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https://www.readbyqxmd.com/read/28812307/the-development-of-perceptual-averaging-learning-what-to-do-not-just-how-to-do-it
#1
Pete R Jones, Tessa M Dekker
The mature visual system condenses complex scenes into simple summary statistics (e.g., average size, location, orientation, etc.). However, children, often perform poorly on perceptual averaging tasks. Children's difficulties are typically thought to represent the suboptimal implementation of an adult-like strategy. This paper examines another possibility: that children actually make decisions in a qualitatively different way to adults (optimal implementation of a non-ideal strategy). Ninety children (6-7, 8-9, 10-11 years) and 30 adults were asked to locate the middle of randomly generated dot-clouds...
August 15, 2017: Developmental Science
https://www.readbyqxmd.com/read/28805170/perspectives-of-patients-close-relatives-nurses-and-physicians-on-end-of-life-medication-management
#2
Marianne K Dees, Eric C T Geijteman, Wim J M Dekkers, Bregje A A Huisman, Roberto S G M Perez, Lia van Zuylen, Agnes van der Heide, Evert van Leeuwen
OBJECTIVE: Our aim was to gain insight into the perspectives of patients, close relatives, nurses, and physicians on medication management for patients with a life expectancy of less than 3 months. METHOD: We conducted an empirical multicenter study with a qualitative approach, including in-depth interviews with patients, relatives, nurses, specialists, and general practitioners (GPs). We used the constant comparative method and ATLAS.ti (v. 7.1) software for our analysis...
August 14, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28795061/a-multi-agent-based-approach-for-prehospital-emergency-management
#3
Reza Safdari, Jaleh Shoshtarian Malak, Niloofar Mohammadzadeh, Azimeh Danesh Shahraki
OBJECTIVE: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. METHODS: Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28792502/harmonization-of-community-health-worker-programs-for-hiv-a-four-country-qualitative-study-in-southern-africa
#4
Jan-Walter De Neve, Henri Garrison-Desany, Kathryn G Andrews, Nour Sharara, Chantelle Boudreaux, Roopan Gill, Pascal Geldsetzer, Maria Vaikath, Till Bärnighausen, Thomas J Bossert
BACKGROUND: Community health worker (CHW) programs are believed to be poorly coordinated, poorly integrated into national health systems, and lacking long-term support. Duplication of services, fragmentation, and resource limitations may have impeded the potential impact of CHWs for achieving HIV goals. This study assesses mediators of a more harmonized approach to implementing large-scale CHW programs for HIV in the context of complex health systems and multiple donors. METHODS AND FINDINGS: We undertook four country case studies in Lesotho, Mozambique, South Africa, and Swaziland between August 2015 and May 2016...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28790900/maladaptive-decision-making-in-adults-with-a-history-of-adolescent-alcohol-use-in-a-preclinical-model-is-attributable-to-the-compromised-assignment-of-incentive-value-during-stimulus-reward-learning
#5
Lauren C Kruse, Abigail G Schindler, Rapheal G Williams, Sophia J Weber, Jeremy J Clark
According to recent WHO reports, alcohol remains the number one substance used and abused by adolescents, despite public health efforts to curb its use. Adolescence is a critical period of biological maturation where brain development, particularly the mesocorticolimbic dopamine system, undergoes substantial remodeling. These circuits are implicated in complex decision making, incentive learning and reinforcement during substance use and abuse. An appealing theoretical approach has been to suggest that alcohol alters the normal development of these processes to promote deficits in reinforcement learning and decision making, which together make individuals vulnerable to developing substance use disorders in adulthood...
2017: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/28775192/seeking-ambulance-treatment-for-primary-care-problems-a-qualitative-systematic-review-of-patient-carer-and-professional-perspectives
#6
Matthew J Booker, Sarah Purdy, Alison R G Shaw
OBJECTIVES: To understand the reasons behind, and experience of, seeking and receiving emergency ambulance treatment for a 'primary care sensitive' condition. DESIGN: A comprehensive, qualitative systematic review. Medline, Embase, PsychInfo, Cumulative Index of Nursing and Allied Health, Health Management Information Systems, Healthcare Management Information Consortium, OpenSigle, EThOS and Digital Archive of Research Theses databases were systematically searched for studies exploring patient, carer or healthcare professional interactions with ambulance services for 'primary care sensitive' problems...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28772103/architecture-function-and-assembly-of-the-mouse-visual-system
#7
Tania A Seabrook, Timothy J Burbridge, Michael C Crair, Andrew D Huberman
Vision is the sense humans rely on most to navigate the world, make decisions, and perform complex tasks. Understanding how humans see thus represents one of the most fundamental and important goals of neuroscience. The use of the mouse as a model for parsing how vision works at a fundamental level started approximately a decade ago, ushered in by the mouse's convenient size, relatively low cost, and, above all, amenability to genetic perturbations. In the course of that effort, a large cadre of new and powerful tools for in vivo labeling, monitoring, and manipulation of neurons were applied to this species...
