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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 -
Aging & Mental Health May 2021Perceptions of dementia are important determinants of support, treatment and care received in the dementia community. Understanding these perceptions are vital for...
Perceptions of dementia are important determinants of support, treatment and care received in the dementia community. Understanding these perceptions are vital for regions such as Latin America, where there is a rapid increase in people living with dementia. The aim of this study is to review and synthesise the general public's perceptions of dementia in Latin America, what factors are associated with these perceptions, and how they differ between countries in the region. Searches were completed across five databases (Medline, SCOPUS, PsychINFO, SciELO, and WoS). Studies were required to capture attitudes or knowledge of dementia in the general public residing within Latin America. English, Spanish and Portuguese search terms were used. Results were synthesised narratively. About 1574 unique records were identified. Following lateral searches, de-duplication and screening, six articles (four studies) met the inclusion criteria for this review. All the studies were quantitative research from Brazil (median, = 722). There was evidence of a limited to moderate knowledge of dementia, though a significant minority had negative or stigmatising attitudes. Only higher levels of education were consistently associated with better attitudes and knowledge of dementia in the region. There is a need for more in-depth research about attitudes of the general public across Latin America, particularly outside of São Paulo state, Brazil. There appears to be a greater need to raise awareness of dementia amongst less educated Latin American groups.
Topics: Brazil; Dementia; Educational Status; Humans; Latin America; Perception
PubMed: 32048522
DOI: 10.1080/13607863.2020.1725738 -
The Journal of Prosthetic Dentistry Aug 2020Oral health-related quality of life (OHRQoL) is a subjective measure that assesses a person's perception of oral health. Patients with Alzheimer disease (AD) suffer from...
STATEMENT OF PROBLEM
Oral health-related quality of life (OHRQoL) is a subjective measure that assesses a person's perception of oral health. Patients with Alzheimer disease (AD) suffer from impaired cognitive function and a compromised ability to perform activities of daily living. Further exploration is needed to clarify whether OHRQoL is negatively impacted by cognitive degeneration and oral health conditions among patients with AD.
PURPOSE
The purpose of this systematic review was to increase understanding of OHRQoL among patients with AD and explore factors that may affect OHRQoL.
MATERIAL AND METHODS
Searches were conducted in PubMed, the Cochrane Library database, Medline, EBSCO, ProQuest, and EMBASE until August 30, 2018, with no date restrictions. The initial search targeted quantitative observational studies published in English that included the keywords AD, oral, prosthesis, and OHRQoL. Data extraction was independently conducted by 2 reviewers. OHRQoL was investigated as the outcome. Cognitive status and oral health conditions were treated as exposures. Tools used to measure OHRQoL included the Geriatric Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile. The research adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS
Six studies were included. The sample sizes ranged from 30 to 226 participants, 5 studies used cross-sectional designs, and 1 was a nonrandomized controlled trial. Three studies reported higher OHRQoL scores among participants with AD than those among controls, but only 1 study showed a statistically significant difference. A statistical analysis was conducted with 4 studies that reported GOHAI scores, and no significant differences were found in GOHAI scores between participants with AD and controls (standard mean difference: 0.09; 95% confidence interval: -0.66 to 0.85). All studies that explored factors affecting OHRQoL showed different associations between cognitive impairment, oral health conditions, and OHRQoL. One study showed that cognitive impairment was negatively associated with OHRQoL. Three studies found oral health conditions (including periodontitis, gingival bleeding, probing depth >4 mm, and number of natural teeth) impaired the OHRQoL of participants with AD. Three studies reported that prosthetic type and quality positively affected OHRQoL among participants with AD.
CONCLUSIONS
OHRQoL may not fully represent actual oral health problems of patients with AD. Clinical dentists should evaluate oral problems in this population, preferably by using both subjective and objective examinations, including oral and dental conditions. This will ensure oral problems among patients with AD can be detected early and timely treatment provided.
Topics: Activities of Daily Living; Aged; Alzheimer Disease; Cross-Sectional Studies; Humans; Oral Health; Quality of Life
PubMed: 31753458
DOI: 10.1016/j.prosdent.2019.08.015 -
BMC Ophthalmology Sep 2019This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery. (Meta-Analysis)
Meta-Analysis
BACKGROUND
This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery.
