Racial biases in healthcare: Examining the contributions of Point of Care tools and unintended practitioner bias to patient treatment and diagnosis

2021 ◽  
pp. 136345932110612
Author(s):  
Sachil Singh
Keyword(s):  
Curriculum Design ◽  
Race And Ethnicity ◽  
Racial Bias ◽  
Medical Training ◽  
Point Of Care ◽  
Scientific Evidence ◽  
Structured Interview ◽  
Patient Treatment ◽  
Structured Interviews ◽  
Healthcare Provision

Sophisticated algorithms are used daily to search through hundreds of medical journals in order to package updated medical insights into commercial databases. Healthcare practitioners can access these searchable databases—called Point of Care (PoC) tools—as downloadable apps on their smartphones or tablets to comprehensively and efficiently inform patient diagnosis and treatment. Because racist biases are unintentionally incorporated into the search reports that the companies generate and that practitioners regularly access, the aim of this article is to examine how healthcare practitioners’ “pre-existing” racial stereotypes interact with pithy conclusions about race and ethnicity in PoC tools. I use qualitative research methods (content analysis, discourse analysis, open-ended semi-structured interviews, and role play) to frame the analysis within the Public Health Critical Race Praxis (PHCRP). This approach facilitates an understanding of how biological racism—the use of scientific evidence to support inherent differences between races—that is embedded in PoC algorithms informs a practitioner’s assessment of a patient, and converges with persistent racial bias in medical training, medical research and healthcare. I contextualize the study with one semi-structured interview with an Editor of a leading PoC tool, MedScope (pseudonomized), and 10 semi-structured interviews with healthcare practitioners in S.E. Ontario, Canada. The article concludes that PoC tools and practitioners’ personal biases contribute to racial prejudices in healthcare provision. This warrants further research on racial bias in medical literature and curriculum design in medical school.

The English Camps as Method of Promoting Fun English at Elementary School Level in Indonesia

2020 ◽  
Vol 4 (2) ◽  
pp. 174
Author(s):  
Meida Rachmawati ◽  
Suzana Widjajanti ◽  
Ahmad Ahmad ◽  
Aslan Aslan
Keyword(s):  
Elementary School ◽  
Language Learning ◽  
Curriculum Design ◽  
Scientific Evidence ◽  
School Curriculum ◽  
School Level ◽  
English Learning ◽  
Learning Method ◽  
School Students ◽  
Scientific Publications

This article aimed to promote English in elementary school students through a fun learning method, called the Fun English Camp. Several studies had been conducted to encounter the best solution to handle this issue. The researchers used PRISMA Protocol as an instrument to collect the data that has been widely used in the process of selecting relevant articles. The researchers reviewed twenty five scientific publications, related to Fun English Camp that has become an English learning approach for beginner students. Through a review of twenty five scientific publications, for instance book and journal, the researchers got scientific evidence that introduction of a learning method with the term Fun English camp has an impact on promoting language learning for elementary school children in Indonesia. Thus, the fun English camp method can be an interesting method to be applied by elementary school curriculum design in Indonesia. Keywords: English Camps, Learning Method, Fun English Learning

Significados de Morte: o Discurso do Sujeito Coletivo da Enfermagem / Meaning of Death: the collective subject speech of the nursing staff

1970 ◽  
Vol 6 (1) ◽  
pp. 52-58
Author(s):  
Fellipe Afonso de Azevedo ◽  
Noé D’jalma Araújo ◽  
Néliton Célio de Novais ◽  
José Vítor da Silva ◽  
Renato Augusto Passos
Keyword(s):  
Nursing Staff ◽  
Hospital Setting ◽  
Field Research ◽  
Structured Interview ◽  
Minas Gerais ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Emergency Units ◽  
Methodological Guidelines

