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1.
BMC Prim Care ; 25(1): 111, 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38605357

RESUMO

BACKGROUND: Despite the potential advantages of Internet-based diabetes self-management education, its adoption was not widespread among Singapore's public primary care clinics (polyclinics). An interactive online tool was thus developed to help educate patients with Type 2 diabetes mellitus (T2DM), and was now ready for user testing before implementation. AIM: To explore the perceived utility and usability of the educational tool in patients with suboptimally-controlled T2DM in a Singapore primary care setting. METHODS: In-depth interviews were used to gather qualitative data from multi-ethnic Asian adults who had suboptimally-controlled T2DM. A total of 17 IDIs were conducted between April 2022 to March 2023, audio-recorded, transcribed, and analyzed to identify emergent themes via thematic analysis. RESULTS: Regarding utility, users found the educational tool useful because it provided them with information that was comprehensive, accessible, reliable, and manageable. Regarding usability, the majority of users reported that the educational tool was easy to use, and suggested ways to improve navigational cues, visual clarity, readability and user engagement. CONCLUSION: Participants generally found the educational tool useful and easy to use. A revised educational tool will be developed based on their feedback and implemented in clinical practice.


Assuntos
Diabetes Mellitus Tipo 2 , Autogestão , Adulto , Humanos , Diabetes Mellitus Tipo 2/terapia , Atenção Primária à Saúde , Poder Psicológico , Singapura
2.
PLoS One ; 19(4): e0298261, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38598458

RESUMO

In the realm of targeted advertising, the demand for precision is paramount, and the traditional centralized machine learning paradigm fails to address this necessity effectively. Two critical challenges persist in the current advertising ecosystem: the data privacy concerns leading to isolated data islands and the complexity in handling non-Independent and Identically Distributed (non-IID) data and concept drift due to the specificity and diversity in user behavior data. Current federated learning frameworks struggle to overcome these hurdles satisfactorily. This paper introduces Fed-GANCC, an innovative federated learning framework that synergizes Generative Adversarial Networks (GANs) and Group Clustering. The framework incorporates a user data augmentation algorithm predicated on adversarial generative networks to enrich user behavior data, curtail the impact of non-uniform data distribution, and enhance the applicability of the global machine learning model. Unlike traditional approaches, our framework offers user data augmentation algorithms based on adversarial generative networks, which not only enriches user behavior data but also reduces the challenges posed by non-uniform data distribution, thereby enhancing the applicability of the global machine learning (ML) model. The effectiveness of Fed-GANCC is distinctly showcased through experimental results, outperforming contemporary methods like FED-AVG and FED-SGD in terms of accuracy, loss value, and receiver operating characteristic (ROC) indicators within the same computing time. Experimental results vindicate the effectiveness of Fed-GANCC, revealing substantial enhancements in accuracy, loss value, and receiver operating characteristic (ROC) metrics compared to FED-AVG and FED-SGD given the same computational time. These outcomes underline Fed-GANCC's exceptional prowess in mitigating issues such as isolated data islands, non-IID data, and concept drift. With its novel approach to addressing the prevailing challenges in targeted advertising such as isolated data islands, non-IID data, and concept drift, the Fed-GANCC framework stands as a benchmark, paving the way for future advancements in federated learning solutions tailored for the advertising domain. The Fed-GANCC framework promises to offer pivotal insights for the future development of efficient and advanced federated learning solutions for targeted advertising.


Assuntos
Publicidade , Algoritmos , Análise por Conglomerados , Poder Psicológico
3.
Ann Card Anaesth ; 27(2): 128-135, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38607876

