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Newsletter - 146
febbraio 2017
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AbstractRecent advances in the adoption and use of health information technology (HIT) have had a dramatic impact on the practice of medicine. In many environments, this has led to the ability to achieve new efficiencies and levels of safety. In others, the impact has been less positive, and is associated with both: 1) workflow and user experience dissatisfaction; and 2) perceptions of missed opportunities relative to the use of computational tools to enable data-driven and precise clinical decision making. Simultaneously, the “pipeline” through which new diagnostic tools and therapeutic agents are being developed and brought to the point-of-care or population health is challenged in terms of both cost and timeliness. Given the confluence of these trends, it can be argued that now is the time to consider new ways in which HIT can be used to deliver health and wellness interventions comparable to traditional approaches (e.g., drugs, devices, diagnostics, and behavioral modifications).
Abstract: Patient education (PE) is expected to help patients with a chronic disease to manage their lives and give them the possibility of adopting, in an appropriate manner, beneficial changes in health behaviors that are prescribed by their physicians. It is aimed at delineating, agreeing on, and implementing a patient's personal action plan and is therefore an essential constituent of the person-centered model of care. The aim of this article is to examine the idea that PE may sometimes be a manipulation that is organized for the good of patients in a paternalistic framework. Theoretically, PE differs from manipulation by addressing the reflective intelligence of patients in full light and helping them make autonomous choices. In this article, we examined some analogies between PE and nudge (ie, techniques used to push people to make good choices by organizing their environment).
There is ongoing debate regarding the best mammography screening practices. Twitter has become a powerful tool for disseminating medical news and fostering healthcare conversations; however, little work has been done examining these conversations in the context of how users are sharing evidence and discussing current guidelines for breast cancer screening. To characterize the Twitter conversation on mammography and assess the quality of evidence used as well as opinions regarding current screening guidelines, individual tweets using mammography-related hashtags were prospectively pulled from Twitter from 5 November 2015 to 11 December 2015. Content analysis was performed on the tweets by abstracting data related to user demographics, content, evidence use, and guideline opinions. Standard descriptive statistics were used to summarize the results. Comparisons were made by demographics, tweet type (testable claim, advice, personal experience, etc.), and user type (non-healthcare, physician, cancer specialist, etc.).
You can't be sick, you're fat. You don't look like your dying. You still have hair. Oh come on, you've been dying for years. It can't be that bad, it's not like you're dying tomorrow. At least you have a few years. Stop complaining. Others have it worse. At least you've lived your life.”This is the crap crowding my (Facebook) news feed. Watching my friends hear well meaning people say insensitive things because they lack the knowledge of what they go through.So, I ask you, are there different degrees of terminal diagnosis? Is one person who manages to live four years into a diagnosis less allowed to be afraid than someone who doesn't get diagnosed before their cancer has metastasized to their bones, brain, liver, kidneys or another organ? Are my friends supposed to be less afraid because they managed to have positive results with certain cocktails of drugs, while others have stopped responding?
If used properly, pre-exposure prophylaxis (PrEP) can stop transmission of the human immunodeficiency virus (HIV) with 90% effectiveness. Although men who have sex with men make up more than half of those infected with HIV in the United States, according to the Centers for Disease Control and Prevention (CDC), many are not aware of the benefits of PrEP. “Doctors have limited time with their patients, but with gay and bisexual male patients, physicians definitely need to make it a point to discuss HIV risks and whether PrEP is a good option,” Julia R. G. Raifman, ScD, a post-doctoral fellow in the Johns Hopkins Bloomberg School of Public Health's Department of Epidemiology, said in a news release. - See more at: http://www.mdmag.com/medical-news/the-people-most-at-risk-for-hiv-dont-know-about-prep#sthash.Lb9XVPtY.dpuf
AbstractConflicting health information is increasing in amount and visibility, as evidenced most recently by the controversy surrounding the risks and benefits of childhood vaccinations. The mechanisms through which conflicting information affects individuals are poorly understood; thus, we are unprepared to help people process conflicting information when making important health decisions. In this viewpoint article, we describe this problem, summarize insights from the existing literature on the prevalence and effects of conflicting health information, and identify important knowledge gaps. We propose a working definition of conflicting health information and describe a conceptual typology to guide future research in this area. The typology classifies conflicting information according to four fundamental dimensions: the substantive issue under conflict, the number of conflicting sources (multiplicity), the degree of evidence heterogeneity and the degree of temporal inconsistency.