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Given the importance of the link between mental and other medical conditions, JCPP Advances organized a special issue on the topic; yet since then, very few papers have focused on this area. As such, this editorial perspective aims not only to highlight the link between mental and other medical conditions, but also to (1) explore the origins of the divide between mental and "physical" health, (2) provide evidence that this so-called divide does not exist in actuality, (3) highlight the harms of maintaining such a divide, and (4) discuss strategies to bridge this divide to address this monumental mistake, which has been perpetuated throughout medicine.
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Miscommunication between hearing care professionals (HCPs), spoken language interpreters, and patients in interpreter-assisted appointments poses serious risks, including misdiagnosis and ineffective treatment. Structured briefing and debriefing sessions between HCPs and interpreters may mitigate these risks. This study examined the perceptions, practices, and factors influencing structured communication sessions between HCPs and interpreters. A mixed-methods design combined semi-structured interviews (n = 33) with an online survey (n = 215) targeting HCPs and interpreters. Descriptive and inferential statistics analysed the quantitative data, while thematic analysis provided qualitative insights. Significant attitude disparities emerged: 75.2% of interpreters favoured pre-appointment briefings versus 53.0% of HCPs (p=.004), while 38.9% and 31.8% respectively supported post-appointment debriefings (p<.001). Two themes emerged: (1) Differing perceptions of briefing contribute to inconsistent implementation, and (2) Limited understanding of debriefing restricts its effective use. A critical gap exists between perceived value and actual implementation of structured communication practices, increasing risks of miscommunication and potential clinical errors. In audiology, these errors risk diagnostic inaccuracy and suboptimal hearing management. Addressing this requires a multilevel intervention combining interprofessional collaboration education with systemic reforms, including dedicated time allocation and formalised protocols integrated into routine clinical workflows to enhance communication accuracy and improve patient outcomes.
Early diagnosis of spinal tuberculosis remains challenging, and inappropriate percutaneous vertebral augmentation can aggravate lesions and worsen clinical symptoms. Relevant clinical evidence on subsequent standardized management remains limited. This study aimed to investigate the clinical efficacy and prognostic outcomes of different treatment strategies in patients with spinal tuberculosis following inappropriate percutaneous vertebral augmentation, and to analyze the clinical characteristics of the patients and provide clinical data for the differential diagnosis of spinal tuberculosis. The clinical data of 53 patients with spinal tuberculosis who underwent vertebral augmentation between January 2012 and January 2024 were retrospectively analyzed. There were 26 males and 27 females, with a mean age of 70.33 ± 5.88 years (range 53-86 years). Thirty-one patients had thoracic tuberculosis, and 22 had lumbar tuberculosis. According to the ASIA Impairment Scale, 7 patients were grade B, 15 were grade C, 24 were grade D, and 7 were grade E. At admission, 52 patients had elevated erythrocyte sedimentation rates (ESRs) and C-reactive protein (CRP) levels, 36 had positive T-SPOT results, and 1 patient had a normal ESR and CRP level and negative T-SPOT result. Twenty-seven patients had single-vertebral involvement, and 26 had multiple-vertebral involvement. Patients were divided into two groups, and a retrospective cohort comparative analysis was conducted: Surgical group (35 patients) received posterior spinal canal decompression, bone graft fusion, and internal fixation; conservative group (18 patients) received non-surgical treatment. Outcomes included ESR, CRP level, VAS score, ASIA grade, and MBI score. Enumeration data were analyzed with the χ2 test for intergroup differences in proportions. Normally distributed continuous data were compared using the independent samples t-test. Non-normally distributed continuous data were analyzed using the Mann-Whitney U test. Paired comparisons were performed using the Wilcoxon signed-rank test. Repeated measures data were analyzed using the rank-sum test. The follow-up period ranged from 18 to 36 months. Early postoperative increases in the ESR and CRP level were significantly greater in the surgical group than in the conservative group, but inflammatory marker levels normalized within 3-6 months in both groups. Before treatment, there were no significant differences in the ESR, CRP level, VAS score, MBI, or ASIA grade between the groups (all p > 0.05). At 3 months and at the final follow-up, the ESR, CRP level, and VAS score decreased significantly and the MBI and ASIA grades improved significantly in both groups (all p < 0.05). The MBI was significantly better in the surgical group at 3 months (p < 0.05). At the final follow-up, no significant differences were found between the groups in any index (all p > 0.05). This retrospective cohort study shows that compared with conservative treatment, surgical treatment results in faster symptomatic and functional recovery in patients with neurological compression after mismanaged vertebral augmentation for spinal tuberculosis. For patients without significant neurological compression or those who are unfit for surgery, conservative treatment achieves satisfactory long-term efficacy, although the recovery time is longer. Long-term outcomes are comparable between the two strategies.
