WorldWideScience

Sample records for overconfident physician opinion

  1. CPOE in Iran--a viable prospect? Physicians' opinions on using CPOE in an Iranian teaching hospital.

    Science.gov (United States)

    Kazemi, Alireza; Ellenius, Johan; Tofighi, Shahram; Salehi, Aref; Eghbalian, Fatemeh; Fors, Uno G

    2009-03-01

    In recent years, the theory that on-line clinical decision support systems can improve patients' safety among hospitalised individuals has gained greater acceptance. However, the feasibility of implementing such a system in a middle or low-income country has rarely been studied. Understanding the current prescription process and a proper needs assessment of prescribers can act as the key to successful implementation. The aim of this study was to explore physicians' opinions on the current prescription process, and the expected benefits and perceived obstacles to employ Computerised Physician Order Entry in an Iranian teaching hospital. Initially, the interview guideline was developed through focus group discussions with eight experts. Then semi-structured interviews were held with 19 prescribers. After verbatim transcription, inductive thematic analysis was performed on empirical data. Forty hours of on-looker observations were performed in different wards to explore the current prescription process. The current prescription process was identified as a physician-centred, top-down, model, where prescribers were found to mostly rely on their memories as well as being overconfident. Some errors may occur during different paper-based registrations, transcriptions and transfers. Physician opinions on Computerised Physician Order Entry were categorised into expected benefits and perceived obstacles. Confidentiality issues, reduction of medication errors and educational benefits were identified as three themes in the expected benefits category. High cost, social and cultural barriers, data entry time and problems with technical support emerged as four themes in the perceived obstacles category. The current prescription process has a high possibility of medication errors. Although there are different barriers confronting the implementation and continuation of Computerised Physician Order Entry in Iranian hospitals, physicians have a willingness to use them if these systems

  2. Overconfidence and Moral Hazard

    DEFF Research Database (Denmark)

    de la Rosa, Leonidas Enrique

    2011-01-01

    In this paper, I study the effects of overconfidence on incentive contracts in a moral-hazard framework. Agent overconfidence can have conflicting effects on the equilibrium contract. On the one hand, an optimistic or overconfident agent disproportionately values success-contingent payments...

  3. Grade Expectations: Rationality and Overconfidence

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    Jan R. Magnus

    2018-01-01

    Full Text Available Confidence and overconfidence are essential aspects of human nature, but measuring (overconfidence is not easy. Our approach is to consider students' forecasts of their exam grades. Part of a student's grade expectation is based on the student's previous academic achievements; what remains can be interpreted as (overconfidence. Our results are based on a sample of about 500 second-year undergraduate students enrolled in a statistics course in Moscow. The course contains three exams and each student produces a forecast for each of the three exams. Our models allow us to estimate overconfidence quantitatively. Using these models we find that students' expectations are not rational and that most students are overconfident, in agreement with the general literature. Less obvious is that overconfidence helps: given the same academic achievement students with larger confidence obtain higher exam grades. Female students are less overconfident than male students, their forecasts are more rational, and they are also faster learners in the sense that they adjust their expectations more rapidly.

  4. Grade Expectations: Rationality and Overconfidence

    Science.gov (United States)

    Magnus, Jan R.; Peresetsky, Anatoly A.

    2018-01-01

    Confidence and overconfidence are essential aspects of human nature, but measuring (over)confidence is not easy. Our approach is to consider students' forecasts of their exam grades. Part of a student's grade expectation is based on the student's previous academic achievements; what remains can be interpreted as (over)confidence. Our results are based on a sample of about 500 second-year undergraduate students enrolled in a statistics course in Moscow. The course contains three exams and each student produces a forecast for each of the three exams. Our models allow us to estimate overconfidence quantitatively. Using these models we find that students' expectations are not rational and that most students are overconfident, in agreement with the general literature. Less obvious is that overconfidence helps: given the same academic achievement students with larger confidence obtain higher exam grades. Female students are less overconfident than male students, their forecasts are more rational, and they are also faster learners in the sense that they adjust their expectations more rapidly. PMID:29375449

  5. Overconfidence and Moral Hazard

    DEFF Research Database (Denmark)

    de la Rosa, Leonidas Enrique

    In this paper, I study the effects of overconfidence on incentive contracts in a moral-hazard framework in which principal and agent knowingly hold asymmetric beliefs regarding the probability of success of their enterprise. Agent overconfidence can have conflicting effects on the equilibrium con...

  6. Overconfidence and Delegated Portfolio Management

    NARCIS (Netherlands)

    Palomino, F.A.; Sadrieh, A.

    2003-01-01

    Following extensive empirical evidence about market anomalies and overconfidence, the analysis of financial markets with agents overconfident about the precision of their private information has received a lot of attention.However, all these models consider agents trading for their own account.In

  7. The opinions of nurses and physicians related to euthanasia

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    Nihal İşler

    2010-09-01

    Full Text Available Objective: The research was conducted to investigate the opinions of nurses and physicians pertaining to euthanasia who are working at Internal Medicine, Surgery and Intensive Care Unit departments at Baskent University Ankara hospital.Methods: The research is a descriptive one. The sample consisted of 154 nurses and physicians who are working at Internal Medicine, Surgery and Intensive Care Unit departments at Baskent University Ankara hospital and accepted to participate and could be reached. A questionnaire with 30 items was used to collect data to obtain the socio-demographic characteristics and the opinions pertaining to euthanasia of nurses and physicians. Frequencies, mean values and chi-square tests were used in statistical analysis.Results: The participants didn’t approve euthanasia with a high ratio however it was determined that almost half of them asserted it as patient’s rights of a patient who want his/her death to be fastened and who has no chance to be cured and who are spending the last days of their life with unbearable pain. Except the age groups and marital status there was no significant difference found statistically between the opinions of physicians and nurses regarding euthanasia (p>0.05.Conclusion: It was stated that nurses and physicians consider not active euthanasia but passive euthanasia as acceptable.

  8. Overconfidence in psychosis: The foundation of delusional conviction?

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    Ryan P. Balzan

    2016-12-01

    Full Text Available A number of recent studies have identified an “overconfidence effect” in psychosis, whereby people with schizophrenia are overconfident in errors while simultaneously slightly underconfident when accurate. This effect may have implications for why delusions, which are based on inaccurate inferences, perceptions and judgements, are typically held with high conviction. Given the importance the overconfidence effect may have in accounting for delusional conviction, the current narrative review aims to summarise and critique the recent evidence for the effect within schizophrenia. People with schizophrenia were consistently found to be overconfident in errors and slightly underconfident in correct appraisals, and this effect appears not to be an artefact of poor task performance. While the overconfidence effect has been linked to delusion-proneness in the general population, there was less direct evidence linking overconfidence to delusional symptoms in clinical populations. Future studies need to adopt longitudinal designs and include additional measures of overconfidence to investigate this association more appropriately, and to also investigate possible mediators of this postulated relationship, such as dopaminergic activity.

  9. Physicians' opinions about partner notification methods: case reporting, patient referral, and provider referral.

    Science.gov (United States)

    Hogben, M; St Lawrence, J S; Montaño, D E; Kasprzyk, D; Leichliter, J S; Phillips, W R

    2004-02-01

    The United States has relied upon partner notification strategies to help break the chain of infection and re-infection for sexually transmitted diseases (STD). Physicians are a vital link in the system of STD control, but little is known of physician opinions about partner notification strategies. We collected opinions about partner notification from a national probability sample of physicians in specialties diagnosing STDs. Physicians responded to 17 questions about three relevant forms of STD partner notification: patient based referral, provider based referral, and case reporting. Exploratory factor analyses showed that responses for each form of partner notification could be grouped into four categories: perceived practice norms, infection control, patient relationships, and time/money. Multivariate analyses of the factors showed that physicians endorsed patient based referral most favourably and provider based referral least favourably. Physicians' opinions about partner notification strategies appear to reflect objective reality in some areas, but not in others. Strategies that improve the fit between physicians' opinions and effective notification are needed: some are discussed here.

  10. The Role of Overconfidence in Romantic Desirability and Competition.

    Science.gov (United States)

    Murphy, Sean C; von Hippel, William; Dubbs, Shelli L; Angilletta, Michael J; Wilson, Robbie S; Trivers, Robert; Barlow, Fiona Kate

    2015-08-01

    Four studies and a computer simulation tested the hypothesis that people who are overconfident in their self-assessments may be more successful in attracting mates. In Study 1, overconfident people were perceived as more confident in their dating profiles, and this perceived confidence predicted increased romantic desirability. Study 2 revealed that overconfident people also tend to be perceived as arrogant, which counteracts the positive effects of perceived confidence. However, Study 3 revealed that overconfidence might confer an advantage in intrasexual competition, as people were less likely to compete with overconfident individuals by virtue of their perceived confidence and arrogance. Study 4 showed that overconfident raters were also more likely to choose to compete for romantic partners. In Study 5, agent-based modeling incorporating the coefficients from these studies suggested that overconfidence facilitates mate acquisition in the presence of intrasexual competition. © 2015 by the Society for Personality and Social Psychology, Inc.

  11. Overconfidence and investment : An experimental approach

    NARCIS (Netherlands)

    Pikulina, E.S.; Renneboog, Luc; Tobler, P.N.

    A positive relation between overconfidence and investment provision has been theoretically justified and practically assumed in the literature, but has not been thoroughly investigated. We test and confirm this positive relation between direct measures of overconfidence in one's financial knowledge

  12. A prototype for evidence-based pharmaceutical opinions to promote physician-pharmacist communication around deprescribing

    Science.gov (United States)

    Tannenbaum, Cara

    2018-01-01

    Context: Interprofessional communication is an effective mechanism for reducing inappropriate prescriptions among older adults. Physicians’ views about which elements are essential for pharmacists to include in an evidence-based pharmaceutical opinion for deprescribing remain unknown. Objective: To develop a prototype for an evidence-based pharmaceutical opinion that promotes physician-pharmacist communication around deprescribing. Methods: A standardized template for an evidence-based pharmaceutical opinion was developed with input from a convenience sample of 32 primary care physicians and 61 primary care pharmacists, recruited from conferences and community settings in Montreal, Canada. Participants were asked to comment on the need for clarifying treatment goals, including personalized patient data and biomarkers, highlighting evidence about drug harms, listing the credibility and source of the recommendations, providing therapeutic alternatives and formalizing official documentation of decision making. The content and format of the prototype underwent revision by community physicians and pharmacists until consensus was reached on a final recommended template. Results: The majority of physicians (84%-97%) requested that the source of the deprescribing recommendations be cited, that alternative management options be provided and that the information be tailored to the patient. Sixteen percent of physicians expressed concern about the information in the opinions being too dense. Pharmacists also questioned the length of the opinion and asked that additional space be provided for the physician’s response. A statement was added making the opinion a valid prescription upon receipt of a signature from physicians. Compared to a nonstandardized opinion, the majority of pharmacists believed the template was easier to use, more evidence based, more time efficient and more likely to lead to deprescribing. Conclusion: Physicians and pharmacists endorsed a standardized

  13. Overconfidence and Managers’ Responsibility Hoarding

    OpenAIRE

    Nieken, Petra; Sadrieh, Abdolkarim; Zhou, Nannan

    2011-01-01

    Overconfidence is a well-established behavioral phenomenon that involves an overestimation of own capabilities. We introduce a model, in which managers and agents exert effort in a joint production, after the manager decides on the allocation of the tasks. A rational manager tends to delegate the critical task to the agent more often than given by the efficient task allocation. In contrast, an overconfident manager is more likely to hoard responsibility, i.e. to delegate the critical task les...

  14. Physicians' opinions on palliative care and euthanasia in the Netherlands.

    Science.gov (United States)

    Georges, Jean-Jacques; Onwuteaka-Philipsen, Bregje D; van der Heide, Agnes; van der Wal, Gerrit; van der Maas, Paul J

    2006-10-01

    In recent decades significant developments in end-of-life care have taken place in The Netherlands. There has been more attention for palliative care and alongside the practice of euthanasia has been regulated. The aim of this paper is to describe the opinions of physicians with regard to the relationship between palliative care and euthanasia, and determinants of these opinions. Cross-sectional. Representative samples of physicians (n = 410), relatives of patients who died after euthanasia and physician-assisted suicide (EAS; n = 87), and members of the Euthanasia Review Committees (ERCs; n = 35). Structured interviews with physicians and relatives of patients, and a written questionnaire for the members of the ERCs. Approximately half of the physicians disagreed and one third agreed with statements describing the quality of palliative care in The Netherlands as suboptimal and describing the expertise of physicians with regard to palliative care as insufficient. Almost two thirds of the physicians disagreed with the suggestion that adequate treatment of pain and terminal care make euthanasia redundant. Having a religious belief, being a nursing home physician or a clinical specialist, never having performed euthanasia, and not wanting to perform euthanasia were related to the belief that adequate treatment of pain and terminal care could make euthanasia redundant. The study results indicate that most physicians in The Netherlands are not convinced that palliative care can always alleviate all suffering at the end of life and believe that euthanasia could be appropriate in some cases.

  15. Truth telling in medical practice: students' opinions versus their observations of attending physicians' clinical practice.

    Science.gov (United States)

    Tang, Woung-Ru; Fang, Ji-Tseng; Fang, Chun-Kai; Fujimori, Maiko

    2013-07-01

    Truth telling or transmitting bad news is a problem that all doctors must frequently face. The purpose of this cross-sectional study was to investigate if medical students' opinions of truth telling differed from their observations of attending physicians' actual clinical practice. The subjects were 275 medical clerks/interns at a medical center in northern Taiwan. Data were collected on medical students' opinions of truth telling, their observations of physicians' clinical practice, students' level of satisfaction with truth telling practiced by attending physicians, and cancer patients' distress level when they were told the truth. Students' truth-telling awareness was significantly higher than the clinical truth-telling practice of attending physicians (pmedical students' opinions on truth telling and attending physicians' actual clinical practice. More research is needed to objectively assess physicians' truth telling in clinical practice and to study the factors affecting the method of truth telling used by attending physicians in clinical practice. Copyright © 2012 John Wiley & Sons, Ltd.

  16. Research of the Stock Price Overreaction and Investor Overconfidence Issues

    Directory of Open Access Journals (Sweden)

    Bayu Raharja

    2017-06-01

    Full Text Available This research examines the existing of investor overconfidence in the capital market and the phenomena of stock prices reversal in the future due to the existing of this behavior. It has a different approach to test the existing of investor overconfidence by introducing firm’s growth as the information which has triggered many investors to behave overconfidently. By using multiple regression analysis, the results of this research confirmed our conducted hypothesis, investor tends to behave overconfident to firms which have higher growth. It proofed by the positive relation between firms’ growth and trading volume. Afterward, this research also found that higher growth firms tend to have declining on its performance in the future. The negative relation between firms’ growth and longterm performance means that the stock’s price reversal caused by the existing of investor overconfidence.

  17. Can Incentives Mitigate Student Overconfidence at Grade Forecasts?

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    Caplan, Dennis; Mortenson, Kristian G.; Lester, Marisa

    2018-01-01

    Research shows that college students exhibit bias in their forecasts of exam performance. Most students are overconfident in their forecasts, academically weaker students are the most overconfident, and top-performing students are underconfident. The literature identifies negative repercussions of these biases, including inadequate preparation for…

  18. The opinions and experiences of family physicians regarding direct-to-consumer advertising.

    Science.gov (United States)

    Lipsky, M S; Taylor, C A

    1997-12-01

    The use of direct-to-consumer advertising (DTCA) by pharmaceutical companies is increasing. Our study examines the opinions and experiences of family physicians concerning DTCA. A survey instrument designed to elicit the opinions, experiences, and perceptions of family physicians about DTCA was sent to a 2% (N = 880) systematic sampling of active physician members of the American Academy of Family Physicians. Descriptive statistics were used to analyze responses with t tests and chi 2 tests for independence used to examine subgroup response differences. Four hundred fifty-four (52%) physicians responded to the survey. Most physicians (95%) had encountered DTCA personally, and had been approached by an average of 7 patients over the previous 6 months with requests for specific prescription drugs. Prescription antihistamines and antihypertensive drugs were the most commonly requested. Overall, 80% of the physician respondents believed that print DTCA was not a good idea, while 84% expressed negative feelings about television and radio advertising. Both groups cited "misleading biased view" and "increased costs" as the most common disadvantages. Some reported benefits included "better informed patients" and "promoting physician-patient communication." Overall, the study group physicians had negative feelings about DTCA in both print and electronic media. Studies directly examining patient perspectives, as well as cost benefits, are necessary to test the validity of the physicians' perceptions about DTCA.

  19. Radiologic reports : attitudes, preferred type, and opinion of referring physicians

    International Nuclear Information System (INIS)

    Kim, Won Young; Hwang, Seong Su; Ahn, Myeong Im and others

    2001-01-01

    To determine referring physicians' general attitudes, preferred reporting types, and opinions on radiologic reports. A survey questionnaire was distributed to the 315 staff and residents of four university hospitals with 400 to 800 beds, and a total of 228 physicians responded. The questionnaire aimed to determine of the general attitude of referring physicians to radiologic reports, the type of report they preferred, and other opinions and suggestions. The responses elicited, as well as discrepancies among residents, staff, internist, and surgeons, were analyzed. Most referring physicians replied that they read an entire report regardless of its length, and the second majority read the conclusion first and then the remainder of the report only if clarification was required. With regard to report length, physicians answered that reports describing the findings of conventional radiography were often too short, while those dealing with MRI were verbose. The majority experienced occasional confusion when reading a report, the major cause being grammatical errors and incomprehensible sentence structure. When confused, most physicians consulted the radiologist ; staff showed a greater inclination than residents to pursue this option. Most physicians preferred brief phrases or telegraphic-style sentences to a style which stressed completeness and detail, a preference which was statistically higher among residents than staff. Whereas physicians favored a brief radiologic report in cases of normal radiologic findings, conventional radiologic studies or no clinical findings, they wished to see a more detailed report in cases of abnormal radiologic findings, specific radiologic studies (special radiographs, US, CT, or MRI), or positive clinical findings. This need for more detail was expressed more frequently by internists than by surgeons. If implemented, the results of this study can be expected to enhance the quality and comprehensibility of radiologic reports, and may

  20. Second medical opinions: the views of oncology patients and their physicians.

    Science.gov (United States)

    Philip, Jennifer; Gold, Michelle; Schwarz, Max; Komesaroff, Paul

    2010-09-01

    Second medical opinions (SMOs) are common in oncology practice, but the nature of these consultations has received relatively little attention. This study examines the views of patients with advanced cancer and their physicians of SMOs. Parallel, concurrent surveys were developed for patients and physicians. The first was distributed to outpatients with advanced cancer-attending specialist clinics in an Australian quaternary hospital. The second survey, developed on the basis of results of exploratory interviews with medical oncologists, was distributed to medical oncologists in Australia. Seventeen of fifty two (33%) patients had sought a SMO, most commonly prompted by concerns around communication with their first doctor, the extreme and desperate nature of their medical condition and the need for reassurance. Most (94%) patients found the SMO helpful, with satisfaction related to improved communication and reassurance. Patients were concerned that seeking a second medical opinion may affect their relationship with their primary doctor. Most physicians (82%) reported seeing between one and five SMO per month, with patients being motivated by the need for additional information and reassurance. Physicians regarded SMO patients as having greater information needs (84%), greater psychosocial needs (58%) and requiring more of the physician's time and energy (77%) than other patients. SMOs are common in cancer care with most patients motivated by the need for improved communication, additional information and reassurance. Physicians identify patients who seek SMOs as having additional psychosocial needs compared with other oncology patients.

  1. Faktor Demografis, Personality Traits, dan Overconfidence (Survey Terhadap Investor Saham di Yogyakarta

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    Liring Dwi Utami

    2016-06-01

    Full Text Available AbstrakPenelitian ini bertujuan untuk mengetahui hubungan antara faktor demografi, personality traits dan overconfidence pada Investor saham di Yogyakarta. Faktor demografis yang digunakan berupa jenis kelamin, usia, pendidikan dan lama investasi sedangkan personality traits menggunakan the big five personality. Penelitian ini menggunakan kuesioner yang disebar kepada 100 orang investor yang dipilih secara random. Sebanyak 87 kuesioner digunakan, sedangkan 13 lainnya didiskualifikasi karena jawaban kuesioner yang tidak lengkap. Data diolah menggunakan SPPS dengan alat ukur Chi Square dan Pearson Correlation. Hasil dari penelitian menemukan bahwa semua faktor demografi yaitu usia, jenis kelamin, pendidikan dan lama investasi tidak berhubungan dengan overconfidence. Hasil lain menunjukkan adanya hubungan yang positif antara conscientiousness dengan overconfidence. Sedangkan extraversion, agreeableness, neuroticism dan openness to experience tidak mempunyai hubungan dengan overconfidence.AbstractThis study aims to determine the relationship between demographic factors, personality traits, and overconfidence with stock investors in Yogyakarta. Demographic factors used are gender, age, education and time frame of holding, while the big five personality was used as a proxy of personality traits. This study used a questionnaire distributed to 100 randomly selected investors. A total of 87 questionnaires were used, while the other 13 were disqualified because of incomplete answers to the questionnaire. The data were processed using chi square and Pearson correlation. The results of the study found that all the demographic factors (age, gender, education and time frame holding had no association with overconfidence. Other results showed a positive relationship between conscientiousness with overconfidence. Whereas extraversion, agreeableness, neuroticism and openness to experience were not related to overconfidence.

  2. Factors affecting the opinions of family physicians regarding generic drugs – a questionnaire based study

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    Pawel Lewek

    2014-12-01

    Full Text Available A range of factors are believed to exert a negative influence on opinions of physicians about generic drugs.The aim of this study was to survey the opinions of primary care doctors on generics, and determine the factors which may affect them. A questionnaire comprising thirty eight questions was distributed among primary care doctors working in seventy out-patient clinics of the Lodzkie province, Poland, during the period of January 1, 2010 – December 31, 2010. A total of170 of 183 participants completed the survey (average age 48.5; 70.0% women: a 92.9%response rate. While 38.8% of physicians claimed that generics were worse than brand name drugs, 54.1% considered them to be better. However, 36.5% of the doctors did not choose generics for their own use. Two key opinions were identified among the responses concerning the effectiveness of generic drugs: use of generic drugs by the physician (p<0.001, and their opinion that pharmacists do inform patients about generic drugs (p<0.05. Although existing evidence confirms that generic and brand name drugs are equally effective, many physicians doubt this, which prevents them from being used as cost effective drug therapy. In order to increase healthcare savings through the use of generics, these factors should be addressed: for example, convincing a physician to adopt generics for personal use may be an efficient way to support more cost effective treatment of his patients.

  3. Joint Decisions on Emission Reduction and Inventory Replenishment with Overconfidence and Low-Carbon Preference

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    Shoufeng Ji

    2018-04-01

    Full Text Available This paper presents a game-theoretical analysis of joint decisions on carbon emission reduction and inventory replenishment with overconfidence and consumer’s low-carbon preference for key supply chain players when facing effort-dependent demand. We consider respectively the overconfidence of a supplier who overestimates the impacts of his emission reduction efforts on product demand and the overconfidence of a retailer who underestimates the variability of the stochastic demand. We find, surprisingly, that the supplier’s overconfidence can mitigate “double marginalization” but hurt self-profit, while the retailer’s overconfidence can be an irrelevant factor for self-profit. The retailer aiming at short-term trading should actively seek an overconfident supplier, while the supplier should actively seek a rational retailer for whom the critical fractile is more than 0.5, whereas for an overconfident retailer, the critical fractile is less than or equal to 0.5. The study also underlines the effect of regulation parameters as an important contextual factor influencing low-carbon operations.

  4. Overconfidence in incorrect perceptual judgments in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Steffen Moritz

    2014-12-01

    Discussion: To the best of our knowledge, this is the first study to demonstrate overconfidence in errors among individuals with psychosis using a visual perception task. Speaking to the specificity of this abnormality for schizophrenia and its pathogenetic relevance, overconfidence in errors and knowledge corruption were elevated in patients with schizophrenia relative to both control groups and were correlated with paranoia.

  5. Who are the opinion leaders? The physicians, pharmacists, patients, and direct-to-consumer prescription drug advertising.

    Science.gov (United States)

    Lee, Annisa Lai

    2010-09-01

    A popular perception holds that physicians prescribe requested drugs to patients influenced by mass mediated direct-to-consumer prescription drug advertising. The phenomenon poses a serious challenge to the two-step flow model, which emphasizes the influence of opinion leaders on their followers and their legitimating power over the informing power of the mass media. This study investigates a 2002 Food and Drug Administration (FDA) survey and finds that patients searching for drug information through mass and hybrid media in newspapers and magazines' small print, the Internet, and toll-free numbers are more likely to seek information through interpersonal communication channels like health care providers. Patients using small print, toll-free numbers, one's own physician, and other physicians are associated with influencing their physicians with various drug-requesting behaviors. But physicians only prescribe requested drugs to patients who are influenced by other health care providers, such as pharmacists and other physicians, not the mass media. The influence of expert opinion leaders of drugs is so strong that the patients even would switch from their own unyielding physicians who do not prescribe drugs as advised by the pharmacists. Physicians and patients all are influenced more by other expert opinion leaders of drugs than by the mass media and therefore still uphold the basic tenet of the two-step model.

  6. Overconfidence and Managers’ Responsibility Hoarding

    OpenAIRE

    Nieken, Petra; Sadrieh, Abdolkarim; Zhou, Nannan

    2011-01-01

    Overconfidence is a well-established behavioral phenomenon that involves an overestimation of own capabilities. We introduce a model, in which managers and agents exert effort in a joint production, after the manager decides on the allocation of the tasks. A rational manager tends to delegate the critical task to the agent more often than given by the efficient task allocation. In contrast, an overconfident manager is more likely to hoard responsibility, i.e. to delegate the critical task les...

  7. Overconfidence in Interval Estimates

    Science.gov (United States)

    Soll, Jack B.; Klayman, Joshua

    2004-01-01

    Judges were asked to make numerical estimates (e.g., "In what year was the first flight of a hot air balloon?"). Judges provided high and low estimates such that they were X% sure that the correct answer lay between them. They exhibited substantial overconfidence: The correct answer fell inside their intervals much less than X% of the time. This…

  8. Euthanasia and physician-assisted suicide in cases of terminal cancer: the opinions of physicians and nurses in Greece.

    Science.gov (United States)

    Parpa, Efi; Mystakidou, Kyriaki; Tsilika, Eleni; Sakkas, Pavlos; Patiraki, Elisabeth; Pistevou-Gombaki, Kyriaki; Govina, Ourania; Vlahos, Lambros

    2008-10-01

    The aim of this study was to investigate the opinions of physicians and nurses on euthanasia and physician-assisted suicide in advanced cancer patients in Greece. Two hundred and fifteen physicians and 250 nurses from various hospitals in Greece completed a questionnaire concerning issues on euthanasia and physician-assisted suicide. More physicians (43.3%) than nurses (3.2%, p < 0.0005) reported that in the case of a cardiac or respiratory arrest, they would not attempt to revive a terminally ill cancer patient. Only 1.9% of physicians and 3.6% of nurses agreed on physician-assisted suicide. Forty-seven per cent of physicians and 45.2% of nurses would prefer the legalization of a terminally ill patient's hastened death; in the case of such a request, 64.2% of physicians and 55.2% of nurses (p = 0.06) would consider it if it was legal. The majority of the participants tended to disagree with euthanasia or physician-assisted suicide in terminally ill cancer patients, probably due to the fact that these acts in Greece are illegal.

