Digital Diary Research Articles

A qualitative study of decision-making and safety in ambulance service transitions

BackgroundDecisions made by front-line ambulance staff are often time critical and based on limited information, but wrong decisions in this context could have serious consequences for patients. There has been little research carried out in the ambulance service setting to identify areas of risk associated with decisions about patient care.AimThe aim of this study was to qualitatively examine potential system-wide influences on decision-making in the ambulance service setting and to identify useful areas for future research and intervention.MethodsWe used a multisite, multimethod qualitative approach across three ambulance service trusts. In phase 1 we carried out 16 interviews to contextualise the study and provide discussion points for phase 2. For phase 2, university and ambulance service researchers observed paramedics on 34 shifts and 10 paramedics completed ‘digital diaries’ that reported challenges to decision-making or to patient safety. Six focus groups were held, three with staff (n = 21) and three with service users (n = 23). From observation and diary data we developed a typology of decisions made at the scene. Data from these and other sources were also coded within a human factors framework and then thematically analysed to identify influences on those decisions. In phase 3, workshops were held at each site to allow participants and stakeholders (n = 45) to comment on the study findings. Participants were asked to rank influences on decisions using a ‘paired comparison’ method.ResultsInterviews provided the context for further qualitative exploration. Nine types of decision were identified from observations and digital diaries, ranging from emergency department conveyance and specialist emergency pathways to non-conveyance. A synthesis of findings from the observations, diaries and staff focus groups revealed seven overarching system influences on decision-making and potential risk factors: meeting increasing demand for emergency care; impacts of performance regime and priorities on service delivery; access to appropriate care options; disproportionate risk aversion; education, training and professional development for crews; communication and feedback to crews; and ambulance service resources. Safety culture issues were also identified. Data from the service user focus groups reflected similar issues to those identified from the staff focus groups. Service user concerns included call handling and communication, triage, patient involvement in decisions, balancing demand, resources, access to care, risk aversion, geographical location and vulnerable patients. Group discussions highlighted a lack of awareness by the public of how best to use emergency and urgent care services. Workshop attendees were satisfied that the findings reflected relevant issues. The two issues ranked highest for warranting attention were staff training and development and access to alternative care.ConclusionsMultiple qualitative methods allowed a range of perspectives to be accessed and validation of issues across perspectives. Recommendations for future research include exploring effective ways of providing access to alternative care pathways to accident and emergency, assessing public awareness and expectations of ambulance and related services, exploring safe ways of improving telephone triage decisions and assessing the effects of different staff skill levels on patient safety.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

MyEpi. Epidemiology of One.

A new concept of within-individual epidemiology termed “myEpi” is introduced. It is argued that traditional epidemiological methods, which are usually applied to populations of humans, can be applicable to a single individual and thus used for self-monitoring and forecasting of “epidemic” outbreaks within an individual. Traditional epidemiology requires that results be generalizable to a predefined population. The key component of myEpi is that a single individual may be viewed as an entire population of events and thus, the analysis should be generalizable to this population. Applications of myEpi are aimed for, but not limited to, the analysis of data collected by individuals with the help of wearable sensors and digital diaries. These data can include physiological measures and records of healthy and risky behaviors (e.g., exercise, sleep, smoking, food consumption, alcohol, and drug use). Although many examples of within-individual epidemiology exist, there is a pressing need for systematic guidance to the analysis and interpretation of intensive individual-level data. myEpi serves this need by adapting statistical methods (e.g., regressions, hierarchical models, survival analysis, agent-based models) to individual-level data.

Feasibility and Acceptability of Cell Phone Diaries to Measure HIV Risk Behavior Among Female Sex Workers

Individual, social, and structural factors affecting HIV risk behaviors among female sex workers (FSWs) are difficult to assess using retrospective surveys methods. To test the feasibility and acceptability of cell phone diaries to collect information about sexual events, we recruited 26 FSWs in Indianapolis, Indiana (US). Over 4 weeks, FSWs completed twice daily digital diaries about their mood, drug use, sexual interactions, and daily activities. Feasibility was assessed using repeated measures general linear modeling and descriptive statistics examined event-level contextual information and acceptability. Of 1,420 diaries expected, 90.3 % were completed by participants and compliance was stable over time (p > .05 for linear trend). Sexual behavior was captured in 22 % of diaries and participant satisfaction with diary data collection was high. These data provide insight into event-level factors impacting HIV risk among FSWs. We discuss implications for models of sexual behavior and individually tailored interventions to prevent HIV in this high-risk group.

