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International Journal of Audiology Sep 2018To develop a decision aid for tinnitus care that would meet international consensus for decision aid quality.
OBJECTIVE
To develop a decision aid for tinnitus care that would meet international consensus for decision aid quality.
DESIGN
A mixed methods design that included qualitative in-depth interviews, literature review, focus groups, user testing and readability checking.
STUDY SAMPLE
Patients and clinicians who have clinical experience of tinnitus.
RESULTS
A decision aid for tinnitus care was developed. This incorporates key evidence of efficacy for the most frequently used tinnitus care options, together with information derived from patient priorities when deciding which choice to make.
CONCLUSION
The decision aid has potential to enable shared decision making between clinicians and patients in audiology. The decision aid meets consensus standards.
Topics: Attitude of Health Personnel; Auditory Perception; Clinical Decision-Making; Consensus; Decision Support Techniques; Female; Focus Groups; Health Communication; Health Knowledge, Attitudes, Practice; Hearing; Humans; Interviews as Topic; Male; Middle Aged; Patient Education as Topic; Patient Participation; Predictive Value of Tests; Professional-Patient Relations; Qualitative Research; Tinnitus
PubMed: 29741407
DOI: 10.1080/14992027.2018.1468093 -
Survey of Ophthalmology 1996The monovision concept of correcting one eye for distance and the other for near may be utilized in presbyopes undergoing refractive surgery. We have performed a... (Review)
Review
The monovision concept of correcting one eye for distance and the other for near may be utilized in presbyopes undergoing refractive surgery. We have performed a systematic review of published literature to evaluate the factors influencing monovision success, and to determine the visual outcome in patients with monovision. Articles in MEDLINE and published bibliographies reporting monovision prescription for correction of presbyopia were systematically identified and reviewed. Pertinent data were abstracted and, when feasible, statistically analyzed. The mean success rate was 73%. The success in monovision correlated with distance correction on dominant eye, alternating dominance, less than 50 seconds of are stereoacuity reduction, and less than 0.6 prism diopter of distance esophoric shifts. Monovision resulted in significant reduction of binocular contrast sensitivity function at spatial frequencies higher than 4 cycles per degree, and 2-6% reduction in task performance, but resulted in minimal reduction of binocular visual acuity, peripheral vision, visual field width and binocular depth of focus. The published literature indicates that monovision is an effective and reasonable therapeutic modality for correcting presbyopia. Proper patient selection and clinical screening are essential for monovision success.
Topics: Adult; Aged; Anisometropia; Contact Lenses; Contrast Sensitivity; Depth Perception; Female; Humans; Male; Middle Aged; Presbyopia; Vision, Binocular; Vision, Monocular; Visual Acuity; Visual Fields
PubMed: 8724641
DOI: 10.1016/s0039-6257(96)82015-7 -
BMC Women's Health Dec 2022Gender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender...
BACKGROUND
Gender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender discrimination. The aim of this study is to assess the factors that influence gender discrimination in Pakistan, and its impact on women's life.
METHODS
A mixed method approach was used in the study in which a systematic review was done in phase one to explore the themes on gender discrimination, and qualitative interviews were conducted in phase two to explore the perception of people regarding gender discrimination. The qualitative interviews (in-depth interviews and focus group discussions) were conducted from married men and women, adolescent boys and girls, Healthcare Professionals (HCPs), Lady Health Visitors (LHVs) and Community Midwives (CMWs). The qualitative interviews were analyzed both manually and electronically through QSR NVivo 10. The triangulation of data from the systematic review and qualitative interviews were done to explore the gender discrimination related issues in Pakistan.
RESULTS
The six major themes have emerged from the systematic review and qualitative interviews. It includes (1) Status of a woman in the society (2) Gender inequality in health (3) Gender inequality in education (4) Gender inequality in employment (5) Gender biased social norms and cultural practices and (6) Micro and macro level recommendations. In addition, a woman is often viewed as a sexual object and dependent being who lacks self identity unless being married. Furthermore, women are restricted to household and child rearing responsibilities and are often neglected and forced to suppress self-expression. Likewise, men are viewed as dominant figures in lives of women who usually makes all family decisions. They are considered as financial providers and source of protection. Moreover, women face gender discrimination in many aspects of life including education and access to health care.
