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1.
R Soc Open Sci ; 11(8): 230239, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39144490

RESUMO

Implicit mentalizing involves the automatic awareness of others' perspectives, but its domain-specificity is debated. The Joint Simon task demonstrates implicit mentalizing as a Joint Simon effect (JSE), proposed to stem from spontaneous action co-representation of a social partner's frame of reference in the Joint (but not Individual) task. However, evidence also shows that any sufficiently salient entity (not necessarily social) can induce the JSE. Here, we investigated the content of co-representation through a novel Joint Simon task where participants viewed a set of distinct images assigned to either themselves or their partner. Critically, a surprise image recognition task allowed us to identify partner-driven effects exclusive to the Joint task-sharing condition, versus the Individual condition. We did not observe a significant JSE, preventing us from drawing confident conclusions about the effect's domain-specificity. However, the recognition task results revealed that participants in the Joint task did not recognize their partner's stimuli more accurately than participants in the Individual task. This implies that participants were no more likely to encode content from their partner's perspective during the Joint task. Overall, this study pushes methodological boundaries regarding the elicitation of co-representation in the Joint Simon task and demonstrates the potential utility of a surprise recognition task.

2.
Cereb Cortex ; 34(8)2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39110414

RESUMO

Adaptive behavior is fundamental to cognitive control and executive functioning. This study investigates how cognitive control mechanisms and episodic feature retrieval interact to influence adaptiveness, focusing particularly on theta (4 to 8 Hz) oscillatory dynamics. We conducted two variations of the Simon task, incorporating response-incompatible, response-compatible, and neutral trials. Experiment 1 demonstrated that cognitive adjustments-specifically, cognitive shielding following incompatible trials and cognitive relaxation following compatible ones-are reflected in midfrontal theta power modulations associated with the Simon effect. Experiment 2 showed that reducing feature overlap between trials leads to less pronounced sequential modulations in behavior and midfrontal theta activity, supporting the hypothesis that cognitive control and feature integration share a common neural mechanism. These findings highlight the interaction of cognitive control processes and episodic feature integration in modulating behavior. The results advocate for hybrid models that combine top-down and bottom-up processes as a comprehensive framework to understand cognitive control dynamics and adaptive behavior.


Assuntos
Cognição , Conflito Psicológico , Função Executiva , Ritmo Teta , Humanos , Ritmo Teta/fisiologia , Masculino , Feminino , Adulto Jovem , Cognição/fisiologia , Adulto , Função Executiva/fisiologia , Tempo de Reação/fisiologia , Eletroencefalografia , Desempenho Psicomotor/fisiologia , Adaptação Psicológica/fisiologia , Encéfalo/fisiologia
3.
J Evol Equ ; 24(3): 59, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38966404

RESUMO

We study the evolution of curves with fixed length and clamped boundary conditions moving by the negative L 2 -gradient flow of the elastic energy. For any initial curve lying merely in the energy space we show existence and parabolic smoothing of the solution. Applying previous results on long-time existence and proving a constrained Lojasiewicz-Simon gradient inequality we furthermore show convergence to a critical point as time tends to infinity.

4.
Cogn Process ; 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38976063

RESUMO

Mirror game (MG) is an exercise in which participants imitate each other. Our study explored its spontaneous behavioral consequences after performance. In a baseline (BL) phase, two participants performed a joint Simon task. Then, they performed a lure task during which we measured the interpersonal distance they spontaneously adopted. The BL phase was followed by two phases (in counterbalanced order). The MG phase started with a MG, before a procedure like the BL phase. The individual movement (IM) phase started with movements performed alone before a procedure like the BL phase. Interpersonal distance analysis suggested that MG enhanced spontaneous approach toward the partner, whereas IM induced spontaneous avoidance. Moreover, the joint Simon effect (JSE) tended to be smaller after IM, suggesting a decreasing inclination to integrate the partner's response in one's own action plan. Furthermore, in IM phase, JSE decreased as interpersonal distance increased.