RESUMO

INTRODUCTION: Extra Corporeal Membrane Oxygenation (ECMO) has long been used for cardiorespiratory support in the immediate post-paediatric cardiac surgery period with a 2-3% success as per the ELSO registry. Success in recovery depends upon the optimal delivery of critical care to paediatric patients and a comprehensive healthcare team. METHODOLOGY: The survival benefit of children placed on central veno arterial (VA) ECMO following elective cardiac surgeries for congenital heart disease (n = 672) was studied in a cohort of 29 (4.3%) cases from the period of Jan 2018 to Dec 2022 in our cardiac surgical centre. Indications for placing these patients on central VA ECMO included inability to wean from cardiopulmonary bypass (CPB), low cardiac output syndrome, severe pulmonary arterial hypertension, significant bleeding, anaphylaxis, respiratory failure and severe pulmonary edema. RESULTS: The mean time to initiation of ECMO was less than 5 h and the mean duration of ECMO support was 56 h with a survival rate of 58.3%. Amongst perioperative complications, sepsis and arrhythmia on ECMO were found to be negatively associated with survival. Improvements in the pH, PaO2 levels and serum lactate levels after initiation of ECMO were associated with survival benefits. CONCLUSION: The early initiation of ECMO for paediatric cardiotomies could be a beacon of hope for families and medical teams confronting these challenging situations. Improvement in indicators of adequate perfusion and ventricular recoveries like pH and serum lactate and absence of arrhythmia and sepsis are associated with good outcomes.


Assuntos
Oxigenação por Membrana Extracorpórea , Hipertensão Pulmonar , Sepse , Humanos , Criança , Arritmias Cardíacas , Poder Psicológico , Lactatos
5.
JMIR Hum Factors ; 11: e51522, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38564261

RESUMO

BACKGROUND: More than 18 million cancer survivors are living in the United States. The effects of cancer and its treatments can have cognitive, psychological, physical, and social consequences that many survivors find incredibly disabling. Posttreatment support is often unavailable or underused, especially for survivors living with disabilities. This leaves them to deal with new obstacles and struggles on their own, oftentimes feeling lost during this transition. Mobile health (mHealth) interventions have been shown to effectively aid cancer survivors in dealing with many of the aftereffects of cancer and its treatments; these interventions hold immense potential for survivors living with disabilities. We developed a prototype for WeCanManage, an mHealth-delivered self-management intervention to empower cancer survivors living with disabilities through problem-solving, mindfulness, and self-advocacy training. OBJECTIVE: Our study conducted a heuristic evaluation of the WeCanManage high-fidelity prototype and assessed its usability among cancer survivors with known disabilities. METHODS: We evaluated the prototype using Nielsen's 10 principles of heuristic evaluation with 22 human-computer interaction university students. On the basis of the heuristic evaluation findings, we modified the prototype and conducted usability testing on 10 cancer survivors with a variety of known disabilities, examining effectiveness, efficiency, usability, and satisfaction, including a completion of the modified System Usability Scale (SUS). RESULTS: The findings from the heuristic evaluation were mostly favorable, highlighting the need for a help guide, addressing accessibility concerns, and enhancing the navigation experience. After usability testing, the average SUS score was 81, indicating a good-excellent design. The participants in the usability testing sample expressed positive reactions toward the app's design, educational content and videos, and the available means of connecting with others. They identified areas for improvement, such as improving accessibility, simplifying navigation within the community forums, and providing a more convenient method to access the help guide. CONCLUSIONS: Overall, usability testing showed positive results for the design of WeCanManage. The course content and features helped participants feel heard, understood, and less alone.


Assuntos
Sobreviventes de Câncer , Aplicativos Móveis , Neoplasias , Humanos , Design Centrado no Usuário , Heurística , Interface Usuário-Computador , Poder Psicológico , Neoplasias/terapia
6.
Front Immunol ; 15: 1373269, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38566987

RESUMO

In Mantle Cell Lymphoma (MCL), the role of macrophages within the tumour microenvironment (TME) has recently gained attention due to their impact on prognosis and response to therapy. Despite their low absolute number in MCL tumour tissue, recent findings reveal an association between the levels of macrophages and prognosis, consistent with trends observed in other lymphoma subtypes. M2-like macrophages, identified by markers such as CD163, contribute to angiogenesis and suppression of the immune response. Clinical trials with MCL patients treated with chemoimmunotherapy and targeted treatments underscore the adverse impact of high levels of M2-like macrophages. Immunomodulatory drugs like lenalidomide reduce the levels of MCL-associated CD163+ macrophages and enhance macrophage phagocytic activity. Similarly, clinical approaches targeting the CD47 "don't eat me" signalling, in combination with the anti-CD20-antibody rituximab, demonstrate increased macrophage activity and phagocytosis of MCL tumour cells. Cell-based therapies such as chimeric antigen receptor (CAR) T-cell have shown promise but various challenges persist, leading to a potential interest in CAR-macrophages (CAR-M). When macrophages are recruited to the TME, they offer advantages including phagocytic function and responsiveness to microenvironment alterations, suggesting their potential as a manipulable and inducible alternative when CAR T-cell therapies fails in the complex landscape of MCL treatment.