RESUMOObjetivo: o presente trabalho teve como objetivo identificar os significados de morte emergentes das equipes de enfermagem que atuam nas unidades de Pronto Socorro e Unidade de Terapia Intensiva (UTI) em uma entidade de médio porte situada no Sul de Minas Gerais. Materiais e métodos: estudo de abordagem qualitativa, do tipo descritivo, de campo e transversal. A amostra estudada foi composta de oito enfermeiros, 22 técnicos e quatro auxiliares de enfermagem, totalizando 34 profissionais, sendo utilizado o instrumento de caracterização pessoal e profissional da equipe de enfermagem e o roteiro de entrevista semiestruturada. A amostragem foi proposital. A coleta de dados foi realizada através de entrevista semiestruturada, gravada e transcrita. As diretrizes metodológicas do Discurso do Sujeito Coletivo foram utilizadas para a seleção das ideias centrais e expressões-chave correspondentes, a partir das quais foram extraídos os discursos dos sujeitos, no cenário da instituição hospitalar. Resultados e Discussão: ao analisar o tema “significados de morte”, obtiveram-se as seguintes ideias centrais: “passagem”, “diversos significados”, “fim da vida” e “fim e começo de outra vida”. Conclusão: As concepções acerca do tema morte para os profissionais participantes deste trabalho reforça a necessidade de estudos sobre o tema durante a formação acadêmica. Certos de que irão vivenciar este tipo de situação no dia-a-dia profissional, é preciso prepará-los psicologicamente para isso.Palavras-chave: Morte, Equipe de enfermagem, Assistência ao paciente.ABSTRACTObjective: This study aimed to identify the meanings of emerging death of the nursing staff working in the Emergency Units and Intensive Care Unit (ICU) in a medium-sized entity located in southern Minas Gerais. Materials and methods: A cross-sectional qualitative field research. The sample was composed of 8 nurses, 22 technicians and 4 nursing assistants, totaling 34 professionals. It was used a tool of personal and professional characterization of the nursing team and a semi-structured interview. Sampling was intentional. Data collection was conducted through semi-structured interviews, that were recorded and transcribed. The methodological guidelines of the Collective Subject Speech were used for the selection of the central ideas and corresponding key expressions, from which the speeches of the subjects were taken, in the hospital setting. Results and discussion: to examine the topic "death meanings" yielded the following core ideas: "pass", "different meanings", "end of life" and "end and beginning of another life." Conclusion: The conceptions about the death theme for the professional participants of this study reinforces the need for studies on the subject during their academic training. It is certain that they will experience this type of situation on their daily professional routine, therefore there is a need to prepare them psychologically for this.Keywords: Death, Nursing staff, Patient care.

scholarly journals Understanding the clinical reasoning processes involved in the management of multimorbidity in an ambulatory setting: study protocol of a stimulated recall research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M.-C. Audétat ◽  
S. Cairo Notari ◽  
J. Sader ◽  
C. Ritz ◽  
T. Fassier ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Reasoning ◽  
Primary Care Physicians ◽  
Video Sequence ◽  
Structured Interview ◽  
Ambulatory Setting ◽  
Structured Interviews ◽  
Stimulated Recall ◽  
Study Results

Abstract Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. Methods A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a “button camera” (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. Conclusion Study results will contribute to the scientific community’s overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient’s care and treatments.

scholarly journals Characteristics of dental note taking: a material based themed analysis of Swedish dental students

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Viveca Lindberg ◽  
Sofia Louca Jounger ◽  
Maria Christidis ◽  
Nikolaos Christidis
Keyword(s):  
Higher Education ◽  
Clinical Training ◽  
Literacy Practices ◽  
Dental Education ◽  
Structured Interview ◽  
Dental Students ◽  
Structured Interviews ◽  
New Literacy ◽  
New Literacy Studies ◽  
Writing Practices

Abstract Background The transition from upper secondary to higher education and from higher education to professional practice requires that students adapt to new literacy practices, academic and professional. However, there is a gap of knowledge regarding literacy practices in dental education. Therefore, the aim of this study was to identify what characterizes dental students’ notetaking and secondarily to determine what dental students express regarding their notetaking. Methods To analyze students’ perspectives about the purposes of notetaking and to examine their written notes in depth, three volunteer students, out of the 24 students that voluntarily and anonymously handed in their notes, were interviewed. The three undergraduate dental students that participated in this material-based, semi-structured interview study, framed within a New Literacy Studies approach, were on their third year (6th semester). The focus of these material-based interviews was on each student’s notes. Questions prepared for semi-structured interviews were open-ended and allowed for individual follow-up questions related to the interviewee’s answer. To analyze the outcome of the interviews a thematic analysis was used. Results From the material-based interviews eight themes that relate to what, how and for what purpose students write were discerned. These eight themes include professional vocabulary, core content as well as clinical examples that belong to what students read and write; multimodal accentuation as well as synthesis that belong to how students read and write; and mnemonic strategies, academic purposes, and professional purposes that belong to for what purpose students read and write. Conclusions Findings from the interviews indicate that the digital development, offering a variety of available tools, has expanded the notion of notetaking. This study identified that dental students’ notetaking has changed during their education from initially being synchronous, to also include multimodal and asynchronous writing, making notetaking more of a writing practice. Further, students’ writing practices seem to be motivated by their knowledge formation in relation to a subject matter, but also in relation to their experiences during clinical training. Although, our hypothesis was that the main purpose of notetaking and writing was to pass their course examinations, this study showed that students that were half-way through their dental education, are aware that literacy practices are for learning for their future profession, and not only for passing their exams.

scholarly journals COVD-07. THE IMPACT OF COVID-19 ON PATIENTS AND CAREGIVERS AFFECTED BY BRAIN TUMORS: THE PATIENT NAVIGATOR PERSPECTIVE

