Patients Decision-Making Characteristics Affects Gynecomastia Treatment Satisfaction: A Multicenter Study Using the BODY-Q Chest Module

Author(s):  
Alessandro Innocenti ◽  
Dario Melita
Author(s):  
Mads Gustaf Jørgensen ◽  
Bu Youn Cho ◽  
Frederik Gulmark Hansen ◽  
Volker-Jürgen Schmidt ◽  
Jens Ahm Sørensen ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hankiz Dolan ◽  
Mu Li ◽  
Deborah Bateson ◽  
Rachel Thompson ◽  
Chun Wah Michael Tam ◽  
...  

Abstract Background In Australia, ethnic Chinese people are one of the largest, youngest and fastest growing overseas-born groups. Yet, little is known about their perceptions of contraceptive methods and their experiences with choosing one. Decisions about contraceptive methods are preference sensitive. Understanding the influencing factors of Chinese migrant women’s contraceptive method choice and practices will help cater to their decision-making needs in a culturally sensitive and responsive way. Methods A qualitative study design underpinned by critical realism approach was used to explore Chinese migrant women’s perceptions and experiences of choosing contraceptive methods. Semi-structured interviews were conducted with 22 women who self-identified as being ethnically Chinese and had been living in Australia for no more than 10 years. The interview guide was adapted from the Ottawa Decision Support Framework. Majority of the interviews were conducted in Mandarin Chinese. Transcribed data was analysed using thematic analysis method. Results Four major themes were identified, including: ‘every medicine is part poison: hormonal contraceptives cause harm to the body’; ‘intrauterine device, a device used in the past for married women’; ‘it takes two (or one) to decide, depending on the relationship dynamics and contraception preferences’; and ‘it is not necessary to seek medical advice in choosing contraceptive methods’. Conclusions Our findings suggest that Chinese migrant women’s perceptions and experiences of choosing contraceptive methods are influenced by complex personal, cultural, societal and inter-relational factors. Chinese migrant women were cautious of using hormonal methods due to fears of side-effects, including reduced or absent menstrual bleeding. Women were also reluctant to consider intrauterine devices as options due to associating them with past experiences of other women and themselves and also fears of potential complications. There was a reluctant attitude towards seeking medical advice regarding contraception due to beliefs that needing to use contraception is not an illness requiring treatment. Such findings are likely to be useful in increasing healthcare professionals’ and policy makers’ understanding of Chinese migrant women’s contraceptive method preferences, beliefs and behaviours. They also help to develop culturally and linguistically sensitive strategies, which goes beyond the provision of contraceptive counselling, in assisting Chinese migrant women’s decision-making needs.


Author(s):  
Ram M. Pendyala ◽  
Venky N. Shankar ◽  
Robert G. McCullough

It is increasingly being recognized at all levels of decision making that freight transportation and economic development are inextricably linked. As a result, many urban entities and states are embarking upon comprehensive freight transportation planning efforts aimed at ensuring safe, efficient, and smooth movement of freight along multimodal and intermodal networks. Over the past few decades there has been considerable published research on (1) freight transportation factors, (2) freight travel demand modeling methods, (3) freight transportation planning issues, and (4) freight data needs, deficiencies, and collection methods. A synthesis of the body of knowledge in these four areas is provided with a view to developing a comprehensive statewide freight transportation planning framework. The proposed framework consists of two interrelated components that facilitate demand estimation and decision making in the freight transportation sector.


2020 ◽  
Vol 14 ◽  
pp. 117954682095341 ◽  
Author(s):  
Todd C Villines ◽  
Mark J Cziraky ◽  
Alpesh N Amin

Real-world evidence (RWE) provides a potential rich source of additional information to the body of data available from randomized clinical trials (RCTs), but there is a need to understand the strengths and limitations of RWE before it can be applied to clinical practice. To gain insight into current thinking in clinical decision making and utility of different data sources, a representative sampling of US cardiologists selected from the current, active Fellows of the American College of Cardiology (ACC) were surveyed to evaluate their perceptions of findings from RCTs and RWE studies and their application in clinical practice. The survey was conducted online via the ACC web portal between 12 July and 11 August 2017. Of the 548 active ACC Fellows invited as panel members, 173 completed the survey (32% response), most of whom were board certified in general cardiology (n = 119, 69%) or interventional cardiology (n = 40, 23%). The survey results indicated a wide range of familiarity with and utilization of RWE amongst cardiologists. Most cardiologists were familiar with RWE and considered RWE in clinical practice at least some of the time. However, a significant minority of survey respondents had rarely or never applied RWE learnings in their clinical practice, and many did not feel confident in the results of RWE other than registry data. These survey findings suggest that additional education on how to assess and interpret RWE could help physicians to integrate data and learnings from RCTs and RWE to best guide clinical decision making.