  9. Self-confidence, overconfidence and prenatal testosterone exposure : Evidence from the lab

    NARCIS (Netherlands)

    Dalton, Patricio S.; Ghosal, Sayantan

    2018-01-01

    This paper examines whether foetal testosterone exposure predicts the extent of confidence and over-confidence in own absolute ability in adulthood. To study this question, we elicited incentive-compatible measures of confidence and over-confidence in the lab and correlate them with measures of

  10. The study of the price of gold futures based on heterogeneous investors' overconfidence

    Institute of Scientific and Technical Information of China (English)

    Wei Jiang; Pupu Luan; Chunpeng Yang

    2014-01-01

    Purpose-The purpose of this paper is to research and analyze the price of gold futures based on heterogeneous investors' overconfidence.Design/methodology/approach-This paper divides the traders of gold futures market into two kinds:the speculators and arbitrageurs,and then constructs a market equilibrium model of futures pricing to analyze the behaviors of the two kinds of traders with overconfidence.After getting the decision-making function,the market equilibrium futures price is attained on the condition of market clearing.Then,this paper analyzes how the overconfidence impacts on futures price,volatility of the price of gold futures and the effects on individual utility.Findings-Under different market conditions,the overconfidence psychological impacts of heterogeneous investor on the price and volatility of futures are different,sometimes completely opposite.Originality/value-In the past literature,the relationships between overconfidence and the price or volatility are positive;however,the study shows that sometimes it is positive,and sometimes it is negative

  11. What is your level of overconfidence? A strictly incentive compatible measurement of absolute and relative overconfidence

    NARCIS (Netherlands)

    Urbig, D.; Stauf, J.; Weitzel, U.|info:eu-repo/dai/nl/276323394

    This study contributes to the ongoing discussion on the appropriate measurement of overconfidence, in particular, its strictly incentive compatible measurement in experiments. Despite a number of significant advances in recent research, several important issues remain to be solved. These relate to

  12. Managerial overconfidence and debt maturity structure of firms Analysis based on China's listed companies

    Institute of Scientific and Technical Information of China (English)

    Jiang Wei; Xiao Min; You Jiaxing

    2011-01-01

    Purpose-The purpose of this paper is to empirically analyze the effects of managerial overconfidence on debt maturity structure decisions in terms of liquidity risk and asset match in Chinese listed companies.Design/methodology/approach-Combining data from CSMAR with some default data collected by hand,this paper selects age,tenure,education,education background and whether the board chair and CEO positions are consolidated in Chinese listed companies as proxies of managerial overconfidence.Thus,the authors acquired needed and credible empirical data.Findings-It was found that,the younger the CEO,the shorter the tenure,the lower the education,having economics or management education and being chairman concurrently,CEOs have stronger managerial overconfidence.Thus,corporate debt maturity structure is more weakly correlated with debt ratio and asset structure.Research limitations/implications-The findings in this study suggest that managerial irrationality,especially overconfidence,does have an effect on the financing decisions of firms.Originality/value-This is the first paper to analyze the effects of managerial overconfidence on debt maturity structure derisions in terms of liquidity risk and asset match.The findings inspire firm risk management policies from managerial overconfidence.

  13. Fortune Favours the Bold: An Agent-Based Model Reveals Adaptive Advantages of Overconfidence in War

    Science.gov (United States)

    Johnson, Dominic D. P.; Weidmann, Nils B.; Cederman, Lars-Erik

    2011-01-01

    Overconfidence has long been considered a cause of war. Like other decision-making biases, overconfidence seems detrimental because it increases the frequency and costs of fighting. However, evolutionary biologists have proposed that overconfidence may also confer adaptive advantages: increasing ambition, resolve, persistence, bluffing opponents, and winning net payoffs from risky opportunities despite occasional failures. We report the results of an agent-based model of inter-state conflict, which allows us to evaluate the performance of different strategies in competition with each other. Counter-intuitively, we find that overconfident states predominate in the population at the expense of unbiased or underconfident states. Overconfident states win because: (1) they are more likely to accumulate resources from frequent attempts at conquest; (2) they are more likely to gang up on weak states, forcing victims to split their defences; and (3) when the decision threshold for attacking requires an overwhelming asymmetry of power, unbiased and underconfident states shirk many conflicts they are actually likely to win. These “adaptive advantages” of overconfidence may, via selection effects, learning, or evolved psychology, have spread and become entrenched among modern states, organizations and decision-makers. This would help to explain the frequent association of overconfidence and war, even if it no longer brings benefits today. PMID:21731627

  14. The Role of Short-Term Memory Capacity and Task Experience for Overconfidence in Judgment under Uncertainty

    Science.gov (United States)

    Hansson, Patrik; Juslin, Peter; Winman, Anders

    2008-01-01

    Research with general knowledge items demonstrates extreme overconfidence when people estimate confidence intervals for unknown quantities, but close to zero overconfidence when the same intervals are assessed by probability judgment. In 3 experiments, the authors investigated if the overconfidence specific to confidence intervals derives from…

  15. Opinions in Denmark on the causes of peptic ulcer disease. A survey among Danish physicians and patients

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T; Andersen, I B

    1994-01-01

    of medicine, and working conditions played a causal role. Around 95% of the physicians indicated that medical drugs and smoking were contributory causes of peptic ulcer disease, and around 80% that alcohol and psychologic factors were so. Only 30-40% of the physicians believed that coffee/tea, food habits...... stated more causes than did their male colleagues (p smoking, side effects......, infection, and working conditions could play a causal role in ulcer disease. It is concluded that the opinion on causal agents in peptic ulcer disease differ considerably among both patients and physicians. Opinions on causes of diseases may influence the way we treat and advise our patients, and attempts...

  16. Determinants of favourable opinions about euthanasia in a sample of French physicians.

    Science.gov (United States)

    Dany, Lionel; Baumstarck, Karine; Dudoit, Eric; Duffaud, Florence; Auquier, Pascal; Salas, Sébastien

    2015-11-05

    The question whether euthanasia should be legalised has led to substantial public debate in France. The objective of this study in a sample of French physicians was to establish the potential determinants of a favourable opinion about euthanasia in general and when faced with a specific situation as embodied in the Humbert affair. The study was a cross-sectional survey investigating two different samples of medical doctors: (1) those specialised in palliative care and affiliated to the French Society for Patient Accompaniment and Palliative Care; (2) medical interns (medical doctors in training course) in a French medical university (Marseille). A questionnaire was sent (email) to each voluntary participant including sociodemographics, professional status, mention of believing in God, and opinion about euthanasia (the question was designed to assess the general opinion about euthanasia and the opinion about a specific case, the Vincent Humbert' case (a man who was rendered quadriplegic, blind, and mute after an accident and has requested euthanasia). A total of 413 physicians participated in the research (participation rate: 48.5%). Less than half of the population were favourable to euthanasia in general and almost two-thirds of the population were favourable to Vincent Humbert's request for euthanasia. Based on the multivariate analysis, individuals believing in God and being a medical intern were significant independent factors linked to having a favourable opinion about euthanasia in general and about the Vincent Humbert's request. There is still no study in France on the development of opinion about euthanasia and its impact. The issue goes beyond the strictly professional sphere and involves broader socio-political stakes. These stakes do not necessarily take into account medical practices and experiences or the desires of end-of-life patients. The professional upheaval that the future French legal framework will doubtlessly trigger will require further

  17. Direct-to-consumer pharmaceutical advertising: physician and public opinion and potential effects on the physician-patient relationship.

    Science.gov (United States)

    Robinson, Andrew R; Hohmann, Kirsten B; Rifkin, Julie I; Topp, Daniel; Gilroy, Christine M; Pickard, Jeffrey A; Anderson, Robert J

    2004-02-23

    Previous studies have shown that direct-to-consumer (DTC) pharmaceutical advertising can influence consumer behavior and that many physicians have negative views of these advertisements. Physician and public opinions about these advertisements and how they may affect the physician-patient relationship are not well established. Mail survey of 523 Colorado physicians and 261 national physicians and telephone survey of 500 Colorado households asking respondents to rate their agreement with statements about DTC advertising. Most physicians tended to view DTC advertisements negatively, indicating that such advertisements rarely provide enough information on cost (98.7%), alternative treatment options (94.9%), or adverse effects (54.8%). Most also believed that DTC advertisements affected interactions with patients by lengthening clinical encounters (55.9%), leading to patient requests for specific medications (80.7%), and changing patient expectations of physicians' prescribing practices (67.0%). Only 29.0% of public respondents agreed that DTC advertising is a positive trend in health care and 28.6% indicated that advertisements make them better informed about medical problems; fewer indicated that advertisements motivated them to seek care (10.5%) or led them to request specific medications from their physicians (13.3%). Most physicians have negative views of DTC pharmaceutical advertising and see several potential effects of these advertisements on the physician-patient relationship. Many public respondents have similarly negative views, and only a few agree that they change their expectations of or interactions with physicians. While these advertisements may be influencing only a few consumers, it seems that the impact on physicians and their interactions with patients may be significant.

  18. [Opinion of primary care physicians from Ourense on various features of the pharmaceutical prescription].

    Science.gov (United States)

    Díaz Grávalos, G J; Palmeiro Fernández, G; Núnñez Masid, E; Casado Górriz, I

    2001-01-01

    To learn the opinion of the primary care Physicians of Ourense (Spain) with respect to certain aspects of their prescription of medicines, such as their awareness of the price of drugs, the induced prescribing perceived, their relationship with the pharmaceutical industry and their opinions concerning possible measures for reducing the expenditure on medicines. In this transversal descriptive study, all of the primary care physicians in the province of Ourense (243) were surveyed by means of a previously-approved questionnaire sent to them by post. The questionnaire included demographic characteristics of the physicians, the influence of cost when prescribing medicines, their estimate of the price of 15 drugs routinely prescribed and their opinion on different aspects relating to induced prescription, the pharmaceutical industry and different strategies in order to curtail the expenditure on medicines. In order to analyze the results, the chi 2 and Student's t tests and an analysis of the variance were used, together with the Spearman correlation coefficient with alpha = 0.05. The level of participation of the physicians surveyed was 42.8% (104). The average daily duration of visits by pharmaceutical company representatives was 13.6 minutes, with new specialities being the topic of greatest interest. Close to 27% admitted to having participated in clinical testing sponsored by the industry. 23% considered the price to be a priority when prescribing. Induced prescription accounted for 39.7% of the total. The majority of physicians chose co-payment as the means for reducing expenditure on medicines. In the estimate of prices, the overall percentage of error was 45.7%, underestimating the more expensive medicines and overestimating the less expensive. There is a significant lack of awareness of the price of drugs among the primary care physicians. Most of the physicians do not feel that the price of a drug should be a priority when prescribing medicines. There is a

  19. Opinions in Denmark on the causes of peptic ulcer disease. A survey among Danish physicians and patients

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T; Andersen, I B

    1994-01-01

    stated more causes than did their male colleagues (p stress, were contributory causes of peptic ulcer disease, whereas only around 40% believed that coffee/tea, alcohol, smoking, side effects...... of medicine, and working conditions played a causal role. Around 95% of the physicians indicated that medical drugs and smoking were contributory causes of peptic ulcer disease, and around 80% that alcohol and psychologic factors were so. Only 30-40% of the physicians believed that coffee/tea, food habits......, infection, and working conditions could play a causal role in ulcer disease. It is concluded that the opinion on causal agents in peptic ulcer disease differ considerably among both patients and physicians. Opinions on causes of diseases may influence the way we treat and advise our patients, and attempts...

  20. Estimating the relationship between skill and overconfidence

    NARCIS (Netherlands)

    Feld, Jan; Sauermann, Jan; de Grip, Andries

    2017-01-01

    The Dunning–Kruger effect states that low performers vastly overestimate their performance while high performers more accurately assess their performance. Researchers usually interpret this empirical pattern as evidence that the low skilled are vastly overconfident while the high skilled are more

  1. Estimating the Relationship between Skill and Overconfidence

    NARCIS (Netherlands)

    Feld, Jan; Sauermann, Jan; de Grip, Andries

    2017-01-01

    The Dunning–Kruger effect states that low performers vastly overestimate their performance while high performers more accurately assess their performance. Researchers usually interpret this empirical pattern as evidence that the low skilled are vastly overconfident while the high skilled are more

  2. Differences between patient and physician opinions on adherence to medication for hypertension and diabetes mellitus.

    Science.gov (United States)

    Liguori, Yuji; Murase, Katsuhito; Hamamura, Misako

    2016-09-01

    Non-adherence to prescribed medication presents a barrier to effective treatment. In order to find improved ways of tackling non-adherence, it is important to understand the perspective of both patients and physicians. A web-based survey study was performed to obtain the views and opinions of patients receiving medical treatment for hypertension or diabetes mellitus in Japan, and physicians treating such patients, on adherence to medication. Forty-four percent of both physicians and patients placed great importance on medication adherence, but 11% of patients considered it of low importance. Overall, 85% of patients reported taking their medication correctly. Patients missed a mean of 4.8 or 5.4 daily doses per 30 day prescription based on patient and physician estimates, respectively. Both patients (64%) and physicians (23%) considered the main reason patients forgot to take their medication was that they "inadvertently forgot". Only 1% of physicians said they do not specifically check for residual drugs, but 46% of patients said they do not report missed doses to their doctor. Measures taken by physicians to reduce residual drugs included use of single packs (64%) and reductions in administration frequency (55%); 63% adjusted prescriptions to take account of any remaining drugs. Only 4% of physicians were satisfied with the effectiveness of measures to reduce non-adherence, whereas 59% of patients felt they managed to successfully perform measures to avoid forgetting to take drugs. The study questionnaires were newly developed and did not incorporate validated instruments to assess adherence. Similar proportions of physicians and patients consider medication adherence to be important, but their opinions about measures used to improve adherence differ to some extent. Importantly, almost half of patients do not tell their doctor about missed doses.

  3. THE IMPACT OF OVERCONFIDENCE ON CAPITAL STRUCTURE IN TURKEY

    Directory of Open Access Journals (Sweden)

    Serpil Tomak

    2013-04-01

    Full Text Available The aim of this study is to investigate the relationship between the overconfidence and capital structure in Turkish manufacturing firms. In addition to management confidence, the impact of the fundamental factors on the market leverage is analyzed. The annual data of 115 manufacturing firms on the Istanbul Stock Exchange (ISE for the period between 2002 and 2011 is used for the analysis by means of the ordinary least squares regression model. The results show that the relationship between confidence and leverage is ambiguous. There isn’t enough evidence for the idea of overconfident managers tends to use more debt level. However, this study provides some evidence for firm specific factors like size and profitability effects on leverage.

  4. Evidence of the overconfidence bias in the Egyptian stock market in different market states

    Directory of Open Access Journals (Sweden)

    Ayman H. Metwally

    2015-11-01

    Full Text Available Traditional finance theories fail to explain several anomalies observed in security markets. High levels of market turnover are among the most challenging market puzzles that have been documented in many security markets. Several studies assert the correlation between past market return and current market turnover. Behavioral finance theories assume that overconfidence bias is the reason behind this relation. Hence, this paper aims to study the impact of overconfidence – a behavioral bias stemming from the second building block of behavioral finance “cognitive psychology” and affecting traders’ beliefs and thereby their trading behavior in form of excessive trading. DeBondt and Tahler (1995. The study tests the overconfidence bias in the Egyptian Stock market during the period from 2002 till 2012 on the aggregate market level trough examining the relation between market returns and market turnover in different market states, seeking to document or deny whether overconfidence bias encourages investors to trade or not . The whole period is divided into four sub periods; two tranquil upward trending (2005-2005 and (2005-2008 and two volatile and down ward trending (financial crisis 2008-2010 and the (Egyptian Revolution Period 2010-2012 A quantitative research using secondary data and applying time series statistical techniques is designed. The research is following Statman et al. (2006 methodology. Time series analysis, which is based on four statistical techniques; mainly Vector Auto Regression, Optimal Lag Selection, Impulse Response Function and Granger Causality Tests are being used. Market Turnover ratios are used as proxies for overconfidence. The research finds a significant impact of past market return on current turnover in lag1, then turns negative in lag 2, and returns back positive in lag3, then remains positive and significant until lag5. This is in line with the overconfidence and self-attribution theory of Denial et al

  5. Concordance of opinions between patients and physicians and their relationship with symptomatic control and future risk in patients with moderate-severe asthma.

    Science.gov (United States)

    Crespo-Lessmann, Astrid; Plaza, Vicente; González-Barcala, Francisco-Javier; Fernández-Sánchez, Toni; Sastre, Joaquín

    2017-01-01

    Differences between the opinions of patients and physicians on the impact of asthma are common. We hypothesised that patient-physician discordance may negatively affect asthma outcome. A total of 2902 patients (61% women, mean age 47 years) with moderate-severe asthma and 231 physicians participated in a prospective study. At the baseline visit, data on demographics, clinical variables, degree of asthma control according to the Asthma Control Test (ACT), basic spirometry and the Hospital Anxiety and Depression Scale (HADS) were collected and an ad hoc questionnaire was completed that allowed the degree of concordance between doctors and patients to be assessed. A scheduled telephone call after 3 months was used to elicit the ACT score and the future risk of asthma. At the final visit at 6 months, the following data were recorded: ACT score, spirometry, HADS score and an ad hoc questionnaire to assess the agreement between the doctor and the patient. Changes in study variables according to patient-physician concordance or discordance were analysed. The rate of patient-physician discordance was 27.2%, with overestimation of disease impact by the physician in 12.3% and underestimation in 14.9%. Patient-physician opinion discordance, particularly in the case of physicians underestimating the impact of asthma, showed worse results with statistically significant differences in ACT score, a higher percentage of patients with poor asthma control and lower HADS scores. The need for hospital and emergency department admissions was also higher. Patient-physician opinion discordance may be contributing to lower symptomatic control and increased future risk, with a higher impact when physicians underestimate the impact of asthma on their patients.

  6. Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public.

    Science.gov (United States)

    Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; van Tol, Donald G; van de Vathorst, Suzanne; de Graeff, Nienke; Weyers, Heleen A M; van der Heide, Agnes; van Thiel, Ghislaine J M W

    2015-01-28

    The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia. In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia. Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients' autonomous wishes and the unbearableness of their suffering. Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients' request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.

  7. Opinions in Denmark on the causes of peptic ulcer disease. A survey among Danish physicians and patients

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T; Andersen, I B

    1994-01-01

    The aim of the study was to investigate opinions among Danish patients and physicians on causes of peptic ulcer disease. Fifty-nine patients with an ulcer history and 77 physicians with a special interest in gastroenterology participated. They were given a questionnaire listing 16 possible causes...... of peptic ulcer and indicated for each whether they believed it was a contributory cause of the disease. The patients stated 0-10 causes each (median, 4), and the physicians 3-12 causes (median, 6) (p ... stated more causes than did their male colleagues (p peptic ulcer disease, whereas only around 40% believed that coffee/tea, alcohol, smoking, side effects...

  8. Are Entrepreneurs more Optimistic and Overconfident than Managers and Employees?

    DEFF Research Database (Denmark)

    Koudstaal, Martin; Sloof, Randolph; Van Praag, Mirjam

    Empirical evidence supports the conventional wisdom that entrepreneurs are more optimistic and overconfident than others. However, the same holds true for top managers. In this lab-in-the-field experiment we directly compare the scores of entrepreneurs, managers and employees on a comprehensive s...

  9. Composition of emergency medical services teams and the problem of specialisation of emergency medical services physicians in the opinions of occupationally active paramedics

    Directory of Open Access Journals (Sweden)

    Dorota Rębak

    2015-01-01

    Full Text Available Introduction: Emergency medicine includes prevention, prehospital care, specialised treatment, rehabilitation, and education. Aim of the research: The objective of the analysis was to determine the opinions of paramedics concerning the problem of the composition of emergency medical services (EMS teams and specialisation of EMS system physicians according to their education level and sense of coherence. Material and methods: The study was conducted among 336 occupationally active paramedics working in EMS teams delivering prehospital care in selected units in Poland. The study was conducted at Ambulance Stations and in Hospital Emergency Departments, which within their structure had an out-of-hospital EMS team. The study was conducted by the method of a diagnostic survey, and the research instrument was the Orientation to Life Questionnaire SOC-29 and a questionnaire designed by the author. Results: The respondents who had licentiate education relatively more frequently indicated paramedics with licentiate education level as persons most suitable to undertake medical actions (26.32% rather than physicians (21.05%. Paramedics with 2-year post-secondary school education relatively more often mentioned physicians (33.07% than those with licentiate education (17.32%. As many as 89.58% of the paramedics reported the need for a physician in the composition of the EMS team delivering prehospital care, while only 10.42% of them expressed an opinion that there should be teams composed of paramedics only. According to 30.65% of respondents, EMS team delivering prehospital care should include a physician with the specialty in emergency medicine, whereas 8.04% of respondents reported the need for a physician, irrespective of specialisation. However, 42.56% of the paramedics expressed an opinion that a physician is needed only in a specialist team with a specialisation in emergency medicine. The opinions of the paramedics concerning the need for a physician

  10. The Effect of Subjective Risk Attitudes and Overconfidence on Risk Taking Behaviors: A Experimental Study Based on Traders of the Chinese Stock Market

    Science.gov (United States)

    Chen, Qi-An; Xiao, Yinghong; Chen, Hui; Chen, Liang

    Our research analyzes the effect of the traders’ subjective risk attitude, optimism and overconfidence on their risk taking behaviors on the Chinese Stock Market by experimental study method. We find that investors’ risk taking behavior is significantly affected by their subjective risk attitude, optimism and overconfidence. Our results also argue that the objective return and volatility of stock are not as good predictors of risk taking behavior as subjective risk and return measures. Moreover, we illustrate that overconfidence and optimism have an significant impact on risk taking behavior In line with theoretical models.

  11. Overconfidence, Managerial Optimism, and the Determinants of Capital Structure

    Directory of Open Access Journals (Sweden)

    Alexandre di Miceli da Silveira

    2008-12-01

    Full Text Available This research examines the determinants of the capital structure of firms introducing a behavioral perspective that has received little attention in corporate finance literature. The following central hypothesis emerges from a set of recently developed theories: firms managed by optimistic and/or overconfident people will choose more levered financing structures than others, ceteris paribus. We propose different proxies for optimism/overconfidence, based on the manager’s status as an entrepreneur or non-entrepreneur, an idea that is supported by theories and solid empirical evidence, as well as on the pattern of ownership of the firm’s shares by its manager. The study also includes potential determinants of capital structure used in earlier research. We use a sample of Brazilian firms listed in the Sao Paulo Stock Exchange (Bovespa in the years 1998 to 2003. The empirical analysis suggests that the proxies for the referred cognitive biases are important determinants of capital structure. We also found as relevant explanatory variables: profitability, size, dividend payment and tangibility, as well as some indicators that capture the firms’ corporate governance standards. These results suggest that behavioral approaches based on human psychology research can offer relevant contributions to the understanding of corporate decision making.

  12. OVERCONFIDENCE, OMENS AND EMOTIONS: RESULTS FROM A FIELD EXPERIMENT

    OpenAIRE

    Maria De Paola; Francesca Gioia; Vincenzo Scoppa

    2013-01-01

    We analyze how overconfidence is affected by superstitious beliefs and emotions induced by positive and negative stimuli in a field experiment involving about 700 Italian students who were randomly assigned to numbered seats in their written examination sessions. According to widespread superstitions, some numbers are considered lucky, while others are considered unlucky. At the end of the examination, we asked students the grade they expected to get. We find that students tend to be systemat...

  13. The Overconfident Principles of Economics Student: An Examination of a Metacognitive Skill.

    Science.gov (United States)

    Grimes, Paul W.

    2002-01-01

    Examined the effect of demographic characteristics, academic endowments, course preparation, and course performance variables on the accuracy of pretest expectations when asking students to predict their performance on a regularly scheduled macroeconomics midterm examination. Finds overconfidence and misjudgments about the scope of the midterm…

  14. A Graph is Worth a Thousand Words: How Overconfidence and Graphical Disclosure of Numerical Information Influence Financial Analysts Accuracy on Decision Making.

    Directory of Open Access Journals (Sweden)

    Ricardo Lopes Cardoso

    Full Text Available Previous researches support that graphs are relevant decision aids to tasks related to the interpretation of numerical information. Moreover, literature shows that different types of graphical information can help or harm the accuracy on decision making of accountants and financial analysts. We conducted a 4×2 mixed-design experiment to examine the effects of numerical information disclosure on financial analysts' accuracy, and investigated the role of overconfidence in decision making. Results show that compared to text, column graph enhanced accuracy on decision making, followed by line graphs. No difference was found between table and textual disclosure. Overconfidence harmed accuracy, and both genders behaved overconfidently. Additionally, the type of disclosure (text, table, line graph and column graph did not affect the overconfidence of individuals, providing evidence that overconfidence is a personal trait. This study makes three contributions. First, it provides evidence from a larger sample size (295 of financial analysts instead of a smaller sample size of students that graphs are relevant decision aids to tasks related to the interpretation of numerical information. Second, it uses the text as a baseline comparison to test how different ways of information disclosure (line and column graphs, and tables can enhance understandability of information. Third, it brings an internal factor to this process: overconfidence, a personal trait that harms the decision-making process of individuals. At the end of this paper several research paths are highlighted to further study the effect of internal factors (personal traits on financial analysts' accuracy on decision making regarding numerical information presented in a graphical form. In addition, we offer suggestions concerning some practical implications for professional accountants, auditors, financial analysts and standard setters.

  15. A Graph is Worth a Thousand Words: How Overconfidence and Graphical Disclosure of Numerical Information Influence Financial Analysts Accuracy on Decision Making.

    Science.gov (United States)

    Cardoso, Ricardo Lopes; Leite, Rodrigo Oliveira; de Aquino, André Carlos Busanelli

    2016-01-01

    Previous researches support that graphs are relevant decision aids to tasks related to the interpretation of numerical information. Moreover, literature shows that different types of graphical information can help or harm the accuracy on decision making of accountants and financial analysts. We conducted a 4×2 mixed-design experiment to examine the effects of numerical information disclosure on financial analysts' accuracy, and investigated the role of overconfidence in decision making. Results show that compared to text, column graph enhanced accuracy on decision making, followed by line graphs. No difference was found between table and textual disclosure. Overconfidence harmed accuracy, and both genders behaved overconfidently. Additionally, the type of disclosure (text, table, line graph and column graph) did not affect the overconfidence of individuals, providing evidence that overconfidence is a personal trait. This study makes three contributions. First, it provides evidence from a larger sample size (295) of financial analysts instead of a smaller sample size of students that graphs are relevant decision aids to tasks related to the interpretation of numerical information. Second, it uses the text as a baseline comparison to test how different ways of information disclosure (line and column graphs, and tables) can enhance understandability of information. Third, it brings an internal factor to this process: overconfidence, a personal trait that harms the decision-making process of individuals. At the end of this paper several research paths are highlighted to further study the effect of internal factors (personal traits) on financial analysts' accuracy on decision making regarding numerical information presented in a graphical form. In addition, we offer suggestions concerning some practical implications for professional accountants, auditors, financial analysts and standard setters.

  16. Experiences and Opinions Related to End-of-Life Discussion: From Oncologists' and Resident Physicians' Perspectives.

    Science.gov (United States)

    Koh, Su-Jin; Kim, Shinmi; Kim, JinShil; Keam, Bhumsuk; Heo, Dae Seog; Lee, Kyung Hee; Kim, Bong-Seog; Kim, Jee Hyun; Chang, Hye Jung; Baek, Sun Kyung

    2018-04-01

    The aims of this study were to explore how oncologists and resident physicians practice end-of-life (EOL) discussions and to solicit their opinions on EOL discussions as a means to improve the quality of EOL care. A survey questionnaire was developed to explore the experiences and opinions about EOL discussions among oncologists and residents. Descriptive statistics, the t test, and the chisquare test were performed for the analyses. A total of 147 oncologists and 229 residents participated in this study. The study respondents reported diverse definitions of "terminal state," and mostrespondents tried to disclose the patient's condition to the patient and/or family members. Both groups were involved in EOL care discussions, with a rather low satisfaction level (57.82/100). The best timing to initiate discussionwas consideredwhen metastasis or disease recurrence occurred orwhen withdrawal of chemotherapy was anticipated. Furthermore, the study respondents suggested that patients and their family members should be included in the EOL discussion. Medical, legal, and ethical knowledge and communication difficulties along with practical issues were revealed as barriers and facilitators for EOL discussion. This study explored various perspectives of oncologists and resident physicians for EOL discussion. Since the Life-Sustaining-Treatment Decision-Making Act will be implemented shortly in Korea, now is the time for oncologists and residents to prepare themselves by acquiring legal knowledge and communication skills. To achieve this, education, training, and clinical tools for healthcare professionals are required.

