How I treat acne scars?

The approach to managing acne scars is unique to every dermatologist. This depends on the skin type of his/her clientele, the tools, techniques and devices available and/or used, and the protocols developed based on his/her experience with treating acne scars, developed over a period of time. Herein, we share our algorithmic treatment approach to acne scars, which allows for a consultative decision-making together with the patient, while offering adequate flexibility to modify the plan based on treatment response. Eventually, a customized and comprehensive system works best, and a partnership approach signified by a robust self-care home plan, helps accelerate the scar revision process.

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Developing an Appropriate Investment Appraisal Model for Strategic Decision Making in the Care Home Sector

10.15396/eres2002_158 ◽

2002 ◽

Keyword(s):

Decision Making ◽

Care Home ◽

Strategic Decision ◽

Strategic Decision Making ◽

Investment Appraisal

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Who determines the final version? The roles of translators, language revisers and editors in the publishing of a literary translation

Across Languages and Cultures ◽

10.1556/084.2021.00002 ◽

2021 ◽

Vol 22 (1) ◽

pp. 14-44

Author(s):

Marija Zlatnar Moe ◽

Tamara Mikolič Južnič ◽

Tanja Žigon

Keyword(s):

Decision Making ◽

Conflict Resolution ◽

Literary Translation ◽

Central Position ◽

Decision Making Process ◽

Translation Process ◽

Revision Process ◽

Final Version ◽

Comparison Of The Results ◽

Selection Of

AbstractThe article explores the interaction among three key figures in the process of publication of a literary translation into a language of low diffusion: the translator, the editor and the language reviser (the latter specific to the Slovene situation). The aim of the research is to identify who has the strongest position of power in the decision-making process of the production of a literary translation, especially when conflict arises. Information was gathered from the three groups with questionnaires, interviews and an analysis of public statements. The questions focused on the selection of the translator and language reviser, the translation process, the revision process and conflict resolution. A cross-comparison of the results indicates that despite the automatic central position of the editors, they tend to yield their decision-making power to translators, while language revisers have a more subservient, consulting role.

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Data linkage and statistical modelling to provide stratified risk assessment for HAI

International Journal for Population Data Science ◽

10.23889/ijpds.v1i1.297 ◽

2017 ◽

Vol 1 (1) ◽

Author(s):

Kim Kavanagh ◽

Jiafeng Pan ◽

Chris Robertson ◽

Marion Bennie ◽

Charis Marwick ◽

...

Keyword(s):

Risk Assessment ◽

Decision Making ◽

Gastric Acid ◽

Clinical Decision Making ◽

Care Home ◽

Clinical Decision ◽

Elevated Risk ◽

Defined Daily Dose ◽

Healthcare Associated Infection ◽

Healthcare Associated

ABSTRACT ObjectivesThe use of “real-time” data to support individual patient management and outcome assessment requires the development of risk assessment models. This could be delivered through a learning health system by the building robust statistical analysis tools onto the existing linked data held by NHS Scotland’s Infection Intelligence Platform (IIP) and developed within the Scottish Healthcare Associated Infection Prevention Institute (SHAIPI). This project will create prediction models for the risk of acquiring a healthcare associated infection (HAI), and particular outcomes, at the point of GP consultation/ hospital admission which could aid clinical decision making. ApproachWe demonstrate the capability using the HAI Clostridium difficile (CDI) from 2010-2013. Using linked national individual level data on community prescribing, hospitalisations, infections and death records we extracted all cases of CDI and by comparing to matched population-based controls, examined the impact of prior hospital admissions, care home residence, comorbidities, exposure to gastric acid suppressive drugs and antibiotic exposure, defined as both cumulative (total defined daily dose (DDD)) and temporal antimicrobial exposure in the previous 6 months, to the risk of CDI acquisition. Antimicrobial exposure was considered for all drugs and the higher risk broad spectrum antibiotics (4Cs). Associations are assessed using conditional logistic regression. Using cross-validation we assess the ability of the model to accurately predict CDI infection. Risk scores for acquisition of CDI are estimated by combining these predictions with age and gender population incidence. ResultsIn the period 2010-2013 there were 1446 cases of CDI with matched 7964 controls. A significant dose-response relationship for exposure to any antimicrobial (1-7 DDDs OR=2.3 rising to OR=4.4 for 29+ DDDs) and, with elevated risk, to the 4C group (1-7 DDDs OR=3.8 rising to OR=17.9 for 29+ DDDs). Exposure elevates CDI risk most in the month after prescription but for 4C antimicrobials the elevated risk remains 6 months later (4C OR=12.4 within 1 month, OR=2.6 4-6 months later). The risk of CDI was also increased with more co-morbidities, previous hospitalisations, care home residency, increased number of prescriptions, and gastric acid suppression. ConclusionDespite limitations to current application in practice,(paucity of patient level in-hospital prescribing data and constraints of the timeliness of the data), when fully developed this system will enable risk classification to identify patients most at risk of HAI and adverse outcomes to aid clinical decision making.

