Pub Date : 2024-09-18DOI: 10.1177/00469580241266364
Hui Lu, Ahmad Alhaskawi, Yanzhao Dong, Xiaodi Zou, Haiying Zhou, Sohaib Hasan Abdullah Ezzi, Vishnu Goutham Kota, Mohamed Hasan Abdulla Hasan Abdulla, Sahar Ahmed Abdalbary
The increasing integration of Artificial Intelligence (AI) in the medical domain signifies a transformative era in healthcare, with promises of improved diagnostics, treatment, and patient outcomes. However, this rapid technological progress brings a concomitant surge in ethical challenges permeating medical education. This paper explores the crucial role of medical educators in adapting to these changes, ensuring that ethical education remains a central and adaptable component of medical curricula. Medical educators must evolve alongside AI’s advancements, becoming stewards of ethical consciousness in an era where algorithms and data-driven decision-making play pivotal roles in patient care. The traditional paradigm of medical education, rooted in foundational ethical principles, must adapt to incorporate the complex ethical considerations introduced by AI. This pedagogical approach fosters dynamic engagement, cultivating a profound ethical awareness among students. It empowers them to critically assess the ethical implications of AI applications in healthcare, including issues related to data privacy, informed consent, algorithmic biases, and technology-mediated patient care. Moreover, the interdisciplinary nature of AI’s ethical challenges necessitates collaboration with fields such as computer science, data ethics, law, and social sciences to provide a holistic understanding of the ethical landscape.
{"title":"Patient Autonomy in Medical Education: Navigating Ethical Challenges in the Age of Artificial Intelligence","authors":"Hui Lu, Ahmad Alhaskawi, Yanzhao Dong, Xiaodi Zou, Haiying Zhou, Sohaib Hasan Abdullah Ezzi, Vishnu Goutham Kota, Mohamed Hasan Abdulla Hasan Abdulla, Sahar Ahmed Abdalbary","doi":"10.1177/00469580241266364","DOIUrl":"https://doi.org/10.1177/00469580241266364","url":null,"abstract":"The increasing integration of Artificial Intelligence (AI) in the medical domain signifies a transformative era in healthcare, with promises of improved diagnostics, treatment, and patient outcomes. However, this rapid technological progress brings a concomitant surge in ethical challenges permeating medical education. This paper explores the crucial role of medical educators in adapting to these changes, ensuring that ethical education remains a central and adaptable component of medical curricula. Medical educators must evolve alongside AI’s advancements, becoming stewards of ethical consciousness in an era where algorithms and data-driven decision-making play pivotal roles in patient care. The traditional paradigm of medical education, rooted in foundational ethical principles, must adapt to incorporate the complex ethical considerations introduced by AI. This pedagogical approach fosters dynamic engagement, cultivating a profound ethical awareness among students. It empowers them to critically assess the ethical implications of AI applications in healthcare, including issues related to data privacy, informed consent, algorithmic biases, and technology-mediated patient care. Moreover, the interdisciplinary nature of AI’s ethical challenges necessitates collaboration with fields such as computer science, data ethics, law, and social sciences to provide a holistic understanding of the ethical landscape.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"21 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-17DOI: 10.1177/00469580241282051
Gisèle Mandiangu Ntanda, Drissa Sia, Eric Nguemeleu Tchouaket, Léonel Philibert
Diet, physical activity, and body shape play an essential role in the development of type 2 diabetes (T2D) and are the social dimensions most targeted by health professionals in their practices or intervention aimed at preventing and controlling T2D. However, several interventions focus more on individual factors and less on social determinants likely to influence the adoption of dietary, body, and physical activity standards favorable to the prevention and control of T2D. This study aims to explore the social determinants influencing the rejection or adoption of dietary, bodily, and physical activity norms favorable to the prevention and control of T2D among migrants from sub-Saharan Africa. A qualitative exploratory design guided data collection and analysis. Semi-structured qualitative interviews and focus groups were conducted between October 2022 and March 2023 in Montreal and Quebec Cities. The cost of food, the difficulty of accessing certain foods, a reliable level of income, work schedules, the gazes of relatives or communities, migration policies, disappointment and stressful situations linked to migratory status, racial microaggressions, and the lack of food guides adapted to the realities of MASS were the main determinants identified by the participants. These determinants can influence the adoption of public health recommendations on diet for the prevention and control of T2D. People living with T2D obviously have an important role to play, but much of the work lies outside their control. Therefore, Preventive, clinical, or awareness-raising interventions should more consider the life and structural contexts in which these people navigate without ignoring their pre-migratory rules of dietary, body, and physical activity norms.