Video blogging as a vehicle of transformation: Exploring the intersection between trans identity and information technology

This article explores the intersection between trans identity and technology as it manifests in trans video blogs on YouTube. Taking my point of departure in eight case-study vloggers I analyse the different ways that the vlog can work as a medium of transformation. The vlogs engender the ongoing process of ‘becoming’ man/woman/trans by inscribing the vlogger in multiple and intersubjective reflections, being visible to themselves and others as an image. I argue that the co-production of trans identity in/through the vlog takes the shape of a mirror, a digital diary or autobiography, and as artistic explorations and communications. The article demonstrates how vloggers take advantage of the multimodality of the medium to tell stories of trans that can animate and motivate others to dare to be visible or claim an identity as trans.

Learning dilemmas in undergraduate student independent essays

Essay-writing is generally viewed as the primary learning activity to foster independence and analytical thinking. In this article, we show that independent research projects do not necessarily lead to critical thinking. University-level education on conducting independent projects can, in several respects, counteract enhanced analytical skills. The purpose of this study is to advance knowledge on the difficulties students experience in acquiring analytical skills. A group of undergraduate political science students were interviewed while they attended an independent research course. They were also asked to record their reflections. The digital diaries provide access to the students' perceptions regarding the assignment and their struggles as they handle scientific problems. We argue that the students are caught up in different learning dilemmas when asked to perform independent academic research. One result is that ambiguous and contradictory understandings of science affect the learning processes and thus affect the students' possibilities for developing analytical thinking.

Emerging technologies for assessing physical activity behaviors in space and time.

Precise measurement of physical activity is important for health research, providing a better understanding of activity location, type, duration, and intensity. This article describes a novel suite of tools to measure and analyze physical activity behaviors in spatial epidemiology research. We use individual-level, high-resolution, objective data collected in a space-time framework to investigate built and social environment influences on activity. First, we collect data with accelerometers, global positioning system units, and smartphone-based digital travel and photo diaries to overcome many limitations inherent in self-reported data. Behaviors are measured continuously over the full spectrum of environmental exposures in daily life, instead of focusing exclusively on the home neighborhood. Second, data streams are integrated using common timestamps into a single data structure, the “LifeLog.” A graphic interface tool, “LifeLog View,” enables simultaneous visualization of all LifeLog data streams. Finally, we use geographic information system SmartMap rasters to measure spatially continuous environmental variables to capture exposures at the same spatial and temporal scale as in the LifeLog. These technologies enable precise measurement of behaviors in their spatial and temporal settings but also generate very large datasets; we discuss current limitations and promising methods for processing and analyzing such large datasets. Finally, we provide applications of these methods in spatially oriented research, including a natural experiment to evaluate the effects of new transportation infrastructure on activity levels, and a study of neighborhood environmental effects on activity using twins as quasi-causal controls to overcome self-selection and reverse causation problems. In summary, the integrative characteristics of large datasets contained in LifeLogs and SmartMaps hold great promise for advancing spatial epidemiologic research to promote healthy behaviors.

Smart Diary: A Smartphone-based Framework for Sensing, Inferring and Logging Users’ Daily Life

In this paper, we present Smart Diary, a novel smartphone based framework that analyzes mobile sensing data to infer, predict, and summarize people's daily activities, such as their behavioral patterns and life styles. Such activities are then used as the basis for knowledge representation, which generates personal digital diaries in an automatic manner. As users do not need to intentionally participate into this process, Smart Diary is able to make inferences and predictions based on a wide range of information sources, such as the phones' sensor readings, locations, and interaction history with the users, by integrating such information into a sustainable mining model. This model is specifically developed to handle heterogeneous and noisy sensing data, and is made to be extensible in that users can define their own logic rules to express short-term, mid-term, and long-term event patterns and predictions. Our evaluation results are based on the Android platform, and they demonstrate that the Smart Diary framework can provide accurate and easy-to-read diaries for end users without their interventions.

Supporting Conversations Between Individuals With Dementia and Their Family Members

Remembrance of recent events is a major problem for individuals with dementia. Consequently, this article explores the process of acceptance and integration of a digital photograph diary (DPD) as a tool for remembrance of and conversations about daily life events. A design for multiple case studies was used. Seven couples, in which one individual in the couple had Alzheimer's disease, tested the DPD for 6 months. Data were collected in three sequences with interviews, observations, and screening instruments. In the analysis, all data were integrated to find common patterns of content. Some couples became regular users, while others used the DPD more sporadically. Factors contributing to regular use were how the DPD matched expectations, actual use, support, experienced usefulness, and reactions from family and friends. For those couples who became regular users, the DPD facilitated their conversation about recent daily activities.

