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1.
Proc Natl Acad Sci U S A ; 118(39)2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34544861

RESUMO

Unbiased science dissemination has the potential to alleviate some of the known gender disparities in academia by exposing female scholars' work to other scientists and the public. And yet, we lack comprehensive understanding of the relationship between gender and science dissemination online. Our large-scale analyses, encompassing half a million scholars, revealed that female scholars' work is mentioned less frequently than male scholars' work in all research areas. When exploring the characteristics associated with online success, we found that the impact of prior work, social capital, and gendered tie formation in coauthorship networks are linked with online success for men, but not for women-even in the areas with the highest female representation. These results suggest that while men's scientific impact and collaboration networks are associated with higher visibility online, there are no universally identifiable facets associated with success for women. Our comprehensive empirical evidence indicates that the gender gap in online science dissemination is coupled with a lack of understanding the characteristics that are linked with female scholars' success, which might hinder efforts to close the gender gap in visibility.


Assuntos
Autoria/normas , Sistemas On-Line/normas , Revisão da Pesquisa por Pares/tendências , Publicações/normas , Ciência/normas , Sexismo/prevenção & controle , Feminino , Humanos , Masculino
2.
Eur J Contracept Reprod Health Care ; 26(4): 343-348, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33688778

RESUMO

OBJECTIVES: The increasing availability of health information online combined with reduced access to health care providers due to the coronavirus pandemic means that more people are using the internet for health information. However, with no standardised regulation of the internet, the population is vulnerable to misinformation regarding important health information. This review aimed to evaluate the quality and readability of the online information available on emergency contraception (EC) options. STUDY DESIGN: In this descriptive study, a Google search was performed using the term 'emergency contraception options' on 13 April 2020 yielding 232 results. Seventy-one results were excluded (34 inaccessible, 37 contained no medical information). The remaining 161 results were categorised by typology and assessed for credibility (JAMA criteria and HONcode), reliability (DISCERN tool) and readability (Flesch-Kincaid Grade Level and Simple Measure of Gobbledygook). RESULTS: Of all webpages evaluated, the most common typology was governmental. Credibility of web pages was poor (average JAMA score of 1.47 out of 4). Only 10.6% of webpages were HONcode certified. The most common DISCERN category was Fair (29.81%), closely followed by Poor (27.95%) reliability. On average, readability levels were above the recommended grade level for health information. The intrauterine device was discussed least frequently (86.96%) of all the EC options. CONCLUSION: Online information was of low credibility, reliability and written above the recommended reading level. Clinicians should be aware of the poor quality of online information on EC options, and actively educate patients on what makes a source credible.


Assuntos
Informação de Saúde ao Consumidor , Anticoncepção Pós-Coito/métodos , Sistemas On-Line/normas , Saúde Reprodutiva/normas , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Informação de Saúde ao Consumidor/métodos , Informação de Saúde ao Consumidor/normas , Confiabilidade dos Dados , Humanos , SARS-CoV-2
3.
Radiat Oncol ; 15(1): 203, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32825848

RESUMO

BACKGROUND: Online adaptive radiotherapy is intended to prevent plan degradation caused by inter-fractional tumor volume and shape changes, but time limitations make online re-planning challenging. The aim of this study was to compare the quality of online-adapted plans to their respective reference treatment plans. METHODS: Fifty-two patients treated on a ViewRay MRIdian Linac were included in this retrospective study. In total 238 online-adapted plans were analyzed, which were optimized with either changing of the segment weights (n = 85) or full re-optimization (n = 153). Five different treatment sites were evaluated: prostate, abdomen, liver, lung and pelvis. Dosimetric parameters of gross tumor volume (GTV), planning target volume (PTV), 2 cm ring around the PTV and organs at risk (OARs) were considered. The Wilcoxon signed-rank test was used to assess differences between online-adapted and reference treatment plans, p < 0.05 was considered significant. RESULTS: The average duration of the online adaptation, consisting of contour editing, plan optimization and quality assurance (QA), was 24 ± 6 min. The GTV was slightly larger (average ± SD: 1.9% ± 9.0%) in the adapted plans than in the reference plans (p < 0.001). GTV-D95% exhibited no significant changes when considering all plans, but GTV-D2% increased by 0.40% ± 1.5% on average (p < 0.001). There was a very small yet significant decrease in GTV-coverage for the abdomen plans. The ring Dmean increased on average by 1.0% ± 3.6% considering all plans (p < 0.001). There was a significant reduction of the dose to the rectum of 4.7% ± 16% on average (p < 0.001) for prostate plans. CONCLUSIONS: Dosimetric quality of online-adapted plans was comparable to reference treatment plans and OAR dose was either comparable or decreased, depending on treatment site. However, dose spillage was slightly increased.