2019 ◽  
Vol 11 (14) ◽  
pp. 14802-14807
Author(s):  
Randall Arguedas ◽  
Elisa C. López ◽  
Lizbeth Ovares

Northern Tamandua Tamandua mexicana is one of the most common roadkill species encountered on Costa Rican highways.  Ten roadkill Northern Tamanduas were collected along different roads in Costa Rica and moved to a veterinary facility where appendicular radiologic studies were undertaken.  The number of fractures present in each individual varied from zero to five (mean=2.6), with only one animal sustaining no fractures at all.  Most fractures were present in the humerus (31%), followed by the ulna and ilium (both 19%), whilst the cranial portion of the body represented the highest number of fractures (61%).  These data can contribute, not only to establishing causes of animal-road-mortalities, but also to the future understanding and decision-making of clinical actions for animals injured on the roads.


2021 ◽  
Author(s):  
Aaron Greenhouse-Tucknott ◽  
James Graeme Wrightson ◽  
Sam Berens ◽  
Jeanne Dekerle ◽  
Neil Andrew Harrison

Introduction: Protracted physical exertion leads to the development of fatigue. The development of fatigue has previously been associated with increased effort costs, influencing decisions to engage in further physical activity. However, whether fatigue-associated changes to effort-based decisions are reflective of a global aversion to effort in response to fatiguing physical exertion, affecting the decision to engage in physical action performed in other parts of the body, is unclear. Methods: To investigate this, we tested whether effort-based choice behaviour was altered by fatigue, pre-induced through physical exertion of a different body part. Twenty-two healthy male participants made a series of choices between two rewarded actions, which varied in both the level of effort required (relative duration of a submaximal contraction of the dominant knee extensors) and reward obtained (monetary incentives). Participants made their choice under two conditions: 1) a pre-induced state of fatigue and 2) a rested (control) state. Results: Across conditions, participants’ choice behaviour demonstrated the anticipated aversion to effort that interacted with the level of reward on offer. However, though prior physical exertion increased the perception of fatigue, prolonged choice selection-time and reduced self-reported confidence in ability to perform chosen effort-demanding actions, participants choice behaviour did not significantly differ between the two conditions. Conclusions:. The findings suggest that a subjective state of fatigue does not increase the general cost of exerting effort across the body but does increase uncertainty within decision-making processes which may alter evaluative processes that precede changes in cost/benefit computations.


Author(s):  
Dengfeng Wang ◽  
Shenhua Li

This work proposes a material selection decision-making method for multi-material lightweight body driven by performance to achieve that the right materials are used for the correct positions of the automotive body. The internal relationship between performance and mass, cross-sectional shape, wall thickness parameters, and material properties of a thin-walled structure is studied. The lightweight material indices driven by performance are then established. The lightweight material indices and material price are taken as the decision-making criteria for the material selection of automotive body components. A hybrid weighting method integrated with the analytic hierarchy process, fuzzy analytic hierarchy process, and quality function deployment is proposed. The difficulty of quantitatively evaluating the performance requirements of different components of the body is solved using the proposed weighting method combined with the numerical analytical results of the component performance under multiple operating conditions of the automotive body. Then, the weight of the decision-making criteria for material selection is calculated. Grey relational analysis is used to make multicriteria decision-making on a variety of candidate materials to select the best material for body components. After the lightweight material selection of the front longitudinal beam of the automotive body, the frontal collision safety performance of the body is effectively improved, and the mass of the front longitudinal beam is reduced by 45%. Material selection result of the front longitudinal beam indicates that the proposed material selection decision-making method can effectively achieve the fast material selection of components in different positions of the body.


Author(s):  
S.Yu. Zhuleva ◽  
A.V. Kroshilin ◽  
S.V. Kroshilina

The process of making a medical decision is characterized by a lack of knowledge and inconsistency of the available information, the lack of the possibility of attracting competent medical experts, limited time resources, incomplete or inaccurate information about the patient's condition. These aspects may be the causes of medical errors, which lead to further aggravation of the problem situation. Purpose – it is necessary to define and justify managerial medical decisions and types of medical information in conditions of uncertainty, when each variant of the sets of outcomes of the situation (recommendations) has its own unique set of values. The fundamental difference between this process for medical use is the concept of the "best medical solution", in which the key role is given to the patient's state of health in obtaining and evaluating alternatives, as well as the need to take into account the time, adverse reactions of the body and the costs of implementing this solution. In the medical field, support for medical decision-making can be classified as organizational-managerial and therapeutic-diagnostic, but both are determined by the position of the person making the medical decision and are aimed at effective management of the medical institution as a whole. The article describes the causes and factors of the nature of uncertainty in the tasks of supporting medical decision-making in medical-diagnostic and organizational-managerial areas. The analysis of the features of supporting medical decision-making in conditions of uncertainty is carried out. Approaches and directions in this area, as well as the concept of “solution”, are considered. The essence of the management medical decision is reflected. The classification of management medical decisions is given, the requirements that are imposed on them are highlighted. The features of the development of management medical solutions in the conditions of incompleteness and uncertainty, the problems that arise when they are implemented in information systems are presented. The general scheme of the process of creating a management medical solution is shown. The features of making group and individual decisions are reflected. The algorithm of actions of the person making the medical decision in the conditions of uncertainty, incompleteness and risk in medical subject areas is presented.


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