5.
Int J Legal Med ; 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38861166

RESUMO

The authors present the case of a 58-year-old man found hanging from a radiator by his shoelaces. The time of death was approximately 6 h before the body was discovered. An autopsy was performed approximately 24 h after the body was found, which revealed hemorrhages in the thoracic aorta at the junctions of the posterior intercostal arteries. Before autopsy, a routine whole-body CT scan was performed. Histologic examination of the aorta and the posterior intercostal arteries revealed a fresh hemorrhage into the tunica adventitia of the aorta. To our knowledge, there is no case description of such findings in hanged persons in the literature. Conclusion: Hemorrhages into the tunica adventitia of the junction of the posterior costal arteries may occur in association with suicidal hanging. The significance of these hemorrhages as a sign of vitality may be debated.

6.
Cureus ; 16(4): e57809, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38721204

RESUMO

Hanging is amongst the most commonly used methods of suicide. Multiple findings could be observed in such cases. Knowing the proper mechanism of their occurrence and how to interpret them is of utmost importance in forensic practice to avoid misinterpretation and wrong conclusions. The study aimed to present a case of hanging with putrefactive changes - external and internal findings, signs or prolonged stay in a hanged position, their interpretation, and discussion as part of the routine forensic practice.

7.
Front Hum Neurosci ; 18: 1384179, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38711801

RESUMO

Increasing evidence suggests that music training correlates with better performance in tasks measuring executive function components including inhibitory control, working memory and selective attention. The Stroop and Simon tasks measure responses to congruent and incongruent information reflecting cognitive conflict resolution. However, there are more reports of a music-training advantage in the Simon than the Stroop task. Reports indicate that these tasks may differ in the timing of conflict resolution: the Stroop task might involve early sensory stage conflict resolution, while the Simon task may do so at a later motor output planning stage. We hypothesize that musical experience relates to conflict resolution at the late motor output stage rather than the early sensory stage. Behavioral responses, and event-related potentials (ERP) were measured in participants with varying musical experience during these tasks. It was hypothesized that musical experience correlates with better performance in the Simon but not the Stroop task, reflected in ERP components in the later stage of motor output processing in the Simon task. Participants were classified into high- and low-music training groups based on the Goldsmith Musical Sophistication Index. Electrical brain activity was recorded while they completed visual Stroop and Simon tasks. The high-music training group outperformed the low-music training group on the Simon, but not the Stroop task. Mean amplitude difference (incongruent-congruent trials) was greater for the high-music training group at N100 for midline central (Cz) and posterior (Pz) sites in the Simon task and midline central (Cz) and frontal (Fz) sites in the Stroop task, and at N450 at Cz and Pz in the Simon task. N450 difference peaks occurred earlier in the high-music training group at Pz. Differences between the groups at N100 indicate that music training may be related to better sensory discrimination. These differences were not related to better behavioral performance. Differences in N450 responses between the groups, particularly in regions encompassing the motor and parietal cortices, suggest a role of music training in action selection during response conflict situations. Overall, this supports the hypothesis that music training selectively enhances cognitive conflict resolution during late motor output planning stages.

8.
J Biopharm Stat ; : 1-15, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38619921

RESUMO

Single-arm phase II trials are very common in oncology. A fixed sample trial may lack sufficient power if the true efficacy is less than the assumed one. Adaptive designs have been proposed in the literature. We propose a Simon's design based, adaptive sequential design. Simon's design is the most used fixed sample design for single-arm phase II oncology trials. A prominent feature of Simon's design is that it minimizes the sample size when there is no clinically meaningful efficacy. We identify Simon's trial as a special group sequential design. Established methods for sample size re-estimation (SSR) can be readily applied to Simon's design. Simulations show that simply adding SSR to Simon's design may still not provide desirable power. We propose some expansions to Simon's design. The expanded design with SSR can provide even more power.