  17. Information, Overconfidence and Trading: Do the Sources of Information Matter?

    OpenAIRE

    Margarida Abreu; Victor Mendes

    2011-01-01

    We investigate how the strength of the positive association between frequency of trading and information acquisition is dependent on investors’ self‐confidence and on the sources of information used by investors. Our results confirm that the more frequently individual investors invest in information, the more they trade in financial products. Our results also confirm previous findings that overconfident investors, who show a better than average bias, trade more frequently. In this paper, we a...

  18. Survey of United States Army Physician Opinion: The Issue of Written ’Do Not Resuscitate’ Orders

    Science.gov (United States)

    1984-08-01

    Westminister Press, 1975), p. 176-7. 71Cushing, p. 29. 72Alexander, p. 26. 73Kevin M. McIntyre, "Mediolegal Aspects of Decision Making in Resuscitation and Life...34Physicians Opinions Toward Legislation Defining Death and Withholding Life Support," Southern Medical Journal 74 (February 1981): 215-18. 82Norman K...Louis S. Let the Patient Decide. Philadelphia: The Westminister Press, 1978. Browning, Mary H. and Lewis, Edith P. comps. The Dying Patient: A Nursing

  19. [Opinion and Participation in the Regional Early Breast Cancer Detection Program in 2007 on the part of family physicians from a health district in the Autonomous Community of Madrid, Spain].

    Science.gov (United States)

    Garrido Elustondo, Sofía; Sánchez Padilla, Elisabeth; Ramírez Alesón, Victoria; González Hernández, Ma José; González Navarro, Andrés; López Gómez, Carlos

    2008-01-01

    Mammogram screening is the most effective method for the early detection of breast cancer. The objective of this study is to evaluate the degree of knowledge, the opinion and the participation in the early breast cancer detection program on the part of the family physicians of the Autonomous Community of Madrid. The population studied was comprised of family physicians from Madrid Health District Seven. An anonymous, self-administered questionnaire comprised of 30 questions grouped into physicians characteristics and opinion concerning the early breast cancer detection programs. A total of 46% of the physicians replied. A total of 94% of the physicians believed that it is their duty to inform their patients concerning preventive activities, including breast cancer screening, and 95% believed their advice to be useful for convincing women to have a mammogram. A total of 72% believed information to be lacking on this program. During the time when mammograms are being taken at their centres, 24% of the physicians surveyed always or almost always ask the women if they have any doubts or would like further information, 43% having set up appointments for them and 95% advising them to have a mammogram taken. The family physicians have a good opinion of the early breast cancer detection program and feel their advice to be effective for improving the participation in the program. They report lack of information and inform women about the program to only a small degree.

  20. The Knowledge Level and Opinions of Physicians about the Medical and Legal Procedures Related to Physical Child Abuse

    Directory of Open Access Journals (Sweden)

    Sema Demirçin

    2017-04-01

    Full Text Available Background: In order to diagnose child abuse, physicians need to consider the possibility of abuse in every child they encounter, have sufficient information about the topic and manage the cases according to current law. Aims: To determine the knowledge level of physicians on child abuse and to learn their opinions about the procedures when they suspect child abuse. Study Design: A questionnaire (cross-sectional study. Methods: A detailed questionnaire was applied to 390 physicians of whom 233 were general practitioners. The first part of the questionnaire included demographic variables (age, gender, occupational experience and the frequency of child physical abuse cases encountered, since that is the most easily diagnosed and proven form of abuse. The second part consisted of 32 questions about diagnosis of physical child abuse and procedures during the follow-up of the cases. Statistical analyses were performed using SPSS version 18.0. Results: Of the participating physicians, 47.4% (n=185 were female and only 13.1% of the physicians had some kind of postgraduate training on child abuse. The correct response rate of specialists compared to general practitioners was significantly higher. A total of 263 (72.3% physicians thought that there was a specific law on physical child abuse in the Turkish Republic. More than two-thirds of physicians thought that reporting should only be addressed to Social Services and physicians should not be obliged to report to law enforcement. Conclusion: The results of the present study adds to the already known necessity for better training of physicians about physical child abuse and the need to refresh their knowledge through postgraduate courses. According to current regulations, it is obligatory to report abuse cases to the public prosecutor and/or police, therefore physicians also need training in respect of the legal status and medico-legal approach to these cases

  1. Research on Overconfidence in Decision-Making for the Capacity Recovery of Damaged Power Systems

    Directory of Open Access Journals (Sweden)

    Xing Bao

    2014-01-01

    Full Text Available This paper studies the influence of two types of overconfident behavior, overestimation and overprecision, on decision of capacity recovery when power system’s critical capacity is seriously damaged. A newsvendor model is used to prove that increasing regulatory punishment for electricity shortage and providing subsidy for capacity recovery are conducive measures to calibrate insufficient service level caused by an overconfident manager. The research also finds that the manager’s overprecision behavior both negatively and positively influences the decision of capacity recovery, and a calibration method could motivate manager to recover more capacity by tuning up the ratio of punishment and subsidy. However, the effectiveness of the calibration mentioned above is inevitably weakened due to the less capacity recovery given by an overestimated manager. This research also indicates that the manager should pay close attention to the random disturbance whose distribution peak is left skewed, and correspondingly more capacity recovery should be given to improve the service level of power system during the disruption.

  2. A delphi exercise to identify characteristic features of gout - opinions from patients and physicians, the first stage in developing new classification criteria.

    Science.gov (United States)

    Prowse, Rebecca L; Dalbeth, Nicola; Kavanaugh, Arthur; Adebajo, Adewale O; Gaffo, Angelo L; Terkeltaub, Robert; Mandell, Brian F; Suryana, Bagus P P; Goldenstein-Schainberg, Claudia; Diaz-Torne, Cèsar; Khanna, Dinesh; Lioté, Frederic; Mccarthy, Geraldine; Kerr, Gail S; Yamanaka, Hisashi; Janssens, Hein; Baraf, Herbert F; Chen, Jiunn-Horng; Vazquez-Mellado, Janitzia; Harrold, Leslie R; Stamp, Lisa K; Van De Laar, Mart A; Janssen, Matthijs; Doherty, Michael; Boers, Maarten; Edwards, N Lawrence; Gow, Peter; Chapman, Peter; Khanna, Puja; Helliwell, Philip S; Grainger, Rebecca; Schumacher, H Ralph; Neogi, Tuhina; Jansen, Tim L; Louthrenoo, Worawit; Sivera, Francisca; Taylor, William J; Alten, Rieke

    2013-04-01

    To identify a comprehensive list of features that might discriminate between gout and other rheumatic musculoskeletal conditions, to be used subsequently for a case-control study to develop and test new classification criteria for gout. Two Delphi exercises were conducted using Web-based questionnaires: one with physicians from several countries who had an interest in gout and one with patients from New Zealand who had gout. Physicians rated a list of potentially discriminating features that were identified by literature review and expert opinion, and patients rated a list of features that they generated themselves. Agreement was defined by the RAND/UCLA disagreement index. Forty-four experienced physicians and 9 patients responded to all iterations. For physicians, 71 items were identified by literature review and 15 more were suggested by physicians. The physician survey showed agreement for 26 discriminatory features and 15 as not discriminatory. The patients identified 46 features of gout, for which there was agreement on 25 items as being discriminatory and 7 items as not discriminatory. Patients and physicians agreed upon several key features of gout. Physicians emphasized objective findings, imaging, and patterns of symptoms, whereas patients emphasized severity, functional results, and idiographic perception of symptoms.

  3. Child abuse consultations initiated by child protective services: the role of expert opinions.

    Science.gov (United States)

    McGuire, Lindsay; Martin, Kimberly D; Leventhal, John M

    2011-01-01

    To describe consultations provided by child abuse pediatricians for cases referred by child protective services (CPS); compare the opinions of the likelihood of child maltreatment of the initial physician, CPS, and the child abuse pediatrician; and examine predictors of the experts' opinions. Cases were referred by CPS for consultations between March 1, 1998, and June 30, 2005, to 2 child abuse pediatricians at Yale-New Haven Children's Hospital. We abstracted demographic and clinical information and the opinions of the initial physician, CPS, and the child abuse expert, each coded using a 5-point scale from definite maltreatment to definite benign cause (eg, accident). Of 187 cases, 50.3% occurred in children younger than 1 year of age. Children's most serious injuries were fractures (50.8%), burns (16.6%), and bruises/abrasions (15.0%). The child abuse experts' opinions were 47.6% definite or probable maltreatment, 8.6% uncertain, and 43.9% definite or probable benign. Of the 119 cases with opinions from all 3 assessors, the expert agreed with the physician in 57.1% of cases (κ = 0.34) and with CPS in 64.7% (κ = 0.42). The best predictor of the expert's opinion that the injury was due to maltreatment was agreement between the physician and CPS that maltreatment had occurred. Levels of agreement were fair to poor between the child abuse expert and either the physician or CPS. Child abuse experts' opinions have important value in selected cases to confirm previous assessments by the physician and/or CPS, or to change the opinion of the case. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  4. ACOG Committee Opinion No. 587: Effective patient-physician communication.

    Science.gov (United States)

    2014-02-01

    Physicians' ability to effectively and compassionately communicate information is key to a successful patient-physician relationship. The current health care environment demands increasing clinical productivity and affords less time with each patient, which can impede effective patient-physician communication. The use of patient-centered interviewing, caring communication skills, and shared decision making improves patient-physician communication. Involving advanced practice nurses or physician assistants may improve the patient's experience and understanding of her visit. Electronic communication with established patients also can enhance the patient experience in select situations.

  5. Different opinions of physicians on the importance of measures to prevent acquisition of Pseudomonas aeruginosa from the environment.

    Science.gov (United States)

    Steinkamp, Gratiana; Ullrich, Gerald

    2003-12-01

    Since chronic infection with mucoid Pseudomonas aeruginosa (PA) is associated with deteriorating lung function, many parents of young children with cystic fibrosis (CF) fear the first PA positive throat swab as a milestone in the progression of the disease. To reduce the risk of PA acquisition from the environment, they perform preventive measures at home or outdoors. In an attempt to evaluate the attitude of CF physicians towards these measures and the respective consulting practice, we mailed a questionnaire to all 65 certified paediatric CF centres in Germany. Physicians from 54 (83%) CF clinics replied. They expressed widely different ideas about the impact of the environment for the acquisition of P. aeruginosa, and recommended a large spectrum of preventive measures. Some physicians proposed only few precautions, which focussed on the prevention of cross-infection between patients, whereas others suggested prevention of any contact with moist or wet places, e.g. use different toothbrushes for mornings and evenings, or do without air-conditioning in the car. CF physicians have different opinions on the risk of PA acquisition from the environment. Doctors who recommend strict precautions could engender a parental fear of a ubiquous threat from invisible bacteria. The resulting extended safety measures might impair the family's quality of life. Copyright 2003 European Cystic Fibrosis Society

  6. Depression, realism, and the overconfidence effect: are the sadder wiser when predicting future actions and events?

    Science.gov (United States)

    Dunning, D; Story, A L

    1991-10-01

    Do depressed individuals make more realistic judgments than their nondepressed peers in real world settings? Depressed and nondepressed Ss in 2 studies were asked to make predictions about future actions and outcomes that might occur in their personal academic and social worlds. Both groups of Ss displayed overconfidence, that is, they overestimated the likelihood that their predictions would prove to be accurate. Of key importance, depressed Ss were less accurate in their predictions, and thus more overconfident, than their nondepressed counterparts. These differences arose because depressed Ss (a) were more likely to predict the occurrence of low base-rate events and (b) were less likely to be correct when they made optimistic predictions (i.e., stated that positive events would occur or that aversive outcomes would not). Discussion focuses on implications of these findings for the depressive realism hypothesis.

  7. Opinions regarding neonatal resuscitation training for the obstetric physician: a survey of neonatal and obstetric training program directors.

    Science.gov (United States)

    Bruno, C J; Johnston, L; Lee, C; Bernstein, P S; Goffman, D

    2018-04-01

    Our goal was to garner opinions regarding neonatal resuscitation training for obstetric physicians. We sought to evaluate obstacles to neonatal resuscitation training for obstetric physicians and possible solutions for implementation challenges. We distributed a national survey via email to all neonatal-perinatal medicine fellowship directors and obstetrics & gynecology residency program directors in the United States. This survey was designed by a consensus method. Ninety-eight (53%) obstetric and fifty-seven (51%) neonatal program directors responded to our surveys. Eighty-eight percent of neonatologists surveyed believe that obstetricians should be neonatal resuscitation program (NRP) certified. The majority of surveyed obstetricians (>89%) believe that obstetricians should have some neonatal resuscitation training. Eighty-six percent of obstetric residents have completed training in NRP, but only 19% of obstetric attendings are NRP certified. Major barriers to NRP training that were identified include time, lack of national requirement, lack of belief it is helpful, and cost. Most obstetric attendings are not NRP certified, but the majority of respondents believe that obstetric providers should have some neonatal resuscitation training. Our study demonstrates that most respondents support a modified neonatal resuscitation course for obstetric physicians.

  8. Evaluation of the physicians‘ of n hospital opinion on clinical trials of medicinal products

    OpenAIRE

    Videikaitė, Lina

    2014-01-01

    Aim of the research. To evaluate the physicians‘ of N Hospital opinion on clinical trials of medicinal products. Objectives. To evaluate the factors affecting physicians' motivation to perform clinical trials of medicinal products as well as those that prevent the physicians getting involved in the trials. To assess physicians' attitude towards clinical trials of medicinal products. To compare the opinions of physicians who have and have’nt participated in clinical trials. Methods of...

  9. [Occupational aspects of emergency medicine practice in Catalonia: the OPENCAT opinion survey].

    Science.gov (United States)

    Jacob, Javier; Gené, Emili; Alonso, Gilberto; Rimbau, Pere; Zorrilla, José; Casarramona, Francesc; Netto, Cristina; Sánchez, Pere; Hernández, Ricard; Escalada, Xavier; Miró, Òscar

    2017-01-01

    To gather information on the contracting and training of members of the Catalan Society of Emergency Medicine (SoCMUE) who work in emergency medicine and services in Catalonia. To survey their opinions on certain aspects of resource availability and working conditions. Cross-sectional descriptive study based on a survey sent to SoCMUE members. We studied the opinions of 5 types of respondent: hospital physicians, out-of-hospital physicians, hospital nurses, out-of-hospital nurses, and emergency medical technicians. Responses were grouped to compare the opinions of physicians and nurses and workers in hospital and prehospital settings. We received 616 responses from 1273 members (48.4% response rate). More physicians than nurses come from outside Catalonia and have contracts specifically linked to emergency care; in addition, physicians have done less postgraduate training in emergency medicine. More hospital staff than prehospital staff have permanent contracts linked to the department where they work. More hospital physicians are specialized in internal medicine than in family and community medicine. The opinion that emergency services are inadequately staffed was widespread. Most respondents believed that patient transport is good or adequate. However, respondents working in prehospital services expressed a lower opinion of transport. Great difficulty in combining work with family (life achieving work-life balance) was expressed by 13.5% overall, and more often by hospital staff. Some type of aggression was experienced by 88.2%; 60% reported the event to superiors. Nurses reported aggression more often than physicians. A police report was filed by 10.1%. Emergency medicine working conditions can be improved in Catalonia according to members of SoCMUE. Relations between groups of professionals are not optimum in some aspects.

  10. DO SELF-THEORIES EXPLAIN OVERCONFIDENCE AND FINANCIAL RISK TAKING? A field experiment.

    OpenAIRE

    Bertrand Koebel; André Schmitt; Sandrine Spaeter

    2015-01-01

    How people develop beliefs about themselves (self-theories) plays an important role on motivation and achievement as shown by Carol Dweck’s life-long research. In this paper, we conduct a field experiment to investigate whether self-theories impact overconfidence and risk taking. Self-theories deal with how an individual perceives some of her attributes such as intelligence, personality or moral character. In this paper, we are interested by how people perceive their mindset (fixed or growth)...

  11. 42 CFR 411.382 - CMS's right to rescind advisory opinions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false CMS's right to rescind advisory opinions. 411.382... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.382 CMS's right to rescind advisory opinions. Any advice CMS gives in an opinion does not prejudice its right to reconsider...

  12. Building legitimacy by criticising the pharmaceutical industry: a qualitative study among prescribers and local opinion leaders.

    Science.gov (United States)

    Pittet, Anne-Laure; Saraga, Michael; Stiefel, Friedrich

    2015-01-01

    The literature has described opinion leaders not only as marketing tools of the pharmaceutical industry, but also as educators promoting good clinical practice. This qualitative study addresses the distinction between the opinion-leader-as-marketing-tool and the opinion-leader-as-educator, as it is revealed in the discourses of physicians and experts, focusing on the prescription of antidepressants. We explore the relational dynamic between physicians, opinion leaders and the pharmaceutical industry in an area of French-speaking Switzerland. Qualitative content analysis of 24 semistructured interviews with physicians and local experts in psychopharmacology, complemented by direct observation of educational events led by the experts, which were all sponsored by various pharmaceutical companies. Both physicians and experts were critical of the pharmaceutical industry and its use of opinion leaders. Local experts, in contrast, were perceived by the physicians as critical of the industry and, therefore, as a legitimate source of information. Local experts did not consider themselves opinion leaders and argued that they remained intellectually independent from the industry. Field observations confirmed that local experts criticised the industry at continuing medical education events. Local experts were vocal critics of the industry, which nevertheless sponsor their continuing education. This critical attitude enhanced their credibility in the eyes of the prescribing physicians. We discuss how the experts, despite their critical attitude, might still be beneficial to the industry's interests.

  13. Emotion perception and overconfidence in errors under stress in psychosis.

    Science.gov (United States)

    Köther, Ulf; Lincoln, Tania M; Moritz, Steffen

    2018-03-21

    Vulnerability stress models are well-accepted in psychosis research, but the mechanisms that link stress to psychotic symptoms remain vague. Little is known about how social cognition and overconfidence in errors, two putative mechanisms for the pathogenesis of delusions, relate to stress. Using a repeated measures design, we tested four groups (N=120) with different liability to psychosis (schizophrenia patients [n=35], first-degree relatives [n=24], participants with attenuated positive symptoms [n=19] and healthy controls [n=28]) and depression patients (n=14) as a clinical control group under three randomized experimental conditions (no stress, noise and social stress). Parallel versions of the Emotion Perception and Confidence Task, which taps both emotion perception and confidence, were used in each condition. We recorded subjective stress, heart rate, skin conductance level and salivary cortisol to assess the stress response across different dimensions. Independent of the stress condition, patients with schizophrenia showed poorer emotion perception performance and higher confidence in emotion perception errors than participants with attenuated positive symptoms and healthy controls. However, they did not differ from patients with depression or first-degree relatives. Stress did not influence emotion perception or the extent of high-confident errors, but patients with schizophrenia showed an increase in high-confident emotion perception errors conditional on higher arousal. A possible clinical implication of our findings is the necessity to provide stress management programs that aim to reduce arousal. Moreover, patients with schizophrenia might benefit from interventions that help them to reduce overconfidence in their social cognition judgements in times in which they feel being under pressure. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Behavioural breaks in the heterogeneous agent model: The impact of herding, overconfidence, and market sentiment

    Czech Academy of Sciences Publication Activity Database

    Kukačka, Jiří; Baruník, Jozef

    2013-01-01

    Roč. 392, č. 23 (2013), s. 5920-5938 ISSN 0378-4371 R&D Projects: GA ČR GA402/09/0965 Institutional support: RVO:67985556 Keywords : Heterogeneous agent model * Behavioural finance * Herding * Overconfidence * Market sentiment * Stock market crash Subject RIV: AH - Economics Impact factor: 1.722, year: 2013 http://library.utia.cas.cz/separaty/2013/E/barunik-0395344.pdf

  15. French hospital nurses' opinion about euthanasia and physician-assisted suicide: a national phone survey.

    Science.gov (United States)

    Bendiane, M K; Bouhnik, A-D; Galinier, A; Favre, R; Obadia, Y; Peretti-Watel, P

    2009-04-01

    Hospital nurses are frequently the first care givers to receive a patient's request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses' opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. A phone survey conducted among a random national sample of 1502 French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call "good" euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia.

  16. Illusion versus Reality: An Empirical Study of Overconfidence and Self Attribution Bias in Business Management Students

    Science.gov (United States)

    Sharma, Vinky; Shakeel, Moonis

    2015-01-01

    Students often exhibit overconfidence and self-attribution bias (SAB). The authors report the findings of a survey of management students across gender. They found why students fail to understand the fact that their performance was actually dismal while their belief about their ability to perform well was high. The results imply that all students…

  17. 42 CFR 411.380 - When CMS issues a formal advisory opinion.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false When CMS issues a formal advisory opinion. 411.380... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.380 When CMS issues a formal advisory opinion. (a) CMS considers an advisory opinion to be issued once it has received payment...

  18. Decision making under uncertainty, therapeutic inertia, and physicians' risk preferences in the management of multiple sclerosis (DIScUTIR MS).

    Science.gov (United States)

    Saposnik, Gustavo; Sempere, Angel Perez; Raptis, Roula; Prefasi, Daniel; Selchen, Daniel; Maurino, Jorge

    2016-05-04

    The management of multiple sclerosis (MS) is rapidly changing by the introduction of new and more effective disease-modifying agents. The importance of risk stratification was confirmed by results on disease progression predicted by different risk score systems. Despite these advances, we know very little about medical decisions under uncertainty in the management of MS. The goal of this study is to i) identify whether overconfidence, tolerance to risk/uncertainty, herding influence medical decisions, and ii) to evaluate the frequency of therapeutic inertia (defined as lack of treatment initiation or intensification in patients not at goals of care) and its predisposing factors in the management of MS. This is a prospective study comprising a combination of case-vignettes and surveys and experiments from Neuroeconomics/behavioral economics to identify cognitive distortions associated with medical decisions and therapeutic inertia. Participants include MS fellows and MS experts from across Spain. Each participant will receive an individual link using Qualtrics platform(©) that includes 20 case-vignettes, 3 surveys, and 4 behavioral experiments. The total time for completing the study is approximately 30-35 min. Case vignettes were selected to be representative of common clinical encounters in MS practice. Surveys and experiments include standardized test to measure overconfidence, aversion to risk and ambiguity, herding (following colleague's suggestions even when not supported by the evidence), physicians' reactions to uncertainty, and questions from the Socio-Economic Panel Study (SOEP) related to risk preferences in different domains. By applying three different MS score criteria (modified Rio, EMA, Prosperini's scheme) we take into account physicians' differences in escalating therapy when evaluating medical decisions across case-vignettes. The present study applies an innovative approach by combining tools to assess medical decisions with experiments from

  19. Physicians' attitudes toward the legalization of marijuana use.

    Science.gov (United States)

    Linn, L S; Yager, J; Leake, B

    1989-06-01

    We asked 303 practicing physicians in general internal medicine, family medicine, gastroenterology, or psychiatry to indicate whether possessing or using marijuana should be considered a felony, a misdemeanor, warrant the issuance of a citation, or be legalized. The position physicians advocated was unrelated to their specialty, experience diagnosing or treating substance abuse problems, their attitudes toward the efficacy of the treatment of drug abuse, or any other work role or habit we measured. Legalization or citation as compared with harsher penalties, however, was more likely favored by physicians who were younger, less religious, politically more liberal, and those less likely to perceive a serious drug problem in society. Legalization was also more likely favored by physicians who themselves had used marijuana, cocaine, and amphetamines but was unrelated to the use of alcohol, cigarettes, or tranquilizers. Although physician opinion should be sought as society deals with the drug problem, this study suggests how physicians' characteristics may influence the opinions that are rendered.

  20. An Analytical Comparison of the Opinions of Physicians Working in Emergency and Trauma Surgery Departments at Tabriz and Vienna Medical Universities Regarding Family Presence during Resuscitation.

    Science.gov (United States)

    Soleimanpour, Hassan; Behringer, Wilhelm; Tabrizi, Jafar Sadegh; Sarahrudi, Kambiz; Golzari, Samad E J; Hajdu, Stefan; Rasouli, Maryam; Nikakhtar, Mehdi; Mehdizadeh Esfanjani, Robab

    2015-01-01

    The present study evaluated the opinions of physicians working in the emergency and trauma surgery departments of Vienna Medical University, in Austria, and Tabriz Medical University, in Iran, regarding the presence of patients' relatives during resuscitation. In a descriptive-analytical study, the data obtained from questionnaires that had been distributed randomly to 40 specialists and residents at each of the participating universities were analyzed. The questionnaire consisted of two sections aimed at capturing the participants' demographic data, the participants' opinions regarding their support for the family's presence during resuscitation, and the multiple potential factors affecting the participants' attitudes, including health beliefs, triggers that could facilitate the procedure, self-efficacy, intellectual norms, and perceived behavioral control. The questionnaire also included a direct question (Question 16) on whether the participants approved of family presence. Each question could be answered using a Likert-type scale. The results showed that the mean scores for Question 16 were 4.31 ± 0.64 and 3.57 ± 1.31 for participants at Vienna and Tabriz universities, respectively. Moreover, physicians at Vienna University disapproved of the presence of patients' families during resuscitation to a higher extent than did those at Tabriz University (P = 0.018). Of the studied prognostic factors affecting the perspectives of Vienna Medical University's physicians, health beliefs (P = 0.000; B = 1.146), triggers (P = 0.000; B = 1.050), and norms (P = 0.000; B = 0.714) were found to be significant. Moreover, of the studied prognostic factors affecting the perspectives of Tabriz Medical University's physicians, health beliefs (P = 0.000; B = 0.875), triggers (P = 0.000; B = 1.11), self-efficacy (P = 0.001; B = 0.5), and perceived behavioral control (P = 0.03; B = 0.713) were significant. Most physicians at Vienna and Tabriz Medical universities were not open

  1. 42 CFR 411.386 - CMS's advisory opinions as exclusive.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false CMS's advisory opinions as exclusive. 411.386... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.386 CMS's advisory... described in § 411.370. CMS has not and does not issue a binding advisory opinion on the subject matter in...

  2. How risky do I invest : the role of risk attitudes, risk perceptions, and overconfidence

    OpenAIRE

    Nosic, Alen; Weber, Martin

    2010-01-01

    Our study analyzes the determinants of investors' risk taking behavior. We find that investors' risk taking behavior is affected by their subjective risk attitude and by the risk and return of an investment alternative. Our results also suggest that consistent with previous findings in the literature objective or historical return and volatility of a stock are not as good predictors of risk taking behavior as subjective risk and return measures. Moreover, we illustrate that overconfidence or ...

  3. Concierge and Second-Opinion Radiology: Review of Current Practices.

    Science.gov (United States)

    Shaikh, Shehbaz; Bafana, Rounak; Halabi, Safwan S

    2016-01-01

    Radiology's core assets include the production, interpretation, and distribution of quality imaging studies. Second-opinion services and concierge practices in radiology aim to augment traditional services by providing patient-centered and physician-centered care, respectively. Patient centeredness enhances patients' understanding and comfort with their radiology tests and procedures and allows them to make better decisions about their health care. As the fee-for-service paradigm shifts to value-based care models, radiology practices have begun to diversify imaging service delivery and communication to coincide with the American College of Radiology Imaging 3.0 campaign. Physician-centered consultation allows for communication of evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. There are disparate practice models and payment schema for the various second-opinion and concierge practices. This review article explores the current state and payment models of second-opinion and concierge practices in radiology. This review also includes a discussion on the benefits, roadblocks, and ethical issues that surround these novel types of practices. Copyright © 2015 Mosby, Inc. All rights reserved.

  4. Bayesian selection of misspecified models is overconfident and may cause spurious posterior probabilities for phylogenetic trees.

