scholarly journals The Friendly Health Issue Network to Support Computer-Assisted Education for Clinical Reasoning in Multimorbidity Patients

Electronics ◽  
2021 ◽  
Vol 10 (17) ◽  
pp. 2075
Author(s):  
Fabrizio Pecoraro ◽  
Fabrizio L. Ricci ◽  
Fabrizio Consorti ◽  
Daniela Luzi ◽  
Oscar Tamburis

Clinical reasoning in multimorbidity conditions asks for the ability to anticipate the possible evolutions of the overall health state of a patient and to identify the interactions among the concurrent health issues and their treatments. The HIN (Health Issue Network) approach, as Petri Nets-based formal language, is introduced as capable of providing a novel perspective to facilitate the acquisition of such competencies, graphically representing the network among a set of health issues (HIs) that affect a person throughout their life, and describing how HIs evolve over time. The need to provide a more immediate user-oriented interface has led to the development of f-HIN (friendly HIN), a lighter version based on the same mathematical properties as HIN, from which stems in turn the f-HINe (friendly HIN extracted) model, used to represent networks related to either real patients’ clinical experiences extracted from electronic health records, or from teacher-designed realistic clinical histories. Such models have also been designed to be embedded in a software learning environment that allows drawing a f-HIN diagram, checking for its format correctness, as well as designing clinical exercises for the learners, including their computer-assisted assessment. The present paper aims at introducing and discussing the f-HIN/f-HINe models and their educational use. It also introduces the main features of the software learning environment it was built upon, pointing out its importance to: (i) help medical teachers in designing and representing the context of a learning outcome; and (ii) handle the complex history of a multimorbidity patient, to be conveyed in Case-Based Learning (CBL) exercises.

Histories ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 69-84
Author(s):  
Tiasa Basu Roy

It was from the middle of the eighteenth century that discussions regarding the strategies taken up by the Protestant missionaries to propagate the Gospel generated the issue of healthcare and medical facilities among people in India. Medical mission, which hitherto was not considered, started to gain importance and reaped positive results in terms of curing individuals and its trustworthiness among tribes residing in the frontier regions. However, this developed a separatist religious identity among the population, which apparently did not appear lethal, but later culminated in the fragmentation and impeachment of solidarity among the adivais (tribal) and vengeance from the Hindu population. This article will show how the Canadian Baptist Mission, with its primary aim of spreading the Kingdom of God among the tribal Savaras in the Ganjam district of Orissa, undertook measures for serving health issues and provided medical facilities to both the caste Oriyas and the tribal Savaras. Although medical activities oriented towards philanthropy and physical well-being, medical mission was not limited to healing illness and caring for all, but also extended to spreading the word of God and influencing the people to embrace Christianity as well, which invited political troubles into the region.


Author(s):  
Marian Sorin Paveliu ◽  
Elena Olariu ◽  
Raluca Caplescu ◽  
Yemi Oluboyede ◽  
Ileana-Gabriela Niculescu-Aron ◽  
...  

Objective: To provide health-related quality of life (HRQoL) data to support health technology assessment (HTA) and reimbursement decisions in Romania, by developing a country-specific value set for the EQ-5D-3L questionnaire. Methods: We used the cTTO method to elicit health state values using a computer-assisted personal interviewing approach. Interviews were standardized following the most recent version of the EQ-VT protocol developed by the EuroQoL Foundation. Thirty EQ-5D-3L health states were randomly assigned to respondents in blocks of three. Econometric modeling was used to estimate values for all 243 states described by the EQ-5D-3L. Results: Data from 1556 non-institutionalized adults aged 18 years and older, selected from a national representative sample, were used to build the value set. All tested models were logically consistent; the final model chosen to generate the value set was an interval regression model. The predicted EQ-5D-3L values ranged from 0.969 to 0.399, and the relative importance of EQ-5D-3L dimensions was in the following order: mobility, pain/discomfort, self-care, anxiety/depression, and usual activities. Conclusions: These results can support reimbursement decisions and allow regional cross-country comparisons between health technologies. This study lays a stepping stone in the development of a health technology assessment process more driven by locally relevant data in Romania.


Author(s):  
Vitaly Omelyanovskiy ◽  
Nuriya Musina ◽  
Svetlana Ratushnyak ◽  
Tatiana Bezdenezhnykh ◽  
Vlada Fediaeva ◽  
...  

Abstract Purpose The most widely used generic questionnaire to estimate the quality of life for yielding quality-adjusted life years in economic evaluations is EQ-5D. Country-specific population value sets are required to use EQ-5D in economic evaluations. The aim of this study was to establish an EQ-5D-3L value set for Russia. Methods A representative sample aged 18+ years was recruited from the Russia`s general population. Computer-assisted face–to–face interviews were conducted based on the standardized valuation protocol using EQ-Portable Valuation Technology. Population preferences were elicited utilizing both composite time trade-off (cTTO) and discrete choice experiment (DCE) techniques. To estimate the value set, a hybrid regression model combining cTTO and DCE data was used. Results A total of 300 respondents who successfully completed the interview were included in the primary analysis. 120 (40.0%) respondents reported no health problems of any dimension, and 56 (18.7%) reported moderate health problems in one dimension of the EQ‐5D‐3L. Median self-rated health using EQ‐VAS was 80 with IQR 70–90. Comparing cTTO and DCE-predicted values for 243 health states resulted in a similar pattern. This supports the use of hybrid models. The predicted value based on the preferred model for the worst health state “33333” was −0.503. Mobility dimension had the most significant impact on the utility decrement, and anxiety/depression had the lowest decrement. Conclusion Determining a Russian national value set may be considered the first step towards promoting cost-utility analysis use to increase comparability among studies and improve the transferability of healthcare decision-making in Russia.