{"title":"Social Determinants Influencing the Non-Adoption of Norms Favorable to the Prevention and Control of Type 2 Diabetes: Qualitative Research","authors":"Gisèle Mandiangu Ntanda, Drissa Sia, Eric Nguemeleu Tchouaket, Léonel Philibert","doi":"10.1177/00469580241282051","DOIUrl":"https://doi.org/10.1177/00469580241282051","url":null,"abstract":"Diet, physical activity, and body shape play an essential role in the development of type 2 diabetes (T2D) and are the social dimensions most targeted by health professionals in their practices or intervention aimed at preventing and controlling T2D. However, several interventions focus more on individual factors and less on social determinants likely to influence the adoption of dietary, body, and physical activity standards favorable to the prevention and control of T2D. This study aims to explore the social determinants influencing the rejection or adoption of dietary, bodily, and physical activity norms favorable to the prevention and control of T2D among migrants from sub-Saharan Africa. A qualitative exploratory design guided data collection and analysis. Semi-structured qualitative interviews and focus groups were conducted between October 2022 and March 2023 in Montreal and Quebec Cities. The cost of food, the difficulty of accessing certain foods, a reliable level of income, work schedules, the gazes of relatives or communities, migration policies, disappointment and stressful situations linked to migratory status, racial microaggressions, and the lack of food guides adapted to the realities of MASS were the main determinants identified by the participants. These determinants can influence the adoption of public health recommendations on diet for the prevention and control of T2D. People living with T2D obviously have an important role to play, but much of the work lies outside their control. Therefore, Preventive, clinical, or awareness-raising interventions should more consider the life and structural contexts in which these people navigate without ignoring their pre-migratory rules of dietary, body, and physical activity norms.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"29 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-17DOI: 10.1177/00469580241273323
Kissa W. Mwamwitwa, Elias M. Bukundi, Betty A. Maganda, Castory Munishi, Adam M. Fimbo, Deus Buma, Eva P. Muro, Wilber Sabiiti, Danstan H. Shewiyo, Morven C. Shearer, Andrew D. Smith, Eliangiringa A. Kaale
The use of chiral medicines (possessing center(s) of asymmetric carbon) may cause adverse drug reactions (ADRs). The safety assurance of these medicines is critical. We aimed to evaluate registered and commonly used anti-infective chiral medicines circulating in the Tanzanian market to establish their safety profile to protect public health. A mixed prospective-retrospective cohort study was conducted to assess the safety profile of amoxicillin, amoxicillin-clavulanic acid and ceftriaxone injection. ADRs causality assessment was conducted by using World Health Organization (WHO)-Algorithm criteria. Data were collected from 7 tertiary hospitals: Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Bugando Medical Centre (BMC), Ligula Referral-Regional Hospital (LRRH), Kitete Referral-Regional Hospital (KRRH), Dodoma Referral-Regional Hospital (DRRH), and Mbeya Zonal-Referral Hospital (MZRH). Data were supplemented by those recorded in the WHO-Vigiflow/VigiLyze database within the same monitoring period. Data were analyzed using STATA version-15. The results were considered statistically significant when P < .05. A total of 2522 patients were enrolled in hospitals: MNH (499), KCMC (407), BMC (396), LRRH (387), KRRH (345), DRRH (249), and MZRH (239). Among those, 1197 (47.5%) were treated with ceftriaxone, 585 (23.2%) amoxicillin and 740(29.3%) amoxicillin-clavulanic acid. Out of those, 102 (4.5%) experienced adverse events (AEs), 49 (48%) were due to ceftriaxone, 37 (36.3%) amoxicillin-clavulanic acid and 16 (15.7%) amoxicillin ( P-value .012). A total of 443 participants from the enrolled and WHO-Vigiflow/VigiLyze database were experienced with ADRs. The ADRs affected mainly gastro-intestinal system 234 (53%), skin and subcutaneous tissue 85 (19%), nervous system 49 (11%), respiratory thoracic 22 (5%), and general disorders 18(4%). In this study, approximately 90% of reported AEs were ADRs possible-related to the monitored medicines, with few plausible and certain. Ceftriaxone injection caused more ADRs. Amoxicillin-clavulanic acid was associated with more ADRs than amoxicillin alone. The safety profile of these medicines is still maintained; however, comprehensive monitoring of ADRs is recommended to improve patient safety and enhance overall treatment outcomes.
{"title":"Adverse Drug Reactions Resulting From the Use of Chiral Medicines Amoxicillin, Amoxicillin-Clavulanic Acid, and Ceftriaxone: A Mixed Prospective-Retrospective Cohort Study","authors":"Kissa W. Mwamwitwa, Elias M. Bukundi, Betty A. Maganda, Castory Munishi, Adam M. Fimbo, Deus Buma, Eva P. Muro, Wilber Sabiiti, Danstan H. Shewiyo, Morven C. Shearer, Andrew D. Smith, Eliangiringa A. Kaale","doi":"10.1177/00469580241273323","DOIUrl":"https://doi.org/10.1177/00469580241273323","url":null,"abstract":"The use of chiral medicines (possessing center(s) of asymmetric carbon) may cause adverse drug reactions (ADRs). The safety assurance of these medicines is critical. We aimed to evaluate registered and commonly used anti-infective chiral medicines circulating in the Tanzanian market to establish their safety profile to protect public health. A mixed prospective-retrospective cohort study was conducted to assess the safety profile of amoxicillin, amoxicillin-clavulanic acid and ceftriaxone injection. ADRs causality assessment was conducted by using World Health Organization (WHO)-Algorithm criteria. Data were collected from 7 tertiary hospitals: Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Bugando Medical Centre (BMC), Ligula Referral-Regional Hospital (LRRH), Kitete Referral-Regional Hospital (KRRH), Dodoma Referral-Regional Hospital (DRRH), and Mbeya Zonal-Referral Hospital (MZRH). Data were supplemented by those recorded in the WHO-Vigiflow/VigiLyze database within the same monitoring period. Data