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Qualitative Health Research May 2011In this article we explore the concept of balance in the context of health. We became interested in balance during a grounded theory study of lay conceptualizations of... (Review)
Review
In this article we explore the concept of balance in the context of health. We became interested in balance during a grounded theory study of lay conceptualizations of cancer risk in which participants were concerned with having a good life, which relied heavily on balancing processes. This led us to the qualitative literature about balance in the context of health, which was large and in need of synthesis. We identified 170 relevant studies and used Thomas and Harden's technique of thematic synthesis to identify key balance-related themes and develop these into more abstract analytic categories. We found that balance and balancing were salient to people in three health-related contexts: health maintenance, disease or disability management, and lay or professional caregiving. In each of these contexts, balance or imbalance could be a state or a process. In addition, those using the word balance had either an internally or externally focused orientation to the world around them. Clinicians and public health practitioners might benefit from using these insights in their research and communication.
Topics: Adaptation, Psychological; Communication; Disease Management; Health Behavior; Health Status; Humans; Interpersonal Relations; Postural Balance; Psychological Theory; Qualitative Research; Risk; Sensation Disorders; Social Support; Stress, Psychological
PubMed: 21343435
DOI: 10.1177/1049732311399781 -
International Journal of Molecular... Jan 2021Androgens represent the main hormones responsible for maintaining hormonal balance and function in the prostate and testis. As they are involved in prostate and... (Review)
Review
Androgens represent the main hormones responsible for maintaining hormonal balance and function in the prostate and testis. As they are involved in prostate and testicular carcinogenesis, more detailed information of their active concentration at the site of action is required. Since the introduction of the term intracrinology as the local formation of active steroid hormones from inactive precursors of the adrenal gland, mainly dehydroepiandrosterone (DHEA) and DHEA-S, it is evident that blood circulating levels of sex steroid hormones need not reflect their actual concentrations in the tissue. Here, we review and critically evaluate available methods for the analysis of human intraprostatic and intratesticular steroid concentrations. Since analytical approaches have much in common in both tissues, we discuss them together. Preanalytical steps, including various techniques for separation of the analytes, are compared, followed by the end-point measurement. Advantages and disadvantages of chromatography-mass spectrometry (LC-MS, GC-MS), immunoanalytical methods (IA), and hybrid (LC-IA) are discussed. Finally, the clinical information value of the determined steroid hormones is evaluated concerning differentiating between patients with cancer or benign hyperplasia and between patients with different degrees of infertility. Adrenal-derived 11-oxygenated androgens are mentioned as perspective prognostic markers for these purposes.
Topics: Adrenal Glands; Androgens; Animals; Gonadal Steroid Hormones; Humans; Male; Prostate; Steroids; Testis
PubMed: 33466491
DOI: 10.3390/ijms22010466 -
The Journal of Physiology Aug 2023Naturally log-scaled quantities abound in the nervous system. Distributions of these quantities have non-intuitive properties, which have implications for data analysis... (Review)
Review
Naturally log-scaled quantities abound in the nervous system. Distributions of these quantities have non-intuitive properties, which have implications for data analysis and the understanding of neural circuits. Here, we review the log-scaled statistics of neuronal spiking and the relevant analytical probability distributions. Recent work using log-scaling revealed that interspike intervals of forebrain neurons segregate into discrete modes reflecting spiking at different timescales and are each well-approximated by a gamma distribution. Each neuron spends most of the time in an irregular spiking 'ground state' with the longest intervals, which determines the mean firing rate of the neuron. Across the entire neuronal population, firing rates are log-scaled and well approximated by the gamma distribution, with a small number of highly active neurons and an overabundance of low rate neurons (the 'dark matter'). These results are intricately linked to a heterogeneous balanced operating regime, which confers upon neuronal circuits multiple computational advantages and has evolutionarily ancient origins.
Topics: Action Potentials; Neurons; Models, Neurological
PubMed: 36086892
DOI: 10.1113/JP282758 -
Journal of Mixed Methods Research Jul 2009Quantitizing, commonly understood to refer to the numerical translation, transformation, or conversion of qualitative data, has become a staple of mixed methods...
Quantitizing, commonly understood to refer to the numerical translation, transformation, or conversion of qualitative data, has become a staple of mixed methods research. Typically glossed are the foundational assumptions, judgments, and compromises involved in converting disparate data sets into each other and whether such conversions advance inquiry. Among these assumptions are that qualitative and quantitative data constitute two kinds of data, that quantitizing constitutes a unidirectional process essentially different from qualitizing, and that counting is an unambiguous process. Among the judgments are deciding what and how to count. Among the compromises are balancing numerical precision with narrative complexity. The standpoints of "conditional complementarity," "critical remediation," and "analytic alternation" clarify the added value of converting qualitative data into quantitative form.
