66 research outputs found
Teachers' experiences with online education
No full textPurpose
This study investigates teachers' experiences and perspectives on online education to enhance teachers’ wellbeing across the globe.
Method
Survey, Interviews and focus groups with university teachers
Results
A survey identified that teachers' educational advice networks are less developed than general advice networks. Through interviews and focus groups with university teachers, positive aspects such as increased efficiency and creative opportunities were found. Simultaneously, challenges of online teaching were identified, such as declining student engagement, shifts in teacher identity, and weakened informal connections with students.
Conclusion
Job resources in online teaching include knowledge exchange, autonomy and support, whereas job demands encompass time constraints and students’ dissatisfaction. Creating informal moments and establishing a knowledge-sharing infrastructure are conducive to teachers’ well-being in online education
"Being Informed About My Health Without Going to a Doctor’s Appointment”:Doctors’ and Patients’ Narratives About a Future with AI
Full text linkThis chapter aims to address an important issue that has been overshadowed in the social sciences: how the expectations of users transmit attitudes about algorithmic technologies in healthcare, generating different and competing ways of thinking about what algorithms are and affecting how these systems are used. To overcome the widespread deterministic perspective on algorithms, we will focus on Artificial Intelligence (AI) technologies able to create and move data, learn from them, and make decisions without any human intervention. This chapter draws on a qualitative study on the expectations of doctors and patients towards intelligent machines applied to the monitoring of Parkinson’s disease (PD) in the Italian context. Adopting the concept of socio-technical imaginary, the empirical section will investigate how these actors negotiate a future scenario characterised by a central role for intelligent algorithm machines. First, we will focus on the dissatisfaction of doctors and patients with the current ways in which people with PD are managed in the Italian healthcare system. Second, we will describe the main characteristics of the emerging socio-technical imaginary, which we have called “the AI-driven monitoring hospital.” Third, we will explore the various tensions that have emerged around this imaginary, mainly concerning the specific ways through which patients’ data should be gathered, analysed, and transmitted
Value-based health care in inflammatory bowel diseases : creating the value quotient
Full text linkThe essence of VBHC is to improve patients' outcomes at lower costs. This thesis attempts to construct the value quotient (vQ) for IBD: a metric for value which incorporates patient value, defined as a combination of disease control, quality of life, and productivity in the numerator, and divides it by the associated IBD-related costs in the denominator. In this thesis we showed the feasibility of monitoring clinical disease control remotely using a mobile app, we showed the impact of IBD on work productivity, and we developed a patient-centric composite score that incorporates all three outcomes as well as individual patient preferences. However, metrics for long term outcomes still need to be incorporated in the vQ. Although ideally this would be done by measuring disease outcomes long-term, this is not practical for short-term improvements. Process measures that are associated with long term outcomes and that are well-grounded in the medical literature offer a feasible short term alternative. Future research is needed to assess which process measures would be appropriate in this context, and to develop a quantifiable way to include these in the vQ.Leiden University Medical Center, Department of Gastroenterology and Hepatology / University of California, Los Angeles, Center for Inflammatory Bowel DiseasesUBL - phd migration 201
Attitudes Toward the Adoption of Remote Patient Monitoring and Artificial Intelligence in Parkinson’s Disease Management:Perspectives of Patients and Neurologists
Full text linkObjective: Early detection of Parkinson's Disease (PD) progression remains a challenge. As remote patient monitoring solutions (RMS) and artificial intelligence (AI) technologies emerge as potential aids for PD management, there's a gap in understanding how end users view these technologies. This research explores patient and neurologist perspectives on AI-assisted RMS. Methods: Qualitative interviews and focus-groups were conducted with 27 persons with PD (PwPD) and six neurologists from Finland and Italy. The discussions covered traditional disease progression detection and the prospects of integrating AI and RMS. Sessions were recorded, transcribed, and underwent thematic analysis. Results: The study involved five individual interviews (four Italian participants and one Finnish) and six focus-groups (four Finnish and two Italian) with PwPD. Additionally, six neurologists (three from each country) were interviewed. Both cohorts voiced frustration with current monitoring methods due to their limited real-time detection capabilities. However, there was enthusiasm for AI-assisted RMS, contingent upon its value addition, user-friendliness, and preservation of the doctor-patient bond. While some PwPD had privacy and trust concerns, the anticipated advantages in symptom regulation seemed to outweigh these apprehensions. Discussion: The study reveals a willingness among PwPD and neurologists to integrate RMS and AI into PD management. Widespread adoption requires these technologies to provide tangible clinical benefits, remain user-friendly, and uphold trust within the physician-patient relationship. Conclusion: This study offers insights into the potential drivers and barriers for adopting AI-assisted RMS in PD care. Recognizing these factors is pivotal for the successful integration of these digital health tools in PD management.</p