This study explored how a history of childhood maltreatment shapes the transition to parenthood, with a focus on how partners jointly negotiate this adjustment within the couple relationship. Using Interpretative Phenomenological Analysis (IPA), in-depth semi-structured interviews were conducted with 11 heterosexual couples (22 individuals) living in the United States, in which at least one partner reported a history of childhood maltreatment. Interviews were analyzed for emergent themes related to adjustment to parenthood, relational functioning, and dyadic support processes. Four overarching dyadic themes emerged: (1) relational meaning-making of childhood maltreatment, (2) relational challenges activated by maltreatment history, (3) dyadic support as co-regulation for maltreatment-related vulnerability, and (4) couples' resilient and intentional orientation toward family life. Findings suggest that supportive romantic partnerships may function as a relational context through which parenting-related self-doubt is negotiated, emotional safety is fostered, and caregiving approaches distinct from participants' own childhood experiences are collaboratively constructed. These insights have implications for dyadic interventions during the transition to parenthood that aim to support reflective parenting and relational resilience.
Background/Objectives: This study aimed to evaluate the effect of adherence to the DASH and Mediterranean diets on cognitive performance in adults. Methods: In this study, the Mediterranean Diet Adherence Screener (MEDAS), DASH Diet Quality Scale (DASH-Q), Oktem Verbal Memory Processes Test (Oktem-VMPT), and Trail Making Test (TMT) were administered face-to-face to adult individuals living in Afyonkarahisar, Türkiye, together with a form assessing sociodemographic characteristics and dietary habits. The collected data were analyzed using SPSS v27 software. Results: As participants' ages increased, DASH scores decreased (p < 0.05). As participants' BMI and waist/hip width increased, a decrease in DASH and MEDAS scores was observed (p < 0.05). As participants' ages increased, the IST-A, IST-B, and IST-Total scores increased (p < 0.05), but as their education level increased, the IST-A, IST-B, and IST-Total scores decreased (p < 0.05). As participants' education level increased, the total recall score on the Oktem-SBST scale tended to increase (p < 0.05). As participants' DASH scores increased, the "Immediate Memory" and "Spontaneous Recall" sub-components of the Oktem-SBST increased, while the "Learning Mistake Score," "USB Mistake Score," and "IST-A," "IST-B," and "IST Total" scores decreased (p < 0.05). As participants' MEDAS scores increased, the sub-components of Oktem-SBST, namely "Criteria Achievement," "Maximum Learning," "Spontaneous Recall," "Recognition," and "Total Recall," also increased, while the "Learning Mistake Score" decreased. (p < 0.05). Conclusions: Age, educational status, DASH, and MEDAS scores are associated with cognitive performance. The DASH and MEDAS diets have a positive impact on cognitive performance, highlighting the importance of healthy eating in public health strategies for maintaining cognitive health.