PubMed: 19865603
DOI: 10.1177/1558689809334210 -
Sensors (Basel, Switzerland) Aug 2022Numerous studies have sought to demonstrate the utility of digital measures of motor function in Parkinson’s disease. Frameworks, such as V3, document digital measure...
Numerous studies have sought to demonstrate the utility of digital measures of motor function in Parkinson’s disease. Frameworks, such as V3, document digital measure development: technical verification, analytical and clinical validation. We present the results of a study to (1) technically verify accelerometers in an Apple iPhone 8 Plus and ActiGraph GT9X versus an oscillating table and (2) analytically validate software tasks for walking and pronation/supination on the iPhone plus passively detect walking measures with the ActiGraph in healthy volunteers versus human raters. In technical verification, 99.4% of iPhone and 91% of ActiGraph tests show good or excellent agreement versus the oscillating table as the gold standard. For the iPhone software task and algorithms, intraclass correlation coefficients (ICCs) > 0.75 are achieved versus the human raters for measures when walking distance is >10 s and pronation/supination when the arm is rotated more than two times. Passively detected walking start and end time was accurate to approx. 1 s and walking measures were accurate to one unit, e.g., one step. The results suggest that the Apple iPhone and ActiGraph GT9X accelerometers are fit for purpose and that task and passively collected measures are sufficiently analytically valid to assess usability and clinical validity in Parkinson’s patients.
Topics: Algorithms; Gait; Healthy Volunteers; Humans; Pronation; Supination; Walking
PubMed: 36016036
DOI: 10.3390/s22166275 -
Neuronal Signaling Apr 2022Inflammatory stimuli and consequent pro-inflammatory immune responses may facilitate neurodegeneration and threaten survival following pathogen infection or trauma, but... (Review)
Review
Inflammatory stimuli and consequent pro-inflammatory immune responses may facilitate neurodegeneration and threaten survival following pathogen infection or trauma, but potential controllers preventing these risks are incompletely understood. Here, we argue that small RNA regulators of acetylcholine (ACh) signaling, including microRNAs (miRs) and transfer RNA fragments (tRFs) may tilt the balance between innate and adaptive immunity, avoid chronic inflammation and prevent the neuroinflammation-mediated exacerbation of many neurological diseases. While the restrictive permeability of the blood-brain barrier (BBB) protects the brain from peripheral immune events, this barrier can be disrupted by inflammation and is weakened with age. The consequently dysregulated balance between pro- and anti-inflammatory processes may modify the immune activities of brain microglia, astrocytes, perivascular macrophages, oligodendrocytes and dendritic cells, leading to neuronal damage. Notably, the vagus nerve mediates the peripheral cholinergic anti-inflammatory reflex and underlines the consistent control of body-brain inflammation by pro-inflammatory cytokines, which affect cholinergic functions; therefore, the disruption of this reflex can exacerbate cognitive impairments such as attention deficits and delirium. RNA regulators can contribute to re-balancing the cholinergic network and avoiding its chronic deterioration, and their activities may differ between men and women and/or wear off with age. This can lead to hypersensitivity of aged patients to inflammation and higher risks of neuroinflammation-driven cholinergic impairments such as delirium and dementia following COVID-19 infection. The age- and sex-driven differences in post-transcriptional RNA regulators of cholinergic elements may hence indicate new personalized therapeutic options for neuroinflammatory diseases.
PubMed: 35211331
DOI: 10.1042/NS20210035 -
Yearbook of Medical Informatics Aug 2020Contemporary bioethics was fledged and is sustained by challenges posed by new technologies. These technologies have affected many lives. Yet health informatics affects...
Contemporary bioethics was fledged and is sustained by challenges posed by new technologies. These technologies have affected many lives. Yet health informatics affects more lives than any of them. The challenges include the development and the appropriate uses and users of machine learning software, the balancing of privacy rights against the needs of public health and clinical practice in a time of Big Data analytics, whether and how to use this technology, and the role of ethics and standards in health policy. Historical antecedents in statistics and evidence-based practice foreshadow some of the difficulties now faced, but the scope and scale of these challenges requires that ethics, too, be brought to scale in parallel, especially given the size of contemporary data sets and the processing power of new computers. Fortunately, applied ethics affords a variety of tools to help identify and rank applicable values, support best practices, and contribute to standards. The bioethics community can in partnership with the informatics community arrive at policies that promote the health sciences while reaffirming the many and varied rights that patients expect will be honored.
