-
BMC Medical Informatics and Decision... 2013Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced... (Review)
Review
BACKGROUND
Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals' knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options.
METHODS
A literature search related to patient decision aids and balance was conducted on Medline, using MeSH terms and PubMed; this search supplemented the 2011 Cochrane Collaboration's review of patient decision aids trials. Only English language articles relevant to patient decision making and addressing the balance of information and options were included. All members of the team independently screened clusters of articles; uncertainties were resolved by seeking review by another member. The team then worked in sub-groups to extract and synthesise data on theory, definitions, and evidence reported in these studies.
RESULTS
A total of 40 articles met the inclusion criteria. Of these, six explained the rationale for balancing the presentation of information and options. Twelve defined "balance"; the definition of "balance" that emerged is as follows: "The complete and unbiased presentation of the relevant options and the information about those options-in content and in format-in a way that enables individuals to process this information without bias". Ten of the 40 articles reported assessing the balance of the relevant decision aid. All 10 did so exclusively from the users' or patients' perspective, using a five-point Likert-type scale. Presenting information in a side-by-side display form was associated with more respondents (ranging from 70% to 96%) judging the information as "balanced".
CONCLUSION
There is a need for comparative studies investigating different ways to improve and measure balance in the presentation of information and options in patient decision aids.
Topics: Consumer Health Information; Decision Support Techniques; Humans; Patient Participation
PubMed: 24625214
DOI: 10.1186/1472-6947-13-S2-S6 -
BMC Public Health Feb 2021Adequate nutrition is a public health challenge due to the increase in the incidence of diet-related diseases. The aim of this study was to examine food and nutrient...
BACKGROUND
Adequate nutrition is a public health challenge due to the increase in the incidence of diet-related diseases. The aim of this study was to examine food and nutrient intakes in the light of the current dietary guidelines of Poland and Norway. This is a suitable model for studying the diet quality in countries with different degrees of government intervention in the food market, which may affect food diversity available for citizens.
METHODS
The food diversity on the market was assessed using national food balance sheets. To show the actual food and nutrient intake within countries, data from 24-h recalls from the national surveys, NORKOST 3 from Norwegians and WOBASZ II from Poles, were used. In order to evaluate whether dietary patterns comply with nutritional and dietary recommendations, the Norwegian and Polish recommendations for nutrition and the national food based dietary guidelines (FBDGs) were analyzed.
RESULTS
Significant differences between the national supplies for most food products were found. Only subtle differences in the national FBDGs and nutritional recommendations were found. Low compliance with the national FBDGs for milk, fish and sugar consumption in Poland was observed. The intakes of most nutrients were in line with the countries' nutrition recommendations. The intakes of folate and vitamin D by both genders and the intake of iron among women, were inadequate in both countries. Calcium and magnesium intakes were below the recommended intake among the adult population of Poland, additionally, insufficient intake of potassium and thiamine was found among Polish women.
CONCLUSIONS
Despite the limited availability of certain food products on the market, the diet of Norwegians was better balanced in terms of food consumed and micronutrient intakes. The good supply of various groups of food has not, however, reduced the problem of widespread deficiency of vitamin D and folic acid in the diet, and action should be taken at national level to eliminate their inadequacy. In view of increasing risk of non-communicable diseases, low compliance with the dietary guidelines requires educational campaigns aimed at increasing dietary literacy in vulnerable groups.
Topics: Adult; Animals; Diet; Diet Surveys; Energy Intake; Female; Humans; Male; Norway; Nutrition Policy; Poland
PubMed: 33563240
DOI: 10.1186/s12889-021-10361-3 -
BMC Public Health Apr 2022Understanding people's subjective experiences of everyday lives with chronic health conditions such as diabetes is important for appropriate healthcare provisioning and...
BACKGROUND
Understanding people's subjective experiences of everyday lives with chronic health conditions such as diabetes is important for appropriate healthcare provisioning and successful self-care. This study explored how individuals with type 2 diabetes in northern Vietnam handle the everyday life work that their disease entails.