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Empirically and clinically useful decision making in psychotherapy: Differential predictions with treatment response models.

Psychological Assessment ◽

10.1037/1040-3590.18.2.133 ◽

2006 ◽

Vol 18 (2) ◽

pp. 133-141 ◽

Cited By ~ 37

Author(s):

Wolfgang Lutz ◽

Stephen M. Saunders ◽

Scott C. Leon ◽

Zoran Martinovich ◽

Joachim Kosfelder ◽

...

Keyword(s):

Decision Making ◽

Treatment Response ◽

Response Models

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E-Health

E-Health Systems Quality and Reliability ◽

10.4018/978-1-61692-843-8.ch005 ◽

2010 ◽

pp. 47-63 ◽

Cited By ~ 4

Author(s):

Anastasius Moumtzoglou

Keyword(s):

Health Care ◽

Decision Making ◽

Structural Change ◽

Health Care Organization ◽

The Other ◽

Care Organization ◽

Shared Decision ◽

Central Values ◽

Centered Care ◽

Partnership Approach

People-centered health care represents a structural change in thinking, which encapsulates before anything else the consideration of the patient. The development of people-centered care might include a partnership approach based on equal footing, capacity-building and the expansion of organizational care. Its central values encompass empowerment, participation, family, community, and the abolition of any kind of discrimination. As a result, they bestow people on shared decision-making not exclusively on issues of treatment but also for health care organization. On the other hand, a global e-health agreement is beginning to take shape on the engagement of stakeholders, the interoperability, and standards. Consequently, e-health can have a significant impact on people-centered care, despite the challenges of implementation and adoption.

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Immuno-Imaging to Predict Treatment Response in Infection, Inflammation and Oncology

Journal of Clinical Medicine ◽

10.3390/jcm8050681 ◽

2019 ◽

Vol 8 (5) ◽

pp. 681 ◽

Cited By ~ 5

Author(s):

Alberto Signore ◽

Chiara Lauri ◽

Sveva Auletta ◽

Kelly Anzola ◽

Filippo Galli ◽

...

Keyword(s):

Decision Making ◽

Nuclear Medicine ◽

Treatment Response ◽

Fungal Infections ◽

Inflammatory Diseases ◽

Imaging Techniques ◽

Nuclear Medicine Imaging ◽

Tumour Immunology ◽

Therapy Decision

Background: Molecular nuclear medicine plays a pivotal role for diagnosis in a preclinical phase, in genetically susceptible patients, for radio-guided surgery, for disease relapse evaluation, and for therapy decision-making and follow-up. This is possible thanks to the development of new radiopharmaceuticals to target specific biomarkers of infection, inflammation and tumour immunology. Methods: In this review, we describe the use of specific radiopharmaceuticals for infectious and inflammatory diseases with the aim of fast and accurate diagnosis and treatment follow-up. Furthermore, we focus on specific oncological indications with an emphasis on tumour immunology and visualizing the tumour environment. Results: Molecular nuclear medicine imaging techniques get a foothold in the diagnosis of a variety of infectious and inflammatory diseases, such as bacterial and fungal infections, rheumatoid arthritis, and large vessel vasculitis, but also for treatment response in cancer immunotherapy. Conclusion: Several specific radiopharmaceuticals can be used to improve diagnosis and staging, but also for therapy decision-making and follow-up in infectious, inflammatory and oncological diseases where immune cells are involved. The identification of these cell subpopulations by nuclear medicine techniques would provide personalized medicine for these patients, avoiding side effects and improving therapeutic approaches.

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Introducing health technology assessment in Tanzania

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319000588 ◽

2019 ◽

Vol 36 (2) ◽

pp. 80-86 ◽

Cited By ~ 3

Author(s):

Gavin Surgey ◽

Kalipso Chalkidou ◽

William Reuben ◽

Fatima Suleman ◽

Jacqui Miot ◽

...