were analyzed using STATA version-15. The results were considered statistically significant when P < .05. A total of 2522 patients were enrolled in hospitals: MNH (499), KCMC (407), BMC (396), LRRH (387), KRRH (345), DRRH (249), and MZRH (239). Among those, 1197 (47.5%) were treated with ceftriaxone, 585 (23.2%) amoxicillin and 740(29.3%) amoxicillin-clavulanic acid. Out of those, 102 (4.5%) experienced adverse events (AEs), 49 (48%) were due to ceftriaxone, 37 (36.3%) amoxicillin-clavulanic acid and 16 (15.7%) amoxicillin ( P-value .012). A total of 443 participants from the enrolled and WHO-Vigiflow/VigiLyze database were experienced with ADRs. The ADRs affected mainly gastro-intestinal system 234 (53%), skin and subcutaneous tissue 85 (19%), nervous system 49 (11%), respiratory thoracic 22 (5%), and general disorders 18(4%). In this study, approximately 90% of reported AEs were ADRs possible-related to the monitored medicines, with few plausible and certain. Ceftriaxone injection caused more ADRs. Amoxicillin-clavulanic acid was associated with more ADRs than amoxicillin alone. The safety profile of these medicines is still maintained; however, comprehensive monitoring of ADRs is recommended to improve patient safety and enhance overall treatment outcomes.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"17 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-17DOI: 10.1177/00469580241282060
Hassan Izzeddin Sarsak
The purpose of this study was to develop the first English-Arabic occupational therapy dictionary mobile application that could be used by occupational therapy service providers and recipients and help fill the gap in understanding and communicating occupational therapy services. Google Play Store and App Store application stores were searched first to identify any current electronic occupational therapy dictionary. While developing the dictionary concept and structure, end users’ needs, language, and culture were taken into consideration applying a user-friendly design, functionalities, and an easy-to-understand language with illustrative visual representations. Our search for currently available electronic occupational therapy dictionaries did not identify any mobile application on the official application stores for iPhone and Android. As a result, a conceptual model was created to develop a mobile application aiming to develop a comprehensive and user-friendly mobile electronic dictionary with over 2400 scientific terms translated and annotated from English to Arabic, more than 350 illustrative pictures, and special features to assist occupational therapy professionals and occupational therapy services recipients in looking up and understanding terminology used in rehabilitation and occupational therapy in the most convenient, fastest, and easiest way possible. The occupational therapy dictionary mobile application has helped create a unified terminology and a common language of shared understanding, proved to be a helpful tool of communicating important messages between Arab occupational therapy professionals and community members through providing an easy access to up-to-date comprehensive English-Arabic lexicography in occupational therapy. It has become the first digital occupational therapy dictionary worldwide and has been made available for everyone to download from Google Play and App Store on their smartphones, computers, or tablets free of charge. Further research is urgently needed for quality improvement and to further enrich Arabic content in occupational therapy through developing evidence-based mobile tools to be used in occupational therapy practice by Arabic-speaking population.
本研究的目的是开发第一款英语-阿拉伯语职业治疗词典移动应用程序,供职业治疗服务提供者和接受者使用,帮助填补理解和交流职业治疗服务方面的空白。首先搜索了 Google Play 商店和 App Store 应用程序商店,以确定目前是否有任何电子职业治疗词典。在开发字典概念和结构时,我们考虑了最终用户的需求、语言和文化,采用了用户友好型设计、功能和通俗易懂的语言,并配有图文并茂的视觉演示。我们对目前可用的电子职业治疗词典进行了搜索,但在 iPhone 和 Android 的官方应用商店中没有找到任何移动应用程序。因此,我们创建了一个开发移动应用程序的概念模型,旨在开发一款全面、用户友好的移动电子词典,其中包含从英语到阿拉伯语的 2400 多个科学术语翻译和注释、350 多张插图和特殊功能,以协助职业治疗专业人员和职业治疗服务接受者以最方便、最快捷、最简单的方式查找和理解康复和职业治疗中使用的术语。职业疗法词典移动应用程序帮助创建了统一的术语和共同理解的共同语言,通过提供最新的全面的职业疗法英语-阿拉伯语词典,被证明是阿拉伯职业疗法专业人员和社区成员之间沟通重要信息的有用工具。它已成为全球第一部数字职业治疗词典,每个人都可以从 Google Play 和 App Store 免费下载到自己的智能手机、电脑或平板电脑上。为了提高质量,进一步丰富职业疗法中的阿拉伯语内容,我们亟需开展进一步的研究,开发以证据为基础的移动工具,供讲阿拉伯语的人群在职业疗法实践中使用。
{"title":"Developing the First Digital Occupational Therapy Dictionary Worldwide: A Promising Mobile Application Model for Occupational Therapy Service Providers and Recipients","authors":"Hassan Izzeddin Sarsak","doi":"10.1177/00469580241282060","DOIUrl":"https://doi.org/10.1177/00469580241282060","url":null,"abstract":"The purpose of this study was to develop the first English-Arabic occupational therapy dictionary mobile application that could be used by occupational therapy service providers and recipients and help fill the gap in understanding and communicating occupational therapy services. Google Play Store and App Store application stores were searched first to identify any current electronic occupational therapy dictionary. While developing the dictionary concept and structure, end users’ needs, language, and culture were taken into consideration applying a user-friendly design, functionalities, and an easy-to-understand language with illustrative visual representations. Our search for currently available electronic occupational therapy dictionaries did not identify any mobile application on the official application stores for iPhone and Android. As a result, a conceptual model was created to develop a mobile application aiming to develop a comprehensive and user-friendly mobile electronic dictionary with over 2400 scientific terms translated and annotated from English to Arabic, more than 350 illustrative pictures, and special features to assist occupational therapy professionals and occupational therapy services recipients in looking up and understanding terminology used in rehabilitation and occupational therapy in the most convenient, fastest, and easiest way possible. The occupational therapy dictionary mobile application has helped create a unified terminology and a common language of shared understanding, proved to be a helpful tool of communicating important messages between Arab occupational therapy professionals and community members through providing an easy access to up-to-date comprehensive English-Arabic lexicography in occupational therapy. It has become the first digital occupational therapy dictionary worldwide and has been made available for everyone to download from Google Play and App Store on their smartphones, computers, or tablets free of charge. Further research is urgently needed for quality improvement and to further enrich Arabic content in occupational therapy through developing evidence-based mobile tools to be used in occupational therapy practice by Arabic-speaking population.