Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 421
Filtrar
1.
Front Psychiatry ; 15: 1345789, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38983369

RESUMO

Background: Script memory is stored information about a sequential structure of an activity (e.g., going shopping), including what actors do, the purpose of the activity, and the likely consequences of the actor's actions. It has been reported that script memory is impaired among schizophrenia patients. The present research investigated the relationship between schizotypal personality tendencies (schizotypy) and script memory by testing Japanese individuals. Method: First, a new test to measure the intactness of the script memory was created by asking the public to report activities they often perform and what behaviors each activity contains. The test contains 15 everyday activities, each accompanied by 15 behavior choices, either strongly associated, completely unrelated, or weakly associated with the activity. Next, undergraduate participants were presented with the test and chose appropriate behaviors for each activity (Study 1 and 2). Their extent of schizotypy was measured using Schizotypal Personality Questionnaire Brief (SPQ-B). Study 3 targeted the public of various ages. In addition to Study 2 procedure, participants reported the extent of psychological burden for performing each activity, their life satisfaction, and subjective evaluation of their memory ability. Results: All studies consistently found that the script memory performance was worse for individuals with higher schizotypy. Signal detection indices for accurate discrimination between correct and incorrect choices, which were A' in Study 1 and C in Study 2 and 3, negatively correlated with the SPQ-B scores (r = -0.16, -0.11, -0.17, respectively). Study 3 found that the relationship between schizotypy and memory task performance was mediated by the extent of psychological burden. When a signal detection index (d') for the memory task was regressed on the SPQ-B, while the psychological burden scores being a mediator, the mediation effect was significant (B = 0.003, SE = 0.001, 95% CI [0.001, 0.005]). Conclusion: Individuals with higher schizotypy seem to associate unrelated behaviors to an event, forming script memory with irrelevant information, maybe due to the schizotypy symptom of having peculiar thoughts. The newly created test must be validated using a clinical population to expand its potential to be used in clinical research.

2.
Rev Med Interne ; 2024 Jul 09.
Artigo em Francês | MEDLINE | ID: mdl-38987065

RESUMO

The Script Concordance Tests (SCTs) are an examination modality introduced by decree in the French National Ranking Exam for medical students in 2024. Their objective is to evaluate clinical reasoning in situations of uncertainty. In practice, SCTs assess the impact of new information on the probability of a hypothesis formulated a priori based on an authentic clinical scenario. This approach resembles probabilistic (or Bayesian) reasoning. Due to the uncertainty associated with the explored clinical situation, SCTs do not compare the student's response to an expected one in a theoretical knowledge reference. Instead, the distribution of responses from a panel of experienced physicians is used to establish the question's scoring scale. Literature data suggest that physicians, even experienced ones, like most humans, often exhibit biased intuitive probabilistic reasoning. These biases raise questions about the relevance of using expert panel responses as scoring scales for SCTs.

3.
Attach Hum Dev ; 26(3): 212-232, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38989770

RESUMO

This study examined the empirical convergence of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous scripts with conceptually corresponding attachment patterns assessed via the Adult Attachment Interview (AAI), and the significance of ASA dimensions for autonomic physiological reactivity during adult attachment assessments. Young adults' (50% male; Mage = 19 years; 80% White/European American) ASA deactivation, hyperactivation, and anomalous content were significantly associated with AAI dismissing (r = .26-.38), preoccupied (r = .31-.35), and unresolved (r = .37) states of mind, respectively. ASA hyperactivation and anomalous content were associated with heightened RSA reactivity to the AAI and ASA, aligning with expectations that these attachment patterns capture the tendency to heighten expressions of negative, traumatic experiences. ASA deactivation was associated with smaller increases in electrodermal activity to the ASA-indicative of less sympathetic arousal-converging with the tendency of individuals higher in deactivation to avoid discussing attachment themes in the ASA.


