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1.
Psychol Rep ; : 332941241268564, 2024 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-39066491

RESUMO

This research tested the assumptions of Terror Management Theory (Pyszczynski et al., 2015) and conservatism as motivated social cognition (Jost et al., 2003) regarding how belief systems relate to existential anxiety. Conservatism as motivated social cognition posits that politically conservative ideologies are uniquely capable of minimizing fears about death. In contrast, TMT asserts that ideological rigidity is associated with less fear of death but it also promotes aggression and intolerance against those with different beliefs. The relation of ideological rigidity and political conservatism to death anxiety and intolerance of those who have differing worldviews was explored in a sample of American university students (n = 134) and of American respondents from the Prolific crowdsourcing platform (n = 199). The results from both samples supported the hypothesis that ideological rigidity was associated with more negative reactions to people with different beliefs. The results regarding death anxiety were more complicated. In the student sample, personal need for structure was the best predictor of death anxiety, with higher scores on personal need for structure being associated with more death anxiety. In the crowdsourcing sample, social conservatism was the best predictor of death anxiety, with more conservatism being associated with less death anxiety.

2.
Clin Infect Dis ; 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39045871

RESUMO

There is an unmet need for developing drugs for the treatment of gonorrhea, due to rapidly evolving resistance of Neisseria gonorrhoeae against antimicrobial drugs used for empiric therapy, an increase in globally reported multidrug resistant cases, and the limited available therapeutic options. Furthermore, few drugs are under development. Development of antimicrobials is hampered by challenges in clinical trial design, limitations of available diagnostics, changes in and varying standards of care, lack of robust animal models, and clinically relevant pharmacodynamic targets. On April 23, 2021, the U.S. Food and Drug Administration; Centers for Disease Control and Prevention; and National Institute of Allergy and Infectious Diseases, National Institutes of Health co-sponsored a workshop with stakeholders from academia, industry, and regulatory agencies to discuss the challenges and strategies, including potential collaborations and incentives, to facilitate the development of drugs for the treatment of gonorrhea. This article provides a summary of the workshop.

3.
Artigo em Inglês | MEDLINE | ID: mdl-39002714

RESUMO

CONTEXT: The Global Atlas of Palliative Care (GAPC) ranked Mexico's palliative care services at a preliminary integration stage into mainstream healthcare services. However, this data does not reflect pediatric palliative care (PPC) development. OBJECTIVES: To analyze the current need and level of development of PPC within Mexico. METHODS: PPC need was estimated using causes of death associated with serious health-related suffering from national mortality data from the General Directorate of Health Information. The level of development was measured through six indicators involving access to PPC services and opioids, then classified using the GAPC development categories adapted to regional territories based on available data. RESULTS: In 2021, 37,444 children died in Mexico. Of those, 10,677 (28.29%) died from conditions with serious health-related suffering, averaging a need for PPC of 25/100,000 children. Out of Mexico's 32 states, two (6.2%) had no PPC activity (category 1), twenty (62.6%) were in a capacity-building phase (category 2), eight (25%) had isolated PPC provision (category 3a), while two (6.2%) had generalized PPC provision (category 3b). No state had early (category 4a) or advanced PPC integration (category 4b). Overall, Mexico was classified as category 2. CONCLUSIONS: PPC services are distributed unevenly across the country, leading to inequitable access to care and an inability to meet the needs of patients and families. There is a disparity between the level of development of adult palliative care services and the underdevelopment of PPC in Mexico. This information can help stakeholders guide the development of PPC where it is needed most.

4.
J Assist Reprod Genet ; 41(7): 1755-1761, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38958870

RESUMO

PURPOSE: The continuous advancement of assisted reproductive technologies (ART) and the evolving attitudes towards marriage and fertility among the general public have led to an increasing number of groups requiring special attention (GRSA) desiring to fulfill their reproductive needs through these technologies. These groups include single women (including single mothers without children), same-sex couples, and women in high-risk occupations, among others. The purpose of this paper is to explore the feasibility of appropriately liberalizing ART for GRSA. METHODS: This paper discusses the advantages of a moderate liberalization of ART for GRSA from two perspectives: a theoretical basis and a practical significance level. It also analyzes the current constraints on liberalizing ART and presents suggestions for moderate liberalization. RESULTS: The moderate liberalization of ART can provide technical support for respecting and realizing the reproductive freedom of GRSA, which has certain theoretical and practical significance. However, it is also subject to constraints. CONCLUSION: We call for government to keep pace with the times, based on the current stage of political, economic, and social development, to further recognize and protect citizens' reproductive rights, prioritize the practical needs of the public, and explore policies and regulations for gradually loosening the restrictions on ART for GRSA.