METHODS
Detailed ethnographic data from 27 extended case studies conducted in northern Vietnam's Thái Bình province in 2018-2020 were analyzed.
RESULTS
The research showed that living with type 2 diabetes in this rural area of Vietnam involves comprehensive everyday life work. This work often includes efforts to downplay the significance of the disease in the attempt to stay mentally balanced and ensure social integration in family and community. Individuals with diabetes balance between disease attentiveness, keeping the disease in focus, and disease discretion, keeping the disease out of focus, mentally and socially. To capture this socio-emotional balancing act, we propose the term "everyday disease diplomacy." We show how people's efforts to exercise careful everyday disease diplomacy poses challenges to disease management.
CONCLUSIONS
In northern Vietnam, type 2 diabetes demands daily labour, as people strive to enact appropriate self-care while also seeking to maintain stable social connections to family and community. Health care interventions aiming to enhance diabetes care should therefore combine efforts to improve people's technical diabetes self-care skills with attention to the lived significance of stable family and community belonging.
Topics: Anthropology, Cultural; Diabetes Mellitus, Type 2; Diplomacy; Humans; Self Care; Vietnam
PubMed: 35468753
DOI: 10.1186/s12889-022-13157-1 -
Frontiers in Neuroscience 2017Postural control during free stance has been frequently interpreted in terms of balancing an inverted pendulum. This even holds, if subjects do not balance their own,...
Postural control during free stance has been frequently interpreted in terms of balancing an inverted pendulum. This even holds, if subjects do not balance their own, but an external body weight. We introduce here a virtual balancing apparatus, which produces torque in the ankle joint as a function of ankle angle resembling the gravity and inertial effects of free standing. As a first aim of this study, we systematically modified gravity, damping, and inertia to examine its effect on postural control beyond the physical constraints given in the real world. As a second aim, we compared virtual balancing to free stance to test its suitability for balance training in patients who are not able to balance their full body weight due to certain medical conditions. In a feasibility study, we analyzed postural control during free stance and virtual balancing in 15 healthy subjects. Postural control was characterized by spontaneous sway measures and measures of perturbed stance. During free stance, perturbations were induced by pseudorandom anterior-posterior tilts of the body support surface. In the virtual balancing task, we systematically varied the anterior-posterior position of the foot plate where the balancing forces are zero following a similar pseudorandom stimulus profile. We found that subjects' behavior during virtual balancing resembles free stance on a tilting platform. This specifically holds for the profile of body excursions as a function of stimulus frequencies. Moreover, non-linearity between stimulus and response amplitude is similar in free and virtual balancing. The overall larger stimulus induced body excursions together with an altered phase behavior between stimulus and response could be in part explained by the limited use of vestibular and visual feedback in our experimental setting. Varying gravity or damping significantly affected postural behavior. Inertia as an isolated factor had a mild effect on the response functions. We conclude that virtual balancing may be well suited to simulate conditions which could otherwise only be realized in space experiments or during parabolic flights. Further studies are needed to examine patients' potential benefit of virtual balance training.
PubMed: 29018320
DOI: 10.3389/fnins.2017.00531 -
Frontiers in Bioengineering and... 2022Total knee arthroplasty (TKA) failures are often attributed to unbalanced knee ligament loading. The current study aims to develop a probabilistic planning process to...