Assuntos
Neoplasias/radioterapia , Sistemas On-Line/normas , Órgãos em Risco/efeitos da radiação , Garantia da Qualidade dos Cuidados de Saúde , Planejamento da Radioterapia Assistida por Computador/normas , Radioterapia Guiada por Imagem/normas , Radioterapia de Intensidade Modulada/normas , Humanos , Imageamento por Ressonância Magnética/métodos , Prognóstico , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia de Intensidade Modulada/métodos , Estudos Retrospectivos
4.
Cell Syst ; 9(5): 417-421, 2019 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-31677972

RESUMO

As more digital resources are produced by the research community, it is becoming increasingly important to harmonize and organize them for synergistic utilization. The findable, accessible, interoperable, and reusable (FAIR) guiding principles have prompted many stakeholders to consider strategies for tackling this challenge. The FAIRshake toolkit was developed to enable the establishment of community-driven FAIR metrics and rubrics paired with manual and automated FAIR assessments. FAIR assessments are visualized as an insignia that can be embedded within digital-resources-hosting websites. Using FAIRshake, a variety of biomedical digital resources were manually and automatically evaluated for their level of FAIRness.


Assuntos
Disseminação de Informação/métodos , Internet/tendências , Sistemas On-Line/normas , Recursos em Saúde/normas , Humanos
5.
J Contin Educ Nurs ; 50(10): 439-441, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31556957

RESUMO

Health care professionals frequently participate in surveys. Increased technology supports low-budget online surveys as a common method for collecting information. Decreased interaction with the surveyor, a lack of trust in the survey process, and time constraints often reduce response rates. Improved communication and shared results can positively influence the participants' experience. [J Contin Educ Nurs. 2019;50(10):439-441].


Assuntos
Atitude do Pessoal de Saúde , Guias como Assunto/normas , Pessoal de Saúde/psicologia , Sistemas On-Line/normas , Inquéritos e Questionários/estatística & dados numéricos , Inquéritos e Questionários/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
PLoS One ; 14(8): e0219177, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31404071

RESUMO

Recent innovations in e-commerce have led to the emergence of online retailing platforms, where millions of products are sold. Most of these products are sold by third-party sellers who pay a fee for the e-retailer (called the platform owner). We investigate how the e-retailer manages the various products in the presence of consumer heterogeneity and diseconomies of scope. Our analytical results indicate that the e-retailer prefers the platform-selling mode when consumers have stronger heterogeneity or when the value of a product is high; moreover, the consumer heterogeneity benefits the e-retailer and hurts the supplier. We also analyze the effect of the relationship of among categories on the e-retailer's choice. We show that the relationship among categories can invert the existing format. In addition, we find that the e-retailer may be better off and raise the number of products under strong diseconomies of scope when the categories are complements, and the opposite is true when the categories are substitutable.


Assuntos
Comportamento de Escolha , Comércio/economia , Comércio/métodos , Comportamento do Consumidor , Marketing/métodos , Modelos Teóricos , Sistemas On-Line/normas , Publicidade , Humanos
7.
BMC Infect Dis ; 18(1): 615, 2018 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-30509195

RESUMO

BACKGROUND: Despite persistent calls for HIV care to adopt a chronic care approach, few HIV treatment services have been able to establish service arrangements that prioritise self-management. To prevent cardiovascular and other chronic disease outcomes, the HealthMap program aims to enhance routine HIV care with opportunities for self-management support. This paper outlines the systematic process that was used to design and develop the HealthMap program, prior to its evaluation in a cluster-randomised trial. METHODS: Program development, planning and evaluation was informed by the PRECEDE-PROCOEDE Model and an Intervention Mapping approach and involved four steps: (1) a multifaceted needs assessment; (2) the identification of intervention priorities; (3) exploration and identification of the antecedents and reinforcing factors required to initiate and sustain desired change of risk behaviours; and finally (4) the development of intervention goals, strategies and methods and integrating them into a comprehensive description of the intervention components. RESULTS: The logic model incorporated the program's guiding principles, program elements, hypothesised causal processes, and intended program outcomes. Grounding the development of HealthMap on a clear conceptual base, informed by the research literature and stakeholder's perspectives, has ensured that the HealthMap program is targeted, relevant, provides transparency, and enables effective program evaluation. CONCLUSIONS: The use of a systematic process for intervention development facilitated the development of an intervention that is patient centred, accessible, and focuses on the key determinants of health-related outcomes for people with HIV in Australia. The techniques used here may offer a useful methodology for those involved in the development and implementation of complex interventions.


Assuntos
Infecções por HIV/terapia , Desenvolvimento de Programas , Sistemas de Apoio Psicossocial , Autogestão/métodos , Telemedicina/métodos , Austrália , Doenças Cardiovasculares/prevenção & controle , Doença Crônica/prevenção & controle , HIV , Infecções por HIV/complicações , Humanos , Avaliação das Necessidades , Sistemas On-Line/organização & administração , Sistemas On-Line/normas , Desenvolvimento de Programas/normas , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Projetos de Pesquisa , Telemedicina/organização & administração
8.
PLoS One ; 13(11): e0206458, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30383766

RESUMO

The accuracy and diversity of recommendation algorithms have always been the research hotspot of recommender systems. A good recommender system should not only have high accuracy and diversity, but also have adequate robustness against spammer attacks. However, the issue of recommendation robustness has received relatively little attention in the literature. In this paper, we systematically study the influences of different spammer behaviors on the recommendation results in various recommendation algorithms. We further propose an improved algorithm by incorporating the inner-similarity of user's purchased items in the classic KNN approach. The new algorithm effectively enhances the robustness against spammer attacks and thus outperforms traditional algorithms in recommendation accuracy and diversity when spammers exist in the online commercial systems.


Assuntos
Segurança Computacional/normas , Comportamento do Consumidor , Guias como Assunto , Internet/normas , Sistemas On-Line/normas , Software , Algoritmos , Redes de Comunicação de Computadores/normas , Humanos , Redes Sociais Online , Interface Usuário-Computador
9.
Phys Med Biol ; 63(15): 155016, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29972147

RESUMO

Medical imaging is currently employed in the diagnosis, planning, delivery and response monitoring of cancer treatments. Due to physiological motion and/or treatment response, the shape and location of the pathology and organs-at-risk may change over time. Establishing their location within the acquired images is therefore paramount for an accurate treatment delivery and monitoring. A feasible solution for tracking anatomical changes during an image-guided cancer treatment is provided by image registration algorithms. Such methods are, however, often built upon elements originating from the computer vision/graphics domain. Since the original design of such elements did not take into consideration the material properties of particular biological tissues, the anatomical plausibility of the estimated deformations may not be guaranteed. In the current work we adapt two existing variational registration algorithms, namely Horn-Schunck and EVolution, to online soft tissue tracking. This is achieved by enforcing an incompressibility constraint on the estimated deformations during the registration process. The existing and the modified registration methods were comparatively tested against several quality assurance criteria on abdominal in vivo MR and CT data. These criteria included: the Dice similarity coefficient (DSC), the Jaccard index, the target registration error (TRE) and three additional criteria evaluating the anatomical plausibility of the estimated deformations. Results demonstrated that both the original and the modified registration methods have similar registration capabilities in high-contrast areas, with DSC and Jaccard index values predominantly in the 0.8-0.9 range and an average TRE of 1.6-2.0 mm. In contrast-devoid regions of the liver and kidneys, however, the three additional quality assurance criteria have indicated a considerable improvement of the anatomical plausibility of the deformations estimated by the incompressibility-constrained methods. Moreover, the proposed registration models maintain the potential of the original methods for online image-based guidance of cancer treatments.


Assuntos
Processamento de Imagem Assistida por Computador/normas , Imagem Multimodal/normas , Sistemas On-Line/normas , Algoritmos , Humanos , Processamento de Imagem Assistida por Computador/métodos
10.
Sci Rep ; 8(1): 7052, 2018 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-29728581

RESUMO

We evaluated the reliability of early life nasopharyngeal carcinoma (NPC) aetiology factors in the questionnaire of an NPC case-control study in Hong Kong during 2014-2017. 140 subjects aged 18+ completed the same computer-assisted questionnaire twice, separated by at least 2 weeks. The questionnaire included most known NPC aetiology factors and the present analysis focused on early life exposure. Test-retest reliability of all the 285 questionnaire items was assessed in all subjects and in 5 subgroups defined by cases/controls, sex, time between 1st and 2nd questionnaire (2-29/≥30 weeks), education (secondary or less/postsecondary), and age (25-44/45-59/60+ years) at the first questionnaire. The reliability of items on dietary habits, body figure, skin tone and sun exposure in early life periods (age 6-12 and 13-18) was moderate-to-almost perfect, and most other items had fair-to-substantial reliability in all life periods (age 6-12, 13-18 and 19-30, and 10 years ago). Differences in reliability by strata of the 5 subgroups were only observed in a few items. This study is the first to report the reliability of an NPC questionnaire, and make the questionnaire available online. Overall, our questionnaire had acceptable reliability, suggesting that previous NPC study results on the same risk factors would have similar reliability.


Assuntos
Exposição Ambiental/efeitos adversos , Carcinoma Nasofaríngeo/epidemiologia , Carcinoma Nasofaríngeo/etiologia , Sistemas On-Line , Inquéritos e Questionários , Adolescente , Adulto , Fatores Etários , Estudos de Casos e Controles , Criança , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Sistemas On-Line/normas , Vigilância em Saúde Pública , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Inquéritos e Questionários/normas , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-29473786

RESUMO

To enable further study and assessment of indoor inhalation exposure risk, an online apparatus enabling measurement of semi-volatile compound partitioning on household particulates was developed. An example for use of the apparatus is described using dimethyl phthalate (DMP). The system employs direct measurement by membrane introduction mass spectrometry (MIMS). The MIMS system was calibrated using known gas phase DMP concentrations produced by gravimetrically calibrated permeation devices. The quantity of DMP sorbed by particles is described first using a model particle type, a reverse-phase liquid chromatography packing material, and then with a household dust sample. In addition, the desorption of semi-volatile compounds from a household dust sample was monitored using the apparatus, and characteristic fragment ion signals for phthalate compounds were observed.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Poeira/análise , Espectrometria de Massas/métodos , Sistemas On-Line , Material Particulado/análise , Ácidos Ftálicos/análise , Adsorção , Calibragem , Cromatografia Gasosa-Espectrometria de Massas/métodos , Cromatografia Gasosa-Espectrometria de Massas/normas , Humanos , Espectrometria de Massas/normas , Sistemas On-Line/instrumentação , Sistemas On-Line/normas , Material Particulado/farmacocinética , Ácidos Ftálicos/farmacocinética
13.
J Proteomics ; 168: 28-36, 2017 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-28757464

RESUMO

Offline high-pH reversed-phase fractionation is widely used to reduce sample complexity in proteomic workflows. This is due to the semi-orthogonality and high peak resolution of the two separations. Offline 2D fractionation, however, is low throughput and requires several manual manipulations and is prone to sample losses. To address these issues, we developed an online two dimensional high-pH - low-pH reversed-phase-reversed-phase (2D RPRP) LC-MRM method whereby hundreds of peptides can be quantified in a single LC-MS/MS injection. The method allowed the reproducible and sensitive quantitation of a test panel of 367 peptides (168 proteins) from undepleted and non-enriched human plasma. Of these, we were able to detect and quantify 95 peptides (29 proteins) by 2D-RPRP that were not detectable by 1D LC-MRM-MS. Online 2D RPRP resulted in an average increase of roughly 10-fold in sensitivity compared to traditional 1D low-pH separations, while improving reproducibility and sample throughput relative to offline 2D RPRP by factors of 1.7 and 5, respectively, compared to offline 2D RPRP. This paper serves as proof-of-concept of the feasibility and efficacy of online 2D RPRP at analytical flow rates for highly multiplexed targeted proteomic analyses.


Assuntos
Proteínas Sanguíneas/análise , Cromatografia de Fase Reversa/métodos , Sistemas On-Line/normas , Proteômica/normas , Humanos , Concentração de Íons de Hidrogênio , Proteômica/métodos
14.
Nurse Educ Today ; 55: 31-37, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28511085

RESUMO

BACKGROUND: Ethical competence, which is reflected in the ability to detect ethical challenges in clinical situations and engage in deliberate thinking on ethical actions, is one of the core competencies of nursing practice. PURPOSE: The purpose of this study was to develop and implement an interactive situational e-learning system, integrating nursing ethical decisions into a nursing ethics course, and to evaluate the effects of this course on student nurses' ethical decision-making competence. PROJECT DESIGN: The project was designed to be carried out in two phases. In the first phase, an interactive situated e-learning system was developed and integrated into the nursing ethics course. The second phase involved implementing the course and evaluating its effects in a quasi-experimental study. The course intervention was designed for 2h per week over one semester (18weeks). PARTICIPANTS: A total of 100 two-year technical college nursing students in their second year of the program participated in the study, with 51 in the experimental group and 49 in the control group. RESULTS: After completing the course, the students in the experimental group showed significant improvement in nursing ethical decision-making competence, including skills in "raising questions," "recognizing differences," "comparing differences," "self-dialogue," "taking action," and "identifying the implications of decisions made," compared to their performance prior to the class. After controlling for factors influencing learning effects, students in the experimental group showed superiority to those in the control group in the competency of "recognizing differences." The students in the experimental group reported that the course pushed them to search for and collect information needed to resolve the ethical dilemma. CONCLUSIONS: The interactive situational e-learning system developed by our project was helpful in developing the students' competence in ethical reasoning. The e-learning system and the situational teaching materials used in this study may be applicable in nursing and related professional ethics courses.


Assuntos
Currículo , Tomada de Decisões , Educação a Distância/métodos , Ética em Enfermagem/educação , Sistemas On-Line/normas , Bacharelado em Enfermagem , Feminino , Humanos , Internet , Masculino , Modelos Educacionais , Avaliação de Programas e Projetos de Saúde , Estudantes de Enfermagem/psicologia , Ensino , Adulto Jovem
15.
Transfusion ; 56(10): 2510-2519, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27456672

RESUMO

BACKGROUND: Extracorporeal photopheresis (ECP) is a therapeutic technique that combines leukapheresis and ultraviolet (UV)A irradiation of the leukapheresate after 8-methoxypsoralen treatment with subsequent retransfusion. It can be achieved with a single device (online) or by combining an apheresis machine with a separate UVA light source (offline). The comparability of both established methods is unknown. STUDY DESIGN AND METHODS: In a prospective setting, four ECP systems were evaluated: one with integrated UVA irradiation for online ECP (Therakos) and three with external UVA irradiation for offline ECP (Amicus, Optia, and Cobe Spectra). Apheresis variables and cell counts were determined by methods including flow cytometry. RESULTS: The duration of apheresis ranged from 120 minutes (Amicus, Optia) to 275 minutes (Therakos). Mononuclear cell (MNC) counts in the treatment bags were comparable between offline ECP methods (median, 57 × 108 - 66 × 108 ) and lower for online ECP (14 × 108 ). CD16+ monocytes were abundant in online ECP (82%) but rarer in offline ECP (median, 14% - 19%). Hematocrit ranged from 0.1% (Therakos) to 8% (Amicus). There were no side effects in any patients. DISCUSSION: All offline ECP systems studied yielded comparable cellular compositions and highly enriched populations of MNCs. In contrast, white blood cells from online ECP displayed enrichment of nonclassical monocytes. The relevance of these findings is unknown as there is no established biomarker to predict the therapeutic efficacy of these procedures.


Assuntos
Fotoferese/instrumentação , Adolescente , Adulto , Idoso , Remoção de Componentes Sanguíneos , Contagem de Células , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Monócitos/citologia , Sistemas On-Line/normas , Fotoferese/métodos , Estudos Prospectivos , Raios Ultravioleta , Adulto Jovem
16.
Stud Health Technol Inform ; 225: 718-20, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27332317

RESUMO

The majority of the adult population in both Europe and North America have access to the internet. Over 70% state that they have used the internet to look for health information and the majority started their search at a search engine. Given that search engines list sites according to popularity and not quality, it is imperative that users have a means of discerning trustworthy and honest information from non-reliable health information. The HONcode, a set of eight quality guidelines, ensures access to standardized trustworthy health information which can be used as a tool to guide consumers.


Assuntos
Informação de Saúde ao Consumidor/normas , Sistemas On-Line/normas , Guias de Prática Clínica como Assunto , Garantia da Qualidade dos Cuidados de Saúde/normas , Ferramenta de Busca/normas , Mídias Sociais/normas , Confiabilidade dos Dados , Sistemas de Informação em Saúde/normas , Internacionalidade
17.
Trends Parasitol ; 32(7): 522-530, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27131629

RESUMO

Traditionally, parasitology courses have mostly been taught face-to-face on campus, but now digital technologies offer opportunities for teaching and learning. Here, we give a perspective on how new technologies might be used through student-centred teaching approaches. First, a snapshot of recent trends in the higher education is provided; then, a brief account is given of how digital technologies [e.g., massive open online courses (MOOCs), flipped classroom (FC), games, quizzes, dedicated Facebook, and digital badges] might promote parasitology teaching and learning in digital learning environments. In our opinion, some of these digital technologies might be useful for competency-based, self-regulated, learner-centred teaching and learning in an online or blended teaching environment.


Assuntos
Computadores , Tecnologia Educacional/normas , Parasitologia/educação , Parasitologia/tendências , Ensino/tendências , Tecnologia Educacional/tendências , Sistemas On-Line/normas
18.
Pain Med ; 17(11): 1985-1992, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27036413

RESUMO

OBJECTIVE: Many physicians struggle to communicate with patients with chronic, non-malignant pain (CNMP). Through the use of a Web module, the authors aimed to improve faculty participants' communication skills knowledge and confidence, use of skills in clinical practice, and actual communication skills. SUBJECTS: The module was implemented for faculty development among clinician-educators with university faculty appointments, outpatient clinical practices, and teaching roles. METHODS: Participants completed the Collaborative Opioid Prescribing Education Risk Evaluation and Mitigation Strategy (COPE-REMS®) module, a free Web module designed to improve provider communication around opioid prescribing. Main study outcomes were improvements in CNMP communication knowledge, attitudes, and skills. Skills were assessed by comparing a subset of participants' Observed Structured Clinical Exam (OSCE) performance before and after the curriculum. RESULTS: Sixty-two percent of eligible participants completed the curriculum in 2013. Knowledge-based test scores improved with curriculum completion (75% vs. 90%; P < 0.001). Using a 5-point Likert-type scale, participants reported improved comfort in managing patients with CNMP both immediately post-curriculum and at 6 months (3.6 pre vs. 4.0 post vs. 4.1 at 6 months; P = 0.02), as well as improvements in prescribing opioids (3.3 vs. 3.8 vs. 3.9, P = 0.01) and conducting conversations about discontinuing opioids (2.8 vs. 3.5 vs. 3.9, P < 0.001). Additionally, CNMP-specific communication skills on the OSCE improved after the curriculum (mean 67% vs. 79%, P = 0.03). CONCLUSIONS: Experienced clinician-educators improved their communication knowledge, attitudes, and skills in managing patients with CNMP after implementation of this curriculum. The improvements in attitudes were sustained at six months. A Web-based curriculum such as COPE-REMS® may be useful for other programs seeking improvement in faculty communication with patients who have CNMP.


Assuntos
Atitude do Pessoal de Saúde , Dor Crônica/terapia , Competência Clínica/normas , Docentes de Medicina/normas , Sistemas On-Line/normas , Relações Médico-Paciente , Analgésicos Opioides/uso terapêutico , Dor Crônica/psicologia , Currículo/normas , Docentes de Medicina/educação , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino
20.
IEEE Trans Haptics ; 9(2): 267-78, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26780819

RESUMO

In the design of a compliant admittance controller for physical human-robot interaction, it is necessary to ensure stable and effective cooperation. The stability of the admittance controller is mainly threatened by a stiff environment. Many methods that guarantee stability in arbitrary environments, impose conservative control gains that limit the effectiveness of the cooperation. Inspired by previous work in frequency domain stability observers, a method is proposed in this paper to detect unstable behavior and stabilize the robot with online adaptation of the admittance control gains. The introduced instability index is based on frequency domain analysis, which very quickly detects unstable behavior by monitoring high frequency oscillation in the force signal. To treat the instability, an adaptation scheme of the admittance parameters is proposed, that relaxes conservative gains and improves the cooperation by considering the effect of variable admittance on the operators' effort. We investigate two human-robot co-manipulation tasks; cooperation within a zero stiffness environment and cooperation in contact with a stiff double-wall virtual environment. The proposed methods are validated experimentally with a number of subjects in cooperation with an LWR manipulator.


Assuntos
Comportamento Cooperativo , Sistemas On-Line/estatística & dados numéricos , Robótica/métodos , Adulto , Algoritmos , Feminino , Humanos , Masculino , Sistemas On-Line/normas , Robótica/instrumentação
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