scholarly journals Heuristic decision making in medicine

2012 ◽  
Vol 14 (1) ◽  
pp. 77-89 ◽  
Keyword(s):  
Health Care ◽  
Future Research ◽  
Medical Decisions ◽  
Decision Strategies ◽  
Health Care Settings ◽  
The Common ◽  
Low Costs ◽  
Greedy Methods ◽  
Time Required ◽  
Available Information

Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care.

scholarly journals Meiosis Progression and Recombination in Holocentric Plants: What Is Known?

2021 ◽  
Vol 12 ◽  
Author(s):  
Paulo G. Hofstatter ◽  
Gokilavani Thangavel ◽  
Marco Castellani ◽  
André Marques
Keyword(s):  
Meiotic Recombination ◽  
Future Research ◽  
Holocentric Chromosomes ◽  
Special Focus ◽  
C Elegans ◽  
The Family ◽  
The Common ◽  
Available Information ◽  
Nuclear Processes

Differently from the common monocentric organization of eukaryotic chromosomes, the so-called holocentric chromosomes present many centromeric regions along their length. This chromosomal organization can be found in animal and plant lineages, whose distribution suggests that it has evolved independently several times. Holocentric chromosomes present an advantage: even broken chromosome parts can be correctly segregated upon cell division. However, the evolution of holocentricity brought about consequences to nuclear processes and several adaptations are necessary to cope with this new organization. Centromeres of monocentric chromosomes are involved in a two-step cohesion release during meiosis. To deal with that holocentric lineages developed different adaptations, like the chromosome remodeling strategy in Caenorhabditis elegans or the inverted meiosis in plants. Furthermore, the frequency of recombination at or around centromeres is normally very low and the presence of centromeric regions throughout the entire length of the chromosomes could potentially pose a problem for recombination in holocentric organisms. However, meiotic recombination happens, with exceptions, in those lineages in spite of their holocentric organization suggesting that the role of centromere as recombination suppressor might be altered in these lineages. Most of the available information about adaptations to meiosis in holocentric organisms is derived from the animal model C. elegans. As holocentricity evolved independently in different lineages, adaptations observed in C. elegans probably do not apply to other lineages and very limited research is available for holocentric plants. Currently, we still lack a holocentric model for plants, but good candidates may be found among Cyperaceae, a large angiosperm family. Besides holocentricity, chiasmatic and achiasmatic inverted meiosis are found in the family. Here, we introduce the main concepts of meiotic constraints and adaptations with special focus in meiosis progression and recombination in holocentric plants. Finally, we present the main challenges and perspectives for future research in the field of chromosome biology and meiosis in holocentric plants.

Prevalence and distribution of pain in children

2013 ◽  
pp. 12-19 ◽  
Author(s):  
Bonnie J. Stevens ◽  
William T. Zempsky
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Clinical Practice ◽  
Infants And Children ◽  
Future Research ◽  
General Estimate ◽  
Health Care Settings ◽  
Pain Prevalence ◽  
Large Groups ◽  
Prevalence Period

There has been a paucity of studies that have attempted to determine the prevalence and distribution of pain (acute or chronic) in large groups of infants and children across multiple settings. Rather, there is a preponderance of single-site studies that report local prevalence and distribution of paediatric pain data. Although one could extrapolate these results to gain a broader sense of pain in children, this approach would garner only a general estimate at best. Furthermore, studies of pain prevalence vary as to the pain and prevalence definitions used, the reporting period (i.e. point prevalence, period prevalence), and stratification by duration of involvement, which makes comparison of findings challenging. In this chapter, definitions of prevalence and acute and chronic pain will be clarified and used to explore the prevalence and distribution of pain in hospitals and in community health care settings for infants and children. Recommendations for clinical practice and future research will be proposed.

scholarly journals Sharing Clinical Notes in a Canadian Mental Health Setting: Recommendations from Applying the Consolidated Framework for Intervention Research

2021 ◽  
Author(s):  
Brian Lo ◽  
Iman Kassam ◽  
Keri Durocher ◽  
Danielle Shin ◽  
Nelson Shen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Optimal Solution ◽  
Intervention Research ◽  
Future Research ◽  
Mental Health Clinicians ◽  
Health Care Settings ◽  
Clinical Notes ◽  
Challenges And Opportunities

During the COVID-19 pandemic, the OpenNotes movement presents an optimal solution for virtual engagement through the sharing of clinical notes within mental health care settings. Therefore, we conducted interviews to discover how mental health clinicians interact with patients using OpenNotes. We integrated The Consolidated Framework for Intervention Research to establish implementation recommendations. As both challenges and opportunities were identified, future research should address challenges to foster patient and clinician engagement in sharing clinical notes.