Assuntos
Linfoma de Célula do Manto , Humanos , Adulto , Linfoma de Célula do Manto/terapia , Microambiente Tumoral , Macrófagos , Rituximab/uso terapêutico , Poder Psicológico
7.
J Public Health Manag Pract ; 30(3): 420-423, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38603749

RESUMO

The Rethinking Incarceration and Empowering Recovery (RIvER) Clinic was launched in June 2021 to address the health disparities experienced during and after incarceration. The RIvER Clinic's multidisciplinary, community-centered team engages patients during jail detention and after release via telehealth, collocated in community locations, on a mobile van, and in clinic. The clinic serves as a bridge between incarceration and the establishment of permanent health care and social services in the community. In 2022, a total of 479 visits were completed. The clinic provided multidisciplinary substance use support to all eligible patients, paying for 104 medication for opioid use disorder (MOUD) prescriptions for uninsured patients. Twenty-five percent of patients were transitioned to community-based care, and less than 5% of patients were reincarcerated. Despite some limitations, results demonstrate that the RIvER Clinic is successfully reintegrating a marginalized population into its community. The purpose of this article is to describe the implementation and preliminary outcomes of this postincarceration clinic.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias , 60648 , Rios , Atenção à Saúde , Poder Psicológico
8.
PLoS One ; 19(4): e0299790, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38626054

RESUMO

BACKGROUND: Patient engagement as partners in diabetes prevention for family members/close relatives is a novel and underexplored approach. This paper aims to assess patients' willingness and confidence in their ability to succeed as health educators for their family members and investigate the influencing factors. METHODS: A cross-sectional descriptive study was conducted between January 2023 and April 2023. A newly developed and validated self-reported questionnaire, based on the Health Belief Model (HBM) and previous research, was administered to a convenient sample of 134 adult participants diagnosed with diabetes. These participants sought care at primary healthcare clinics at King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs in Riyadh and Jeddah (MNGHA). The data was examined using statistical methods including descriptive analysis, ANOVA, Tukey's HSD (Honestly Significant Difference) Post Hoc tests, and Pearson's correlation coefficients. RESULTS: The majority of participants expressed a willingness to assume the role of health educators for their family members (n = 117, 87.31%) and reported a high level of willingness and confidence, as indicated by self-efficacy scores ranging from 12.00 to 25.00, with a mean of 21.12 (SD = 2.76). Participants' willingness to be health educators exhibited positive correlations with their perceptions of diabetes severity and susceptibility (r = .433, p < .01), perceived benefits and barriers (r = .451, p < .01), cues to action (r = .520, p < .01), self-efficacy (r = .789, p < .01), and the total score of the questionnaire (r = .640, p < .01). CONCLUSIONS: The majority of participants expressed their willingness to assume the role of health educators for their family members, and a significant portion reported confidence in their capacity to accomplish this objective. Healthcare providers should emphasize the importance of equipping patients with the skills and knowledge necessary to effectively convey health messages and serve as health educators within their communities. This expansion of the approach holds the potential to have a significant impact on public health strategies for diabetes prevention.


