A Randomized Controlled Trial in the Evaluation of a Novel Stress Management Tool: A Lounge Chair Experience.

OBJECTIVES: The aim of this study was to compare the stress reduction effects of spending 25 minutes reclining in a SolTec™ Lounge between 2 intervention groups. Group 1 experienced the Lounge with multilayered music on an external speaker, while group 2 experienced the Lounge with multilayered music and synchronous vibration and magnetic stimulation from within the chair. SUBJECTS: In total, 110 participants with a self-reported stress level of 4 or higher on a 0- to 10-point scale were recruited from the local community including employees. Participants were randomized into receiving 1 of the 2 interventions. There were no significant differences between the group's average stress levels prior to the interventions. INTERVENTIONS: Both groups received a 25-minute session in a dimly lit, quiet area on the Lounge with multilayered music. The second group also received vibration and magnetic stimulation that were synchronized with the music. DESIGN: Current stress level as well as ratings or feelings of anxiety, tenseness, energy, focus, happiness, relaxation, nervousness, creativeness, and being rested were recorded before and after the session. RESULTS: Both groups of participants reported equivalent decreased feelings of stress after using the Lounge. Participants receiving the synchronous multilayered music, vibration, and magnetic stimulation did report significantly reduced feelings of tenseness, feeling more relaxed, and feeling more creative when compared with the group that received music only. CONCLUSION: Spending 25 minutes in the SolTec™ Lounge with multilayered music is an effective way to reduce self-reported stress in individuals who self-report having a high stress level. If confirmed by future studies, including synchronous vibration and magnetic stimulation with the multilayered music might be an effective stress reduction strategy.

Determining the Validity and Accuracy of Multiple Activity-Tracking Devices in Controlled and Free-Walking Conditions.

PURPOSE: Clinicians and fitness professionals are increasingly recommending the use of activity trackers. This study compares commercially available activity tracking devices for step and distance accuracy in common exercise settings. DESIGN: Cross sectional. SETTING: Rochester, Minnesota. PARTICIPANTS: Thirty-two men (n = 10) and women (n = 22) participated in the study. MEASURES: Researchers manually counted steps and measured distance for all trials, while participants wore 6 activity tracking devices that measured steps and distance. ANALYSIS: We computed the difference between the number of steps measured by the device and the actual number of steps recorded by the observers, as well as the distance displayed by the device and the actual distance measured. RESULTS: The analyses showed that both the device and walking trials affected the accuracy of the results (steps or distance, P < .001). Hip-based devices were more accurate and consistent for measuring step count. No significant differences were found among devices or locations for the distance measured. CONCLUSIONS: Hip-based activity tracking devices varied in accuracy but performed better than their wrist-based counterparts for step accuracy. Distance measurements for both types of devices were more consistent but lacked accuracy.

Partnering with clinical providers to enhance the efficiency of an EMR.

Implementing an electronic medical record to replace paper records and associated processes does not guarantee the benefits of an EMR will be achieved. Specifically, it can introduce steps into a provider's work flow that adversely affect the projected benefits of efficiency, and, ultimately, quality and safety. At Mayo Clinic in Rochester, Minnesota, implementation of the Mayo Integrated Clinical Systems, or MICS, the organization's EMR, is nearly complete. However providers perceive inefficiencies in their work flow using MICS. In response, a study was undertaken to enhance MICS and associated processes to improve provider efficiency. Through direct observation and feedback from 101 providers, this study identified seven major themes for enhancements: training; work flow and processes; dual environments; navigation-viewing integration;patient-reported information; clinical problems management; and consolidated medication documentation. This paper reviews the methods used to collect and analyze the data and discusses how improvement opportunities can positively enhance efficiency in using an EMR.

Predictors of 6-month tobacco abstinence among 1224 cigarette smokers treated for nicotine dependence.

This study examined baseline characteristics associated with abstinence from tobacco 6 months after treatment for nicotine dependence. A total of 1224 cigarette smokers (619 females, 605 males) receiving clinical services for treatment of nicotine dependence between January 1, 1995 and June 30, 1997 were studied. The intervention involves a 45-min consultation with a nicotine dependence counselor. A treatment plan individualized to the patient's needs is then developed. The main outcome measure was the self-reported 7-day point prevalence abstinence from tobacco obtained by telephone interview 6-months after the consultation. A bootstrap resampling methodology for predictor variable selection was used to identify a set of multivariate predictors of 6-month tobacco abstinence. Five variables were multivariately associated with tobacco abstinence: male gender, no current psychiatric diagnosis, higher stage of change, longest duration of previous abstinence from tobacco of <1 or > or =30 days, and Fagerström Test for Nicotine Dependence (FTND) score of < or =5. Assessment of these variables may be useful clinically by assisting health care providers in tailoring nicotine dependence interventions to enhance outcomes.

Computer-based anesthesiology paging system.

UNLABELLED: For more than a century, Mayo Clinic has used various communication strategies to optimize the efficiency of physicians. Anesthesiology has used colored wooden tabs, colored lights, and, most recently, a distributed video paging system (VPS) that was near the end of its useful life. A computer-based anesthesiology paging system (CAPS) was developed to replace the VPS. The CAPS uses a hands-off paradigm with ubiquitous displays to inform the practice where personnel are needed. The system consists of a dedicated Ethernet network connecting redundant central servers, terminal servers, programmable keypads, and light-emitting diode displays. Commercially available hardware and software tools minimized development and maintenance costs. The CAPS was installed in >200 anesthetizing and support locations. Downtime for the CAPS averaged 0.144 min/day, as compared with 24.2 min/day for the VPS. During installation, neither system was available and the department used beepers for communications. With a beeper, the median response time of an anesthesiologist to a page from a beeper was 2.78 min, and with the CAPS 1.57 min; this difference was statistically significant (P = 0.021, t(67) = 2.36). We conclude that the CAPS is a reliable and efficient paging system that may contribute to the efficiency of the practice. IMPLICATIONS: Mayo Clinic installed a computer-based anesthesiology paging system (CAPS) to inform operating suite personnel when assistance is needed in procedure and recovery areas. The CAPS is more reliable than the system it replaced. Anesthesiologists arrive at a patient's bedside faster when they are paged with the CAPS than with a beeper.