Topics: Artificial Intelligence; Big Data; Bioethical Issues; Confidentiality; Humans; Information Dissemination; Learning Health System; Medical Informatics; Privacy; Public Policy
PubMed: 32303095
DOI: 10.1055/s-0040-1701966 -
Surgery Jul 2021Physicians use perioperative decision-support tools to mitigate risks and maximize benefits to achieve the most successful outcome for patients. Contemporary... (Review)
Review
Physicians use perioperative decision-support tools to mitigate risks and maximize benefits to achieve the most successful outcome for patients. Contemporary risk-assessment practices augment surgeons' judgement and experience with decision-support algorithms driven by big data and machine learning. These algorithms accurately assess risk for a wide range of postoperative complications by parsing large datasets and performing complex calculations that would be cumbersome for busy clinicians. Even with these advancements, large gaps in perioperative risk assessment remain; decision-support algorithms often cannot account for risk-reduction therapies applied during a patient's perioperative course and do not quantify tradeoffs between competing goals of care (eg, balancing postoperative pain control with the risk of respiratory depression or balancing intraoperative volume resuscitation with the risk for complications from pulmonary edema). Multiobjective optimization solutions have been applied to similar problems successfully but have not yet been applied to perioperative decision support. Given the large volume of data available via electronic medical records, including intraoperative data, it is now feasible to successfully apply multiobjective optimization in perioperative care. Clinical application of multiobjective optimization would require semiautomated pipelines for analytics and reporting model outputs and a careful development and validation process. Under these circumstances, multiobjective optimization has the potential to support personalized, patient-centered, shared decision-making with precision and balance.
Topics: Algorithms; Anesthesia; Clinical Decision-Making; Decision Support Techniques; Humans; Pain Management; Pain Measurement; Perioperative Care; Risk Assessment; Surgical Procedures, Operative
PubMed: 33334583
DOI: 10.1016/j.surg.2020.11.005 -
Frontiers in Psychology 2022The various social issues that accompany economic development pose new challenges for leaders to integrate economic benefits, social responsibility, and environmental... (Review)
Review
The various social issues that accompany economic development pose new challenges for leaders to integrate economic benefits, social responsibility, and environmental protection. In this context, various new leadership styles have emerged. Among them, sustainable leadership reveals the key role of leaders in balancing the triple goals of economy, society and environment, and has become an important part of leadership theory research in recent years. We searched the literature related to sustainable leadership in databases such as Web of Science, EBSCO and CNKI. Based on the existing literature, we systematically review the origins, connotations, analytical perspectives, measurement methods, and conceptual comparisons of sustainable leadership. And we also construct an integrated analytical framework of sustainable leadership on the premise of sorting out and summarizing the antecedents and consequences of sustainable leadership. Finally, we provide an outlook on the future research areas of sustainable leadership in order to further promote research of sustainable leadership.
PubMed: 36420377
DOI: 10.3389/fpsyg.2022.1045570 -
PharmacoEconomics May 2019This paper provides an educational review covering the consideration of costs for cost-effectiveness analysis (CEA), summarising relevant methods and research from the... (Review)
Review
This paper provides an educational review covering the consideration of costs for cost-effectiveness analysis (CEA), summarising relevant methods and research from the published literature. Cost data are typically generated by applying appropriate unit costs to healthcare resource-use data for patients. Trial-based evaluations and decision analytic modelling represent the two main vehicles for CEA. The costs to consider will depend on the perspective taken, with conflicting recommendations ranging from focusing solely on healthcare to the broader 'societal' perspective. Alternative sources of resource-use are available, including medical records and forms completed by researchers or patients. Different methods are available for the statistical analysis of cost data, although consideration needs to be given to the appropriate methods, given cost data are typically non-normal with a mass point at zero and a long right-hand tail. The choice of covariates for inclusion in econometric models also needs careful consideration, focusing on those that are influential and that will improve balance and precision. Where data are missing, it is important to consider the type of missingness and then apply appropriate analytical methods, such as imputation. Uncertainty around costs should also be reflected to allow for consideration on the impacts of the CEA results on decision uncertainty. Costs should be discounted to account for differential timing, and are typically inflated to a common cost year. The choice of methods and sources of information used when accounting for cost information within CEA will have an effect on the subsequent cost-effectiveness results and how information is presented to decision makers. It is important that the most appropriate methods are used as overlooking the complicated nature of cost data could lead to inaccurate information being given to decision makers.
Topics: Cost-Benefit Analysis; Decision Making; Decision Support Techniques; Delivery of Health Care; Health Care Costs; Humans; Models, Econometric; Quality-Adjusted Life Years
PubMed: 30746613
DOI: 10.1007/s40273-019-00771-y