9.
Stat Methods Med Res ; 33(6): 945-952, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38573793

RESUMO

In single-arm trials with a predefined subgroup based on baseline biomarkers, it is often assumed that a biomarker defined subgroup, the biomarker positive subgroup, has the same or higher response to treatment compared to its complement, the biomarker negative subgroup. The goal is to determine if the treatment is effective in each of the subgroups or in the biomarker positive subgroup only or not effective at all. We propose the isotonic stratified design for this problem. The design has a joint set of decision rules for biomarker positive and negative subjects and utilizes joint estimation of response probabilities using assumed monotonicity of response between the biomarker negative and positive subgroups. The new design reduces the sample size requirement when compared to running two Simon's designs in each biomarker positive and negative. For example, the new design requires 23%-35% fewer patients than running two Simon's designs for scenarios we considered. Alternatively, the new design allows evaluating the response probability in both biomarker negative and biomarker positive subgroups using only 40% more patients needed for running Simon's design in the biomarker positive subgroup only.


Assuntos
Biomarcadores , Projetos de Pesquisa , Humanos , Tamanho da Amostra , Ensaios Clínicos como Assunto/estatística & dados numéricos , Modelos Estatísticos
10.
Hum Mov Sci ; 95: 103210, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38531224

RESUMO

Past research indicates that anticipatory postural adjustment (APA) errors may be due to the incorrect selection of responses to visual stimuli. In the current study we used the Simon task as a methodological tool to challenge the response selection stage of processing by presenting visual cues with conflicting spatial context; in this case generating a step response to a left pointing arrow which appears to the participant's right side or vice versa. We expected greater mediolateral APA errors, delayed APA and step onset times, and greater lateral CoP displacement prior to stepping for visual cues with incongruent spatial contexts compared to cues with congruent. Thirteen healthy young adults completed step initiation trials (n = 40) from a force platform while whole-body kinematic motion was tracked. Participants were presented with arrows pointing to the left or right, indicating to step with the left or right limb, respectively. These arrows were presented on the same side as the desired step direction (congruent) or the opposite side (incongruent). Results revealed that incongruent trials resulted in significantly more incidences of mediolateral APA errors and greater mediolateral CoP deviations during the APA compared to congruent visual cue context trials. No effects were observed for the temporal outcomes, suggesting that young adults can maintain temporal execution of steps despite these motor control errors. This study demonstrates that the spatial context of visual information significantly impacts the success of response selection processes during step initiation, furthering our knowledge of how humans integrate visual information to initiate whole body movement.


Assuntos
Antecipação Psicológica , Sinais (Psicologia) , Equilíbrio Postural , Desempenho Psicomotor , Tempo de Reação , Humanos , Masculino , Feminino , Adulto Jovem , Equilíbrio Postural/fisiologia , Desempenho Psicomotor/fisiologia , Adulto , Fenômenos Biomecânicos , Antecipação Psicológica/fisiologia , Percepção Espacial , Postura/fisiologia , Percepção Visual/fisiologia
11.
J Math Biol ; 88(4): 41, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38446165

RESUMO

Clinical and pre-clinical data suggest that treating some tumors at a mild, patient-specific dose might delay resistance to treatment and increase survival time. A recent mathematical model with sensitive and resistant tumor cells identified conditions under which a treatment aiming at tumor containment rather than eradication is indeed optimal. This model however neglected mutations from sensitive to resistant cells, and assumed that the growth-rate of sensitive cells is non-increasing in the size of the resistant population. The latter is not true in standard models of chemotherapy. This article shows how to dispense with this assumption and allow for mutations from sensitive to resistant cells. This is achieved by a novel mathematical analysis comparing tumor sizes across treatments not as a function of time, but as a function of the resistant population size.


Assuntos
Neoplasias , Humanos , Neoplasias/tratamento farmacológico , Neoplasias/genética , Mutação , Densidade Demográfica
12.
J Forensic Sci ; 69(3): 1021-1024, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38362738

