- Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. [Journal Article]
- JIJ Interprof Care 2019 Jul 22; :1-11
- Professionals in healthcare are increasingly encouraged to work together. This has acted as a catalyst for research on interprofessional collaboration. Authors suggest developing interprofessional co…
Professionals in healthcare are increasingly encouraged to work together. This has acted as a catalyst for research on interprofessional collaboration. Authors suggest developing interprofessional collaboration is not just the job of managers and policy makers; it also requires active contributions of professionals. Empirical understanding of whether professionals make such contributions and if so, how and why, remains fragmented. This systematic review of 64 studies from the past 20 years shows there is considerable evidence for professionals actively contributing to interprofessional collaboration. Although the evidence is limited, we can show they do so in three distinct ways: by bridging professional, social, physical and task-related gaps, by negotiating overlaps in roles and tasks, and by creating spaces to be able to do so. Professionals from different professions seem to make different contributions. Moreover, differences exist between collaborative settings and healthcare subsectors. We conclude by proposing a research agenda to advance our understanding of these contributions in theoretical, methodological and empirical ways.
- Psychiatry and the Sociology of Novelty: Negotiating the US National Institute of Mental Health "Research Domain Criteria" (RDoC). [Journal Article]
- STSci Technol Human Values 2019; 44(4):612-633
- In the United States, the National Institute of Mental Health (NIMH) is seeking to encourage researchers to move away from diagnostic tools like the Diagnostic and Statistical Manual of Mental Disord…
In the United States, the National Institute of Mental Health (NIMH) is seeking to encourage researchers to move away from diagnostic tools like the Diagnostic and Statistical Manual of Mental Disorders (the DSM). A key mechanism for this is the "Research Domain Criteria" (RDoC) initiative, closely associated with former NIMH Director Thomas Insel. This article examines how key figures in US (and UK) psychiatry construct the purpose, nature, and implications of the ambiguous RDoC project; that is, how its novelty is constituted through discourse. In this paper, I explore and analyze these actors' accounts of what is new, important, or (un)desirable about RDoC, demonstrating how they are constituted through institutional context and personal affects. In my interviews with mental health opinion leaders, RDoC is presented as overly reliant on neurobiological epistemologies, distant from clinical imaginaries and imperatives, and introduced in a top-down manner inconsistent with the professional norms of scientific research. Ultimately, the article aims to add empirical depth to current understandings about the epistemological and ontological politics of contemporary (US) psychiatry and to contribute to science and technology studies (STS) debates about "the new" in technoscience. Accordingly, I use discussions about RDoC as a case study in the sociology of novelty.
- Using big data analytics to improve HIV medical care utilisation in South Carolina: A study protocol. [Journal Article]
- BOBMJ Open 2019 Jul 19; 9(7):e027688
- Linkage and retention in HIV medical care remains problematic in the USA. Extensive health utilisation data collection through electronic health records (EHR) and claims data represent new opportunit…
Linkage and retention in HIV medical care remains problematic in the USA. Extensive health utilisation data collection through electronic health records (EHR) and claims data represent new opportunities for scientific discovery. Big data science (BDS) is a powerful tool for investigating HIV care utilisation patterns. The South Carolina (SC) office of Revenue and Fiscal Affairs (RFA) data warehouse captures individual-level longitudinal health utilisation data for persons living with HIV (PLWH). The data warehouse includes EHR, claims and data from private institutions, housing, prisons, mental health, Medicare, Medicaid, State Health Plan and the department of health and human services. The purpose of this study is to describe the process for creating a comprehensive database of all SC PLWH, and plans for using BDS to explore, identify, characterise and explain new predictors of missed opportunities for HIV medical care utilisation.
- Modulating the Use of Multiple Memory Systems in Value-based Decisions with Contextual Novelty. [Journal Article]
- JCJ Cogn Neurosci 2019 Jul 19; :1-13
- With multiple learning and memory systems at its disposal, the human brain can represent the past in many ways, from extracting regularities across similar experiences (incremental learning) to stori…
With multiple learning and memory systems at its disposal, the human brain can represent the past in many ways, from extracting regularities across similar experiences (incremental learning) to storing rich, idiosyncratic details of individual events (episodic memory). The unique information carried by these neurologically distinct forms of memory can bias our behavior in different directions, raising crucial questions about how these memory systems interact to guide choice and the factors that cause one to dominate. Here, we devised a new approach to estimate how decisions are independently influenced by episodic memories and incremental learning. Furthermore, we identified a biologically motivated factor that biases the use of different memory types-the detection of novelty versus familiarity. Consistent with computational models of cholinergic memory modulation, we find that choices are more influenced by episodic memories following the recognition of an unrelated familiar image but more influenced by incrementally learned values after the detection of a novel image. Together this work provides a new behavioral tool enabling the disambiguation of key memory behaviors thought to be supported by distinct neural systems while also identifying a theoretically important and broadly applicable manipulation to bias the arbitration between these two sources of memories.
