Examining Cognitive Disengagement Syndrome in Relation to Social Problem Solving in Young Adults.

OBJECTIVE: Cognitive disengagement syndrome (CDS), previously referred to as sluggish cognitive tempo (SCT), is characterized by symptoms such as excessive daydreaming, mental confusion, and hypoactivity. CDS symptoms are associated with emotional, social, and daily life impairments. The way in which one solves problems in their daily life is associated with experiences of further problems, such that maladaptive problem-solving can lead to further physical and psychological problems. However, there is limited information on how CDS symptoms are associated with problem solving. The current study examined CDS symptoms in relation to different social problem solving approaches. METHOD: A total of 280 college students (ages 18-23 years; 77.9% female) completed measures of psychopathology symptoms and social problem solving. RESULTS: Above and beyond ADHD and internalizing symptoms, CDS symptoms were independently associated with negative problem orientation and avoidance style domains of maladaptive problem solving. CONCLUSION: Findings indicate that CDS symptoms are related to specific difficulties with social problem solving. CDS symptoms may lead to difficulties attending to problems or working through relevant steps needed to identify solutions for the problem, which may then lead to avoidance and social withdrawal. Longitudinal research is needed to evaluate maladaptive problem solving as a potential mechanism in the association between CDS, social withdrawal, and internalizing symptoms.

Vitamin D levels in children with attention deficit hyperactivity disorder: Association with seasonal and geographical variation, supplementation, inattention severity, and theta:beta ratio.

We examined seasonal and geographic effects on vitamin D [25(OH)D] levels, association with attention-deficit/hyperactivity disorder (ADHD) symptom severity, and effects of supplementation in 222 children age 7-10 with rigorously diagnosed ADHD. 25(OH)D insufficiency rates were 47.2 % in Ohio and 28.5 % 400 miles south in North Carolina. Nadir of 25(OH)D levels was reached by November in Ohio, not until January in NC. Thirty-eight children with insufficiency/deficiency took vitamin D (1000-2000 IU/day for a month); levels rose 52 %. Although inattention did not correlate with 25(OH)D at screen nor improve significantly with supplementation, inattention improvement after supplementation correlated with 25(OH)D increase (rho = 0.41, p = 0.012). A clinically significant proportion of children with ADHD have insufficient 25(OH)D even at summer's end, more so in the winter and north of the 37th parallel. The significant correlation of inattention improvement with 25(OH)D increase suggests further research on 25(OH)D as ADHD treatment.

Sociotechnical challenges to developing technologies for patient access to health information exchange data.

BACKGROUND: Providing patients with access to their medical data is widely expected to help educate and empower them to manage their own health. Health information exchange (HIE) infrastructures could potentially help patients access records across multiple healthcare providers. We studied three HIE organizations as they developed portals to give consumers access to HIE data previously exchanged only among healthcare organizations. OBJECTIVE: To follow the development of new consumer portal technologies, and to identify barriers and facilitators to patient access to HIE data. METHODS: Semistructured interviews of 15 key informants over a 2-year period spanning the development and early implementation of three new projects, coded according to a sociotechnical framework. RESULTS: As the organizations tried to develop functionality that fully served the needs of both providers and patients, plans were altered by technical barriers (primarily related to data standardization) and cultural and legal issues surrounding data access. Organizational changes also played an important role in altering project plans. In all three cases, patient access to data was significantly scaled back from initial plans. CONCLUSIONS: This prospective study revealed how sociotechnical factors previously identified as important in health information technology success and failure helped to shape the evolution of three novel consumer informatics projects. Barriers to providing patients with seamless access to their HIE data were multifactorial. Remedies will have to address technical, organizational, cultural, and other factors.

Consumer experience with and attitudes toward health information technology: a nationwide survey.

Electronic health records (EHR) are becoming more common because of the federal EHR incentive programme, which is also promoting electronic health information exchange (HIE). To determine whether consumers' attitudes toward EHR and HIE are associated with experience with doctors using EHR, a nationwide random-digit-dial survey was conducted in December 2011. Of 1603 eligible people contacted, 1000 (63%) participated. Most believed EHR and HIE would improve healthcare quality (66% and 79%, respectively). Respondents whose doctor had an EHR were more likely to believe that these technologies would improve quality (for EHR, OR 2.3; for HIE, OR 1.7). However, experience with physicians using EHR was not associated with privacy concerns. Consumers whose physicians use EHR were more likely to believe that EHR and HIE will improve healthcare when compared to others. However, experience with a physician using an EHR had no relationship with privacy concerns.

Consumer perceptions of electronic health information exchange.

BACKGROUND: Public support will be critical to the success and long-term sustainability of electronic health information exchange (HIE) initiatives currently promoted by federal policy. PURPOSE: The goal of this study was to assess consumer perceptions of HIE in a state (New York) with a 6-year history of successful HIE organizations. METHODS: The Empire State Poll is a random-digit-dial telephone survey of adult New York State residents conducted annually by the Survey Research Institute at Cornell University. In 2011, it contained 77 items. RESULTS: The survey was conducted and data were analyzed in 2011. Eight hundred respondents participated (71% response rate). Large majorities supported HIE among healthcare providers (69%); thought it would improve quality of care (68%); and supported "break the glass" access to HIE data without need for consent in emergencies (90%). Support was lower among people who rated large corporations as less trustworthy. Privacy and security concerns were expressed by 68%. Respondents were supportive whether the architecture involved a physician sending data to another physician, a physician sending data to a patient who could send it to other physicians, or a physician accessing data from other institutions. CONCLUSIONS: In New York, public support for HIE is strong. Policy and outreach pertaining to this type of exchange may be most effective if it clarifies the roles and responsibilities of large businesses involved in different aspects of the exchange, and privacy and security controls. Differing architectures received similar levels of support.