CONCLUSION
Gender discrimination is deeply rooted in the Pakistani society. To prevent gender discrimination, the entire society, especially women should be educated and gendered sensitized to improve the status of women in Pakistan.
Topics: Male; Adolescent; Humans; Female; Pakistan; Sexism; Qualitative Research; Focus Groups; Social Behavior
PubMed: 36550528
DOI: 10.1186/s12905-022-02011-6 -
The Cochrane Database of Systematic... 2004White spots can appear on teeth during fixed brace treatment because of early decay around the brace attachments. Fluoride is effective at reducing decay in susceptible... (Review)
Review
BACKGROUND
White spots can appear on teeth during fixed brace treatment because of early decay around the brace attachments. Fluoride is effective at reducing decay in susceptible individuals and is routinely prescribed in various different forms to patients during orthodontic treatment.
OBJECTIVES
To evaluate the effectiveness of fluoride in preventing white spots during orthodontic treatment and to compare the different modes of delivery of fluoride.
SEARCH STRATEGY
We searched the Cochrane Oral Health Group's Trials Register (to 22 August 2002); CENTRAL (The Cochrane Library Issue 3, 2002); MEDLINE (January 1966 to July 2003); EMBASE (January 1980 to week July 2003). Authors of trials were contacted for further data.
SELECTION CRITERIA
Trials were selected if they met the following criteria: a randomised or quasi-randomised clinical trial, involving the use of a fluoride-containing product compared with no use or use of a non-fluoride control and enamel demineralisation was assessed during or after orthodontic treatment.
DATA COLLECTION AND ANALYSIS
Six reviewers independently, in duplicate, extracted data. The primary outcome was the difference in the presence or absence of white spots between experimental and control patients for parallel design studies, and between experimental and control quadrants, for split-mouth design studies. Potential sources of heterogeneity were examined. Sensitivity analyses were undertaken for the items assessed for quality and publication bias.
MAIN RESULTS
The primary outcome of the review was the presence or absence of white spots by patient at the end of treatment. Secondary outcomes included any quantitative assessment of enamel mineral loss or lesion depth. Other outcomes such as differences in size and severity of white spots, any patient based outcomes, such as perception of white spots could not be included because there were insufficient data. Fifteen trials, with 723 participants, provided data for this review. None of the studies fulfilled all of the methodological quality assessment criteria. There is some evidence that a daily sodium fluoride mouthrinse reduces the severity of enamel decay surrounding a fixed brace (weighted mean difference for lesion depth -70.0; 95% CI -118.2 to -21.8) and that use of a glass ionomer cement for bracket bonding reduces the prevalence (Peto OR 0.35; 95% CI 0.15 to 0.84) and severity of white spots (weighted mean difference for mineral loss -645 vol%.microm; 95% CI -915 to -375) compared with composite resins.
REVIEWERS' CONCLUSIONS
There is some evidence that the use of topical fluoride or fluoride-containing bonding materials during orthodontic treatment reduces the occurrence and severity of white spot lesions, however there is little evidence as to which method or combination of methods to deliver the fluoride is the most effective. Based on current best practice in other areas of dentistry, for which there is evidence, we recommend that patients with fixed braces rinse daily with a 0.05% sodium fluoride mouthrinse. More high quality, clinical research is required into the different modes of delivering fluoride to the orthodontic patient.
Topics: Dental Caries; Fluorides; Humans; Mouthwashes; Orthodontic Brackets; Randomized Controlled Trials as Topic
PubMed: 15266503
DOI: 10.1002/14651858.CD003809.pub2 -
Computational and Mathematical Methods... 2021Artificial Intelligence (AI) is the domain of computer science that focuses on the development of machines that operate like humans. In the field of AI, medical disease...