Assuntos
Sistema Nervoso Autônomo , Apego ao Objeto , Humanos , Masculino , Feminino , Adulto Jovem , Sistema Nervoso Autônomo/fisiologia , Resposta Galvânica da Pele/fisiologia , Adolescente , Adulto , Entrevista Psicológica
4.
Attach Hum Dev ; 26(3): 233-252, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38989771

RESUMO

This study examined the stability of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous content and their significance for parenting outcomes in mothers (Mage = 31 years; 78% White/European American) and 6-month-old infants. Comparable to ASA secure base script knowledge (SBSK), mothers' ASA deactivation, hyperactivation, and anomalous content were significantly, moderately stable over two years (r's = .40 - .43). Mothers' ASA hyperactivation and anomalous content were associated with greater maternal intrusiveness, whereas ASA deactivation was associated with greater detachment and less intrusiveness. Only ASA anomalous content was associated with lower maternal sensitivity. Mothers' ASA deactivation was associated with less dynamic change in respiratory sinus arrhythmia during the Still-Face Procedure-reflective of limited mobilization of physiological resources to support responding to infants. Findings support the validity of ASA deactivation, hyperactivation, and anomalous content scripts, and demonstrate their utility in examining adult attachment stability and predictive significance for parent-child outcomes.


Assuntos
Relações Mãe-Filho , Apego ao Objeto , Poder Familiar , Humanos , Feminino , Lactente , Relações Mãe-Filho/psicologia , Adulto , Poder Familiar/psicologia , Masculino , Mães/psicologia , Comportamento Materno/psicologia , Arritmia Sinusal Respiratória/fisiologia
5.
Attach Hum Dev ; 26(3): 253-271, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38989772

RESUMO

This study examined the significance of a novel coding system for evaluating hyperactivation, deactivation, and anomalous content in the Attachment Script Assessment for romantic relationship functioning. In a sample of 208 couples (69% White, Mage 28.7 years), we tested whether ASA hyperactivation and deactivation were associated with theoretically relevant correlates, including observed behavior, parasympathetic reactivity, self-reported affective reactivity to conflict, and relationship satisfaction. Exploratory analyses examined associations of secure base script knowledge (SBSK) and anomalous content with these outcomes. ASA hyperactivation and deactivation were associated with behavioral, physiological, and self-reported functioning in theory-consistent ways. Anomalous content was not associated with romantic functioning. SBSK was associated with satisfaction, but this was not robust to covariates. Findings support the predictive validity of the hyperactivation and deactivation dimensions and suggest that these scales complement SBSK, enabling researchers to assess a wider range of behavioral and physiological indicators associated with distinctive forms of attachment insecurity.


Assuntos
Relações Interpessoais , Apego ao Objeto , Satisfação Pessoal , Humanos , Masculino , Feminino , Adulto , Adulto Jovem
6.
Attach Hum Dev ; 26(3): 203-211, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38989773

RESUMO

Although research on adult attachment has yielded insight into the legacy of attachment for functioning in adulthood, methodological challenges persist in the assessment of adult attachment. The Adult Attachment Interview (AAI) offers a rich assessment of secure, insecure, and unresolved states of mind. However, it is resource intensive to administer and code. Attachment Script Assessment (ASA) offers a resource-effective alternative to the AAI. However, the ASA coding system only yields a single, security-like dimension: secure base script knowledge. Here, we introduce a complementary coding system for the ASA to assess attachment deactivation (i.e. script characterized by limited interpersonal connection and minimization of attachment problems/emotions), hyperactivation (i.e. script in which attachment-relevant problems and negative emotions are heightened), and anomalous content (i.e. script in which attachment problems contain elements of fear and/or disorientation); and we discuss the conceptual convergence of these scripts with corresponding patterns of attachment insecurity and disorganization.


Assuntos
Emoções , Apego ao Objeto , Humanos , Adulto , Relações Interpessoais , Entrevista Psicológica
7.
Infant Child Dev ; 33(2)2024.
Artigo em Inglês | MEDLINE | ID: mdl-38836131