    Science.gov (United States)

    Yang, Ziheng; Zhu, Tianqi

    2018-02-20

    The Bayesian method is noted to produce spuriously high posterior probabilities for phylogenetic trees in analysis of large datasets, but the precise reasons for this overconfidence are unknown. In general, the performance of Bayesian selection of misspecified models is poorly understood, even though this is of great scientific interest since models are never true in real data analysis. Here we characterize the asymptotic behavior of Bayesian model selection and show that when the competing models are equally wrong, Bayesian model selection exhibits surprising and polarized behaviors in large datasets, supporting one model with full force while rejecting the others. If one model is slightly less wrong than the other, the less wrong model will eventually win when the amount of data increases, but the method may become overconfident before it becomes reliable. We suggest that this extreme behavior may be a major factor for the spuriously high posterior probabilities for evolutionary trees. The philosophical implications of our results to the application of Bayesian model selection to evaluate opposing scientific hypotheses are yet to be explored, as are the behaviors of non-Bayesian methods in similar situations.

  5. PENGARUH ILLUSIONS OF CONTROL, OVERCONFIDENCE DAN EMOTION TERHADAP PENGAMBILAN KEPUTUSAN INVESTASI PADA INVESTOR DI YOGYAKARTA

    OpenAIRE

    Kartini, Kartini; Nugraha, Nuris Firmansyah

    2015-01-01

    Nowadays Investors often make investment decision irrationally. The decision is often based on their judgment that is far away from rational assumption. When investors face risky situa-tion, there are some objectivities, emotions, and other psychological factors that usually ef-fect their decision making. This purpose of study is to examine the effect of illusions of control, risk tolerance, overconfidence and emotion on investment decision making among investors in yogyakarta. Sample of this...

  6. Opinions of Polish occupational medicine physicians on workplace health promotion.

    Science.gov (United States)

    Puchalski, Krzysztof; Korzeniowska, Elzbieta; Pyzalski, Jacek; Wojtaszczyk, Patrycja

    2005-01-01

    According to the current Polish legislation on occupational health services, occupational medicine physicians should perform workplace health promotion (WHP) activities as a part of their professional work. The concept of workplace health promotion or health promotion programs, however, has not been defined in this legislation in any way. Therefore, two essential questions arise. First, what is the physicians' attitude towards workplace health issues and second, what is actually carried out under the label of health promotion? The main objective of the research described in this paper was to answer these questions. The survey was carried out by the National Center for Workplace Health Promotion in 2002. A questionnaire prepared by the Center for the purpose of this survey was sent to a random sample of occupational medicine physicians. The results of the survey showed that 53% of occupational medicine physicians consider WHP just as a new name for prophylactics. On the other hand almost all of the respondents (94%) agree that occupational medicine physicians should perform WHP activities and find them useful in improving patients' health (78%). The main obstacle for the development of this activity in the perception of physicians is the lack of interest in workplace health promotion among employers (86%). In the modern understanding of workplace health promotion concept this type of intervention includes not only safety measures and health education, but also a profound organizational change that allows employers, employees and social partners to improve wellbeing of people at work. Each of such projects should facilitate changes necessary to create a health promoting workplace. It also needs a skilled leader--well trained and aware of a multidisciplinary dimension of WHP interventions. Occupational medicine specialists should become natural partners of employers and employees. The majority of the occupational medicine physicians, however, are not sufficiently

  7. Chinese Management Research Needs Self-Confidence but not Over-confidence

    DEFF Research Database (Denmark)

    Li, Xin; Ma, Li

    2018-01-01

    Chinese management research aims to contribute to global management knowledge by offering rigorous and innovative theories and practical recommendations both for managing in China and outside. However, two seemingly opposite directions that researchers are taking could prove detrimental......-confidence, limiting theoretical innovation and practical relevance. Yet going in the other direction of overly indigenous research reflects over-confidence, often isolating the Chinese management research from the mainstream academia and at times, even becoming anti-science. A more integrated approach of conducting...... to the healthy development of Chinese management research. We argue that the two directions share a common ground that lies in the mindset regarding the confidence in the work on and from China. One direction of simply following the American mainstream on academic rigor demonstrates a lack of self...

  8. US primary care physicians' opinions about conscientious refusal: a national vignette experiment.

    Science.gov (United States)

    Brauer, Simon G; Yoon, John D; Curlin, Farr A

    2016-02-01

    Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians' beliefs about what responses are appropriate. We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient's physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent's judgements. Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one's objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient's request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86). This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one's personal or professional standards. Referring seems to be physicians' preferred way of responding to requests for interventions to which physicians object. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Orthopedic surgeons’ and neurologists’ attitudes towards second opinions in the Israeli healthcare system: a qualitative study

    Directory of Open Access Journals (Sweden)

    Greenfield Geva

    2012-07-01

    Full Text Available Abstract Background Second opinion is a treatment ratification tool that may critically influence diagnosis, treatment, and prognosis. Second opinions constitute one of the largest expenditures of the supplementary health insurance programs provided by the Israeli health funds. The scarcity of data on physicians’ attitudes toward second opinion motivated this study to explore those attitudes within the Israeli healthcare system. Methods We interviewed 35 orthopedic surgeons and neurologists in Israel and qualitatively analyzed the data using the Grounded Theory approach. Results As a common tool, second opinion reflects the broader context of the Israeli healthcare system, specifically tensions associated with health inequalities. We identified four issues: (1 inequalities between central and peripheral regions of Israel; (2 inequalities between private and public settings; (3 implementation gap between the right to a second opinion and whether it is covered by the National Health Insurance Law; and (4 tension between the authorities of physicians and religious leaders. The physicians mentioned that better mechanisms should be implemented for guiding patients to an appropriate consultant for a second opinion and for making an informed choice between the two opinions. Conclusions While all the physicians agreed on the importance of the second opinion as a tool, they raised concerns about the way it is provided and utilized. To be optimally implemented, second opinion should be institutionalized and regulated. The National Health Insurance Law should strive to provide the mechanisms to access second opinion as stipulated in the Patient’s Rights Law. Further studies are needed to assess the patients' perspectives.

  10. Melanoma in the shopping mall: A utilitarian argument for offering unsolicited medical opinions in informal settings.

    Science.gov (United States)

    Preller, Gustav; Salloch, Sabine

    2018-03-01

    Doctors occasionally make diagnoses in strangers outside of formal medical settings by using the medical skill of visual inspection, such as noticing signs of melanoma or the symptoms of hyperthyroidism. This may cause considerable moral unease and doubts on the side of the diagnosing physician. Such encounters force physicians to consider whether or not to intervene by introducing themselves to the stranger and offering an unsolicited medical opinion despite the absence of a formal doctor-patient relationship. A small body of literature has addressed the topic of the unsolicited medical opinion, often with a primary focus on practical advice. This article seeks to establish an ethical-theoretical basis for physicians' ethical obligation to offer an unsolicited medical opinion when they make a diagnosis by visual inspection in a stranger outside of the formal medical context. Using a utilitarian approach, it is argued that, if it is in the physicians' power to prevent a possible loss of well-being, without thereby sacrificing anything of equal value, physicians have an ethical obligation to intervene. © 2018 John Wiley & Sons Ltd.

  11. Confidence and Information Access in Clinical Decision-Making: An Examination of the Cognitive Processes that affect the Information-seeking Behavior of Physicians.

    Science.gov (United States)

    Uy, Raymonde Charles; Sarmiento, Raymond Francis; Gavino, Alex; Fontelo, Paul

    2014-01-01

    Clinical decision-making involves the interplay between cognitive processes and physicians' perceptions of confidence in the context of their information-seeking behavior. The objectives of the study are: to examine how these concepts interact, to determine whether physician confidence, defined in relation to information need, affects clinical decision-making, and if information access improves decision accuracy. We analyzed previously collected data about resident physicians' perceptions of information need from a study comparing abstracts and full-text articles in clinical decision accuracy. We found that there is a significant relation between confidence and accuracy (φ=0.164, p<0.01). We also found various differences in the alignment of confidence and accuracy, demonstrating the concepts of underconfidence and overconfidence across years of clinical experience. Access to online literature also has a significant effect on accuracy (p<0.001). These results highlight possible CDSS strategies to reduce medical errors.

  12. Parents' knowledge of and opinions about healthcare laws and technology in primary care.

    Science.gov (United States)

    Thompson, Lindsay A; Black, Erik W; Saliba, Heidi; Schentrup, Anzeela M

    2012-01-01

    Historically, parents have demonstrated poor understanding of adolescent healthcare laws. This study assessed US parents' current knowledge and opinions about technology facilitated physician-adolescent communication and applicable laws to enhance transition to adult health care. A brief survey in two low-income academic paediatric clinics asked parents about their knowledge of health care and laws, and their opinions about technology facilitated contact between physicians and adolescents. Almost all parents (96.7%) have internet access at home, work or via a mobile device. Only 44.1% approved of having a physician directly contact their child about annual examinations, immunisations or to discuss issues of sexuality. Half (55.4%) were aware that adolescents could receive confidential sexuality information and treatment without parents' permission. Only one-third (32.2%) approved of a specific technology for direct communication. Parents are divided about direct physician-adolescent contact. Future plans to engage adolescents to understand their health will require parental education and involvement on the value of physician-adolescent communication.

  13. Attitudes toward Suicide: Italian and United States Physicians.

    Science.gov (United States)

    Domino, George; Perrone, Luisa

    1993-01-01

    Administered Suicide Opinion Questionnaire to 100 Italian and 100 U.S. physicians, comparable in age, gender, and medical field. Found significant difference on seven of eight scales, with Italian physicians showing greater agreement on mental illness, right to die, religion, impulsivity, normality, aggression, and moral evil scales. Found gender…

  14. Causality Illusion and Overconfidence in Predicting (QuasiStochastic Financial Events

    Directory of Open Access Journals (Sweden)

    Petr Houdek

    2017-03-01

    Full Text Available We argue that individuals systematically interpret sequences of events in a  causal manner. The aim of this article is to show that people do so even if they are aware of the stochastic nature of the respective sequence. The bias can explain some anomalous behaviour of investors in financial markets. Small as well as professional investors may illusorily perceive causality of former random success and future yield. Laboratory experiments testing the interpretation of stochastically occurring events in financial designs as well as analyses of real trading data from financial markets confirm that investors indeed interpret (quasirandom events casually; they make incorrect predictions and they egocentrically allocate responsibility for their success. The causality illusion induces overconfidence, inefficient investment and risk seeking. In the conclusion, we discuss factors that may limit effects of the causality illusion and suggest future areas for research.

  15. Doctor knows best: physician endorsements, public opinion, and the politics of comparative effectiveness research.

    Science.gov (United States)

    Gerber, Alan S; Patashnik, Eric M; Doherty, David; Dowling, Conor M

    2014-02-01

    The Obama administration has made a major investment in comparative effectiveness research (CER) to learn what treatments work best for which patients. CER has the potential to reduce wasteful medical spending and improve patient outcomes, but the political sustainability of this initiative remains unclear because of concerns that it will threaten the doctor-patient relationship. An unresolved question is whether it is possible to boost public support for the use of CER as a cost-control strategy. We investigate one potential source of public support: Americans' trust in physicians as faithful agents of patient interests. We conducted two national surveys to explore the public's confidence in doctors compared to other groups. We find that doctors are viewed as harder workers, more trustworthy, and more caring than other professionals. Through survey experiments, we demonstrate that the support of doctors' groups for proposals to control costs and use CER have a greater influence on aggregate public opinion than do cues from political actors including congressional Democrats, Republicans, and a bipartisan commission. Our survey results suggest that the medical profession's stance will be an important factor in shaping the political viability of efforts to use CER as a tool for health care cost control.

  16. The opinion of patients at a local South Africa teaching hospital on ...

    African Journals Online (AJOL)

    2012-09-24

    Sep 24, 2012 ... Gift giving is a technique that is commonly used by the pharmaceutical industry to generate feelings of reciprocity and obligation in physicians, and research has clearly demonstrated that physicians are susceptible to this practice.1-3 As a result, the pharmaceutical industry spends. The opinion of patients ...

  17. Patients' reflections on communication in the second-opinion hematology-oncology consultation.

    Science.gov (United States)

    Goldman, Roberta E; Sullivan, Amy; Back, Anthony L; Alexander, Stewart C; Matsuyama, Robin K; Lee, Stephanie J

    2009-07-01

    The nature of communication between patients and their second-opinion hematology consultants may be very different in these one-time consultations than for those that are within long-term relationships. This study explored patients' perceptions of their second-opinion hematology-oncology consultation to investigate physician-patient communication in malignant disease at a critical juncture in cancer patients' care and decision-making. In-depth telephone interviews with a subset of 20 patients from a larger study, following their subspecialty hematology consultations. Most patients wanted to contribute to the consultation agenda, but were unable to do so. Patients sought expert and honest advice delivered with empathy, though most did not expect the consultant to directly address their emotions. They wanted the physician to apply his/her knowledge to the specifics of their individual cases, and were disappointed and distrustful when physicians cited only general prognostic statistics. In contrast, physicians' consideration of the unique elements of patients' cases, and demonstrations of empathy and respect made patients' feel positively about the encounter, regardless of the prognosis. Patients provided concrete recommendations for physician and patient behaviors to enhance the consultation. Consideration of these recommendations may result in more effective communication and increased patient satisfaction with medical visits.

  18. [The Madrid autonomous community epidemiological bulletin. A survey on its dissemination and opinion thereof on among primary care physicians for the year 2000].

    Science.gov (United States)

    Fernández Rodríguez, Silvia; Zorrilla Torras, Belén; Ramírez Fernández, Rosa; Alvarez Castillo, M Carmen; López-Gay Lucio, Dulce; Ibáñez Martín, Cosuelo; Bueno Vallejos, Rafael

    2002-01-01

    The Autonomous Community of Madrid Epidemiological Bulletin is the main communications link between epidemiological monitoring system and health care professionals. The purpose of this study is that of ascertaining the dissemination and opinion of this Autonomous Community of Madrid Epidemiological Bulletin among primary care physicians for the purpose of adapting this publication to its readers' interests. A telephone survey among primary care physicians in the Autonomous Community of Madrid, asking how often they read the Bulletin, the interest and usefulness of the information included in it. The sample size was estimated at 346 physicians. A two-stage sampling process was carried out-by cluster sampling in the first stage, randomly selecting 125 health care centers and 2.7 physicians per center, 17% being primary care team coordinators. A comparison is made of the results among physicians and coordinators by means of the Chi-square and Fisher's Exact Test method, with Epi-Info v.6. A total of 305 surveys were conducted (245 physicians and 60 coordinators). There was an awareness of the existence of the Autonomous Community of Madrid Epidemiological Bulletin on the part of 91.5% (CI 95%: 88.1-94.8), and 27.2% (CI 95%: 21.9-32.5) were familiar with more than 50% of the last issues published. A total of 92.4% (CI 95%: 89.4-95.8) considered the Bulletin to be interesting or highly interesting, grading its usefulness an average of 3.5 on a maximum scale of 5. Of the permanent sections, the most highly-valued was Epidemic Outbreaks, those reports related to meningococcal infection, tuberculosis and HIV/AIDS being the most highly-valued. The Autonomous Community of Madrid Epidemiological Bulletin is a publication which, although not widely-known by the primary care physicians in the Community, is well-valued when it is read, thus being a useful feedback tool within the Epidemiological Monitoring System.

  19. Valued Components of a Consultant Letter from Referring Physicians' Perspective: a Systematic Literature Synthesis.

    Science.gov (United States)

    Rash, Arjun H; Sheldon, Robert; Donald, Maoliosa; Eronmwon, Cindy; Kuriachan, Vikas P

    2018-03-05

    Effective communication between the consultants and physicians form an integral foundation of effective and expert patient care. A broad review of the literature has not been undertaken to determine the components of a consultant's letter of most value to the referring physician. We aimed to identify the components of a consultant's letter preferred by referring physicians. We searched Embase and MEDLINE (OVID) Medicine (EBM) Reviews and Cochrane Database of Systematic Reviews for English articles with no restriction on initial date to January 6, 2017. Articles containing letters from specialists to referring physicians regarding outpatient assessments with either an observational or experimental design were included. Studies were excluded if they pertained to communications from referring physicians to consultant specialists, or pertained to allied health professionals, inpatient documents, or opinion articles. We enumerated the frequencies with which three common themes were addressed, and the positive or negative nature of the comments. The three themes were the structure of consultant letters, their contents, and whether referring physicians and consultants shared a common opinion about the items. Eighteen articles were included in our synthesis. In 11 reports, 91% of respondents preferred structured formats. Other preferred structural features were problem lists and brevity (four reports each). The most preferred contents were oriented to insight: diagnosis, prognosis, and management plan (16/21 mentions in the top tertile). Data items such as history, physical examination, and medication lists were less important (1/23 mentions in the top tertile). Reports varied as to whether referring physicians and consultants shared common opinions about letter features. Referring physicians prefer brief, structured letters from consultants that feature diagnostic and prognostic opinions and management plans over unstructured letters that emphasize data elements such as

  20. The Effect of Overconfidence and Experience on Belief Adjustment Model in Investment Judgement (P.39-47

    Directory of Open Access Journals (Sweden)

    Luciana Spica Almilia

    2017-02-01

    Full Text Available This study examines the effect overconfidence and experience on increasing or reducing the information order effect in investment decision making. Subject criteria in this research are: professional investor (who having knowledge and experience in the field of investment and stock market and nonprofessional investor (who having knowledge in the field of investment and stock market. Based on the subject criteria, then subjects in this research include: accounting students, capital market and investor. This research is using experimental method of 2 x 2 (between subjects. The researcher in conducting this experimental research is using web based. The characteristic of individual (high confidence and low confidence is measured by calibration test. Independent variable used in this research consist of 2 active independent variables (manipulated which are as the followings: (1 Pattern of information presentation (step by step and end of sequence; and (2 Presentation order (good news – bad news or bad news – good news. Dependent variable in this research is a revision of investment decision done by research subject. Participants in this study were 78 nonprofessional investor and 48 professional investors. The research result is consistent with that predicted that individuals who have a high level of confidence that will tend to ignore the information available, the impact on individuals with a high level of confidence will be spared from the effects of the information sequence. Keywords: step by step, end of sequence, investment judgement, overconfidence, experimental method

  1. Parents' opinions and sources of information on immunization in children

    Directory of Open Access Journals (Sweden)

    Agata Anna Salwa

    2017-07-01

    Conclusions. Despite their doubts about their effectiveness and safety, parents expressed their positive opinion about the use of immunization in children. Increase physician activation as they are the primary source of health information for parents.

  2. Exploring the opinion of hemodialysis patients about their dialysis unit

    OpenAIRE

    Ahmed Farouk Donia; Mohamed Ahmed Elhadedy; Hanzada Mohamed El-Maghrabi; Mohamed Hamed Abbas; Mohamed Ashraf Foda

    2015-01-01

    Hemodialysis (HD) patients are subjected to a number of physical and mental stresses. Physicians might be unaware of some of these problems. We assessed our patients′ opinion about the service provided at the dialysis unit. Our unit has 89 patients on HD. A questionnaire exploring our patients′ opinion relative to the service provided was prepared. The patients were asked to fill-in the questionnaire in a confidential manner. Questionnaires were then collected and examined while unaware of pa...

  3. Opinions of Primary Care Family Physicians About Family Medicine Speciality Training Program

    Directory of Open Access Journals (Sweden)

    Hamit Sirri Keten

    2014-04-01

    Material and Method: A total of 170 family physicians working in Kahramanmaras were included in the study. After obtaining informed consent a questionnaire comprising questions regarding socio-demographic properties, conveying contracted family physicians as family medicine specialists and organization of the training program was applied to participants. Results: Among physicians participating in the study 130 (76.5% were male and 40 (23.5% were female, with a mean age of 40.7±7.1 (min = 26 years, max = 64 years. The mean duration of professional experience of physicians was 15.3±7.0 (min = 2 years, max = 40 years years. Of all, 91 (53.5% participants had already read the decree on family medicine specialist training program for contracted family physicians. A hundred and fifteen (67.6% family physicians supported that Family Medicine Specialty program should be taken part-time without interrupting routine medical tasks. Only 51 (30.0% participants stated the requirement of an entrance examination (TUS for family medicine specialty training. Conclusion: Family medicine specialty training program towards family physicians should be considered in the light of scientific criteria. In family medicine, an area exhibited a holistic approach to the patient; specialty training should be through residency training instead of an education program. For this purpose, family medicine departments in medical faculties should play an active role in this process. Additionally further rotations in needed branches should be implemented with a revision of area should be performed. In medicine practical training is of high importance and distant or part-time education is not appropriate, and specialist training shall be planned in accordance with the medical specialty training regulations. [Cukurova Med J 2014; 39(2.000: 298-304

  4. “The library catalog is definitely the best place to find articles!” Overconfidence among Undergraduate Library Users

    OpenAIRE

    Katelyn Angell; Gary Kose

    2016-01-01

    Beginning in the 1980s, researchers in a wide array of academic disciplines surveyed undergraduate students to learn if they were overconfident with regard to their knowledge of disciplinary subject matter. The majority of researchers have found that students tend to overestimate their abilities within a certain body of knowledge. Up until recently, most of these projects were conducted in the fields of education, psychology, and economics. In the past few years, several academic librarians h...

  5. Eyewitness confidence in simultaneous and sequential lineups: a criterion shift account for sequential mistaken identification overconfidence.

    Science.gov (United States)

    Dobolyi, David G; Dodson, Chad S

    2013-12-01

    Confidence judgments for eyewitness identifications play an integral role in determining guilt during legal proceedings. Past research has shown that confidence in positive identifications is strongly associated with accuracy. Using a standard lineup recognition paradigm, we investigated accuracy using signal detection and ROC analyses, along with the tendency to choose a face with both simultaneous and sequential lineups. We replicated past findings of reduced rates of choosing with sequential as compared to simultaneous lineups, but notably found an accuracy advantage in favor of simultaneous lineups. Moreover, our analysis of the confidence-accuracy relationship revealed two key findings. First, we observed a sequential mistaken identification overconfidence effect: despite an overall reduction in false alarms, confidence for false alarms that did occur was higher with sequential lineups than with simultaneous lineups, with no differences in confidence for correct identifications. This sequential mistaken identification overconfidence effect is an expected byproduct of the use of a more conservative identification criterion with sequential than with simultaneous lineups. Second, we found a steady drop in confidence for mistaken identifications (i.e., foil identifications and false alarms) from the first to the last face in sequential lineups, whereas confidence in and accuracy of correct identifications remained relatively stable. Overall, we observed that sequential lineups are both less accurate and produce higher confidence false identifications than do simultaneous lineups. Given the increasing prominence of sequential lineups in our legal system, our data argue for increased scrutiny and possibly a wholesale reevaluation of this lineup format. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  6. How do we talk about doctors and drugs? Sentiment analysis in forums expressing opinions for medical domain.

    Science.gov (United States)

    Jiménez-Zafra, Salud María; Martín-Valdivia, M Teresa; Molina-González, M Dolores; Ureña-López, L Alfonso

    2018-04-20

    The main goal of this study is to examine how people express their opinion in medical forums. We analyze the language used in order to determine the best way to tackle sentiment analysis in this domain. We have applied supervised learning and lexicon-based sentiment analysis approaches over two different corpora extracted from social web. Specifically, we have focused on two aspects: drugs and doctors. We have selected two forums and we have collected corpora for each one: (i) DOS, a Spanish corpus of drug reviews and (ii) COPOS, a Spanish corpus of patients' opinions about physicians. The classification results show that drug reviews are more difficult to classify than those about physicians. In order to understand the difference in the results, we have studied the linguistic features of both corpora. Although opinions about physicians and drugs are written in most cases by non-professional users, reviews about physicians are characterized by the use of an informal language while reviews about drugs are characterized by a combination of informal language with specific terminology (e.g. adverse effects, drug names) with greater lexical diversity, making the task of sentiment analysis difficult. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives.

    Science.gov (United States)

    Wright, David Kenneth; Fishman, Jennifer R; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

    2015-01-01

    Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. We conducted a discourse analysis of print media on physicians' perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician's perspective. We identified 3 predominant discourses about physicians' public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies.

  8. From community to commodity: the ethics of pharma-funded social networking sites for physicians.

    Science.gov (United States)

    Landa, Amy Snow; Elliott, Carl

    2013-01-01

    A growing number of doctors in the United States are joining online professional networks that cater exclusively to licensed physicians. The most popular are Sermo, with more than 135,000 members, and Doximity, with more than 100,000. Both companies claim to offer a valuable service by enabling doctors to "connect" in a secure online environment. But their business models raise ethical concerns. The sites generate revenue by selling access to their large networks of physician-users to clients that include global pharmaceutical companies, market research and consulting firms, and hedge funds and other investors. In exchange for a fee, these clients are offered a variety of tools to monitor, analyze, and solicit physicians' opinions. In Sermo's case, clients are also offered opportunities to conduct "awareness campaigns" on the site that are aimed at influencing physician sentiment about specific drugs and medical devices. In effect, these online networks have created an even more efficient means for the pharmaceutical industry to track physician sentiment, disseminate messages, and cultivate key opinion leaders. This paper argues that the dual nature of these sites (a) undermines their integrity and transparency as forums for the exchange of medical opinion and (b) presents an ethical conflict for the doctors who use them. © 2013 American Society of Law, Medicine & Ethics, Inc.

  9. “The library catalog is definitely the best place to find articles!” Overconfidence among Undergraduate Library Users

    Directory of Open Access Journals (Sweden)

    Katelyn Angell

    2016-02-01

    Full Text Available Beginning in the 1980s, researchers in a wide array of academic disciplines surveyed undergraduate students to learn if they were overconfident with regard to their knowledge of disciplinary subject matter. The majority of researchers have found that students tend to overestimate their abilities within a certain body of knowledge. Up until recently, most of these projects were conducted in the fields of education, psychology, and economics. In the past few years, several academic librarians have applied these methodologies to their undergraduate patrons, curious as to whether this population demonstrates similar overconfidence in their grasp of academic research. The present study surveyed 34 undergraduates enrolled in psychology classes at a large urban university in the United States to determine if these students were overconfident about their knowledge in key library research areas. These questions included citing and referencing, identifying components of scholarly and popular sources, and developing and applying searches in electronic resources. A general knowledge survey was created for comparison purposes. Statistical analysis showed that students displayed marked overconfidence on both tools, signifying a need for increased library and metacognitive skill instruction. Depuis les années 80, les chercheurs d’un vaste éventail des domaines académiques sondaient des étudiants universitaires afin d’apprendre s’ils étaient trop confiants au sujet de leurs connaissances de la discipline. La plupart des chercheurs ont trouvé que les étudiants ont une tendance à surestimer leurs compétences dans un certain corps de connaissance. Jusqu’à récemment, la majorité de ces projets étaient menés dans les domaines de l’éducation, de la psychologie et de l’économie. Au cours de ces dernières années, plusieurs bibliothécaires académiques ont appliqué ces méthodologies sur leurs étudiants “clients”, curieux de savoir

  10. The Review of Studies on Manager Overconfidence and Corporate Investment and Financing%管理者过度自信与企业投融资决策研究述评

    Institute of Scientific and Technical Information of China (English)

    张大为; 孙福明

    2014-01-01

    新兴的行为公司财务学将管理者非理性纳入企业财务决策研究视角,弥补了传统理论的缺陷,为传统理论研究注入了新的生命力。回顾管理者过度自信内涵和心理学证据,简要分析管理者过度自信产生原因,归纳已有的过度自信度量方法;阐述和总结管理者过度自信对公司投资和融资的影响。通过对现有研究的梳理和分析,以便更好地解释企业管理者投资、融资行为,提高企业的财务决策效率。%Emerging behavioral corporate finance puts managers irrational into the corporate financial decision research perspective , makes up tradi-tional theory, and injects new vitality into the traditional theory .We first review the meaning of managerial overconfidence and psychological evi-dence, a brief analysis of the causes of managerial overconfidence and summarize the existing measurement of overconfidence;secondly we describe and summarize the impact of manager overconfidence on investment and financing; Finally we give conclusions and outlook.We tease through the existing research and analysis in order to give a better explanation to the business managers investment , financing behavior, improve the efficiency of the corporate financial decision-making.