METHODS
All comparative clinical trials that involved bilaterally implanting EDOF IOLs in patients with cataract were retrieved from the literature database. We used random effects models to pool weighted mean differences (WMD) and risk ratio (RR) for continuous and dichotomous variables, respectively.
RESULTS
Nine studies with a total of 1336 eyes were identified. The subgroup analysis was conducted according to the type of IOLs used in the control group. Compared with monofocal IOLs, EDOF IOLs produced better uncorrected intermediate visual acuity (WMD: -0.17, 95% CI: - 0.26 to - 0.08, P = 0.0001) and uncorrected near visual acuity (WMD: -0.17, 95% CI: - 0.21 to - 0.12, P < 0.00001). EDOF IOLs resulted in reduced contrast sensitivity, more frequent halos, however, higher spectacle independence (RR: 2.81, 95% CI: 1.06 to 7.46, P = 0.04) than monofocal IOLs. Compared with trifocal IOLs, EDOF IOLs produced worse near visual acuity (MD: 0.10, 95% CI: 0.07 to 0.13, P < 0.0001). EDOF IOLs performed better than trifocal IOls in contrast sensitivity, and there were no significant difference in halos and spectacle independence. Serious postoperative complications were rare, with no adverse events were reported in most studies.
CONCLUSIONS
Increasing the risk of contrast reduction and more frequent halos, EDOF IOLs provided better intermediate and near VAs than monofocal IOLs. At the expense of near vision, patients receiving EDOF IOLs have better contrast sensitivity than those receiving trifocal IOLs. Halo incidence and spectacle independence of EDOF IOLs were similar to those of trifocal IOLs.
Topics: Cataract Extraction; Depth Perception; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Prosthesis Design; Pseudophakia; Randomized Controlled Trials as Topic; Refraction, Ocular; Treatment Outcome; Visual Acuity
PubMed: 31477053
DOI: 10.1186/s12886-019-1204-0 -
Research in Social & Administrative... Apr 2020Antineoplastic medicines affect the patients' physical and psychosocial well-being posing challenges for patients, caregivers and healthcare professionals. However,... (Review)
Review
BACKGROUND
Antineoplastic medicines affect the patients' physical and psychosocial well-being posing challenges for patients, caregivers and healthcare professionals. However, little is known about the patients' lived experience with medicines (PLEM) for antineoplastic treatment. It is the lived experience that gives meaning to each individual's perception of a particular phenomenon which is influenced by internal and external factors relevant to the individual.
OBJECTIVES
To critically appraise, synthesise and present the available evidence of patients' lived experience with antineoplastic medicines prescribed for the management of malignant solid tumours.
METHOD
A systematic literature search was conducted in six electronic databases for articles published in English with no date restrictions. The search terms were related to beliefs, practice and burden in relation to patient, antineoplastic medicines, tumours and lived experience. Study selection, quality assessment and data extraction were performed independently by 2 reviewers. Research findings were analysed using narrative and meta-synthesis approaches.
RESULTS
The search retrieved 31,004 articles with only 10 studies satisfying the inclusion and exclusion criteria. These studies were published between 2005 and 2016 in Europe (n = 6), America (n = 3) and Asia (n = 1). Nine themes were identified to contribute to the patients' lived experience with antineoplastic medicines. These were (a) influence from family members, healthcare professionals, media and culture, (b) general attitude towards medicine, (c) accepting medicine, (d) modifying or altering medicine regimen or dose, (e) medicine characteristics, (f) medicine routine, (g) medicine adverse events, (h) medicine and social burden and (i) healthcare associated medicine burden. Patients tend to undergo a continuous process of reinterpretations of their experience with medicines throughout their treatment journey.
CONCLUSION
The use of antineoplastic medicines has a profound effect on the patients' lives. Further longitudinal in-depth studies are required to provide deeper insight into PLEM and support patients in their treatment journey.