RESUMO

Attachment theorists claim that the quality of parental support is internalized as a mental representation of early relationship experiences. Increasingly, the content of attachment representations is evaluated by studying the extent to which adults demonstrate knowledge of the secure base script, either in the context of the Attachment Script Assessment (ASA) or during the Adult Attachment Interview (AAIsbs). Preliminary evidence from a high-risk sample showed that AAIsbs was more strongly associated with the quality of antecedent caregiving than was the more traditional approach to the measurement of adult attachment focused on the coherence of adults' AAI discourse (Waters, et al., 2017). Drawing on new coding of data from the NICHD Study of Early Child Care and Youth Development (SECCYD), we found that AAIsbs around age 18 years was significantly predicted by observations of maternal (r = .21) and paternal (r = .12) sensitivity assessed prospectively through age 15 years, and with attachment security in the first three years of life (r =.08). AAIsbs was also associated with existing measures of adult attachment (rs = .31-.42). Pre-registered analyses revealed that AAIsbs performed in a manner roughly comparable to traditional, though more labor intensive approaches to coding the AAI. Based on all available evidence from the SECCYD and the pragmatic challenges and advantages of different narrative methods for assessing adult attachment representations (Booth-LaForce & Roisman, 2014; Steele et al., 2014), researchers seeking to measure attachment representations should strongly consider the strengths of the ASA in term of practicality, performance, and adaptability to various age groups across development (Waters & Waters, 2021).

8.
J Psycholinguist Res ; 53(4): 51, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38913110

RESUMO

Previous research has demonstrated cognate translation priming effects in masked priming lexical decision tasks (LDTs) even when a bilingual's two languages have different scripts. Because those effect sizes are normally larger than with noncognates, the effects have been partially attributed to the impact of prime-target phonological similarity. The present research extended that work by examining priming effects when using triple different-script cognates, i.e., /ka1 feɪ1/-coffee-コーヒー/KoRhiR/. Specifically, masked cognate priming effects were examined in six different priming directions (i.e., L1↔L2, L1↔L3, and L2↔L3) for Chinese-English-Japanese trilinguals using LDTs. Significant priming effects were observed only when the primes were from the stronger language. This asymmetric pattern suggests that the phonological similarity of cognate primes only facilitates the processing of different-script triple cognates to the extent that the processing of the prime is robust enough to make phonology available before target processing is finished.


Assuntos
Multilinguismo , Humanos , Adulto , Adulto Jovem , Tomada de Decisões , Masculino , Feminino , Psicolinguística , Idioma , Mascaramento Perceptivo/fisiologia , Fonética , População do Leste Asiático
9.
Korean J Med Educ ; 36(2): 213-221, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38835313

RESUMO

PURPOSE: This study developed and implemented case-based flipped learning using illness script worksheets and investigated the responses of preclinical students and professors to the intervention in terms of its effectiveness, design, and implementation. METHODS: The study was conducted at a medical school in Korea, where the "clinical reasoning method" course, originally a lecture-oriented course, was redesigned into a flipped learning. In total, 42 second-year medical students and 15 professors participated in this course. After the class, online surveys were conducted, and a focus group interview was held with seven students to explore the students' experiences in more detail. RESULTS: In total, 37 students and seven professors participated in the survey. The mean score for all items is 3.12/4 for the student survey and 3.43/4 for the professor survey. The focus group interview results were categorized as the beneficial aspects and challenges for the development of clinical reasoning. CONCLUSION: The findings indicated that their responses to the intervention were generally positive, and it is thought to be an effective instructional method for fostering clinical reasoning skills in preclinical medical students.


Assuntos
Raciocínio Clínico , Currículo , Educação de Graduação em Medicina , Grupos Focais , Aprendizagem Baseada em Problemas , Estudantes de Medicina , Humanos , Aprendizagem Baseada em Problemas/métodos , Educação de Graduação em Medicina/métodos , República da Coreia , Inquéritos e Questionários , Competência Clínica , Docentes de Medicina , Faculdades de Medicina , Avaliação Educacional , Masculino , Feminino
10.
BMC Med Educ ; 24(1): 658, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38872172