July 25, 2017: Annual Review of Neuroscience
https://www.readbyqxmd.com/read/28764704/objective-impairments-of-gait-and-balance-in-adults-living-with-hiv-1-infection-a-systematic-review-and-meta-analysis-of-observational-studies
#8
Karina Berner, Linzette Morris, Jochen Baumeister, Quinette Louw
BACKGROUND: Gait and balance deficits are reported in adults with HIV infection and are associated with reduced quality of life. Current research suggests an increased fall-incidence in this population, with fall rates among middle-aged adults with HIV approximating that in seronegative elderly populations. Gait and postural balance rely on a complex interaction of the motor system, sensory control, and cognitive function. However, due to disease progression and complications related to ongoing inflammation, these systems may be compromised in people with HIV...
August 1, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28762616/policy-choices-in-dementia-care-an-exploratory-analysis-of-the-alberta-continuing-care-system-accs-using-system-dynamics
#9
Monica Cepoiu-Martin, Diane P Bischak
BACKGROUND: The increase in the incidence of dementia in the aging population and the decrease in the availability of informal caregivers put pressure on continuing care systems to care for a growing number of people with disabilities. Policy changes in the continuing care system need to address this shift in the population structure. One of the most effective tools for assessing policies in complex systems is system dynamics. Nevertheless, this method is underused in continuing care capacity planning...
August 1, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28756780/an-integrated-perspective-on-the-assessment-of-technologies-integrate-hta
#10
Philip Wahlster, Louise Brereton, Jacob Burns, Björn Hofmann, Kati Mozygemba, Wija Oortwijn, Lisa Pfadenhauer, Stephanie Polus, Eva Rehfuess, Imke Schilling, Gert Jan van der Wilt, Ansgar Gerhardus
OBJECTIVES: Current health technology assessment (HTA) is not well equipped to assess complex technologies as insufficient attention is being paid to the diversity in patient characteristics and preferences, context, and implementation. Strategies to integrate these and several other aspects, such as ethical considerations, in a comprehensive assessment are missing. The aim of the European research project INTEGRATE-HTA was to develop a model for an integrated HTA of complex technologies...
July 31, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28754650/modeling-patient-treatment-with-medical-records-an-abstraction-hierarchy-to-understand-user-competencies-and-needs
#11
Justin D St-Maurice, Catherine M Burns
BACKGROUND: Health care is a complex sociotechnical system. Patient treatment is evolving and needs to incorporate the use of technology and new patient-centered treatment paradigms. Cognitive work analysis (CWA) is an effective framework for understanding complex systems, and work domain analysis (WDA) is useful for understanding complex ecologies. Although previous applications of CWA have described patient treatment, due to their scope of work patients were previously characterized as biomedical machines, rather than patient actors involved in their own care...
July 28, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28750913/identification-of-key-factors-in-consumers-adoption-behavior-of-intelligent-medical-terminals-based-on-a-hybrid-modified-madm-model-for-product-improvement
#12
Yupeng Liu, Yifei Chen, Gwo-Hshiung Tzeng
BACKGROUND: As a new application technology of the Internet of Things (IoT), intelligent medical treatment has attracted the attention of both nations and industries through its promotion of medical informatisation, modernisation, and intelligentisation. Faced with a wide variety of intelligent medical terminals, consumers may be affected by various factors when making purchase decisions. PURPOSE: To examine and evaluate the key influential factors (and their interrelationships) of consumer adoption behavior for improving and promoting intelligent medical terminals toward achieving set aspiration level in each dimension and criterion...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28747313/long-term-complications-reoperations-and-survival-following-cardioverter-defibrillator-implant
#13
Nathaniel Mark Hawkins, Maja Grubisic, Jason G Andrade, Flora Huang, Lillian Ding, Min Gao, Jamil Bashir
OBJECTIVE: Implantable cardioverter-defibrillators (ICDs) reduce risk of death in select populations, but are also associated with harms. We aimed to characterise long-term complications and reoperation rate. METHODS: We assessed the rate, cumulative incidence and predictors of long-term reoperation and survival using a prospective, multicentre registry serving British Columbia in Canada, a universal single payer healthcare system with 4.5 million residents. 3410 patients (mean 63...
July 26, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28744848/systems-and-precision-medicine-approaches-to-diabetes-heterogeneity-a-big-data-perspective
#14
Enrico Capobianco
Big Data, and in particular Electronic Health Records, provide the medical community with a great opportunity to analyze multiple pathological conditions at an unprecedented depth for many complex diseases, including diabetes. How can we infer on diabetes from large heterogeneous datasets? A possible solution is provided by invoking next-generation computational methods and data analytics tools within systems medicine approaches. By deciphering the multi-faceted complexity of biological systems, the potential of emerging diagnostic tools and therapeutic functions can be ultimately revealed...