Objectives: Sleep-wake state discrepancy, the discrepancy between self-reported and objective sleep measures, is commonly experienced in poor sleep and insomnia. While perfectionism is implicated in insomnia, its relationship to sleep-wake state discrepancy has not been investigated. This study aimed to assess the association between sleep-wake state discrepancy and perfectionism and explore whether dysfunctional sleep beliefs and pre-sleep arousal mediate that relationship. Methods: Sixty adult participants from community and clinical populations were conveniently sampled (85% females, mean age 30.28 ± 11.13 years, 38% with insomnia symptoms). Sleep-wake state discrepancy measures were calculated using data from actigraphy and sleep diary collected over 14 days. The Frost Multidimensional Perfectionism Scale (FMPS), Hewitt-Flett Multidimensional Perfectionism Scale (HFMPS), Dysfunctional Beliefs about Sleep (DBAS), and Pre-sleep Arousal Scale (PSAS) were also collected. Results: High perfectionism levels were associated with high levels of sleep-wake state discrepancy. Concern over Mistakes and Doubts about Actions correlated with sleep onset latency discrepancy with small effects (r = 0.26 and 0.29, respectively). Doubts about Actions was associated with sleep onset latency discrepancy. Furthermore, pre-sleep arousal and cognitive pre-sleep arousal mediated relationships between sleep onset latency discrepancy and Concern over Mistakes and Doubts about Actions. Conclusions: Concern over Mistakes and Doubts about Actions relate to a poorer perception of sleep relative to objective sleep measures. During sleep onset, cognitive pre-sleep arousal appears to mediate relationships between perfectionism and sleep-wake state discrepancy. Therefore, perfectionism may be an important cognitive-emotional factor to consider when assessing and treating sleep-wake state discrepancy that commonly accompanies insomnia.
The error-related negativity (ERN) is a measurable brain response to mistakes that is thought to reflect a modifiable cognitive/emotional bias contributing to the development of anxiety disorders. We previously demonstrated that a psychosocial intervention to reduce error sensitivity can reduce the ERN among (nonclinical) adults and children who have relatively large ERNs. We have also demonstrated that a brain response (balance N1) evoked by a disturbance to standing balance shares the ERN's relationship to anxiety. We hypothesized that if ERN and N1 reflect the same underlying brain mechanisms, then an intervention to reduce the ERN should similarly reduce the balance N1. In this pre-registered randomized controlled trial, 54 children with anxiety disorders (age 9-12 years) were randomized into either a brief (45-min) single-session computerized psychosocial intervention to reduce error sensitivity, or a similarly formatted control condition. Primary outcome measures were changes in the ERN (measured in a Go/NoGo task) and balance N1 (measured in a lean-and-release balance task). The ERN was reduced after the psychosocial intervention, while the balance N1 remained unchanged. A brief computerized psychosocial intervention to reduce error sensitivity can reduce the ERN among clinically anxious children, but the limited effect may warrant a larger dosage. Discrepant outcomes between the ERN and balance N1 suggest the intervention targets mechanisms not shared between these brain responses. We speculate the intervention may have helped children manage overreactions to trivial mistakes while preserving the inherent significance of a loss of balance. CLINICAL TRIAL REGISTRATION: Computerized intervention targeting the error-related negativity and balance N1 in anxious children. https://clinicaltrials.gov/study/NCT05503017.
Interpersonal contact is essential for health professions. Simulation with actors in a safe, protected environment followed by feedback from teachers and simulated patients can positively impact anxiety symptoms related to social anxiety, which this project focuses on. To assess social anxiety in medical students and their relationship with practical simulations during the first year, determining the prevalence of social anxiety; and to qualitatively analyze students' narratives about simulations with simulated patients. Self-administered questionnaires measured social anxiety (LSAS - Liebowitz Social Anxiety Scale) and trait anxiety weeks before the experience, and monthly on simulation days, assessing LSAS and state anxiety. Free narratives on expectations (before) and experiences (on simulation day) were collected. The mean baseline LSAS was 56.66 ± 26.71; mean trait anxiety was 49.03 ± 12.05. Expectations showed high motivation and recognition of the learning potential and personal development through simulations, but also anxiety, nervousness, self-doubt, and insecurity. On simulation days, 80 students gave 107 responses; mean LSAS was 51.95 ± 28.49, not significantly different from baseline (p=0.30). Mean state anxiety was 48.93 ± 10.75. Among 21 students with repeated responses, no significant change was found in state anxiety (p=0.66) or LSAS (p=0.09) over time. Qualitative analysis highlighted anxiety and performance insecurity, but also ambivalence, with reports of fear alongside pleasure and gratitude. Students saw simulations as opportunities for self-reflection and growth in a safe space to learn from mistakes. High anxiety linked to simulations is a concern and should be addressed in simulation planning to ensure a psychologically safe learning environment. Social anxiety may hinder clinical performance and should be addressed in health professions education.
