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Development of Web-Based Education Modules to Improve Carer Engagement in Cancer Care: Design and User Experience Evaluation of the e-Triadic Oncology (eTRIO) Modules for Clinicians, Patients, and Carers.

BackgroundCarers often assume key roles in cancer care. However, many carers report feeling disempowered and ill-equipped to support patients. Our group published evidence-based guidelines (the Triadic Oncology [TRIO] Guidelines) to improve oncology clinician engagement with carers and the management of challenging situations involving carers.ObjectiveTo facilitate implementation of the TRIO Guidelines in clinical practice, we aimed to develop, iteratively refine, and conduct user testing of a suite of evidence-based and interactive web-based education modules for oncology clinicians (e-Triadi

Human brain evolution and the "Neuroevolutionary Time-depth Principle:" Implications for the Reclassification of fear-circuitry-related traits in DSM-V and for studying resilience to warzone-related posttraumatic stress disorder.

The DSM-III, DSM-IV, DSM-IV-TR and ICD-10 have judiciously minimized discussion of etiologies to distance clinical psychiatry from Freudian … "distal (evolutionary) neurobiology" with clinical "proximal neurobiology," utilizing neurological heuristics. It is noted that the value of re-clustering fear traits based on behavioral ethology, human-phylogenomics-derived endophenotypes and on ontogenomics (gene-environment interactions) can be confirmed or disconfirmed using epidemiological or twin stud …

Physical and physicochemical factors effecting transport of chlorohydrocarbon gases from lung alveolar air to blood as measured by the causation of narcosis.

This systematic investigation examines gas transport in the lung for two sets of chlorohydrocarbons (CHCs): the chloromethanes (C1) and chloroethanes (C2). The C1 series includes chloromethane, methylene chloride, chloroform, and carbon tetrachloride, and the C2 series includes chloroethane, 1,2-dichloroethane, 1, 1, 2-trichloroethane, and 1, 1, 2, 2-tetrachloroethane. Most CHC gases cause narcosis. The comprehensive narcosis work of Lehmann and colleagues on CHCs was used as a basis for the narcosis endpoint in the present examination. The sites for narcosis are located in the brain (midline

Usability testing of Avoiding Diabetes Thru Action Plan Targeting (ADAPT) decision support for integrating care-based counseling of pre-diabetes in an electronic health record.

PURPOSE: Usability testing can be used to evaluate human-computer interaction (HCI) and communication in shared decision making (SDM) for patient-provider behavioral change and behavioral contracting. Traditional evaluations of usability using scripted or mock patient scenarios with think-aloud protocol analysis provide a way to identify HCI issues. In this paper we describe the application of these methods in the evaluation of the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) tool, and test the usability of the tool to support the ADAPT framework for integrated care counseling of pre-d

Depoliticisation, Resilience and the Herceptin Post-Code Lottery Crisis: Holding Back the Tide.

Research Highlights and Abstract This article: Covers new empirical terrain in the study of depoliticisation, with an in-depth case study of health technology regulation;Analyses depoliticisation from a novel analytical perspective, examining how depoliticised institutions are resilient to external pressure for politicisation;Posits a distinctive framework for analysing resilience, drawing on cognate literatures on policy networks and agencification;Raises interesting and distinctive questions about the nature of depoliticisation in advanced liberal democracies, arguing it is more contested th

Intuitive vs Deliberative Approaches to Making Decisions About Life Support: A Randomized Clinical Trial.

ImportancePatients with serious illnesses are often encouraged to actively deliberate about the desirability of life support. Yet it is unknown whether deliberation changes the substance or quality of such decisions.ObjectiveTo identify differences in decisions about life support interventions and goals of care made intuitively vs deliberatively by patients with serious illnesses.Design, setting, and participantsRandomized clinical trial in which patients were asked to express treatment preferences in a series of clinical scenarios. Participants were 199 hospitalized patients aged 60 years and

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… Thus, patients who were cognitively loaded may have more commonly relied on heuristics such as extremeness aversion (tendency to pick middle options) 42 , 43 and recency effects, 44 , 45 , 46 both of which would bias toward more aggressive choices among patients responding intuitively. … Trends Cogn Sci . 2007 ; 11 ( 2 ): 45 - 46 . doi: 10.1016/j.tics.2006.11.007 17188556 10 Tversky A , Kahneman D Judgment under uncertainty: heuristics and biases . …

Design and implementation of mHealth applications for older people with cancer: A scoping review.

ObjectiveThis scoping review aimed to systematically synthesize the evidence on the functions, design, implementation strategies, and evaluation approaches of mobile health (mHealth) applications (apps) developed for older adults with cancer, to inform future research and practice.MethodsA scoping review was conducted using Arksey and O'Malley's methodological framework, with an updated systematic search of five databases (Medline, Web of Science, CINAHL, Embase, and the Cochrane Library) from January 1, 2008, to February 28, 2025. The review adhered to the PRISMA-ScR guidelines for scoping re

Response-The Road Less Travelled: Why did Miles Little Turn to Qualitative Research and Where Did This Lead?

