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2.
Int J Med Inform ; 131: 103945, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31561193

RESUMO

BACKGROUND: Electronic health information systems (HIS) are critical components of national health systems, and have been identified as a key element in the development and strengthening of health systems globally. Novel approaches are needed to effectively and efficiently train health care workers on the use of HIS. One such approach is the use of digital eLearning programs, either alone or blended with face-to-face learning activities. METHODS: We developed a novel blended eLearning course based on an in-person HIS training package previously developed by the United States Centers for Disease Control and Prevention. We then conducted a pilot implementation of the eLearning course in Namibia and Tanzania. RESULTS: The blended eLearning pilot program enrolled 131 people, 72 (55%) from Namibia and 59 (45%) from Tanzania. The majority of enrollees were female (n = 88, 67%) and were nurses (n = 66, 50%). Of the 131 people who participated in the in-person orientation, 95 (73%) completed some or all of the eLearning modules. Across all three modules, the mean score on the post-test was significantly greater than on the pre-test (p < 0.001). When comparing results from previous in-person workshops and the blended eLearning course, we found that participants experienced strong learning gains in both, although learning gains were somewhat greater in the in-person course. Blended eLearning course participants reported good to very good satisfaction with the overall content of the course and with the eLearning modules (3.5 and 3.6 out of 5-point Likert scale). We estimate that the total cost per participant is 2.2-3.4 times greater for the in-person course (estimated cost USD $980) than for the blended eLearning course (estimated cost USD $287-$437). CONCLUSION: A blended eLearning course is an effective method with which to train healthcare workers in the basic features of HIS, and the cost is up to 3.4 times less expensive than for an in-person course with similar content.


Assuntos
Instrução por Computador/métodos , Sistemas de Informação em Saúde/estatística & dados numéricos , Pessoal de Saúde/educação , Aprendizagem , Sistemas On-Line/estatística & dados numéricos , Recursos Humanos/estatística & dados numéricos , Feminino , Humanos , Masculino , Namíbia , Tanzânia
3.
Int J Med Inform ; 130: 103939, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31434043

RESUMO

BACKGROUND: Normal users' voluntary behaviors (e.g., knowledge sharing) in virtual communities (VCs) has been well investigated; however, research on health professionals' voluntary behaviors in online health communities (OHCs) is limited. OBJECTIVE: This paper focuses on OHCs for mental health and aims to explore how intrinsic and extrinsic motivations influence mental health service providers' voluntary behaviors. METHODS: Based on motivation theory and prior studies, we incorporated technical competence as intrinsic motivation and online reputation and economic rewards as extrinsic motivations, and proposed five hypotheses. We crawled objective data from YiXinLi, a Chinese OHC for mental health, and tested the hypotheses based on the Poisson regression model. All hypotheses are supported. RESULTS: 1) Technical competence, online reputation, and economic rewards positively influence mental health service providers' voluntary behaviors; 2) the interaction effect between technical competence and online reputation negatively influences mental health service providers' voluntary behaviors; 3) the interaction effect between technical competence and economic rewards negatively influences mental health service providers' voluntary behaviors. CONCLUSIONS: Both intrinsic motivations and extrinsic motivations positively influence mental health service providers' voluntary behaviors, and their interaction effects negatively influence mental health service providers' voluntary behaviors. This study first contributes to the literature on health professionals' voluntary behaviors in OHCs by verifying the positive effect of economic rewards. It then contributes to motivation theory by incorporating a situation where intrinsic motivations and extrinsic motivations could negatively interact.


Assuntos
Comunicação em Saúde/tendências , Pessoal de Saúde/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Serviços de Saúde Mental/normas , Saúde Mental/normas , Sistemas On-Line/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , China , Feminino , Humanos , Masculino , Motivação , Papel Profissional , Saúde Pública
4.
Psiquiatr. biol. (Internet) ; 26(2): 73-79, mayo-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185034