RESUMO

BACKGROUND: The consensus that clinical reasoning should be explicitly addressed throughout medical training is increasing; however, studies on specific teaching methods, particularly, for preclinical students, are lacking. This study investigated the effects of an illness script worksheet approach in flipped learning on the development of clinical reasoning abilities in preclinical students. It also explored whether the impact of this intervention differed depending on clinical reasoning ability after dividing the students into high and low groups based on their pre-diagnostic thinking inventory (DTI) scores. METHODS: This study used a one-group pre-post test design and convenience sampling. Forty-two second-year medical students were invited to participate in this study. The course, "clinical reasoning method," was redesigned as an illness script worksheet approach in flipped learning. The course was an eight-week long program. The students met once or twice per week with a different professor each time and engaged with 15 clinical cases in small groups in one classroom. Each time, one professor facilitated seven groups in a single classroom. The effectiveness of the intervention was measured using DTI before and after the intervention. A learning experience survey was conducted with post-DTI assessment. RESULTS: Thirty-six students participated in the survey and their data were analyzed. The mean pre-DTI score was 170.4, and the mean post-DTI score was 185.2, indicating an 8.68% increase (p < .001). Significant differences were also found in both high and low groups between the pre- and post-DTI assessments. However, the low group improved much more than the high group and exhibited a significant increase in one of the DTI subscales as well. The overall average score on the learning experience survey was 3.11 out of 4. CONCLUSION: The findings indicated that the intervention was an effective instructional method for the development of clinical reasoning in preclinical students and was more beneficial for students with a low level of clinical reasoning ability. This study demonstrated that the intervention can be a feasible and scalable method to effectively and efficiently train clinical reasoning in preclinical students in a classroom.


Assuntos
Raciocínio Clínico , Educação de Graduação em Medicina , Avaliação Educacional , Aprendizagem Baseada em Problemas , Estudantes de Medicina , Humanos , Estudantes de Medicina/psicologia , Educação de Graduação em Medicina/métodos , Feminino , Masculino , Competência Clínica , Adulto Jovem , Currículo
11.
Cereb Cortex ; 34(6)2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38858838

RESUMO

We revisited the anatomo-functional characteristics of the basal temporal language area (BTLA), first described by Lüders et al. (1986), using electrical cortical stimulation (ECS) in the context of Japanese language and semantic networks. We recruited 11 patients with focal epilepsy who underwent chronic subdural electrode implantation and ECS mapping with multiple language tasks for presurgical evaluation. A semiquantitative language function density map delineated the anatomo-functional characteristics of the BTLA (66 electrodes, mean 3.8 cm from the temporal tip). The ECS-induced impairment probability was higher in the following tasks, listed in a descending order: spoken-word picture matching, picture naming, Kanji word reading, paragraph reading, spoken-verbal command, and Kana word reading. The anterior fusiform gyrus (FG), adjacent anterior inferior temporal gyrus (ITG), and the anterior end where FG and ITG fuse, were characterized by stimulation-induced impairment during visual and auditory tasks requiring verbal output or not, whereas the middle FG was characterized mainly by visual input. The parahippocampal gyrus was the least impaired of the three gyri in the basal temporal area. We propose that the BTLA has a functional gradient, with the anterior part involved in amodal semantic processing and the posterior part, especially the middle FG in unimodal semantic processing.


Assuntos
Mapeamento Encefálico , Idioma , Lobo Temporal , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , População do Leste Asiático , Estimulação Elétrica , Epilepsias Parciais/fisiopatologia , Epilepsias Parciais/cirurgia , Japão , Imageamento por Ressonância Magnética , Lobo Temporal/fisiologia
12.
PeerJ ; 12: e17504, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38912043

RESUMO

Background: The development of serodiagnostic tests and vaccines for COVID-19 depends on the identification of epitopes from the SARS-CoV-2 genome. An epitope is the specific part of an antigen that is recognized by the immune system and can elicit an immune response. However, when the genetic variants contained in epitopes are used to develop rapid antigen tests (Ag-RDTs) and DNA or RNA vaccines, test sensitivity and vaccine efficacy can be low. Methods: Here, we developed a "variant on epitope (VOE)" software, a new Python script for identifying variants located on an epitope. Variant analysis and sensitivity calculation for seven recommended epitopes were processed by VOE. Variants in 1,011 Omicron SRA reads from two variant databases (BCFtools and SARS-CoV-2-Freebayes) were processed by VOE. Results: A variant with HIGH or MODERATE impact was found on all epitopes from both variant databases except the epitopes KLNDLCFTNV, RVQPTES, LKPFERD, and ITLCFTLKRK on the S gene and ORF7a gene. All epitope variants from the BCFtools and SARS-CoV-2 Freebayes variant databases showed about 100% sensitivity except epitopes APGQTGK and DSKVGGNYN on the S gene, which showed respective sensitivities of 28.4866% and 6.8249%, and 87.7349% and 71.1177%. Conclusions: Therefore, the epitopes KLNDLCFTNV, RVQPTES, LKPFERD, and ITLCFTLKRK may be useful for the development of an epitope-based peptide vaccine and GGDGKMKD on the N gene may be useful for the development of serodiagnostic tests. Moreover, VOE can also be used to analyze other epitopes, and a new variant database for VOE may be further established when a new variant of SARS-CoV-2 emerges.


