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JMIR Human Factors Feb 2022Boundary objects can add value for innovative design and implementation research in health care through their organizational focus and the dynamic structure between... (Review)
Review
BACKGROUND
Boundary objects can add value for innovative design and implementation research in health care through their organizational focus and the dynamic structure between ill-structured and tailored use. However, when innovation is approached as a boundary object, more attention will need to be paid to the preimplementation phase. Research and design thinking pay attention to the preimplementation stage but do not have a social or organizational focus per se. The integration of boundary objects in design methodologies can provide a more social and organizational focus in innovative design projects by mapping out the mechanisms that occur at boundaries during design. Four dialogical learning mechanisms that can be triggered at boundaries have been described in the literature: identification, coordination, reflection, and transformation. These mechanisms seem suitable for integration in innovative design research on health.
OBJECTIVE
Focusing on innovation in health, this study aims to find out whether the different learning mechanisms can be linked to studies on health innovation that mention boundary objects as a concept and assess whether the related mechanisms provide insight into the stage of the design and implementation or change process.
METHODS
The following 6 databases were searched for relevant abstracts: PubMed, Scopus, Education Resources Information Center, PsycINFO, Information Science and Technology Abstracts, and Embase. These databases cover a wide range of published studies in the field of health.
RESULTS
Our initial search yielded 3102 records; after removing the duplicates, 2186 (70.47%) records were screened on the title and abstract, and 25 (0.81%) papers were included; of the 13 papers where we identified 1 mechanism, 5 (38%) described an innovation or innovative project, and of the 12 papers where we identified more mechanisms, 9 (75%) described the development or implementation of an innovation. The reflective mechanism was not identified solely but was present in papers describing a more successful development or implementation project of innovation. In these papers, the predetermined goals were achieved, and the process of integration was relatively smoother.
CONCLUSIONS
The concept of boundary objects has found its way into health care. Although the idea of a boundary object was introduced to describe how specific artifacts can fulfill a bridging function between different sociocultural sites and thus have a social focus, the focus in the included papers was often on the boundary object itself rather than the social effect. The reflection and transformation mechanisms were underrepresented in the included studies but based on the findings in this review, pursuing to trigger the reflective mechanism in design, development, and implementation projects can lead to a more fluid and smooth integration of innovation into practice.
PubMed: 35113023
DOI: 10.2196/31167 -
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing... Aug 2023The cell nuclear damage is mainly caused by the radiation and various carcinogenic compounds, the essence of the damage is molecular adhesion fracture and chemical... (Review)
Review
The cell nuclear damage is mainly caused by the radiation and various carcinogenic compounds, the essence of the damage is molecular adhesion fracture and chemical modification. After nuclear damage, the cells whose nuclei may be abnormal in morphology, structure and function, then become a kind of morbid cells or defective cells. The cell nuclear damage can affect gene expression and regulation, leading to dysfunctions or abnormalities of transcription and protein synthesis, which results in aging and induces various chronic refractory diseases, such as hypertension, atherosclerosis, diabetes, Alzheimer's disease, autoimmune diseases, and so on. The cell nuclear damage can also affect the state of cell differentiation and lead to restart of genes related to division and proliferation, thus inducing cancer. The cancer cells are derived from the cells with nuclear abnormalities, and the biological behavior or characteristics of cancer cells (shedding and metastasis, immune tolerance, uncontrolled, loss of contact inhibition, etc.) are derived from cells with nuclear abnormalities. This article reviewed the chronic refractory diseases caused by nuclear damage and their mechanisms, which provided a new idea for occupational health and toxicology research, as well as a new method and strategy for occupational disease prevention and treatment.
Topics: Humans; Cell Nucleus; Carcinogens; Cell Differentiation; Chronic Disease
PubMed: 37667165
DOI: 10.3760/cma.j.cn121094-20230302-00059 -
Problemy Sotsial'noi Gigieny,... Dec 2022The article gives an idea of health and diseases in various historical epochs. Depending on the historical period, there is a different amount of information about...