Artificial Intelligence (AI) is the domain of computer science that focuses on the development of machines that operate like humans. In the field of AI, medical disease detection is an instantly growing domain of research. In the past years, numerous endeavours have been made for the improvements of medical disease detection, because the errors and problems in medical disease detection cause serious wrong medical treatment. Meta-heuristic techniques have been frequently utilized for the detection of medical diseases and promise better accuracy of perception and prediction of diseases in the domain of biomedical. Particle Swarm Optimization (PSO) is a swarm-based intelligent stochastic search technique encouraged from the intrinsic manner of bee swarm during the searching of their food source. Consequently, for the versatility of numerical experimentation, PSO has been mostly applied to address the diverse kinds of optimization problems. However, the PSO techniques are frequently adopted for the detection of diseases but there is still a gap in the comparative survey. This paper presents an insight into the diagnosis of medical diseases in health care using various PSO approaches. This study presents to deliver a systematic literature review of current PSO approaches for knowledge discovery in the field of disease detection. The systematic analysis discloses the potential research areas of PSO strategies as well as the research gaps, although, the main goal is to provide the directions for future enhancement and development in this area. This paper gives a systematic survey of this conceptual model for the advanced research, which has been explored in the specified literature to date. This review comprehends the fundamental concepts, theoretical foundations, and conventional application fields. It is predicted that our study will be beneficial for the researchers to review the PSO algorithms in-depth for disease detection. Several challenges that can be undertaken to move the field forward are discussed according to the current state of the PSO strategies in health care.
Topics: Alzheimer Disease; Artificial Intelligence; Bayes Theorem; Computational Biology; Diagnosis, Computer-Assisted; Humans; Image Interpretation, Computer-Assisted; Machine Learning; Neural Networks, Computer; Nonlinear Dynamics; Stochastic Processes
PubMed: 34557257
DOI: 10.1155/2021/5990999 -
Frontiers in Psychology 2018Gifted students who also have learning disabilities (G/LD) are often overlooked when students are assessed either for giftedness or specific learning disabilities. The...
Gifted students who also have learning disabilities (G/LD) are often overlooked when students are assessed either for giftedness or specific learning disabilities. The cognitive and non-cognitive characteristics of these G/LD students are habitually discussed only briefly alongside identification and intervention issues and, beyond that, the relevance of non-cognitive characteristics is often left unconsidered. Accordingly, this study aims to conduct an in-depth review of the non-cognitive characteristics of these students for identification and intervention purposes. Detailed analysis was performed on 23 publications. High levels of negative emotions, low self-perception, and adverse interpersonal relationships, as well as high levels of motivation, coping skills and perseverance were found among these students. A common characteristic was a high degree of frustration with the academic situation. The study reveals that these students show considerably duality in their non-cognitive characteristics which requires tailored counseling skills to provide effective support for their learning needs.
PubMed: 29731728
DOI: 10.3389/fpsyg.2018.00504 -
JMIR MHealth and UHealth Jul 2020Although there is a push toward encouraging mobile health (mHealth) adoption to harness its potential, there are many challenges that sometimes go beyond the technology...
BACKGROUND
Although there is a push toward encouraging mobile health (mHealth) adoption to harness its potential, there are many challenges that sometimes go beyond the technology to involve other elements such as social, cultural, and organizational factors.
OBJECTIVE
This review aimed to explore which frameworks are used the most, to understand clinicians' adoption of mHealth as well as to identify potential shortcomings in these frameworks. Highlighting these gaps and the main factors that were not specifically covered in the most frequently used frameworks will assist future researchers to include all relevant key factors.
METHODS
This review was an in-depth subanalysis of a larger systematic review that included research papers published between 2008 and 2018 and focused on the social, organizational, and technical factors impacting clinicians' adoption of mHealth. The initial systematic review included 171 studies, of which 50 studies used a theoretical framework. These 50 studies are the subject of this qualitative review, reflecting further on the frameworks used and how these can help future researchers design studies that investigate the topic of mHealth adoption more robustly.
RESULTS
The most commonly used frameworks were different forms of extensions of the Technology Acceptance Model (TAM; 17/50, 34%), the diffusion of innovation theory (DOI; 8/50, 16%), and different forms of extensions of the unified theory of acceptance and use of technology (6/50, 12%). Some studies used a combination of the TAM and DOI frameworks (3/50, 6%), whereas others used the consolidated framework for implementation research (3/50, 6%) and sociotechnical systems (STS) theory (2/50, 4%). The factors cited by more than 20% of the studies were usefulness, output quality, ease of use, technical support, data privacy, self-efficacy, attitude, organizational inner setting, training, leadership engagement, workload, and workflow fit. Most factors could be linked to one framework or another, but there was no single framework that could adequately cover all relevant and specific factors without some expansion.