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii22-ii22
Author(s):  
Kyle Walsh
Keyword(s):  
Clinical Trials ◽  
Brain Tumor ◽  
Clinical Care ◽  
Structured Interview ◽  
Patient Navigator ◽  
Structured Interviews ◽  
Social Distancing ◽  
Tumor Patient ◽  
Patient Navigators ◽  
The Impact

Abstract BACKGROUND Preliminary evidence indicates that glioma patients are at higher risk for COVID-19 complications due to systemic immunosuppression. Interruptions in cancer care may exacerbate patient and caregiver anxiety, but surveying patients/caregivers about their COVID-19 experiences is often limited by attainable sample sizes and over-reliance upon single-institution experiences. METHODS To explore how COVID-19 is impacting brain tumor patients/caregivers across the U.S., we performed semi-structured interviews with brain tumor patient navigators employed by two different 501(c)3 nonprofit organizations. A semi-structured interview guide was used, utilizing prompts and open-ended questions to facilitate dialogue. A core set of COVID-19 topics were covered, including: financial issues, coping strategies, geographic variability, variability by tumor grade/histology, disruptions in care continuity, accessing clinical trials, psychosocial issues, and end-of-life care. Interviews were audio-recorded, transcribed, and organized by discussion topic to identify emerging themes. Inductive sub-coding was completed using the constant comparison method, within and between transcripts. RESULTS/CONCLUSIONS Ten patient navigators were interviewed between April 15th and May 8th, with interviews lasting approximately one hour (range 38-77minutes). Navigators reported having contact with 183 unique brain tumor families during the pandemic (range 7–38 families per navigator). High concordance emerged across narratives, revealing important considerations for the neuro-oncology workforce. The most prominent theme was increased caregiver burden, attributed to maintaining social distancing by reducing visits from home-health aides and friends/family. A related theme that applied to both patients and caregivers was increased social isolation due to social distancing, suspension of in-person support groups, and church/temple closures. Accessing clinical trials was a recurrent issue, exacerbated by patients’ increasing unwillingness to travel. Glioblastoma patients, especially those with recurrent tumors, expressed greater reluctance to travel. Access to standard-of-care treatment was rarely interrupted, but reduced access to supportive services – especially physical and occupational therapy – was identified as an emerging COVID-related deficiency in clinical care.

“There is still a perception that homelessness is a housing problem”: devolution, homelessness and health in the UK

2016 ◽  
Vol 19 (2) ◽  
pp. 33-44 ◽  
Author(s):  
Martin Whiteford ◽  
Glenn Simpson
Keyword(s):  
Qualitative Interviews ◽  
Homeless People ◽  
Small Sample ◽  
Issue Salience ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Policy And Practice ◽  
Content Type ◽  
The Uk ◽  
Comparative Policy

Purpose The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland. Design/methodology/approach Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories. Findings The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness. Originality/value The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions.

Investigating Corruption in the Afghan Police Force

2020 ◽  
Author(s):  
Danny Singh
Keyword(s):  
Police Officers ◽  
Urban Areas ◽  
Structured Interview ◽  
Police Force ◽  
Public Confidence ◽  
Structured Interviews ◽  
Police Corruption ◽  
State Legitimacy ◽  
Post Conflict ◽  
Political Economic

This book provides a unique study on the lower ranks of the Afghan police force due to the lack of empirical evidence of what attributes to the causes, practices and consequences of corruption in this institution. The book is divided into a number of sections. It commences with an understanding of how corruption, and narrowly police corruption, impact on the police force, state legitimacy and the strategies in place to mitigate such problems as part of broader security and post-conflict reconstruction initiatives. The theoretical framework comprises political, economic and cultural drivers of police corruption by drawing on semi-structured interviews with elites and a survey and structured interview conducted with street-level police officers. The findings infer that weak oversight and low pay are causes of police corruption which intensify bribery and roadside extortion. The lack of professionalism, partly due to short and unclear training, and patronage are deemed as meanings of police corruption. In terms of motivation, there is no sense of pride in Afghan policing to fulfil a clear mandate. Moreover, non-meritocratic recruitment is prevalent which exacerbates local influences, loyalties and job buying in either high-drug cultivating or urban areas. To curb patronage, police officers are rotated to distant provinces but economic hardship is further increased when catering for large families with fewer breadwinners. The book concludes that the problems with police corruption and failure to combat it results in low public confidence and state illegitimacy which can support violent opposition groups to create further instability in war-torn societies.