Assuntos
Técnicas de Reprodução Assistida , Humanos , Técnicas de Reprodução Assistida/tendências , China , Feminino , Masculino , Direitos Sexuais e Reprodutivos , Fertilidade , Casamento
5.
Artigo em Inglês | MEDLINE | ID: mdl-39060504

RESUMO

PURPOSE: In the contemporary workplace, enduring fatigue has become a standard for employees. This investigation assesses whether such working conditions exacerbate the depletion of employees' personal resources. The need for recovery serves as an indicator of the necessity to mitigate post-work fatigue. A high need for recovery signifies that employees must commence a new workday while already fatigued. METHODS: This research recruited two cohorts of nurses, categorized by a high need for recovery and a low need for recovery, to examine the correlation between work effort and hair cortisol concentrations in each group. RESULTS: Hair cortisol concentrations serve as a biological marker of cumulative cortisol secretion over a specific time frame, reflecting overall personal resource expenditure during this interval. Findings revealed a notable positive correlation between intrinsic work effort (over-commitment) and hair cortisol levels exclusively among nurses with a high need for recovery. CONCLUSION: These outcomes imply that active effort amidst fatigue may lead to excessive strain. This insight enriches the classic 'effort-recovery' model by illustrating how an employee' s personal volition can influence the accumulation of fatigue.

6.
Artigo em Inglês | MEDLINE | ID: mdl-39034204

RESUMO

BACKGROUND: While covalent Bruton's tyrosine kinase inhibitors (cBTKis) have become a standard of care treatment for relapsed/refractory mantle cell lymphoma (R/R MCL), response duration is limited and resistance to BTKi and/or adverse events develop in a subset of patients. However, little real-world evidence on post-cBTKi clinical and economic outcomes exists for these patients. PATIENTS AND METHODS: This retrospective study used 2010 to 2019 U.S. Medicare claims, to identify elderly (≥ 66 years) patients with newly-diagnosed MCL who received third-line (3L) treatment and had evidence of cBTKi use in a prior line of therapy. Outcomes were assessed ≥ 12-months post 3L-treatment initiation and included treatment patterns, all-cause and MCL-related HRU and costs, and overall survival. RESULTS: The final sample contained 230 elderly patients with R/R MCL receiving 3L treatment who had cBTKi use in a prior line of therapy (mean age 75.0, 21.7% age > 80 years; 67.4% male; 93.9% White). Common 3L treatments included chemotherapy (26.1%), lenalidomide (18.7%), and bortezomib (18.3%); 1-quarter (25.7%) of patients received a cBTKi (17.8% ibrutinib; 7.8% acalabrutinib). Overall survival was poor from 3L treatment initiation (median OS = 9.4 months; 1-years survival rate = 43.7%). Patients exhibited high rates of HRU (73.6% experienced hospitalization) and substantial costs ($145,726) in the 12-months after 3L initiation. CONCLUSION: A large unmet need exists in this patient subpopulation, highlighting the importance of ongoing development of novel therapeutics.

7.
Soins ; 69(887): 11-14, 2024.
Artigo em Francês | MEDLINE | ID: mdl-39019509

RESUMO

Chronic kidney disease (CKD) is a public health problem. However, the management of patients with CKD is confined to the diagnosis of the disease and its conventional treatment by dialysis or renal transplantation. The aim of this article is to describe the specific characteristics of patients suffering from kidney disease and to determine their needs according to the stage of their renal disease.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Humanos , Insuficiência Renal Crônica/terapia , Diálise Renal
8.
Artigo em Alemão | MEDLINE | ID: mdl-39025703