The article gives an idea of health and diseases in various historical epochs. Depending on the historical period, there is a different amount of information about medicine, including diseases and the concept of «Health». This is due to the amount of archaeological and documentary evidence. For a long time, ideas about health have been closely linked with religion. Hippocrates and other scientists of the ancient world at the heart of health determined the state of equilibrium of the four main fluids. With the development of anatomy, physiology and medicine, the development of diseases was considered as damage to anatomical structures and disruption of their functions. In the XIV-XV centuries, a direction appeared that considers the influence of social and social factors on human health. In the XIX century, the ideas of health and disease are further developed based on physiological and anatomical studies. The German Anatomical School compared the concepts of human health and pathology, linked the development of diseases with changes in cells. During the 20th century, on the one hand, medicine became more and more molecular and submicroscopic; on the other hand, global attention to people, both healthy and sick, resumed, which gave rise to synergetic, multifaceted definitions of health. The World Health Organization in 1946 formulated the definition of health as «a state of complete physical, mental and social well-being, and not just the absence of diseases or physical defects.» In the future, this concept was repeatedly criticized, as it considered health as an ideal and brought it closer to the concept of happiness. Today it is obvious that the concept of health is a multifactorial concept and, in addition to the medical component, is closely related to other areas of human life: sociology, ecology, cultural studies, economics, etc.
Topics: Humans; Ecology; Medicine; Health Status
PubMed: 36385081
DOI: 10.32687/0869-866X-2022-30-s1-1091-1096 -
The Egyptian Heart Journal : (EHJ) :... Dec 2021This meta-analysis aimed to assess the value of the CHEST score to facilitate population screening and detection of AF risk in millions of populations and validate risk... (Review)
Review
BACKGROUND
This meta-analysis aimed to assess the value of the CHEST score to facilitate population screening and detection of AF risk in millions of populations and validate risk scores and their composition and discriminatory power for identifying people at high or low risk of AF. We searched major indexing databases, including Pubmed/Medline, ISI web of science, Scopus, Embase, and Cochrane central, using ("C2HEST" OR "risk scoring system" OR "risk score") AND ("atrial fibrillation (AF)" OR "atrial flutter" OR "tachycardia, supraventricular" OR "heart atrium flutter") without any language, study region or study type restrictions between 1990 and 2021 years. Analyses were done using Meta-DiSc. The title and abstract screening were conducted by two independent investigators.
RESULTS
Totally 679 records were found through the initial search, of which ultimately, nine articles were included in the qualitative and quantitative analyses. The risk of AF accompanied every one-point increase of CHEST score (OR 1.03, 95% CI 1.01-1.05, p < 0.00001), with a high heterogeneity across studies (I = 100%). The SROC for CHEST score in the prediction of AF showed that the overall area under the curve (AUC) was 0.91 (95% CI 0.85-0.96), AUC in Asian population was 0.87 (95% CI: 0.78-0.95) versus non-Asian 0.95 (95% CI 0.91-0.99), and in general population was 0.92 (95% CI 0.85-0.99) versus those with chronic conditions 0.83 (95% CI 0.71-0.95), respectively.
CONCLUSIONS
The results of this research support the idea that this quick score has the opportunity for use as a risk assessment in patients' AF screening strategies.
PubMed: 34862957
DOI: 10.1186/s43044-021-00230-0 -
Philosophical Transactions of the Royal... Feb 2022We propose that the entirety of the prefrontal cortex (PFC) can be seen as fundamentally premotor in nature. By this, we mean that the PFC consists of an action...
We propose that the entirety of the prefrontal cortex (PFC) can be seen as fundamentally premotor in nature. By this, we mean that the PFC consists of an action abstraction hierarchy whose core function is the potentiation and depotentiation of possible action plans at different levels of granularity. We argue that the apex of the hierarchy should revolve around the process of goal-selection, which we posit is inherently a form of optimization over action abstraction. Anatomical and functional evidence supports the idea that this hierarchy originates on the orbital surface of the brain and extends dorsally to motor cortex. Accordingly, our viewpoint positions the orbitofrontal cortex in a key role in the optimization of goal-selection policies, and suggests that its other proposed roles are aspects of this more general function. Our proposed perspective will reframe outstanding questions, open up new areas of inquiry and align theories of prefrontal function with evolutionary principles. This article is part of the theme issue 'Systems neuroscience through the lens of evolutionary theory'.
