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1.
Child Care Health Dev ; 50(5): e13331, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39300755

RESUMEN

BACKGROUND: The study aimed to understand the experience of and identify the motivations for parents participating in health research for their children with medical complexity (CMC). Patient-oriented research strategies are increasingly important in health research to ensure that the voices of patients and parents help shape and direct research programmes. To bring a family-centred and patient-oriented focus to our research and objectives, we asked parents about their experiences when they participated in healthcare research related to their child with CMC. METHODS: A parent partner, who also has a CMC, interviewed 12 parents (11 mothers and 1 father) of children living with medical complexity to understand their motivations to participate in healthcare research for their child. The parent partner conducted and transcribed the interviews and led our data analysis. Interpretive phenomenological analysis (IPA) was used to inform our data coding and analytic process. RESULTS: Parents described numerous reasons for their participation in research about their children. These motivations landed within four main themes: feeling helpless and hopeful, child-centred motivation, being part of something good and forming a relationship with the research team. In addition to these themes, parents highlighted factors that influenced their ability or desire to participate, such as time, capacity and the level of invasiveness for their child. Ultimately, the reflections by parents emphasized their unique lives in caring for their CMC and the need to integrate their lived experiences with the research they engage in. CONCLUSION: This study offers important insights for healthcare teams who want to engage parents of CMC to participate in research. Understanding parents' motivation to participate in research can help researchers create richer engagement and more meaningful experiences for themselves and their participants, thereby bolstering research programmes.


Asunto(s)
Motivación , Padres , Investigación Cualitativa , Humanos , Femenino , Masculino , Niño , Padres/psicología , Adulto , Preescolar , Adolescente , Enfermedad Crónica/psicología , Niños con Discapacidad/psicología , Investigación sobre Servicios de Salud , Persona de Mediana Edad
2.
World Psychiatry ; 23(3): 364-386, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39279422

RESUMEN

Psychiatry shares most ethical issues with other branches of medicine, but also faces special challenges. The Code of Ethics of the World Psychiatric Association offers guidance, but many mental health care professionals are unaware of it and the principles it supports. Furthermore, following codes of ethics is not always sufficient to address ethical dilemmas arising from possible clashes among their principles, and from continuing changes in knowledge, culture, attitudes, and socio-economic context. In this paper, we identify topics that pose difficult ethical challenges in contemporary psychiatry; that may have a significant impact on clinical practice, education and research activities; and that may require revision of the profession's codes of ethics. These include: the relationships between human rights and mental health care, research and training; human rights and mental health legislation; digital psychiatry; early intervention in psychiatry; end-of-life decisions by people with mental health conditions; conflicts of interests in clinical practice, training and research; and the role of people with lived experience and family/informal supporters in shaping the agenda of mental health care, policy, research and training. For each topic, we highlight the ethical concerns, suggest strategies to address them, call attention to the risks that these strategies entail, and highlight the gaps to be narrowed by further research. We conclude that, in order to effectively address current ethical challenges in psychiatry, we need to rethink policies, services, training, attitudes, research methods and codes of ethics, with the concurrent input of a range of stakeholders, open minded discussions, new models of care, and an adequate organizational capacity to roll-out the implementation across routine clinical care contexts, training and research.

3.
Glob Ment Health (Camb) ; 11: e70, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39257677

RESUMEN

Social contact refers to the facilitation of connection and interactions between people with and without mental health conditions. It can be achieved, for example, through people sharing their lived experience of mental health conditions, which is an effective strategy for stigma reduction. Meaningful involvement of people with lived experience (PWLE) in leading and co-leading anti-stigma interventions can/may promote autonomy and resilience. Our paper aimed to explore how PWLE have been involved in research and anti-stigma interventions to improve effective means of involving PWLE in stigma reduction activities in LMICs. A qualitative collective case study design was adopted. Case studies from four LMICs (China, Ethiopia, India and Nepal) are summarized, briefly reflecting on the background of the work, alongside anticipated and experienced challenges, strategies to overcome these, and recommendations for future work. We found that the involvement of PWLEs in stigma reduction is commonly a new concept in LMIC. Experienced and anticipated challenges were similar, such as identifying suitable persons to engage in the work and sustaining their involvement. Such an approach can be difficult because PWLE might be apprehensive about the negative consequences of disclosure. In many case studies, we found that long-standing professional connectedness, continued encouragement, information sharing, debriefing and support helped the participants' involvement. We recommend that confidentiality of the individual, cultural norms and family concerns be prioritized and respected during the implementation. Taking into account socio-cultural contextual factors, it is possible to directly involve PWLEs in social contact-based anti-stigma interventions.