RESUMO

INTRODUCTION: In the German rehabilitation system, gaps in care exist that particularly affect people with complex impairments under 60 years of age. Home-based rehabilitation, an outreach form of outpatient rehabilitation, could bridge this gap by providing access to rehabilitation for this group of patients. Corresponding facilities so far barely exist in Germany. In view of the likely complexity and the associated problems of this group of people, needs-based care may also require a cross-indication approach in order to adequately address rehabilitation needs across different organ systems. The aim of this study is to assess 1) the general need for home-based rehabilitation and associated potentials, 2) attitudes towards a cross-indication approach, and 3) indication and allocation criteria for this approach from an expert perspective. METHODS: Data was collected from 08/2022 to 10/2022 through semi-structured individual telephone interviews with experts in the field of rehabilitation. Data were analyzed using qualitative content analysis according to Kuckartz and Rädiker. RESULTS: A total of n = 22 experts were interviewed. The experts see a high need for home-based rehabilitation for people with complex health impairments under the age of 60 in order to counteract existing care gaps within current rehabilitative offers. The potentials offered by home-based rehabilitation include, amongst others, flexibility, participation orientation and involvement of the social environment (e.g., of relatives). A cross-indication approach is considered relevant by the majority of the experts, especially in order to meet more complex needs (e.g., in the case of multimorbidity) in a holistic and needs-based manner. CONCLUSION: The results demonstrate the relevance of this topic and the necessity of expanding (cross-indication) home-based rehabilitation in Germany. According to the experts, (cross-indication) home-based rehabilitation can help to ensure the participation of a group of patients with complex and severe impairments under the age of 60.

9.
Int J Cardiol ; 412: 132324, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-38971537

RESUMO

BACKGROUND: Pediatric heart disease is becoming a major contributor to childhood mortality. Almost half of congenital heart defects require intervention, either surgical or trans-catheter. Rheumatic heart disease also remains a global health problem in Low-and-middle-income-countries (LMICs). Intervention timing depends on the natural course and hemodynamic significance of the lesion with an emphasis on earlier intervention to prevent the damage of volume or pressure load and hypoxia. OBJECTIVE: describe the current unmet intervention need of children with heart diseases presenting to Bahir Dar University Tibebe-Ghion Specialized Teaching Hospital. METHODS: This is a descriptive cross-sectional study involving three-hundred-seventy-six children (376) who had echocardiography-confirmed cardiac diseases over fifteen months from August 01, 2022, to October 30, 2023. Variables were analysed using IBM SPSS version 27 software. RESULTS: Of the 376 children with heart diseases, 54% were boys. The mean (SD) age was 53 (58) months, the median (IQR) being 26 (5-96). Congenital heart defects (CHDs) account for 68% of pediatric heart diseases. 77% of CHDs were acyanotic. Isolated Ventricular septal defect (21%) is the most common acyanotic CHD followed by patent ductus arteriosus (13.2%). Tetralogy of Fallot is the most common cyanotic CHD (41%). Rheumatic heart disease is the most common acquired heart disease (76.9%). 89.4% (336) of children were eligible for intervention need assessment. 35.4% (119) of intervention-eligible children had delayed presentation. 79.8% (268) of intervention-eligible children need intervention at the current presentation. 61%(163) of children who need intervention had delayed intervention timing. 242/268 (90.3%) of children with intervention needs were candidates for surgery. Only 0.7% of children had intervention. CONCLUSION: Our study illustrates the unmet intervention need for pediatric heart diseases our health facilities faced to achieve the 2030 Sustained-development-goal (SDG) target.


Assuntos
Países em Desenvolvimento , Hospitais de Ensino , Avaliação das Necessidades , Humanos , Masculino , Feminino , Estudos Transversais , Pré-Escolar , Etiópia/epidemiologia , Criança , Cardiopatias Congênitas/epidemiologia , Lactente , Cardiopatias/epidemiologia
10.
J Appl Res Intellect Disabil ; 37(5): e13246, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38982871

RESUMO

BACKGROUND: Measurement instruments to understand self-determined motivation towards physical activity among college students with intellectual disabilities are needed to develop programs to support physical and psychological health and well-being. The purpose of the current study was to validate a modified questionnaire measuring basic psychological needs towards physical activity among college students with intellectual disabilities. METHODS: A total of 108 college students with intellectual disabilities completed the modified questionnaire. Validity and reliability of the questionnaire was examined. RESULTS: Confirmatory factor analysis demonstrated a six-factor model had good model fit. Cronbach's alpha values showed acceptable reliability evidence of the instrument as a whole, although some alpha values in subdomains of the instrument were below acceptable values. CONCLUSION: The modified questionnaire was found to have acceptable validity evidence. Further studies are needed with refinement of answer options and the addition of more questions to increase reliability.