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"25 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2, although largely affecting the respiratory system, commonly presents with numerous clinical symptoms from other systems. COVID-19 has been associated with both acute and persistent neurological abnormalities in a substantial proportion of patients. Notably, post-COVID-19 neuropsychological abnormalities have garnered attention, highlighting a high prevalence of neurocognitive issues in affected individuals. This narrative review synthesizes current knowledge on the neuropsychological impact of COVID-19, drawing insights from an extensive online search of published literature conducted in the PubMed (MEDLINE) and Scopus databases. The findings underscore significant neuropsychological effects of COVID-19 observed at both individual and societal levels during the ongoing pandemic. Neuropsychological deficits such as memory difficulties, attention problems, and executive dysfunction, alongside physical symptoms like headaches and fatigue were commonly reported. Additionally, psychological challenges, including fear, anxiety, and depression, emerged as prevalent issues arising from the uncertainties surrounding the situation, social isolation, and employment insecurities. The identified neuropsychological manifestations of COVID-19 can significantly impede normal cognitive and emotional functioning, potentially resulting in decreased productivity and an overall decline in mental health and quality of life. Early identification of signs indicative of neurological or psychological decline becomes imperative, offering a crucial opportunity to mitigate the risk of long-term neuropsychological dysfunction through the development of targeted interventions.
{"title":"Highlighting the Neuropsychological Consequences of COVID-19: Evidence From a Narrative Review","authors":"Kalliopi Megari, Evanthia Thomaidou, Electra Chatzidimitriou","doi":"10.1177/00469580241262442","DOIUrl":"https://doi.org/10.1177/00469580241262442","url":null,"abstract":"The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2, although largely affecting the respiratory system, commonly presents with numerous clinical symptoms from other systems. COVID-19 has been associated with both acute and persistent neurological abnormalities in a substantial proportion of patients. Notably, post-COVID-19 neuropsychological abnormalities have garnered attention, highlighting a high prevalence of neurocognitive issues in affected individuals. This narrative review synthesizes current knowledge on the neuropsychological impact of COVID-19, drawing insights from an extensive online search of published literature conducted in the PubMed (MEDLINE) and Scopus databases. The findings underscore significant neuropsychological effects of COVID-19 observed at both individual and societal levels during the ongoing pandemic. Neuropsychological deficits such as memory difficulties, attention problems, and executive dysfunction, alongside physical symptoms like headaches and fatigue were commonly reported. Additionally, psychological challenges, including fear, anxiety, and depression, emerged as prevalent issues arising from the uncertainties surrounding the situation, social isolation, and employment insecurities. The identified neuropsychological manifestations of COVID-19 can significantly impede normal cognitive and emotional functioning, potentially resulting in decreased productivity and an overall decline in mental health and quality of life. Early identification of signs indicative of neurological or psychological decline becomes imperative, offering a crucial opportunity to mitigate the risk of long-term neuropsychological dysfunction through the development of targeted interventions.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"2 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/00469580241273247
Lesley Ann Foster-Nicholas, David Shavlik, Celine Heskey, Patricia Dyett, Gina Segovia-Siapco
Nutritional epidemiologists use culture-specific food frequency questionnaires (FFQs) to assess the dietary intake of groups based on country, region or ethnic groups. This study aimed to validate a culture-specific semi-quantitative electronic Food Frequency Questionnaire (e-FFQ) to estimate food group intake in the adult population of Trinidad and Tobago. A 139-item semi-quantitative e-FFQ containing local dishes and street food was administered twice to adults 18 years and older and compared against four 1-day food records (FRs) using digital photographs, which served as the reference method. The validity and reproducibility of the e-FFQ food group intake estimates were determined using paired t-tests, bivariate correlations, and cross-classifications. Reproducibility correlations between the reported food group intakes in the first and repeat administration of the e-FFQ ranged from moderate ( r = .44, P ≤ .0001) for sweetened beverages to high ( r = .91 P ≤ .0001) for alcohol. The cross-classification agreements ranged from 70% (street food) to 92% (alcohol). Energy-adjusted deattenuated validity correlations between the e-FFQ and FR ranged from ( r = .08) for water to ( r = .81) for food from animal sources, with a mean validity correlation of .36. An average of 68% of the e-FFQ estimates was correctly classified within the ±1 quintile of the exact agreement with the FRs. Agreements between the e-FFQ and FRs ranged from 55% for street foods to 95% for water, all significant at P ≤ .0001. This study shows that the culture-specific e-FFQ is a valid tool for assessing and ranking food category intake estimates of the adult population living in Trinidad and Tobago.