Evaluation of an electronic diary for improvement of adherence to interferon beta-1b in patients with multiple sclerosis: design and baseline results of an observational cohort study

BackgroundMultiple sclerosis is a chronic, incurable, demyelinating disease that requires long-term treatment. Rates of non-adherence to prescribed therapy of up to 50% have been reported for chronic diseases. Strategies to improve treatment adherence are therefore of the utmost importance. This study will evaluate the effect of using electronic and paper diaries on treatment adherence to interferon beta-1b in patients with a first clinical isolated syndrome (CIS) or relapsing-remitting multiple sclerosis (RRMS). Here we report on the study design and results of baseline assessments.MethodsPatients were recruited into a prospective national multicenter cohort study for an observational period of 2 years. At the start of the study, patients opted to use a digital (DiD) or paper diary (PD) to document self-administered injections of interferon beta-1b. Adherence to treatment will be assessed on the dropout rate at the end of the observation period and on the regularity of injections every other day at 6-month intervals. Patient-related health outcomes will also be evaluated.Results700 patients with a mean age of 38.3 (SD 10.3) years and a mean duration of disease since diagnosis of 3.6 (SD 5.9) years were enrolled. 383 patients opted for the digital diary, 192 of which included an injection reminder. Significantly more male than female patients opted for the DiD. Only gender was identified as a factor influencing the decision for DiD or PD. Based on rating scales, a significantly higher proportion of women had depressive comorbidities at baseline.ConclusionsDemographic characteristics of the two cohorts were similar at baseline. More women chose a paper diary, and more had depression at baseline. These imbalances will be addressed in the analysis of the study as possible confounders influencing long-term treatment adherence in the digital and paper diary cohorts.Trial RegistrationClinicalTrials.gov Identifier: NCT00902135.

Investigation on views and attitudes of students in Faculty of Education about reading and writing on screen

The purpose of this research is to determine points of view and attitudes of students of Faculty of Education about reading and writing on screen. In this research, descriptive survey model is used. The working group includes 254 students of UAŸak University, Faculty of Education. A new measurement tool developed by the researcher was used in this study as a data collection tool. Students in this study express that the most important opportunity of on-screen reading is that they contribute to intertextual meaning establishment by enabling connection to other texts, visuals, etc. in digital media, from the text that is being studied on but the most difficulty stated by the students is eye tiredness. For opportunities of writing on screen, the students express that it enables connections to other texts, visuals, etc. in digital media and that it allows for creation of digital notebook and diary; and for the difficulties of on-screen writing, they express that it can be eye tiring, it can be difficult to use the keyboard and screen instead of pen and paper, and it can cause backache and vertebral ache. Key words: Reading, writing, reading on screen, writing on screen, attitude, e-book

Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability

BackgroundThe prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers.This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education.MethodsWe have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user’s own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews.ResultsBoth home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home. The digital health diary was used as background information in the individual consultations and by some participants as a self-management tool. Participant retention was high, with no dropouts. None of the participants reported that the six-week duration of the home programmes was too long.ConclusionsThe Internet-enabled programmes for home-based groups in pulmonary rehabilitation and diabetes education were generally well accepted by the participants. Our findings indicate that conventional programmes have the potential to be delivered in socially supportive group settings at home.

Professional caregivers’ perceptions on the prerequisites for and consequences of people with mild dementia using a digital photo diary

Research is currently ongoing to investigate the use of assistive technology by people with mild dementia to support independent living at home. The aim of this study was to describe professional caregivers’ perceptions on the prerequisites for and consequences of people with mild dementia using a digital photo diary to facilitate their talks about daily events with their family members. A questionnaire was sent out to 582 participants (response rate 70.1%) to elucidate the professional caregivers’ perceptions on the use of the digital photo diary. The questionnaire contained both quantitative and qualitative data and was analyzed with descriptive statistics, factor analysis, multivariate analysis of covariance and qualitative content analysis. This study reports the results related to prerequisites and consequences of using the photo diary. The results from the factor analysis revealed four factors: Trust, Vulnerability, Dependency/Independency and Control. The qualitative content analysis resulted in five categories: Immediate implementation after receiving a diagnose is required, Relatives’ participation is a necessity, Strengthened self-esteem and meaningful everyday life, Increased alienation and a feeling of isolation and Assistive digital devices provide opportunities. The theme was interpreted as: Personalization and the preservation of dignity. The conclusion that can be drawn from this study is that the participants had an overall positive view of the usage of this specific digital photo diary for people suffering from dementia, but rigorous considerations needs before implementation of the device and regularly follow ups if dignity is to be maintained for people with dementia.