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In humans, the ligamentum mucosum (LM) is described as a ligamentous structure originating from the femoral intercondylar notch and inserting into the infrapatellar fat pad. Proposed clinical implications include knee stabilization, contribution to post-operative revascularization of adjacent structures, and causation of anterior knee pain if inflamed. Published reports of the LM are rare in dogs and, to our knowledge, none exist for cats. Because common veterinary gross anatomy texts omit the LM from their descriptive anatomy of the stifle, students sometimes mistake the LM for the cranial cruciate ligament. Therefore, a description of the LM in the feline and canine stifle would serve as an important veterinary anatomy learning resource. The aim of this project was to characterize the LM in the cat and dog. Stifles were dissected from 62 cat hindlimbs (n = 24 preserved, n = 38 fresh) and 47 dog hindlimbs (n = 9 preserved, n = 38 fresh). The presence or absence of the LM was determined and described. Representative samples were processed for haematoxylin and eosin staining. Grossly, the LM was found bilaterally in 95.2% of cats and in 83.0% of canine limbs, appearing as an elastic, friable band of white-to-pink tissue tethering the infrapatellar fat pad to the femoral intercondylar notch. Histological samples revealed collagen fibrils, vascular structures and neural tissue. These data provide evidence of the LM in the cat and dog, and bolster currently available anatomic educational resources. The presence of the LM in the canine and feline stifle merits further investigation into its function in health and disease states.
Forecast errors of severe weather events aggravate economic damage and degrade public mental health. Whether forecast errors are underestimated or overestimated can shape public emotional responses differently, which remains unknown. In this study, we investigate the socio-psychological impacts of forecast errors during the landfall of Typhoon Khanun over the Korean Peninsula. We evaluate the predictive performance of multiple lead-hour precipitation forecasts against observational data and conduct a sentimental analysis of over 43,000 online discourses from the NAVER Weather Report Talk platform. Multiple lead-hour precipitation forecasts demonstrate underestimation in the eastern and southeastern regions of the Korean Peninsula and overestimation in the western and southwestern regions. The spatial discrepancies of precipitation forecasts are associated with distinct emotional responses: overestimation (underestimation) makes anxiety and worry (stress and confusion) the dominant emotion types in the discourses from the NAVER Report Talk platform. The findings of this study suggest that expectation-reality mismatch is a key mechanism in risk communication, and the direction of this mismatch differentiates public response. This study provides insights into the potential value of improved forecast accuracy on reducing emotional distress and strengthening public resilience during extreme weather events. This study looks at how mistakes in weather forecasts affect people's emotions during a landfalling tropical cyclone over the Korean Peninsula. This study compares predicted rainfall with what happened. This study also analyzes over 43,000 online comments to see how people reacted emotionally. This study finds that forecasts sometimes underestimated rainfall in the eastern and southeastern regions and overestimated it in the western and southwestern regions. These different directions of errors led to different emotional responses. When the forecast predicted more rain than occurred (overestimation), people felt anxious and worried. When it predicted less rain than observed (underestimation), people felt stressful and confused. Overall, the study shows that when there is a mismatch between what people expect and what really happens, it strongly affects how they feel. It also suggests that improving the accuracy of weather forecasts could help reduce emotional distress and help people cope better during extreme weather events.
In pediatrics, a personalized educational approach is required to reduce medication administration mistakes made by parents, responsible for 84.4% of outpatient medication errors. The Pediatric Instructive Kit for Adherence optimization to MEDication (PIKAMED) tool aims to optimize medication intake by providing clear instructions on administering liquid oral antibiotics (LOAs).The primary objective was to evaluate the impact of PIKAMED on parents of children in complying with a fictitious LOA prescription, in two simulated situations. Secondary objectives were to detect any misunderstandings caused by PIKAMED and optimize the tool based on the parents' experience. A prospective, single center, comparative study was conducted. Participants were parents of hospitalized children aged 28 days to 6 years old, who had never received any particular training on medical care for their children. Parents were sequentially allocated to one of two groups: a control group following the usual practice, and an experimental group using PIKAMED. The steps involved in reconstituting, administering, and storing LOAs were simulated. A specific audit grid was used to assess parents' adherence to the fictitious prescription. Parents' ability to correctly comply with a fictitious prescription for amoxicillin oral suspension was better with PIKAMED. The median overall success rate reached 93% in the PIKAMED group, compared to 54% in the control group (P < .001). PIKAMED was significantly associated with greater success in reconstituting and administering the medication (OR = 42 [3.49; + ∞ [, P = .007). PIKAMED shows significant potential for enhancing the accuracy of dosing pediatric medication, thus reducing medication errors.
