Open notes sounds great, but will a provider’s documentation change? An exploratory study of the effect of open notes on oncology documentation
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ABSTRACT: Objective
The effects of shared clinical notes on patients, care partners, and
SUBMITTER: Rahimian M
PROVIDER: S-EPMC8518311 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objects and events in the sensory environment are generally predictable, making most of the energy impinging upon sensory transducers redundant. Given this fact, efficient sensory systems should detect, extract, and exploit predictability in order to optimize sensitivity to less predictable inputs that are, by definition, more informative. Not only are perceptual systems sensitive to changes in physical stimulus properties, but growing evidence reveals sensitivity both to relative predictability of stimuli and to co-occurrence of stimulus attributes within stimuli. Recent results revealed that auditory perception rapidly reorganizes to efficiently capture covariance among stimulus attributes. Acoustic properties per se were perceptually abandoned, and sounds were instead processed relative to patterns of co-occurrence. Here, we show that listeners' ability to distinguish sounds from one another is driven primarily by the extent to which they are consistent or inconsistent with patterns of covariation among stimulus attributes and, to a lesser extent, whether they are heard frequently or infrequently. When sounds were heard frequently and deviated minimally from the prevailing pattern of covariance among attributes, they were poorly discriminated from one another. In stark contrast, when sounds were heard rarely and markedly violated the pattern of covariance, they became hyperdiscriminable with discrimination performance beyond apparent limits of the auditory system. Plausible cortical candidates underlying these dramatic changes in perceptual organization are discussed. These findings support efficient coding of stimulus statistical structure as a model for both perceptual and neural organization.
| S-EPMC4979885 | biostudies-literature
Project description:Mental body-representations are highly plastic and can be modified after brief exposure to unexpected sensory feedback. While the role of vision, touch and proprioception in shaping body-representations has been highlighted by many studies, the auditory influences on mental body-representations remain poorly understood. Changes in body-representations by the manipulation of natural sounds produced when one's body impacts on surfaces have recently been evidenced. But will these changes also occur with non-naturalistic sounds, which provide no information about the impact produced by or on the body? Drawing on the well-documented capacity of dynamic changes in pitch to elicit impressions of motion along the vertical plane and of changes in object size, we asked participants to pull on their right index fingertip with their left hand while they were presented with brief sounds of rising, falling or constant pitches, and in the absence of visual information of their hands. Results show an "auditory Pinocchio" effect, with participants feeling and estimating their finger to be longer after the rising pitch condition. These results provide the first evidence that sounds that are not indicative of veridical movement, such as non-naturalistic sounds, can induce a Pinocchio-like change in body-representation when arbitrarily paired with a bodily action.
| S-EPMC5515978 | biostudies-literature
Project description:This paper aims examines the role of hierarchical inference in sound change. Through hierarchical inference, a language learner can distribute credit for a pronunciation between the intended phone and the larger units in which it is embedded, such as triphones, morphemes, words and larger syntactic constructions and collocations. In this way, hierarchical inference resolves the longstanding debate about the unit of sound change: it is not necessary for change to affect only sounds, or only words. Instead, both can be assigned their proper amount of credit for a particular pronunciation of a phone. Hierarchical inference is shown to generate novel predictions for the emergence of stable variation. Under standard assumptions about linguistic generalization, it also generates a counterintuitive prediction of a U-shaped frequency effect in an advanced articulatorily-motivated sound change. Once the change has progressed far enough for the phone to become associated with the reduced pronunciation, novel words will be more reduced than existing words that, for any reason, have become associated with the unreduced variant. Avoiding this prediction requires learners to not consider novel words to be representative of the experienced lexicon. Instead, learners should generalize to novel words from other words that are likely to exhibit similar behavior: rare words, and the words that occur in similar contexts. Directions for future work are outlined.
| S-EPMC8387583 | biostudies-literature
Project description: Not available
| S-EPMC8441746 | biostudies-literature
Project description:The effect of sound on the behaviour of sharks has not been investigated since the 1970s. Sound is, however, an important sensory stimulus underwater, as it can spread in all directions quickly and propagate further than any other sensory cue. We used a baited underwater camera rig to record the behavioural responses of eight species of sharks (seven reef and coastal shark species and the white shark, Carcharodon carcharias) to the playback of two distinct sound stimuli in the wild: an orca call sequence and an artificially generated sound. When sounds were playing, reef and coastal sharks were less numerous in the area, were responsible for fewer interactions with the baited test rigs, and displayed less 'inquisitive' behaviour, compared to during silent control trials. White sharks spent less time around the baited camera rig when the artificial sound was presented, but showed no significant difference in behaviour in response to orca calls. The use of the presented acoustic stimuli alone is not an effective deterrent for C. carcharias. The behavioural response of reef sharks to sound raises concern about the effects of anthropogenic noise on these taxa.