4.
Patient Educ Couns ; 130: 108404, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39232364

RESUMEN

OBJECTIVE: To describe compare and assess expert and consumer evaluations of videos the National Bowel Cancer Screening Program in Australia to inform the future development of effective promotional materials. METHODS: From July to November, 2022 consumers (n = 487) were randomly assigned to see 3 of 15 videos and 34 "experts" (i.e., researchers, clinicians, and health promotion specialists) viewed all 15 videos. Participants completed 22 items reflecting positive and negative perceptions and perceived efficacy in encouraging screening participation. Multiple analyses of covariance assessed mean differences in expert and consumer ratings controlling for age and gender differences. RESULTS: Experts and consumers reported similar perceptions about videos, with no difference in the degree to which each would encourage kit completion. However, compared to those containing personal stories, experts rated instructional and informational videos significantly lower than consumers in terms of encouraging actions that facilitate kit completion. CONCLUSIONS: Experts may underestimate the degree to which information and personal narratives resonate with consumers viewing bowel cancer screening videos. PRACTICAL IMPLICATIONS: It is valuable to consult consumers when designing bowel cancer screening promotion and education videos as opposed to relying solely on expert opinion especially in the context of encouraging actions that lead to kit completion.

5.
JMIR Form Res ; 8: e59963, 2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39167434

RESUMEN

BACKGROUND: Queer individuals continue to be marginalized in South Africa; they experience various health care challenges (eg, stigma, discrimination, prejudice, harassment, and humiliation), mental health issues (eg, suicide and depression), and an increased spread of HIV or AIDS and sexually transmitted illnesses (STIs; chlamydia, gonorrhea, and syphilis). Mobile health (mHealth) apps have the potential to resolve the health care deficits experienced by health care providers when managing queer individuals and by queer individuals when accessing sexual-reproductive health care services and needs, thus ensuring inclusivity and the promotion of health and well-being. Studies have proven that the nominal group technique (NGT) could be used to solve different social and health problems and develop innovative solutions. This technique ensures that different voices are represented during decision-making processes and leads to robust results. OBJECTIVE: This study aims to identify important contents to include in the development of an mHealth app for addressing the sexual-reproductive health care services and needs of queer individuals. METHODS: We invited a group of 13 experts from different fields, such as researchers, queer activists, sexual and reproductive health experts, private practicing health care providers, innovators, and private health care stakeholders, to take part in a face-to-face NGT. The NGT was conducted in the form of a workshop with 1 moderator, 2 research assistants, and 1 principal investigator. The workshop lasted approximately 2 hours 46 minutes and 55 seconds. We followed and applied 5 NGT steps in the workshop for experts to reach consensus. The main question that experts were expected to answer was as follows: Which content should be included in the mHealth app for addressing sexual-reproductive health care services and needs for queer individuals? This question was guided by user demographics and background, health education and information, privacy and security, accessibility and inclusivity, functionality and menu options, personalization and user engagement, service integration and partnerships, feedback and improvement, cultural sensitivity and ethical considerations, legal and regulatory compliance, and connectivity and data use. RESULTS: Overall, experts voted and ranked the following main icons: menu options (66 points), privacy and security (39 points), user engagement (27 points), information hub (26 points), user demographics (20 points), connectivity (16 points), service integration and partnerships (10 points), functionalities (10 points), and accessibility and inclusivity (7 points). CONCLUSIONS: Conducting an NGT with experts from different fields, possessing vast skill sets, knowledge, and expertise, enabled us to obtain targeted data on the development of an mHealth app to address sexual-reproductive health care services and needs for queer individuals. This approach emphasized the usefulness of a multidisciplinary perspective to inform the development of our mHealth app and demonstrated the future need for continuity in using this approach for other digital health care innovations and interventions.