RESUMO

Objetivos: Explorar las diferencias entre el efecto de un programa presencial u online de reducción del estrés basado en mindfulness (REBM) sobre el malestar psicológico general en población española. Además, se estudia si la adhesión y satisfacción con el programa difiere entre ambas modalidades. Metodología: Estudio cuasiexperimental en el que 373 participantes realizaron un programa REBM de 8 semanas. Se compararon 2modalidades: presencial (n = 109) y online (n = 264). Resultados: Los participantes de ambas modalidades presentaron reducciones significativas de malestar (p < 0,001). No hubo una diferencia significativa en la reducción de malestar entre ambas modalidades (p = 0,314). La adhesión (p < 0,001) y satisfacción (p = 0,024) fueron significativamente superiores en los participantes de la modalidad presencial (p < 0,001) que en los de la modalidad online. Conclusiones: Ambas modalidades de REBM (presencial y online) reducen el malestar psicológico general. Sin embargo, la modalidad presencial tiene mayores niveles de adhesión y satisfacción


Objectives: Explore the reduction in general psychological distress after a face-to-face versus an online mindfulness-based stress reduction (MBSR) program in a Spanish population. In addition, we study if program adherence and satisfaction differ between modalities. Methods: We performed an 8-week quasi-experimental study in which 373 participants took part in an MBSR program in which face-to-face (n=109) and online (n=264) modalities were compared. Results: Participants in both modalities showed a significant reduction in distress (P<0.001). However, there was no significant difference in this reduction between modalities (P=0.314). Adherence (P<0.001) and satisfaction (P=0.024) were significantly better in face-to-face sessions (P<0.001) compared to online ones. Conclusions: The MBSR program reduces general psychological distress in both modalities (face-to-face and online). However, the face-to-face modality has higher levels of adherence and program satisfaction


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estresse Psicológico/terapia , Atenção Plena/métodos , Meditação/métodos , Resultado do Tratamento , Sistemas On-Line/estatística & dados numéricos , Telepsicologia , Educação de Pacientes como Assunto/métodos
5.
Enferm. clín. (Ed. impr.) ; 29(4): 239-244, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182918

RESUMO

Introducción: En la Comunidad de Madrid existe un 42,7% de retraso diagnóstico de VIH. La atención primaria es la puerta de entrada al sistema sanitario y se desconoce la frecuencia de serologías solicitadas por estos profesionales. Los objetivos fueron conocer la frecuencia y factores asociados a la solicitud de serologías de VIH por profesionales de medicina y de enfermería de atención primaria de la Comunidad de Madrid. Método: Mediante encuesta on-line, se preguntó por la solicitud de serologías para VIH en los últimos 12 meses, a profesionales que participaron en el estudio de evaluación de estrategias de diagnóstico precoz de VIH en consultas de atención primaria de la Comunidad de Madrid (ESTVIH). La asociación entre la solicitud de serologías y las características sociodemográficas y de práctica clínica de los profesionales se cuantificó mediante odds ratio ajustadas (ORa) según regresión logística. Resultados: Se obtuvieron 264 encuestas (59,5% medicina). El 82,2% de profesionales medicina y el 18,7% de enfermería refirieron haber solicitado alguna serología de VIH en los últimos 12 meses (mediana de 15 y 2 serologías solicitadas, respectivamente). En medicina esta petición se asoció con sexo masculino (ORa: 2,95; IC95%: 0,82-10,56) y estar entrenado para dar consejo pre-post prueba de VIH (ORa: 2,42; IC95%: 0,84-6,93); en enfermería se asoció con edad (<50años; ORa: 2,75; IC95%: 0,97-7,75) y tiempo trabajado en atención primaria (>13años; ORa: 3,02; IC95%: 1,07-8,52). Conclusión: Es necesario promover la solicitud de pruebas de VIH y el entrenamiento pre-post prueba de VIH en profesionales de medicina y enfermería de atención primaria


Introduction: In the Community of Madrid there is 42.7% late HIV diagnosis. Primary care is the gateway to the health system and the frequency of serological tests requested by these professionals is unknown. The objectives were to establish the frequency of requests for HIV serology by medical and nursing primary care professionals in the Community of Madrid and the factors associated with these requests. Method: An 'on-line' survey was conducted, asking professionals who participated in the evaluation study of strategies to promote early diagnosis of HIV in primary care in the Community of Madrid (ESTVIH) about the number of HIV-serology tests requested in the last 12 months. The association between HIV-serology requesting and the sociodemographic and clinical practice characteristics of the professionals was quantified using adjusted odds ratios (aOR) according to logistic regression. Results: 264 surveys (59.5% physicians). Eighty-two point two percent of medical and 18.7% of nursing professionals reported requesting at least one HIV-serology in the last 12 months (median: 15 and 2 HIV-serology request, respectively). The doctors associated the request with: being male (aOR: 2.95; 95% CI: 0.82-10.56), being trained in pre-post HIV test counselling (aOR: 2.42; 95% CI: 0.84-6.93) and the nurses with: age (<50 years; aOR: 2.75; 95% CI: 0.97-7.75), and number of years working in primary care (>13 years; aOR: 3.02; 95% CI: 1.07-8.52). Conclusion: It is necessary to promote HIV testing and training in pre-post HIV test counselling for medical and nursing professionals in primary care centres