Residents’ attitudes toward tourism development at Al-Juhfa, Saudi Arabia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ali Ahmad Algassim ◽  
Akhmad Saufi ◽  
Diswandi Diswandi ◽  
Noel Scott
Keyword(s):  
Saudi Arabia ◽  
Social Exchange ◽  
Social Exchange Theory ◽  
Tourism Development ◽  
Structured Interview ◽  
Environmental Benefits ◽  
Structured Interviews ◽  
Content Type ◽  
Negative Impacts ◽  
Residents Attitudes

Purpose Al-Juhfa is a small village located near Rabigh City, between Makkah and Madinah, Saudi Arabia, with significant archaeological and religious resources. The purpose of this paper is to examine residents’ attitudes toward tourism development at Al-Juhfa. Design/methodology/approach The qualitative study uses purposive interviewing to recruit informants. Data was collected using semi-structured interview and open-ended questions. Eight semi-structured interviews were made and a list of open-ended questions was distributed to 134 informants. All data were analysed and no new codes were found after the answer of the first 49 informants analysed. Findings The results show that residents’ attitudes toward tourism development in general were positive with residents expecting to receive economic, social and environmental benefits. Residents were aware of potential positive and negative impacts of tourism development and appeared to balance these in developing their attitudes. Tourism was seen to empower residents and the religiosity of the community influenced their perception of tourism development. Originality/value This study contributes to the literature by supporting the use of social exchange theory in this context and by recommending the inclusion of religiosity in further studies.

Frequent Indoor Tanners’ Beliefs About Indoor Tanning and Cessation

2018 ◽  
Vol 33 (2) ◽  
pp. 293-299 ◽  
Author(s):  
Karen Glanz ◽  
Amy Jordan ◽  
DeAnn Lazovich ◽  
Amy Bleakley
Keyword(s):  
Skin Cancer ◽  
White Women ◽  
Social Acceptance ◽  
The United States ◽  
Structured Interview ◽  
Indoor Tanning ◽  
Psychological Benefits ◽  
Structured Interviews ◽  
Self Confidence ◽  
Increased Risk

Purpose: Indoor tanning is associated with an increased risk of developing skin cancer. In the United States, nearly 1 in 5 white women aged 18 to 25 are indoor tanners. This study elicited beliefs about tanning indoors and quitting/cutting back on indoor tanning. Design: Semi-structured interviews. Participants and Setting: Forty 18- to 25-year-old white females who engaged in frequent indoor tanning participated in either in-person or telephone interviews. Most were college students from southeastern Pennsylvania and Delaware. Method: A semi-structured interview was used to elicit beliefs about indoor tanning and quitting or cutting back. Data analyses using NVivo and multiple coders identified key themes about going and quitting/cutting back on indoor tanning. Results: Key themes stated as reasons for indoor tanning included improving physical appearance, social acceptance, increased confidence, and happiness. The main themes identified as advantages of quitting/cutting back on indoor tanning were to decrease skin cancer risk and save money. Perceived disadvantages of quitting/cutting back included themes of concerns about being pale and a decline in self-confidence. The prospect of saving money and warm weather were seen as facilitating quitting/cutting back. Conclusion: Findings suggest the necessity of addressing appearance concerns, psychological benefits associated with feeling more attractive, and short-term gains such as saving money. These findings provide a foundation for developing effective anti-indoor tanning communication.

scholarly journals The most problematic symptoms of prion disease – an analysis of carer experiences

2018 ◽  
Vol 31 (08) ◽  
pp. 1181-1190
Author(s):  
Liz Ford ◽  
Peter Rudge ◽  
Kathy Robinson ◽  
John Collinge ◽  
Michele Gorham ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Prion Disease ◽  
Prion Diseases ◽  
Formal Analysis ◽  
Structured Interview ◽  
Disease Stage ◽  
Structured Interviews ◽  
Wide Range ◽  
The Uk ◽  
And Behavior

ABSTRACTObjectives:Prion diseases are rare dementias that most commonly occur sporadically, but can be inherited or acquired, and for which there is no cure. We sought to understand which prion disease symptoms are most problematic for carers, to inform the development of outcome measures.Design:Self-completed questionnaire with follow-up of a subset of participants by structured interview.Setting:A nested study in the UK National Prion Monitoring Cohort, a longitudinal observational study.Participants and measurements:71 carers, of people with different prion diseases with a wide range of disease severity, identified 236 of their four most problematic symptoms by questionnaire which were grouped into ten domains. Structured interviews were then done to qualitatively explore these experiences. Eleven family carers of people with prion disease were selected, including those representative of a range of demographics and disease subtypes and those who cared for people with prion disease, living or recently deceased. Interviews were transcribed and formally studied.Results:The six most problematic symptom domains were: mobility and coordination; mood and behavior; personal care and continence; eating and swallowing; communication; and cognition and memory. The prevalence of these symptoms varied significantly by disease stage and type. A formal analysis of structured interviews to explore these domains is reported.Conclusions:We make suggestions about how healthcare professionals can focus their support for people with prion disease. Clinical trials that aim to generate evidence regarding therapies that might confer meaningful benefits to carers should consider including outcome measures that monitor the symptomatic domains we have identified as problematic.

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