6.
Sci Rep ; 14(1): 20086, 2024 08 29.
Artículo en Inglés | MEDLINE | ID: mdl-39209919

RESUMEN

This study compared the multiple object tracking (MOT) performance of athletes vs. non-athletes and expert athletes vs. novice athletes by systematically reviewing and meta-analyzing the literature. A systematic literature search was conducted using five databases for articles published until July 2024. Healthy people were included, specifically classified as athletes and non-athletes, or experts and novices. Potential sources of heterogeneity were selected using a random-effects model. Moderator analyses were also performed. A total of 23 studies were included in this review. Regarding the overall effect, athletes were significantly better at MOT tasks than non-athletes, and experts performed better than novices. Subgroup analyses showed that expert athletes had a significantly larger effect than novices, and that the type of sport significantly moderated the difference in MOT performance between the two groups. Meta-regression revealed that the number of targets and duration of tracking moderated the differences in performance between experts and novices, but did not affect the differences between athletes and non-athletes. This meta-analysis provides evidence of performance advantages for athletes compared with nonathletes, and experts compared with novices in MOT tasks. Moreover, the two effects were moderated by different factors; therefore, future studies should classify participants more specifically according to sports levels.


Asunto(s)
Atletas , Rendimiento Atlético , Humanos , Rendimiento Atlético/fisiología , Desempeño Psicomotor/fisiología , Deportes/fisiología
7.
Acta Psychol (Amst) ; 249: 104470, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39191176

RESUMEN

Children are increasingly active consumers in the media world and are thus confronted with a wide range of information. Making good decisions in such an environment is a major challenge. Weighting valid information in decision-making is an important skill that children must learn and apply. Yet, how do children weight information and which weights do they use? We developed a measuring instrument for children's weighting of advices by cue validity - the so-called Space Treasure Hunt. It is an easy to understand, child-friendly decision game. By anchoring it in the reality of children's media lives, we are able to assess the influence of familiarity and affect on children's decision making. During a treasure hunt in game situated in outer space, children are confronted with various characters who provide contradictory advice regarding where to find treasures. One of the advice-givers was an expert (valid cue), whereas the other advice-giver varied in terms of its media familiarity and affect. In our study (N = 372), we found that media familiar characters had a strong influence on children's decision-making. Media idols showed an assimilation effect, meaning that children followed the expert's advice the least often when it contradicted their media idol. Conversely, media familiar but less liked characters showed a contrast effect, meaning that children followed the expert's advice most often when it contradicted the media familiar, less liked character. Moreover, we found differences between children in terms of a three-way split: One third of the children, respectively, systematically followed the expert's advice, the media idol, or made their decisions unsystematically. We discuss how our results indicate the use of different weights in children's decision making.


Asunto(s)
Toma de Decisiones , Humanos , Toma de Decisiones/fisiología , Niño , Masculino , Femenino , Reconocimiento en Psicología/fisiología , Señales (Psicología) , Medios de Comunicación de Masas , Confianza
8.
Int J Law Psychiatry ; 96: 102003, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39167850

RESUMEN

The decision-making process of experts in forensic psychiatric investigations (FPI) is complex and reasoning regarding psychiatric diagnosis and severe mental disorder (SMD, the judicial concept central to legal exemption in Swedish law) has severe ramifications. Nevertheless, the qualitative aspects of FPI experts' decision-making process have seldom been studied systematically. METHOD: The participants (N = 41) were FPI experts: forensic psychiatrists (n = 15), forensic psychologists (n = 15) and forensic social workers (n = 11). Using three case vignettes and qualitative content analysis, it was explored how case-specific characteristics could affect which hypotheses FPI experts generated regarding a) psychiatric diagnosis and b) severe mental disorder and c) which information sources they required. Each case vignette described a diagnostically ambiguous case but indicated emphasis on: psychotic symptoms (case 1); personality disorder symptoms (case 2) and neurodevelopmental disorder symptoms (case 3). RESULTS: Experts reasoned in a similar manner regarding generating hypotheses and required information, but also in a case-adapted manner. Experts considered various diagnostic alternatives, and some (e.g. psychosis) were mentioned for all three cases. Other diagnoses were only suggested as hypotheses in certain cases (e.g. case 3: intellectual disability). DISCUSSION: In Sweden, a core basis for SMD is psychotic-like functioning, and psychosis was suggested as a hypothesis for all three cases. Experts reasoned in similar ways regarding SMD in all cases, considering various perspectives for and against SMD. Some case-specific arguments for and against SMD adapted to the psychopathological circumstances were found. These could be related to aspects of the SMD concept that become important to ascertain when the type of psychopathology indicated in the case vignette was present; for example, ascertaining reality monitoring for a person with potential delusions of being followed by a criminal gang requires investigation of criminal history and related conflicts. Taken together, FPI-experts considered a broad range of psychiatric diagnoses in various cases. Their reasoning regarding SMD was both based on general and case-specific (or psychopathology-specific) factors.


