Learning technologies and health technologies in complementary medicine clinical work and education: Examination of the perspectives of academics and students in Australia and the US

2021 ◽  
Author(s):  
Alastair C. Gray ◽  
Amie Steel ◽  
Jon Adams
Keyword(s):  
Complementary Medicine ◽  
Clinical Work ◽  
Learning Technologies ◽  
Health Technologies ◽  
The Us

CONGRESSIONAL STUDY QUESTIONS VALUE OF OUTCOMES RESEARCH

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 669-669
Author(s):  
J. F. L.
Keyword(s):  
Technology Assessment ◽  
Government Printing ◽  
Unintended Effects ◽  
Policy Makers ◽  
Health Technologies ◽  
Large Databases ◽  
The Us ◽  
Us Government ◽  
Office Of Technology Assessment ◽  
Care Costs

The 320-page report, "Identifying Health Technologies that Work: Searching for Evidence," by the Office of Technology Assessment, has significant implications for both researchers and health policy makers ... The Office of Technology Assessment found that the hopes for effectiveness research are not misplaced, but they have been overly optimistic and often misdirected, the report concludes. It will not necessarily reduce health care costs significantly ... The analysis of large databases ... has proved not to be a particularly useful tool in providing valid, believable answers about comparative effectiveness. The report suggests that experimental research based on randomized, controlled trials might provide more valid results. Clinical practice guidelines themselves came under fire in the Office of Technology Assessment report because of how they are developed and disseminated. Simply issuing them to physicians often has no effect, and unless they promote "extremely compelling" practices or are issued by credible organizations, they may have the unintended effects as clinicians try to circumvent them ... The report is available for $20 from the US Government Printing Office. S/N 052-003-01389-4. Call 202/512-1800.

scholarly journals Almost half of references in reports on new and emerging nondrug health technologies are grey literature

2019 ◽  
Vol 107 (1) ◽  
Author(s):  
Kelly Farrah ◽  
Monika Mierzwinski-Urban
Keyword(s):  
Medical Devices ◽  
Laboratory Tests ◽  
Evidence Synthesis ◽  
Grey Literature ◽  
Regulatory Agencies ◽  
Literature Searching ◽  
Health Technologies ◽  
Clinical Trial Registries ◽  
Horizon Scanning ◽  
The Us

Objective: The research investigated how frequently grey literature is used in reports on new and emerging nondrug health technologies, which sources are most cited, and how grey literature searching is reported.Methods: A retrospective review of references cited in horizon scanning reports on nondrug health technologies—including medical devices, laboratory tests, and procedures—was conducted. A quasi-random sample of up to three reports per agency was selected from a compilation of reports published in 2014 by international horizon scanning services and health organizations.Results: Twenty-two reports from 8 agencies were included in the analysis. On average, 47% (288/617) of references listed in the bibliographies of the horizon scanning reports were grey literature. The most frequently cited type of grey literature was information from manufacturers (30% of all grey literature references), regulatory agencies (10%), clinical trial registries (9%), and other horizon scans or evidence synthesis reports (9%). The US Food and Drug Administration (FDA) and ClincalTrials.gov were the most frequently cited specific sources, constituting 7% and 8% of grey literature references, respectively. Over two-thirds (15/22) of the analyzed reports provided some details on search methodology; all 15 of these reported searching some grey literature.Conclusions: In this sample, grey literature represented almost half of the references cited in reports on new and emerging nondrug health technologies. Of these grey literature references, almost half came from three sources: the manufacturers, ClinicalTrials.gov, and the FDA. There was wide variation in the other sources cited. Literature search methodology was often insufficiently reported for analysis.

scholarly journals Complementary medicine use in US adults with a history of colorectal cancer: a nationally representative survey

2020 ◽  
Vol 29 (1) ◽  
pp. 271-278
Author(s):  
Charlene HL Wong ◽  
Tobias Sundberg ◽  
Vincent CH Chung ◽  
Petra Voiss ◽  
Holger Cramer
Keyword(s):  
Colorectal Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Complementary Medicine ◽  
Medicine Use ◽  
The Past ◽  
The Us ◽  
History Of ◽  
Mind Body Medicine ◽  
Colorectal Cancer Patients

Abstract Background In the USA, colorectal cancer is among the top diagnosed cancers. The current study specifically targets the US adult population that have a history of colorectal cancer. Methods We used the 2017 National Health Interview Survey (NHIS) to investigate the prevalence and predictors of colorectal cancer survivors using complementary medicine in the past 12 months in a representative sample of the US population (N = 26,742). We descriptively analyzed the 12-month prevalence of any complementary medicine use separately for individuals with a prior diagnosis of colorectal cancer and those without. Using chi-squared tests and backward stepwise multiple logistic regression analyses, we identified predictors of complementary medicine use in the past 12 months. Results A weighted total of 1,501,481 US adults (0.6%) had a history of colorectal cancer. More individuals without (weighted n = 76,550,503; 31.2%) than those with a history of colorectal cancer (weighted n = 410,086; 27.3%) had used complementary medicine. The most commonly used complementary medicine among colorectal cancer patients was mind-body medicine, followed by chiropractic. A higher prevalence of complementary medicine use was associated with being female, higher educated and/or living in the US Midwest or South. Conclusions In this study, over one fourth of the US colorectal cancer survivors had used complementary medicine. Mind-body medicine was found to be the most commonly used. With evidence supporting the effectiveness and safety of mind-body medicine use among colorectal cancer patients, promoting the use of evidence-based mind-body medicine for colorectal cancer management could be considered.