Diverse preferences, different solutions: Exploring remote monitoring preferences in Parkinson's disease through a discrete choice experiment
Full text link: BackgroundRemote monitoring solutions (RMS) have the potential to improve Parkinson's disease (PD) management by enabling continuous symptom tracking and personalized care. Understanding patient preferences for RMS features is essential for successful implementation.ObjectiveThis study aimed to investigate the preferences of people with Parkinson's disease (PwP) for RMS features and identify preference heterogeneity across distinct patient subgroups.MethodsFrom November 2023 to February 2024, a discrete choice experiment (DCE) was conducted among PwP in Finland and Italy to elicit preferences for RMS attributes, including monitoring frequency, time spent filling questionnaires, home video recordings, and clinical benefits (delay in advanced symptom onset). Latent class analysis (LCA) was used to identify subgroups with distinct preference patterns, and adoption probabilities under varying RMS scenarios were estimated.ResultsA total of 411 PwP participated, revealing significant heterogeneity in RMS preferences. While clinical benefits, particularly delaying advanced symptom onset, were the most valued attribute overall, preferences diverged across subgroups. Some participants strongly preferred home video recordings, whereas others expressed aversion to this feature. A smaller subgroup exhibited reluctance toward RMS adoption, regardless of its benefits.ConclusionsPwP generally view RMS favorably, but preferences for specific features vary substantially across subgroups. Clinical benefits are a key driver of adoption, while home video recordings elicit both strong preference and aversion, highlighting the impracticality of a one-size-fits-all approach. Tailoring RMS to diverse patient needs, addressing concerns, and enhancing usability through customization are essential for successful implementation and widespread acceptance in PD management
Antibodies to anti-TNF therapy—consequences for IBD management
No full textCellular mechanisms in basic and clinical gastroenterology and hepatolog
Anti-TNF antibodies in inflammatory bowel disease:do we finally know how it works?
No full textTumor necrosis factor (TNF) is a central pro-inflammatory cytokine that regulates the expression of numerous signaling pathways implicated in the progression of the immunological reaction. Unraveling the importance of TNF on the pathogenesis of inflammatory bowel disease (IBD) promoted anti-TNF antibodies as novel therapeutic agents. Initially, the main hypothesis behind the clinical application of anti-TNF antagonists in the clinic was that they exert their effects solely through neutralization of TNF. Anti-TNF antibodies induce and maintain clinical remission in patients with minimal side-effects. However, the cellular and molecular mechanisms of actions of the anti-TNF antibodies remain unknown. Various mechanisms of action have been proposed such as activation of transmembrane TNF mediated reverse signaling, induction of apoptosis, pro-inflammatory cytokine down-regulation, complement dependent cytotoxicity, antibodydependent cell-mediated cytotoxicity, and finally activation of regulatory immune cells via interactions with the Fc receptors. The observed discrepancies in the clinical efficacies as well as the differences in the structure of the various TNF antagonists nourish the investigation for additional modes of function.</p
A Pilot Study of a Palliative Care Service Embedded in a Hepatology Clinic at a Large Public Hospital
Full text linkBackground: End-stage liver disease (ESLD) patients carry heavy symptom burdens and risk receiving aggressive and sometimes unwanted care at end of life. Palliative care (PC), which aims to alleviate symptoms and facilitate goal-concordant care in serious illness, may offer substantial benefits for ESLD patients but is not widely provided.Objectives: To assess the impact of PC integrated within hepatology (PCIH) services on health care utilization, advance care planning (ACP), and hospice enrollment.Design: We compared patients who received PCIH (n = 55) to a retrospective cohort (n = 57) receiving usual care in an outpatient hepatology clinic.Setting/Subjects: From June 2016 to November 2017, we enrolled patients receiving care in a U.S. public hospital clinic who met the following inclusion criteria: (1) ESLD with a Model for End-Stage Liver Disease score >= 20, (2) hepatology approval for PC referral, and (3) at least one advanced complication of ESLD.Measurements: We assessed patient demographics, clinical information, health care insurance status, health care utilization, completion of psychosocial assessments, and ACP using two-sided Fisher's exact test and Mann-Whitney U tests.Results: Patients receiving PCIH more frequently had goals of care discussions (87.3% vs. 21.2%
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