Performance of a new symptom checker in patient triage: Canadian cohort study

Background Computerized algorithms known as symptom checkers aim to help patients decide what to do should they have a new medical concern. However, despite widespread implementation, most studies on symptom checkers have involved simulated patients. Only limited evidence currently exists about symptom checker safety or accuracy when used by real patients. We developed a new prototype symptom checker and assessed its safety and accuracy in a prospective cohort of patients presenting to primary care and emergency departments with new medical concerns. Method A prospective cohort study was done to assess the prototype’s performance. The cohort consisted of adult patients (≥16 years old) who presented to hospital emergency departments and family physician clinics. Primary outcomes were safety and accuracy of triage recommendations to seek hospital care, seek primary care, or manage symptoms at home. Results Data from 281 hospital patients and 300 clinic patients were collected and analyzed. Sensitivity to emergencies was 100% (10/10 encounters). Sensitivity to urgencies was 90% (73/81) and 97% (34/35) for hospital and primary care patients, respectively. The prototype was significantly more accurate than patients at triage (73% versus 58%, p<0.01). Compliance with triage recommendations in this cohort using this iteration of the symptom checker would have reduced hospital visits by 55% but cause potential harm in 2–3% from delay in care. Interpretation The prototype symptom checker was superior to patients in deciding the most appropriate treatment setting for medical issues. This symptom checker could reduce a significant number of unnecessary hospital visits, with accuracy and safety outcomes comparable to existing data on telephone triage.

El hombre es un ser en el mundo. / Man is a being in the world.

El ser humano a través del tiempo ha asumido un papel activo en relación con la comprensión, estudio, explotación y aprovechamiento de la naturaleza, sin embargo, a través de ciertos aportes filosóficos se ha dejado entrever la importancia inminente que cobra la naturaleza en cuento a la supervivencia humana, ello ajustado a los estudios que en Grecia desarrollaron tanto los filósofos presocráticos como Sócrates, Platón y Aristóteles, dejando un legado que a través de la ética configuraba una forma de vida ajustada a la virtud como modo de cuidar el ambiente por medio del conocimiento de sí y del cuidado de los otros. Legadoque actualmente ha desaparecido por el influjo de procesos culturales tales como el imperialismo, la industrialización y el capitalismo, con los cuales se ha proliferado un consumo excesivo y una forma de vida insaciable en relación con el deseo de poseer. En este sentido, el problema del medio ambiente que ocupa al hombre actual, entendido como un ser en el mundo, lo han llevado a cuestionarse en relación con su forma actual de vivir y, sobre todo, con las decisiones que debe tomar para que volviendo a la ética como fuente de cuidado procure garantizar una mejor calidad de vida y una relación armónica con el ambiente, con lacual se pueda garantizar un desarrollo sostenible en la tierra.ABSTRACT: The human being through time has assumed an active role in relation to the understanding, study, exploitation and use of nature, however, through certain philosophical contributions, the imminent importance of nature in relation to human survival, this adjusted to the studies carried out in Greece by both the pre-Socratic philosophers and Socrates, Plato and Aristotle, leaving a legacy that goes through ethics configured a way of life adjusted to virtue as a way of caring for the environment through knowledge of himself and the care of others. Legacy that currently has disappeared due to the influence of cultural processes, tales such as imperialism, industrialization, capitalism, with which excessive consumption and an insatiable way of life have proliferated in relation to the desire to possess. In this sense, the problem of the environment that occupies the current man, understood as a being in the world, has led him to question himself in relation to his current way of living and, above all, with the decisions he must make so that he can return to ethics as a source of care, seek to obtain a better quality of life and a harmonious relationship with the environment, with the quality of which sustainable development can be obtained on earth.

STRATEGIES OF FAMILIES IN THE CARE OF CHILDREN WITH CHRONIC DISEASES

ABSTRACTthis study aimed to know the strategies of families in the care of children with chronic diseases. A descriptive and exploratory research was carried out using a qualitative approach, in a Pediatric Unit of a university hospital in the south of Brazil, during the first and second halves of 2013. The study involved 15 participating families. Data were collected by means of interviews subjected to thematic analysis. It was identified as strategies: balance work, study and care, share tasks throughout the day, adapt the physical area of the house, engage the child in their own care, seek resources in the network of social support and faith, seek assistance in another city; and engage in physical activity to reduce stress. It was concluded that it is necessary that the nurses participate of the family support network, as a support source for the strengthening of the family to the care, acquiring skills and expertise to a positive coping of the child's chronic disease.

Themes in Reminiscence Groups with Older Women

The preponderance of older women in the United States is apparent to all professionals in health care for elderly individuals. Because there is much emphasis on health care promotion for all age groups, providers of health care seek strategies for health promotion for older women. Although the literature is replete with information on reminiscence in general, and specifically reminiscence group therapy, there has been little discussion about the use of themes in reminiscence therapy groups. There are no publications about themes appropriate for reminiscence groups composed solely of older women. This article is based on three research studies and analyzes themes used in the three protocols for those studies. Appropriate themes for an all women's group are discussed and implications for practice are suggested.