Professional Caregivers' Perceptions on how Persons with Mild Dementia Might Experience the Usage of a Digital Photo Diary.

Cognitive impairments influence the possibility of persons with dementia to remember daily events and maintain a sense of self. In order to address these problems a digital photo diary was developed to capture information about events in daily life. The device consisted of a wearable digital camera, smart phone with Global Positioning System (GPS) and a home memory station with computer for uploading the photographs and touch screen. The aim of this study was to describe professional caregiver’s perceptions on how persons with mild dementia might experience the usage of this digital photo diary from both a situation when wearing the camera and a situation when viewing the uploaded photos, through a questionnaire with 408 respondents. In order to catch the professional caregivers’ perceptions a questionnaire with the semantic differential technique was used and the main question was “How do you think Hilda (the fictive person in the questionnaire) feels when she is using the digital photo diary?”. The factor analysis revealed three factors; Sense of autonomy, Sense of self-esteem and Sense of trust. An interesting conclusion that can be drawn is that professional caregivers had an overall positive view of the usage of digital photo diary as supporting autonomy for persons with mild dementia. The meaningfulness of each situation when wearing the camera and viewing the uploaded pictures to be used in two different situations and a part of an integrated assistive device has to be considered separately. Individual needs and desires of the person who is living with dementia and the context of each individual has to be reflected on and taken into account before implementing assistive digital devices as a tool in care.

'아날로그-디지털 인터랙션 흔적'에 관한 개념 연구와 미디어 아트에의 응용

본 논문에서는 인터랙티브 미디어 작품 제작에 적용 가능한 개념을 제안하고 개념이 적용된 미디어 아트작품에 대한 사용자 경험과 그것에 대한 결과물을 통해 개념의 타당성과 그 가능성을 시험해보고자 한다. 이를 위해 사용자 인터랙션 흔적을 아날로그와 디지털 형태로 남기도록 하는 '에이디-트레이스(AD-Trace)'라는 개념을 세우고, 이를 적용한 다양한 인터랙티브 미디어 아트 작품 창작을 시도하였다. 에이디-트레이스는 디자인 요소로서 '아날로그 흔적(Analogue Trace)', '디지털 흔적(Digital Trace)', 그리고 두 요소를 연결하면서 사용자의 인터랙션을 유도하여 보다 의미 있는 흔적을 남길 수 있도록 지원하는 '인터랙션 메타포(Interaction Metaphor)'를 갖는다. 이 세 가지 요소는 본 연구자의 세 개 작품인 '에이디-피디(AD-PD)', '에이디-스타(AD-Star)', 그리고 '에이디-맵(AD-Map)'에서 각 작품의 콘셉트에 맞게 디자인 되었으며, 사용자 참여 후 얻어진 결과물을 통해 에이디-트레이스가 가질 수 있는 특성을 분석하였다. This paper describes the development of the media art environment concept, in which the user's interaction becomes visual arts in both digital and analogue media. It describes AD-Trace, an experimental media art component that investigates the aesthetic and technological possibilities through the development of interactive media artworks that utilizes that the traces of the user's interaction. The AD-Trace consists of three design components: Analogue Trace, Digital Trace, and Interaction Metaphor to guide user interactions with user's understanding. Three artworks are proposed to demonstrate the real world applications of the concept: AD-PD(analogue digital picture diary), AD-Star (analogue digital star), and AD-Map (analogue digital map).

All-About Digital Diaries: Opportunities and Challenges

All-about diaries—software platforms that record, in a browsable and machine-processable format, the everyday activities of people, communities, and objects—offer a wealth of application opportunities, but their full-fledge implementation will require overcoming several challenges.

Dietary Digital Diaries: Documenting Adolescents' Obesogenic Environment.

Obesogenic built environments may contribute to excessive eating and obesity. Twenty-three 12- to 17-year-old low-income African American adolescents created digital diaries by photographing their lunchtime food environment in a summer academic program. Digitally depicted foods were classified as appearing on the platescape (student's or others' plate) or the tablescape (food buffet). Height, weight, BMI percentile, and waist-to-hip ratio were calculated at baseline and week 4. Adolescents digitally depicted high caloric, high fat foods on the platescape and tablescape, particularly adolescents with a higher waist-to-hip ratio. Weight gain during the 4-week program was significantly predicted by the number of calories and the amount of fat content depicted on the student's plates. Digital diaries, then, can document adolescents' perspectives of their food environments that promote their overconsumption of high caloric and high fat foods that contribute to weight gain and put them at risk for obesity.