  11. A Survey of Cancer Pain Management Knowledge and Attitudes of British Columbian Physicians

    OpenAIRE

    Gallagher, R; Hawley, P; Yeomans, W

    2004-01-01

    INTRODUCTION: There are many potential barriers to adequate cancer pain management, including lack of physician education and prescription monitoring programs. The authors surveyed physicians about their specific knowledge of pain management and the effects of the regulation of opioids on their prescribing practices.METHODS: A questionnaire was mailed out to British Columbia physicians who were likely to encounter cancer patients. The survey asked for physicians' opinions about College of Phy...

  12. Attitudes of pharmacists and physicians to antibiotic policies in hospitals.

    Science.gov (United States)

    Adu, A; Simpson, J M; Armour, C L

    1999-06-01

    Antibiotic therapy in hospitals has substantial impact on patient outcome and the pharmacy drug budget. Antibiotic policies have been implemented by some hospitals to improve the quality of patient outcome and cost of antibiotic therapy. Antibiotic policies impose certain requirements on pharmacists and physicians. Pharmacists' and physicians' attitudes to and opinions about antibiotic policies are likely to affect the usefulness of such policies. To determine the attitudes of pharmacists and physicians to antibiotic policies in New South Wales (NSW) hospitals. Pharmacists and physicians in NSW public hospitals were surveyed to determine their attitudes to and opinions on antibiotic policies. A simple one-stage cluster sample of 241 pharmacists and a two-stage cluster sample of 701 physicians were obtained. Factor analysis was used to identify the attitudinal dimensions. General linear modelling was used to investigate the effects of predictor variables on outcome variables. The response rates were 91% and 77% for pharmacists and physicians, respectively. Factor analysis identified three dimensions of attitude to antibiotic policies: that they encourage rational antibiotic use; that they improve the quality of antibiotic prescribing and that they are associated with some problems. The reliability of these factors (Cronbach's alpha) ranged from 0.71 to 0.74, and was 0.90 for the overall attitude scale. Pharmacists and physicians had a positive overall attitude to antibiotic policies. Whereas physicians recognize that antibiotic policies improve the quality of prescribing, this was highly correlated with identification of problems (alpha = 0.71). In urban hospitals, pharmacists were more likely than physicians to associate antibiotics with problems. There was a positive overall attitude to hospital antibiotic policies expressed by pharmacists and physicians.

  13. Implementing technology in healthcare: insights from physicians.

    Science.gov (United States)

    Ruiz Morilla, Maria Dolors; Sans, Mireia; Casasa, Albert; Giménez, Nuria

    2017-06-27

    Technology has significantly changed the way health organizations operate. However, the role it plays in healthcare systems remains unclear. This aim of this study was to evaluate the opinion of physicians regarding e-health and determine what factors influence their opinion and describe the advantages, inconveniences and threats they may perceive by its use. A cross-sectional questionnaire-based study. A questionnaire which had been previously designed and validated by the authors was used to interview physicians from the Barcelona Medical Association. 930 physicians were contacted by phone to participate in the study. Seven hundred sixty physicians responded to the questionnaire (response rate: 82%). The usefulness of telemedicine scored 7.4 (SD 1.8) on a scale from 1-10 (from the lowest to the highest) and the importance of the Internet in the workplace was 8.2 points (SD 1.8). Therapeutic compliance (7.0 -SD 1.8-) and patient health (7.0 -SD 1.7-) showed the best scores, and there were differences between professionals who had and had not previously participated in a telemedicine project (p technology outweigh its possible difficulties and shortcomings. Physicians demanded projects with appropriate funding and technology, as well as specific training to improve their technological abilities. The relationship of users with technology differs according to their personal or professional life. Although a 2.0 philosophy has been incorporated into many aspects of our lives, healthcare systems still have a long way to go in order to adapt to this new understanding of the relationship between patients and their health.

  14. Probiotics as therapy in gastroenterology: a study of physician opinions and recommendations.

    Science.gov (United States)

    Williams, Michael D; Ha, Christina Y; Ciorba, Matthew A

    2010-10-01

    The objective of this study was to determine how gastroenterologists perceive and use probiotic-based therapies in practice. In the United States, there has been a recent increase in research investigating the therapeutic capacities of probiotics in human disease and an accompanying increase in product availability and marketing. How medical care providers have interpreted the available literature and incorporated it into their practice has not been earlier assessed. A 16-question survey (see Survey, Supplemental Digital Content 1, http://links.lww.com/JCG/A14) was distributed to practicing gastroenterologists and physicians with a specific interest in GI disorders within a large metropolitan area. All physicians responded that they believed probiotics to be safe for most patients and 98% responded that probiotics have a role in treating gastrointestinal illnesses or symptoms. Currently 93% of physicians have patients taking probiotics most often for irritable bowel syndrome. Commonly used probiotics included yogurt-based products, Bifidobacterium infantis 35624 (Align), and VSL#3. Most surveyed physicians recommended probiotics for irritable bowel syndrome, antibiotic, and Clostridium difficile-associated diarrhea because they believed that the literature supports their usage for these conditions. However, physician practice patterns did not consistently correlate with published, expert-panel-generated recommendations for evidence-based probiotic use. This study suggests most gastrointestinal disease specialists recognize a role for and have used probiotics as part of their therapeutic armamentarium; however, the effective implementation of this practice will benefit from additional supporting studies and the eventual development of clinical practice guidelines supported by the major gastroenterology societies.

  15. Physicians, patients, and Facebook: Could you? Would you? Should you?

    Science.gov (United States)

    Peluchette, Joy V; Karl, Katherine A; Coustasse, Alberto

    2016-01-01

    This article investigates the opinions of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. We analyzed 290 comments posted on online discussion boards and found that most (51.7%) were opposed to physicians being Facebook "friends" with patients and many (42%) were opposed to physicians having any kind of Facebook presence. Some believed that health care organizations should have a social media policy and provide social media training. We conclude with suggestions for how health care administrators can provide assistance to physicians and effectively manage their social media presence.

  16. A clinical study of COPD severity assessment by primary care physicians and their patients compared with spirometry.

    Science.gov (United States)

    Mapel, Douglas W; Dalal, Anand A; Johnson, Phaedra; Becker, Laura; Hunter, Alyssa Goolsby

    2015-06-01

    Primary care physicians often do not use spirometry to confirm the diagnosis of chronic obstructive pulmonary disease. This project was designed to see how well physicians' impressions about their patients' chronic obstructive pulmonary disease severity correlate with the severity of airflow obstruction measured by spirometry and to assess whether spirometry results subsequently changed the physicians' opinions about chronic obstructive pulmonary disease severity and treatment. We performed a multicenter, cross-sectional, observational study conducted in 83 primary care clinics from across the United States. A total of 899 patients with a clinical diagnosis of chronic obstructive pulmonary disease completed a questionnaire and spirometry testing. Physicians completed a questionnaire and case report forms. Concordance among physician ratings, patient ratings, and spirometry results was evaluated. Physicians' chronic obstructive pulmonary disease severity ratings before spirometry were accurate for only 30% of patients with evaluable spirometry results, and disease severity in 41% of patients was underestimated. Physicians also underestimated severity compared with patients' self-assessment among 42% of those with evaluable results. After spirometry, physicians changed their opinions on the severity for 30% of patients and recommended treatment changes for 37%. Only 75% of patients performed at least 1 high-quality spirometry test; however, the physicians' opinions and treatment decisions were similar regardless of suboptimal test results. Without performing spirometry, physicians are likely to underestimate their patients' chronic obstructive pulmonary disease severity or inadequately characterize their patients' lung disease. Spirometry changed the physicians' clinical impressions and treatments for approximately one third of these patients; thus, spirometry is a valuable tool for chronic obstructive pulmonary disease management in primary care. Copyright © 2015

  17. Attitudes to the administrative management of service patients with epilepsy and related disorders among army physicians.

    Science.gov (United States)

    Whiteoak, R; Findley, L J

    1986-02-01

    The case histories of ten patients suffering from epilepsy or related disorders were sent to all serving Consultant Physicians and Senior Specialists in Medicine in the Army. They were asked their opinions on the PULHEEMS Grading and restriction of duty in each case. In many cases there was a wide range of opinion on the management. Clearer guidelines concerning the diagnosis and administrative management of patients need to be drawn up to allow Service physicians to be consistent and fair to their patients.

  18. Continuous sedation until death: moral justifications of physicians and nurses-a content analysis of opinion pieces

    NARCIS (Netherlands)

    Rys, S.; Mortier, F.; Deliens, L.; Deschepper, R.; Battin, M.P.; Bilsen, J.

    2013-01-01

    Continuous sedation until death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, often provokes medical-ethical discussions in the opinion sections of medical and nursing journals. A content analysis of opinion pieces in medical and nursing literature

  19. Oral contraception and menstrual bleeding during treatment of venous thromboembolism: Expert opinion versus current practice: Combined results of a systematic review, expert panel opinion and an international survey

    NARCIS (Netherlands)

    Klok, F. A.; Schreiber, K.; Stach, K.; Ageno, W.; Middeldorp, S.; Eichinger, S.; Delluc, A.; Blondon, M.; Ay, C.

    2017-01-01

    The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians. 10

  20. Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives

    Science.gov (United States)

    Wright, David Kenneth; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

    2015-01-01

    Background Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. Methods We conducted a discourse analysis of print media on physicians’ perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician’s perspective. Results We identified 3 predominant discourses about physicians’ public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Interpretation Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies. PMID:26389090

  1. [Medical students' attitudes towards legalisation of euthanasia and physician-assisted suicide].

    Science.gov (United States)

    Nordstrand, Magnus Andreas; Nordstrand, Sven Jakob; Materstvedt, Lars Johan; Nortvedt, Per; Magelssen, Morten

    2013-11-26

    We wished to investigate prevailing attitudes among future doctors regarding legalisation of euthanasia and physician-assisted suicide. This issue is important, since any legalisation of these practices would confer a completely new role on doctors. Attitudes were identified with the aid of a questionnaire-based survey among medical students in their 5th and 6th year of study in the four Norwegian medical schools. Altogether 531 students responded (59.5% of all students in these cohorts). Of these, 102 (19%) were of the opinion that euthanasia should be legalised in the case of terminal illness, 164 (31%) responded that physician-assisted suicide should be permitted for this indication, while 145 (28%) did not know. A minority of the respondents would permit euthanasia and physician-assisted suicide in other situations. Women and those who reported that religion was important to them were less positive than men to permitting euthanasia or physician-assisted suicide. In most of the situations described, the majority of the students in this survey rejected legalisation. Opinions are more divided in the case of terminal illness, since a larger proportion is in favour of legalisation and more respondents are undecided.

  2. Physicians' opinions of a health information exchange.

    Science.gov (United States)

    Hincapie, Ana Lucia; Warholak, Terri L; Murcko, Anita C; Slack, Marion; Malone, Daniel C

    2011-01-01

    Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. A total of 29 clinicians participated in the study. The attendance rate was 66% (N=19) for the first and last month of focus-group meetings and 52% (N=15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of "doctor shopping"; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system. Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available.

  3. Seeking a second medical opinion: composition, reasons and perceived outcomes in Israel.

    Science.gov (United States)

    Shmueli, Liora; Davidovitch, Nadav; Pliskin, Joseph S; Balicer, Ran D; Hekselman, Igal; Greenfield, Geva

    2017-12-08

    Seeking a second-opinion (SO) is a common clinical practice that can optimize treatment and reduce unnecessary procedures and risks. We aim to characterize the composition of the population of SO seekers, their reasons for seeking a SO and choosing a specific physician, and their perceived outcomes following the SO. A cross-sectional national telephone survey, using a representative sample of the general Israeli population (n = 848, response rate = 62%). SO utilization was defined as seeking an additional clinical opinion from a specialist within the same specialty, for the same medical concern. We describe the characteristics of respondents who obtained SOs, their reasons for doing so and their perceived outcomes: (1) Satisfaction with the SO; (2) Experiencing health improvement after receiving a SO; (3) A difference in the diagnosis or treatment suggested in the first opinions and the second opinions; (4) Preference of the SO over the first one. Most of the respondents who sought a SO (n = 344) were above 60 years old, secular, living with a partner, perceived their income to be above average and their health status to be not so good. For the patients who utilized SOs, orthopedic surgeons were sought out more than any other medical professional.Reasons for seeking a SO included doubts about diagnosis or treatment (38%), search for a sub-specialty expert (19%) and dissatisfaction with communication (19%). SO seekers most frequently chose a specific specialist based on a recommendation from a friend or a relative (33%). About half of the SO seekers also searched for information on the internet. Most of the respondents who sought a SO mentioned that they were satisfied with it (84%), felt health improvement (77%), mentioned that there was a difference between the diagnosis or treatment between the first opinion and the SO (56%) and preferred the SO over the first one (91%). Clinical uncertainty or dissatisfaction with patient-physician communication

  4. Physician Perspectives on Long-Term Relationships and Friendships with Patients: A National Assessment.

    Science.gov (United States)

    Hines, Harrison G; Avila, Cynthia J; Rudakevych, Tanya M; Curlin, Farr A; Yoon, John D

    2017-11-01

    Shifts in the healthcare environment have introduced challenges to the long-term continuity of the doctor-patient relationship. This study examines whether certain demographic or religious characteristics of physicians are associated with maintaining long-term relationships (LTRs) and/or friendships with their patients and describes physicians' opinions regarding the influence of such patient relationships on health outcomes. In 2011, survey responses were obtained from 1289 US physicians from various specialties. Physicians answered 8 items that assessed their opinions regarding their friendships, sense of meaningfulness, and experience in LTRs. The χ 2 test was used to examine bivariate associations between each demographic characteristic and physician responses to the importance of LTRs. The survey included 2 questions about the duration of physician practice and the number of patients seen in a typical week, 4 questions about perceived meaningfulness and friendship in the doctor-patient relationship, and 2 questions about the doctor-patient relationship setting. The adjusted survey response rate was 69% (1289/1863), 43% of physicians indicated that many or most of their patient relationships are LTRs, and 13.7% indicated they consider many or most of their patients to be friends. Just fewer than half of physicians (45.1%) perceive LTRs to have a great impact on clinical outcomes, 64.8% believe that LTRs contribute to patient trust, and 52.2% believe that LTRs are more likely to cause a patient to follow a physician's medical recommendations. This study presents a representative picture of US physicians' perceptions regarding relationships with patients. Physicians generally perceive LTRs to have a positive impact on patients' clinical outcomes, although the majority of physicians report they have few or no such relationships.

  5. Excesso de confiança do Chief Executive Officer e a prática de gerenciamento de resultados = Overconfident chief executive officer and earnings management practice

    Directory of Open Access Journals (Sweden)

    Cristian Bau Dal Magro

    2018-03-01

    Full Text Available Diversos estudos têm sugerido que o excesso de confiança leva a expectativas de desempenho futuro, e os gerentes podem desenvolver predisposição para o gerenciamento de resultados. O objetivo do estudo é identificar a influência do excesso de confiança de gestores nas práticas de gerenciamento de resultados das empresas brasileiras. A metodologia da pesquisa é descritiva, com abordagem quantitativa, por meio de pesquisa documental. Os métodos estatísticos utilizados foram: entropia, TOPSIS e a regressão linear múltipla. A amostra foi composta de 127 empresas brasileiras listadas na BM&FBovespa. Conclui-se que o menor excesso de confiança impacta positivamente no gerenciamento de resultados. Sugere que os gestores com menor confiança acreditam, com menor intensidade, em suas habilidades, e, para garantir resultados organizacionais que satisfaçam às expectativas de analistas, praticam o gerenciamento de resultados de maneira oportuna para aumentar os resultados organizacionais. Several studies have suggested that overconfidence leads to expectations of future performance, and managers can develop predisposition to earnings management. The objective of the study is to identify the influence of overconfident managers on Brazilian companies’ earning management practices. The methodology of the research is descriptive, with quantitative approach, through documentary research. The statistical methods used were: entropy, TOPSIS and multiple linear regression. The sample consisted of 127 Brazilian companies listed on the BM&FBovespa. It is concluded that lower overconfidence has a positive impact on earnings management, suggesting that less confident managers believe with less intensity in their abilities, and, in order to guarantee organizational results that satisfy the expectations of analysts, they conduct the earnings management in an opportunistic way so as to increase organizational results.

  6. Physicians' perspectives of pharmacist-physician collaboration in the United Arab Emirates: Findings from an exploratory study.

    Science.gov (United States)

    Hasan, S; Stewart, K; Chapman, C B; Kong, D C M

    2018-03-28

    Interprofessional collaborative care has been shown to improve patient outcomes. Physicians' views on collaboration with pharmacists give an insight into what contributes to a well-functioning team. Little is known about these views from low and ​middle-income countries and nothing from the United Arab Emirates (UAE). The purpose of this study is to investigate physicians' opinions on collaborative relationships with community pharmacists in the UAE. Semi-structured individual interviews and group discussions are conducted with a purposive sample of physicians. Thematic analysis based on the framework approach is used to generate themes. A total of 53 physicians participated. Three themes about collaboration emerged: perceived benefits of collaboration, facilitators of collaboration and perceived barriers to collaboration. Perceived benefits include reducing the burden on physicians, having the pharmacist as an extra safety check within the system, having the pharmacist assist patients to manage their medications: coping with side effects, reducing drug waste and costs, and attaining professional and health-system gains. Perceived facilitators included awareness and trust building, professional role definition, pharmacists' access to patient records and effective communication. Perceived barriers included patient and physician acceptance, logistic and financial issues and perceived pharmacist competence. This study has, for the first time, provided useful information to inform the future development of pharmacist-physician collaboration in the UAE and other countries with similar healthcare systems.

  7. Should physicians have facial piercings?

    Science.gov (United States)

    Newman, Alison W; Wright, Seth W; Wrenn, Keith D; Bernard, Aline

    2005-03-01

    The objective of this study was to assess attitudes of patrons and medical school faculty about physicians with nontraditional facial piercings. We also examined whether a piercing affected the perceived competency and trustworthiness of physicians. Survey. Teaching hospital in the southeastern United States. Emergency department patrons and medical school faculty physicians. First, patrons were shown photographs of models with a nontraditional piercing and asked about the appropriateness for a physician or medical student. In the second phase, patrons blinded to the purpose of the study were shown identical photographs of physician models with or without piercings and asked about competency and trustworthiness. The third phase was an assessment of attitudes of faculty regarding piercings. Nose and lip piercings were felt to be appropriate for a physician by 24% and 22% of patrons, respectively. Perceived competency and trustworthiness of models with these types of piercings were also negatively affected. An earring in a male was felt to be appropriate by 35% of patrons, but an earring on male models did not negatively affect perceived competency or trustworthiness. Nose and eyebrow piercings were felt to be appropriate by only 7% and 5% of faculty physicians and working with a physician or student with a nose or eyebrow piercing would bother 58% and 59% of faculty, respectively. An ear piercing in a male was felt to be appropriate by 20% of faculty, and 25% stated it would bother them to work with a male physician or student with an ear piercing. Many patrons and physicians feel that some types of nontraditional piercings are inappropriate attire for physicians, and some piercings negatively affect perceived competency and trustworthiness. Health care providers should understand that attire may affect a patient's opinion about their abilities and possibly erode confidence in them as a clinician.

  8. ADHERENCE TO LONG-TERM TREATMENT OF CARDIOVASCULAR DISEASE AND NON-COMPLIANCE WITH MEDICAL RECOMMENDATIONS: THE OPINION OF PATIENTS AND PHYSICIANS BY THE RESULTS OF FOCUSED INTERVIEW

    Directory of Open Access Journals (Sweden)

    O. N. Semenova

    2015-09-01

    Full Text Available Aim. To study the subjective opinion of patients and doctors about their individual experiences with adherence to treatment for chronic cardiovascular diseases in the group focused interview of patients and their physicians.Material and methods. 3 groups of patients from clinical studies adhering to the doctor's recommendations (focus-group 1 and 3 groups of patients hospitalized for cardiovascular events, not adhering to recommendations after discharge (focus-group 2 and one focus-group of doctors were analyzed. Group discussion was performed by a moderator (experienced sociologist, with no medical training who was not familiar with the patients and physicians.Results. 47 patients (25 (53.2 % men and 22 (46.8% women and 6 doctors participated in the study. Paternalistic model of communication with doctors present in the minds of all patients. In patients of the first group this results in a full confidence in the doctor and compliance with all recommendations while in patients of the second group lack of care in the outpatient clinic makes them "offended" by the underestimation of their trust and causes non-compliance. Physicians intuitively divide patients into less and more "attractive" for themselves. This "division" on the one hand may have some predictive value in respect of patients’ adherence to a further treatment, and on the other hand, the "doctors’ prejudice" in relation to the patient may adversely effect the behavior of the patients and failure to follow the recommendations in the future.Conclusion. The significant paternalism on the part of the patient on the one hand increases the responsibility of the physician for his patient, and on the other hand – increases opportunities for his influence on the patients’ behavior.

  9. ADHERENCE TO LONG-TERM TREATMENT OF CARDIOVASCULAR DISEASE AND NON-COMPLIANCE WITH MEDICAL RECOMMENDATIONS: THE OPINION OF PATIENTS AND PHYSICIANS BY THE RESULTS OF FOCUSED INTERVIEW

    Directory of Open Access Journals (Sweden)

    O. N. Semenova

    2014-01-01

    Full Text Available Aim. To study the subjective opinion of patients and doctors about their individual experiences with adherence to treatment for chronic cardiovascular diseases in the group focused interview of patients and their physicians.Material and methods. 3 groups of patients from clinical studies adhering to the doctor's recommendations (focus-group 1 and 3 groups of patients hospitalized for cardiovascular events, not adhering to recommendations after discharge (focus-group 2 and one focus-group of doctors were analyzed. Group discussion was performed by a moderator (experienced sociologist, with no medical training who was not familiar with the patients and physicians.Results. 47 patients (25 (53.2 % men and 22 (46.8% women and 6 doctors participated in the study. Paternalistic model of communication with doctors present in the minds of all patients. In patients of the first group this results in a full confidence in the doctor and compliance with all recommendations while in patients of the second group lack of care in the outpatient clinic makes them "offended" by the underestimation of their trust and causes non-compliance. Physicians intuitively divide patients into less and more "attractive" for themselves. This "division" on the one hand may have some predictive value in respect of patients’ adherence to a further treatment, and on the other hand, the "doctors’ prejudice" in relation to the patient may adversely effect the behavior of the patients and failure to follow the recommendations in the future.Conclusion. The significant paternalism on the part of the patient on the one hand increases the responsibility of the physician for his patient, and on the other hand – increases opportunities for his influence on the patients’ behavior.

  10. Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects.

    Science.gov (United States)

    Dückers, Michel L A; Stegeman, Inge; Spreeuwenberg, Peter; Wagner, Cordula; Sanders, Karin; Groenewegen, Peter P

    2009-08-01

    The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation, between the extent to which physicians notice their CEOs stimulate improvement initiatives and the number of projects joined by physicians, is moderated by the consensus among physicians working in the same hospital. Multilevel analyses are applied on data of 286 physicians from eight hospitals to: (1) estimate whether participation depends on noticing if CEOs stimulate improvement, (2) test if an individual's participation differs when more colleagues have the same opinion (effect modification). Significant moderator effects are found. The participation of physicians, noticing that CEOs stimulate improvement is higher when more colleagues share this opinion. For physicians not knowing whether improvement is encouraged, higher consensus coincides with lower participation. Project involvement of physicians depends on their consensus about encouragement by CEOs. This confirms the importance of strategic leaders in dissemination programs. Further research is recommended into causes of CEO leadership visibility and methods to strengthen leadership climate.

  11. Relationship between physicians' perceived stigma toward depression and physician referral to psycho-oncology services on an oncology/hematology ward.

    Science.gov (United States)

    Kim, Won-Hyoung; Bae, Jae-Nam; Lim, Joohan; Lee, Moon-Hee; Hahm, Bong-Jin; Yi, Hyeon Gyu

    2018-03-01

    This study was performed to identify relationships between physicians' perceived stigma toward depression and psycho-oncology service utilization on an oncology/hematology ward. The study participants were 235 patients in an oncology/hematology ward and 14 physicians undergoing an internal medicine residency training program in Inha University Hospital (Incheon, South Korea). Patients completed the Patient Health Questionnaire-9 (PHQ-9), and residents completed the Perceived Devaluation-Discrimination scale that evaluates perceived stigma toward depression. A total PHQ-9 score of ≥5 was defined as clinically significant depression. Physicians decided on referral on the basis of their opinions and those of their patients. The correlates of physicians' recommendation for referral to psycho-oncology services and real referrals psycho-oncology services were examined. Of the 235 patients, 143 had PHQ-9 determined depression, and of these 143 patients, 61 received psycho-oncology services. Physicians recommended that 87 patients consult psycho-oncology services. Multivariate analyses showed that lower physicians' perceived stigma regarding depression was significantly associated with physicians' recommendation for referral, and that real referral to psycho-oncology services was significantly associated with presence of a hematologic malignancy and lower physicians' perceived stigma toward depression. Physicians' perceived stigma toward depression was found to be associated with real referral to psycho-oncology services and with physician recommendation for referral to psycho-oncology services. Further investigations will be needed to examine how to reduce physicians' perceived stigma toward depression. Copyright © 2017 John Wiley & Sons, Ltd.

  12. 42 CFR 411.375 - Fees for the cost of advisory opinions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Fees for the cost of advisory opinions. 411.375... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.375 Fees for the cost... revised the amount of the initial fee in a program issuance, in which case, the requestor must include the...

  13. Loaded Questions: Internet Commenters' Opinions on Physician-Patient Firearm Safety Conversations.

    Science.gov (United States)

    Knoepke, Christopher E; Allen, Amanda; Ranney, Megan L; Wintemute, Garen J; Matlock, Daniel D; Betz, Marian E

    2017-08-01

    Medical and public health societies advocate that healthcare providers (HCPs) counsel at-risk patients to reduce firearm injury risk. Anonymous online media comments often contain extreme viewpoints and may therefore help in understanding challenges of firearm safety counseling. To help inform injury prevention efforts, we sought to examine commenters' stated opinions regarding firearm safety counseling HCPs. Qualitative descriptive analysis of online comments posted following news items (in May-June, 2016) about a peer-reviewed publication addressing when and how HCPs should counsel patients regarding firearms. Among 871 comments posted by 522 individuals, most (57%) were generally negative toward firearm discussions, 17% were positive, and 26% were neutral/unclear. Two major categories and multiple themes emerged. "Areas of agreement" included that discussions may be valuable (1) when addressing risk of harm to self or others, (2) in pediatric injury prevention, and (3) as general safety education (without direct questioning), and that (4) HCPs lack gun safety and cultural knowledge. "Areas of tension" included whether (1) firearms are a public health issue, (2) counseling is effective prevention practice, (3) suicide could/should be prevented, and (4) firearm safety counseling is within HCPs' purview. Among this set of commenters with likely extreme viewpoints, opinions were generally negative toward firearm safety conversations, but with some support in specific situations. Providing education, counseling, or materials without asking about firearm ownership was encouraged. Engaging firearm advocates when developing materials may enhance the acceptability of prevention activities.

  14. Euthanasia and physician-assisted suicide policy in The Netherlands and Oregon: a comparative analysis.

    Science.gov (United States)

    Patel, Kant

    2004-01-01

    This article presents a comparative analysis of euthanasia and physician-assisted suicide policy in The Netherlands and the state of Oregon in the United States. The topics of euthanasia and physician-assisted suicide are discussed in the context of the historical setting of The Netherlands and the United States with special emphasis placed on public opinion, role of the courts and the legislative bodies, and opinions of physicians. Major similarities and differences in the laws of The Netherlands and Oregon are discussed. The article examines whether the passage of the law has led to a slide down the slippery slope in The Netherlands and Oregon as had been suggested by the opponents of the law. The article concludes that the empirical evidence does not support the contention of the opponents. However, the author argues that the potential for this happening is much greater in The Netherlands than in Oregon.