Asunto(s)
Testimonio de Experto , Psiquiatría Forense , Trastornos Mentales , Investigación Cualitativa , Humanos , Suecia , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Femenino , Masculino , Testimonio de Experto/legislación & jurisprudencia , Adulto , Persona de Mediana Edad , Toma de Decisiones , Psicología Forense , Trabajadores Sociales/psicología
9.
Front Med (Lausanne) ; 11: 1430263, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39131091

RESUMEN

Importance: Public trust in health experts has been decreasing leading to decreased adherence to expert recommendations. Objective: To evaluate public perceptions of conflict and uncertainty among experts in healthcare recommendations and association with decreased trust in health entities for accurate health information. Methods: Analysis of the US nationally representative Health Information National Trends Survey (HINTS 6-2022). Adults aged 18 and older were respondents to the survey (unweighted n = 5,842, representing 241 million adults). The main outcome was trust in doctors, scientists and government health agencies for health information. Analyses examined trust in experts with public perceptions of conflict about recommendations and changing recommendations. Results: There was high trust in doctors for health information (95%) versus 84% in scientists and 70% in government health agencies. Only 18% have high trust in the health information on social media. Respondents who felt expert recommendations change often were less likely to have high trust (65%) in government agencies compared to those who felt that the recommendations did not often change (82%) (p < 0.01). In logistic regressions controlling for age, sex, race, education, income and trust in social media for health information perceptions of low conflict among expert health recommendations is associated with likelihood of high trust in government health agencies (OR 2.86; 95% CI 1.96-4.15). Conclusion: The public has low trust in government health agencies and perceptions of conflict among experts over recommendations is likely playing a role in the erosion of trust in health experts.

10.
Res Involv Engagem ; 10(1): 86, 2024 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-39123251

RESUMEN

BACKGROUND: In recent years, academics have increasingly acknowledged the importance of involving health service users and community stakeholders as active partners in health research. Yet, the involvement of older adults, the largest group of health service users, as research partners remains limited, possibly due to ageist attitudes that devalue older adults' contributions. During the three years of our Awakening Canadians to Ageism study, we convened an advisory group consisting of older adults and gerontological experts to discuss issues related to ageism, help interpret the study findings, and develop a range of knowledge mobilization strategies to dispel ageism. METHODS: To understand the experiences of members of the advisory group and solicit recommendations for improving future groups, we conducted a qualitative descriptive study and interviewed 8 older adults and 6 gerontological experts. Data were content analyzed. RESULTS: Four categories that were developed to explain participants' experiences and suggestions for future advisory groups included: organization and management, group experience, suggestions for future advisory groups and moving forward. A key finding was the value that the older adults and gerontological experts ascribed to conversations about the prevalence of ageism and their desire to continue these types of conversations in their personal groups and professional networks. Numerous helpful strategies for future advisory groups were identified, such as enhancing social diversity, both in terms of racial/ethnic/cultural representation and gender. Older adults wanted more "getting to know you time" in meetings and gerontological experts wanted more details about the research process and their role. CONCLUSIONS: This study's partnership approach can guide researchers seeking to involve key health service users and community stakeholders in health research and help enact positive social change.


In 2022 we developed an advisory group consisting of older adults and gerontological experts to review the findings of the first stage of our study Awakening Canadians to Ageism and provide guidance on knowledge mobilization and next steps. We interviewed 12 older adults and 6 gerontological experts from our advisory group to learn about their experiences with the group and provide suggestions for future groups. Participants provided feedback on group organization, management and processes, in addition to their experiences and strategies for future advisory groups. Both groups suggested enhancing the social diversity of the group, both in terms of racial/ethnic/cultural representation and gender. Older adults wanted more meeting time dedicated to getting to know the other groups members and gerontological experts wanted more details about the research process and their role.