{"title":"Validity and Reproducibility of a Culture-Specific Electronic Food Frequency Questionnaire: A Trinidad and Tobago Diet Assessment Study","authors":"Lesley Ann Foster-Nicholas, David Shavlik, Celine Heskey, Patricia Dyett, Gina Segovia-Siapco","doi":"10.1177/00469580241273247","DOIUrl":"https://doi.org/10.1177/00469580241273247","url":null,"abstract":"Nutritional epidemiologists use culture-specific food frequency questionnaires (FFQs) to assess the dietary intake of groups based on country, region or ethnic groups. This study aimed to validate a culture-specific semi-quantitative electronic Food Frequency Questionnaire (e-FFQ) to estimate food group intake in the adult population of Trinidad and Tobago. A 139-item semi-quantitative e-FFQ containing local dishes and street food was administered twice to adults 18 years and older and compared against four 1-day food records (FRs) using digital photographs, which served as the reference method. The validity and reproducibility of the e-FFQ food group intake estimates were determined using paired t-tests, bivariate correlations, and cross-classifications. Reproducibility correlations between the reported food group intakes in the first and repeat administration of the e-FFQ ranged from moderate ( r = .44, P ≤ .0001) for sweetened beverages to high ( r = .91 P ≤ .0001) for alcohol. The cross-classification agreements ranged from 70% (street food) to 92% (alcohol). Energy-adjusted deattenuated validity correlations between the e-FFQ and FR ranged from ( r = .08) for water to ( r = .81) for food from animal sources, with a mean validity correlation of .36. An average of 68% of the e-FFQ estimates was correctly classified within the ±1 quintile of the exact agreement with the FRs. Agreements between the e-FFQ and FRs ranged from 55% for street foods to 95% for water, all significant at P ≤ .0001. This study shows that the culture-specific e-FFQ is a valid tool for assessing and ranking food category intake estimates of the adult population living in Trinidad and Tobago.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"41 1","pages":"469580241273247"},"PeriodicalIF":1.7,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/00469580241273178
Siân Williams, Genevie Fernandes, Peymané Adab, Rachel Adams, Jaime Correia de Sousa, Chunhua Chi, Andrew P. Dickens, Alexandra Enocson, Amanda Farley, Mariam Maglakelidze, Tamaz Maglakelidze, Sonia Martins, Alice Sitch, Aleksandra Stamenova, Katarina Stavrikj, Rafael Stelmach, Alice Turner, Zihan Pan, Hui Pang, Jianxin Zhang, Rachel E. Jordan
Communication is a core component of a clinician’s role; however, when clinicians conduct research, communicating the emerging findings and recommendations to different types of stakeholders can be unfamiliar territory. Communicating research to advocate for change can be even more challenging. Clinician researchers seeking to be agents for change need to conceive and craft specific, evidence-based messages and communicate these effectively to different stakeholders to negotiate action. As part of a global health research program, we developed and tested a novel game-based model to strengthen the communication skills of clinician researchers, from 4 countries, for improving services for chronic obstructive pulmonary disease. This model focused on communication with 3 key stakeholder groups for knowledge translation: Patients/carers, healthcare providers and policy makers/healthcare managers. Delivered through a series of facilitated, online meetings, this model consisted of 2 parts: developing and rehearsing advocacy messages with coaching support, and then testing them with a panel of 3 representative stakeholders, and an audience of fellow researchers. All the country teams reported increased confidence in crafting advocacy messages for specific stakeholders and have applied lessons learned from the model. Delivering this model within a global health research program requires mentoring, time, commitment, resources and translation support to address language barriers. It offers an exemplar to build the communication skills of clinician and non-clinician researchers so that they can go beyond dissemination toward translation of evidence into policy and practice.