Keyword(s):

Decision Making ◽

Health Technology Assessment ◽

Low Income ◽

Priority Setting ◽

Technology Assessment ◽

Health Technology ◽

Sub Saharan Africa ◽

Essential Medicines ◽

Revision Process ◽

Decision Making Processes

AbstractObjectivesHealth technology assessment (HTA) is a cost-effective resource allocation tool in healthcare decision-making processes; however, its use is limited in low-income settings where countries fall short on both absorptive and technical capacity. This paper describes the journey of the introduction of HTA into decision-making processes through a case study revising the National Essential Medicines List (NEMLIT) in Tanzania. It draws lessons on establishing and strengthening transparent priority-setting processes, particularly in sub-Saharan Africa.MethodsThe concept of HTA was introduced in Tanzania through revision of the NEMLIT by identifying a process for using HTA criteria and evidence-informed decision making. Training was given on using economic evidence for decision making, which was then put into practice for medicine selection for the NEMLIT. During the revision process, capacity-building workshops were held with reinforcing messages on HTA.ResultsBetween the period 2014 and 2018, HTA was introduced in Tanzania with a formal HTA committee being established and inaugurated followed by the successful completion and adoption of HTA into the NEMLIT revision process by the end of 2017. Consequently, the country is in the process of institutionalizing HTA for decision making and priority setting.ConclusionWhile the introduction of HTA process is country-specific, key lessons emerge that can provide an example to stakeholders in other low- and middle-income countries (LMICs) wishing to introduce priority-setting processes into health decision making.

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Schema therapy versus cognitive behavioral therapy versus individual supportive therapy for depression in an inpatient and day clinic setting: study protocol of the OPTIMA-RCT

BMC Psychiatry ◽

10.1186/s12888-020-02880-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Johannes Kopf-Beck ◽

Petra Zimmermann ◽

Samy Egli ◽

Martin Rein ◽

Nils Kappelmann ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Treatment Response ◽

Treatment Approach ◽

Behavioral Therapy ◽

Antidepressant Medication ◽

Supportive Therapy ◽

Cognitive Behavioral ◽

Schema Therapy ◽

Clinic Setting ◽

Day Clinic

Abstract Background Major depressive disorder represents (MDD) a major cause of disability and disease burden. Beside antidepressant medication, psychotherapy is a key approach of treatment. Schema therapy has been shown to be effective in the treatment of psychiatric disorders, especially personality disorders, in a variety of settings and patient groups. Nevertheless, there is no evidence on its effectiveness for MDD in an inpatient nor day clinic setting and little is known about the factors that drive treatment response in such a target group. Methods In the current protocol, we outline OPTIMA (OPtimized Treatment Identification at the MAx Planck Institute): a single-center randomized controlled trial of schema therapy as a treatment approach for MDD in an inpatient and day clinic setting. Over the course of 7 weeks, we compare schema therapy with cognitive behavioral therapy and individual supportive therapy, conducted in individual and group sessions and with no restrictions regarding concurrent antidepressant medication, thus approximating real-life treatment conditions. N = 300 depressed patients are included. All study therapists undergo a specific training and supervision and therapy adherence is assessed. Primary outcome is depressive symptom severity as self-assessment (Beck Depression Inventory-II) and secondary outcomes are clinical ratings of MDD (Montgomery-Asberg Depression Rating Scale), recovery rates after 7 weeks according to the Munich-Composite International Diagnostic Interview, general psychopathology (Brief Symptom Inventory), global functioning (World Health Organization Disability Assessment Schedule), and clinical parameters such as dropout rates. Further parameters on a behavioral, cognitive, psychophysiological, and biological level are measured before, during and after treatment and in 2 follow-up assessments after 6 and 24 months after end of treatment. Discussion To our knowledge, the OPTIMA-Trial is the first to investigate the effectiveness of schema therapy as a treatment approach of MDD, to investigate mechanisms of change, and explore predictors of treatment response in an inpatient and day clinic setting by using such a wide range of parameters. Insights from OPTIMA will allow more integrative approaches of psychotherapy of MDD. Especially, the identification of intervention-specific markers of treatment response can improve evidence-based clinical decision for individualizing treatment. Trial registration Identifier on clinicaltrials.gov: NCT03287362; September, 12, 2017

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