scholarly journals The Antecedents and Consequences of Health Care Professional–Patient Online Interactions: Systematic Review

10.2196/13940 ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. e13940 ◽  
Author(s):  
Lili Shang ◽  
Meiyun Zuo ◽  
Dan Ma ◽  
Qinjun Yu
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Future Research ◽  
Online Interaction ◽  
Health Care Settings ◽  
Online Interactions ◽  
Care Services ◽  
Antecedents And Consequences

Background Online health care services effectively supplement traditional medical treatment. The development of online health care services depends on sustained interactions between health care professionals (HCPs) and patients. Therefore, it is necessary to understand the demands and gains of health care stakeholders in HCP-patient online interactions and determine an agenda for future work. Objective This study aims to present a systematic review of the antecedents and consequences of HCP-patient online interactions. It seeks to reach a better understanding of why HCPs and patients are willing to interact with each other online and what the consequences of HCP-patient online interactions are for health care stakeholders. Based on this, we intend to identify the gaps in existing studies and make recommendations for future research. Methods In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic retrieval was carried out from the Web of Science, PubMed, and Scopus electronic databases. The search results were confined to those papers published in English between January 1, 2000 and June 30, 2018. Selected studies were then evaluated for quality; studies that did not meet quality criteria were excluded from further analysis. Findings of the reviewed studies related to our research questions were extracted and synthesized through inductive thematic analysis. Results A total of 8440 records were found after the initial search, 28 papers of which were selected for analysis. Accessibility to HCPs, self-management, and unmet needs were the main triggers for patients to participate in online interaction. For HCPs, patient education, career needs, and self-promotion were the major reasons why they took the online approach. There were several aspects of the consequences of HCP-patient online interactions on health care stakeholders. Consequences for patients included patient empowerment, health promotion, and acquisition of uncertain answers. Consequences for HCPs included social and economic returns, lack of control over their role, and gaining more appointments. HCP-patient online interactions also improved communication efficiency in offline settings and helped managers of online health care settings get a better understanding of patients’ needs. Health care stakeholders have also encountered ethical and legal issues during online interaction. Conclusions Through a systematic review, we sought out the antecedents and consequences of HCP-patient online interactions to understand the triggers for HCPs and patients to participate and the consequences of participating. Potential future research topics are the influences on the chain of online interaction, specifications and principles of privacy design within online health care settings, and roles that sociodemographic and psychological characteristics play. Longitudinal studies and the adoption of text-mining method are worth encouraging. This paper is expected to contribute to the sustained progress of online health care settings.

scholarly journals The Antecedents and Consequences of Health Care Professional–Patient Online Interactions: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Lili Shang ◽  
Meiyun Zuo ◽  
Dan Ma ◽  
Qinjun Yu
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Future Research ◽  
Online Interaction ◽  
Health Care Settings ◽  
Online Interactions ◽  
Care Services ◽  
Antecedents And Consequences

BACKGROUND Online health care services effectively supplement traditional medical treatment. The development of online health care services depends on sustained interactions between health care professionals (HCPs) and patients. Therefore, it is necessary to understand the demands and gains of health care stakeholders in HCP-patient online interactions and determine an agenda for future work. OBJECTIVE This study aims to present a systematic review of the antecedents and consequences of HCP-patient online interactions. It seeks to reach a better understanding of why HCPs and patients are willing to interact with each other online and what the consequences of HCP-patient online interactions are for health care stakeholders. Based on this, we intend to identify the gaps in existing studies and make recommendations for future research. METHODS In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic retrieval was carried out from the Web of Science, PubMed, and Scopus electronic databases. The search results were confined to those papers published in English between January 1, 2000 and June 30, 2018. Selected studies were then evaluated for quality; studies that did not meet quality criteria were excluded from further analysis. Findings of the reviewed studies related to our research questions were extracted and synthesized through inductive thematic analysis. RESULTS A total of 8440 records were found after the initial search, 28 papers of which were selected for analysis. Accessibility to HCPs, self-management, and unmet needs were the main triggers for patients to participate in online interaction. For HCPs, patient education, career needs, and self-promotion were the major reasons why they took the online approach. There were several aspects of the consequences of HCP-patient online interactions on health care stakeholders. Consequences for patients included patient empowerment, health promotion, and acquisition of uncertain answers. Consequences for HCPs included social and economic returns, lack of control over their role, and gaining more appointments. HCP-patient online interactions also improved communication efficiency in offline settings and helped managers of online health care settings get a better understanding of patients’ needs. Health care stakeholders have also encountered ethical and legal issues during online interaction. CONCLUSIONS Through a systematic review, we sought out the antecedents and consequences of HCP-patient online interactions to understand the triggers for HCPs and patients to participate and the consequences of participating. Potential future research topics are the influences on the chain of online interaction, specifications and principles of privacy design within online health care settings, and roles that sociodemographic and psychological characteristics play. Longitudinal studies and the adoption of text-mining method are worth encouraging. This paper is expected to contribute to the sustained progress of online health care settings.