| S-EPMC6502882 | biostudies-literature
Project description:BackgroundThe past few years have seen an increase in interest in sharing visit notes with patients. Sharing visit notes with patients is also known as "open notes." Shared notes are seen as beneficial for patient empowerment and communication, but concerns have also been raised about potential negative effects. Understanding barriers is essential to successful organizational change, but most published studies on the topic come from countries where shared notes are incentivized or legally required.ObjectiveWe aim to gather opinions about sharing outpatient clinic visit notes from patients and hospital physicians in the Netherlands, where there is currently no policy or incentive plan for shared visit notes.MethodsThis multimethodological study was conducted in an academic and a nonacademic hospital in the Netherlands. We conducted a survey of patients and doctors in March-April 2019. In addition to the survey, we conducted think-aloud interviews to gather more insight into the reasons behind participants' answers. We surveyed 350 physicians and 99 patients, and think-aloud interviews were conducted with an additional 13 physicians and 6 patients.ResultsMost patients (81/98, 77%) were interested in viewing their visit notes, whereas most physicians (262/345, 75.9%) were opposed to allowing patients to view their visit notes. Most patients (54/90, 60%) expected the notes to be written in layman's terms, but most physicians (193/321, 60.1%) did not want to change their writing style to make it more understandable for patients. Doctors raised concerns that reading the note would make patients feel confused and anxious, that the patient would not understand the note, and that shared notes would result in more documentation time or losing a way to communicate with colleagues. Interviews also revealed concerns about documenting sensitive topics such as suspected abuse and unlikely but worrisome differential diagnoses. Physicians also raised concerns that documenting worrisome thoughts elsewhere in the record would result in fragmentation of the patient record. Patients were uncertain if they would understand the notes (46/90, 51%) and, in interviews, raised questions about security and privacy. Physicians did anticipate some benefits, such as the patients remembering the visit better, shared decision-making, and keeping patients informed, but 24% (84/350) indicated that they saw no benefit. Patients anticipated that they would remember the visit better, feel more in control, and better understand their health.ConclusionsDutch patients are interested in shared visit notes, but physicians have many concerns that should be addressed if shared notes are pursued. Physicians' concerns should be addressed before shared notes are implemented. In hospitals where shared notes are implemented, the effects should be monitored (objectively, if possible) to determine whether the concerns raised by our participants have actualized into problems and whether the anticipated benefits are being realized.
| S-EPMC8387887 | biostudies-literature
Project description:Our study details the creation of a series of national open source low-level geographical measures of accessibility to health-related features for Great Britain. We create 14 measures across three domains: retail environment (fast food outlets, gambling outlets, pubs/bars/nightclubs, off-licences, tobacconists), health services (General Practitioners, pharmacies, dentists, hospitals, leisure centres) and the physical environment (green space and air quality). Using the network analysis process of Routino, postcode accessibility (km) to each of these features were calculated for the whole of Great Britain. An average score for each domain was calculated and subsequently combined to form an overall Index highlighting 'Access to Healthy Assets and Hazards'. We find the most accessible healthy areas are concentrated in the periphery of the urban cores, whilst the least accessible healthy areas are located in the urban cores and the rural areas. The open data resource is important for researchers and policy makers alike with an interest in measuring the role of spatial features on health.