Assuntos
Diabetes Mellitus , Educadores em Saúde , Adulto , Humanos , Estudos Transversais , Inquéritos e Questionários , Poder Psicológico , Conhecimentos, Atitudes e Prática em Saúde
10.
PLoS One ; 19(4): e0298166, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38578820

RESUMO

Indigenous and Northern women in Canada experience high rates of intimate partner violence (IPV), and this is particularly true in the Northwest Territories (NWT). Adolescents are also at increased risk of IPV, which has far-reaching, lifelong effects. Indigenous youth are particularly vulnerable to IPV due to ongoing effects of intergenerational trauma caused by colonialism, racism and residential school legacies. We explored attitudes towards IPV and the healthy relationship knowledge, skills, and experiences among participants of Fostering Open eXpression among Youth (FOXY) and Strength, Masculinities, and Sexual Health (SMASH) Peer Leader Retreats in the NWT. Multi-method approaches included quantitative surveys youth completed before and immediately following retreats. Quantitative analysis from retreats (2018-2021) included 240 participants aged 12-19 (mean age 14.5) who reported ever having an intimate partner. Most were from the FOXY program (64.2%), Indigenous (69.6%) and heterosexual (66.4%). Qualitative methods included Focus Group Discussions (FGD) (n = 69) conducted with peer leaders and apprentices (n = 311) and youth and adult staff (n = 14 FGDs, n = 165 participants). We thematically analysed FGDs to explore healthy relationship knowledge and skills, alongside paired t-tests to examine pre/post retreat changes in attitudes towards IPV. Qualitative findings suggest that leadership and embodied learning were effective in equipping youth with violence prevention and healthy relationship skills. While young women were committed to sharing knowledge and skills about healthy relationships in their communities, young men resonated with values of respect and appreciated support to identify and express emotions. Participants across programmes demonstrated their belief that healthy intimate relationships have communal, relational and intergenerational benefits. Quantitatively, we found a statistically significant reduction in attitudes accepting of IPV among young women, but no changes were noted among young men. Findings contribute to emergent evidence on strengths-based, culturally-responsive IPV prevention programming. Components of effective IPV prevention programming with young men merit further exploration.


Assuntos
Violência por Parceiro Íntimo , Comportamento Sexual , Masculino , Adulto , Adolescente , Humanos , Feminino , Territórios do Noroeste , Parceiros Sexuais , Canadá , Violência por Parceiro Íntimo/prevenção & controle , Poder Psicológico
11.
Sci Rep ; 14(1): 6269, 2024 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491134

RESUMO

Soil health is essential for whirling stale soil into rich coffee-growing land. By keeping healthy soil, coffee producers may improve plant growth, leaf health, buds, cherry and bean quality, and yield. Traditional soil monitoring is tedious, time-consuming, and error-prone. Enhancing the monitoring system using AI-based IoT technologies for quick and precise changes. Integrated soil fertility control system to optimize soil health, maximize efficiency, promote sustainability, and prevent crop threads using real-time data analysis to turn infertile land into fertile land. The RNN-IoT approach uses IoT sensors in the coffee plantation to collect real-time data on soil temperature, moisture, pH, nutrient levels, weather, CO2 levels, EC, TDS, and historical data. Data transmission using a wireless cloud platform. Testing and training using recurrent neural networks (RNNs) and gated recurrent units gathered data for predicting soil conditions and crop hazards. Researchers are carrying out detailed qualitative testing to evaluate the proposed RNN-IoT approach. Utilize counterfactual recommendations for developing alternative strategies for irrigation, fertilization, fertilizer regulation, and crop management, taking into account the existing soil conditions, forecasts, and historical data. The accuracy is evaluated by comparing it to other deep learning algorithms. The utilization of the RNN-IoT methodology for soil health monitoring enhances both efficiency and accuracy in comparison to conventional soil monitoring methods. Minimized the ecological impact by minimizing water and fertilizer utilization. Enhanced farmer decision-making and data accessibility with a mobile application that provides real-time data, AI-generated suggestions, and the ability to detect possible crop hazards for swift action.