CONCLUSIONS
Health care technologies are generally more complex than tools that address individual user needs as they usually support patients with comorbidities who are typically treated by multidisciplinary teams who might even work in different health care organizations. This special nature of how the health care sector operates and its highly regulated nature, the usual budget deficits, and the interdependence between health care organizations necessitate some crucial expansions to existing theoretical frameworks usually used when studying adoption. We propose a shift toward theoretical frameworks that take into account implementation challenges that factor in the complexity of the sociotechnical structure of health care organizations and the interplay between the technical, social, and organizational aspects. Our consolidated framework offers recommendations on which factors to include when investigating clinicians' adoption of mHealth, taking into account all three aspects.
Topics: Biomedical Technology; Humans; Practice Patterns, Physicians'; Telemedicine; Workflow
PubMed: 32442132
DOI: 10.2196/18072 -
Palliative Medicine Sep 2019Families' experiences of assisted dying are under-investigated and families are rarely considered in clinical guidelines concerning assisted dying.
BACKGROUND
Families' experiences of assisted dying are under-investigated and families are rarely considered in clinical guidelines concerning assisted dying.
AIM
To systematically review family experiences of assisted dying.
DESIGN
A systematic literature review using thematic synthesis.
DATA SOURCES
MEDLINE, Embase, CINAHL, AMED (Allied and Complementary Medicine) and PsycINFO databases (January 1992 to February 2019). Studies investigating families' experiences on the practice of legalised assisted dying were included. We excluded studies prior to legalisation within the jurisdiction, secondary data analysis and opinion papers.
RESULTS
Nineteen articles met the inclusion criteria. Publications were derived from four countries: The Netherlands, United States (Oregon, Washington and Vermont), Canada and Switzerland. Dutch studies predominately investigated family involvement in euthanasia, while Swiss and American studies only reported on assisted suicide. Eleven studies had a qualitative design, using predominately in-depth interviews; seven were retrospective surveys. Five analytical themes represented families' experiences in assisted dying: (1) , (2) , (3) , (4) and (5) . The results showed that families can be very involved in supporting patients seeking assisted dying, where open communication is maintained. Family involvement appeared to be influenced by the type of legislation in their country and the families' perception of the social acceptability of assisted dying.
CONCLUSION
Our data confirm that families across all jurisdictions are involved in assisted suicide decision and enactment. Family needs are under-researched, and clinical guidelines should incorporate recommendations about how to consider family needs and how to provide them with evidence-based tailored interventions.
Topics: Canada; Decision Making; Euthanasia; Family; Humans; Netherlands; Switzerland; United States
PubMed: 31244384
DOI: 10.1177/0269216319857630 -
The Cochrane Database of Systematic... Feb 2014Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer... (Review)
Review
BACKGROUND
Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer generation passes retirement age. As older adults make up an increasing proportion of the population, they are an important consideration when designing future evidence-based traffic safety policies, particularly those that lead to restrictions or cessation of driving. Research has shown that cessation of driving among older drivers can lead to negative emotional consequences such as depression and loss of independence. Older adults who continue to drive tend to do so less frequently than other demographic groups and are more likely to be involved in a road traffic crash, possibly due to what is termed the "low mileage bias". Available research suggests that older driver crash risk estimates based on traditional exposure measures are prone to bias. When annual driving distances are taken in to consideration, older drivers with low driving distances have an increased crash risk, while those with average or high driving distances tend to be safer drivers when compared to other age groups. In addition, older drivers with lower distance driving tend to drive in urban areas which, due to more complex and demanding traffic patterns, tend to be more accident-prone. Failure to control for actual annual driving distances and driving locations among older drivers is referred to as "low mileage bias" in older driver mobility research. It is also important to note that older drivers are more vulnerable to serious injury and death in the event of a traffic crash due to changes in physiology associated with normal ageing. Vision, cognition, and motor functions or skills (e.g., strength, co-ordination, and flexibility) are three key domains required for safe driving. To drive safely, an individual needs to be able to see road signs, road side objects, traffic lights, roadway markings, other vulnerable road users, and other vehicles on the road, among many other cues-all while moving, and under varying light and weather conditions. It is equally important that drivers must have appropriate peripheral vision to monitor objects and movement to identify possible threats in the driving environment. It is, therefore, not surprising that there is agreement among researchers that vision plays a significant role in driving performance. Several age-related processes/conditions impair vision, thus it follows that vision testing of older drivers is an important road safety issue. The components of visual function essential for driving are acuity, static acuity, dynamic acuity, visual fields, visual attention, depth perception, and contrast sensitivity. These indices are typically not fully assessed by licensing agencies. Also, current vision screening regulations and cut-off values required to pass a licensing test vary from country to country. Although there is a clear need to develop evidence-based and validated tools for vision screening for driving, the effectiveness of existing vision screening tools remains unclear. This represents an important and highly warranted initiative to increase road safety worldwide.
OBJECTIVES
To assess the effects of vision screening interventions for older drivers to prevent road traffic injuries and fatalities.
SEARCH METHODS
For the update of this review we searched the Cochrane Injuries Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP) and ISI Web of Science: (CPCI-S & SSCI). The searches were conducted up to 26 September 2013.
SELECTION CRITERIA
Randomised controlled trials (RCTs) and controlled before and after studies comparing vision screening to non-screening of drivers aged 55 years and older, and which assessed the effect on road traffic crashes, injuries, fatalities and any involvement in traffic law violations.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened the reference lists for eligible articles and independently assessed the articles for inclusion against the criteria. If suitable trials had been available, two review authors would have independently extracted data using a standardised extraction form.
MAIN RESULTS
No studies were found that met the inclusion criteria for this review.
AUTHORS' CONCLUSIONS
Most countries require a vision screening test for the renewal of an individual's driver's licence. There is, however, lack of methodologically sound studies to assess the effects of vision screening tests on subsequent motor vehicle crash reduction. There is a need to develop valid and reliable tools of vision screening that can predict driving performance.
Topics: Accidents, Traffic; Aged; Automobile Driving; Humans; Vision Screening
PubMed: 24563119
DOI: 10.1002/14651858.CD006252.pub4 -
Journal of Surgical Education 2018The gastric sleeve resection and gastric bypass are the 2 most commonly performed bariatric procedures. This article provides an overview of current teaching and...
OBJECTIVE
The gastric sleeve resection and gastric bypass are the 2 most commonly performed bariatric procedures. This article provides an overview of current teaching and learning methods of those techniques in resident and fellow training.
DESIGN
A database search was performed on Pubmed, Embase, and the Education Resources Information Center (ERIC) to identify the methods used to provide training in bariatric surgery worldwide. After exclusion based on titles and abstracts, full texts of the selected articles were assessed. Included articles were reviewed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
RESULTS
In total, 2442 titles were identified and 14 full text articles met inclusion criteria. Four publications described an ex vivo training course, and 6 focused on at least 1 step of the gastric bypass procedure. Two randomized controlled trials (RCT) provided high-quality evidence on training aspects. Surgical coaching caused significant improvement of Bariatric Objective Structured Assessment of Technical Skills (BOSATS) scores (3.60 vs. 3.90, p = 0.017) and reduction of technical errors (18 vs. 10, p = 0.003). A preoperative warm-up increased global rating scales (GRS) scores on depth perception (p = 0.02), bimanual dexterity (p = 0.01), and efficiency of movements (p = 0.03).
CONCLUSION
Stepwise education, surgical coaching, warming up, Internet-based knowledge modules, and ex vivo training courses are effective in relation to bariatric surgical training of residents and fellows, possibly shortening their learning curves.
Topics: Bariatric Surgery; Clinical Competence; Curriculum; Education, Medical, Graduate; Female; Humans; Internship and Residency; Male; Netherlands; Program Evaluation; Teaching
PubMed: 29033273
DOI: 10.1016/j.jsurg.2017.09.023