RESUMO

The conventional methamphetamine (MA) detection method using the Simon reaction can be affected by false positives owing to compounds similar to aliphatic secondary amines. In this study, we examined the new Simon reaction to improve the qualitative accuracy of MA detection to discriminate substances that give false positives in a conventional Simon reaction. After the conventional Simon reaction for MA and false positives (N-isopropylbenzylamine (NIP-BA), N-methylbenzylamine (NMe-BA), L-proline (Pro), and L-hydroxyproline (HYP)), which are colored blue, di-tert-butyl dicarbonate (t-Boc) reagent was added, and color tone changes were observed. When t-Boc was added to the false positives (NIP-BA, NMe-BA, Pro, and HYP), the colors of MA, Pro, and HYP changed to purple; NIP-BA changed to blue; and NMe-BA changed to light pink after 3 min. These results suggested that MA can be differentiated from NIP-BA and NMe-BA. Furthermore, the solid-phase chromogenic method was examined, and it was confirmed that MA could be differentiated from Pro and HYP. The method developed in this study should increase the accuracy of MA appraisal at crime scenes and contribute to the reduction of misclassifications arising from false-positive substances.


Assuntos
Toxicologia Forense , Metanfetamina , Humanos , Reações Falso-Positivas , Toxicologia Forense/métodos , Estimulantes do Sistema Nervoso Central/análise , Cor
13.
Behav Processes ; 216: 105005, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38365010

RESUMO

Nonhuman animals have demonstrated various cooperative behaviors; however, many examples can be interpreted as individual contributions to a task rather than true behavioral coordination. In this study, we used the joint Simon task in rats to determine whether the presence of and task sharing with a partner affected performance in a joint activity. Rats were trained to discriminate between two auditory stimuli (3 and 12 kHz tones) and individually performed an auditory Simon task. They were paired with another rat and tested to perform half of the task, while the other rat performed the other half (joint task condition). The Simon effect was confirmed when the two rats completed half of a joint task. In contrast, when they were placed side by side but only one rat completed half of the task, the Simon effect was not observed. Further analyses revealed that the Simon effect observed in the joint task could not be explained by the simple addition of the two half tasks. In conclusion, task sharing affected individual performance in rats.


Assuntos
Desempenho Psicomotor , Análise e Desempenho de Tarefas , Animais , Ratos , Tempo de Reação , Comportamento Cooperativo
14.
BMC Med Res Methodol ; 24(1): 22, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38273261

RESUMO

When multiple influential covariates need to be balanced during a clinical trial, stratified blocked randomization and covariate-adaptive randomization procedures are frequently used in trials to prevent bias and enhance the validity of data analysis results. The latter approach is increasingly used in practice for a study with multiple covariates and limited sample sizes. Among a group of these approaches, the covariate-adaptive procedures proposed by Pocock and Simon are straightforward to be utilized in practice. We aim to investigate the optimal design parameters for the patient treatment assignment probability of their developed three methods. In addition, we seek to answer the question related to the randomization performance when additional covariates are added to the existing randomization procedure. We conducted extensive simulation studies to address these practically important questions.


Assuntos
Projetos de Pesquisa , Humanos , Simulação por Computador , Probabilidade , Distribuição Aleatória , Tamanho da Amostra , Ensaios Clínicos como Assunto
15.
Artigo em Inglês | MEDLINE | ID: mdl-38196142

RESUMO

AIMS: To investigate the prevalence of familial hypercholesterolaemia (FH) and compare the performance of clinical criteria and genetic testing in patients undergoing coronary angiography. METHODS: The prevalence of FH was determined with the Dutch Lipid Clinical Network (DLCN), US-MEDPED, Simon Broome (SB) criteria, the 'Familial Hypercholesterolaemia Case Ascertainment Tool' (FAMCAT), and a clinical algorithm. Genetic screening was conducted with a custom array from Affymetrix (CARRENAL array) harboring 944 FH mutations. RESULTS: The study cohort consisted of 3267 patients (78.6% with coronary artery disease [CAD]). FH was diagnosed in 2.8%, 2.2%, 3.9%, and 7.9% using the DLCN, US-MEDPED, SB criteria, and the FAMCAT. The clinical algorithm identified the same patients as the SB criteria. Pathogenic FH mutations were found in 1.2% (1.2% in patients with CAD, 1.0% in patients without CAD). FH was more frequently diagnosed in younger patients. With genetic testing as reference, the clinical criteria achieved areas under the ROC curve (AUCs) in the range of 0.56-0.68. Using only LDL-C corrected for statin intake, an AUC of 0.68 was achieved. CONCLUSION: FH is up to fourfold more prevalent in patients undergoing coronary angiography than in contemporary cohorts representing the general population. Different clinical criteria yield substantially different diagnosis rates, overestimating the prevalence of FH compared to genetic testing. LDL-C testing alone may be sufficient to raise the suspicion of FH, which then needs to be corroborated by genetic testing.