Miles Little is an Australian surgeon, poet, and philosopher whose published work spans diverse topics in surgery, medicine, philosophy, and bioethics. In 1974 he co-authored a survey that included an analysis of interviews conducted with amputees. This was his first foray into qualitative research. Twenty years later he established a research centre at the University of Sydney that initiated a programme of qualitative research in cancer medicine. For twenty years after that, the centre acted as a hub for research that applied qualitative methods from the social sciences to study the experienc

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… This points to another wellspring of EBM in the early 1970s: research into the heuristics people use to make judgments in the face of uncertainty and which give rise to systematic errors or what epidemiologists call “biases” (Tversky and Kahnemann 1974 ). … Sullivan MD Placebo controls and epistemic control in orthodox medicine Journal of Medicine and Philosophy 1993 18 2 213 231 10.1093/jmp/18.2.213 8315363 Tversky A Kahnemann D Judgment under uncertainty: Heuristics and biases Science 1974 185 4157 1124 1131 10.1126/science.185.4157.1124 17835457 United …

Стратегия Монте-Карло по планированию последующей медицинской деятельности: пример множественных данных о миеломе.

Ключевое значение для индивидуального лечения раковых заболеваний имеет разработка стратегий последующей деятельности в интересах конкретных пациентов. Весьма полезными были бы инструменты оказания помощи врачам в принятии решений о лечении и планировании последующих мероприятий на основе предпочтений пациентов и медицинских данных. Эти инструменты должны включать реалистичные модели развития заболеваний в рамках лечения, многоцелевую оптимизацию стратегий лечения и эффективные алгоритмы для индивидуализации последующих мер с учетом истории пациента. Мы предлагаем модель эволюции рака с исполь

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… In our medical framework, one may build interesting rollout policies exploiting the hidden mode of the disease to provide good heuristics to the simulation part of POMCP. … The mode policy, being based on the full observation of the process, is likely to underestimate the real cost of an optimal control policy, which is a useful property for the convergence of a heuristic search method [ 47 ]. …

Скринэтон 2.0:: Проведение совместного обследования с участием человека и АИ на основе данных о состоянии здоровья пациентов.

Систематические обзоры имеют важное значение для проведения исследований, основанных на фактических данных, однако традиционный процесс отбора требует много времени и его трудно масштабировать. Скрининг, проводимый исключительно для человека, может привести к непоследовательности, в то время как полностью автоматизированные подходы с использованием моделей Большого языка зачастую не имеют контекстуального суждения, необходимого для принятия сложных решений. Для решения этой проблемы мы внедряем методологию скрининга на основе толпы, которая сочетает человеческий опыт и адаптивное машинное обуч

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… At the same time, we needed pragmatic heuristics to make a live, two-day collaborative screening event operationally feasible. … Because relying on heuristics instead of estimated stopping rules, carries the risk of leaving relevant papers unscreened or retaining incorrect labels 42 , we mitigated this risk by implementing an extensive post-processing quality check phase. …

Капиллероскопия с капиллароскопией в диабетической ретинопатии: микровирусные озарения, клиническая ценность и проблемы с переводом - обзор повествования.

Диабетическая ретинопатия (DR) является одним из основных микроваскуловых осложнений сахарного диабета и одной из основных причин предотвратимой потери зрения. В настоящее время DR рассматривается как проявление системной диабетической микроангиопатии, а не изолированного окулярного расстройства. Оценка на основе сетчатки может не в полной мере отражать системное микроваскулярное бремя, особенно в тех случаях, когда доступ к специализированной сетчатке сетчатки ограничен. Капиллероскопия с капиллярным влагом (НКЦ) позволяет напрямую и неинвазивно визуализировать периферическую капиллярную морф

Модель диагностики болезней MS на основе плотности с использованием алгоритма поиска капуцинов и ансамбля глубоких нейронных сетей.

Множественный склероз (MS) — серьезная болезнь мозга, которая постоянно разрушает клетки мозга, влияет на зрение, баланс, мышечный контроль и повседневную активность. В этом исследовании используется взвешенное сочетание глубоких нейронных сетей и методов оптимизации для диагностики заболеваний MS. Этот метод использует кусочки изображений магнитного резонанса (MRI) в качестве входных. Затем, после предварительной обработки, процесс сегментации и идентификации района, представляющего интерес (РОИ), осуществляется с использованием сочетания алгоритма " нечеткие " c-means (FCM) и алгор

Cooperation, Trust, and Antagonism: How Public Goods Are Promoted.

One of the most continually vexing problems in society is the variability with which citizens support endeavors that are designed to help a great number of people. In this article, we examine the twin roles of cooperative and antagonistic behavior in this variability. We find that each plays an important role, though their contributions are, understandably, at odds. It is this opposition that produces seeming unpredictability in citizen response to collective need. In fact, we suggest that careful consideration of the research allows one to often predict when efforts to provide a collectively

Разработка Novel Digitals Eliction Measure for Clinical Use у пожилых людей с гематологическими злокачественными свойствами: Ценности-HM.