Assuntos
Fertilizantes , Solo , Agricultura , Fazendas , Poder Psicológico
12.
Nutrients ; 16(6)2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38542717

RESUMO

Uterine fibroids (UFs) are the most common prevalent benign tumor among women of reproductive age, disproportionately affecting women of color. This paper introduces an innovative management strategy for UFs, emphasizing the curbing of disease prevention and progression. Traditionally, medical intervention is deferred until advanced stages, necessitating invasive surgeries such as hysterectomy or myomectomy, leading to high recurrence rates and increased healthcare costs. The strategy, outlined in this review, emphasizes UF disease management and is named LIFE UP awareness-standing for Lifestyle Interventions, Food Modifications, and Environmental Practices for UF Prevention. These cost-effective, safe, and accessible measures hold the potential to prevent UFs, improve overall reproductive health, reduce the need for invasive procedures, and generate substantial cost savings for both individuals and healthcare systems. This review underscores the importance of a proactive UF management method, paving the way for future research and policy initiatives in this domain.


Assuntos
Leiomioma , Miomectomia Uterina , Neoplasias Uterinas , Feminino , Humanos , Neoplasias Uterinas/prevenção & controle , Neoplasias Uterinas/patologia , Leiomioma/prevenção & controle , Leiomioma/patologia , Estilo de Vida , Poder Psicológico
13.
Adv Physiol Educ ; 48(2): 356-365, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38482563

RESUMO

Effective communication skills are pivotal in health care, particularly when conveying distressing information to patients and their families. However, medical education still lacks the adoption of a universal model that can be incorporated into the curricula to train and assess students in effectively communicating with patients. This study aims to assess the impact of training undergraduate medical students to deliver bad news effectively using the Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module. This randomized case-control study involved medical students from the first, second, and third professional years (study group, n = 75; control group, n = 75). For the study group, the EMBRACE modules were distributed. Then, a 1-hour training session on effectively delivering bad news was followed by a multiple-choice question test and objective structured clinical examination with response, interpretation, and communication skills stations. Participants' feedback was obtained on a five-point Likert scale. There was a highly significant improvement in knowledge and skills among the study group compared to controls with a P value less than 0.0001. Of the participants, 98.76% perceived that the training equipped them with practical skills, and 98.77% felt that the facilitator had demonstrated the steps of delivering bad news clearly and effectively. Only 4.44% of participants were confident in effectively interacting with patients before the session, and an overwhelming 81.11% gained confidence in their communication skills after the training. With demonstrated significant improvement in knowledge and skills, this study supports the adoption of EMBRACE modules in undergraduate medical education, ultimately improving patient experiences, doctor-patient relationships, and health outcomes.NEW & NOTEWORTHY The Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module is noteworthy for its holistic approach to training medical students in the delicate art of delivering distressing news to patients. It not only incorporates the evidence-based setting, perception, invitation, knowledge, emotions, and strategy (SPIKES) method but also distinguishes itself by providing real-life conversation examples and self-assessment cases, which make the training highly relatable and practical for students to actively engage in their learning and personal development.


Assuntos
Empatia , Estudantes de Medicina , Humanos , Revelação da Verdade , Estudantes de Medicina/psicologia , Estudos de Casos e Controles , Comunicação , Poder Psicológico
14.
Vet Rec ; 194(7): 280, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38551302

RESUMO

Expert speakers will provide practical tips and advice to help you feel empowered and thrive in your business and career at this summer's BVA Live.


Assuntos
Comércio , Poder Psicológico , Animais
15.
Ann Med ; 56(1): 2302979, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38466794