{"title":"Strengthening Clinician-Researchers’ Communication and Knowledge Translation Skills: An Innovative Game Model From the Breathe Well Group","authors":"Siân Williams, Genevie Fernandes, Peymané Adab, Rachel Adams, Jaime Correia de Sousa, Chunhua Chi, Andrew P. Dickens, Alexandra Enocson, Amanda Farley, Mariam Maglakelidze, Tamaz Maglakelidze, Sonia Martins, Alice Sitch, Aleksandra Stamenova, Katarina Stavrikj, Rafael Stelmach, Alice Turner, Zihan Pan, Hui Pang, Jianxin Zhang, Rachel E. Jordan","doi":"10.1177/00469580241273178","DOIUrl":"https://doi.org/10.1177/00469580241273178","url":null,"abstract":"Communication is a core component of a clinician’s role; however, when clinicians conduct research, communicating the emerging findings and recommendations to different types of stakeholders can be unfamiliar territory. Communicating research to advocate for change can be even more challenging. Clinician researchers seeking to be agents for change need to conceive and craft specific, evidence-based messages and communicate these effectively to different stakeholders to negotiate action. As part of a global health research program, we developed and tested a novel game-based model to strengthen the communication skills of clinician researchers, from 4 countries, for improving services for chronic obstructive pulmonary disease. This model focused on communication with 3 key stakeholder groups for knowledge translation: Patients/carers, healthcare providers and policy makers/healthcare managers. Delivered through a series of facilitated, online meetings, this model consisted of 2 parts: developing and rehearsing advocacy messages with coaching support, and then testing them with a panel of 3 representative stakeholders, and an audience of fellow researchers. All the country teams reported increased confidence in crafting advocacy messages for specific stakeholders and have applied lessons learned from the model. Delivering this model within a global health research program requires mentoring, time, commitment, resources and translation support to address language barriers. It offers an exemplar to build the communication skills of clinician and non-clinician researchers so that they can go beyond dissemination toward translation of evidence into policy and practice.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"84 1","pages":"469580241273178"},"PeriodicalIF":1.7,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Performance evaluation is important for improving medical quality and services. But, there is a lack of research for medical quality in traditional Chinese medicine (TCM) hospitals. This study examines the medical quality and various indicators of tertiary public traditional Chinese medicine hospitals in Gansu Province, to establish a foundation for improving the medical and management standards of these hospitals. This study collected performance assessment data from 10 tertiary TCM hospitals in Gansu Province from 2019 to 2022. Thirteen indicators with TCM characteristics were selected and categorized into 3 aspects: control of medical costs, internal operational dimensions, and comprehensive management. The level of medical quality in different hospitals and in different years were determined using the TOPSIS method for ranking and the RSR method for grading. Firstly, in terms of TCM characteristic indicators, hospital H had the highest control of medical costs and comprehensive management among different hospitals, with 45.87% and 24.20% respectively. The highest values for control of medical costs and comprehensive management were observed in 2020, with 40.65% and 18.69% respectively among different years. When evaluating the medical quality of different hospitals using the TOPSIS method, it was found that hospital H had the highest ranking from 2020 to 2022, with C<jats:sub>i</jats:sub> values of 0.725, 0.778, and 0.667 respectively. Additionally, the RSR method indicated that hospital H had a high level of grading from 2020 to 2022, with P<jats:sub>i</jats:sub> values of 0.687, 0.690, and 0.723 respectively. These findings suggest that the medical quality of hospital H is at a high and stable level of development. Based on the TOPSIS method to evaluate the performance appraisal results and ranking of different hospitals from 2019 to 2022. The results showed that the highest ranking was hospital B(C<jats:sub>i</jats:sub> = 0.913) in 2019. The highest ranking was hospital C(C<jats:sub>i</jats:sub> = 0.809)in 2020. The highest ranking was hospital D(C<jats:sub>i</jats:sub> = 0.689) in 2021. The highest ranking was hospital J(C<jats:sub>i</jats:sub> = 0.865) in 2022. The RSR method indicated that high grading level were hospitals B(P<jats:sub>i</jats:sub> = 0.899),F(P<jats:sub>i</jats:sub> = 0.795) in 2019. The highest grading level was hospital C(P<jats:sub>i</jats:sub> = 0.809) in 2020. The highest grading level were hospitals A(P<jats:sub>i</jats:sub> = 0.868), D(P<jats:sub>i</jats:sub> = 0.813), E(P<jats:sub>i</jats:sub> = 0.689), G(P<jats:sub>i</jats:sub> = 0.873), J(P<jats:sub>i</jats:sub> = 0.813), K(P<jats:sub>i</jats:sub> = 0.842) in 2022. Based on the above results indicate that there is a large variation in the medical quality profile of different hospitals from 2019 to 2022. By comparing the results of TOPSIS and RSR method from 2019 to 2022, we found that the hospitals with identical ranking were D and J, and the hospitals with ≤2