11.
Stud Health Technol Inform ; 316: 565-569, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39176805

RESUMEN

This paper establishes requirements for assessing the usability of Explainable Artificial Intelligence (XAI) methods, focusing on non-AI experts like healthcare professionals. Through a synthesis of literature and empirical findings, it emphasizes achieving optimal cognitive load, task performance, and task time in XAI explanations. Key components include tailoring explanations to user expertise, integrating domain knowledge, and using non-propositional representations for comprehension. The paper highlights the critical role of relevance, accuracy, and truthfulness in fostering user trust. Practical guidelines are provided for designing transparent and user-friendly XAI explanations, especially in high-stakes contexts like healthcare. Overall, the paper's primary contribution lies in delineating clear requirements for effective XAI explanations, facilitating human-AI collaboration across diverse domains.


Asunto(s)
Inteligencia Artificial , Humanos , Comprensión
12.
Artículo en Inglés | MEDLINE | ID: mdl-38973006

RESUMEN

BACKGROUND: We describe a collection of themes for a research agenda for personality disorders that was originally formulated for the ESSPD Borderline Congress in 2022. METHODS: Experts with lived and living experience (EE), researchers and clinicians met virtually, exchanged ideas and discussed research topics for the field of personality disorders. The experts - patients, relatives, significant others - named the topics they thought most relevant for further research in the field. These topics were presented at the ESPPD conference in October 2022. RESULTS: The five top themes were: 1. Prevention, early detection and intervention, 2. Recovery beyond symptom improvement, 3. Involvement of relatives in treatment, 4. Gender dysphoria, and 5. Stigma. CONCLUSIONS: In general, the topics reflect current issues and changes in societal values. Overarching aims of research on these topics are the improvement of social participation and integration in society, better dissemination of research, and better information of the general public and political stakeholders.

13.
Food Res Int ; 191: 114689, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39059948

RESUMEN

The aim of this article is to better understand why experts give different scores to the same wines in identical tasting environments. This research focuses on the personal characteristics of experts (or judges), such as their gender, industry credentials, and occupation within the wine industry, and examines how judges respond to their peers' characteristics. Using a dataset of 5,395 wines judged in the 2022 International Wine and Spirits Competition, we analyse 18,224 scores from different judges. We estimate a series of grade equations at the judge level to understand why a same wine received different scores from judges. A first model makes use of the panel structure of the dataset, incorporates wine fixed effects, and focuses on the personal characteristics of judges. A second model encompasses characteristics of the judging team, without the inclusion of wine fixed effects. At large, on-trade buyers give lower scores than off-trade buyers, as well as female judges compared to male ones. While credentials are not a very significant factor per se, they do have the potential to generate peer effects. Judges tend to be more generous in their assessments when they are assigned to a team with Master of Wine judges. Conversely, they are also consistently more severe when the number of female judges on the team increases. Estimation results converge across sub-datasets, with the exception of sparkling wines. Given the feminisation of the wine industry, in terms of producers, consumers, and experts, the severity of female judges could be beneficial in terms of social welfare.


Asunto(s)
Vino , Vino/análisis , Humanos , Femenino , Masculino , Factores Sexuales , Ocupaciones , Gusto , Juicio , Habilitación Profesional
14.
Rev Med Interne ; 2024 Jul 09.
Artículo en Francés | MEDLINE | ID: mdl-38987065

RESUMEN

The Script Concordance Tests (SCTs) are an examination modality introduced by decree in the French National Ranking Exam for medical students in 2024. Their objective is to evaluate clinical reasoning in situations of uncertainty. In practice, SCTs assess the impact of new information on the probability of a hypothesis formulated a priori based on an authentic clinical scenario. This approach resembles probabilistic (or Bayesian) reasoning. Due to the uncertainty associated with the explored clinical situation, SCTs do not compare the student's response to an expected one in a theoretical knowledge reference. Instead, the distribution of responses from a panel of experienced physicians is used to establish the question's scoring scale. Literature data suggest that physicians, even experienced ones, like most humans, often exhibit biased intuitive probabilistic reasoning. These biases raise questions about the relevance of using expert panel responses as scoring scales for SCTs.