The integration of artificial intelligence in medical image classification for screening has the potential to enhance efficiency, diagnostic accuracy and accessibility. However, ethical concerns such as accountability, bias, transparency and the impact on healthcare professionals remain critical. This review synthesises qualitative evidence on the ethical considerations surrounding artificial intelligence adoption in screening programmes. A systematic search of qualitative studies, from June 2020 to September 2024, was conducted across multiple databases: MEDLINE, EMBASE, PsycInfo® (American Psychological Association, Washington, DC, USA) and Cumulative Index to Nursing and Allied Health Literature. Primary qualitative studies exploring healthcare professionals', patients' and other stakeholders' perspectives on artificial intelligence in screening were included. Thematic analysis was performed, and findings were assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach to evaluate confidence in the evidence. Fourteen qualitative studies were included, covering perspectives from clinicians, radiologists, artificial intelligence developers, policy-makers and patients. Key ethical concerns identified included: (1) the necessity of human oversight to ensure that artificial intelligences diagnostic recommendations are appropriate; (2) challenges in assigning liability when artificial intelligence errors occur; (3) risks of algorithmic bias due to discrepancies between training data sets and real-world populations; (4) concerns over data privacy, cybersecurity and informed consent in artificial intelligence-driven decision-making; (5) the need for transparency in artificial intelligence decision-making processes to build trust and (6) potential deskilling of healthcare professionals and shifts in professional responsibilities. While artificial intelligence was seen as a valuable tool to augment clinical decision-making, stakeholders emphasised that ethical frameworks must guide its implementation to maintain public trust and patient safety. This review highlights the critical considerations that must be addressed to ensure the responsible integration of artificial intelligence in medical screening. Policy-makers, healthcare institutions and developers should prioritise human oversight, robust regulatory frameworks and strategies to mitigate bias and ensure transparency. Future research should focus on disease-specific artificial intelligence applications and long-term ethical implications. The protocol for this study is registered on PROSPERO as CRD42024599536. This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR172233) and is published in full in Health Technology Assessment; Vol. 30, No. 51. See the NIHR Funding and Awards website for further award information. Research is exploring if artificial Intelligence could help doctors find cancer by looking at medical images like X-rays and scans. Artificial intelligence could spot tiny signs of cancer that people might miss. This could help detect cancer and other diseases earlier and more accurately, for example in breast cancer and diabetic eye screening. Artificial intelligence can also speed up the process, so patients get results faster. However, ethical questions arise with using artificial intelligence in this way. While there are not yet specific national or international guidelines for artificial intelligence in screening, general healthcare guidance highlights the following key issues: transparency: being clear about how artificial intelligence makes decisions fairness: ensuring artificial intelligence treats everyone equally and does not discriminate against certain groups accountability: making sure someone is responsible for artificial intelligence’s actions reducing risks: ensuring artificial Intelligence systems are safe to use and do not cause harm governance and oversight: having strong systems in place to make sure artificial intelligence is used responsibly and ethically. This study examined ethical concerns of artificial intelligence in screening by reviewing research involving the general public, clinicians and patients. Initially focusing on diabetic retinopathy and breast cancer, it expanded to other conditions due to limited evidence. The study highlighted several ethical concerns raised in the literature, such as accountability for artificial intelligence mistakes, bias, data privacy, transparency and artificial intelligence’s impact on doctors’ professional roles. In addition, people in the studies included in the literature expressed worries about related issues, particularly keeping humans in control of decisions, who is responsible when errors occur and whether artificial intelligence systems can be trusted to act fairly. Ethical challenges related to the implementation of artificial intelligence in clinical screening were also highlighted. These included healthcare inequality (with resource-limited hospitals potentially not benefiting equally), risks to patient safety from delays or errors in artificial intelligence-generated reports, the need for trust through rigorous testing and the importance of clear governance guidelines to ensure that artificial intelligence remains an assistive tool rather than replacing human judgement. This study provides useful information by identifying recurring ethical concerns that can inform the development of governance frameworks, guide safe implementation of artificial intelligence in screening and highlight priorities for future research and policy. Despite providing useful information, this study has some limitations due to incomplete research available. Future studies could focus on specific diseases and ethical issues, reassessing ethical considerations as new evidence becomes available.