Clostridium difficilein foods and animals: history and measures to reduce exposure

2013 ◽  
Vol 14 (1) ◽  
pp. 11-29 ◽  
Author(s):  
Alex Rodriguez-Palacios ◽  
Stefan Borgmann ◽  
Terence R. Kline ◽  
Jeffrey T. LeJeune
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Human Exposure ◽  
Medical Personnel ◽  
Prevention Strategies ◽  
Health Care Settings ◽  
Poultry Products ◽  
Molecular Studies ◽  
And Behavior ◽  
Available Information

AbstractMany articles have summarized the changing epidemiology ofClostridium difficileinfections (CDI) in humans, but the emerging presence ofC. difficilein foods and animals and possible measures to reduce human exposure to this important pathogen have been infrequently addressed. CDIs have traditionally been assumed to be restricted to health-care settings. However, recent molecular studies indicate that this is no longer the case; animals and foods might be involved in the changing epidemiology of CDIs in humans; and genome sequencing is disproving person-to-person transmission in hospitals. Although zoonotic and foodborne transmission have not been confirmed, it is evident that susceptible people can be inadvertently exposed toC. difficilefrom foods, animals, or their environment. Strains of epidemic clones present in humans are common in companion and food animals, raw meats, poultry products, vegetables, and ready-to-eat foods, including salads. In order to develop science-based prevention strategies, it is critical to understand howC. difficilereaches foods and humans. This review contextualizes the current understanding of CDIs in humans, animals, and foods. Based on available information, we propose a list of educational measures that could reduce the exposure of susceptible people toC. difficile. Enhanced educational efforts and behavior change targeting medical and non-medical personnel are needed.

scholarly journals Bringing HIV Self-Testing to Scale in the United States: a Review of Challenges, Potential Solutions, and Future Opportunities

2019 ◽  
Vol 57 (11) ◽  
Author(s):  
Kevin Steehler ◽  
Aaron J. Siegler
Keyword(s):  
United States ◽  
Health Care ◽  
Test Performance ◽  
Large Scale ◽  
Linkage To Care ◽  
The United States ◽  
Ease Of Use ◽  
Future Research ◽  
Health Care Settings ◽  
Self Testing

ABSTRACT HIV self-testing (HIVST) provides an at-home option to counter the barriers that patients face with testing performed in health care settings. HIVST has gradually increased in popularity in a time when social media and technology-based solutions are preferred. In this paper, we consider the aspects of self-testing that merit its integration into HIV testing and prevention systems in the United States. Several elements favor self-testing for large-scale implementation, including ease of use, convenience, potential for integration with mobile health (mHealth), and availability for various modes of distribution. HIVST has a demonstrated ability to reach at-risk individuals who otherwise rarely test. The paradigm of self-testing, however, introduces new challenges, including lesser test performance relative to that in health care settings, nonstandard counseling following receipt of test results, and difficulty in providing linkage to care. After discussing the performance of oral fluid versus blood-based HIVST, we review data regarding acceptability of HIVST, offer insights into counseling and linkage to care for HIVST, and provide examples of novel applications of and future research directions for HIVST.

Student Preparation for Dysphagia Practice: Universities and Practicum Sites Supporting a Common Outcome

2016 ◽  
Vol 1 (13) ◽  
pp. 122-129 ◽  
Author(s):  
Wendy Chase ◽  
Lucinda Soares Gonzales
Keyword(s):  
Health Care ◽  
Student Performance ◽  
Classroom Setting ◽  
Medical Settings ◽  
Student Preparation ◽  
Health Care Settings ◽  
The University ◽  
University Of Connecticut

This article will describe the approach to dysphagia education in a classroom setting at the University of Connecticut (UCONN), explore the disparity between student performance in schools vs. health care settings that was discovered at UCONN, and offer suggestions for practicum supervisors in medical settings to enhance student acquisition of competence.

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