Attributes of packaging and influences on waste

AbstractAn important area of focus for the reduction of domestic waste is packaging and food packaging specifically. At some point in the life of packaging in the consumers' home, the packaging goes through a transition from something of use, of value and of worth to the consumer to something that is no longer any of these. Being able to indentify attributes of packaging that might have an impact on this transitional point to change the use or value so that the packaging is re‐used, recycled or composted rather than being landfilled is very important in successfully diverting packaging waste from landfill.This research aimed to conduct a variety of tests to indentify attributes of packaging that have an influence on the eventual waste route and to determine what that influence was. The research included an extensive literature study looking at consumer test methods, current waste and packaging waste studies, and packaging design literature. This was followed by a series of four tests: ‘bin raids’, ‘digital diary’, ‘visual survey’ and ‘ethnography’. These tests were designed to determine how consumers would treat specific examples of packaging in an end‐of‐life scenario and what influences those decisions. Copyright © 2011 John Wiley & Sons, Ltd.

Facial Solar UV Exposure of Austrian Farmers During Occupation

Optoelectronic personal UV-meters were used to monitor the occupational facial solar erythemally effective exposure of 12 Austrian full-time farmers with high temporal resolution. To ensure high quality measurements several quality assurance procedures were applied, like calibration with respect to solar elevation and total ozone column. From April to October the test persons carried the UV-meters on the forehead during working hours. A digital diary (activity, location, weather, photoprotective measures) was completed on an hourly basis. Our field test produced 1427 complete daily records (measurement and diary). The total exposures showed high variability (77-757 standard erythema dose [SED]) which correlates with the number of working days and even stronger with the little numbers of days with high exposure (>10 SED). Risk factors for high exposures were: mixed-culture farms with aggravated working conditions, low degree of automation of working processes, inadequate operating logistics (summarized as manual work outdoor), driving machines without cabins, and female gender. UV exposure of female farmers was approximately twice as high as that of men: Women received 15% of ambient radiation while men got 8%. Avoiding daily exposure >10 SED could reduce exposure down to 40% and the risk in developing skin cancer by a factor of 40.

Affective loop experiences: designing for interactional embodiment

Involving our corporeal bodies in interaction can create strong affective experiences. Systems that both can be influenced by and influence users corporeally exhibit a use quality we name an affective loop experience. In an affective loop experience, (i) emotions are seen as processes, constructed in the interaction, starting from everyday bodily, cognitive or social experiences; (ii) the system responds in ways that pull the user into the interaction, touching upon end users' physical experiences; and (iii) throughout the interaction the user is an active, meaning-making individual choosing how to express themselves-the interpretation responsibility does not lie with the system. We have built several systems that attempt to create affective loop experiences with more or less successful results. For example, eMoto lets users send text messages between mobile phones, but in addition to text, the messages also have colourful and animated shapes in the background chosen through emotion-gestures with a sensor-enabled stylus pen. Affective Diary is a digital diary with which users can scribble their notes, but it also allows for bodily memorabilia to be recorded from body sensors mapping to users' movement and arousal and placed along a timeline. Users can see patterns in their bodily reactions and relate them to various events going on in their lives. The experiences of building and deploying these systems gave us insights into design requirements for addressing affective loop experiences, such as how to design for turn-taking between user and system, how to create for 'open' surfaces in the design that can carry users' own meaning-making processes, how to combine modalities to create for a 'unity' of expression, and the importance of mirroring user experience in familiar ways that touch upon their everyday social and corporeal experiences. But a more important lesson gained from deploying the systems is how emotion processes are co-constructed and experienced inseparable from all other aspects of everyday life. Emotion processes are part of our social ways of being in the world; they dye our dreams, hopes and bodily experiences of the world. If we aim to design for affective interaction experiences, we need to place them into this larger picture.

Which Characteristics of a Reciprocal Peer Coaching Context Affect Teacher Learning as Perceived by Teachers and Their Students?

In the present study, the role of five categories of characteristics of a reciprocal peer coaching context was studied in relation to teacher learning. Both self-reports and student perceptions were used to measure teacher learning. Data were gathered on 28 secondary school teachers (14 coaching dyads). A mixed-method approach was adopted combining quantitative and qualitative data. To study the associations between five categories of characteristics of a peer coaching context (independent variable) and teacher learning (dependent variable), questionnaire results (quantitative data) and digital diaries (qualitative data) were examined. It was found that teachers learn when they are intrinsically motivated to take part in professional development programs; when they feel a certain pressure toward experimenting with new instructional methods; and when they are able to discuss their experiences within a safe, constructive, and trustworthy reciprocal peer coaching environment.