Topics: Brain; Brain Mapping; Motor Cortex; Prefrontal Cortex
PubMed: 34957853
DOI: 10.1098/rstb.2020.0524 -
Philosophical Transactions. Series A,... Jul 2023General mathematical reasoning is computationally undecidable, but humans routinely solve new problems. Moreover, discoveries developed over centuries are taught to...
General mathematical reasoning is computationally undecidable, but humans routinely solve new problems. Moreover, discoveries developed over centuries are taught to subsequent generations quickly. What structure enables this, and how might that inform automated mathematical reasoning? We posit that central to both puzzles is the structure of procedural abstractions underlying mathematics. We explore this idea in a case study on five sections of beginning algebra on the Khan Academy platform. To define a computational foundation, we introduce Peano, a theorem-proving environment where the set of valid actions at any point is finite. We use Peano to formalize introductory algebra problems and axioms, obtaining well-defined search problems. We observe existing reinforcement learning methods for symbolic reasoning to be insufficient to solve harder problems. Adding the ability to induce reusable abstractions ('tactics') from its own solutions allows an agent to make steady progress, solving all problems. Furthermore, these abstractions induce an order to the problems, seen at random during training. The recovered order has significant agreement with the expert-designed Khan Academy curriculum, and second-generation agents trained on the recovered curriculum learn significantly faster. These results illustrate the synergistic role of abstractions and curricula in the cultural transmission of mathematics. This article is part of a discussion meeting issue 'Cognitive artificial intelligence'.
PubMed: 37271179
DOI: 10.1098/rsta.2022.0044 -
Cureus Dec 2022The National Occupational Competency Profile (NOCP)-the competency framework for paramedics in Canada-is presently undergoing revision. Since the NOCP was published in... (Review)
Review
The National Occupational Competency Profile (NOCP)-the competency framework for paramedics in Canada-is presently undergoing revision. Since the NOCP was published in 2011, paramedic practice, healthcare, and society have changed dramatically. To inform the revision, we sought to identify emerging concepts in the literature that would inform the development of competencies for paramedics. We conducted a restricted literature review and content analysis of all published and grey literature pertaining to or informing Canadian paramedicine from 2011 to 2022. Three authors performed a title, abstract, and full-text review to identify and label concepts informed by existing findings. A total of 302 articles were categorized into 11 emerging concepts related to competencies: inclusion, diversity, equity, and accessibility (IDEA) in paramedicine; social responsiveness, justice, equity, and access; anti-racism; healthy professionals; evidence-informed practice and systems; complex adaptive systems; learning environment; virtual care; clinical reasoning; adaptive expertise; and planetary health. This review identified emerging concepts to inform the development of the 2023 National Occupational Standard for Paramedics (NOSP). These concepts will inform data analysis, the development of group discussions, and competency identification.
PubMed: 36699791
DOI: 10.7759/cureus.32864 -
Experimental Physiology Sep 2021What is the topic of this review? This Lecture covers the role of caudal brainstem GLP1 neurons in acute and chronic stress responses. What advances does it highlight?... (Review)
Review
NEW FINDINGS
What is the topic of this review? This Lecture covers the role of caudal brainstem GLP1 neurons in acute and chronic stress responses. What advances does it highlight? This Lecture focuses on the recent advances in our understanding of GLP1 neurons and their physiological role in many aspects of stress. Particular focus is given to the recent elucidation, in part, of the anatomical basis for recruitment of GLP1 neurons in response to acute stress. Finally, the potential, but at this time somewhat speculative, role of GLP1 neurons in chronic stress is discussed.