16.
Hum Brain Mapp ; 45(1): e26549, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38224538

RESUMO

The ability to identify and resolve conflicts between standard, well-trained behaviors and behaviors required by the current context is an essential feature of cognitive control. To date, no consensus has been reached on the brain mechanisms involved in exerting such control: while some studies identified diverse patterns of activity across different conflicts, other studies reported common resources across conflict tasks or even across simple tasks devoid of the conflict component. The latter reports attributed the entire activity observed in the presence of conflict to longer time spent on the task (i.e., to the so-called time-on-task effects). Here, we used an extended Multi-Source Interference Task (MSIT) which combines Simon and flanker types of interference to determine shared and conflict-specific mechanisms of conflict resolution in fMRI and their separability from the time-on-task effects. Large portions of the activity in the dorsal attention network and decreases of activity in the default mode network were shared across the tasks and scaled in parallel with increasing reaction times. Importantly, the activity in the sensory and sensorimotor cortices, as well as in the posterior medial frontal cortex (pMFC) - a key region implicated in conflict processing - could not be exhaustively explained by the time-on-task effects.


Assuntos
Encéfalo , Conflito Psicológico , Humanos , Encéfalo/diagnóstico por imagem , Tempo de Reação , Lobo Frontal , Mapeamento Encefálico
17.
Neurosci Biobehav Rev ; 156: 105468, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37979735

RESUMO

Brain mechanisms of error processing have often been investigated using response interference tasks and focusing on the posterior medial frontal cortex, which is also implicated in resolving response conflict in general. Thereby, the role other brain regions may play has remained undervalued. Here, activation likelihood estimation meta-analyses were used to synthesize the neuroimaging literature on brain activity related to committing errors versus responding successfully in interference tasks and to test for commonalities and differences. The salience network and the temporoparietal junction were commonly recruited irrespective of whether responses were correct or incorrect, pointing towards a general involvement in coping with situations that call for increased cognitive control. The dorsal posterior cingulate cortex, posterior thalamus, and left superior frontal gyrus showed error-specific convergence, which underscores their consistent involvement when performance goals are not met. In contrast, successful responding revealed stronger convergence in the dorsal attention network and lateral prefrontal regions. Underrecruiting these regions in error trials may reflect failures in activating the task-appropriate stimulus-response contingencies necessary for successful response execution.


Assuntos
Mapeamento Encefálico , Encéfalo , Humanos , Mapeamento Encefálico/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Neuroimagem , Córtex Pré-Frontal , Cognição/fisiologia , Imageamento por Ressonância Magnética/métodos
18.
Neuroimage ; 285: 120473, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38040400

RESUMO

Collaboration is a critical skill in everyday life. It has been suggested that collaborative performance may be influenced by social factors such as interpersonal distance, which is defined as the perceived psychological distance between individuals. Previous literature has reported that close interpersonal distance may promote the level of self-other integration between interacting members, and in turn, enhance collaborative performance. These studies mainly focused on interdependent collaboration, which requires high levels of shared representations and self-other integration. However, little is known about the effect of interpersonal distance on independent collaboration (e.g., the joint Simon task), in which individuals perform the task independently while the final outcome is determined by the parties. To address this issue, we simultaneously measured the frontal activations of ninety-four pairs of participants using a functional near-infrared spectroscopy (fNIRS)-based hyperscanning technique while they performed a joint Simon task. Behavioral results showed that the Joint Simon Effect (JSE), defined as the RT difference between incongruent and congruent conditions indicating the level of self-other integration between collaborators, was larger in the friend group than in the stranger group. Consistently, the inter-brain neural synchronization (INS) across the dorsolateral and medial parts of the prefrontal cortex was also stronger in the friend group. In addition, INS in the left dorsolateral prefrontal cortex negatively predicted JSE only in the friend group. These results suggest that close interpersonal distance may enhance the shared mental representation among collaborators, which in turn influences their collaborative performance.