  15. Difficulties facing physician mothers in Japan.

    Science.gov (United States)

    Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

    2011-11-01

    Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce. © 2011 Tohoku University Medical Press

  16. CORPORATE GOVERNANCE AND STRATEGIC PERSONNEL MANAGEMENT: WOMEN ON THE BOARD AND FEMALE LEADERSHIP, CEO OVERCONFIDENCE, LAYOFF DECISIONS Capital Market Perception and Shareholder Wealth Effects

    OpenAIRE

    Hinrichsen, Anna Verena

    2017-01-01

    The present dissertation deals with selected aspects of corporate governance and personnel management and provides an in-depth analysis of capital markets’ perception of these issues and the effects on shareholder wealth. Subjects of the investigation are the role and effects of gender diversity on corporate boards and female leadership, CEO overconfidence and corporate layoff decisions. Chapter 2 offers a comprehensive overview of existing research on the effects of an increased female ...

  17. How should we train physicians for remote and rural practice? What the present incumbents say.

    Science.gov (United States)

    Wilson, P; McHardy, K C

    2004-08-01

    To obtain the views of the current remote and rural consultant physicians with regards to their opinion on components of an ideal training programme for an aspirant remote and rural physician. A questionnaire was designed to elicit information in three main areas: experience and training prior to appointment, current pattern of service provision and opinions on components of an ideal training programme for remote and rural physicians. Five Scottish rural hospitals in Shetland, Wick, Stornoway, Fort William and Oban. Thirteen consultant physicians based in the five rural hospitals chosen. The response rate to the questionnaire was 85%. All had previous experience in acute general medicine, and most in one of a variety of subspecialties. Each physician had developed interests and skills in other branches of medicine following appointment in order to meet local service needs. Most felt that there was a need for expansion of consultant numbers in the future, 45% citing the European Working Time Directive as the major reason. There was an encouraging degree of commonality between the current consultants as to what they felt should be included in a training programme for remote and rural physicians. There are challenges in meeting training needs for consultant physicians intending to work in a remote setting. Development of broader-based training than offered by most current dual training programmes is essential. Only imaginative approaches to training will produce physicians who are fit for purpose.

  18. Queen Victoria, her physicians, and her cataracts.

    Science.gov (United States)

    Ravin, J G

    1994-01-01

    Decreasing vision due to cataracts became a significant problem for Queen Victoria toward the end of the 19th century. Her personal physician, Sir James Reid, obtained consultations with two eminent British ophthalmologists, George Lawson and Edward Nettleship. The Queen was not satisfied, and requested an opinion from the German professor Hermann Pagenstecher. All the doctors agreed on the diagnosis, but the Queen never underwent surgery.

  19. Attitudes of health care professionals, relatives of advanced cancer patients and public towards euthanasia and physician assisted suicide.

    Science.gov (United States)

    Parpa, Efi; Mystakidou, Kyriaki; Tsilika, Eleni; Sakkas, Pavlos; Patiraki, Elisabeth; Pistevou-Gombaki, Kyriaki; Govina, Ourania; Panagiotou, Irene; Galanos, Antonis; Gouliamos, Athanasios

    2010-10-01

    Nowadays, euthanasia has the meaning of the direct administration of a lethal agent to the patient by another party with a merciful intent after patients' request. Physician assisted suicide refers to the patient intentionally and wilfully ending his or her own life with the assistance of a physician. The objectives of the manuscript were to investigate the opinions of Greek physicians, nurses, lay people and relatives of advanced cancer patients on euthanasia and physician assisted suicide. The final sample consisted of 215 physicians, 250 nurses, 218 relatives and 246 lay people. A survey questionnaire was used concerning issues such as euthanasia and physician assisted suicide. The survey instrument included 13 questions and described issues such as religious and spiritual beliefs, euthanasia, physician assisted suicide and decision-making situations. 43.3% physicians and 41.3% relatives would agree in advance that in case of heart and/or respiratory arrest there would not be an effort to revive a terminally ill cancer patient. 20.5% physicians had a request for euthanasia. Significant associations were found between physicians (9.3%), relatives (1.8%, p=0.001) and lay people (3.7%, p=0.020) on their opinions regarding withdrawing treatment. The majority of the participants were opposed to euthanasia and physician assisted suicide. However many would agree to the legalization of an advanced cancer patient's hastened death. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  20. [German national second-opinion network for testicular cancer and penile carcinoma : Two sources for evidence-based information].

    Science.gov (United States)

    Schrader, M; Zengerling, F; Hakenberg, O W; Protzel, C

    2016-09-01

    The second-opinion network for testicular cancer is an internet-based platform addressing physicians treating testicular cancer patients. They are offered a second-opinion before determining further therapy after orchiectomy and completion of staging. The high rate of discrepancies between the first and second opinion in more than 30 % supports the assumption of a deficit in the implementation of treatment guidelines. In 2015, approximately 22 % of the newly diagnosed cases with testicular cancer in Germany were covered by this system. According to the present interim analysis, the second-opinion platform helps to avoid overtreatment of testicular cancer patients. The high acceptance of the project and the encouraging results of this interim analysis gave rise to considerations to apply the second-opinion model to penile carcinoma. Data from the UK and the Netherlands show that the second-opinion network for penile cancer could help to improve treatment standards and results in Germany. Current data and the intended further development of the system are discussed.

  1. Physician Opinions about an Anatomy Core Curriculum: A Case for Medical Imaging and Vertical Integration

    Science.gov (United States)

    Orsbon, Courtney P.; Kaiser, Rebecca S.; Ross, Callum F.

    2014-01-01

    Pre-clinical anatomy curricula must provide medical students with the knowledge needed in a variety of medical and surgical specialties. But do physicians within specialties agree about what anatomical knowledge is most important in their practices? And, what is the common core of anatomical knowledge deemed essential by physicians in different…

  2. Brazilian doctors' perspective on the second opinion strategy before a C-section.

    Science.gov (United States)

    Osis, Maria José Duarte; Cecatti, José Guilherme; de Pádua, Karla Simônia; Faúndes, Anibal

    2006-04-01

    To describe the opinion of doctors who participated in the Latin American Study on Cesarean section in Brazil regarding the second opinion strategy when faced with the decision of performing a C-section. Seventy-two doctors from the hospitals where the study took place (where the second opinion was routinely sought) and 70 from the control group answered a pre-tested self-administered structured questionnaire. Descriptive tables were prepared based on the frequency of relevant variables on opinion of physicians regarding: effectiveness of the application of the second opinion strategy; on whether they would recommend implementation of this strategy and reasons for not recommending it in private institutions; feasibility of the strategy implementation and reasons for not considering this implementation feasible in private institutions. Half of the doctors from the intervention hospitals (50%) and about two thirds of those in the control group (65%) evaluated the second opinion as being or having the potential of being effective/very effective in their institutions. The great majority of those interviewed from both intervention and control hospitals considered this strategy feasible in public (87% and 95% respectively) but not in private hospitals (64% and 70% respectively), mainly because in the latter the doctors would not accept interference from a colleague in their decision-making process. Although the second opinion strategy was perceived as effective in reducing C-section rates, doctors did not regard it feasible outside the public health system in Brazil.

  3. Consumer opinions of emergency room medical care.

    Science.gov (United States)

    McMillan, J R; Younger, M S; DeWine, L C

    1984-12-01

    If hospital management is to adapt successfully to an increasingly competitive environment, and to retain a viable emergency department, it well be necessary to objectively and accurately assess the hospital's image in the community served. Knowledge of the consumers' views is an essential input into the formulation of strategic plans. This article reports on a study in which consumer opinions on 15 dimensions of emergency room health care were obtained from 723 respondents using a mail questionnaire. Findings reveal that consumers view the emergency room as being more expensive than other health care providers. Except for being available or convenient, little or no advantage is perceived for the emergency room over the personal physician. Even though the emergency room has specialized staff and equipment, consumers do not believe patients receive better or faster treatment in an emergency room than would be obtained in a physician's office. Unless changed, these perceptions will diminish the role of the emergency room in the delivery of health care services.

  4. Factors driving physician-hospital alignment in orthopaedic surgery.

    Science.gov (United States)

    Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

    2013-06-01

    The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

  5. OpinionFlow: Visual Analysis of Opinion Diffusion on Social Media.

    Science.gov (United States)

    Wu, Yingcai; Liu, Shixia; Yan, Kai; Liu, Mengchen; Wu, Fangzhao

    2014-12-01

    It is important for many different applications such as government and business intelligence to analyze and explore the diffusion of public opinions on social media. However, the rapid propagation and great diversity of public opinions on social media pose great challenges to effective analysis of opinion diffusion. In this paper, we introduce a visual analysis system called OpinionFlow to empower analysts to detect opinion propagation patterns and glean insights. Inspired by the information diffusion model and the theory of selective exposure, we develop an opinion diffusion model to approximate opinion propagation among Twitter users. Accordingly, we design an opinion flow visualization that combines a Sankey graph with a tailored density map in one view to visually convey diffusion of opinions among many users. A stacked tree is used to allow analysts to select topics of interest at different levels. The stacked tree is synchronized with the opinion flow visualization to help users examine and compare diffusion patterns across topics. Experiments and case studies on Twitter data demonstrate the effectiveness and usability of OpinionFlow.

  6. Euthanasia and physician-assisted suicide not meeting due care criteria in the Netherlands: a qualitative review of review committee judgements.

    Science.gov (United States)

    Miller, David Gibbes; Kim, Scott Y H

    2017-10-25

    ObjectivesTo assess how Dutch regional euthanasia review committees (RTE) apply the euthanasia and physician-assisted suicide (EAS) due care criteria in cases where the criteria are judged not to have been met ('due care not met' (DCNM)) and to evaluate how the criteria function to set limits in Dutch EAS practice. A qualitative review using directed content analysis of DCNM cases in the Netherlands from 2012 to 2016 published on the RTE website (https://www.euthanasiecommissie.nl/) as of 31 January 2017. Of 33 DCNM cases identified (occurring 2012-2016), 32 cases (97%) were published online and included in the analysis. 22 cases (69%) violated only procedural criteria, relating to improper medication administration or inadequate physician consultation. 10 cases (31%) failed to meet substantive criteria, with the most common violation involving the no reasonable alternative (to EAS) criterion (seven cases). Most substantive cases involved controversial elements, such as EAS for psychiatric disorders or 'tired of life', in incapacitated patients or by physicians from advocacy organisations. Even in substantive criteria cases, the RTE's focus was procedural. The cases were more about unorthodox, unprofessional or overconfident physician behaviours and not whether patients should have received EAS. However, in some cases, physicians knowingly pushed the limits of EAS law. Physicians from euthanasia advocacy organisations were over-represented in substantive criteria cases. Trained EAS consultants tended to agree with or facilitate EAS in DCNM cases. Physicians and families had difficulty applying ambiguous advance directives of incapacitated patients. As a retrospective review of physician self-reported data, the Dutch RTEs do not focus on whether patients should have received EAS, but instead primarily gauge whether doctors conducted EAS in a thorough, professional manner. To what extent this constitutes enforcement of strict safeguards, especially when cases contain

  7. Non-physician-assisted suicide in The Netherlands: a cross-sectional survey among the general public.

    Science.gov (United States)

    Schoonman, Merel Kristi; van Thiel, Ghislaine José Madeleine Wilhelmien; van Delden, Johannes Jozef Marten

    2014-12-01

    In The Netherlands, approximately 45% of patients' requests for euthanasia are granted by a physician. After a rejected request, some patients approach non-physicians and ask them for assistance in suicide. Recently, a non-physician who assisted his mother's suicide was declared guilty without punishment. The aim of the current study was to investigate the opinion of the Dutch general public on non-physician-assisted suicide. A cross-sectional survey among the Dutch general public was performed. A total of 1113 respondents were included (response rate 80%). The survey covered two case descriptions in which a patient asks a non-physician for assisted suicide after a non-granted request for physician-assisted dying. In both cases, a son, friend or professional facilitates the suicide by either the provision of information or the purchase of lethal medication. Respondents were invited to give their opinion on these cases and in addition on 10 propositions on non-physician-assisted suicide. When a son provides information on how to acquire lethal medication in case of a patient with a terminal illness, this involvement is accepted by 62% of the respondents. The actual purchase of lethal medication receives less support (38%). If the patient suffers without a serious disease, both forms of assistance are less accepted (46% and 24%, respectively). In addition, only 21% support the legalisation of non-physician-assisted suicide. The Dutch public prefer involvement of a physician in assisted suicide (69%). The Dutch general public consider non-physician-assisted suicide in some specific cases a tolerable alternative for patients with a rejected request for physician-assisted dying if the assistance is limited to the provision of information. However, the majority do not support the legalisation of non-physician-assisted suicide. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Resident physicians' opinions and behaviors regarding the use of interpreters in New Orleans.

    Science.gov (United States)

    Sandler, Rachel; Myers, Leann; Springgate, Benjamin

    2014-11-01

    In academic medical centers, resident physicians are most involved in the care of patients, yet many have little training in the proper use of interpreters in the care of patients with limited English-language proficiency. Residents have cited lack of time and lack of access to trained medical interpreters as barriers to the use of professional interpreter services. The purpose of this study was to examine the usage patterns of interpreters and perceived barriers to using interpreters in New Orleans. Subjects included resident physicians training in internal medicine, pediatrics, and combined internal medicine and pediatrics at Tulane University and Louisiana State University in New Orleans. A survey that consisted of demographics, short-answer, and Likert-scale questions regarding attitudes related to the use of interpreters was used as the metric. The overall response rate was 55.5%. A total of 92.4% of subjects surveyed stated that they had used an interpreter during their residency. Telephone services and family members were the most commonly used types of interpreters (41.3% and 30.5%, respectively). Resident physicians were most likely to use interpreter services during their initial history taking as well as at discharge, but use declined throughout patients' hospitalization (P New Orleans have experience using interpreter services; however, they continue to use untrained interpreters and use varies during the hospital encounter. Targeted training for residents, including interpreter logistics, may help increase the use of interpreters.

  9. Physician recruitment and retention in Manitoba: results from a survey of physicians' preferences for rural jobs.

    Science.gov (United States)

    Witt, Julia

    2017-01-01

    Rural recruitment and retention continues to present challenges to health workforce planners. This paper reports and analyzes the results of a survey sent to physicians in Manitoba, eliciting their opinions regarding rural jobs. A survey was sent to all physicians in Manitoba. Part 1 of the survey included questions about background and demographic information; part 2 was a set of job satisfaction questions regarding respondents' current job; and part 3 included 2 sets of stated-choice questions eliciting preferences for a set of attributes relevant to rural recruitment and retention. Of the 2487 physicians who received surveys, 561 (22.6%) responded. Respondents indicated that income, hours worked and on-call frequency are very important: overall job satisfaction increased with income and decreased with hours worked. Income, hours and on-call frequency were ranked "very important" by the largest proportions of physicians. The estimated compensation for on-call more frequent than 1-in-4 was very high (82% of average income), and additional hours worked were worth $183 per hour. Other attributes that were important included professional interaction, housing availability and community incentives during the first year, which were valued at 11%-31% of annual income. Work-life balance is a key consideration for rural jobs, and there are incentives that can compensate for less desirable attributes.

  10. Survey of doctors' opinions of the legalisation of physician assisted suicide

    Directory of Open Access Journals (Sweden)

    Rayner Lauren

    2009-03-01

    Full Text Available Abstract Background Assisted dying has wide support among the general population but there is evidence that those providing care for the dying may be less supportive. Senior doctors would be involved in implementing the proposed change in the law. We aimed to measure support for legalising physician assisted dying in a representative sample of senior doctors in England and Wales, and to assess any association between doctors' characteristics and level of support for a change in the law. Methods We conducted a postal survey of 1000 consultants and general practitioners randomly selected from a commercially available database. The main outcome of interest was level of agreement with any change in the law to allow physician assisted suicide. Results The corrected participation rate was 50%. We analysed 372 questionnaires. Respondents' views were divided: 39% were in favour of a change to the law to allow assisted suicide, 49% opposed a change and 12% neither agreed nor disagreed. Doctors who reported caring for the dying were less likely to support a change in the law. Religious belief was also associated with opposition. Gender, specialty and years in post had no significant effect. Conclusion More senior doctors in England and Wales oppose any step towards the legalisation of assisted dying than support this. Doctors who care for the dying were more opposed. This has implications for the ease of implementation of recently proposed legislation.

  11. A Survey of Italian Physicians' Opinion about Stem Cells Research: What Doctors Prefer and What the Law Requires

    Directory of Open Access Journals (Sweden)

    Paola Frati

    2014-01-01

    Full Text Available To evaluate the Italian physicians' knowledge/information level about the therapeutic potential of stem cells, the research choice between embryonic and cordonal stem cells, and the preference between autologous and heterologous storage of cordonal stem cells, we performed a national survey. The questionnaire—distributed to 3361 physicians—involved physicians of different religious orientations and of different medical specialities. Most of the physicians involved (67% were Catholics, and the majority were gynaecologists and paediatricians (43% who are mainly in charge to inform future mothers about the possibility of cordonal stem cells conservation. The majority of the physicians interviewed do not have specific knowledge about stem cells (59%, most of them having only generic information (92%. The largest part of physicians prefer to use umbilical cord blood cells rather than embryonic stem cells. Nevertheless, a large percentage of physicians were in favour of embryo research, especially when embryos are supernumerary (44% versus 34%. Eighty-seven % of the physicians interviewed proved to have a general knowledge about stem cells and believe in their therapeutic potential. They prefer research on cordonal stem cells rather than on embryo stem cells. Although they are in favour of heterologous stem cells donation, they still prefer cryopreservation for personal use.

  12. An empirical analysis of ethical and professional issues in physicians' advertising: A comparative cross-sectional study.

    Science.gov (United States)

    Moser, H Ronald; Stevens, Robert; Loudon, David

    2016-01-01

    The purpose of this study is to investigate current attitudes and opinions of physicians' advertising and to compare them to the attitudes expressed 10 years previously. This study was designed to determine (a) consumers' attitudes toward advertising by physicians, and (b) whether age, occupation, income, education, or sex of consumer accounted for any significant difference in attitudes toward physicians who advertise. The study seems to confirm the belief of many marketing professionals that advertising and marketing do not have a place in the management and operation of professional services.

  13. Direct-to-physician and direct-to-consumer advertising: Time to have stringent regulations.

    Science.gov (United States)

    Kannan, S; Gowri, S; Tyagi, V; Kohli, S; Jain, R; Kapil, P; Bhardwaj, A

    2015-01-01

    Direct to physician advertisements and direct to consumer advertisement (DTCA) is a well-known marketing strategy of pharmaceutical companies. Studies from the West and also from the Indian sub-continent revealed several lacunae in such advertisements. The present study was carried out to understand the international and national scenario regarding the lacunae in drug advertisements and the opinion of both physicians and patients regarding DTCA. The present study was conducted after obtaining approval from the institutional ethics committee. Warning letters (WLs) issued to pharmaceutical companies by United States Food and Drug Administration (USFDA) and Therapeutic Goods Administration (TGA) due to discrepancies in the advertisements were analyzed for reasons that were grouped into one of the following categories: overstatement of efficacy; unapproved indication; lack of adequate directions to use; omission of adverse effects; misleading claims; advertisement made for an unapproved drug (investigational new product). Drug advertisements in Current Index of Medical Specialties (CIMS) April-July 2014 issue was also analyzed for lacunae depending on categories as mentioned above. Physicians and patients in a tertiary care medical college and hospital were administered a validated questionnaire exploring their views about crucial aspects of DTCA. Descriptive statistics was used for each of the categories. A total of 93 WLs issued by USFDA and 36 by TGA were assessed. Majority of the WLs by USFDA were issued for omission of adverse effects (61/93, 65.6%) followed by misleading claims (54/93, 58.1%). Similarly, WLs by TGA were also mainly issued for the presence of misleading claims (35/36, 97.2%) followed by overstatement of efficacy (26/36, 72.2%) and CIMS evaluation had revealed that 78/92 (84.8%) advertisements omitted adverse effects, 20/92 (21.7%) had misleading claims, 9/92 (9.8%) had unapproved indications and 7/92 (7.6%) overstated the efficacy. With regard to

  14. Conscientious refusals to refer: Findings from a national physician survey

    Science.gov (United States)

    Combs, Michael P.; Antiel, Ryan M.; Tilburt, Jon C.; Mueller, Paul S.; Curlin, Farr A.

    2014-01-01

    Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method We conducted a cross-sectional survey of a random sample of 2000 U.S. physicians from all specialties. Our primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. Fifty-seven percent of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one’s practice (multivariable odds ratios, 1.6 to 2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. PMID:21335574

  15. Continuous Palliative Sedation for Existential Distress? A Survey of Canadian Palliative Care Physicians' Views.

    Science.gov (United States)

    Voeuk, Anna; Nekolaichuk, Cheryl; Fainsinger, Robin; Huot, Ann

    2017-01-01

    Palliative sedation can be used for refractory symptoms during end-of-life care. However, continuous palliative sedation (CPS) for existential distress remains controversial due to difficulty determining when this distress is refractory. The aim was to determine the opinions and practices of Canadian palliative care physicians regarding CPS for existential distress. A survey focusing on experience and views regarding CPS for existential distress was sent to 322 members of the Canadian Society of Palliative Care Physicians. Eighty-one surveys returned (accessible target, 314), resulting in a response rate of 26%. One third (31%) of the respondents reported providing CPS for existential distress. On a 5-point Likert-type scale, 40% of participants disagreed, while 43% agreed that CPS could be used for existential distress alone. Differing opinions exist regarding this complex and potentially controversial issue, necessitating the education of health-care professionals and increased awareness within the general public.

  16. Physician smoking status, attitudes toward smoking, and cessation advice to patients: an international survey.

    Science.gov (United States)

    Pipe, Andrew; Sorensen, Michelle; Reid, Robert

    2009-01-01

    The smoking status of physicians can impact interactions with patients about smoking. The 'Smoking: The Opinions of Physicians' (STOP) survey examined whether an association existed between physician smoking status and beliefs about smoking and cessation and a physician's clinical interactions with patients relevant to smoking cessation, and perceptions of barriers to assisting with quitting. General and family practitioners across 16 countries were surveyed via telephone or face-to-face interviews using a convenience-sample methodology. Physician smoking status was self-reported. Of 4473 physicians invited, 2836 (63%) participated in the survey, 1200 (42%) of whom were smokers. Significantly fewer smoking than non-smoking physicians volunteered that smoking was a harmful activity (64% vs 77%; Pnon-smoking physicians identified willpower (37% vs 32%; P<0.001) and lack of interest (28% vs 22%; P<0.001) as barriers to quitting, more smoking physicians saw stress as a barrier (16% vs 10%; P<0.001). Smoking physicians are less likely to initiate cessation interventions. There is a need for specific strategies to encourage smoking physicians to quit, and to motivate all practitioners to adopt systematic approaches to assisting with smoking cessation.

  17. When doctor becomes patient: challenges and strategies in caring for physician-patients.

    Science.gov (United States)

    Domeyer-Klenske, Amy; Rosenbaum, Marcy

    2012-01-01

    The current study was aimed at exploring the challenges that arise in the doctor-patient relationship when the patient is also a physician and identifying strategies physicians use to meet these challenges. No previous research has systematically investigated primary care physicians' perspectives on caring for physician-patients. Family medicine (n=15) and general internal medicine (n=14) physicians at a large Midwestern university participated in semi-structured interviews where they were asked questions about their experiences with physician-patients and the strategies they used to meet the unique needs of this patient population. Thematic analysis was used to identify common responses. Three of the challenges most commonly discussed by physician participants were: (1) maintaining boundaries between relationships with colleagues or between roles as physician/colleague/friend, (2) avoiding assumptions about patient knowledge and health behaviors, and (3) managing physician-patients' access to informal consultations, personal test results, and opinions from other colleagues. We were able to identify three main strategies clinicians use in addressing these perceived challenges: (1) Ignore the physician-patient's background, (2) Acknowledge the physician-patient's background and negotiate care, and (3) Allow care to be driven primarily by the physician-patient. It is important that primary care physicians understand the challenges inherent in treating physicians and develop a strategy with which they are comfortable addressing them. Explicitly communicating with the physician-patient to ensure boundaries are maintained, assumptions about the physician-patient are avoided, and physician-patient access is properly managed are key to providing quality care to physician-patients.

  18. A Survey of Italian Physicians' Opinion about Stem Cells Research: What Doctors Prefer and What the Law Requires

    OpenAIRE

    Frati, Paola; Gulino, Matteo; Pacchiarotti, Arianna; D'Errico, Stefano; Sicuro, Lorella; Fineschi, Vittorio

    2014-01-01

    To evaluate the Italian physicians' knowledge/information level about the therapeutic potential of stem cells, the research choice between embryonic and cordonal stem cells, and the preference between autologous and heterologous storage of cordonal stem cells, we performed a national survey. The questionnaire—distributed to 3361 physicians—involved physicians of different religious orientations and of different medical specialities. Most of the physicians involved (67%) were Catholics, and th...

  19. Physicians' and Nurses' Opinions about the Impact of a Computerized Provider Order Entry System on Their Workflow.

    Science.gov (United States)

    Ayatollahi, Haleh; Roozbehi, Masoud; Haghani, Hamid

    2015-01-01

    In clinical practices, the use of information technology, especially computerized provider order entry (CPOE) systems, has been found to be an effective strategy to improve patient care. This study aimed to compare physicians' and nurses' views about the impact of CPOE on their workflow. This case study was conducted in 2012. The potential participants included all physicians (n = 28) and nurses (n = 145) who worked in a teaching hospital. Data were collected using a five-point Likert-scale questionnaire and were analyzed using SPSS version 18.0. The results showed a significant difference between physicians' and nurses' views about the impact of the system on interorganizational workflow (p = .001) and working relationships between physicians and nurses (p = .017). Interorganizational workflow and working relationships between care providers are important issues that require more attention. Before a CPOE system is designed, it is necessary to identify workflow patterns and hidden structures to avoid compromising quality of care and patient safety.

  20. Is physician supervision of the capsaicin 8% patch administration procedure really necessary? An opinion from health care professionals

    Directory of Open Access Journals (Sweden)

    Kern KU

    2013-07-01

    Full Text Available Kai-Uwe Kern,1 Janice England,2 Andrea Roth-Daniek,3 Till Wagner3 1Institute for Pain Medicine/Pain Practice, Wiesbaden, Germany; 2Pain Medicine and Anaesthesia, The Christie National Health Service Foundation Trust, Manchester, UK; 3Pain Therapy and Palliative Care Department, Medizinisches Zentrum Städteregion Aachen, Aachen, Germany Abstract: Neuropathic pain is difficult to treat and can have a severe effect on quality of life. The capsaicin 8% patch is a novel treatment option that directly targets the source of peripheral neuropathic pain. It can provide pain relief for up to 12 weeks in patients with peripheral neuropathic pain. Treatment with the capsaicin 8% patch follows a clearly defined procedure, and patch application must be carried out by a physician or a health care professional under the supervision of a physician. Nonetheless, in our experience, nurses often take the lead role in capsaicin 8% patch application without the involvement of a physician. We believe that the nurse's key role is of benefit to the patients, as he or she may be better placed, because of time constraints and patient relationships, to support the patient through the application procedure than a physician. Moreover, a number of frequently prescribed drugs, including botulinum toxin and infliximab, can be administered by health care professionals without the requirement for physician supervision. Here we argue that current guidance should be amended to remove the requirement for physician supervision during application of the capsaicin 8% patch. Keywords: capsaicin, neuropathic pain, topical, health care professional, physician, nurse

  1. A Systematic Review of Physician Leadership and Emotional Intelligence

    Science.gov (United States)

    Mintz, Laura Janine; Stoller, James K.