Topics: Antineoplastic Agents; Europe; Family; Health Personnel; Humans; Neoplasms
PubMed: 31311718
DOI: 10.1016/j.sapharm.2019.06.020 -
Otology & Neurotology : Official... Aug 2019By discussing the design, findings, strengths, and weaknesses of available studies investigating the influence of angular insertion depth on speech perception, we intend...
OBJECTIVE
By discussing the design, findings, strengths, and weaknesses of available studies investigating the influence of angular insertion depth on speech perception, we intend to summarize the current status of evidence; and using evidence based conclusions, possibly contribute to the determination of the optimal cochlear implant (CI) electrode position.
DATA SOURCES
Our search strategy yielded 10,877 papers. PubMed, Ovid EMBASE, Web of Science, and the Cochrane Library were searched up to June 1, 2018. Both keywords and free-text terms, related to patient population, predictive factor, and outcome measurements were used. There were no restrictions in languages or year of publication.
STUDY SELECTION
Seven articles were included in this systematic review. Articles eligible for inclusion: (a) investigated cochlear implantation of any CI system in adults with post-lingual onset of deafness and normal cochlear anatomy; (b) investigated the relationship between angular insertion depth and speech perception; (c) measured angular insertion depth on imaging; and (d) measured speech perception at, or beyond 1-year post-activation.
DATA EXTRACTION AND SYNTHESIS
In included studies; quality was judged low-to-moderate and risk of bias, evaluated using a Quality-in-Prognostic-Studies-tool (QUIPS), was high. Included studies were too heterogeneous to perform meta-analyses, therefore, effect estimates of the individual studies are presented. Six out of seven included studies found no effect of angular insertion depth on speech perception.
CONCLUSION
All included studies are characterized by methodological flaws, and therefore, evidence-based conclusions regarding the influence of angular insertion depth cannot be drawn to date.
Topics: Adult; Cochlea; Cochlear Implantation; Cochlear Implants; Deafness; Humans; Speech Perception; Treatment Outcome
PubMed: 31135680
DOI: 10.1097/MAO.0000000000002298 -
British Journal of Anaesthesia Aug 2019Pain is recognised to have both a sensory dimension (intensity) and an affective dimension (unpleasantness). Pain feels like a single unpleasant bodily experience, but...
BACKGROUND
Pain is recognised to have both a sensory dimension (intensity) and an affective dimension (unpleasantness). Pain feels like a single unpleasant bodily experience, but investigations of human pain have long considered these two dimensions of pain to be separable and differentially modifiable. The evidence underpinning this separability and differential modifiability is seldom presented. We aimed to fill this gap by evaluating the current evidence base for whether or not the sensory and affective dimensions of pain can be selectively modulated using cognitive manipulations.
METHODS
A rigorous systematic search, based on a priori search terms and consultation with field experts, yielded 4270 articles. A detailed screening process was based on the following recommendations: (i) evaluation of effectiveness; (ii) examination of methodological rigour, including each study having an a priori intention to cognitively modulate one of the two dimensions of pain; and (iii) sound theoretical reasoning. These were used to ensure that included studies definitively answered the research question.
RESULTS
After in-depth critique of all 12 articles that met the inclusion criteria, we found that there is no compelling evidence that the sensory and affective dimensions of pain can be selectively and intentionally modulated using cognitive manipulations in humans.
CONCLUSIONS
We offer potential explanations for this discrepancy between assumptions and evidence and contend that this finding highlights several important questions for the field, from both the research and clinical perspectives.
Topics: Affect; Humans; Mind-Body Therapies; Pain; Pain Measurement; Pain Perception
PubMed: 31053232
DOI: 10.1016/j.bja.2019.03.033 -
Journal of Dairy Science May 2019We aimed to determine how research regarding farmers' personalities and attitudes as risk factors is reported (methodological approaches to assessing, extracting, and...
Invited review: Examining farmers' personalities and attitudes as possible risk factors for dairy cattle health, welfare, productivity, and farm management: A systematic scoping review.