Total knee arthroplasty (TKA) failures are often attributed to unbalanced knee ligament loading. The current study aims to develop a probabilistic planning process to optimize implant component positioning that achieves a ligament-balanced TKA. This planning process accounts for both subject-specific uncertainty, in terms of ligament material properties and attachment sites, and surgical precision related to the TKA process typically used in clinical practice. The consequent uncertainty in the implant position parameters is quantified by means of a surrogate model in combination with a Monte Carlo simulation. The samples for the Monte Carlo simulation are generated through Bayesian parameter estimation on the native knee model in such a way that each sample is physiologically relevant. In this way, a subject-specific uncertainty is accounted for. A sensitivity analysis, using the delta-moment-independent sensitivity measure, is performed to identify the most critical ligament parameters. The designed process is capable of estimating the precision with which the targeted ligament-balanced TKA can be realized and converting this into a success probability. This study shows that without additional subject-specific information (e.g., knee kinematic measurements), a global success probability of only 12% is estimated. Furthermore, accurate measurement of reference strains and attachment sites critically improves the success probability of the pre-operative planning process. To allow more precise planning, more accurate identification of these ligament properties is required. This study underlines the relevance of investigating or intraoperative measurement techniques to minimize uncertainty in ligament-balanced pre-operative planning results, particularly prioritizing the measurement of ligament reference strains and attachment sites.
PubMed: 36466330
DOI: 10.3389/fbioe.2022.930724 -
Epilepsia Dec 2007Clinical and epidemiological research studies are essential to advancing our understanding of human health conditions such as epilepsy. To be of value, studies must not... (Review)
Review
Clinical and epidemiological research studies are essential to advancing our understanding of human health conditions such as epilepsy. To be of value, studies must not only address important questions, they must do so in such a way as to contribute usefully to existing knowledge. Comprehensive understanding of the subject matter is only one component of successful research and research reports. A firm grasp of research methods and statistical issues and a scholarly command of the relevant and current literature are essential components to high-quality research. No single study, however, is perfect nor can any single study definitively answer a given single research question. Studies must be designed and evaluated in light of historical, scientific, pragmatic, and ethical realities that may constrain them. Selected but essential methodological and statistical concepts are discussed along with the need to balance innovation and novelty against methodological rigor.
Topics: Bias; Data Collection; Data Interpretation, Statistical; Epidemiologic Studies; Epilepsy; Ethics, Research; Humans; Research; Research Design
PubMed: 17868050
DOI: 10.1111/j.1528-1167.2007.01312.x -
Scientific Reports Apr 2021Humans and other complex organisms exhibit intelligent behaviors as individual agents and as groups of coordinated agents. They can switch between independent and...
Humans and other complex organisms exhibit intelligent behaviors as individual agents and as groups of coordinated agents. They can switch between independent and collective modes of behavior, and flexible switching can be advantageous for adapting to ongoing changes in conditions. In the present study, we investigated the flexibility between independent and collective modes of behavior in a simulated social foraging task designed to benefit from both modes: distancing among ten foraging agents promoted faster detection of resources, whereas flocking promoted faster consumption. There was a tradeoff between faster detection versus faster consumption, but both factors contributed to foraging success. Results showed that group foraging performance among simulated agents was enhanced by loose coupling that balanced distancing and flocking among agents and enabled them to fluidly switch among a variety of groupings. We also examined the effects of more sophisticated cognitive capacities by studying how human players improve performance when they control one of the search agents. Results showed that human intervention further enhanced group performance with loosely coupled agents, and human foragers performed better when coordinating with loosely coupled agents. Humans players adapted their balance of independent versus collective search modes in response to the dynamics of simulated agents, thereby demonstrating the importance of adaptive flexibility in social foraging.
PubMed: 33875697
DOI: 10.1038/s41598-021-87717-7 -
Cureus Feb 2024Introduction The concept of work-life balance is a complex, multidimensional intertwinement of the roles an individual plays in their professional and personal life....