RESUMO

AIM: To evaluate the acceptability of two co-designed mobile applications Mit Sygehus [a knowledge-based solution] and Genoptræn.dk [a self-training solution] to support a cross-sectoral, person-centred and empowering stroke rehabilitation. SETTING: The applications were implemented and tested throughout two stroke rehabilitation trajectories in Southern Denmark, comprising two acute, two sub-acute and two municipal stroke rehabilitation settings. METHODS, PARTICIPANTS AND ANALYSIS: A process evaluation focusing on acceptability was conducted. Individual and dyadic interviews were performed with ten stroke survivors (three women and seven men, aged 50-84) with moderate stroke and seven significant others (five women and two men, aged 50-78) post-rehabilitation. A constructivist Grounded Theory analysis was used to explore what, why, when, and how the apps worked or did not work throughout the stroke rehabilitation trajectory and if adaptions were needed. RESULTS: Participants found that Mit Sygehus provided adequate and sufficient knowledge and was easy to use, however, acceptability of Mit Sygehus declined throughout the rehabilitation process. Also, knowledge on 'return-to-work' and 're-gaining driver's license/permission to drive' needed to be developed. The content in Genoptræn.dk was perceived as acceptable, through content being person-centred, motivating and meaningful. Genoptræn.dk furthermore, supported the transfer between rehabilitation settings, provided a sense of progress throughout the rehabilitation process, facilitated positive habits regarding self-training, and relieved the burden on significant others. Genoptræn.dk was perceived most acceptable in the sub-acute rehabilitation setting and declined when rehabilitation continued in the municipal setting. CONCLUSION: Stroke survivors and their significant others found Mit Sygehus and Genoptræn.dk acceptable to support cross-sectoral, person-centred and empowering stroke rehabilitation, however acceptability declined throughout the rehabilitation process. Further investigations are required to determine how cognitive rehabilitation can play a greater role in app-supported stroke rehabilitation and how the need for more long-term follow-up can be supported.


By using process evaluation, the user acceptability of newly developed and complex interventions can be evaluated.ICT and app-based solutions can support cross-sectoral person-centred and empowering stroke rehabilitation.Therapists play an important role in implementing and supporting stroke survivors using app-based solutions to support person-centred and empowering stroke rehabilitation.


Assuntos
Aplicativos Móveis , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Masculino , Humanos , Feminino , Reabilitação do Acidente Vascular Cerebral/métodos , Atenção à Saúde , Poder Psicológico
16.
Front Public Health ; 12: 1348242, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38476491

RESUMO

More young people are living in the world than ever before, 90% of whom reside in low and middle income countries (LMICs). To address their needs, it is critical to have sustainable youth engagement when determining policy and to advance effective implementation of youth-focused interventions. Youth Community Advisory Boards (CABs) are a sustainable mechanism to achieve this goal. This paper describes engagement with youth CAB members across four locations in Tanzania. To set youth CAB meeting agendas and priorities, we asked youth CAB members to write (using free text) the top five challenges faced by young people in their communities (highest to lower priority). The Google Forms survey link was presented at the May 2023 youth CAB meeting and disseminated through WhatsApp. The survey was completed by smartphone, tablet, or paper provided to the youth liaison for data entry. Results were translated from Swahili to English and coded using excel. Findings were then presented back to the youth CABs at the September 2023 meeting. At that meeting, youth CAB members were then asked to write (free text) potential solutions to the most commonly described challenges. The surveys had response rates of 90% (84/93) for challenges and 78% (71/93) for solutions. The number one reported challenge was unemployment and financial instability (45%). Gender based violence (13%), sexual reproductive health issues (8%), and alcohol and drug use (8%) were in the top four both by priority and frequency of report. Other important challenges included physical and mental health, malnutrition, relationships, education, and societal and environmental norms, among others. Solutions included job creation, improved education, expanded legal systems, youth-friendly health care services, and increased social support through peer networks and community support. The National Accelerated Action and Investment Agenda for Adolescent Health and Wellbeing (NAIA-AHW) 2021/22-2024/25 includes most, but not all, of these top challenges and solutions. Ensuring young people have a seat at the policy table is critical to effective youth-empowerment in health and other related programs. Including a youth CAB member to represent this collective in youth-related government activities is a sustainable model to achieve this goal.


Assuntos
Saúde Mental , Poder Psicológico , Humanos , Adolescente , Tanzânia
18.
J Nurs Adm ; 54(4): 196-197, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38512081

RESUMO

ABSTRACT: Recognizing the positive impact of clinical data outcomes and patient care experiences, coupled with the growing preference for advanced practice RNs among patients, it is imperative that nurse leaders propel legislative reforms and infrastructure support from health systems. This strategic approach is crucial for maximizing the potential of nurses in improving patient care experience and outcomes, as well as increasing accessibility to healthcare in every community.


Assuntos
Atenção à Saúde , Poder Psicológico , Humanos
19.
Health Expect ; 27(2): e14006, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38497286

RESUMO

BACKGROUND: Decisions about driving for individuals living with dementia (ILWD) can be challenging. There are limited evidence-based person-centred interventions in the United Kingdom that support decisions about transitioning to not driving or guidelines for developing decision aids for ILWD. This study aimed to understand the important features of a decision aid through the cultural adaptation of Australian dementia and driving decision aid (DDDA) for ILWD residing in the United Kingdom. METHODS: This qualitative study was theoretically underpinned by a person-centred framework and conducted over three stages: (1) Development of a draft UK-specific DDDA; (2) semistructured interviews with ILWD and an online survey with stakeholders to obtain their views on a draft UK DDDA and (3) content analysis and synthesis of qualitative data to inform the final version of the decision aid. RESULTS: Eleven ILWD and six of their spouses participated in interviews, and 102 stakeholders responded to an online survey. The four broad features identified as important to include in a decision aid for drivers living with dementia were: a structured and interactive format; positive and supportive messaging and presentation; relevant and concise content and choice-centred. The perceived benefits of the decision aid were identified as supporting conversations, enhancing collaborative decision making and enabling agency with decisions about driving and future mobility options. CONCLUSIONS: Decision aids that are underpinned by interactive choice-driven questions enhance a person-centred approach to decisions about driving. Positively framing decision aids through the presentation and content can facilitate engagement with the decision-making process about driving. The findings have implications for the development of decision aids designed for ILWD on other important health and social topics. PATIENT AND PUBLIC INVOLVEMENT: Advocating for the development of a UK DDDA were ILWD. Healthcare professionals contributed to the development of a draft UK DDDA. Former and current drivers living with dementia, family members, healthcare professionals and other support networks of ILWD participated in interviews or an online survey which informed the final version of the UK DDDA.


Assuntos
Técnicas de Apoio para a Decisão , Demência , Humanos , Tomada de Decisões , Respeito , Austrália , Poder Psicológico
20.
BMC Infect Dis ; 24(1): 338, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38515014

RESUMO

BACKGROUND: A dearth of studies showed that infectious diseases cause the majority of deaths among under-five children. Worldwide, Acute Respiratory Infection (ARI) continues to be the second most frequent cause of illness and mortality among children under the age of five. The paramount disease burden in developing nations, including Ethiopia, is still ARI. OBJECTIVE: This study aims to determine the magnitude and predictors of ARI among under-five children in Ethiopia using used state of the art machine learning algorithms. METHODS: Data for this study were derived from the 2016 Ethiopian Demographic and Health Survey. To predict the determinants of acute respiratory infections, we performed several experiments on ten machine learning algorithms (random forests, decision trees, support vector machines, Naïve Bayes, and K-nearest neighbors, Lasso regression, GBoost, XGboost), including one classic logistic regression model and an ensemble of the best performing models. The prediction ability of each machine-learning model was assessed using receiver operating characteristic curves, precision-recall curves, and classification metrics. RESULTS: The total ARI prevalence rate among 9501 under-five children in Ethiopia was 7.2%, according to the findings of the study. The overall performance of the ensemble model of SVM, GBoost, and XGBoost showed an improved performance in classifying ARI cases with an accuracy of 86%, a sensitivity of 84.6%, and an AUC-ROC of 0.87. The highest performing predictive model (the ensemble model) showed that the child's age, history of diarrhea, wealth index, type of toilet, mother's educational level, number of living children, mother's occupation, and type of fuel they used were an important predicting factor for acute respiratory infection among under-five children. CONCLUSION: The intricate web of factors contributing to ARI among under-five children was identified using an advanced machine learning algorithm. The child's age, history of diarrhea, wealth index, and type of toilet were among the top factors identified using the ensemble model that registered a performance of 86% accuracy. This study stands as a testament to the potential of advanced data-driven methodologies in unraveling the complexities of ARI in low-income settings.


Assuntos
Saúde da Criança , Infecções Respiratórias , Criança , Humanos , Teorema de Bayes , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Aprendizado de Máquina , Diarreia/epidemiologia , Demografia , Poder Psicológico
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