December 2017: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/28740622/drug-pricing-and-reimbursement-information-management-processes-and-decision-making-in-the-global-economy
#15
Dimitrios Tsourougiannis
Background: Cost-containment initiatives are re-shaping the pharmaceutical business environment and affecting market access as well as pricing and reimbursement decisions. Effective price management procedures are too complex to accomplish manually. Prior to February 2013, price management within Astellas Pharma Europe Ltd was done manually using an Excel database. The system was labour intensive, slow to update, and prone to error. An innovative web-based pricing information management system was developed to address the shortcomings of the previous system...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28739880/neoantigen-expression-in-steady-state-langerhans-cells-induces-ctl-tolerance
#16
Helen Strandt, Douglas Florindo Pinheiro, Daniel H Kaplan, Dagmar Wirth, Iris Karina Gratz, Peter Hammerl, Josef Thalhamer, Angelika Stoecklinger
The skin hosts a variety of dendritic cells (DCs), which act as professional APC to control cutaneous immunity. Langerhans cells (LCs) are the only DC subset in the healthy epidermis. However, due to the complexity of the skin DC network, their relative contribution to either immune activation or immune tolerance is still not entirely understood. To specifically study the function of LCs in vivo, without altering the DC subset composition in the skin, we have generated transgenic mouse models for tamoxifen-inducible de novo expression of Ags in LCs but no other langerin(+) DCs...
July 24, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28734786/clinical-usefulness-of-tools-to-support-decision-making-for-palliative-treatment-of%C3%A2-metastatic-colorectal-cancer-a-systematic-review
#17
Ellen G Engelhardt, Dóra Révész, Hans J Tamminga, Cornelis J A Punt, Mirjam Koopman, Bregje D Onwuteaka-Philipsen, Ewout W Steyerberg, Ilse P Jansma, Henrica C W De Vet, Veerle M H Coupé
BACKGROUND: Decision-making regarding palliative treatment for patients with metastatic colorectal cancer (mCRC) is complex and comprises numerous decisions. Decision-making should be guided by the premise of maintaining and/or improving patients' quality of life, by patient preference, and by the trade-off between treatment benefits and harm. Decision support systems (DSSs) for clinicians (eg, nomograms) can assist in this process. The present systematic review aimed to provide a comprehensive overview of the available DSSs for incurable mCRC and to assess their clinical usefulness...
June 24, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28733440/dose-transition-pathways-the-missing-link-between-complex-dose-finding-designs-and-simple-decision-making
#18
Christina Yap, Lucinda J Billingham, Ying Kuen Cheung, Charlie Craddock, John O'Quigley
The ever increasing pace of development of novel therapies mandates efficient methodologies for assessment of their tolerability and activity. Evidence increasingly support the merits of model-based dose-finding designs in identifying the recommended Phase II dose compared to conventional rule-based designs such as the 3+3 but despite this, their use remains limited. Here, we propose a useful tool, Dose Transition Pathways (DTP), which helps overcome several commonly-faced practical and methodological challenges in the implementation of model-based designs...
July 21, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28729232/development-feasibility-and-small-scale-implementation-of-a-web-based-prognostic-tool-surveillance-epidemiology-and-end-results-cancer-survival-calculator
#19
Michelle Henton, Bridget Gaglio, Laurie Cynkin, Eric J Feuer, Borsika A Rabin
BACKGROUND: Population datasets and the Internet are playing an ever-growing role in the way cancer information is made available to providers, patients, and their caregivers. The Surveillance, Epidemiology, and End Results Cancer Survival Calculator (SEER*CSC) is a Web-based cancer prognostic tool that uses SEER data, a large population dataset, to provide physicians with highly valid, evidence-based prognostic estimates for increasing shared decision-making and improving patient-provider communication of complex health information...
July 20, 2017: JMIR Cancer
https://www.readbyqxmd.com/read/28727833/refugee-and-migrant-women-s-engagement-with-sexual-and-reproductive-health-care-in-australia-a-socio-ecological-analysis-of-health-care-professional-perspectives
#20
Zelalem B Mengesha, Janette Perz, Tinashe Dune, Jane Ussher
BACKGROUND: In Australia only 2.2% of published health research has focused on multi-cultural health despite the increase of culturally and linguistically diverse populations. Research on the perceptions and experiences of health care professionals (HCPs) in engaging with refugee and migrant women is also lacking. Given the integral role of HCPs in providing sexual and reproductive health (SRH) care for these populations, an understanding of the challenges they experience is required...
2017: PloS One
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