Assuntos
Exercício Físico , Deficiência Intelectual , Estudantes , Humanos , Deficiência Intelectual/psicologia , Masculino , Feminino , Adulto Jovem , Estudantes/psicologia , Adulto , Reprodutibilidade dos Testes , Universidades , Psicometria/normas , Psicometria/instrumentação , Adolescente , Inquéritos e Questionários , Motivação
11.
J Family Med Prim Care ; 13(6): 2389-2396, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39027827

RESUMO

Context: Reported literatures revealed the problems of access and misconceptions, low contraceptive usage and high unmet need for family planning among the tribes. Aims: Our aim was to find out the prevalence of contraceptive usage, unmet need and their determinants among tribal married reproductive women. Settings and Design: A community-based, observational, analytical research using cross-sectional design was conducted among 290 tribal women of the Nadia district of West Bengal. Subjects and Methods: After obtaining ethical clearance, an interviewer-administered pre-designed, structured proforma was used to collect information on socio-demographic attributes, marital history, contraceptives and fertility status, unmet needs and the reasons for not using contraceptives. Statistical Analysis Used: Bi-variate analysis was used to know the differences and a two-tailed significance test with a P value of 0.05 or less was considered statistically significant. Results: The present study revealed a high prevalence of teenage marriage (60.7%) and pregnancy (27.6%). Every one in six tribal women was illiterate. The contraceptive prevalence rate was 43.8%. Tubectomy (38.6%) was the most common method (38.6%) and unfelt need (19.6%) was the most common reason for non-use. Age, occupation of women, social class, living status, marital duration, number of living children and desire to have a future child were found to be associated with the current contraceptive use. Social class, number of living children, contraceptive awareness, source and place of availability, abortion history, opposition from family and husband, and husband participation all were significantly associated with the unmet need for family planning. Conclusion: In-depth counselling focusing on achieving a satisfactory level of awareness and acceptance of family planning methods may help to achieve reproductive health by reducing unmet needs.

12.
BMC Pulm Med ; 24(1): 349, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39026200

RESUMO

Asthma, influenced by genetic, environmental, and social factors is leading to poor outcomes and preventable mortality due to inadequate care and limited access to effective treatments. This study aimed to analyze self-reported asthma prevalence in Turkey, focusing on its determinants, such as individual factors, lifestyle, socioeconomic status, and healthcare access.This study conducts a secondary analysis of the 2019 Turkiye Health Survey (THS), employing a nationally representative cross-sectional design by the Turkish Statistical Institute. The sampling utilized a stratified, two-stage cluster sampling method, with data from 16,976 adults (aged 15 years and older) analyzed for asthma determinants. The independent variables are categorized into four domains: individual factors, lifestyle assessment, socioeconomic factors, and access to the healthcare services.The prevalence of asthma is 9.8%, varying significantly across demographics. Higher asthma rates are observed among older, divorced/widowed individuals, those with communication difficulties, and obese individuals. Cost-related unmet healthcare needs and appointment scheduling delays increase asthma risk. Logistic regression models identified age, marital status, obesity, education level, and healthcare access as significant predictors of asthma.This study underscores the multifaceted determinants of asthma in Turkey, highlighting the necessity for targeted interventions addressing individual, lifestyle, socioeconomic, and healthcare access factors.


Assuntos
Asma , Acessibilidade aos Serviços de Saúde , Estilo de Vida , Autorrelato , Fatores Socioeconômicos , Humanos , Asma/epidemiologia , Turquia/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Estudos Transversais , Adulto Jovem , Adolescente , Idoso , Prevalência , Inquéritos Epidemiológicos , Modelos Logísticos , Fatores de Risco
13.
Artigo em Russo | MEDLINE | ID: mdl-39003553

RESUMO

The objective analysis of state of medical personnel, along with assessment of real need for specialists, is the basis of improving activities of any health care service. In relation to pathologists, there is unique opportunity to perform similar analysis, based on application of current corresponding staff standards that consider volume of workload of physicians in order to determine required number of positions. The implementation of corresponding original methodology permitted to establish that the actual number of staff positions of pathologists in 2022 amounted up to average 40.6% of the number required according to staffing standards in the Irkutsk Oblast. The physician staffing ratio, calculated on the basis of required number of positions found according to proposed methodology, decreases to 29.1% and staffing with physicians excluding combined jobs to 17.1%. At that, implemented workload per one pathologist reaches 5.9 of standard positions. The deficiency of representatives of this specialty in the region, even if current combined jobs ratio is maintained, is 154 specialists.