15.
Soc Hist Med ; 37(1): 69-92, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38947274

RESUMEN

During the 1970s, the National Childbirth Trust (NCT) began to provide information and support to women experiencing postnatal mental illness, building on its promotion of natural childbirth and emphasis on the emotional wellbeing of women around birth, which had occupied the organisation since its establishment in 1956. This article argues that, alongside emotional, social and medical factors, the NCT attributed postnatal depression to the shift to hospital deliveries, involving high levels of intervention and frustrating women's choice and agency. While sharing ambitions to improve care in childbirth and giving women a voice in describing their experiences, it is suggested that the NCT's relationship with the feminist health movement remained ambiguous. The article also explores the NCT's collaboration with a variety of experts and advisors, some of whom emphasised the risk of postnatal depression to the bonding process and infant's development, potentially exacerbating the mental distress of new mothers.

16.
Nurs Open ; 11(7): e2229, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38957104

RESUMEN

AIM: To determine the consensus and importance of care practices related to the management of peripheral venous catheter (PVC)-related phlebitis in hospitalized patients through the views of experts from different disciplines. BACKGROUND: PVCs are commonly used in hospitals but are associated with complications such as phlebitis. Their management differs widely, and studies are heterogeneous. DESIGN: Delphi method. METHODS: Four stages: problem area (with Web of Science bibliometric review in July 2022), panel members, two Delphi rounds and closing criteria. In the Delphi survey, experts answered an online questionnaire based on assessment, treatment and follow-up dimensions (September 2022-February 2023). Statistical analyses were conducted of frequencies, percentages, measures of central tendency and levels of dispersion (QD). A space for comments was created, and a thematic analysis conducted of them. RESULTS: Eighteen experts (nurses, doctors and pharmacists) participated in the Delphi rounds. Forty-five activities were identified: 19 in assessment, 15 in treatment and 11 in follow-up. A high consensus level (QD ≤ 0.6) was found in five activities (11.12%), moderate level (0.6 < QD < 1.0) in 19 (42.22%) and low level (QD > 1.0) in 21 (46.66%). Seven themes were determined (patient perspective, lack of consensus, low evidence-based practices, stage-based treatments, prevention activities, high variability in practice and specialist teams and interdisciplinary work). CONCLUSION: The importance of systematic assessment scales is highlighted together with consensus on signs and symptoms (pain, redness, inflammation, palpable cord and induration). Treatment according to severity and daily visual recording and monitoring are emphasized along with the need for patient participation and healthcare literacy. A high level of consensus was obtained in 11% of the activities, showing the large variability of criteria and interventions for phlebitis management. Highlighted needs include working in a team, the use of specialist teams and promoting evidence- and prevention-based activities. RELEVANCE TO CLINICAL PRACTICE: Clinical variability is noted and, therefore, the importance of consensus on standardized care for PVC phlebitis and evidence-based practice. REPORTING METHOD: Delphi studies (CREDES). PATIENT OR PUBLIC CONTRIBUTION: Experts contribution.


Asunto(s)
Cateterismo Periférico , Técnica Delphi , Flebitis , Humanos , Flebitis/etiología , Cateterismo Periférico/efectos adversos , Encuestas y Cuestionarios , Consenso , Femenino , Masculino , Adulto , Persona de Mediana Edad , Internacionalidad
17.
Front Aging Neurosci ; 16: 1328301, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38894849

RESUMEN

Introduction: Mild cognitive impairment (MCI) is an important stage in Alzheimer's disease (AD) research, focusing on early pathogenic factors and mechanisms. Examining MCI patient subtypes and identifying their cognitive and neuropathological patterns as the disease progresses can enhance our understanding of the heterogeneous disease progression in the early stages of AD. However, few studies have thoroughly analyzed the subtypes of MCI, such as the cortical atrophy, and disease development characteristics of each subtype. Methods: In this study, 396 individuals with MCI, 228 cognitive normal (CN) participants, and 192 AD patients were selected from ADNI database, and a semi-supervised mixture expert algorithm (MOE) with multiple classification boundaries was constructed to define AD subtypes. Moreover, the subtypes of MCI were obtained by using the multivariate linear boundary mapping of support vector machine (SVM). Then, the gray matter atrophy regions and severity of each MCI subtype were analyzed and the features of each subtype in demography, pathology, cognition, and disease progression were explored combining the longitudinal data collected for 2 years and analyzed important factors that cause conversion of MCI were analyzed. Results: Three MCI subtypes were defined by MOE algorithm, and the three subtypes exhibited their own features in cortical atrophy. Nearly one-third of patients diagnosed with MCI have almost no significant difference in cerebral cortex from the normal aging population, and their conversion rate to AD are the lowest. The subtype characterized by severe atrophy in temporal lobe and frontal lobe have a faster decline rate in many cognitive manifestations than the subtype featured with diffuse atrophy in the whole cortex. APOE ε4 is an important factor that cause the conversion of MCI to AD. Conclusion: It was proved through the data-driven method that MCI collected by ADNI baseline presented different subtype features. The characteristics and disease development trajectories among subtypes can help to improve the prediction of clinical progress in the future and also provide necessary clues to solve the classification accuracy of MCI.