We aimed to determine how research regarding farmers' personalities and attitudes as risk factors is reported (methodological approaches to assessing, extracting, and processing data and analyzing risk factors) and to explore evidence for the effect of farmers' attitudes and personalities on dairy cattle health, welfare, productivity, and management. Therefore, we conducted a systematic review of studies on personality and attitude as risk factors for dairy cattle health, welfare, productivity, and farm management. Database searches captured 1,144 records, and 38 were finally included in the review. Thirty-three manuscripts assessed farmers' attitudes, 1 assessed their personalities, and 4 assessed both as risk factors. These potential risk factors were checked for relationships with more than 50 different outcome variables regarding farm management (17 manuscripts), animal health (13 manuscripts), animal productivity (11 manuscripts), and animal welfare (4 manuscripts). The approaches to assessing risk factors and processing and interpreting data varied greatly; thus, drawing conclusions regarding the effects of attitude and personality as risk factors is impeded because manuscripts are difficult to compare. Our findings highlight the need for harmonization of attitudes and personality assessments in future research. Furthermore, researchers should carefully consider which depth of detail to apply when planning and evaluating related research. Nevertheless, results highlight the importance of the effect of personality and attitude on outcomes. Farmers' personality and attitudes are associated with dairy cattle health, welfare, productivity, and management. In general, attitudes indicating higher degrees of technical knowledge, affection with problems, perceived responsibility, perception of control of a situation, a better human-animal relationship, or a positive evaluation of the benefits of management decisions tended to affect outcomes in a beneficial way. "Agreeableness" and "conscientiousness" were shown to promote better farm performance, whereas "neuroticism" had a negative effect. Therefore, further research on attitude and personality and their consideration by professionals and decision-makers within the dairy sector and politics is strongly recommended. This might provide the chance to better understand the needs of dairy farmers and therefore develop tailored advice and support strategies to improve both satisfactory and constructive cooperation.
Topics: Animal Welfare; Animals; Attitude; Cattle; Dairying; Decision Making; Efficiency; Farmers; Farms; Health Status; Humans; Perception; Personality; Risk Factors
PubMed: 30852027
DOI: 10.3168/jds.2018-15037 -
Journal of Endourology Sep 2018Laparoscopy is widely used in the urological field. This systematic review and a meta-analysis were conducted to assess the clinical and surgical efficacy of the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Laparoscopy is widely used in the urological field. This systematic review and a meta-analysis were conducted to assess the clinical and surgical efficacy of the three-dimensional (3D) laparoscopic system in comparison with two-dimensional (2D) laparoscopy for treatment of different urological conditions.
METHODS
Following guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic literature search in Web of Science, PubMed, Cochrane Library, and EMBase was carried out to identify relevant studies published up to May 2018. Articles published in the English language of both randomized and observational studies comparing 3D and 2D laparoscopic systems in urological surgeries were included. Level of evidence and quality assessments of all included studies were conducted. Interested data were extracted for comparison and meta-analysis.
RESULTS
Our literature search generated 17 studies comparing 3D and 2D laparoscopic systems in different urological surgeries. Of these, 13 studies containing 548 and 449 patients operated on with 2D and 3D laparoscopic systems, respectively, were included for meta-analysis. These 13 studies were divided into three groups according to surgical type. Group 1: Partial nephrectomy (PN); operative time (p = 0.19), estimated blood loss (EBL) (p = 0.51), dissecting time (p = 0.58), and suturing time (p = 0.28) were not statistically significant between 2D and 3D laparoscopic systems. However, warm ischemia time during PN was significantly shorter during 3D laparoscopy (p < 0.00001). Group 2: Pyeloplasty; this procedure showed no significant difference between the two systems. Group 3: Radical prostatectomy (RP); shorter operative time (p < 0.0001) and lower EBL (p = 0.001) were associated with the 3D laparoscopic system.
CONCLUSION
Three-dimensional laparoscopy mainly improves the depth of perception, leading to better visibility, which is important for some complex urological surgeries such as PN, pyeloplasty, and RP. Based on our findings, 3D laparoscopy seems to provide better clinical and surgical outcomes in some urological procedures compared with conventional 2D laparoscopy.
Topics: Blood Loss, Surgical; Humans; Imaging, Three-Dimensional; Laparoscopy; Operative Time; Urologic Surgical Procedures; Warm Ischemia
PubMed: 29969912
DOI: 10.1089/end.2018.0411 -
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