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Systems Thinking

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https://www.readbyqxmd.com/read/29778583/a-novel-view-on-the-pathogenesis-of-complications-after-intravesical-bcg-for-bladder-cancer
#1
Manu P Bilsen, Krista E van Meijgaarden, Hanna K de Jong, Simone A Joosten, Corine Prins, Lucia J M Kroft, Jacqueline T Jonker, Stijn Crobach, Rob C Pelger, Tom H M Ottenhoff, Sandra M Arend
Intravesical Bacillus Calmette-Guérin (BCG) is widely used for high-risk, non-muscle-invasive bladder cancer. We describe four cases which illustrate the spectrum of BCG-induced complications, varying from granulomatous prostatitis to sepsis. Considerable debate exists whether inflammation or infection is the predominant mechanism in the pathogenesis of BCG-disease. In two patients with systemic illness symptoms resolved first after adding prednisone, indicating a principle role for inflammation in systemic disease...
May 17, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29778089/implications-for-faculty-development-for-emerging-clinical-teachers-at-distributed-sites-a-qualitative-interpretivist-study
#2
Julia Blitz, Marietjie De Villiers, Susan Van Schalkwyk
INTRODUCTION: Medical faculties have the responsibility to graduate competent health professionals and a consequent obligation to assure the quality and effectiveness of their students' clinical teaching. Many institutions are responding to rural workforce needs by extending clinical training from the traditional academic teaching hospital to include rural and remote sites distributed away from the central training institution. It is incumbent upon medical schools to consider how this might impact on the faculty development of these clinicians as teachers...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29776734/taking-into-consideration-explanations-of-perception-action-interactions-that-may-be-less-dramatic-but-more-reflective-of-what-happens-in-the-real-world
#3
Robert W Proctor, Aiping Xiong
Bruce Bridgeman and colleagues reported the first experiments providing evidence of two functionally distinct visual-processing systems. We summarize that work and subsequent research that resulted in modifications of this view. Then, we describe studies of stimulus-response correspondence effects that provide evidence for distinct representations of responses. More recently, Bridgeman and colleagues examined whether "action affects perception", concluding that the phenomena can be more accurately construed as "information affects memory"...
May 15, 2018: Consciousness and Cognition
https://www.readbyqxmd.com/read/29775734/defining-the-osteoarthritis-patient-back-to-the-future
#4
REVIEW
Geoffrey P Dobson, Hayley L Letson, Andrea Grant, Peter McEwen, Kaushik Hazratwala, Matthew Wilkinson, Jodie L Morris
The history of osteoarthritis (OA) is important because it can help broaden our perspective on past and present controversies. The naming of OA, beginning with Heberden's nodes, is itself a fascinating story. According to Albert Hoffa, R. Llewellyn Jones and Archibald Edward Garrod, the name OA was introduced in the mid-19th century by surgeon Richard von Volkmann who distinguished it from rheumatoid arthritis and gout. Others preferred the terms 'chronical rheumatism', 'senile arthritis', 'hypertrophic arthritis' or 'arthritis deformans'...
May 15, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29773322/polarization-of-the-vaccination-debate-on-facebook
#5
Ana Lucía Schmidt, Fabiana Zollo, Antonio Scala, Cornelia Betsch, Walter Quattrociocchi
BACKGROUND: Vaccine hesitancy has been recognized as a major global health threat. Having access to any type of information in social media has been suggested as a potential influence on the growth of anti-vaccination groups. Recent studies w.r.t. other topics than vaccination show that access to a wide amount of content through the Internet without intermediaries resolved into major segregation of the users in polarized groups. Users select information adhering to theirs system of beliefs and tend to ignore dissenting information...
May 14, 2018: Vaccine
https://www.readbyqxmd.com/read/29772950/systems-thinking-for-assistive-technology-a-commentary-on-the-great-summit
#6
Malcolm MacLachlan, Marcia Scherer
The area of assistive technology has a long history of technological ingenuity and innovation. In order to ensure that the benefits of assistive technology are equitably distributed across the population and life course, it is necessary to adopt a systemic approach to the area. We describe examples of systems thinking and non-systems thinking across 10 Ps. These Ps are People (or users, as the primary beneficiaries of assistive technology), Policy, Products, Personnel, Provision (as key strategic drivers at systems level); and Procurement, Place, Pace, Promotion and Partnership (as key situational factors for systems)...
May 17, 2018: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/29767821/formative-research-on-knowledge-and-preferences-for-stool-based-tests-compared-to-colonoscopy-what-patients-and-providers-think
#7
John S Luque, Kristin Wallace, Bridgette F Blankenship, Lydia G Roos, Frank G Berger, Nancy R LaPelle, Cathy L Melvin
The rates of colorectal cancer (CRC) screening in the U.S. remain below national targets, so many people at risk are not being screened. The objective of this qualitative research project was to assess patient and provider knowledge and preferences about CRC screening modalities and specifically the use of the fecal immunochemical test (FIT) as a first line screening choice. Nine focus groups were conducted with a medically underserved patient population and qualitative interviews were administered to their medical providers...