{"title":"Characteristics of Medical Quality in Tertiary Traditional Chinese Medicine Hospitals by TOPSIS and RSR Methods","authors":"Lijiao Ma, Yuanyuan Li, Jianlan Xue, Lin Xu, Xianwen Li, Xuhong Chang","doi":"10.1177/00469580241275324","DOIUrl":"https://doi.org/10.1177/00469580241275324","url":null,"abstract":"Performance evaluation is important for improving medical quality and services. But, there is a lack of research for medical quality in traditional Chinese medicine (TCM) hospitals. This study examines the medical quality and various indicators of tertiary public traditional Chinese medicine hospitals in Gansu Province, to establish a foundation for improving the medical and management standards of these hospitals. This study collected performance assessment data from 10 tertiary TCM hospitals in Gansu Province from 2019 to 2022. Thirteen indicators with TCM characteristics were selected and categorized into 3 aspects: control of medical costs, internal operational dimensions, and comprehensive management. The level of medical quality in different hospitals and in different years were determined using the TOPSIS method for ranking and the RSR method for grading. Firstly, in terms of TCM characteristic indicators, hospital H had the highest control of medical costs and comprehensive management among different hospitals, with 45.87% and 24.20% respectively. The highest values for control of medical costs and comprehensive management were observed in 2020, with 40.65% and 18.69% respectively among different years. When evaluating the medical quality of different hospitals using the TOPSIS method, it was found that hospital H had the highest ranking from 2020 to 2022, with C<jats:sub>i</jats:sub> values of 0.725, 0.778, and 0.667 respectively. Additionally, the RSR method indicated that hospital H had a high level of grading from 2020 to 2022, with P<jats:sub>i</jats:sub> values of 0.687, 0.690, and 0.723 respectively. These findings suggest that the medical quality of hospital H is at a high and stable level of development. Based on the TOPSIS method to evaluate the performance appraisal results and ranking of different hospitals from 2019 to 2022. The results showed that the highest ranking was hospital B(C<jats:sub>i</jats:sub> = 0.913) in 2019. The highest ranking was hospital C(C<jats:sub>i</jats:sub> = 0.809)in 2020. The highest ranking was hospital D(C<jats:sub>i</jats:sub> = 0.689) in 2021. The highest ranking was hospital J(C<jats:sub>i</jats:sub> = 0.865) in 2022. The RSR method indicated that high grading level were hospitals B(P<jats:sub>i</jats:sub> = 0.899),F(P<jats:sub>i</jats:sub> = 0.795) in 2019. The highest grading level was hospital C(P<jats:sub>i</jats:sub> = 0.809) in 2020. The highest grading level were hospitals A(P<jats:sub>i</jats:sub> = 0.868), D(P<jats:sub>i</jats:sub> = 0.813), E(P<jats:sub>i</jats:sub> = 0.689), G(P<jats:sub>i</jats:sub> = 0.873), J(P<jats:sub>i</jats:sub> = 0.813), K(P<jats:sub>i</jats:sub> = 0.842) in 2022. Based on the above results indicate that there is a large variation in the medical quality profile of different hospitals from 2019 to 2022. By comparing the results of TOPSIS and RSR method from 2019 to 2022, we found that the hospitals with identical ranking were D and J, and the hospitals with ≤2","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"29 1","pages":"469580241275324"},"PeriodicalIF":1.7,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/00469580241278018
Ifon E. Dora, Refka E. Khalil, Robert A. Adler, Ashraf S. Gorgey
We examined the association among basal metabolic rate (BMR) as well as dietary intakes of vitamin D (Vit D) and calcium on body composition and bone mineral density (BMD) after spinal cord injury (SCI). Cross-sectional design. Veterans Affairs Medical Center, Richmond, VA. About 33 individuals with chronic SCI who recorded their food consumption 3 days per week for 2 weeks. BMR was measured after 10 to 12 h of overnight fast. Average daily vit D and calcium intakes, and total caloric intake were recorded and analyzed using the Nutrition Data System for Research (NDSR) software. Fasting blood analysis for 25-hydroxyvitamin D (25[OH]D) status and Triiodothyronine (T3) status was performed (n = 10). Total and regional BMD, % fat mass (FM), and % lean mass (LM) were measured by dual X-ray absorptiometry scans. Participants consumed less than the Institute of Medicine (IOM) recommended daily allowances (RDA) for vit D (600-800 IU) and calcium (1000-1200 mg) for adults. BMR was positively related to total-lean mass ( r = .62, P = .0001; n = 32) and leg-lean mass ( r = .51, P = .003; n = 32). Adjusted BMR was negatively related to BMD of the left (r = −.38, P = .047; n = 28) and the right (r = −.41, P = .032; n = 28) proximal tibia. Vit D intake was negatively related to percentage total-FM ( r = −.33, P = .07; n = 29) and legs-%FM ( r = −.37, P = .047; n = 29). Multivariate regression models indicated that adjusted BMR explained the variance in leg fat mass (34%; P = .002) and percentage fat mass (44%; P < .0001). Persons with SCI are likely to consume less than the RDAs for vit D and calcium. BMR may explain the changes in body composition and bone metabolism. Dietary vit D should be considered as a prophylactic intervention in maintenance of bone health after SCI.
我们研究了脊髓损伤(SCI)后基础代谢率(BMR)以及膳食中维生素 D(Vit D)和钙摄入量与身体组成和骨矿物质密度(BMD)之间的关系。横断面设计。弗吉尼亚州里士满退伍军人事务医疗中心。约 33 名慢性脊髓损伤患者在两周内每周记录 3 天的食物摄入量。隔夜禁食 10 到 12 小时后测量 BMR。使用研究营养数据系统(NDSR)软件记录和分析每日维生素 D 和钙的平均摄入量以及总热量摄入量。对空腹血液中 25- 羟基维生素 D(25[OH]D)和三碘甲状腺原氨酸(T3)的状况进行了分析(n = 10)。通过双 X 射线吸收扫描测量了总 BMD 和区域 BMD、脂肪量百分比 (FM) 和瘦肉量百分比 (LM)。参与者的维生素D摄入量(600-800 IU)和钙摄入量(1000-1200 mg)均低于美国医学研究所(IOM)推荐的成人每日允许摄入量(RDA)。基础代谢率与总瘦体重(r = .62,P = .0001;n = 32)和腿瘦体重(r = .51,P = .003;n = 32)呈正相关。调整后的基础代谢率与左侧(r = -.38,P = .047;n = 28)和右侧(r = -.41,P = .032;n = 28)胫骨近端的 BMD 呈负相关。维生素 D 摄入量与总 FM 百分比(r = -.33, P = .07; n = 29)和腿部 FM 百分比(r = -.37, P = .047; n = 29)呈负相关。多变量回归模型表明,调整后的血液容积可以解释腿部脂肪量(34%;P = .002)和脂肪量百分比(44%;P < .0001)的差异。SCI 患者的维生素 D 和钙摄入量很可能低于 RDA 标准。基础代谢率可以解释身体成分和骨代谢的变化。膳食中的维生素 D 应被视为维持 SCI 后骨骼健康的预防性干预措施。