2001 ◽  
Vol 16 (3) ◽  
pp. 94-98
Author(s):  
Marc Brodsky

The Kabuki Actors Study set out to explore the health status of Kabuki actors, their performance-related medical problems, and the nature and extent of their health care. Two hundred sixteen Kabuki performers voluntarily completed an anonymous three-page survey addressing their health issues. Thirty-eight percent of the actors reported a history of at least one significant medical condition, and 88% of them identified at least one musculoskeletal or nonmusculoskeletal problem associated with performance. Sixty-nine percent of the performers had visited a physician over the preceding year, and 30% of them had consulted nonphysician medical practitioners. Kabuki actors, the Kabuki management, and physicians can use the findings of this study as a starting point to investigate why these injuries occur and how to prevent and treat them. Pain severity scales or other measurable outcomes of therapy can be used to compare the efficacies of physician and nonphysician treatments.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Heesun Lee ◽  
Chang-Hwan Yoon ◽  
Hyun-Young Park ◽  
Hea Young Lee ◽  
Dong-Ju Choi ◽  
...  

Background: Gestational hypertensive disorders and diabetes are well-known to increase the risk of cardiovascular disease (CVD) and diabetes later in life. However, there were few researches to evaluate the association between family history of cardiovascular disease and the occurrence of pregnancy-related medical disorders. We aimed to investigate whether family history of CVD could predict gestational hypertensive disorders and diabetes. Methods: The Korean Nurses’ Survey was conducted through web-based computer-assisted self-administered questionnaires, which were compiled by consultation to cardiologists, gynecologists, and statisticians, from October to December 2011. We enrolled a total of 9,989 female registered nurses who could answer reliably the questionnaires based on their medical knowledge. Multivariate logistic regression analysis was used to clarify the effect of family history of CVD on pregnancy-related medical disorders. Result: In this survey, 3900 subjects had more than 1 pregnancy. Among them, 247 interviewees (6.3%) had experienced hypertensive disorders during pregnancy, which included preeclampsia (n = 160, 4.1%) and transient hypertension (n = 144, 3.7%), and 120 (3.1%) had experienced gestational diabetes. And, 2872 subjects (73.6%) answered that they had at least 1 family history of CVD. Having family history of CVD increased the risk of gestational hypertensive disorders (adjusted RR 1.51, 95% CI 1.08-2.11, p = 0.015) and diabetes (adjusted RR 2.40, 95% CI 1.38-4.17, p = 0.002). In particular, family history of hypertension was significantly associated with gestational hypertensive disorders (adjusted RR 2.00, 95% CI 1.47-2.50, p <0.001), and diabetes was highly related with gestational diabetes (adjusted RR 3.37, 95% CI 2.35-4.83, p <0.001), respectively. Furthermore, this relationship was observed regardless of maternal parity. Conclusion: Family history of CVD was a significant predictor of pregnancy-related medical disorders in this survey. Meticulous history taking for family history of CVD can provide the risk of gestational hypertensive disease and diabetes. Thus, special attention should be paid to women with family history of CVD during pregnancy.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Simone Silveira Amorim

Different aspects impacted the work of primary school teachers in the 19th century: the lack of materials for the teaching of classes, the delay in paying salaries and the release of resources to pay the rent of the houses where the classes worked, the health issues that implied the removal of the teacher for treatment, among others. Given this context, the objective is to inform how the teaching profession was configured based on the challenges faced by primary teachers in the 19th century. As a research in the field of History of Education, newspapers and official communications will be taken as sources, being analyzed from the conceptions of configuration and representation. It is possible to perceive that the profession of primary teacher was configured in the face of challenges and confrontations, corroborating the construction of the representation of the qualified teacher in the 19th century.


2018 ◽  
Vol 11 (6) ◽  
pp. 442-463 ◽  
Author(s):  
Angela Martin ◽  
Megan Woods ◽  
Sarah Dawkins

Purpose Mental health conditions such as depression are prevalent in working adults, costly to employers, and have implications for legal liability and corporate social responsibility. Managers play an important role in determining how employees’ and organizations’ interests are reconciled in situations involving employee mental ill-health issues. The purpose of this paper is to explore these situations from the perspective of managers in order to develop theory and inform practice in workplace mental health promotion. Design/methodology/approach Semi-structured interviews were conducted with 24 Australian managers who had supervised an employee with a mental health issue. Interview transcripts were content analyzed to explore themes in managers’ experiences. Findings Managing an employee with a mental health issue involves becoming aware of the issue, taking action to understand the situation and develop an action response, implementing the response and managing the ongoing situation. Each of these tasks had a range of positive and negative aspects to them, e.g., managing the situation can be experienced as both a source of stress for the manager but also as an opportunity to develop greater management skills. Practical implications Understanding line managers’ experiences is critical to successful implementation of HR policies regarding employee health and well-being. HR strategies for dealing with employee mental health issues need to consider implementation support for managers, including promotion of guiding policies, training, emotional support and creating a psychosocial safety climate in their work units or teams. Originality/value The insights gained from this study contribute to the body of knowledge regarding psychosocial safety climate, an emergent theoretical framework concerned with values, attitudes and philosophy regarding worker psychological health. The findings also have important implications for strategic human resource management approaches to managing mental health in the workplace.


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