scholarly journals Automated Identification of Citizen Science Observations for Ecological Studies

2018 ◽  
Vol 2 ◽  
pp. e25450
Author(s):  
Pierre Bonnet ◽  
Christophe Botella ◽  
François Munoz ◽  
Pascal Monestiez ◽  
Mathias Chouet ◽  
...  
Keyword(s):  
Plant Species ◽  
Learning Technologies ◽  
Melia Azedarach ◽  
Automated Identification ◽  
Tropical Regions ◽  
Fine Grained ◽  
Starting Point ◽  
The Us ◽  
Unique Material ◽  
Project Data

Pl@ntNet is an international initiative which was the first one attempting to combine the force of citizens networks with automated identification tools based on machine learning technologies (Joly et al. 2014). Launched in 2009 by a consortium involving research institutes in computer sciences, ecology and agriculture, it was the starting point of several scientific and technological productions (Goëau et al. 2012) which finally led to the first release of the Pl@ntNet app (iOS in February 2013 (Goëau et al. 2013) and Android (Goëau et al. 2014) the following year). Initially based on 800 plant species, the app was progressively enlarged to thousands of species of the European, North American and tropical regions. Nowadays, the app covers more than 15 000 species and is adapted to 22 regional and thematic contexts, such as the Andean plant species, the wild salads of southern Europe, the indigenous trees species of South Africa, the flora of the Indian Ocean Islands, the New Caledonian Flora, etc. The app is translated in 11 languages and is being used by more than 3 millions of end-users all over the world, mostly in Europe and the US. The analysis of the data collected by Pl@ntnet users, which represent more than 24 millions of observations up to now, has a high potential for different ecological and management questions. A recent work (Botella et al. 2018), in particular, did show that the stream of Pl@ntNet observations could allow a fine-grained and regular monitoring of some species of interest such as invasive ones. However, this requires cautious considerations about the contexts in which the application is used. In this talk, we will synthesize the results of this study and present another one related to phenology. Indeed, as the phenological stage of the observed plants is also recorded, these data offer a rich and unique material for phenological studies at large geographical or taxonomical scale. We will share preliminary results obtained on some important pantropical species (such as the Melia azedarach L., and the Lantana camara L.), for which we have detected significant intercontinental phenological patterns, among the project data.

scholarly journals Turning Points in the Assessment and Clinical Applications of Individual Differences in Attachment

Psychology ◽  
2021 ◽  
Author(s):  
Patricia Crittenden ◽  
Susan J. Spieker ◽  
Steve Farnfield
Keyword(s):  
Individual Differences ◽  
Attachment Theory ◽  
Clinical Work ◽  
Well Being ◽  
The United States ◽  
Clinical Applications ◽  
Future Research ◽  
Central Research ◽  
Funding Sources ◽  
The Us

Attachment may have reached a turning point in which two sometimes incompatible approaches to individual differences in attachment are being compared. The outcome could influence future work in attachment. This article focuses on individual differences because applications of attachment are predicated on the consequences of individual differences for adaptation and well-being. The issue is which model is better suited to future research and clinical applications. Both models augment the original Ainsworth ABC model that everyone agrees is not sufficiently differentiated to cover the range of human behavior. The two models are “ABC+D” (the model that has disorganization (D) as its fourth category) and “DMM” (the model that expands the A and C categories from two subcategories each to a total of eight each, plus A/C combinations). The current disagreement has two sources: (a) the increasing acceptance outside the United States of the DMM, particularly in clinical and forensic settings, while the US remains largely unaware of the DMM; and (b) the recent announcement by prominent ABC+D researchers from Europe and the US that D is not a suitable category for clinical or forensic use. ABC+D researchers have not proposed an alternative, and some US funding sources and courts eschew attachment altogether, believing the theory itself lacks validity and utility, thus weakening attachment’s potential to inform clinical research and decision-making. This article proposes DMM as a viable alternative to both ABC+D and psychiatric diagnoses and examines the development and contributions of each model for the purpose of creating a model of individual differences in attachment that is scientifically robust, open to change as new evidence becomes available, and applicable to troubled individuals and families. Notably, attachment theory has engendered controversy from its beginnings. When John Bowlby offered attachment as a universal human characteristic that promoted species and individual survival, he was criticized by others in his field. When Mary Ainsworth identified the ABC categories of individual differences in attachment, her ideas were attacked from outside attachment theory. While the “first generation” issue around the existence of attachment has largely died away, a second generation of attachment theorists is disputing the nature of individual differences, their focus on individuals (ABC+D) or interpersonal systems (DMM Family Functional Formulations), and their relevance to clinical work. The ABC+D and DMM models that expand Ainsworth’s work were developed by two of her students, Mary Main (ABC+D) and Patricia Crittenden (DMM). They and their colleagues have worked separately for half a century producing two large and sometimes discrepant bodies of work, which have now become the topic of open debate. This bibliography focuses on the conceptual and empirical bases for that exchange. Part I outlines the roots of the ABC+D and DMM models, together with comparative validating information. Part II presents the central research findings on individual differences in attachment from four decades of research with each model. The authors wish to thank Robbie Duschinsky, Udita Iyengar, and Andrea Landini for their helpful comments on this bibliography.