{"title":"Basal Metabolic Rate Versus Dietary Vitamin D and Calcium Intakes and the Association With Body Composition and Bone Health After Chronic Spinal Cord Injury","authors":"Ifon E. Dora, Refka E. Khalil, Robert A. Adler, Ashraf S. Gorgey","doi":"10.1177/00469580241278018","DOIUrl":"https://doi.org/10.1177/00469580241278018","url":null,"abstract":"We examined the association among basal metabolic rate (BMR) as well as dietary intakes of vitamin D (Vit D) and calcium on body composition and bone mineral density (BMD) after spinal cord injury (SCI). Cross-sectional design. Veterans Affairs Medical Center, Richmond, VA. About 33 individuals with chronic SCI who recorded their food consumption 3 days per week for 2 weeks. BMR was measured after 10 to 12 h of overnight fast. Average daily vit D and calcium intakes, and total caloric intake were recorded and analyzed using the Nutrition Data System for Research (NDSR) software. Fasting blood analysis for 25-hydroxyvitamin D (25[OH]D) status and Triiodothyronine (T3) status was performed (n = 10). Total and regional BMD, % fat mass (FM), and % lean mass (LM) were measured by dual X-ray absorptiometry scans. Participants consumed less than the Institute of Medicine (IOM) recommended daily allowances (RDA) for vit D (600-800 IU) and calcium (1000-1200 mg) for adults. BMR was positively related to total-lean mass ( r = .62, P = .0001; n = 32) and leg-lean mass ( r = .51, P = .003; n = 32). Adjusted BMR was negatively related to BMD of the left (r = −.38, P = .047; n = 28) and the right (r = −.41, P = .032; n = 28) proximal tibia. Vit D intake was negatively related to percentage total-FM ( r = −.33, P = .07; n = 29) and legs-%FM ( r = −.37, P = .047; n = 29). Multivariate regression models indicated that adjusted BMR explained the variance in leg fat mass (34%; P = .002) and percentage fat mass (44%; P < .0001). Persons with SCI are likely to consume less than the RDAs for vit D and calcium. BMR may explain the changes in body composition and bone metabolism. Dietary vit D should be considered as a prophylactic intervention in maintenance of bone health after SCI.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"215 1","pages":"469580241278018"},"PeriodicalIF":1.7,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1177/00469580241277443
Rachel Coghlan, Nazanin Zadeh-Cummings, Mila Petrova, PhD, Paul Spiegel
How can palliative care framings advance humanitarian discourse? The imperative for palliative care in humanitarian settings is increasingly urgent. Recent efforts by health and humanitarian organizations demonstrate increasing attention to the issue. Yet palliative care is still not adequately formally considered or enacted by humanitarian agencies in rhetoric, policy, research, or practice. Even where it is considered in humanitarian action, palliative care is often assumed to be a novel intervention, rather than a caring practice that has existed from time immemorial, including in humanitarian situations. The generation of ideas in this paper has followed a dynamic, iterative, and reflexive process through engagement with key literature, critical thinking, conversations with colleagues across both sectors, primary data, and debate amongst the authors. The paper argues that the current dominant frame of a new, specialized, professionalized, and medicalized palliative care in the humanitarian sector would perpetuate existing challenges. It contends that viewing both fields through a “new-old” lens, where historical and traditional caring practices intertwine with progressive discourse for a more just and appropriate public health response, can further humanitarianism. It posits that the humanitarian-development nexus, decoloniality, and localization thought can benefit from palliative care practice through critical interaction with a broad range of literature.
{"title":"The “New-Old” Dimensions of Caring in Humanitarian Response: The Opportunity for Public Health Palliative Care to Advance the Humanitarian-Development Nexus, Decoloniality, and Localization Thought","authors":"Rachel Coghlan, Nazanin Zadeh-Cummings, Mila Petrova, PhD, Paul Spiegel","doi":"10.1177/00469580241277443","DOIUrl":"https://doi.org/10.1177/00469580241277443","url":null,"abstract":"How can palliative care framings advance humanitarian discourse? The imperative for palliative care in humanitarian settings is increasingly urgent. Recent efforts by health and humanitarian organizations demonstrate increasing attention to the issue. Yet palliative care is still not adequately formally considered or enacted by humanitarian agencies in rhetoric, policy, research, or practice. Even where it is considered in humanitarian action, palliative care is often assumed to be a novel intervention, rather than a caring practice that has existed from time immemorial, including in humanitarian situations. The generation of ideas in this paper has followed a dynamic, iterative, and reflexive process through engagement with key literature, critical thinking, conversations with colleagues across both sectors, primary data, and debate amongst the authors. The paper argues that the current dominant frame of a new, specialized, professionalized, and medicalized palliative care in the humanitarian sector would perpetuate existing challenges. It contends that viewing both fields through a “new-old” lens, where historical and traditional caring practices intertwine with progressive discourse for a more just and appropriate public health response, can further humanitarianism. It posits that the humanitarian-development nexus, decoloniality, and localization thought can benefit from palliative care practice through critical interaction with a broad range of literature.","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"17 1","pages":"469580241277443"},"PeriodicalIF":1.7,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}