Assuntos
Carga de Trabalho , Humanos , Carga de Trabalho/estatística & dados numéricos , Carga de Trabalho/normas , Patologistas/normas , Patologistas/estatística & dados numéricos , Federação Russa , Recursos Humanos , Sibéria/epidemiologia
14.
Healthcare (Basel) ; 12(13)2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-38998805

RESUMO

Traumatic peripheral nerve injuries (PNI), present with symptoms ranging from pain to loss of motor and sensory function. Difficulties in intraoperative visual assessment of nerve functional status necessitate intraoperative nerve conduction studies (INCSs) by neurosurgeons and neurologists to determine the presence of functioning axons in the zone of a PNI. This process, also referred to as nerve "inching", uses a set of stimulating and recording electrode hooks to lift the injured nerve from the surrounding surgical field and to determine whether an electrical stimulus can travel through the zone of injury. However, confounding electrical signal artifacts can arise from the current workflow and electrode design, particularly from the mandatory lifting of the nerve, complicating the definitive assessment of nerve function and neurosurgical treatment decision-making. The objective of this study is to describe the design process and verification testing of our group's newly designed stimulating and recording electrodes that do not require the lifting or displacement of the injured nerve during INCSs. Ergonomic in vivo analysis of the device within a porcine model demonstrated successful intraoperative manipulation of the device, while quantitative nerve action potential (NAP) signal analysis with an ex vivo simulated "inching" procedure on healthy non-human primate nerve tissue demonstrated excellent reproducible recorded NAP fidelity and the absence of NAP signal artifacts at all points of recording. Lastly, electrode pullout force testing determined maximum forces of 0.43 N, 1.57 N, and 3.61 N required to remove the device from 2 mm, 5 mm, and 1 cm nerve models, respectively, which are well within established thresholds for nerve safety. These results suggest that these new electrodes can safely and successfully perform accurate PNI assessment without the presence of artifacts, with the potential to improve the INCS standard of care while remaining compatible with currently used neurosurgical technology, infrastructure, and clinical workflows.

15.
J Pediatr Nurs ; 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38997912

RESUMO

PURPOSE: This study aimed to determine the level of anxiety, depression, support needs and opinions of mothers of children with cerebral palsy. DESIGN AND METHODS: The study used a descriptive qualitative design. The population of the study consisted of children with cerebral palsy who were educated in special education centers in a province of Eastern Turkey. All participants who volunteered for the study were accepted and the study was completed with 126 mothers. RESULTS: Caregiver mothers with male cerebral palsy patients had higher carer support needs and anxiety total mean scores. The mean scores of depression and anxiety of the mothers who were older were statistically higher. This study found that mothers of children with diseases other than cerebral palsy had statistically higher mean depression scores. The mothers of child with cerebral palsy who had a high gross motor classification score had higher mean carer support needs, depression, and anxiety total scores. CONCLUSIONS: According to the study, depression and trait anxiety were linked to greater maternal support needs. Qualitative interviews revealed that mothers experienced issues such as stigmatization and withdrawal from social activities as a result of their children's illness. PRACTICE IMPLICATIONS: This study shows the relationship of need for support of mothers of children with cerebral palsy and mental problems such as depression and trait anxiety. Pediatric nurses should provide emotional support to mothers and guide them towards support groups and training programs.

16.
Leuk Lymphoma ; : 1-14, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38975903

RESUMO

To quantify the clinical unmet need of r/r MCL patients who progress on a covalent Bruton tyrosine kinase inhibitor (BTKi), we conducted a systematic review to identify studies that reported overall survival (OS), progression-free survival (PFS), or response outcomes of patients who received a chemo(immunotherapy) ± targeted agent standard therapy (STx) or brexucabtagene autoleucel (brexu-cel) in the post-BTKi setting. Twenty-six studies (23 observational; three trials) reporting outcomes from 2005 to 2022 were included. Using two-stage frequentist meta-analyses, the estimated median PFS/OS for patients treated with an STx was 7.6 months (95% CI: 3.9-14.6) and 9.1 months (95% CI: 7.3-11.3), respectively. The estimated objective response rate (ORR) was 45% (95% CI: 34-57%). For patients treated with brexu-cel, the estimated median PFS/OS was 14.9 months (95% CI: 10.5-21.0) and 32.1 months (95% CI: 25.2-41.2), with a pooled ORR of 89% (95% CI: 86-91%). Our findings highlight a significant unmet need for patients whose disease progresses on a covalent BTKi.