May 16, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29764540/-2018-national-consensus-on-cardiopulmonary-resuscitation-training-in-china
#8
Lixiang Wang, Qingyi Meng, Tao Yu
To promote the technical training and scientific popularization of cardiopulmonary resuscitation (CPR) in China, the Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association combined with the Science Popularization Branch of the Chinese Medical Association wrote "2018 National consensus on cardiopulmonary resuscitation training in China". The formation was based on the general outline about "2016 National consensus on cardiopulmonary resuscitation in China", and to implement the important strategies included the "three pre" policy, prevention, precognition, and pre-warning, before the cardiac arrest (CA); the "three modernization" methods, standardized, diversified and individualized, during the CA; and the "three life" strategies, the rebirth, the extra and the extended, after the CA; and also combined with the concrete National conditions and clinical practice of China area...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29761710/who-s-the-boss-determining-the-control-pathways-of-cardiovascular-and-cellular-immune-responses-to-acute-stress
#9
Kate M Edwards, Nathan B Morris
Acute stress responses are known to include increases in heart rate and blood pressure, as well as increases in the number of circulating immune cells, all of which are governed by the autonomic nervous system. This laboratory practical measures cardiovascular and circulating immune cell responses to a passive (cold pressor) and active (mental arithmetic) acute stress task in student participants. The results allow them to examine the different patterns of autonomic response they elicit (approximated by heart rate and blood pressure responses), and knowledge of these responses can then be used to infer the governing autonomic aspect of the increases in circulating immune cells from the results...
June 1, 2018: Advances in Physiology Education
https://www.readbyqxmd.com/read/29760032/white-privilege-in-a-white-coat-how-racism-shaped-my-medical-education
#10
Max J Romano
In this essay, I reflect on some of the ways racial privilege influenced my experience as a white physician in training. While white Americans often think of "racism" as a social construct primarily affecting people of color, "racism" is a system of both racial disadvantage as well as reciprocal racial advantage. Medical professionals are increasingly aware of how social determinants of health lead to important health disparities, however white physicians seldom ask how their own racial privilege reinforces a white supremacist culture and what effects this may have on our patients' health...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29758089/current-commercial-techniques-for-mri-guided-attenuation-correction-are-insufficient-and-will-limit-the-wider-acceptance-of-pet-mri-technology-in-the-clinic
#11
Ciprian Catana, Harald H Quick, Habib Zaidi
Whole-body hybrid PET/MR imaging has been used since its introduction in 2010 in clinical and research settings for diagnosis, staging and restaging, assessment of response to treatment and radiation therapy planning. However, the quantitative potential of PET/MRI is challenged by the lack of reliable and accurate MRI-guided attenuation correction (MRAC) owing to the lack of direct relationship between MRI signal, reflecting proton density and relaxation time properties, and electron density, which is linked to photon attenuation properties of biological tissues...
May 14, 2018: Medical Physics
https://www.readbyqxmd.com/read/29756531/the-ethics-of-end-of-trial-obligations-in-a-pediatric-malaria-vaccine-trial-the-perspectives-of-stakeholders-from-ghana-and-tanzania
#12
Claire Leonie Ward, David Shaw, Evelyn Anane-Sarpong, Osman Sankoh, Marcel Tanner, Bernice Elger
This study explores stakeholder experiences and perspectives on end-of-trial obligations at the close of a phase II/III Pediatric Malaria Vaccine Trial (PMVT) [GSK/PATH-MVI RTS, S) (NCT00866619]. We conducted 52 key informant interviews with major stakeholders of an international multicentre PMVT in Ghana and Tanzania. The responses fell into four main themes: (a) Communicating End-of-Trial, (b) Maintaining Health Care Services, (c) Dissemination of Results, and (d) Post-Trial Access. Interviewee responses shared important practical experiences and insights that complement current thinking in the literature on research ethics guidance: (a) accompany end-of-trial communication with information on personal and family health care responsibilities, (b) establish public health indicators to measure the impact of research on a health care system,...
May 1, 2018: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/29754403/-one-size-does-not-fit-all-perspectives-on-diversity-in-community-aged-care
#13
Claudia Meyer, Arti Appannah, Sally McMillan, Colette Browning, Rajna Ogrin
OBJECTIVES: Typically, older people are viewed via a single health condition, yet health outcomes are likely impacted by the intersection of many individual characteristics. Promoting inclusive health care is underpinned by reducing bias, respectful communication and supporting individual needs and preferences. This study explores perspectives of community aged care workers on diversity training and implementing training into practice. METHODS: Ninety community aged care workers were telephone-interviewed three months after a one-day diversity training workshop...