Assuntos
Vacinas contra COVID-19 , COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/imunologia , SARS-CoV-2/genética , COVID-19/prevenção & controle , COVID-19/diagnóstico , COVID-19/imunologia , Vacinas contra COVID-19/imunologia , Epitopos/imunologia , Epitopos/genética , Software , Sensibilidade e Especificidade
13.
Cogn Emot ; : 1-8, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38869967

RESUMO

Digital communication has generated forms of written speech that may deviate from standard ones, such as Greeklish (a Latin-alphabet-based script) vs. Greek. The question of interest is how different orthographic representations of the same referent (e.g. petaloyda, "butterfly", in Greeklish vs. πϵταλούδα "butterfly" in Greek) may influence word processing, particularly visual word recognition and access to affective connotations. 120 Greek native speakers were tested on a lexical decision task, in which script (Greeklish vs. Greek) and valence (positive vs. negative vs. neutral) were manipulated within participants. Words were matched for word class, frequency, concreteness, length, number of syllables and orthographic neighbourhood. Emotional words differed from neutral ones in valence and arousal. Results yielded faster response times for words written in the standard script (Greek) than the non-standard script (Greeklish). Moreover, regardless of script, response times were negatively correlated with the words' valence, with slowest responses for negative words and fastest for positive ones, suggesting that positive content accelerates lexical access, whereas negative content slows it down. To sum up, although script type was found to affect word recognition, activation of and access to emotional content seemed to resist non-standard characteristics of visual word processing.

14.
JMIR Med Educ ; 10: e53997, 2024 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-38693686

RESUMO

SaNuRN is a five-year project by the University of Rouen Normandy (URN) and the Côte d'Azur University (CAU) consortium to optimize digital health education for medical and paramedical students, professionals, and administrators. The project includes a skills framework, training modules, and teaching resources. In 2027, SaNuRN is expected to train a significant portion of the 400,000 health and paramedical professions students at the French national level. Our purpose is to give a synopsis of the SaNuRN initiative, emphasizing its novel educational methods and how they will enhance the delivery of digital health education. Our goals include showcasing SaNuRN as a comprehensive program consisting of a proficiency framework, instructional modules, and educational materials and explaining how SaNuRN is implemented in the participating academic institutions. SaNuRN is a project aimed at educating and training health-related and paramedics students in digital health. The project results from a cooperative effort between URN and CAU, covering four French departments. The project is based on the French National Referential on Digital Health (FNRDH), which defines the skills and competencies to be acquired and validated by every student in the health, paramedical, and social professions curricula. The SaNuRN team is currently adapting the existing URN and CAU syllabi to FNRDH and developing short-duration video capsules of 20 to 30 minutes to teach all the relevant material. The project aims to ensure that the largest student population earns the necessary skills, and it has developed a two-tier system involving facilitators who will enable the efficient expansion of the project's educational outreach and support the students in learning the needed material efficiently. With a focus on real-world scenarios and innovative teaching activities integrating telemedicine devices and virtual professionals, SaNuRN is committed to enabling continuous learning for healthcare professionals in clinical practice. The SaNuRN team introduced new ways of evaluating healthcare professionals by shifting from a knowledge-based to a competencies-based evaluation, aligning with the Miller teaching pyramid and using the Objective Structured Clinical Examination and Script Concordance Test in digital health education. Drawing on the expertise of URN, CAU, and their public health and digital research laboratories and partners, the SaNuRN project represents a platform for continuous innovation, including telemedicine training and living labs with virtual and interactive professional activities. The SaNuRN project provides a comprehensive, personalized 30-hour training package for health and paramedical students, addressing all 70 FNRDH competencies. The program is enhanced using AI and NLP to create virtual patients and professionals for digital healthcare simulation. SaNuRN teaching materials are open-access. The project collaborates with academic institutions worldwide to develop educational material in digital health in English and multilingual formats. SaNuRN offers a practical and persuasive training approach to meet the current digital health education requirements.