- An immersive orientation programme to improve medical student integration and well-being. [Journal Article]
- CTClin Teach 2019 Jul 17
- Multiple common challenges exist for medical students transitioning to regional clinical placements, including a relative paucity of well-being skills required for the promotion of work-life integrat…
Multiple common challenges exist for medical students transitioning to regional clinical placements, including a relative paucity of well-being skills required for the promotion of work-life integration. Beginning Education at Central Coast Hospitals (BEACCHES) is an immersive orientation programme aimed at negotiating this transition and promoting student well-being through improved social connectedness. The programme was evaluated with the objectives of understanding the most highly valued and effective components.
- Executive Functioning, Muscle Power and Reactive Balance Are Major Contributors to Gait Adaptability in People With Parkinson's Disease. [Journal Article]
- FAFront Aging Neurosci 2019; 11:154
- CONCLUSIONS: Superior executive function, effective reactive balance and good muscle power were associated with successful gait adaptability. Executive function and reactive balance appear particularly important for precise foot placements; and cognitive capacity for step length adjustments for avoiding obstacles. These findings suggest that impaired inhibitory control contributes to stepping errors and may increase fall risk in people with PD. These findings help elucidate mechanisms for why people with PD fall and may facilitate fall risk assessments and fall prevention strategies for this group.
- Navigating the Liminal Space: Trauma, Transition, and Connection in Bereaved Carers' Experiences of Specialist Palliative Care in Western Sydney. [Journal Article]
- JSJ Soc Work End Life Palliat Care 2018 Apr-Sep; 14(2-3):225-239
- Caregiving at the end-of-life has been associated with a range of physical, spiritual, social, and psychological outcomes, and influenced by encounters with providers of specialist palliative care. T…
Caregiving at the end-of-life has been associated with a range of physical, spiritual, social, and psychological outcomes, and influenced by encounters with providers of specialist palliative care. The purpose of this qualitative study was to explore experiences of bereaved carers of people with a life-limiting illness, in the context of care provided through a Western Sydney supportive and palliative care service. Thirteen bereaved caregivers participated in semi-structured, in-depth interviews. Transcripts were analyzed using a thematic approach, informed by thematic networks. Four domains appeared to mediate carer experiences: confrontations with trauma, suffering, and death; navigating transitions and boundaries and the caregiving role as liminal space; encountering connection in formal care contexts; and negotiating system issues. This study is one of the first to explore caregiver experiences within a low socioeconomic population in Western Sydney and provides a nuanced understanding of factors which may shape experiences of palliative care. Findings suggest that ongoing attention to the cultivation of skilful practitioners is warranted; able to companion caregivers in a manner attuned to the potential for trauma in the context of expected death. Additionally, findings call for investment in specialist sites of care alongside greater attention to public health approaches to palliative care.
- Burdened parents sharing their concerns for their children with the doctor. The impact of trust in general practice: a qualitative study. [Journal Article]
- SJScand J Prim Health Care 2019 Jul 16; :1-8
- Objective: The aim of this study was to recognise the preconditions experienced by general practitioners (GPs) in addressing the children's needs when ill and substance abusing parents consult for t…
Objective: The aim of this study was to recognise the preconditions experienced by general practitioners (GPs) in addressing the children's needs when ill and substance abusing parents consult for their own health problems. Design: Qualitative analysis of 38 case stories told by GPs in focus group interviews. Setting: Focus group interviews of four continuing medical education groups for GPs in western Norway. Subjects: 27 GPs (nine females) with at least 5 years' experiences in general practice. Results: Different aspects of the GPs' perceived mandate of trust from the parents was a precondition for the children's situation to be addressed. In some case stories the participants took an open mandate from the parent for granted, while in others they assumed that the parent did not want to discuss their family situation. Sometimes the participants had faith that by continuing with their ordinary GP tasks, they might obtain a more open mandate of trust. Their evaluation of the mandate of trust seemed to impact on how the GP could adopt a mediating role between the parents and various support agencies, thus supporting children who were at risk. Discussion/conclusion: The children most at risk may remain invisible in GPs' encounters with their parents, possibly because their parent's health problems and overall situation overshadow the children's situation. The mandate of trust from burdened parents to GPs can be a fruitful concept in understanding the interaction regarding the welfare of the parent's children. Negotiating the mandate of trust with parents by explicitly addressing trust and having an ongoing discussion about the mandate and its limits might be an option to secure the children support if necessary. KEY POINTS Offering children of burdened parents information and support can be crucial for health promotion and illness prevention. A general practitioner's (GP's) evaluation of the trust parents have in them can determine the extent of support children receive. Depending on the parents' level of trust, GPs may take a mediating role between support services and parents for the benefit of the children. A negotiation concerning the trust parents have in the GP may open up possibilities for GPs to offer children necessary support.