The aim of this French physician initiated, multicentre, prospective, randomised trial with blinded criteria for re-intervention was to evaluate the efficacy of paclitaxel coated balloons (DCBs) in the treatment of arteriovenous fistula stenosis. One hundred and fifty patients with an arteriovenous fistula stenosis were included, and 145 were randomised 1:1 in the ABISS trial (Angioplastie au Ballon Imprégné de paclitaxel vs. angioplastie Standard pour le traitement des Sténoses sur fistule artérioveineuse; ClinicalTrials.gov identifier: NCT02753998) between a DCB (Lutonix, BD, Franklin Lakes, NJ, USA) and a placebo balloon. The main outcome was the rate of primary patency loss at 6 months. The primary analysis was performed in the modified intention to treat population. Missing outcome data were handled using a conservative imputation approach. The per-protocol analysis excluded patients who were included by mistake, not treated according to the randomisation arm, lost to follow up, or who missed a visit. In the modified intention to treat analysis, there was no significant difference between the groups regarding primary patency loss at 6 months (31% [22 of 70] in the DCB group vs. 42% [30 of 71] in the placebo group; p = .09; hazard ratio = 0.62 [95% confidence interval {CI} 0.36 - 1.07]). Primary patency loss was lower in the DCB than in the placebo group at 3 months (4.2% vs. 22.5%; p = .002; hazard ratio = 0.18 [95% CI 0.05 - 0.60]), but not at 12 months (58.6% vs. 57.7%; p = .57; hazard ratio = 0.88 [95% CI 0.57 - 1.35]). In the per-protocol analysis, the primary patency loss was significantly lower in the DCB group than in the placebo group (26% [16 of 61] in the DCB group vs. 50% [28 of 56] in the placebo group; p = .004). In the ABISS trial, the use of a DCB was not superior to a placebo balloon at 6 months in the modified intention to treat analysis.
Mistakes in clinical reasoning are common. Cognitive biases have gained attention as potential sources of error. Over 100 biases have been defined, and over 40 have been identified in clinical reasoning literature. Understanding contextual factors (e.g., clinical setting or emotions) that influence clinical reasoning is a first step towards improving reasoning and reducing errors. Explore the interactions of cognitive biases and distracting contextual factors and their influence on clinical reasoning accuracy. The authors conducted a simulation study. Participants watched video encounters of common conditions with or without added distracting contextual factors (DCFs, e.g., English as a second language or patient anxiety), then completed a post-encounter form and a think-aloud exercise. Reasoning was analyzed with an analytic integrative approach of latent thematic analysis. MANOVA assessed for potential associations of biases and contextual factors on reasoning accuracy, which was followed with univariate ANOVA. Thirteen cognitive biases were identified. Anchoring, availability, and confirmation bias were most common. MANOVA found lower diagnostic reasoning accuracy in cases with DCFs (72% vs. 80%). There was a lower but not statistically significant difference in management reasoning accuracy (70% vs. 73%). Univariate ANOVA found that the number of biases and the cooccurrence of bias and a DCF was associated with lower diagnostic reasoning accuracy. Three themes emerged when exploring biases' influence on reasoning: (1) gestalt from context or error avoidance, (2) optimistic processing, and (3) momentum clouds reasoning in the present and afterward. Two additional themes emerged when exploring the interactions between biases and DCFs: (1) lack of confidence and knowledge deficit, and (2) emphasizing easily available information. Cognitive biases can affect clinical reasoning in multiple ways. DCFs may amplify the negative influence of biases on diagnostic reasoning accuracy. Exploring the interactions of cognitive biases, DCFs, and clinical reasoning, as well as delineating diagnostic reasoning from management reasoning may help future research and interventions improve reasoning accuracy.