May 13, 2018: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29754115/delusional-misidentifications-in-a-procrustean-bed
#14
EDITORIAL
G N Christodoulou, M Margariti, N Christodoulou
The Delusional Misidentification Syndromes (DMSs) are characterized by defective integration of the normally The Delusional Misidentification Syndromes (DMSs) are characterized by defective integration of the normally fused functions of perception and recognition. The classical sub-types are: the syndromes of Capgras, Fregoli,Intermetamorphosis (mentioned in 3) and Subjective doubles. These syndromes occur in a clear sensorium and shouldbe differentiated from the banal transient misidentifications occurring in confusional states and in mania and from thenon-delusional misidentifications (e...
January 2018: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/29754020/the-relationship-between-schizotypal-traits-and-hoarding-symptoms-an-examination-of-symptom-specificity-and-the-role-of-perceived-cognitive-failures
#15
Marc J Weintraub, Caitlin A Brown, Kiara R Timpano
BACKGROUND: Hoarding disorder presents significant individual and interpersonal consequences. Because hoarding has only recently been added to the DSM, relatively little is known about associated comorbidity patterns. Several researchers have postulated a relationship between hoarding and schizotypy. To date, however, no investigations have considered which specific types of schizotypal traits relate to hoarding symptoms. METHODS: We examined the association between hoarding and schizotypal symptoms using multivariate analyses in two samples-a sample of 120 young adults and a community sample of 291 individuals recruited from Mechanical Turk's online crowdsourcing system...
May 4, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29751086/decanalizing-thinking-on-genetic-canalization
#16
REVIEW
Kerry Geiler-Samerotte, Federica M O Sartori, Mark L Siegal
The concept of genetic canalization has had an abiding influence on views of complex-trait evolution. A genetically canalized system has evolved to become less sensitive to the effects of mutation. When a gene product that supports canalization is compromised, the phenotypic impacts of a mutation should be more pronounced. This expected increase in mutational effects not only has important consequences for evolution, but has also motivated strategies to treat disease. However, recent studies demonstrate that, when putative agents of genetic canalization are impaired, systems do not behave as expected...
May 8, 2018: Seminars in Cell & Developmental Biology
https://www.readbyqxmd.com/read/29750863/replacing-recycling-rates-with-life-cycle-metrics-as-government-materials-management-targets
#17
Malak Anshassi, Steven Laux, Timothy G Townsend
In Florida, the passing of the Energy, Climate Change, and Economic Security Act of 2008 established a statewide mass-based municipal solid waste recycling rate goal of 75% by 2020. In this study, we describe an alternative approach to tracking performance of materials management systems that incorporates life-cycle thinking. Using both greenhouse gas (GHG) emissions and energy use as life-cycle indicators, two different materials management baselines were developed based on a hypothetical 75% recycling rate in Florida in 2008...
May 11, 2018: Environmental Science & Technology
https://www.readbyqxmd.com/read/29745608/-design-of-magneto-acoustic-electrical-detection-system-and-verification-of-its-linear-sweep-theory
#18
Ming Dai, Siping Chen, Fangfang Li, Mian Chen, Haoming Lin, Xin Chen
Clinical studies had demonstrated that early diagnosis of lesion could significantly reduce the risk of cancer. Magneto-acoustic-electrical tomography (MAET) is expected to become a new detection method due to its advantages of high resolution and high contrast. Based on thinking of modular design, a low-cost, digital magneto-acoustic conductivity detection system was designed and implemented in this study. The theory of MAET using chirp continuous wave excitation was introduced. The results of homogeneous phantom experiment with 0...
February 1, 2018: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
https://www.readbyqxmd.com/read/29744286/adolescent-pregnancy-and-challenges-in-kenyan-context-perspectives-from-multiple-community-stakeholders
#19
Manasi Kumar, Keng-Yen Huang, Caleb Othieno, Dalton Wamalwa, Beatrice Madeghe, Judith Osok, Simon Njuguna Kahonge, Joyce Nato, Mary McKernon McKay
Objective: The key objective of this paper is to provide a phenomenological account of the mental health challenges and experiences of adolescent new mothers. We explore the role of social support and the absence of empathy plays in depression among pregnant adolescents. The project also collected data on the adolescents' caregiving environment which includes the adolescents' mothers, their partners, the community, and health care workers, as well as feedback from staff nurses at the maternal and child health centers...
March 2018: Global Social Welfare: Research, Policy & Practice
https://www.readbyqxmd.com/read/29743217/strategies-for-addressing-the-challenges-of-patient-centered-medical-home-implementation-lessons-from-oregon
#20
Sherril Gelmon, Nicole Bouranis, Billie Sandberg, Shauna Petchel
BACKGROUND: Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). METHODS: Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics...
May 2018: Journal of the American Board of Family Medicine: JABFM
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