| S-EPMC6602943 | biostudies-literature
Project description:A certain level of masking sound is necessary to control the disturbance caused by speech sounds in open-plan offices. The sound is usually provided with evenly distributed loudspeakers. Pseudo-random noise is often used as a source of artificial sound masking (PRMS). A recent laboratory experiment suggested that water-based masking sound (WBMS) could be more favorable than PRMS. The purpose of our study was to determine how the employees perceived different WBMSs compared to PRMS. The experiment was conducted in an open-plan office of 77 employees who had been accustomed to work under PRMS (44 dB LAeq). The experiment consisted of five masking conditions: the original PRMS, four different WBMSs and return to the original PRMS. The exposure time of each condition was 3 weeks. The noise level was nearly equal between the conditions (43-45 dB LAeq) but the spectra and the nature of the sounds were very different. A questionnaire was completed at the end of each condition. Acoustic satisfaction was worse during the WBMSs than during the PRMS. The disturbance caused by three out of four WBMSs was larger than that of PRMS. Several attributes describing the sound quality itself were in favor of PRMS. Colleagues' speech sounds disturbed more during WBMSs. None of the WBMSs produced better subjective ratings than PRMS. Although the first WBMS was equal with the PRMS for several variables, the overall results cannot be seen to support the use of WBMSs in office workplaces. Because the experiment suffered from some methodological weaknesses, conclusions about the adequacy of WBMSs cannot yet be drawn.
| S-EPMC5515102 | biostudies-other
Project description:BackgroundUmbilical Cord Blood (UCB) banking done either for private storage or for donation to public cord blood banks involves active participation of obstetricians. Counseling the expectant parents, providing them with unbiased and balanced information, and collecting the UCB with diligence confer a lot of social as well as moral responsibility upon obstetricians. This makes it even more important that the obstetricians in current practice stay well-informed and updated with UCB collection and its storage guidelines. The present study was conducted to assess the current status of obstetricians about UCB banking in terms of their awareness, attitude, and expectations from it.Materials and methodsA cross-sectional study was conducted across three hospitals. A self-administered 22-item questionnaire was given to obstetricians to assess their awareness, attitude, and expectations about UCB banking. Finally, 154 completed questionnaires were analyzed using SPSS software (version 15.0). The awareness, attitude, and expectations were assessed and reported as primary endpoints and the self-rated knowledge levels, and sources of information were reported as secondary endpoints.ResultsOverall, the awareness was poor, but the attitude was favorable for UCB banking amongst obstetricians. Around 74% felt that obstetricians must be well-informed about UCB banking-related counseling and collection protocols. However, 55% felt it to be an additional burden for the obstetrician, and 57% believed that financial compensation must be given to obstetricians involved with cord blood collection procedures. The majority remained unclear about their expectations from UCB banking. The self-rated knowledge was poor and very poor for 75% obstetricians. 89.6% derived their information from representatives of private cord blood companies.ConclusionAlthough poor in awareness levels, obstetricians possessed a favorable attitude towards UCB banking. Continuing medical education needs to focus more on such current issues of public importance to keep professionals updated. This is one way to minimise percolation of wrong facts and figures by the industries with conflicting interest to the healthcare providers.
| S-EPMC6431514 | biostudies-literature
Project description:BackgroundCesarean section (CS) rate has increased rapidly over the past two decades in China mainly driven by non-medical factors. This study was to compare recalled preferences for CS among first-time mothers in early and late pregnancy with actual delivery mode; to explore factors related to CS preference and CS performed without medical indications; and to consider the role of healthcare providers in delivery mode preferences.MethodsAn anonymous questionnaire survey, combined with data on CS indications taken from the patient record, was conducted among 272 first-time mothers having their first postnatal check-up in one university affiliated obstetrics and gynecology hospital in Shanghai, China, between September 2006 and January 2007. Logistic regression was used to study factors related to the recalled preference for CS and CS performed without medical indication, adjusting for maternal age, education and income.ResultsThe CS rate was 57% (151/263) among all women, 17% with medical indications and 40% without medical indications. For women without medical indications for CS (n = 215), there was no significant difference between women's preference for CS in early (25%) and late pregnancy (28%); 48% of women actually had CS. Women recalled preferring a vaginal delivery but who had CS were more likely to have had a CS suggested by a prenatal care doctor [OR (95% CI): 20 (3.88-107.1)] or by a delivery obstetrician [OR (95% CI): 26 (6.26-105.8)]. Among women recalled preferring and having CS, a suggestion from the prenatal care doctor to have CS was very common.ConclusionsIn the primiparous women without a medical indication for CS, women recall of a provider suggestion for CS was a strong predictor of CS both among women who recalled a preference for CS and among women who recalled a preference for vaginal delivery. Public health education needs strengthening, including discussion of the risks associated with CS and psychological and social support given to women to help them prepare for and cope with childbirth.
| S-EPMC4148545 | biostudies-literature