How can coup d’etat affect DR-TB morbidity and mortality in Myanmar?”. -
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Thank you for your interest and question. Yes, there were difficulties since it was field-based. One of them was that we had criteria on which person to include in the group discussion, and we already informed to local authorities in the villages about the criteria. However, the authorities had minor misunderstandings in it, and when we arrived, some of the people already in the group gathered by authorities for discussion had variations from the criteria.
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It is true that most medical personnel tend to prioritize the treatment, and most technical specialists focus only in the electronic system in a healthcare setting. They are doing their jobs fine however, without an informatician in between, the whole workflow will be disrupted. With an informatician in place, both of the professionals described above will be able to focus on their jobs without distress and patient loss.
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