Introduction The concept of work-life balance is a complex, multidimensional intertwinement of the roles an individual plays in their professional and personal life. Work-life balance is crucial for every profession, and doctors have no exemption not exempted from it. Medical students and young graduates face numerous challenges that potentially impact their work (study)-life balance. Objectives of the study The aim is to assess the hours spent in study and the hours spent in non-study activities by medical students and graduates in India and to assess the study-life balance among them. Methodology A cross-sectional observational study employing a predefined web-basedsurvey to investigate the study-life balance among medical students and graduates across India. A predesigned questionnaire was designed and made accessible through Google Forms, which was distributed among doctors across India via popular social media platforms. Data management was conducted using Microsoft Excel and Data analysis was done using SPSS (IBM Corp., Armonk, NY). Results A total of 416 responses were included in the study. The study participants were predominantly female (64.2%). Most of the study participants were from the State of Telangana (63.9%). The time spent studying was < 10 hours/week for 43.8% students and 10-25 hours/week for 27.2% students. Around 24% students reported spending 10-25 hours/week in hospital. While 47.4% reported spending less than one to two hours per day with their family, 26% of the participants answered "yes" to the question "Do you feel that your study-life is stressful?." Conclusions Self-care and study-life balance is a multi-factorial focal area that is based on balancing stress and happiness, with completing the tasks of the medical school. Medical students need to receive proper guidelines to transition into medical school for better study-life balance.
PubMed: 38558639
DOI: 10.7759/cureus.55293 -
Brain Topography Jul 2017Balance control is a fundamental component of human every day motor activities such as standing or walking, and its impairment is associated with an increased risk of...
Balance control is a fundamental component of human every day motor activities such as standing or walking, and its impairment is associated with an increased risk of falling. However, in humans the exact neurobiological mechanisms underlying balance control are still unclear. Specifically, although previous studies have identified a number of cortical regions that become significantly activated during real or imagined balancing, the interactions within and between the relevant cortical regions remain to be investigated. The working hypothesis of this study is that cortical networks contribute to an optimization of balance control, and that this contribution can be revealed by partial directed coherence-a time-variant, frequency-selective and directed functional connectivity analysis tool. Electroencephalographic activity was recorded in 37 subjects during single-leg balancing on a stable as well as an unstable surface. Results of this study show that in the transition from balancing on a stable surface to an unstable surface, two topographically delimitable connectivity networks (weighted directed networks) are established; one associated with the alpha and one with the theta frequency band. The theta network sequence can be described as a set of subnetworks (modules) comprising the frontal, central and parietal cortex with individual temporal and spatial developments within and between those modules. In the alpha network, the occipital electrodes O1 and O2 act as a source, and the interactions propagate predominantly in the directions from occipital to parietal and to centro-parietal areas. These important findings indicate that balance control is supported by at least two functional cortical networks.
Topics: Adult; Alpha Rhythm; Brain Mapping; Cerebral Cortex; Electroencephalography; Humans; Male; Postural Balance; Theta Rhythm; Young Adult
PubMed: 28466295
DOI: 10.1007/s10548-017-0567-x -
The Bone & Joint Journal Nov 2014Total knee replacement (TKR) smart tibial trials have load-bearing sensors which will show quantitative compartment pressure values and femoral-tibial tracking patterns.... (Review)
Review
Total knee replacement (TKR) smart tibial trials have load-bearing sensors which will show quantitative compartment pressure values and femoral-tibial tracking patterns. Without smart trials, surgeons rely on feel and visual estimation of imbalance to determine if the knee is optimally balanced. Corrective soft-tissue releases are performed with minimal feedback as to what and how much should be released. The smart tibial trials demonstrate graphically where and how much imbalance is present, so that incremental releases can be performed. The smart tibial trials now also incorporate accelerometers which demonstrate the axial alignment. This now allows the surgeon the option to perform a slight recut of the tibia or femur to provide soft-tissue balance without performing soft-tissue releases. Using a smart tibial trial to assist with soft-tissue releases or bone re-cuts, improved patient outcomes have been demonstrated at one year in a multicentre study of 135 patients (135 knees).
Topics: Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Computer Simulation; Humans; Knee Joint; Knee Prosthesis; Range of Motion, Articular
PubMed: 25381414
DOI: 10.1302/0301-620X.96B11.34339