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Sorodiagnóstico da AIDS/tendências , Atenção Primária à Saúde/normas , Pessoal de Saúde , Diagnóstico Precoce , Inquéritos e Questionários , Sistemas On-Line/estatística & dados numéricos
6.
J Am Pharm Assoc (2003) ; 59(3): 349-355, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31000435

RESUMO

OBJECTIVES: To examine the characteristics of patient experience in community pharmacies through pattern exploration techniques of the unstructured free-text data from an online review website. DESIGN: Retrospective observational study design using structural topic model (STM) and term frequency-inverse document frequency (tf-idf) to categorize free-text data. Tf-idf scores words in terms of importance, and STM extracts latent themes from free-text data based on the co-occurrence of words in a review. Human labels were assigned to STM output, with each topic's prevalence mapped to each level of the 1- to 5-star review ratings. SETTING AND PARTICIPANTS: Data were obtained from the Yelp Academic data set from April 2006 through December 2017. These data were available for analysis from certain cities in the United States, Canada, and Europe. Included reviews were filtered based on the presence of pharmacy-specific character strings (e.g., "prescri"). MAIN OUTCOME MEASURES: Descriptive statistics of Yelp review characteristics, tf-idf scores, and topics produced from STM were used to characterize the content of Yelp reviews at each star-rating level. RESULTS: The filtered data set contained 4463 reviews from 964 pharmacies in 8 U.S. states. The mean (±SD) review rating was 2.97 ± 0.91. The mean number of words in a review was 135 ± 116. STM revealed 9 topics that influenced patient experiences at community pharmacies, including waiting time, service attitude, and physical store characteristics. Friendly and helpful staff accounted for 28.3% of content in 5-star ratings, whereas waiting time accounted for 19.4% of 1-star ratings. CONCLUSION: Yelp reviews provide a public look into patient experience at community pharmacies, and the reviews likely influence other patients' decisions to use the pharmacy. Pharmacies should focus their efforts on enabling pharmacy staff to provide high-quality care and minimizing unnecessary waiting times for patients.


Assuntos
Serviços Comunitários de Farmácia/tendências , Sistemas On-Line/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/tendências , Canadá , Europa (Continente) , Humanos , Internet , Farmácias , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Estudos Retrospectivos , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos
7.
Artigo em Inglês | MEDLINE | ID: mdl-30884754

RESUMO

As a new type of public health service product, online medical websites (OMWs) are becoming quite popular. OMWs can address patients' basic medical problems remotely and give health guidance online. Compared to traditional hospitals, OMWs are more convenient and inexpensive, they can usually provide a better service for patients with poor medical conditions (especially in rural areas), and they also contribute to the rational distribution of medical resources. Therefore, key factors that affect patients' acceptance of OMWs must be identified to contribute to public health. By integrating perceived risk (PR) and the technology acceptance model (TAM), we proposed a modified TAM and clarified how PR and other factors affect patients' behavioral intention (BI) towards OMWs. A sample of 245 research participants in China took part in this study and the structural equation model (SEM) was used to test our hypotheses. The results revealed that perceived usefulness (PU) is a positive predictor of BI but has no significant effect on attitude (ATT), while perceived ease of use (PEOU) can affect BI through PU and attitude (ATT). Moreover, trust (TRU) was identified as a mediator of PR and PU/PEOU. Also, the doctor⁻patient relationship (DPR) was shown to moderate PR and TRU. In order to increase patients' BI, OMW providers need further innovations to improve patients' TRU and reduce their PR.


Assuntos
Atitude Frente aos Computadores , Internet , Informática Médica/estatística & dados numéricos , Sistemas On-Line/estatística & dados numéricos , China , Confidencialidade , Humanos , Modelos Teóricos , Relações Médico-Paciente , Confiança
9.
J Med Syst ; 43(3): 75, 2019 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-30756252

RESUMO

Modern smart infusion pumps are wirelessly connected to a network server for easy data communications. The two-way communication allows uploading of infusion data and downloading of drug library updates. We have discovered significant delays in library updates. This research aimed at studying the drug library update process of one vendor pump and the contributing factors of pump update delays. Our data included BD Alaris™ pump status and infusion reports of two hospital systems (92 and 80 days, respectively, in 2015). We analyzed drug library update progressions at the individual device and fleet levels. To complete a library update, a pump goes through two status transitions: from noncurrent to a new library pending, and from pending to current. On average it took five to nine days for 50% of a pump fleet to become current after a new drug library was disseminated. We confirmed factors that affect noncurrent-to-pending time to include time to first power-on and total power-on time. We also found that high pump utilization promotes shorter pending-to-current time. Two distinctive and important steps of a drug library update on Alaris™ pumps are pending a new library and completing the library installation. To avoid potential patient harm caused by infusion pumps without appropriate drug limits due to update delays, hospitals should monitor the progression of a drug library update on its pump fleet. Potential ways to improve drug library updates on a fleet of pumps include better technologies, improved pump user-interface design, and more staff training.


Assuntos
Bombas de Infusão , Sistemas On-Line/estatística & dados numéricos , Tecnologia sem Fio , Humanos , Fatores de Tempo
10.
Malar J ; 18(1): 21, 2019 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-30678733

RESUMO

BACKGROUND: Current World Health Organization recommendations for the management of malaria include the need for a parasitological confirmation prior to triggering appropriate treatment. The use of rapid diagnostic tests (RDTs) for malaria has contributed to a better infection recognition and a more targeted treatment. Nevertheless, low-density infections and parasites that fail to produce HRP2 can cause false-negative RDT results. Microscopy has traditionally been the methodology most commonly used to quantify malaria and characterize the infecting species, but the wider use of this technique remains challenging, as it requires trained personnel and processing capacity. OBJECTIVE: In this study, the feasibility of an on-line system for remote malaria species identification and differentiation has been investigated by crowdsourcing the analysis of digitalized infected thin blood smears by non-expert observers using a mobile app. METHODS: An on-line videogame in which players learned how to differentiate the young trophozoite stage of the five Plasmodium species has been designed. Images were digitalized with a smartphone camera adapted to the ocular of a conventional light microscope. Images from infected red blood cells were cropped and puzzled into an on-line game. During the game, players had to decide the malaria species (Plasmodium falciparum, Plasmodium malariae, Plasmodium vivax, Plasmodium ovale, Plasmodium knowlesi) of the infected cells that were shown in the screen. After 2 months, each player's decisions were analysed individually and collectively. RESULTS: On-line volunteers playing the game made more than 500,000 assessments for species differentiation. Statistically, when the choice of several players was combined (n > 25), they were able to significantly discriminate Plasmodium species, reaching a level of accuracy of 99% for all species combinations, except for P. knowlesi (80%). Non-expert decisions on which Plasmodium species was shown in the screen were made in less than 3 s. CONCLUSION: These findings show that it is possible to train malaria-naïve non-experts to identify and differentiate malaria species in digitalized thin blood samples. Although the accuracy of a single player is not perfect, the combination of the responses of multiple casual gamers can achieve an accuracy that is within the range of the diagnostic accuracy made by a trained microscopist.


Assuntos
Crowdsourcing/estatística & dados numéricos , Malária/classificação , Sistemas On-Line/estatística & dados numéricos , Plasmodium/classificação , Jogos de Vídeo/estatística & dados numéricos , Especificidade da Espécie , Trofozoítos/classificação
11.
Artigo em Inglês | MEDLINE | ID: mdl-30634467

RESUMO

BACKGROUND: In the Internet era, many web-based appointment systems for hospitals have been established to replace traditional systems. Our study aimed to highlight the features of online appointment systems for hospitals in Taiwan, where patients can visit outpatient departments without a referral. METHODS: All hospitals online appointment systems were surveyed in October 2018. Features of first-visit registrations were analyzed and stratified according to the hospitals' accreditation levels. RESULTS: Of the 417 hospitals, 59.7% (249) had public online appointment systems. For first-visit patients, only 199 hospitals offered the option of making appointments online from 7 to 98 (mean 38.9) days prior to the appointment itself. Before appointments, 68 (34.2%) hospitals recommended specialties for patients to choose according to their symptoms, and only 11 (5.5%) had a function for sending messages to doctors. After appointments, 176 (88.4%) provided links to real-time monitoring of outpatient service progress. CONCLUSIONS: More than half of the hospitals in Taiwan have public online appointment systems. However, most of these systems simply fulfill the function of registration, and rarely take the opportunity to improve efficiency by gathering information regarding patients' medical history or reasons for making the appointment.


Assuntos
Agendamento de Consultas , Administração Hospitalar/métodos , Sistemas On-Line/estatística & dados numéricos , Adulto , Assistência Ambulatorial/métodos , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Inquéritos e Questionários , Taiwan
13.
Ann Oncol ; 30(1): 96-102, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30335127

RESUMO

Background: Multiple features in the presentation of randomized controlled trial (RCT) results are known to influence comprehension and interpretation. We aimed to compare interpretation of cancer RCTs with time-to-event outcomes when the reported treatment effect measure is the hazard ratio (HR), difference in restricted mean survival times (RMSTD), or both (HR+RMSTD). We also assessed the prevalence of misinterpretation of the HR. Methods: We carried out a randomized experiment. We selected 15 cancer RCTs with statistically significant treatment effects for the primary outcome. We masked each abstract and created three versions reporting either the HR, RMSTD, or HR+RMSTD. We randomized corresponding authors of RCTs and medical residents and fellows to one of 15 abstracts and one of 3 versions. We asked how beneficial the experimental treatment was (0-10 Likert scale). All participants answered a multiple-choice question about interpretation of the HR. Participants were unaware of the study purpose. Results: We randomly allocated 160 participants to evaluate an abstract reporting the HR, 154 to the RMSTD, and 155 to both HR+RMSTD. The mean Likert score was statistically significantly lower in the RMSTD group when compared with the HR group (mean difference -0.8, 95% confidence interval, -1.3 to -0.4, P < 0.01) and when compared with the HR+RMSTD group (difference -0.6, -1.1 to -0.1, P = 0.05). In all, 47.2% (42.7%-51.8%) of participants misinterpreted the HR, with 40% equating it with a reduction in absolute risk. Conclusion: Misinterpretation of the HR is common. Participants judged experimental treatments to be less beneficial when presented with RMSTD when compared with HR. We recommend that authors present RMST-based measures alongside the HR in reports of RCT results.


Assuntos
Neoplasias/mortalidade , Sistemas On-Line/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia Combinada , Humanos , Neoplasias/patologia , Neoplasias/terapia , Prognóstico , Taxa de Sobrevida , Fatores de Tempo
14.
Artigo em Inglês | MEDLINE | ID: mdl-30227666

RESUMO

Hatred directed at members of groups due to their origin, race, gender, religion, or sexual orientation is not new, but it has taken on a new dimension in the online world. To date, very little is known about online hate among adolescents. It is also unknown how online disinhibition might influence the association between being bystanders and being perpetrators of online hate. Thus, the present study focused on examining the associations among being bystanders of online hate, being perpetrators of online hate, and the moderating role of toxic online disinhibition in the relationship between being bystanders and perpetrators of online hate. In total, 1480 students aged between 12 and 17 years old were included in this study. Results revealed positive associations between being online hate bystanders and perpetrators, regardless of whether adolescents had or had not been victims of online hate themselves. The results also showed an association between toxic online disinhibition and online hate perpetration. Further, toxic online disinhibition moderated the relationship between being bystanders of online hate and being perpetrators of online hate. Implications for prevention programs and future research are discussed.


Assuntos
Comunicação , Ódio , Sistemas On-Line/estatística & dados numéricos , Comportamento Problema/psicologia , Estudantes/estatística & dados numéricos , Adolescente , Feminino , Alemanha , Humanos , Masculino , Estudantes/psicologia
15.
Am J Mens Health ; 12(5): 1728-1745, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30045654

RESUMO

The purpose of this study was to identify effective channels, sources, and content approaches for communicating prostate cancer prevention information to Black men. The Web of Science, PubMed and GoogleScholar databases, as well as reviews of reference lists for selected publications, were searched to select articles relevant to cancer communication channels, sources or content for Black men, focused on male-prevalent cancers and published in English. Articles were excluded if they examined only patient-provider communication, dealt exclusively with prostate cancer patients or did not separate findings by race. The selection procedures identified 41 relevant articles, which were systematically and independently reviewed by two team members to extract data on preferred channels, sources, and content for prostate cancer information. This review revealed that Black men prefer interpersonal communication for prostate cancer information; however, video can be effective. Trusted sources included personal physicians, clergy, and other community leaders, family (especially spouses) and prostate cancer survivors. Men want comprehensive information about screening, symptoms, treatment, and outcomes. Messages should be culturally tailored, encouraging empowerment and "ownership" of disease. Black men are open to prostate cancer prevention information through mediated channels when contextualized within spiritual/cultural beliefs and delivered by trusted sources.


Assuntos
Afro-Americanos/estatística & dados numéricos , Informática Aplicada à Saúde dos Consumidores/métodos , Sistemas On-Line/estatística & dados numéricos , Educação de Pacientes como Assunto/métodos , Preferência do Paciente , Neoplasias da Próstata/terapia , Idoso , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Relações Médico-Paciente , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/etnologia , Fatores de Risco , Estados Unidos
16.
Am J Mens Health ; 12(5): 1665-1669, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29888641

RESUMO

Reading and understanding health information, both components of health literacy, can influence patient decisions related to disease management. Older adults, the population of males at greatest risk for prostate cancer, may have compromised capacity to understand and use health information. The purpose of this study was to determine the readability of prostate cancer materials on the Internet using five recommended readability tests. Using a cleared Internet browser, a search was conducted for "prostate cancer." The URLs of the first 100 websites in English were recorded to create the sample. The readability scores for each website were determined using an online, recommended service. This service generates five commonly recommended readability tests. All five tests revealed that the majority of websites had difficult readability. There were no significant differences identified between websites with .org, .gov, or .edu extension versus those with .com, .net, or other extension. It is apparent that the Internet is used often as a resource for health-related information. This study demonstrates that the large majority of information available on the Internet about prostate cancer will not be readable for many individuals.


Assuntos
Compreensão , Informação de Saúde ao Consumidor/normas , Letramento em Saúde , Internet/estatística & dados numéricos , Sistemas On-Line/estatística & dados numéricos , Idoso , Informação de Saúde ao Consumidor/tendências , Estudos Transversais , Humanos , Masculino , Informática Médica , Pessoa de Meia-Idade , Estados Unidos
17.
J Affect Disord ; 236: 243-251, 2018 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-29751239

RESUMO

BACKGROUND: Psychological online interventions (POIs) for depression have demonstrated promising effects. However, there are fewer randomized controlled studies on POIs among older adults with depression. The goal of the present study was to compare the use and efficacy of Deprexis, an online intervention for depression, among Millennials (18-35 years) and Baby Boomers (50-65 years). METHODS: We completed a secondary data analysis on a subset (N = 577) of participants in the EVIDENT trial, a parallel-groups, pragmatic, randomized, controlled single-blind study, which compared a 12-week POI (Deprexis) to care as usual (CAU). Outcomes were assessed at baseline, 3 months (post-assessment) and 6 months (follow-up). The main outcome of interest was change on self-rated depression severity (PHQ-9). RESULTS: Compared to Millennials, Boomers used the intervention significantly more often (d = 0.45) and for a longer duration (d = 0.46), and endorsed more positive attitudes towards POIs (d = 0.14). There was no significant Age Group by Intervention Group interaction for change in PHQ-9. The post-assessment between-group effect size (intervention vs. CAU control) for Millennials and Boomers were d = 0.26 and d = 0.39, respectively, and were stable at follow-up (d = 0.37 and d = 0.39). LIMITATIONS: Age-based dichotomization may not accurately represent participants' experiences with and use of technology. CONCLUSIONS: The POI examined in this trial was superior to CAU and was comparably effective among groups of adults defined as Millennials and Baby Boomers. Adults of the Baby Boomer generation who participate in POIs may have more positive attitudes towards POIs compared to their younger counterparts.


Assuntos
Fatores Etários , Depressão/terapia , Exclusão Digital , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Psicoterapia/métodos , Adolescente , Adulto , Idoso , Efeito de Coortes , Pesquisa Comparativa da Efetividade , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas On-Line/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Ensaios Clínicos Pragmáticos como Assunto , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
18.
Funct Neurol ; 33(1): 51-55, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29633697

RESUMO

It is crucial that all headache specialists receive adequate training. Considering the unsatisfactory results obtained with standard updating courses and the growing need for continuing professional education, a digital platform was developed as a training tool. The platform has been active since 1 October 2014. It is readily accessible to doctors by free registration. Users have access to all the material available on the platform, which includes scientific articles, e-books, presentations and images. Users can share their own material and clinical cases directly. At the time of this study, the platform had 37 users. In the second year following its launch 316 files were downloaded and five discussions were started. These saw 22 contributions. Fifteen of the 37 members did not perform any action on the platform. In total, 74 files were uploaded in the second year of activity, but 90% of the contributions came from a very small group of users. There were no significant differences in use of the platform between members of the Italian Society for the Study of Headache and other specialists. Even though the platform appears to be an easily accessible, interactive and inexpensive instrument, the higher number of downloads than uploads suggests that it is used passively.


Assuntos
Educação Médica Continuada , Transtornos da Cefaleia/terapia , Cefaleia/terapia , Sistemas On-Line , Adulto , Criança , Educação Médica Continuada/estatística & dados numéricos , Humanos , Itália , Sistemas On-Line/estatística & dados numéricos
19.
Future Oncol ; 14(6s): 23-28, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29664356

RESUMO

This report highlights the results of the Italian video-assisted thoracoscopic surgery (VATS) Group, launched in mid 2013, which now has a website and an established database with over 4000 VATS lobectomy cases recruited from 67 thoracic surgery units across Italy. The year 2016 has been crucial for the following steps: inclusion of a dedicated biostatistician and a 'Survey Analysis & Data Quality Check'; the First Consensus Meeting with statements consequently adopted as Recommendations for the Italian Thoracic Surgery Society and published in a peer-reviewed journal; two papers published under the logo Italian VATS Group and seven abstracts accepted at annual international meetings (European Society of Thoracic Surgeons, European Association of Cardio-Thoracic Surgeons, European Lung Cancer Conference and European Respiratory Society); the institution of a Master Course on VATS lobectomy; the partnership with AME Publishing Company.


Assuntos
Neoplasias Pulmonares/cirurgia , Sistemas On-Line/estatística & dados numéricos , Pneumonectomia/normas , Sistema de Registros/estatística & dados numéricos , Cirurgia Torácica Vídeoassistida/normas , Conferências de Consenso como Assunto , Bases de Dados como Assunto , Humanos , Itália/epidemiologia , Pulmão/patologia , Pulmão/cirurgia , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Pneumonectomia/efeitos adversos , Pneumonectomia/economia , Pneumonectomia/métodos , Cirurgia Torácica Vídeoassistida/efeitos adversos , Cirurgia Torácica Vídeoassistida/economia , Cirurgia Torácica Vídeoassistida/métodos , Resultado do Tratamento
20.
Int J Comput Assist Radiol Surg ; 13(6): 769-776, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29594854

RESUMO

PURPOSE: Surgical robots are increasingly common, yet routine tasks such as tissue grasping remain potentially harmful with high occurrences of tissue crush injury due to the lack of force feedback from the grasper. This work aims to investigate whether a blended shared control framework which utilizes real-time identification of the object being grasped as part of the feedback may help address the prevalence of tissue crush injury in robotic surgeries. METHODS: This work tests the proposed shared control framework and tissue identification algorithm on a custom surrogate surgical robotic grasping setup. This scheme utilizes identification of the object being grasped as part of the feedback to regulate to a desired force. The blended shared control is arbitrated between human and an implicit force controller based on a computed confidence in the identification of the grasped object. The online identification is performed using least squares based on a nonlinear tissue model. Testing was performed on five silicone tissue surrogates. Twenty grasps were conducted, with half of the grasps performed under manual control and half of the grasps performed with the proposed blended shared control, to test the efficacy of the control scheme. RESULTS: The identification method resulted in an average of 95% accuracy across all time samples of all tissue grasps using a full leave-grasp-out cross-validation. There was an average convergence time of [Formula: see text] ms across all training grasps for all tissue surrogates. Additionally, there was a reduction in peak forces induced during grasping for all tissue surrogates when applying blended shared control online. CONCLUSION: The blended shared control using online identification more successfully regulated grasping forces to the desired target force when compared with manual control. The preliminary work on this surrogate setup for surgical grasping merits further investigation on real surgical tools and with real human tissues.


Assuntos
Algoritmos , Retroalimentação , Força da Mão , Sistemas On-Line/estatística & dados numéricos , Procedimentos Cirúrgicos Robóticos/métodos , Humanos
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