18.
Public Underst Sci ; : 9636625241253968, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38863414

RESUMEN

The coronavirus pandemic increased the role played by scientific advisers in counselling governments and citizens on issues around public health. This raises questions about how citizens evaluate scientists, and in particular the grounds on which they trust them. Previous studies have identified various factors associated with trust in scientists, although few have systematically explored a range of judgements and their relative effects. This study takes advantage of scientific advisers' heightened public profile during the pandemic to explore how people's trust in scientists is shaped by perceptions of their features and traits, along with evaluations of their behaviour and role within the decision-making process. The study also considers people's trust in politicians, thereby enabling us to identify whether trust in scientists reflects similar or distinctive considerations to trust in partisan actors. Data are derived from specially designed conjoint experiments and surveys of nationally representative samples in Britain and the United States.

19.
Can Assoc Radiol J ; : 8465371241257910, 2024 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-38869196

RESUMEN

Introduction: Incidental pulmonary nodules (IPN) are common radiologic findings, yet management of IPNs is inconsistent across Canada. This study aims to improve IPN management based on multidisciplinary expert consensus and provides recommendations to overcome patient and system-level barriers. Methods: A modified Delphi consensus technique was conducted. Multidisciplinary experts with extensive experience in lung nodule management in Canada were recruited to participate in the panel. A survey was administered in 3 rounds, using a 5-point Likert scale to determine the level of agreement (1 = extremely agree, 5 = extremely disagree). Results: Eleven experts agreed to participate in the panel; 10 completed all 3 rounds. Consensus was achieved for 183/217 (84.3%) statements. Panellists agreed that radiology reports should include a standardized summary of findings and follow-up recommendations for all nodule sizes (ie, <6, 6-8, and >8 mm). There was strong consensus regarding the importance of an automated system for patient follow-up and that leadership support for organizational change at the administrative level is of utmost importance in improving IPN management. There was no consensus on the need for standardized national referral pathways, development of new guidelines, or establishing a uniform picture archiving and communication system. Conclusion: Canadian IPN experts agree that improved IPN management should include standardized radiology reporting of IPNs, standardized and automated follow-up of patients with IPNs, guideline adherence and implementation, and leadership support for organizational change. Future research should focus on the implementation and long-term effectiveness of these recommendations in clinical practice.

20.
Eval Program Plann ; 105: 102449, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38830317

RESUMEN

In the intensely developing information society, the education of pre-service teachers presents an organisational, methodological, and conceptual challenge. Recent years have necessitated reflection on the content and modalities of the formation of digital competence in pre-service teachers. This article - considers which components the digital competences of the new generations of teachers should contain and how this area can be effectively developed within academic education. The article is the result of interviews conducted with 35 experts (recognized scholars in the field of media pedagogy) from North and South America, Africa, Australia and Oceania, Asia, and Europe. Qualitative interviews using the Delphi methodology were conducted between June and September 2022. Using grounded theory principles, it was noted that there is a need to modify pre-service teachers' curricula in the following areas: creating, retrieving and managing digital content; integrating ICT into subject content; developing soft skills; enhancing interactivity in the classroom; social aspects of ICT; distance learning; new socio-technical processes; advanced digital competencies; predictive learning; analysing the impact of ICT on human life; data protection; e-risks; low digital competencies; understanding media messaging; and supporting people with disabilities.


Asunto(s)
Curriculum , Técnica Delphi , Humanos , Educación a Distancia/organización & administración , Competencia Profesional/normas , Tecnología Digital , Teoría Fundamentada , Entrevistas como Asunto , Investigación Cualitativa
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