- A driving simulation study to examine the impact of available sight distance on driver behavior along rural highways. [Journal Article]
- AAAccid Anal Prev 2019 Jul 12; 131:200-212
- The available sight distance (ASD) is the maximum length of the roadway ahead visible to the driver. It is a fundamental factor in road geometry principles and is used by road designers to ensure saf…
The available sight distance (ASD) is the maximum length of the roadway ahead visible to the driver. It is a fundamental factor in road geometry principles and is used by road designers to ensure safe driving conditions. However, designers do not know how a specific ASD may affect the longitudinal and transversal behavior of drivers engaged in negotiating curves. This paper focuses on analyzing driver longitudinal behavior along rural highways curves with limited visibility. A number of virtual sight condition scenarios were recreated and tested in the driving simulator. Three tracks were designed with various combinations of radii and sight obstructions (a continuous wall) along the roadside located at various offsets from the lane centerline, combinations which resulted with a minimum ASD of 56.6 m. Roadside factors capable of influencing the risk perception of drivers (e.g., traffic barriers, posted speed limit signs, vegetation) were all excluded from the simulations. Results indicate that speed and trajectory dispersion from the lane centerline depend linearly on ASD in the investigated range of curve radii (from 120 to 430 m). In general, when ASD increases, so does speed and the trajectories tend to be less dispersed around the lane centerline. As a result, in safety terms, any variation in ASD will have the polar opposite effect on safety related parameters. Furthermore, different curves with similar ASD values resulted in different speed and lateral control behaviors. Analysis from ANOVA support the same findings; in addition, radius, curve direction, and distance from trajectory to sight obstruction have been identified as significant independent parameters. Road designers should adjust the ASD and these parameters when seeking to encourage drivers to adopt appropriate behaviors. To optimize safe driving conditions, ASD should be designed so that it is slightly greater than the required sight distance, since excessive ASD values may encourage drivers to drive at inappropriate speeds.
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- Contamination of foods with arsenic and mercury in Iran: a comprehensive review. [Journal Article]
- ESEnviron Sci Pollut Res Int 2019 Jul 13
- Human and animals are exposed to heavy metals such as arsenic (As) and mercury (Hg) through atmospheric depositions, industrial effluents, chemical pesticides and fertilizers, erosion of geological b…
Human and animals are exposed to heavy metals such as arsenic (As) and mercury (Hg) through atmospheric depositions, industrial effluents, chemical pesticides and fertilizers, erosion of geological beds, and mining wastes which can result in the contamination of food chains. The aim of the current study was to review the available papers reporting contamination levels of As and Hg in commonly consumed foods in Iran. A descriptive search was carried out with specific keywords and entry criteria in databases of Science-Direct, PubMed, Scopus, Google Scholar, and Scientific Iranian Database (SID) published from January 2000 to July 2018. All articles were assessed by two reviewers, and final decision was made through discussions or a third reviewer arbitration. The articles were categorized based on the type of food groups including rice, fruit, vegetable, fish, seafood, drinking water, tea, and miscellanies. Of 221 identified articles on As and Hg contaminations in foods, 92 articles were selected using defined criteria. Published articles were reviewed to report contamination (mean and rate) of each food group in Iran. Results showed that rice and fish included the highest contamination rates of As and Hg, respectively. In general, As and Hg contents in Iranian foods cause serious health concerns due to the consumption quantities of the main foods. Further risk-based surveillance studies must be carried out to decrease exposure to As and Hg from dietary and non-dietary sources.