ABSTRACT
The brain responds rapidly to stressful stimuli by increasing sympathetic outflow, activating the hypothalamic-pituitary-adrenal axis and eliciting avoidance behaviours to limit risks to safety. Stress responses are adaptive and essential but can become maladaptive when the stress is chronic, causing autonomic imbalance, hypothalamic-pituitary-adrenal axis hyper-reactivity and a state of hypervigilance. Ultimately, this contributes to the development of cardiovascular disease and affective disorders, including major depression and anxiety. Stress responses are often thought to be driven mainly by forebrain areas; however, the brainstem nucleus of the solitary tract (NTS) is ideally located to control both autonomic outflow and behaviour in response to stress. Here, I review the preclinical evidence that the NTS and its resident glucagon-like peptide-1 (GLP1)-expressing neurons are prominent mediators of stress responses. This Lecture introduces the reader to the idea of good and bad stress and outlines the types of stress that engage the NTS and GLP1 neurons. I describe in particular detail the recent studies by myself and others aimed at mapping sources of synaptic inputs to GLP1 neurons and consider the implications for our understanding of the role of GLP1 neurons in stress. This is followed by a discussion of the contribution of brain GLP1 and GLP1 neurons to behavioural and physiological stress responses. The evidence reviewed highlights a potentially prominent role for GLP1 neurons in the response of the brain to acute stress and reveals important unanswered questions regarding their role in chronic stress.
Topics: Glucagon-Like Peptide 1; Hypothalamo-Hypophyseal System; Neurons; Pituitary-Adrenal System; Solitary Nucleus
PubMed: 34302307
DOI: 10.1113/EP089445 -
BioEssays : News and Reviews in... May 2021Cell membranes are now emerging as finely tuned molecular systems, signifying that re-evaluation of our understanding of their structure is essential. Although the idea... (Review)
Review
Cell membranes are now emerging as finely tuned molecular systems, signifying that re-evaluation of our understanding of their structure is essential. Although the idea that cell membrane lipid bilayers do little more than give shape and form to cells and limit diffusion between cells and their environment is totally passé, the structural, compositional, and functional complexity of lipid bilayers often catches cell and molecular biologists by surprise. Models of lipid bilayer structure have developed considerably since the heyday of the fluid mosaic model, principally by the discovery of the restricted diffusion of membrane proteins and lipids within the plane of the bilayer. In reviewing this field, we now suggest that further refinement of current models is necessary and propose that describing lipid bilayers as "finely-tuned molecular assemblies" best portrays their complexity and function. Also see the video abstract here: https://www.youtube.com/watch?v=ddkP-QRZTl8.
Topics: Cell Membrane; Diffusion; Lipid Bilayers; Membrane Lipids; Membrane Proteins
PubMed: 33656770
DOI: 10.1002/bies.202100021 -
Journal of Experimental Psychology.... Mar 2020In their seminal study of chess expertise, Simon and Chase (Chase & Simon, 1973; Simon & Chase, 1973) proposed that perceptual learning was a necessary component of...
In their seminal study of chess expertise, Simon and Chase (Chase & Simon, 1973; Simon & Chase, 1973) proposed that perceptual learning was a necessary component of skill acquisition. In their view, acquisition of skill results from the strategic use of learning at multiple levels to adaptively overcome inherent limitations. The knowledge acquired by way of perceptual learning that supported increasingly sophisticated perceptual discrimination processes, according to Simon and Chase, was referred to as a chunk. The chunk was conceptualized as a meaningful complex set of features that abstracted the notion of a perceptual object. Simon and Chase further suggested that meaningful combinations of chunks could be combined to form configurations (Simon & Chase, 1973, p. 399). The present study addresses this idea by framing the notion of a chunk in terms of two formal metatheories, one that addresses representation (Ashby & Townsend, 1986) and one that addresses processing (Townsend & Nozawa, 1995), and tests the prediction that perceptual learning produces organized perceptual objects (chunks). Two experiments combine behavioral and electroencephelographic (EEG) measures to show that perceptual learning produces (a) a shift from perceptual independence and separability to violations of separability, and (b) shifts from limited-capacity serial processing to supercapacity parallel processing. The evidence from both experiments is strong and consistent: perceptual learning does indeed induce chunking-the production of perceptual objects, and the foundation of perceptual expertise. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topics: Adult; Contrast Sensitivity; Electroencephalography; Female; Humans; Learning; Male; Pattern Recognition, Visual; Psychomotor Performance; Young Adult
PubMed: 31219302
DOI: 10.1037/xlm0000735