Error-related potentials (ErrPs) have been studied to evaluate wrong decisions or actions in several contexts. An ErrP is an electrical potential on the scalp generated by the perception of errors and occurs unwittingly. In human-robot collaboration (HRC), ErrP detection can be used to trigger a feedback or an action to adapt the system to the user. This contributes to the improvement of HRC, taking into account user performance. However, to our knowledge, the detection of ErrPs in HRC has not been widely explored, resulting in only a few studies. This systematic review will present work on ErrP-based interfaces related to adaptation, control, and neuroergonomics for HRC. Thirteen articles were included after the exclusion criteria of the review stages. The average accuracy of ErrP detection was between 54 and 87.2%. In most cases, the authors simulated the occurrence of unexpected behavior of the robot. The robot mistakes occurred randomly between 20 and 35% of the total trials. Some works focused on the robot learning process and adaptation between humans and robots. The mental model and the robot behavior policy were updated based on the decoded ErrPs during collaborative interactions. Control-related works have included ErrPs detection/features as input inside the control loop or algorithm. Other studies assessed the influence of mental workload variability in the adaptation process, given that a high mental workload affects the cognitive processes needed to perceive errors. Thus, ErrPs present advantages for enhancing HRC, and this review opens the way to further developments in the robotic domain.
As increasing numbers of individuals with intellectual and developmental disabilities (IDD) live into adulthood, they struggle to access high-quality, age-appropriate healthcare. Physicians who feel ill-prepared to care for adults with IDD contribute to worsened access to and quality of care, which can ultimately lead to poorer health outcomes for this population. Investigate physician-in-training perceptions of, experiences with and needs for treating patients with IDD. We conducted qualitative, semistructured interviews with 20 senior resident physicians from five residency programs affiliated with the University of Colorado. We analysed data using thematic content analysis to identify and develop overarching themes. Four major themes emerged using thematic content analysis. First, communication challenges decreased resident confidence in the quality of care they provide. Second, residents felt that they did not have adequate skills to treat patients with IDD. Third, residents felt that this population of adults is not within the purview of most of their practice specialties. Lastly, physicians-in-training felt that more exposure to and support in caring for patients with IDD would increase their comfort treating patients with IDD. Residents in adult specialties felt ill-equipped to care for adults with IDD and limited experiences heightened their fear of making mistakes. Greater experiential learning and better support resources could improve their confidence and future care quality for this important population.
Microsurgery is an essential skill for plastic surgeons and a basic microsurgical course should be integrated into all plastic surgery residents' training programs, as mastering this technique cannot be reached only through observation and requires regular practice. Despite living models better simulate reality, non-living models have been shown to be valid tools for basic/intermediate microsurgical training. While many single preclinical exercises are described in the literature, there is lack of proposals for a complete basic program on non-living models. The aim of this study is to propose a basic microsurgical program entirely based on non-living models and to evaluate its feasibility with a cross-sectional study that analyses the outcomes of its application via the "Queen Mary University London microsurgery global rating scale" scoring system. Nine different exercises for microsurgical training on non-living models were chosen based on a literature review. A basic step-by-step microsurgical training program was built. The program was proposed to the Plastic Surgery residents of our unit through a five-day training, during 2020-2023. No participants 'selection was made. All participants were examined with a practical test before and after the proposed program. The results of pre- and post-training test were collected and analysed. Each trainee was able to complete a posterior-wall-first technique end-to-end anastomosis on the chicken thigh femoral artery with no major mistakes at the end of the program. Moreover, the data analysis revealed a statistically significant improvement of each evaluated skill after the training. The proposed basic program is easy to organize and allows the trainee to develop the basic microsurgical skills needed to move to advanced training on living animals or on guided clinical practice.