Введение. Недавнее расширение возможностей лечения пожилых людей, страдающих раком крови, повысило необходимость понимания предпочтений и ценностей пациентов для принятия решений о лечении. В настоящее время для клинического применения в этой группе населения не было подтверждено никаких мер по расчету значений. Величины-HM (показатель вымогательства для гематологовых злоумышленников) представляют собой новый показатель вымогательства, основанный на наилучших значениях масштаба. Он был разработан специально для пожилых людей, страдающих раком крови, с участием многих заинтересованных сторон, в

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… priorities of patients and other stakeholders in health and has been used in other clinical settings in oncology. 40 , 41 The development of Values-HM was an iterative process that included data from more than 800 patients, 200 caregivers, and clinical and methodological experts in addition to formal heuristic … Minimal cognitive bias | Study design should minimize potential cognitive biases such as framing, anchoring, or ordering effect. | The choice task design limits anchoring and simplifying heuristics by not presenting numerical values. …

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.

BACKGROUND: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of

Bedside implications of the use of surrogate endpoints in solid and haematological cancers: implications for our reliance on PFS, DFS, ORR, MRD and more.

Clinical endpoints, such as overall survival, directly measure relevant outcomes. Surrogate endpoints, in contrast, are intermediate, stand-in measures of various tumour-related metrics and include tumour growth, tumour shrinkage, blood results, etc. Surrogates may be a time point measurement, that is, tumour shrinkage at some point (eg, response rate) or biomarker-assessed disease status, measured at given time points (eg, circulating tumour DNA, ctDNA). They can also be measured over time, as with progression-free survival, which is the time until a patient presents with either disease progr

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… trials, including those supporting marketing authorisations (ie, approvals) of novel drugs: some consider them a direct measure of antitumour effects, they may allow patients more rapid access to innovation, they may help in the interpretation of other cancer outcomes, and they may serve as useful heuristics … efficacy Progression-free survival (PFS) | PFS is a time-to-event endpoint assessing the time from treatment initiation or randomisation to disease progression or death | May be considered a direct measure of antitumour effects May allow patients more rapid access to innovation May serve as useful heuristics …

Pyramidal Decision Support Framework Leverages Subspecialty Expertise across Enterprise to Achieve Superior Cancer Outcomes and Personalized, Precision Care Plans.

The complexity of cancer care requires integrated and continuous support to deliver appropriate care. An expert network with complementary expertise and the capability of multidisciplinary care is an integral part of contemporary oncology care. Appropriate infrastructure is necessary to empower this network to deliver personalized precision care to their patients. Providing decision support as cancer care becomes exponentially more complex with new diagnostic and therapeutic choices remains challenging. City of Hope has developed a Pyramidal Decision Support Framework to address these challeng

Quality of Life as a Non-mortality Patient-centred Outcome in the Critically Ill: A Retrospective Analysis.

ObjectivesMortality is a common gauged endpoint in critically ill patients. Reduced quality of life is an aligned repercussion of protracted critical illness. Baseline status, severity of illness and its trajectory influence the outcomes. Patient-oriented outcomes are those that matter the most to a patient. However, quite often, family approves of trade-offs with survivorship in the Indian context. We looked at non-mortality outcomes in patients on high-intensity life-sustaining interventions admitted to the intensive care unit (ICU) despite poor prognosis and died on full support or survived

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… We had to piece together the dying trajectories from patient information available in charts with practicable heuristics. CONCLUSION A number of findings from this study show a route for clinical care. …

The Challenges of Prognosticating Persistent Critical Illness: A Qualitative Study.

BackgroundMedical decision-making in the ICU is influenced by a patient's anticipated clinical course. However, intensivists struggle to identify accurately which patients will experience within-ICU events-such as new late-onset shock or acute hypoxic respiratory failure (AHRF)-that contribute to the development of persistent critical illness (PerCI). Given the uniqueness of patients who experience PerCI, understanding how intensivists process and incorporate evolving clinical information into their prognostication remains unknown for this population.Research questionWhat processes do intensiv

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… Heuristics: foundations for a novel approach to medical decision making . Intern Emerg Med . 2015 ; 10 : 195 – 203 . 25348561 10.1007/s11739-014-1143-y 38. Zaza SI , Arnold RM , Schwarze ML . Innovations in surgical communication 4—present the downsides of surgery, not just the risk . …

Наличие медленно расширяющихся повреждений в множестве склероза предсказывает прогрессивное демиэлирование в пределах повреждений и нормального образования тканей с течением времени.

Множественные склерозы (MS) медленно расширяющиеся повреждения (SELs) определяются магнитно-резонансными изображениями (MRI) как прилегающие районы ранее существовавших фокусных неконтражных повреждений Т2 с постоянным и концентрическим расширением на традиционных участках T1-weighted и T2-weighted Изображение. СЭЛ связаны с повышенным риском развития инвалидности. МЕТОДЫ: Изменения, связанные с миелином, которые были обнаружены с использованием миелинской доли воды (MWF) и коэффициента переноса магнитизации (MTR) в SELs и повреждениях Т2, были измерены поверх них. 192 неделями в составе участ