Assuntos
Mapeamento Encefálico , Relações Interpessoais , Humanos , Mapeamento Encefálico/métodos , Espectroscopia de Luz Próxima ao Infravermelho , Córtex Pré-Frontal/diagnóstico por imagem , Amigos , Encéfalo , Comportamento Cooperativo
19.
Q J Exp Psychol (Hove) ; 77(1): 70-89, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36803063

RESUMO

When performing a joint action task, we automatically represent the action and/or task constraints of the co-actor with whom we are interacting. Current models suggest that, not only physical similarity, but also abstract, conceptual features shared between self and the interacting partner play a key role in the emergence of joint action effects. Across two experiments, we investigated the influence of the perceived humanness of a robotic agent on the extent to which we integrate the action of that agent into our own action/task representation, as indexed by the Joint Simon Effect (JSE). The presence (vs. absence) of a prior verbal interaction was used to manipulate robot's perceived humanness. In Experiment 1, using a within-participant design, we had participants perform the joint Go/No-go Simon task with two different robots. Before performing the joint task, one robot engaged in a verbal interaction with the participant and the other robot did not. In Experiment 2, we employed a between-participants design to contrast these two robot conditions as well as a human partner condition. In both experiments, a significant Simon effect emerged during joint action and its amplitude was not modulated by the humanness of the interacting partner. Experiment 2 further showed that the JSE obtained in robot conditions did not differ from that measured in the human partner condition. These findings contradict current theories of joint action mechanisms according to which perceived self-other similarity is a crucial determinant of self-other integration in shared task settings.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Humanos , Tempo de Reação , Relações Interpessoais
20.
Implement Sci ; 18(1): 68, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-38049844

RESUMO

BACKGROUND: Under- and uninsured cancer survivors have significant medical, social, and economic complexity. For these survivors, effective care coordination between oncology and primary care teams is critical for high-quality, comprehensive care. While evidence-based interventions exist to improve coordination between healthcare teams, testing implementation of these interventions for cancer survivors seen in real-world safety-net settings has been limited. This study aimed to (1) identify factors influencing implementation of a multicomponent care coordination intervention (nurse coordinator plus patient registry) focused on cancer survivors with multiple comorbidities in an integrated safety-net system and (2) identify mechanisms through which the factors impacted implementation outcomes. METHODS: We conducted semi-structured interviews (patients, providers, and system leaders), structured observations of primary care and oncology operations, and document analysis during intervention implementation between 2016 and 2020. The practice change model (PCM) guided data collection to identify barriers and facilitators of implementation; the PCM, Consolidated Framework for Implementation Research, and Implementation Research Logic Model guided four immersion/crystallization data analysis and synthesis cycles to identify mechanisms and assess outcomes. Implementation outcomes included appropriateness, acceptability, adoption, and penetration. RESULTS: The intervention was appropriate and acceptable to primary care and oncology teams based on reported patient needs and resources and the strength of the evidence supporting intervention components. Active and sustained partnership with system leaders facilitated these outcomes. There was limited adoption and penetration early in implementation because the study was narrowly focused on just breast and colorectal cancer patients. This created barriers to real-world practice where patients with all cancer types receive care. Over time, flexibility intentionally designed into intervention implementation facilitated adoption and penetration. Regular feedback from system partners and rapid cycles of implementation and evaluation led to real-time adaptations increasing adoption and penetration. DISCUSSION: Evidence-based interventions to coordinate care for underserved cancer survivors across oncology and primary care teams can be implemented successfully when system leaders are actively engaged and with flexibility in implementation embedded intentionally to continuously facilitate adoption and penetration across the health system.


Assuntos
Sobreviventes de Câncer , Neoplasias , Humanos , Oncologia , Neoplasias/terapia , Qualidade da Assistência à Saúde
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