Assuntos
Educação em Saúde , Educação a Distância/métodos , Educação a Distância/tendências , Previsões , Educação em Saúde/tendências , Educação em Saúde/métodos
15.
Med Phys ; 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38810282

RESUMO

BACKGROUND: As radiotherapy techniques advance, so do planning methods for multi-target intracranial SRS cases. Multi-target-single-isocenter (MTSI) planning offers high-precision beam delivery with shortened duration. However, accommodating all targets in a single Patient-Specific-Quality-Assurance (PSQA) with QA devices like SRS MapCHECK (SRS MC) is generally impractical. PURPOSE: Consequently, we conducted PSQA, using a custom script, by relocating each Target or Neighboring-Target-Group (T-NTG) relative to the beam isocenter on the PSQA device, ensuring each target's dose coverage at high precision. METHODS: SRS treatment plans use 6MV-FFF beams, consisting of four Volumetric Modulated ARC Therapy (VMAT) arcs, including one full-arc and three half arcs with couch-kicks. A custom script calculated T-NTG coordinates relative to the beam isocenter. QA verification plans were created for each T-NTG, redefining the beam isocenter for precise alignment with the center of the SRS MC. CBCT images were acquired during PSQA for SRS MC alignment, and gamma-index analysis (GIA) was performed. A single-tail paired t-test assessed the passing rate (PR) for 75 QA verification plans. RESULTS: GIA with l.0 mm/2.0% criteria for each QA plan yielded a PR > 95.5%, with an average of 98.9%. Plans achieving PR > 99.0% and > 97.0% constituted 63% and 92% of studied plans, respectively. Statistical significance was observed in a t-test with an ideal PR value of 100%, while insignificance was found with a PR value of 99%, suggesting that PSQA for individual targets consistently approaches 99% PR. In MTSI cases using 6MV-FFF beams, targets within the lateral dose-fall-off region require careful verification for acceptability. Our clinical study on individual T-NTG relocation demonstrates that the presented PSQA methods are generally acceptable, supported by a statistically insignificant PR against a 99% PR value. CONCLUSIONS: Presented statistical analysis results indicate that the proposed PSQA approach can serve as a reliable tool in clinical settings.

16.
BMC Med Educ ; 24(1): 536, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38750546

RESUMO

BACKGROUND: An illness script is a specific script format geared to represent patient-oriented clinical knowledge organized around enabling conditions, faults (i.e., pathophysiological process), and consequences. Generative artificial intelligence (AI) stands out as an educational aid in continuing medical education. The effortless creation of a typical illness script by generative AI could help the comprehension of key features of diseases and increase diagnostic accuracy. No systematic summary of specific examples of illness scripts has been reported since illness scripts are unique to each physician. OBJECTIVE: This study investigated whether generative AI can generate illness scripts. METHODS: We utilized ChatGPT-4, a generative AI, to create illness scripts for 184 diseases based on the diseases and conditions integral to the National Model Core Curriculum in Japan for undergraduate medical education (2022 revised edition) and primary care specialist training in Japan. Three physicians applied a three-tier grading scale: "A" denotes that the content of each disease's illness script proves sufficient for training medical students, "B" denotes that it is partially lacking but acceptable, and "C" denotes that it is deficient in multiple respects. RESULTS: By leveraging ChatGPT-4, we successfully generated each component of the illness script for 184 diseases without any omission. The illness scripts received "A," "B," and "C" ratings of 56.0% (103/184), 28.3% (52/184), and 15.8% (29/184), respectively. CONCLUSION: Useful illness scripts were seamlessly and instantaneously created using ChatGPT-4 by employing prompts appropriate for medical students. The technology-driven illness script is a valuable tool for introducing medical students to key features of diseases.


Assuntos
Competência Clínica , Educação de Graduação em Medicina , Humanos , Japão , Inteligência Artificial , Currículo , Avaliação Educacional , Estudantes de Medicina
17.
JMIR Form Res ; 8: e51013, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38776539