    2014-01-01

    Objective This review evaluates the current understanding of emotional intelligence (EI) and physician leadership, exploring key themes and areas for future research. Literature Search We searched the literature using PubMed, Google Scholar, and Business Source Complete for articles published between 1990 and 2012. Search terms included physician and leadership, emotional intelligence, organizational behavior, and organizational development. All abstracts were reviewed. Full articles were evaluated if they addressed the connection between EI and physician leadership. Articles were included if they focused on physicians or physicians-in-training and discussed interventions or recommendations. Appraisal and Synthesis We assessed articles for conceptual rigor, study design, and measurement quality. A thematic analysis categorized the main themes and findings of the articles. Results The search produced 3713 abstracts, of which 437 full articles were read and 144 were included in this review. Three themes were identified: (1) EI is broadly endorsed as a leadership development strategy across providers and settings; (2) models of EI and leadership development practices vary widely; and (3) EI is considered relevant throughout medical education and practice. Limitations of the literature were that most reports were expert opinion or observational and studies used several different tools for measuring EI. Conclusions EI is widely endorsed as a component of curricula for developing physician leaders. Research comparing practice models and measurement tools will critically advance understanding about how to develop and nurture EI to enhance leadership skills in physicians throughout their careers. PMID:24701306

  2. The process of palliative sedation as viewed by physicians and nurses working in palliative care in Brazil.

    Science.gov (United States)

    Spineli, Vívian Marina Calixto Damasceno; Kurashima, Andrea Yamaguchi; De Gutiérrez, Maria Gaby Rivero

    2015-10-01

    Our aim was to describe the process of palliative sedation from the point of view of physicians and nurses working in palliative care in Brazil. Ours was a descriptive study conducted between May and December of 2011, with purposeful snowball sampling of 32 physicians and 29 nurses working in facilities in Brazil that have adopted the practice of palliative care. The symptoms prioritized for an indication of palliative sedation were dyspnea, delirium, and pain. Some 65.6% of respondents believed that the survival time of a patient in the final phase was not a determining factor for the indication of this measure, and that the patient, family, and healthcare team should participate in the decision-making process. For 42.6% of these professionals, the opinion of the family was the main barrier to an indication of this therapy. The opinion of the physicians and nurses who participated in this study converged with the principal national and international guidelines on palliative sedation. However, even though it is a therapy that has been adopted in palliative care, it remains a controversial practice.

  3. Cardiopulmonary resuscitation: knowledge and opinions among the U.S. general public. State of the science-fiction.

    Science.gov (United States)

    Marco, Catherine A; Larkin, Gregory L

    2008-12-01

    Cardiopulmonary resuscitation is undertaken more than 250,000 times annually in the United States. This study was undertaken to determine knowledge and opinions of the general public regarding cardiopulmonary resuscitation. Validated multisite community-based cross-sectional survey. Knowledge and opinions about resuscitative practices and outcomes, using hypothetical clinical scenarios and other social, spiritual, and environmental considerations. Among 1831 participants representing 38 states, markedly inaccurate perceptions of cardiac arrest were reported. Participants' mean estimate of predicted survival rate after cardiac arrest was 54% (median 50%, IQR 35-75%), and mean estimated duration of resuscitative efforts in the ED was 28min (median 15min; IQR 10-30). Projected age and health status were independent predictors of resuscitation preferences in a series of 4 hypothetical scenarios. Participants indicated that physicians should consider patient and family wishes as the most important factors when making resuscitation decisions. Participants considered advanced technology and physician communication to be the most important actions during attempted resuscitation. Inaccurate perceptions regarding resuscitation and survival rates exist among the lay public. Participants indicated strong preferences regarding resuscitation and advance directives.

  4. Conflicts and conflict management in the collaboration between nurses and physicians - a qualitative study.

    Science.gov (United States)

    Leever, A M; Hulst, M V D; Berendsen, A J; Boendemaker, P M; Roodenburg, J L N; Pols, J

    2010-11-01

    In health care, optimal collaboration between nurses and physicians is crucial in the quality of the care process – but not self-generating. Little is known about how health-care professionals cope with conflicts within their collaboration. This qualitative study investigates the way nurses and physicians cope with conflict and clarifies the determinants of conflict management styles. All respondents formulate clear expectations which in their opinion are essential to collaboration. When collaboration leads to disagreement, physicians and nurses choose between ignoring the conflict or engaging in it. Choice is determined by five factors: the influence of oneself, the influence of the other, the nature of the conflict, the context of conflict, and personal motives.

  5. Comparison of knowledge, attitudes and behaviour regarding smoking among Estonian and Finnish physicians.

    Science.gov (United States)

    Pärna, Kersti; Rahu, Kaja; Barengo, Noël C; Rahu, Mati; Sandström, Patrick H; Jormanainen, Vesa J; Myllykangas, Markku T

    2005-01-01

    To compare smoking behaviour, attitudes and opinions towards smoking and smoking cessation among Estonian and Finnish physicians. A cross-sectional postal survey using a self-administered questionnaire was carried out among 2,480 Estonian and 2,075 Finnish physicians. Daily smoking prevalence was higher among Estonian physicians than among their Finnish counterparts in both male (18.6% and 6.7%) and female (6.6% and 3.6%). Compared to Estonia, physicians in Finland more often agreed that smoking is very harmful to their health, that trying to convince people to stop smoking is their responsibility and that smoking prevention should be part of the normal and special training of health professionals. In both countries, non-smoking physicians held more unfavourable attitudes towards smoking than those who were smoking. Physicians' own smoking patterns and quitting behaviour are important because physicians serve as models for their patients and play a key role in the reinforcement of smoke-free health facilities. These results remain a challenge to medical educators, especially in Estonia. Estonia needs to improve medical education in terms of motivating physicians to ask about the smoking patterns of their patients and of training medical students and resident physicians to counsel their patients to stop smoking.

  6. Changing physician behavior: what works?

    Science.gov (United States)

    Mostofian, Fargoi; Ruban, Cynthiya; Simunovic, Nicole; Bhandari, Mohit

    2015-01-01

    There are various interventions for guideline implementation in clinical practice, but the effects of these interventions are generally unclear. We conducted a systematic review to identify effective methods of implementing clinical research findings and clinical guidelines to change physician practice patterns, in surgical and general practice. Systematic review of reviews. We searched electronic databases (MEDLINE, EMBASE, and PubMed) for systematic reviews published in English that evaluated the effectiveness of different implementation methods. Two reviewers independently assessed eligibility for inclusion and methodological quality, and extracted relevant data. Fourteen reviews covering a wide range of interventions were identified. The intervention methods used include: audit and feedback, computerized decision support systems, continuing medical education, financial incentives, local opinion leaders, marketing, passive dissemination of information, patient-mediated interventions, reminders, and multifaceted interventions. Active approaches, such as academic detailing, led to greater effects than traditional passive approaches. According to the findings of 3 reviews, 71% of studies included in these reviews showed positive change in physician behavior when exposed to active educational methods and multifaceted interventions. Active forms of continuing medical education and multifaceted interventions were found to be the most effective methods for implementing guidelines into general practice. Additionally, active approaches to changing physician performance were shown to improve practice to a greater extent than traditional passive methods. Further primary research is necessary to evaluate the effectiveness of these methods in a surgical setting.

  7. Factors affecting the extent of utilization of physiotherapy services by physicians in Saudi Arabia

    Science.gov (United States)

    Alshehri, Mansour Abdullah; Alhasan, Hammad; Alayat, Mohamed; Al-subahi, Moayad; Yaseen, Khalid; Ismail, Ayah; Tobaigy, Abdullah; Almalki, Obaid; Alqahtani, Abdulfattah; Fallata, Basmah

    2018-01-01

    [Purpose] To investigate physicians’ attitudes, opinions and experiences towards physiotherapy services as well as to identify the potential factors that may affect the extent of utilization of physiotherapy services (based on physicians’ beliefs) in Saudi Arabia (SA). [Subjects and Methods] A cross-sectional study was conducted. [Results] A total of 108 respondents met the inclusion criteria. The respondents’ attitude towards physiotherapy was slightly low (53.5%), while their opinions and experiences of physiotherapy indicated some important issues. For example, 50% of them believed that physiotherapists did not create a good awareness about physiotherapy services and 55.5% admitted that they did not have enough information about physiotherapy services. The most potential factor reported by physicians that may affect the extent of utilization of physiotherapy services was the lack of physiotherapist’s skills and knowledge to assess and treat patients (55.3%), followed by the limited knowledge of physicians regarding the types of physiotherapy services (44.5%) and the lack of cooperation between physicians and physiotherapists (40.7%). [Conclusion] There were some factors that limited the extent of utilization of physiotherapy services in SA. Physiotherapy academics and clinicians should attempt to change physicians’ negative attitudes, promoting awareness to provide them with a better understanding of physiotherapy services. PMID:29545681

  8. The Effect of Overconfidence and Experience on Belief Adjustment Model in Investment Judgement

    Directory of Open Access Journals (Sweden)

    Luciana Spica Almilia

    2016-04-01

    Full Text Available This study examines the effect overconfidence and experience on increasing or reducing the information order effect in investment decision making. Subject criteria in this research are: professional investor (who having knowledge and experience in the field of investment and stock market and nonprofessional investor (who having knowledge in the field of investment and stock market. Based on the subject criteria, then subjects in this research include: accounting students, capital market and investor. This research is using experimental method of 2 x 2 (between subjects. The researcher in conducting this experimental research is using web based. The characteristic of individual (high confidence and low confidence is measured by calibration test. Independent variable used in this research consist of 2 active independent variables (manipulated which are as the followings: (1 Pattern of information presentation (step by step and end of sequence; and (2 Presentation order (good news – bad news or bad news – good news. Dependent variable in this research is a revision of investment decision done by research subject. Participants in this study were 78 nonprofessional investor and 48 professional investors. The research result is consistent with that predicted that individuals who have a high level of confidence that will tend to ignore the information available, the impact on individuals with a high level of confidence will be spared from the effects of the information sequence.

  9. Normatology: a review and commentary with reference to abortion and physician-assisted suicide.

    Science.gov (United States)

    Brodie, H K; Banner, L

    1997-06-01

    This article opens with a review of the concept of "normatology," which was developed by Sabshin and Offer in four books published over a period of 30 years. Normatology seeks to produce an "operational definition of normality and health" over the life cycle. Such a definition can be used as a guideline in the deliver of health care. The importance of this field of study is highlighted when considering issues such as abortion or physician-assisted suicide. Fortunately, the proclivity of Americans to conduct public opinion polls helps researchers determine what is considered "normal" at any given time. Gallup Polls, which have posed the same question about the legality of abortion from 1975 to 1995, indicate that about half of all Americans continuously occupy the middle ground on this issue despite a somewhat liberalizing trend. In general, public opinion holds that it is normal to want to avoid giving birth to a damaged child, to place the mother's health and safety above that of the fetus, and to terminate a pregnancy resulting from rape. It is less normal to abort a healthy fetus on demand. Thus, abortion will likely continue to be a source of controversy and confusion in our society and among psychiatric patients. In comparison, psychiatrists express attitudes about abortion that are more liberal than normal. In the case of physician-assisted suicide, public approval has increased since 1950 as scientific advancements have facilitated the prolongation of unproductive and painful life. If legalized, physician-assisted suicide may depend upon psychiatric assessment of an absence of mental disease. Such an assessment is required in the Northern Territory of Australia, where voluntary euthanasia is legal, but not in the Netherlands, where it is government-regulated. Psychiatrists must understand public opinion in order to influence it or deal with it competently.

  10. [Pleural procedures in patients treated by platelet aggregation inhibitors: An opinion survey].

    Science.gov (United States)

    Dangers, L; Similowski, T; Chenivesse, C

    2016-01-01

    When pleural procedures (thoracocentesis, blind pleural biopsies and chest tube insertion) are required in patients taking long-term platelet aggregation inhibitors, the risk of bleeding must be balanced against the risk of arterial thrombosis. Currently, the bleeding risk of pleural procedures is poorly understood. The objective of the survey was to gather the opinion of respiratory physicians regarding the bleeding risk of pleural procedures in patients taking platelet aggregation inhibitors. We emailed a standardized questionnaire designed by the French National Authority for Health to 2697 French respiratory physicians. One hundred and eighty-eight of the 2697 questionnaires were returned (response rate: 7 %). The respiratory physicians declared that they performed an average of 8 pleural procedures per month. One hundred and seventy-five responders (95 %) practised pleural procedures in patients receiving platelet aggregation inhibitors; 68 of them (39 %) reported experiencing haemorrhagic complications. The bleeding risk associated with thoracentesis and chest tube insertion was considered minor by 97.8 and 65 % of responders respectively, whereas it was considered major for blind pleural biopsies by 73.4 %. Respiratory physicians were more reticent about performing pleural procedures in patients treated with clopidogrel than in those taking aspirin. This study provides an overview of how respiratory physicians perceive the bleeding risk associated with pleural procedures in patients taking platelet aggregation inhibitors. Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  11. Depression-Burnout Overlap in Physicians.

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    Walter Wurm

    Full Text Available Whether burnout is a distinct phenomenon rather than a type of depression and whether it is a syndrome, limited to three "core" components (emotional exhaustion, depersonalization and low personal accomplishment are subjects of current debate. We investigated the depression-burnout overlap, and the pertinence of these three components in a large, representative sample of physicians.In a cross-sectional study, all Austrian physicians were invited to answer a questionnaire that included the Major Depression Inventory (MDI, the Hamburg Burnout Inventory (HBI, as well as demographic and job-related parameters. Of the 40093 physicians who received an invitation, a total of 6351 (15.8% participated. The data of 5897 participants were suitable for analysis.Of the participants, 10.3% were affected by major depression. Our study results suggest that potentially 50.7% of the participants were affected by symptoms of burnout. Compared to physicians unaffected by burnout, the odds ratio of suffering from major depression was 2.99 (95% CI 2.21-4.06 for physicians with mild, 10.14 (95% CI 7.58-13.59 for physicians with moderate, 46.84 (95% CI 35.25-62.24 for physicians with severe burnout and 92.78 (95% CI 62.96-136.74 for the 3% of participants with the highest HBI_sum (sum score of all ten HBI components. The HBI components Emotional Exhaustion, Personal Accomplishment and Detachment (representing depersonalization tend to correlate more highly with the main symptoms of major depression (sadness, lack of interest and lack of energy than with each other. A combination of the HBI components Emotional Exhaustion, Helplessness, Inner Void and Tedium (adj.R2 = 0.92 explained more HBI_sum variance than the three "core" components (adj.R2 = 0.85 of burnout combined. Cronbach's alpha for Emotional Exhaustion, Helplessness, Inner Void and Tedium combined was 0.90 compared to α = 0.54 for the combination of the three "core" components.This study demonstrates the

  12. Workplace violence against physicians in Turkey's emergency departments: a cross-sectional survey.

    Science.gov (United States)

    Bayram, Başak; Çetin, Murat; Çolak Oray, Neşe; Can, İsmail Özgür

    2017-06-29

    We aimed to determine the prevalence of violence directed at emergency department (ED) physicians in Turkey and confirm the factors influencing such violence. Cross-sectional survey study. Country of Turkey. Physicians currently practising in EDs in Turkey. The prevalence of violence directed at physicians and factors that may influence it, such as physicians' personal characteristics, ED characteristics and physicians' opinions regarding the causes of and suggested methods of preventing violence. A total of 713 physicians participated. Of these, 78.1% reported being subjected to violence in the past year and 65.9% reported more than one such incident. Being subjected to violence was related to age (p=0.008), working in an ED with a high patient admission rate (p=0.018), current position (pviolence. The present safety precautions against violence do not appear to influence the prevalence of violence. Our results indicated that ED physicians' experience of violence is related to personal characteristics such as age and level of expertise, and hospital and ED characteristics such as high patient admission rates. Presently, no measures taken to reduce this violence have been proven effective. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. [The general practitioners in front of reforms: the reactions of the sample group of liberal physicians of the region PACA].

    Science.gov (United States)

    Videau, Yann; Ventelou, Bruno; Combes, Jean-Baptiste; Verger, Pierre; Paraponaris, Alain

    2007-05-01

    The general practitioners in front of reforms: the reactions of the sample group of liberal physicians of the region PACA This article intends to analyse the opinion of general practioners (GPs) about the two laws of July 2004, relating to the health insurance reform and to public health planning. We used a panel data sample of 528 GPs practising in Provence Alpes Côte d'Azur in order to analyse the determinants of physicians' adherence to the reform, using multinomial logistic regression models. The results show that GPs do not seem to be fully convinced by this reform (45% agree with it, whereas 48% don't): this mistrustful opinion is more marked for young physicians and appears little correlated with their practices. 75% of the GPs are favourable to the Personal Medical File (Dossier Médical Personnel in french) and 76% estimate that they should draw a better attention to the public health dimension of their practice. Two barriers concerning GPs' adherence to the doctor > reform (réforme du ) seem relevant: the burden of administrative tasks and the disadvantage of young physicians who have not already fixed their own clientele.

  14. Opinions and practices of medical rehabilitation professionals regarding prayer and meditation.

    Science.gov (United States)

    Schoenberger, Nancy E; Matheis, Robert J; Shiflett, Samuel C; Cotter, Ann C

    2002-02-01

    To assess the attitudes and practices of professionals in the field of physical medicine and rehabilitation (PM&R) regarding prayer and meditation. A national mail survey that included questions about the use of a number of complementary and alternative therapies. The survey was mailed to 7,479 physicians, nurses, physical therapists, and occupational therapists who specialize in PM&R, and 1221 (17%) returned completed surveys. Although the majority of respondents endorsed prayer as a legitimate health care practice, there was greater belief in the benefits of meditation. Older respondents were more likely to recommend meditation to their patients and more likely to meditate themselves. Gender differences that were observed in opinions and practices are better interpreted as differences in professional specialty. In general, nurses and occupational therapists responded more positively toward meditation and prayer than did physicians and physical therapists. Personal use of a technique was the strongest predictor of professional behaviors. Attitude was a stronger predictor of professional use or referral for prayer than meditation, but correlations between attitude and behavior were generally weak for both techniques. Despite their acceptance of these techniques, the vast majority of rehabilitation professionals did not refer their patients for meditation or religious consultation. Although there were significant relationships among beliefs, and personal and professional behaviors regarding these techniques, a large part of the variance in professional behaviors was not accounted for by age, gender, opinion, or personal behavior, indicating that other influences exert a stronger effect on professional practice decisions.

  15. The organizational commitment of emergency physicians in Spanish public hospitals

    Science.gov (United States)

    Noval de la Torre, A; Bulchand Gidumal, J; Melián González, S

    2016-12-30

    Background. There are not too many studies that deal with the organizational commitment of emergency physicians. This commitment has been shown to impact organizational performance. The aim of this paper is to analyse the degree of commitment of the emergency physicians in Spanish public hospitals and the factors that may influence it. Method. Online survey using SurveyMonkey to emergency physicians in Spanish public hospitals. Results. Two hundred and five questionnaires were received, 162 from physicians and 43 from heads of the emergency service. Results show an intermediate level of commitment, with affective commitment showing the lowest level and continuance commitment showing the highest level. The capabilities of the physician have an influence on their affective commitment; specific training in emergency procedures and seniority has an influence on their continuance commitment; and the opinion they hold about the organization of their service influences affective commitment. Conclusions. Emergency physicians show an average involvement in the hospital in which they work (average 3.8 on a range of 1 to 5), feel an average affection for it (3.4), and have a high intention to keep working there (4.0). The resources the hospital has due to its level do not have an influence on this commitment, while the training and perceptions of the service do have an influence.

  16. Medical professionalism of foreign-born and foreign-trained physicians under close scrutiny: A qualitative study with stakeholders in Germany.

    Science.gov (United States)

    Klingler, Corinna; Ismail, Fatiha; Marckmann, Georg; Kuehlmeyer, Katja

    2018-01-01

    Hospitals in Germany employ increasing numbers of foreign-born and foreign-trained (FB&FT) physicians. Studies have investigated how FB&FT physicians experience their professional integration into the German healthcare system, however, the perspectives of stakeholders working with and shaping the work experiences of FB&FT physicians in German hospitals have so far been neglected. This study explores relevant stakeholders' opinions and attitudes towards FB&FT physicians-which likely influence how these physicians settle in-and how these opinions were formed. We conducted a qualitative interview study with 25 stakeholders working in hospitals or in health policy development. The interviews were analyzed within a constructivist research paradigm using methods derived from Grounded Theory (situational analysis as well as open, axial and selective coding). We found that stakeholders tended to focus on problems in FB&FT physicians' work performance. Participants criticized FB&FT physicians' work for deviating from presumably shared professional standards (skill or knowledge and behavioral standards). The professional standards invoked to justify problem-focused statements comprised the definition of an ideal behavior, attitude or ability and a tolerance range that was adapted in a dynamic process. Behavior falling outside the tolerance range was criticized as unacceptable, requiring action to prevent similar deviations in the future. Furthermore, we derived three strategies (minimization, homogenization and quality management) proposed by participants to manage deviations from assumed professional standards by FB&FT physicians. We critically reflect on the social processes of evaluation and problematization and question the legitimacy of professional standards invoked. We also discuss discriminatory tendencies visible in evaluative statements of some participants as well as in some of the strategies proposed. We suggest it will be key to develop and implement better

  17. Norwegian physicians' knowledge of the prices of pharmaceuticals: a survey.

    Science.gov (United States)

    Eriksen, Ida Iren; Melberg, Hans Olav; Bringedal, Berit

    2013-01-01

    The objectives of this study are to measure physicians' knowledge of the prices of pharmaceuticals, and investigate whether there are differences in knowledge of prices between groups of physicians. This article reports on a survey study of physicians' knowledge of the prices of pharmaceuticals conducted on a representative sample of Norwegian physicians in the autumn of 2010. The importance of physicians' knowledge of costs derives from their influence on total spending and allocation of limited health-care resources. Physicians are important drivers in the effort to contain costs in health care, but only if they have the knowledge needed to choose the most cost-effective treatment options. A survey was sent to 1543 Norwegian physicians, asking them for price estimates and their opinions on the importance of considering the cost of treatment to society as a decision factor when treating their patients. This article deals with a subsection in which the physicians were asked to estimate the price of five pharmaceuticals: simvastatin, alendronate (Fosamax), infliximab (Remicade), natalizumab (Tysabri) and escitalopram (Cipralex). The response rate was 65%. For all the five pharmaceuticals, more than 50% and as many as 83% gave responses that differed more than 50% from the actual drug price. The price of more expensive pharmaceuticals was underestimated, while the opposite was the case for less expensive medicines. The data show that physicians in general have poor knowledge of the prices of the pharmaceuticals they offer their patients. However, the physicians who frequently deal with a drug have better knowledge of its price than those who do not handle a medication as often. The data also suggest that those physicians who agree that cost of care to society is an important decision factor have better knowledge of drug prices.

  18. Physicians' intentions and use of three patient decision aids

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    Mitchell Susan L

    2007-07-01

    Full Text Available Abstract Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270 returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80% also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians ( Conclusion Despite strong support for the format, content, and quality of patient decision aids, and physicians' stated intentions to adopt them into clinical practice, most did not use them within three months of completing the survey. There is a wide gap between intention and behaviour. Further research is required to study the determinants of this intention-behaviour gap and to develop interventions aimed at barriers to physicians' use of decision aids.

  19. Leader's opinion priority bounded confidence model for network opinion evolution

    Science.gov (United States)

    Zhu, Meixia; Xie, Guangqiang

    2017-08-01

    Aiming at the weight of trust someone given to participate in the interaction in Hegselmann-Krause's type consensus model is the same and virtual social networks among individuals with different level of education, personal influence, etc. For differences between agents, a novelty bounded confidence model was proposed with leader's opinion considered priority. Interaction neighbors can be divided into two kinds. The first kind is made up of "opinion leaders" group, another kind is made up of ordinary people. For different groups to give different weights of trust. We also analyzed the related characteristics of the new model under the symmetrical bounded confidence parameters and combined with the classical HK model were analyzed. Simulation experiment results show that no matter the network size and initial view is subject to uniform distribution or discrete distribution. We can control the "opinion-leader" good change the number of views and values, and even improve the convergence speed. Experiment also found that the choice of "opinion leaders" is not the more the better, the model well explain how the "opinion leader" in the process of the evolution of the public opinion play the role of the leader.

  20. [An evaluation of the clinical competence of a population of specialist physicians educated by the medical internship and residency system].

    Science.gov (United States)

    Pujol, R; Busquet, J; Feliu, E; Castellsague, J; Gómez Sáez, J M; Martínez Carretero, J M; Rozman, C

    1995-10-21

    The quality of physicians who have undergone resident official training (MIR) should logically be better than that of the remaining physicians who were not able to enter into this official training. The present study was designed with the aim of verifying this hypothesis. A sample of physicians who underwent the MIR examination in 1982 and who upon passing the same were permitted to initiate the MIR training in 1983 was selected. The group was subdivided into MIR and no MIR and according to the specialty followed. When the physicians were practicing as specialists two types of surveys were carried out with one being by telephone and the other personal in which the personal characteristics, preparation for the MIR test, professional satisfaction and personal motivation were analyzed. The pharmaceutic prescriptions of both groups were analyzed according to indicators of the Servei Català de la Salut (Catalonian Health Service) and the opinion of colleagues of each of the members of each group was evaluated with another questionnaire. The written resolution of hypothetical clinical cases were given to each of the individuals included. A level of global competence defined as a percentage for the following components was identified using: curricular evaluation (10%), professional satisfaction (20%), personal motivation (10%), hypothetical case resolution (35%) and peer opinion (25%). The global competence of the physicians trained under the MIR system was greater than that of the no MIR group (p < 0.01). On analysis by sections the differences of greatest note were observed in the resolution of hypothetical cases (p < 0.0001), curricular evaluation (p < 0.0001) and the quality of pharmaceutical prescription (p < 0.0001). The differences were less of note in comparison of personal motivation (p < 0.02) and professional satisfaction (p < 0.02). No differences were observed in peer opinion. The professional quality of physicians trained by MIR who presented for the 1982

  1. Exploring the opinion of hemodialysis patients about their dialysis unit.

    Science.gov (United States)

    Donia, Ahmed Farouk; Elhadedy, Mohamed Ahmed; El-Maghrabi, Hanzada Mohamed; Abbas, Mohamed Hamed; Foda, Mohamed Ashraf

    2015-01-01

    Hemodialysis (HD) patients are subjected to a number of physical and mental stresses. Physicians might be unaware of some of these problems. We assessed our patients' opinion about the service provided at the dialysis unit. Our unit has 89 patients on HD. A questionnaire exploring our patients' opinion relative to the service provided was prepared. The patients were asked to fill-in the questionnaire in a confidential manner. Questionnaires were then collected and examined while unaware of patient identities. Sixty-nine patients (77.5%) responded to the questionnaire. Eight patients (11.6%) revealed their names on the questionnaire. According to the questionnaire, the patients were asked to assess the service of each service by choosing one of the following grades: "excellent," "mediocre" or "bad." For the whole group of contributing patients, there were 563 "excellent," 85 "mediocre" and five "bad" choices in addition to 37 blank "no comment" choices. Food service had the least percentage (68%) of evaluation as "excellent," while doctor' performance got the highest excellent evaluation (85.5%). Thirty-five patients (50.7%) added further comment(s). An audit meeting was conducted to discuss these results. Exploring the opinion of patients on HD might uncover some areas of dissatisfaction and help in improving the provided service. We recommend widespread usage of questionnaires to assess patient satisfaction as well as to assess other health-care aspects.

  2. Exploring the opinion of hemodialysis patients about their dialysis unit

    Directory of Open Access Journals (Sweden)

    Ahmed Farouk Donia

    2015-01-01

    Full Text Available Hemodialysis (HD patients are subjected to a number of physical and mental stresses. Physicians might be unaware of some of these problems. We assessed our patients′ opinion about the service provided at the dialysis unit. Our unit has 89 patients on HD. A questionnaire exploring our patients′ opinion relative to the service provided was prepared. The patients were asked to fill-in the questionnaire in a confidential manner. Questionnaires were then collected and examined while unaware of patient identities. Sixty-nine patients (77.5% responded to the questionnaire. Eight patients (11.6% revealed their names on the questionnaire. According to the questionnaire, the patients were asked to assess the service of each service by choosing one of the following grades: "excellent," "mediocre" or "bad." For the whole group of contributing patients, there were 563 "excellent," 85 "mediocre" and five "bad" choices in addition to 37 blank "no comment" choices. Food service had the least percentage (68% of evaluation as "excellent," while doctor′ performance got the highest excellent evaluation (85.5%. Thirty-five patients (50.7% added further comment(s. An audit meeting was conducted to discuss these results. Exploring the opinion of patients on HD might uncover some areas of dissatisfaction and help in improving the provided service. We recommend widespread usage of questionnaires to assess patient satisfaction as well as to assess other health-care aspects.