Abstract 367: Comparison of the Healthcare Systems of the United States and Portugal: Epidemiology and Management of Coronary Heart Disease

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Mariana F Lobo ◽  
Vanessa Azzone ◽  
Bruno Melica ◽  
Alberto Freitas ◽  
Francisco R Gonçalves ◽  
...  
Keyword(s):  
United States ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Technology Use ◽  
The United States ◽  
Healthcare Systems ◽  
Public Hospitals ◽  
The European Union ◽  
Health Technologies ◽  
The Us

Objectives: Adoption of health technologies may yield significant individual and societal benefits. Because different healthcare systems vary in their adoption speeds, an understanding of the underlying healthcare system is critical. We compared the United States (US) and Portugal (PT) healthcare systems focusing on coronary heart disease (CHD). CHD remains one of the main causes of death in high-income countries with significant economic costs. Methods: We conducted a comprehensive literature review based on publications from national governmental bodies, international institutional organizations, professional associations, and scientific journals. We abstracted information regarding risk factors, incidence, access to health technologies, and hospital mortality rates in CHD observed between 2000 and 2011. Findings: The prevalence of obesity and high cholesterol levels is higher in the US while higher rates of hypertension and tobacco consumption prevail in PT. The 2009 incidence of cardiovascular disease per 100000 population in the US is 1944.5 versus 1320.4 in PT. The percentage of total health expenditure financed through public funds is 48.2% in the US versus 65.8% in PT. Public hospitals represent 26% (1526 of 5754) of US hospitals and 55% (129 of 231) of hospitals in PT. Between 2000 and 2011, the average high-risk device approval time was 43 months quicker in the European Union (EU) compared to the US. Drug-eluting stents were approved in 2002 in the EU and in PT versus 2003 in the US. Speeds of approval for pharmaceuticals vary – prasugrel, and ticagrelor were approved 5 and 8 months faster in PT compared to the US but PT approval of glycoprotein IIb/IIIa inhibitors was slower (18 months slower on average). However, US CHD standardized mortality is more than twice that of PT (126.5 vs 59.4 per 100000). Conclusions: Procedure and new technology use differ dramatically between the two healthcare systems for CHD care. Portugal offers an interesting contrast to the US for studies focusing on health technologies adoption, diffusion, cost-effectiveness and determinants of outcomes in the realm of CHD. How these factors directly impact patient outcomes remains unknown and deserves further investigation.

A Biomarker for Concussion: The Good, the Bad, and the Unknown

2019 ◽  
Vol 5 (1) ◽  
pp. 170-182
Author(s):  
Jenna T Reece ◽  
Michael Milone ◽  
Ping Wang ◽  
Daniel Herman ◽  
Dmitriy Petrov ◽  
...  
Keyword(s):  
Clinical Work ◽  
Work Flow ◽  
Clinical Context ◽  
Head Ct ◽  
Blood Biomarker ◽  
Prognostic Assessment ◽  
The Us ◽  
To Receive ◽  
Head Computed Tomography ◽  
Intended Use

Abstract Background Traumatic brain injury (TBI) is a significant cause of morbidity, mortality, and disability in the US, with >2.8 million patients presenting to the emergency department (ED) annually. However, the diagnosis of TBI is challenging and presents a number of difficulties, particularly at the mildest end of the spectrum: concussion. A number of groups have researched biomarkers to aid in the evaluation of TBI, and most recently in 2018 the Food and Drug Administration approved a new blood-based immunoassay biomarker using ubiquitin carboxyl hydrolase L1 and glial fibrillary acidic protein to aid in head computed tomography (CT) triage. Content This review clarifies the practical challenges in assessing and implementing a new blood biomarker. It then examines the clinical context and need, as well as the evidence used to validate this new immunoassay. Summary Concussion is a multifaceted diagnosis with a need for biomarkers to assist in diagnostic and prognostic assessment. Recent articles in the lay press have revealed misunderstanding about the function of this new test, expressing hopes that this biomarker serves patients at the mildest end of the spectrum and is useful for athletes and children. None of these assumptions are correct, as this biomarker has been evaluated in patients only at the moderate end of the spectrum and has been validated only in adults presenting to the ED who have already been triaged to receive head CT, not in athletes or children. The next steps for this assay should consider clinical work flow and clarifying its intended use, including integration with existing triage methods, and validating the assay for a broader population.

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