17.
Front Psychol ; 15: 1393966, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39035084

RESUMO

Background: Grounded in self-determination theory, this article deals with a multidimensional measurement of the support of the basic psychological needs and the individual and combined effects on the development of intrinsic motivation and perceived competence in physical education. In addition to the supportive teacher behaviors of autonomy support, competence support and relatedness support, peer relatedness support is examined as an additional factor. Methods: A total of 1,047 students from 72 classes from various German-speaking Swiss cantons took part in the study. The hypothesized four factorial structure was analyzed using multilevel confirmatory factor analyses. Longitudinal measurement invariance testing of intrinsic motivation and perceived competence indicates scalar measurement invariance. Multilevel regression analyses were specified to analysis the longitudinal effects on the development of intrinsic motivation and perceived competence, whereby both the effects of the individual factors as well as the adjusted effects under the inclusion of all predictors were examined. Results: Results of multilevel confirmatory factor analysis indicate that the hypothesized four-factor model (e.g., CFI = 0.97; TLI = 0.96; RMSEA = 0.04; SRMR between = 0.11) is to be favored over alternative models at both levels. Regarding the prediction of the development of intrinsic motivation and perceived competence our study underlines the predictive value of basic psychological need support. The models that examine the effects of the individual predictors indicate that the effects are largely consistent with expectations at both the class and individual level. At class level, however, autonomy support appears to be no significant predictor for the development of intrinsic motivation (p < 0.10), but for perceived competence (p < 0.05). Peer relatedness support is a significant predictor for both outcome variables at both levels of analysis. Regarding the simultaneous integration of all predictors, only the effects of peer relatedness support remain significant for both outcome variables. Discussion: The empirical support of the multidimensionality of the instrument is particularly interesting in the context of the common conceptualization of a unidimensional measurement of autonomy support or a composite factor of psychological need support, whereby only few studies have adequately tested the factorial validity. Although significant effects of supportive teacher behaviors can be demonstrated in the multilevel regression analyses, it is also indicated that the different dimensions lack of incremental predictive validity. Particularly noteworthy is the rarely investigated role of peer relatedness support, which has been shown to be a meaningful predictor, even when supportive teacher behaviors are taken into account.

18.
Front Med (Lausanne) ; 11: 1408553, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39005652

RESUMO

The European Medicines Agency's conditional marketing authorization (CMA) aims to expedite patient access to medicines for unmet medical needs by shifting a part of the drug development process post-authorization. We highlight ethical issues surrounding CMA, comprising (i) the complexity of defining unmet medical need; (ii) poor understanding of CMA and its impact on informed consent; (iii) hope versus unrealistic optimism; (iv) implications of prolonged post-authorization studies and potential patient harm; (v) rights and duties of patients surrounding participation in post-authorization studies; (vi) access to previously authorized CMA medicines; and (vii) the "benefit slippage" phenomenon, defined as the gradual shift of strict criteria to less strict criteria. We propose a comprehensive research agenda to address these ethical issues, and stress the need for multi-stakeholder engagement to ensure patient-centered use of CMA.

19.
Assessment ; : 10731911241260545, 2024 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-39066602

RESUMO

Norming of psychological tests is decisive for test score interpretation. However, conventional norming based on subgroups results either in biases or require very large samples to gather precise norms. Continuous norming methods, namely inferential, semi-parametric, and (simplified) parametric norming, propose to solve those issues. This article provides a systematic review of continuous norming. The review includes 121 publications with overall 189 studies. The main findings indicate that most studies used simplified parametric norming, not all studies considered essential distributional assumptions, and the evidence comparing different norming methods is inconclusive. In a real data example, using the standardization sample of the Need for Cognition-KIDS scale, we compared the precision of conventional, semi-parametric, and parametric norms. A hierarchy in terms of precision emerged with conventional norms being least precise, followed by semi-parametric norms, and parametric norms being most precise. We discuss these findings by comparing our findings and methods to previous studies.

20.
Stud Health Technol Inform ; 315: 691-692, 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39049384

RESUMO

Women with domestic violence experiences often refuse to seek help face-to-face due to embarrassment. They begin to share their emotions and seek help from online health communities. Understanding and responding to these posts can be crucial in providing timely support to the victims. We proposed a fine-tuned large language model (LLM) capable of accurately predicting the informational need based on the content of postings. We fine-tuned the LAMMA2-7B-chat model based on the guidance of identifying the information need and a dataset comprising 273 posts from Reddit, which are manually annotated by domain experts. Furthermore, we evaluated the performance of our model using a random sample of 15 posts, and 66.6% were accurately predicted. The results demonstrate that our model can rapidly capture the information needs expressed in the posts, enabling healthcare providers to provide timely and useful support based on our predictions.


Assuntos
Violência Doméstica , Sobreviventes , Humanos , Sobreviventes/psicologia , Feminino , Processamento de Linguagem Natural , Mídias Sociais , Avaliação das Necessidades
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