RESUMO

BACKGROUND: Patient adherence to medications can be assessed using interactive digital health technologies such as electronic monitors (EMs). Changes in treatment regimens and deviations from EM use over time must be characterized to establish the actual level of medication adherence. OBJECTIVE: We developed the computer script CleanADHdata.R to clean raw EM adherence data, and this tutorial is a guide for users. METHODS: In addition to raw EM data, we collected adherence start and stop monitoring dates and identified the prescribed regimens, the expected number of EM openings per day based on the prescribed regimen, EM use deviations, and patients' demographic data. The script formats the data longitudinally and calculates each day's medication implementation. RESULTS: We provided a simulated data set for 10 patients, for which 15 EMs were used over a median period of 187 (IQR 135-342) days. The median patient implementation before and after EM raw data cleaning was 83.3% (IQR 71.5%-93.9%) and 97.3% (IQR 95.8%-97.6%), respectively (Δ+14%). This difference is substantial enough to consider EM data cleaning to be capable of avoiding data misinterpretation and providing a cleaned data set for the adherence analysis in terms of implementation and persistence. CONCLUSIONS: The CleanADHdata.R script is a semiautomated procedure that increases standardization and reproducibility. This script has broader applicability within the realm of digital health, as it can be used to clean adherence data collected with diverse digital technologies.

18.
J Am Acad Dermatol ; 2024 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-38588820

RESUMO

Cognitive bias may lead to medical error, and awareness of cognitive pitfalls is a potential first step to addressing the negative consequences of cognitive bias (see Part 1). For decision-making processes that occur under uncertainty, which encompass most physician decisions, a so-called "adaptive toolbox" is beneficial for good decisions. The adaptive toolbox is inclusive of broad strategies like cultural humility, emotional intelligence, and self-care that help combat implicit bias, negative consequences of affective bias, and optimize cognition. Additionally, the adaptive toolbox includes situational-specific tools such as heuristics, narratives, cognitive forcing functions, and fast and frugal trees. Such tools may mitigate against errors due to cultural, affective, and cognitive bias. Part 2 of this two-part series covers metacognition and cognitive bias in relation to broad and specific strategies aimed at better decision-making.

19.
Insects ; 15(4)2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38667379

RESUMO

Crop rotation is an important strategy for pest reduction. For mono-, or oligophagous pests that overwinter at a previously infested site, crop rotation means that the pests must find new host crop sites in the following year, and it is more efficient if a pest-specific distance is applied. Here, we report the development of a GIS-based tool for efficient cultivation planning using the example of the pest complex pea moth (Cydia nigricana) and grain and green peas (Pisum sativum). Monitoring data for four consecutive years (2016-2019) from 513 sites were used. Infestation of pea seeds and the distance to the previous year's pea sites were recorded. An adjustable Python script was developed by means of infestation-distance-correlation as a pest and crop-specific minimum migration distance (MD). The output of the tool is a risk map as decision support for cultivation planning. It shows different risk buffers with distances from 1261 m to 1825 m, depending on the cultivation type. The web tool is easily adjustable to other pests and crops anywhere in the world. The tool helps to prevent damages caused by agricultural, mono-, or oligophagous insect pests and consequently reduces pesticide applications for the benefit of the environment and biodiversity.

20.
Dev Sci ; : e13522, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38676297

RESUMO

Leveraging data from a longitudinal study of Chinese families (n = 364), this research aims to understand the role of secure base script knowledge as a cognitive mechanism by which early caregiving experiences inform adolescents' friendship quality and feelings of loneliness. Results showed that observed maternal sensitivity at 14 and 24 months old was negatively associated with adolescents' self-reported conflicts with close friends (ß = -0.17, p = 0.044) at 15 years old, and this association was partially mediated by their secure base script knowledge assessed at 10 years old. Further, secure base script knowledge moderated the link between adolescents' friend conflict and feelings of loneliness (ß = -0.15, p = 0.037). The results support a cognitive script perspective on the association between early caregiving experiences and later socio-emotional adjustment. Furthermore, this study adds to the developmental literature that has previously focused on more stringent and authoritarian aspects of parenting in Chinese families, thereby contributing to our understanding of how sensitive and supportive parenting practices contribute to socio-emotional development outside of Western contexts. RESEARCH HIGHLIGHTS: Maternal sensitivity during infancy and toddlerhood has a long-term association with adolescents' friendship quality and adolescents' secure base script partially explains the association. First evidence to demonstrate that the secure base script in attachment relationships mediates the association between early maternal caregiving and socio-emotional development in Chinese adolescents. Adolescents lacking secure base script knowledge are particularly vulnerable to feelings of loneliness when facing high levels of conflict in close friendships.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA