Value for solidarity: a proxy for community understanding and acceptance of the basic principles of community-based health insurance in rural Ethiopia.

BACKGROUND: Solidarity is an aspect of human association that gives emphasis to the cohesive social bond that holds a group together and is valued and understood by all members of the group. A lack of understanding of the solidarity principle is one of the main reasons for low population coverage in microhealth insurance schemes. This study aimed to examine the extent to which people value solidarity and the factors that explain the differences. METHODS: A community-based cross-sectional study was carried out in two districts of northeast Ethiopia among 1232 randomly selected households which have ever been registered in a community-based health insurance scheme. Face-to-face interviews were conducted with household heads using a standardized questionnaire deployed to an electronic data collection platform. Solidarity was measured using three dimensions: income solidarity, risk solidarity, and cost coverage. Principal component analysis was used to construct composite variables, and the reliability of the tools was checked using Cronbach's alpha. A multivariable analysis was performed using the partial proportional odds model to determine the associations between variables. The degree of association was assessed using the odds ratio, and statistical significance was determined at 95% confidence interval. RESULTS: Three-quarters (75%) of the respondents rated risk solidarity as high, while 70% and 63% rated income solidarity and cost coverage as high, respectively. Place of residence (AOR = 2.23; 95% CI: 1.68, 2.94), wealth index (AOR = 1.51; 95% CI: 1.07, 2.12), self-rated health status (AOR = 1.64; 95% CI: 1.12, 2.40), trust in insurance schemes (AOR = 1.68; 95% CI: 1.22, 2.30), perceived quality of care (AOR = 1.75; 95% CI: 1.33, 2.31) and frequency of outpatient visits (AOR = 2.05; 95% CI: 1.30, 3.24) were significant predictors of value for solidarity. CONCLUSIONS: The community placed greater value for solidarity, indicating community understanding and acceptance of the core principles of microhealth insurance. Administrators of the insurance scheme, health authorities, and other actors should strive to create a transparent management system and improve access to high-quality health care, which will facilitate community acceptance of the insurance scheme and its guiding principles.

The immediate, intermediate, and long-term effectiveness of audiovisuals for providing pre-treatment information to patients with cancer: A systematic review.

OBJECTIVE: To assess the effectiveness of audiovisuals in providing pre-treatment information to patients with cancer. Following the Six Function Model of Medical Communication, we distinguish between immediate, intermediate, and long-term outcomes. METHODS: A systematic search was performed in five electronic databases for quantitative studies comparing the addition of audiovisuals with standard care or alternative interventions. Quality was assessed using Cochrane's Risk of Bias 2. RESULTS: After abstract (n = 10,179) and full-text (n = 85) screening, 37 articles were included. Audiovisuals positively impacted patients' anxiety, knowledge, understanding, and physiological responses shortly after the consultation, particularly when video was compared with standard verbal care without audiovisual. Only five studies measured long-term outcomes, leaving the long-term effectiveness of audiovisuals unexplored. Majority of studies showed 'high risk of bias' (n = 34). CONCLUSION: Although caution is warranted because of the variability in study design and quality, the results suggest potential benefits of using audiovisuals alongside interpersonal communication. PRACTICAL IMPLICATIONS: More high-quality and longitudinal research is needed with emphasis on comparing counseling with and without usage of audiovisual tools. Healthcare providers can improve the short-term impact of information provision by using audiovisuals alongside standard care, but should carefully consider content, for whom, how, and timing.

Twenty-five years of Nipah outbreaks in Southeast Asia: A persistent threat to global health.

Objectives: Nipah virus (NiV), a bat-borne zoonotic pathogen, poses persistent threats to global public health due to severe clinical manifestation and high case fatality rate (CFR). A critical examination of NiV outbreaks is essential for refining strategies and mitigating the impact of future infections. In this study, we provide a concise update on global NiV outbreaks that occurred during the past 25 years. Methods: In this geospatial study, we conducted an in-depth examination of the epidemiological characteristics of human NiV cases and deaths from 1998 to 2024 through multiple analyses of public data and official reports. Results: NiV emerged in 1998 in Malaysia during an outbreak among pig farmers. Since then, NiV outbreaks have been documented in five countries of South and Southeast Asia (Bangladesh, India, Malaysia, Philippines, and Singapore). As of May 2024, there have been 754 confirmed human NiV cases with 435 deaths (CFR: 58%) reported in these five countries. Bangladesh records the highest incidence (341 cases and 241 deaths; CFR: 71%) followed by Malaysia (283 cases and 109 deaths; CFR: 39%), India (102 cases and 74 deaths; CFR: 73%), the Philippines (17 cases and nine deaths; CFR: 53%), and Singapore (11 cases and one death; CFR: 9%). Conclusions: The clinical outcomes of NiV have been underscoring constant global public health threats as no effective therapies and vaccines are available. Strong global understandings, with an eye on developing vaccines and therapeutics, are required to minimize clinical outcomes and future threats of NiV.

Simulation as a method in a supervision course, experiences of midwives and specialist nurses: A qualitative study.

AIM: To explore supervisors' experience of simulation in a student supervision course BACKGROUND: The relationship between student and supervisor is crucial for the students' learning and quality of education. The supervisors have an important role in facilitating a good start and the best learning opportunities for students in clinical placement. Supervision can be demanding and there is a need to strengthen supervisors in their role. An interprofessional supervision course was designed, using simulation as a method. Simulation is frequently used for acute situations to improve patient safety but is less common in student supervision. In our supervision course, simulation was introduced in the digital component and practiced in the physical component. The 4-6 members of the interprofessional simulation groups were assigned roles as either participants or active observers. They were guided by a facilitator, who constructed student-supervisor scenarios, allocated roles and facilitated reflection. DESIGN: A qualitative, explorative design involving focus groups and written reflections. METHODS: Two focus groups (n=9) were conducted following a pilot course in addition to written reflections (n= 80) after four courses. After revising the course and the interview guide, two additional focus groups (n =10) were held and a further 43 written reflections received. The empirical data were analyzed using thematic analysis by Braun and Clarke. RESULTS: The three themes. 1. Interprofessional simulation provides a wider perspective on the student- supervisor relationship. The participants experienced being active in different roles, followed by subsequent joint reflection. They expressed increased relational understanding as well as the importance of verbal and nonverbal communication in supervision through learning from other interprofessional supervisors. 2. Simulation provides realism by entering into the situation. Simulation fostered activation of the senses that improved the supervisor's ability to be attentive to the student's needs. 3.Challenging to simulate the role of supervisor. Most participants were willing to force themselves out of their comfort zone to learn. However, quite a few felt uncomfortable participating in simulation on communication and preferred observing others. CONCLUSION: The participants experienced simulation as valuable for strengthening their awareness of their ability to influence students' learning and relational understanding. The results showed the value of reflective observation in addition to participating in simulation. Simulation might contribute to improved supervision, although different experiences that inhibit learning outcomes must be acknowledged.

The effect of subjective understanding on patients' trust in AI pharmacy intravenous admixture services.

Introduction: Medical services are getting automated and intelligent. An emerging medical service is the AI pharmacy intravenous admixture service (PIVAS) that prepares infusions through robots. However, patients may distrust these robots. Therefore, this study aims to investigate the psychological mechanism of patients' trust in AI PIVAS. Methods: We conducted one field study and four experimental studies to test our hypotheses. Study 1 and 2 investigated patients' trust of AI PIVAS. Study 3 and 4 examined the effect of subjective understanding on trust in AI PIVAS. Study 5 examined the moderating effect of informed consent. Results: The results indicated that patients' reluctance to trust AI PIVAS (Studies 1-2) stems from their lack of subjective understanding (Study 3). Particularly, patients have an illusion of understanding humans and difficulty in understanding AI (Study 4). In addition, informed consent emerges as a moderating factor, which improves patients' subjective understanding of AI PIVAS, thereby increasing their trust (Study 5). Discussion: The study contributes to the literature on algorithm aversion and cognitive psychology by providing insights into the mechanisms and boundary conditions of trust in the context of AI PIVAS. Findings suggest that medical service providers should explain the criteria or process to improve patients' subjective understanding of medical AI, thus increasing the trust in algorithm-based services.

Health care workers' knowledge and perceptions on WHO hand hygiene guidelines, and the perceived barriers to compliance with hand hygiene in Cyprus.

BACKGROUND: Hand hygiene (HH) is recognized as an important measure to avoid the transmission of harmful germs, and assists significantly in preventing healthcare-associated infections. HH compliance among health care workers (HCWs) is a result of their knowledge and perceptions. AIM: To investigate the knowledge and perceptions of WHO hand hygiene guidelines among HCWs, and the perceived barriers to compliance with hand hygiene in a major public hospital in Cyprus. METHODS: A descriptive correlational study was conducted in September of 2019. The target population was all of the HCWs in Nicosia General Hospital (N = 1,386). The final sample consisted of 820 participants (119 physicians, 613 nurses, 27 physiotherapists, 59 ward assistants, 2 unidentified). This study used the HH knowledge and perception questionnaire that was developed by the WHO. RESULTS: The results revealed that the average percentage score for knowledge among our sample was 61%, and statistically significant differences were observed among HCWs with regard to certain questions. It was found that HCWs, in most of their responses, presented high percentages of correct answers regarding their perceptions on hand hygiene guidelines but several perceived barriers to compliance on HH guidelines were identified as well. CONCLUSIONS: Knowledge and perceptions of HH guidelines among HCWs were moderate and good respectively. In addition, several perceived barriers to compliance on HH recommendations were identified. HH education is recognized as an important tool for removing these barriers but the recommended HH strategy should be multi-modal and consider local resources, administrative support and barriers to compliance with HH.

Concept Maps to Assess System Understanding: Are Graphical Explanations More Accurate than Verbal Ones?

Solving problems in a technical system usually requires people to understand its functioning on different levels of abstraction (i.e., goals, functions, components, characteristics) that are connected via means-ends links. We combined this abstraction hierarchy with concept mapping to assess people's understanding of system functioning. The present study examines the benefits and drawbacks of the proposed method by comparing it to a viable alternative, namely verbal explanation. Using a set of pre-defined concepts, twenty-four participants explained the functioning of two everyday systems: one graphically by constructing a concept map and one verbally. The verbal explanations were subsequently transformed into concept maps by the authors. Compared to verbal explanations, participant-constructed concept maps contained a higher proportion of functional propositions, and lower proportions of structural, temporal, general, and other propositions. Contrary to our expectations, there was no difference regarding the accuracy of functional propositions. Even though participants needed far less time to explain system functioning verbally, our results indicate that concept mapping is better suited to assess functional system understanding. We discuss how this benefit relates to the cognitive processes during concept mapping, and how the method needs to be adapted to assess functional understanding of more complex systems.

RetinaViT: Efficient Visual Backbone for Online Video Streams.

In online video understanding, which has a wide range of real-world applications, inference speed is crucial. Many approaches involve frame-level visual feature extraction, which often represents the biggest bottleneck. We propose RetinaViT, an efficient method for extracting frame-level visual features in an online video stream, aiming to fundamentally enhance the efficiency of online video understanding tasks. RetinaViT is composed of efficiently approximated Transformer blocks that only take changed tokens (event tokens) as queries and reuse the already processed tokens from the previous timestep for the others. Furthermore, we restrict keys and values to the spatial neighborhoods of event tokens to further improve efficiency. RetinaViT involves tuning multiple parameters, which we determine through a multi-step process. During model training, we randomly vary these parameters and then perform black-box optimization to maximize accuracy and efficiency on the pre-trained model. We conducted extensive experiments on various online video recognition tasks, including action recognition, pose estimation, and object segmentation, validating the effectiveness of each component in RetinaViT and demonstrating improvements in the speed/accuracy trade-off compared to baselines. In particular, for action recognition, RetinaViT built on ViT-B16 reduces inference time by approximately 61.9% on the CPU and 50.8% on the GPU, while achieving slight accuracy improvements rather than degradation.

MS Pattern Explorer: interactive visual exploration of temporal activity patterns for multiple sclerosis.

OBJECTIVES: This article describes the design and evaluation of MS Pattern Explorer, a novel visual tool that uses interactive machine learning to analyze fitness wearables' data. Applied to a clinical study of multiple sclerosis (MS) patients, the tool addresses key challenges: managing activity signals, accelerating insight generation, and rapidly contextualizing identified patterns. By analyzing sensor measurements, it aims to enhance understanding of MS symptomatology and improve the broader problem of clinical exploratory sensor data analysis. MATERIALS AND METHODS: Following a user-centered design approach, we learned that clinicians have 3 priorities for generating insights for the Barka-MS study data: exploration and search for, and contextualization of, sequences and patterns in patient sleep and activity. We compute meaningful sequences for patients using clustering and proximity search, displaying these with an interactive visual interface composed of coordinated views. Our evaluation posed both closed and open-ended tasks to participants, utilizing a scoring system to gauge the tool's usability, and effectiveness in supporting insight generation across 15 clinicians, data scientists, and non-experts. RESULTS AND DISCUSSION: We present MS Pattern Explorer, a visual analytics system that helps clinicians better address complex data-centric challenges by facilitating the understanding of activity patterns. It enables innovative analysis that leads to rapid insight generation and contextualization of temporal activity data, both within and between patients of a cohort. Our evaluation results indicate consistent performance across participant groups and effective support for insight generation in MS patient fitness tracker data. Our implementation offers broad applicability in clinical research, allowing for potential expansion into cohort-wide comparisons or studies of other chronic conditions. CONCLUSION: MS Pattern Explorer successfully reduces the signal overload clinicians currently experience with activity data, introducing novel opportunities for data exploration, sense-making, and hypothesis generation.

The ESCAPE Trial for Older People With Chronic Low Back Pain: A Feasibility Study of a Clinical Trial of Group-Based Exercise in Primary Health Care.

Low back pain is a highly disabling health condition that generates high costs for patients and healthcare systems. For this reason, it is considered a serious public health problem worldwide. This pilot study aimed to assess the feasibility of a future randomized controlled trial (RCT) by evaluating adherence to treatment, contamination between groups, satisfaction with treatment, and understanding of the exercise instructions provided by the physiotherapist. Additionally, we sought to identify and implement necessary modifications to the exercise protocol for better suitability in older people. We conducted a prospective, registered pilot RCT comparing an 8-week group-based exercise program with a waiting list in older people (≥60 years old) with chronic low back pain. Sixty participants were recruited through social media, pamphlets, and invitations at community referral centers. The study demonstrated the feasibility of a full RCT. Participants reported high satisfaction with the treatment (i.e., 100% indicated willingness to return for future services) and a high understanding of the exercise instructions (i.e., 81.8% reported "very easy" comprehension). Adherence to the exercise program exceeded the average reported for group exercise interventions in older adults (i.e., 82.58%). Dropout was associated solely with preexisting physical activity levels. The exercise protocol was successfully adapted to better suit the needs of the older adult population. This pilot RCT demonstrates the feasibility of a full-scale RCT to evaluate the effectiveness of group exercise in improving pain intensity and disability in older adults with chronic low back pain. The implemented adjustments to the exercise protocol and overall study approach strengthen the methodological foundation and expected accuracy of the future RCT.

Exploring seafarers' knowledge, understanding, and proficiency in SEEMP: A strategic training framework for enhancing seafarers' competence in energy-efficient ship operations.

With 2.89 % of global carbon emissions caused by human activity, the maritime industry faces an imminent challenge in curbing its carbon footprint despite regulatory initiatives. As the shipping sector expands, the industry faces a projected increase in carbon emissions. Recognizing the key role of seafarers in emission reduction, this article introduces a comprehensive training framework designed to enhance awareness, knowledge, understanding, and skills for implementing energy-efficient ship operations. This study utilizes structural equation modeling to assess the effectiveness of seafarers' training on energy-efficient operation of ships (EEOS) by surveying 144 seafarers across 42 shipping companies worldwide and using structured questionnaires. This study found significant positive correlations between implementing the Ship Energy Efficiency Management Plan (SEEMP) and the training programs initiated by the International Maritime Organization (IMO) and shipping companies. The results of this study indicate that traditional institutional and specialized training programs on EEOS are relatively ineffective for seafarers in implementing SEEMP onboard ships. Furthermore, the study argues that computer and simulator-based training facilitates knowledge, understanding, and proficiency of SEEMP among seafarers more effectively than the onboard training provided by the ship's master and the chief engineer. The proposed training framework emphasizes the importance of initial training using the IMO E-Learning course and IMO "Train the Trainer" programs, followed by shipping companies' in-house training by classification societies, company project teams, and simulator-based training by service providers. The study proposes a strategic training framework that encompasses in-house training conducted by shipping companies in collaboration with partners, simulator-based training provided by specialized training providers, and ongoing onboard training facilitated by the vessel's master and chief engineer, with integration of computer-based training (CBT). This strategic approach intends to improve seafarers' competence in energy-efficient ship operations to meet predetermined carbon intensity targets, which aligns with the broader goal of leading the maritime industry toward a future of net-zero emissions.

Balinese story texts dataset for narrative text analyses.

Automatic narrative text analysis is gaining traction as artificial intelligence-based computational linguistic tools such as named entity recognition systems and natural language processing (NLP) toolkits become more prevalent. Character identification is the first stage in narrative text analysis; however, it is difficult due to the diversity of appearances and distinctive characteristics among regions. Further challenging analyses, such as role classification, emotion and personality profiling, and character network development, require successful character identification initially, which is crucial. Because there are so many annotated English datasets, computational linguistic tools are mostly focused on English literature. However, there are restricted tools for analyzing Balinese story texts because of a scarcity of low-resource language datasets. The study presents the first annotated Balinese story texts dataset for narrative text analyses, consisting of four sub-datasets for character identification, alias clustering (named entity linking, alias resolution), and character classification. The dataset is a compilation of 120 manually annotated Balinese stories from books and public websites, spanning multiple genres such as folk tales, fairy tales, fables, and mythology. Two Balinese native speakers, including an expert in sociolinguistics and macrolinguistics, annotated the dataset using predetermined guidelines set by an expert. The inter-annotator agreement (IAA) score is calculated using Cohen's Kappa Coefficient, Jaccard Similarity Coefficient, Mean F1-score to measure the level of agreement between annotators and dataset consistency and its reliability. The first subdataset consists of 89,917 annotated words with five labels referring to the Balinese-character named entities. Each character entity's appearance in 6,634 sentences is further annotated in the second subdataset. These two sub-datasets can be used for character identification purposes at the word and sentence level. The list of character groups which are groups of various aliases for each character entity has been annotated in the third subdataset for alias clustering purposes. The third subdataset contains 930-character groups from 120 story texts with each story text containing an average of 7-to-8-character groups. In the fourth subdataset, 848-character groups-of the 930-character groups in the third subdataset-have been categorized as protagonists and antagonists. The protagonists (66.16 %) make up most character groups, with the antagonists (33.84 %) making up the rest of the groups. The fourth subdataset can be used for computing-based classification of characters into two roles between protagonist and antagonist. These datasets have the potential to improve research in narrative text analyses, especially in the areas of computational linguistic tools and advanced machine learning (ML) and deep learning (DL) models in low resource languages. It can also be used for further research including character network development, character relationship extraction, and character classification beyond protagonist and antagonist.

Associations of quality of social support and accurate beliefs about curability among older adults with advanced cancer.

INTRODUCTION: Supporting older adults with advanced cancer to better understand their disease and its prognosis is important for shared decision-making. Social support is a potentially modifiable factor that may influence disease understanding. In this study, we examined the associations of quantity and quality of social support with patients' beliefs about the curability of their advanced cancer. MATERIALS AND METHODS: We performed a secondary analysis of a cluster-randomized trial that recruited older adults aged ≥70 with advanced incurable cancer. At enrollment, patients completed the Older Americans Resources and Services (OARS) Medical Social Support form that measures both quantity (number of close friends and relatives) and quality of social support. Quality of social support was measured using 12 questions in instrumental and emotional support, each ranging from 1 (none of the time) to 5 (all of the time). Higher cumulative scores indicated greater quality of support. For beliefs about curability, patients were asked, "What do you believe are the chances that your cancer will go away and never come back with treatment?" Responses were 0 %, <50 %, 50/50, >50 %, and 100 %. Ordinal logistic regression was used to investigate the association of quantity and quality of social support with beliefs about curability, adjusting for potential confounders. RESULTS: We included 347 patients; mean age was 76.4 years and 91 % were white. Quantity of social support was not associated with belief in curability [adjusted odds ratio (AOR) 1.03, 95 % confidence interval (CI) (0.92, 1.16)]. For every unit increase in the quality of social support (OARS Medical Social Support score), the odds of believing in curability decreased by 26.7 % [AOR 0.73, 95 % CI (0.56, 0.97)]. DISCUSSION: Our study demonstrated that the quality, but not the quantity, of social support was associated with patients' beliefs about curability. These findings suggest that bolstering social support may directly enhance disease understanding. This insight informs supportive care interventions that specifically address disease comprehension among patients.

Dogs with prior experience of a task still overimitate their caregiver.

Domestic dogs have been shown to copy their caregiver's actions, including ones which are causally-irrelevant to a physical goal-a behaviour called "overimitation". In a new overimitation task with a non-food reward, this study investigated "causal misunderstanding"-falsely assuming causally-irrelevant actions to have functional relevancy-as an explanation for dog overimitation (N = 81). By providing dogs with prior experience of the task to learn about the consequences of its irrelevant box-stepping and relevant bucket-opening action to obtain a toy-ball, we tested whether and when dogs would copy their caregiver's irrelevant-action demonstrations. Dogs with and without prior experience were compared to a third (control) group of dogs, who had neither prior experience nor caregiver demonstrations of the task. Results revealed that the timing of overimitation, rather than its frequency, was closely related to dogs' prior experience: dogs with prior experience attended to their reward first, then interacted with the irrelevant box later ("post-goal overimitation"), while dogs without prior experience first interacted with the irrelevant box ("pre-goal overimitation"). Our results suggest that, when action consequences are understood, dogs are overimitating for a secondary social goal that is clearly distinct from the task goal of obtaining a physical reward.

Laypersons' understanding of statistical concepts commonly used in prescription drug promotion: A review of the research literature.

BACKGROUND: The prevalence of direct-to-consumer (DTC) advertising for prescription drugs has led to concerns about how consumers interpret the medical information conveyed in these ads. One strategy for improving lay understanding of medical information involves incorporating quantitative information about a treatment's potential benefits and risks. OBJECTIVE: This literature review investigates laypersons' interpretations of statistical concepts, expanding on past reviews and including terms that may be used in DTC prescription drug advertising. METHODS: We searched six databases for articles published from January 2000 to October 2021. Articles were included if they were in English and examined general or lay audiences' comprehension of quantitative or statistical concepts, without limiting the context of the studies to medical situations. RESULTS: We identified 25 eligible articles. The evidence suggests that likelihood ratios, odds ratios, probabilities, numbers needed to treat/harm, and confidence intervals hinder comprehension of quantitative information. The results are mixed for information presented as frequencies, percentages, absolute risk reduction, and relative risk reduction. The mixed findings could be due to numeracy, framing as risks or benefits, and operationalization of the outcomes. We found no studies examining interpretations of minimum, maximum, central tendency, power, statistical significance, or hazard ratio. CONCLUSION: Studies spanning several decades have examined how laypeople interpret statistical concepts. While a few terms are consistently studied, many questions still remain on how to make risk information more understandable to lay audiences, particularly those with low numeracy.

Humanização na perspectiva dos profissionais da saúde atuantes em unidades de terapia intensiva: revisão integrativa / Humanization from the perspective of health professionals workingin Intensive Care Units: integrative review / La humanización desde la perspectiva de los profesionales de la salud que trabajan en Unidades de Cuidados Intensivos: revisión integrativa

Introdução:Esteartigo apresenta uma revisão integrativa da literatura em relação à compreensãodos profissionais sobre humanização na Unidade de Terapia Intensiva. Objetivo: Analisar os estudos científicos que abordem a percepção sobre humanização entre profissionais da saúde atuantes em Unidades de Terapia Intensiva.Metodologia:Revisão integrativa da literatura. Nas bases de dados e biblioteca virtual selecionadas, utilizou-se os descritores em ciências da saúde: percepção, humanização da assistência e unidades de terapia intensiva, combinados com o operador booleano "AND".As etapas de seleção dos artigos,compreenderam: identificação do tema e seleção da pergunta norteadora; estabelecimento dos critérios de inclusão e exclusão; identificação dos estudos selecionados e pré-selecionados; categorização dos estudos selecionados; análise e interpretação dos resultados; apresentação dos achados da revisão com a síntese do conhecimento.Os critérios de inclusão abrangeram:publicações dos últimos 10 anos (2013-2023), que atendessem ao objetivo do estudo, artigos disponíveis na íntegra nas bases de dados selecionadas, nos idiomas inglês, português e espanhol. Foram excluídos estudos duplicados, trabalhos de conclusão de curso, teses, dissertações, editoriais, cartas, resumos de anais, livros, estudo de caso e relatos de experiência. Resultados:Foram incluídos 16 artigos, revelandotrês categorias temáticas: compreensão dos profissionais sobre a humanização, fatores facilitadores e dificultadores para consolidar a humanização e os benefícios da prática humanizada.Considerações finais:Verificou-se a dificuldade em definir um conceito de humanização pelos profissionais da saúde. Foram destacados os elementos facilitadores da prática humanizada, incluindo empatia, respeito, acolhimento e comunicação adequada. Além disso, foi possível observar os obstáculos, como a falta de materiais, dimensionamento inadequado, ambiente inadequado, sobrecarga de trabalho, rotatividade da equipe e estresse. Adicionalmente, foi possível observar a percepção dos profissionais quanto aos benefícios da prática humanizada na Unidade de Terapia Intensiva (AU).

Introduction:This article presents an integrative literature revision of the understanding ofprofessionals about humanization in the Intensive Care Unit. Objective:Analyze scientific studies that address the perception of humanization among health professionals working in Intensive Care Units. Methodology:Literature integrative revision. In thedatabases and virtual library selected, we used the descriptors in health sciences: perception, humanization of assistance and intensive care units, combined with the Boolean operator "AND". The article selection steps included: identification of the topic and selection of the guiding question; establishment of inclusion and exclusion criteria; identification of the selected and pre-selected studies; categorization of the selected studies; analysis and interpretation of the results; presentation of the results of the revision and the synthesis of knowledge. The inclusion criteria were: publications from the last 10 years (2013-2023), which met the study's objective, articles available in full in the selected databases, in English, Portuguese and Spanish. Duplicate studies, term papers, theses, dissertations, editorials, letters, abstracts from proceedings, books, case studies and experience reports were excluded. Results:Sixteen articles were included, disclosing three thematic categories: professionals' understanding of humanization, factors that facilitate and hinder the consolidation of humanization, and the benefits of humanized practice. Final considerations:Health professionals had difficulty defining a concept of humanization. The elements that facilitate humanized practice were highlighted, including empathy, respect, hospitality and proper communication. In addition, there were obstacles including a shortage of materials, inadequate dimensioning, an unsuitable environment, work overload, staff turnover and stress. In addition, it was possible to observe the professionals' perception of the benefits of humanized practice in the Intensive Care Unit (AU).

Introducción:Este artículo presenta una revisión integradora de la literatura en relación a la comprensión de los profesionales sobre humanización en la Unidad de Cuidados Intensivos. Objetivo:Analizar los estúdios científicos que aborden la percepciónsobre humanización entre profesionales de la salud actuantes en Unidades de Cuidados Intensivos. Metodología:Revisión integrativa de la literatura. En las bases de datos y biblioteca virtual seleccionadas, se utilizó los descriptores en ciencias de la salud: percepción, humanizaciónde la asistencia y unidades de cuidados intensivos.Las etapasde selección de los artículos fueron las siguientes: identificación del tema y selección de la pregunta orientadora; establecimiento de los criterios de inclusión y exclusión;identificación de los estúdios seleccionados y preseleccionados; categorización de los estudios seleccionados; análisis e interpretación de los resultados; presentación de los hallazgos de la revisióncon la síntesis delconocimiento. Los criterios de inclusión abarcaron: publicaciones de los últimos diez años (2013-2023),que atendieran al objetivo del estudio, artículos disponibles íntegramente en las bases de datos seleccionadas, en los idiomas inglés, portugués y español. Se excluyeron estudios duplicados, trabajos de fin de grado, tesis, disertaciones, editoriales, cartas, resúmenes de anales, libros, estudio de caso y relatos de experiencia. Resultados:Fueron incluidos 16 artículos, revelando tres categorías temáticas: comprensión de los profesionales sobre la humanización, factores facilitadores y dificultadores para consolidar la humanización y los beneficios de la práctica humanizada. Consideraciones finales:Se verificó la dificultad para definir un concepto de humanización por los profesionales de la salud. Se destacaron los elementos facilitadores de la práctica humanizada, incluyendo empatía, respeto, acogimiento y comunicación adecuada. Además de eso, fue posible observar los obstáculos, como la falta de materiales, dimensionamiento inadecuado, ambiente inadecuado, sobrecarga de trabajo, rotación del equipo y estrés. Adicionalmente, fue posible observar la percepción de los profesionales en cuanto a los beneficios de la práctica humanizada en la Unidad de Cuidados Intensivos (AU).

Identifying Facilitators and Inhibitors of Shared Understanding: An Ethnography of Diagnosis Communication in Acute Medical Settings.

BACKGROUND AND AIMS: Communication is important in determining how patients understand the diagnostic process. Empirical studies involving direct observation of communication within diagnostic processes are relatively limited. This ethnographic study aimed to identify communicative practices facilitating or inhibiting shared understanding between patients and doctors in UK acute secondary care settings. METHODS: Data were collected in acute medical sectors of three English hospitals. Researchers observed doctors as they assessed patients; semistructured interviews were undertaken with doctors and patients directly afterwards. Patients were also interviewed 2-4 weeks later. Case studies of individual encounters (consisting of these interviews and observational notes) were created, and were cross-examined by an interdisciplinary team to identify divergence and convergence between doctors' and patients' narratives. These data were analysed thematically. RESULTS: We conducted 228 h of observation, 24 doctor interviews, 32 patient interviews and 15 patient follow-up interviews. Doctors varied in their communication. Patient diagnostic understanding was sometimes misaligned with that of their doctors; interviews revealed that they often made incorrect assumptions to make sense of the fragmented information received. Thematic analysis identified communicative practices that seemed to facilitate, or inhibit, shared diagnostic understanding between patient and doctor, revealing three themes: (1) communicating what has been understood from the medical record, (2) sharing the thought process and diagnostic reasoning and (3) closing the loop and discharge communication. Shared understanding was best fostered by clear communication about the diagnostic process, what had already been done and what was achievable in acute settings. Written information presents an underutilised tool in such communication. CONCLUSIONS: In UK acute secondary settings, the provision of more information about the diagnostic process often fostered shared understanding between doctor and patient, helping to minimise the confusion and dissatisfaction that can result from misaligned expectations or conclusions about the diagnosis, and the uncertainty therein. PATIENT/PUBLIC CONTRIBUTION: A patient and public involvement group (of a range of ages and backgrounds) was consulted. They contributed to the design of the protocol, including the timing of interviews, the acceptability of a follow-up telephone interview, the development of the interview guides and the participant information sheets.

Cross-view motion consistent self-supervised video inter-intra contrastive for action representation understanding.

Self-supervised contrastive learning draws on power representational models to acquire generic semantic features from unlabeled data, and the key to training such models lies in how accurately to track motion features. Previous video contrastive learning methods have extensively used spatially or temporally augmentation as similar instances, resulting in models that are more likely to learn static backgrounds than motion features. To alleviate the background shortcuts, in this paper, we propose a cross-view motion consistent (CVMC) self-supervised video inter-intra contrastive model to focus on the learning of local details and long-term temporal relationships. Specifically, we first extract the dynamic features of consecutive video snippets and then align these features based on multi-view motion consistency. Meanwhile, we compare the optimized dynamic features for instance comparison of different videos and local spatial fine-grained with temporal order in the same video, respectively. Ultimately, the joint optimization of spatio-temporal alignment and motion discrimination effectively fills the challenges of the missing components of instance recognition, spatial compactness, and temporal perception in self-supervised learning. Experimental results show that our proposed self-supervised model can effectively learn visual representation information and achieve highly competitive performance compared to other state-of-the-art methods in both action recognition and video retrieval tasks.

Understanding dementia in minority ethnic communities: The perspectives of key stakeholders interviewed as part of the IDEAL programme.

Future populations of older adults in the UK, those aged 65+, will demonstrate increased diversity in terms of their ethnic identity resultant from the ageing of the post-war migrants from India, Pakistan, Bangladesh, and the Caribbean. As a consequence, there will be an increase in the numbers of older adults from these communities living with age-related chronic diseases such as dementia. In response to these demographic changes, we need to develop a research, policy and practice agenda that is inclusive and provides evidence for the development of culturally diverse and effective models of service delivery. This requires engagement with three key stakeholder groups: (a) people with dementia; (b) their carers; and (c) the wider community. As part of the IDEAL research programme on living well with dementia, we undertook semi-structured interviews with twelve community leaders, defined as known and trusted individuals active in their respective communities, and six community members (two people living with dementia and four carers). We explored their understandings, experiences, and views of about dementia. Our analysis identified two overarching themes. The migrant lifecourse highlighted issues of not belonging, discrimination and racism. This framed our second theme, the cultural context of dementia, which addressed dementia knowledge and attitudes, service provision and service access, and how being part of a minority ethnic community made a difference to these experiences. Our study highlights how lifecourse experiences of negative hostile social and policy environments and services can be profound and long-lasting and provide a prism through which accessing dementia care is experienced. Our findings argue for the inclusion of diverse views and lifecourse experiences within the context of developing a dementia strategy for research, policy and practice that is appropriate for a multicultural and heterogenous society.

Perspectives of medical imaging professionals about the impact of AI on Swiss radiographers.

INTRODUCTION: Artificial Intelligence (AI) is increasingly implemented in medical imaging practice, however, its impact on radiographers practice is not well studied. The aim of this study was to explore the perceived impact of AI on radiographers' activities and profession in Switzerland. METHODS: A survey conducted in the UK, translated into French and German, was disseminated through professional bodies and social media. The participants were Swiss radiographers (clinical/educators/ researchers/students) and physicians working within the medical imaging profession (radiology/nuclear medicine/radiation-oncology). The survey covered five sections: demographics, AI-knowledge, skills, confidence, perceptions about the AI impact. Descriptive, association statistics and qualitative thematic analysis were conducted. RESULTS: A total of 242 responses were collected (89% radiographers; 11% physicians). AI is being used by 43% of participants in clinical practice, but 64% of them did not feel confident with AI-terminology. Participants viewed AI as an opportunity (57%), while 19% considered it as a threat. The opportunities were associated with streamlining repetitive tasks, minimizing errors, increasing time towards patient-centered care, research, and patient safety. The significant threats identified were reduction on work positions (23%), decrease of the radiographers' expertise level due to automation bias (16%). Participants (68%) did not feel well trained/prepared to implement AI in their practice, highlighting the non-availability of specific training (88%). 93% of the participants mentioned that AI education should be included at undergraduate education program. CONCLUSION: Although most participants perceive AI as an opportunity, this study identified areas for improvement including lack of knowledge, educational supports/training, and confidence in radiographers. Customised training needs to be implemented to improve clinical practice and understanding of how AI can benefit radiographers.