  3. Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: a mixed methods approach.

    Science.gov (United States)

    Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; Schermer, Maartje H N; van Thiel, Ghislaine J M W; Trappenburg, Margo J; van de Vathorst, Suzanne; van der Vegt, Bea J; Vezzoni, Cristiano; Weyers, Heleen; van Tol, Donald G; van der Heide, Agnes

    2013-03-01

    The practice of euthanasia and physician-assisted suicide (PAS) in the Netherlands has been regulated since 2002 by the Euthanasia Act. In the ongoing debate about the interpretation of this Act, comparative information about the opinions of the different stakeholders is needed. To evaluate the opinions of Dutch physicians, nurses and the general public on the legal requirements for euthanasia and PAS. A cross-sectional survey among Dutch physicians and nurses in primary and secondary care and members of the Dutch general public, followed by qualitative interviews among selected respondents. The participants were: 793 physicians, 1243 nurses and 1960 members of the general public who completed the questionnaire; 83 were interviewed. Most respondents agreed with the requirement of a patient request (64-88%) and the absence of a requirement concerning life expectancy (48-71%). PAS was thought acceptable by 24-39% of respondents for patients requesting it because of mental suffering due to loss of control, chronic depression or early dementia. In the case of severe dementia, one third of physicians, 58% of nurses and 77% of the general public agreed with performing euthanasia based on an advance directive. Interviewees illustrated these findings and supported the Act. Health care professionals and the general public mostly support the legal requirements for euthanasia and PAS. The law permits euthanasia or PAS for mental suffering but this possibility is not widely endorsed. The general public is more liberal towards euthanasia for advanced dementia than health care professionals. We conclude that there is ample support for the law after eight years of legal euthanasia.

  4. Workplace Bullying Among Family Physicians: A Gender Focused Study.

    Science.gov (United States)

    Rouse, Linda P; Gallagher-Garza, Shalena; Gebhard, Roberta E; Harrison, Suzanne L; Wallace, Lorraine S

    2016-09-01

    Continuing gender disparities within the medical profession have raised concerns about the extent to which women physicians face an inhospitable work environment. The purpose of this study was to examine the types and frequency of workplace bullying reported by a national sample of family physicians employed in academic settings, as related to gender. Data for this study were gathered as part of the Council of Academic Family Medicine (CAMF) Educational Research Alliance (CERA) omnibus electronic survey. Respondents completed questions addressing sociodemographic and practice characteristics, general experience with bullying, types of bullying, actions in response to bullying, and outcomes. A total of 1065 academic family physicians (male = 56.8%; female = 43.2%), mostly non-Hispanic white (84.2%) or Asian (5.3%) and between the ages 30 and 60 (58.7%) completed the CERA survey. One in 10 respondents acknowledged bullying someone in the workplace; 30% had been personally bullied in the workplace. Compared to men, female physicians were more likely to report being bullied overall and, specifically, to experience having their opinions ignored, lack of recognition for good work, feeling pressured not to claim rightful benefits, and being given unmanageable workloads. Despite some gender differences in actions taken, outcomes for each kind of action were the same for men and women.

  5. Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians' attitudes and prescribing habits: a systematic review.

    Science.gov (United States)

    Fickweiler, Freek; Fickweiler, Ward; Urbach, Ewout

    2017-09-27

    The objective of this review is to explore interactions between physicians and the pharmaceutical industry including sales representatives and their impact on physicians' attitude and prescribing habits. PubMed, Embase, Cochrane Library and Google scholar electronic databases were searched from 1992 to August 2016 using free-text words and medical subject headings relevant to the topic. Studies included cross-sectional studies, cohort studies, randomised trials and survey designs. Studies with narrative reviews, case reports, opinion polls and letters to the editor were excluded from data synthesis. Two reviewers independently extracted the data. Data on study design, study year, country, participant characteristics, setting and number of participants were collected. Pharmaceutical industry and pharmaceutical sales representative (PSR) interactions influence physicians' attitudes and their prescribing behaviour and increase the number of formulary addition requests for the company's drug. Physician-pharmaceutical industry and its sales representative's interactions and acceptance of gifts from the company's PSRs have been found to affect physicians' prescribing behaviour and are likely to contribute to irrational prescribing of the company's drug. Therefore, intervention in the form of policy implementation and education about the implications of these interactions is needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. [Assessment of a residency training program in endocrinology and nutrition by physicians: results of a survey].

    Science.gov (United States)

    Moreno-Fernández, Jesús; Gutiérrez-Alcántara, Carmen; Palomares-Ortega, Rafael; García-Manzanares, Alvaro; Benito-López, Pedro

    2011-12-01

    The current training program for resident physicians in endocrinology and nutrition (EN) organizes their medical learning. Program evaluation by physicians was assessed using a survey. The survey asked about demographic variables, EN training methods, working time and center, and opinion on training program contents. Fifty-one members of Sociedad Castellano-Manchega de Endocrinología, Nutrición y Diabetes, and Sociedad Andaluza de Endocrinología y Nutrición completed the survey. Forty-percent of them disagreed with the compulsory nature of internal medicine, cardiology, nephrology and, especially, neurology rotations (60%); a majority (>50%) were against several recommended rotations included in the program. The fourth year of residence was considered by 37.8% of respondents as the optimum time for outpatient and inpatient control and monitoring without direct supervision. The recommended monthly number of on-call duties was 3.8±1.2. We detected a positive opinion about extension of residence duration to 4.4±0.5 years. Doctoral thesis development during the residence period was not considered convenient by 66.7% of physicians. Finally, 97.8% of resident physicians would recommend residency in EN to other colleagues. Endocrinologists surveyed disagreed with different training program aspects such as the rotation system, skill acquisition timing, and on-call duties. Therefore, an adaptation of the current training program in EN would be required. Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.

  7. Support for immigration reduction and physician distrust in the United States

    Directory of Open Access Journals (Sweden)

    Frank L Samson

    2016-06-01

    Full Text Available Objectives: Health research indicates that physician trust in the United States has declined over the last 50 years. Paralleling this trend is a decline in social capital, with researchers finding a negative relationship between immigration-based diversity and social capital. This article examines whether physician distrust is also tied to immigration-based diversity and declining social capital. Methods: Data come from the 2012 General Social Survey, one of the gold standards of US public opinion surveys, using a national probability sample of 1080 adult US respondents. Key measures included support for reducing levels of immigration to the United States and multiple measures of physician trust. Results: The results of ordinary least squares regressions, using survey weights, indicate that support for reducing immigration is positively linked to physician distrust, bringing physician distrust into the orbit of research on diversity and declining social capital. Models controlled for age, education, income, gender, race, nativity, conservatism, unemployed status, lack of health insurance, and self-rated health. Furthermore, analyses of a subset of respondents reveal that measures of general trust and some forms of institutional trust do not explain away the association between support for immigration reduction and physician distrust, though confidence in science as an institution appears relevant. Conclusion: Consistent with diversity and social capital research, this article finds that an immigration attitude predicts physician distrust. Physician distrust may not be linked just to physician–patient interactions, the structure of the health care system, or health policies, but could also be tied to declining social trust in general.

  8. Depression-Burnout Overlap in Physicians

    Science.gov (United States)

    Wurm, Walter; Vogel, Katrin; Holl, Anna; Ebner, Christoph; Bayer, Dietmar; Mörkl, Sabrina; Szilagyi, Istvan-Szilard; Hotter, Erich; Kapfhammer, Hans-Peter; Hofmann, Peter

    2016-01-01

    Background Whether burnout is a distinct phenomenon rather than a type of depression and whether it is a syndrome, limited to three “core” components (emotional exhaustion, depersonalization and low personal accomplishment) are subjects of current debate. We investigated the depression-burnout overlap, and the pertinence of these three components in a large, representative sample of physicians. Methods In a cross-sectional study, all Austrian physicians were invited to answer a questionnaire that included the Major Depression Inventory (MDI), the Hamburg Burnout Inventory (HBI), as well as demographic and job-related parameters. Of the 40093 physicians who received an invitation, a total of 6351 (15.8%) participated. The data of 5897 participants were suitable for analysis. Results Of the participants, 10.3% were affected by major depression. Our study results suggest that potentially 50.7% of the participants were affected by symptoms of burnout. Compared to physicians unaffected by burnout, the odds ratio of suffering from major depression was 2.99 (95% CI 2.21–4.06) for physicians with mild, 10.14 (95% CI 7.58–13.59) for physicians with moderate, 46.84 (95% CI 35.25–62.24) for physicians with severe burnout and 92.78 (95% CI 62.96–136.74) for the 3% of participants with the highest HBI_sum (sum score of all ten HBI components). The HBI components Emotional Exhaustion, Personal Accomplishment and Detachment (representing depersonalization) tend to correlate more highly with the main symptoms of major depression (sadness, lack of interest and lack of energy) than with each other. A combination of the HBI components Emotional Exhaustion, Helplessness, Inner Void and Tedium (adj.R2 = 0.92) explained more HBI_sum variance than the three “core” components (adj.R2 = 0.85) of burnout combined. Cronbach’s alpha for Emotional Exhaustion, Helplessness, Inner Void and Tedium combined was 0.90 compared to α = 0.54 for the combination of the three

  9. Opinion and Persuasion

    OpenAIRE

    Ioan Constantin Dima; Daniela Gîfu

    2014-01-01

    The research proves that persuasion has two types of objectives. Its main objective is the change of opinion. Its fundamental and foundational objectives are the change in attitude, generic conduct and situational behaviour. The main objective controls the fundamental objectives. The change in attitudes and conduct/behaviour is presided by changes in opinion. Persuasion is thus shown to be primarily and ultimately a matter of opinion. As such, its mechanism to manage and generate ...

  10. Mad scientists, compassionate healers, and greedy egotists: the portrayal of physicians in the movies.

    Science.gov (United States)

    Flores, Glenn

    2002-07-01

    Cinematic depictions of physicians potentially can affect public expectations and the patient-physician relationship, but little attention has been devoted to portrayals of physicians in movies. The objective of the study was the analysis of cinematic depictions of physicians to determine common demographic attributes of movie physicians, major themes, and whether portrayals have changed over time. All movies released on videotape with physicians as main characters and readily available to the public were viewed in their entirety. Data were collected on physician characteristics, diagnoses, and medical accuracy, and dialogue concerning physicians was transcribed. The results showed that in the 131 films, movie physicians were significantly more likely to be male (p film physicians has declined steadily in recent decades. Movie physicians are most commonly surgeons (33%), psychiatrists (26%), and family practitioners (18%). Physicians were portrayed negatively in 44% of movies, and since the 1960s positive portrayals declined while negative portrayals increased. Physicians frequently are depicted as greedy, egotistical, uncaring, and unethical, especially in recent films. Medical inaccuracies occurred in 27% of films. Compassion and idealism were common in early physician movies but are increasingly scarce in recent decades. A recurrent theme is the "mad scientist," the physician-researcher that values research more than patients' welfare. Portrayals of physicians as egotistical and materialistic have increased, whereas sexism and racism have waned. Movies from the past two decades have explored critical issues surrounding medical ethics and managed care. We conclude that negative cinematic portrayals of physicians are on the rise, which may adversely affect patient expectations and the patient-physician relationship. Nevertheless, films about physicians can serve as useful gauges of public opinion about the medical profession, as tools for medical education, and as

  11. Factors associated with physicians’ perception of physician-patient relationship

    Directory of Open Access Journals (Sweden)

    Johnny Francisco Casanova Saldarriaga

    2017-03-01

    Full Text Available Objective: To determine the factors associated in the perception of physician-patient relationship by physicians who work at the Hospital Nacional Edgardo Rebagliati Martins, 2015. Materials and methods: An observational, prospective, cross-sectional, analytic, non-experimental study. The study population consisted of all the physicians who work at the Head and Neck Surgery Department, which includes the Otolaryngology (15 physicians, Ophthalmology (25 physicians, and Head and Neck (14 physicians Specialty Areas. The research instrument was a self-administered survey based on three topics: 1 Influence of technology and specialization in dehumanizing physician-patient relationship. 2 Influence of judicialization of medicine. 3 Respect and confidence of patients. Eighteen questions based on the three main topics were asked, and physician’s sociodemographic, educational and cultural data were collected. The instrument was validated by a team of experts, at a confidence level of 0.92 (Cronbach’s Alpha score. Besides the survey, physicians underwent a personal interview, in order to find out their personal opinion about their physician-patient relationship. Data were analyzed using IBM SPSS Statistics statistical software. Statistical analysis was conducted using chi-square test, with a significance level of 5%. Results: The research assessed 30 specialty physicians with a mean age of 53.57 years: 83.3% of the interviewed physicians were male, 43% majored in ophthalmology, 36.7% were born in Lima, 43.3% finished high school at a public school, 66.7% studied medicine at a public university, 93.3% pursued major studies at a public university, 46.7% stated that their mother was born in the Peruvian highlands, 63.3% stated that their father was born in the Peruvian highlands, 87% were Catholics, 83% said that they chose to study medicine by vocation, 90% practiced medicine in the private sector, 43% volunteered in social support programs for low

  12. Psychosocial determinants of physicians' intention to practice euthanasia in palliative care.

    Science.gov (United States)

    Lavoie, Mireille; Godin, Gaston; Vézina-Im, Lydi-Anne; Blondeau, Danielle; Martineau, Isabelle; Roy, Louis

    2015-01-22

    Euthanasia remains controversial in Canada and an issue of debate among physicians. Most studies have explored the opinion of health professionals regarding its legalization, but have not investigated their intentions when faced with performing euthanasia. These studies are also considered atheoretical. The purposes of the present study were to fill this gap in the literature by identifying the psychosocial determinants of physicians' intention to practice euthanasia in palliative care and verifying whether respecting the patient's autonomy is important for physicians. A validated anonymous questionnaire based on an extended version of the Theory of Planned Behavior was mailed to a random sample of 445 physicians from the province of Quebec, Canada. The response rate was 38.3% and the mean score for intention was 3.94 ± 2.17 (range: 1 to 7). The determinants of intention among physicians were: knowing patients' wishes (OR = 10.77; 95%CI: 1.33-86.88), perceived behavioral control-physicians' evaluation of their ability to adopt a given behavior-(OR = 4.35; 95%CI: 1.44-13.15), moral norm-the appropriateness of adopting a given behavior according to one's personal and moral values-(OR = 3.22; 95%CI: 1.29-8.00) and cognitive attitude-factual consequences of the adoption of a given behavior-(OR = 3.16; 95%CI: 1.20-8.35). This model correctly classified 98.8% of physicians. Specific beliefs that might discriminate physicians according to their level of intention were also identified. For instance, physicians' moral norm was related to the ethical principle of beneficence. Overall, physicians have weak intentions to practice euthanasia in palliative care. Nevertheless, respecting patients' final wishes concerning euthanasia seems to be of particular importance to them and greatly affects their motivation to perform euthanasia.

  13. Opinion dynamics in activity-driven networks

    Science.gov (United States)

    Li, Dandan; Han, Dun; Ma, Jing; Sun, Mei; Tian, Lixin; Khouw, Timothy; Stanley, H. Eugene

    2017-10-01

    Social interaction between individuals constantly affects the development of their personal opinions. Previous models such as the Deffuant model and the Hegselmann-Krause (HK) model have assumed that individuals only update their opinions after interacting with neighbors whose opinions are similar to their own. However, people are capable of communicating widely with all of their neighbors to gather their ideas and opinions, even if they encounter a number of opposing attitudes. We propose a model in which agents listen to the opinions of all their neighbors. Continuous opinion dynamics are investigated in activity-driven networks with a tolerance threshold. We study how the initial opinion distribution, tolerance threshold, opinion-updating speed, and activity rate affect the evolution of opinion. We find that when the initial fraction of positive opinion is small, all opinions become negative by the end of the simulation. As the initial fraction of positive opinions rises above a certain value —about 0.45— the final fraction of positive opinions sharply increases and eventually equals 1. Increased tolerance threshold δ is found to lead to a more varied final opinion distribution. We also find that if the negative opinion has an initial advantage, the final fraction of negative opinion increases and reaches its peak as the updating speed λ approaches 0.5. Finally we show that the lower the activity rate of individuals, the greater the fluctuation range of their opinions.

  14. Just How Important Is the Messenger versus the Message? The Case of Framing Physician-Assisted Suicide

    Science.gov (United States)

    Haider-Markel, Donald P.; Joslyn, Mark R.

    2004-01-01

    As a political issue, death and dying topics only sometimes reach the political agenda. However, some issues, such as physician-assisted suicide (PAS) have been highly salient. This article explores attitudes toward PAS by examining the malleability of opinion when respondents are exposed to issue frames and when specific messengers present those…

  15. [Discussion on professor SHAO Jing-Ming's academic opinion of focusing spirit].

    Science.gov (United States)

    Ma, Qiao-Lin; Gao, Xi-Yan; Shao, Su-Ju; Shao, Su-Xia; Hu, Bin

    2014-06-01

    During professor SHAO Jing-ming's academic research and medical practice, his academic opinion of focusing spirit is gradually developed. In terms of nurturing the spirit, attention should be paid on persistence as well as everyday health maintenance and exercise to nurture the spirit of physician. In terms of clinical diagnosis and treatment, patients' psychology, employment and life status should be observed and experienced, which could bring more methods to take essential care of patients' spirit. The treatment should work with psychological counseling, advocating that based on patients' qi and spirit, various forms of treatment methods should be properly used, such as acupuncture or moxibustion or combination of acupuncture and medicine, along with simple acupoint selection and harmony medication. Before clinical treatment of acupuncture, calming the mind is critically emphasized to make a clear diagnosis. During the acupuncture, calming and focusing the mind is necessary as well as emphasizing the details, so acupuncture could be integrated with Chi Gong to create a new warming-sensation technique. In a word, the academic opinion of focusing spirit is shedding an inspiring light upon further study.

  16. HIPPA privacy regulations: practical information for physicians.

    Science.gov (United States)

    McMahon, E B; Lee-Huber, T

    2001-07-01

    After much debate and controversy, the Bush administration announced on April 12, 2001, that it would implement the Health Insurance Portability and Accountability Act (HIPAA) privacy regulations issued by the Clinton administration in December of 2000. The privacy regulations became effective on April 14, 2001. Although the regulations are considered final, the Secretary of the Department of Health and Human Services has the power to modify the regulations at any time during the first year of implementation. These regulations affect how a patient's health information is used and disclosed, as well as how patients are informed of their privacy rights. As "covered entities," physicians have until April 14, 2003, to comply fully with the HIPAA privacy regulations, which are more than 1,500 pages in length. This article presents a basic overview of the new and complex regulations and highlights practical information about physicians' compliance with the regulations. However, this summary of the HIPAA privacy regulations should not be construed as legal advice or an opinion on specific situations. Please consult an attorney concerning your compliance with HIPAA and the regulations promulgated thereunder.

  17. Physicians' preference for controller medication in mild persistent asthma.

    Science.gov (United States)

    Bakirtas, Arzu; Kutlu, Ali; Baccioglu, Ayse; Erkekol, Ferda Oner; Bavbek, Sevim; Kalayci, Omer

    2017-10-01

    Although the asthma guidelines recommend inhaled corticosteroids(ICS) or leukotriene receptor antagonists-(LTRAs) for the treatment of mild persistent asthma, factors governing the physicians' preference are unknown. We aimed to investigate the preference of physicians for the controller medication and the factors governing their choice. A self-administered questionnaire composed of 16 questions that aimed to determine the preference of the physicians for the first choice controller medication in mild persistent asthma and physician and patient related factors that may be associated with this selection was e-mailed to the members of the Turkish National Society of Allergy and Clinical Immunology and distributed to participants in the 21st congress. Of the 670 questionnaires, there were 51% participants and 336 of them were complete enough to be included in the analysis. Low dose ICS was preferred as the first choice controller medication for mild persistent asthma by 84.5% of the physicians. The reasons for physicians' preference were different for ICS and LTRA. In the logistic regression analysis, use of asthma guidelines (OR:3.5, 95%CI:1.3-9.3, p = 0.01), alignment in guidelines (OR:2.9, 95%CI:1.4-5.8, p = 0.002) and the opinion that it is a more effective (OR:2.3, 95%CI:1.1-4.8, p = 0.02) were independently associated with ICS preference. Being a pediatrician (OR:5.4, 95%CI: 2.7-10.5, p asthma. Asthma guidelines, training background (pediatrician versus not) and perceived efficacy and patient compliance appeared to influence their preferences. Copyright © 2017. Published by Elsevier Ltd.

  18. Travel opinion leaders and seekers

    DEFF Research Database (Denmark)

    Yoo, Kyung-Hyan; Gretzel, Ulrike; Zach, Florian

    2011-01-01

    While opinion leadership has been recognized as important in tourism, there has been very little empirical research investigating the phenomenon. Given new developments in social media technologies, it is especially important to understand whether travel opinion leadership and seeking are drivers...... of specific social media perceptions and behaviours. Based on an online survey of US online travellers, this paper seeks to identify travel opinion leaders and seekers and their characteristics. Further, the research conducted investigated linkages between travel opinion leadership/seeking and travel social...... media use. The findings suggest that travel opinion leadership and seeking are distinct but connected. Both opinion leaders and seekers are technology savvy, young, educated, involved in travel planning and engaged in social media use for travel. What distinguishes opinion leaders is their greater...

  19. The Moral Difference or Equivalence Between Continuous Sedation Until Death and Physician-Assisted Death: Word Games or War Games?

    NARCIS (Netherlands)

    Rys, S.; Deschepper, R.; Mortier, F.; Deliens, L.; Atkinson, D.; Bilsen, J.

    2012-01-01

    Continuous sedation until death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, often provokes medical-ethical discussions in the opinion sections of medical and nursing journals. Some argue that CSD is morally equivalent to physician-assisted death

  20. Quantification of informed opinion

    International Nuclear Information System (INIS)

    Rasmuson, D.M.

    1985-01-01

    The objective of this session, Quantification of Informed Opinion, is to provide the statistician with a better understanding of this important area. The NRC uses informed opinion, sometimes called engineering judgment or subjective judgment, in many areas. Sometimes informed opinion is the only source of information that exists, especially in phenomenological areas, such as steam explosions, where experiments are costly and phenomena are very difficult to measure. There are many degrees of informed opinion. These vary from the weatherman who makes predictions concerning relatively high probability events with a large data base to the phenomenological expert who must use his intuition tempered with basic knowledge and little or no measured data to predict the behavior of events with a low probability of occurrence. The first paper in this session provides the reader with an overview of the subject area. The second paper provides some aspects that must be considered in the collection of informed opinion to improve the quality of the information. The final paper contains an example of the use of informed opinion in the area of seismic hazard characterization. These papers should be useful to researchers and statisticians who need to collect and use informed opinion in their work

  1. Online professional networks for physicians: risk management.

    Science.gov (United States)

    Hyman, Jon L; Luks, Howard J; Sechrest, Randale

    2012-05-01

    The rapidly developing array of online physician-only communities represents a potential extraordinary advance in the availability of educational and informational resources to physicians. These online communities provide physicians with a new range of controls over the information they process, but use of this social media technology carries some risk. The purpose of this review was to help physicians manage the risks of online professional networking and discuss the potential benefits that may come with such networks. This article explores the risks and benefits of physicians engaging in online professional networking with peers and provides suggestions on risk management. Through an Internet search and literature review, we scrutinized available case law, federal regulatory code, and guidelines of conduct from professional organizations and consultants. We reviewed the OrthoMind.com site as a case example because it is currently the only online social network exclusively for orthopaedic surgeons. Existing case law suggests potential liability for orthopaedic surgeons who engage with patients on openly accessible social network platforms. Current society guidelines in both the United States and Britain provide sensible rules that may mitigate such risks. However, the overall lack of a strong body of legal opinions, government regulations as well as practical experience for most surgeons limit the suitability of such platforms. Closed platforms that are restricted to validated orthopaedic surgeons may limit these downside risks and hence allow surgeons to collaborate with one another both as clinicians and practice owners. Educating surgeons about the pros and cons of participating in these networking platforms is helping them more astutely manage risks and optimize benefits. This evolving online environment of professional interaction is one of few precedents, but the application of risk management strategies that physicians use in daily practice carries over

  2. Occupational physicians' perceptions and impact of 2009 GMC consent guidelines.

    Science.gov (United States)

    Stern, A F; Sperber, S

    2012-10-01

    In 2009, the General Medical Council (GMC) updated its guidance on consent, introducing a new statement that employees should be offered the opportunity to view reports, before the reports are sent to the employer. To investigate the effects of this change on the perceptions and practice of occupational physicians. A cross-sectional survey of UK occupational physicians via the Society of Occupational Medicine e-newsletter, seeking their opinions of the anticipated and actual effects of the guidance on employers, employees, occupational physicians and occupational health services. Two hundred and ninety-five completed questionnaires were returned (estimated response rate 30%). Respondents included 25% of accredited UK specialists. Some reported improved standards and greater transparency, however the change was generally perceived as unfavourable, with employee and employer losses: 50% reported delay providing timely advice to employers and 35% reported delays in employees returning to work. Significant variation in practice and increased costs were reported, with variable effects on different services. Difficulties in areas such as pensions and health surveillance were reported. Some occupational physicians had moved to instant reporting; others had moved away from this to allow more care with wording of reports. We found significant variations in practice between occupational physicians and concerns of employee and employer losses as a result of changes to the GMC consent guidance. Clearer guidance on practical implementation was desired. The background ethical reasoning should be stated so that the parameters of the guidance are delineated and its reach should be clarified.

  3. Public opinion polls on nuclear energy

    International Nuclear Information System (INIS)

    Heller, E.D.

    1980-07-01

    Future developments in the attitude towards nuclear energy can not be predicted on account of this public opinion survey. The survey shows just how many different factors influence the attitude towards issues of public and political interst. For this reason in particular, it would be desirable to include such aspects into future surveys. The survey shows that public opinion polls quite often investigate on the ordering party's opinion rather than the pollees opinion. The attempt at making public opinion polls a means of forming political opinions, implying a certain desired opinion to be the majority opinion has brought those polls into disrepute. If real results are not required and manipulation prevails, results are prevented, which must not be blamed on the principle of public opinion polls as such. (orig.) [de

  4. Opinion Integration and Summarization

    Science.gov (United States)

    Lu, Yue

    2011-01-01

    As Web 2.0 applications become increasingly popular, more and more people express their opinions on the Web in various ways in real time. Such wide coverage of topics and abundance of users make the Web an extremely valuable source for mining people's opinions about all kinds of topics. However, since the opinions are usually expressed as…

  5. Minority politics in the house of medicine: the physicians forum and the New York County Medical Society, 1938-1965.

    Science.gov (United States)

    Brickman, J P

    1999-01-01

    The late 1930s challenged laissez-faire medicine. Recognition of serious inadequacies in the distribution of medical services stirred activists who questioned fee-for-service delivery and posited a national health program, including health insurance. The AMA and its components--state and county medical societies--counterattacked, mobilizing money and their powerful political arsenal to fight government intrusion in private medicine. The Physicians Forum, initially under the leadership of Ernst P. Boas, emerged as a formidable element within the New York County Medical Society (the largest component of the AMA). The Forum provoked discussion of medical indigence and economics, upsetting the Society leadership with independent candidate slates and telling the public that doctors spoke with more than one voice. For 25 years, the Physicians Forum altered the dynamics of the Medical Society of the County of New York. While the Forum effort to institutionalize minority opinion in the councils of medicine failed, the interchange between County regulars and Forum insurgents broadened the medical reform agenda and moved the County Society in directions that historically it had avoided. Although medical economics formed an unbridgeable chasm between County regulars and rebels, Forum members demonstrated that medicine was not monolithic, that "majority opinion [was not] ... unanimous opinion," and that doctors must speak to issues of medical and social policy.

  6. Medical professionalism of foreign-born and foreign-trained physicians under close scrutiny: A qualitative study with stakeholders in Germany

    Science.gov (United States)

    Ismail, Fatiha; Marckmann, Georg; Kuehlmeyer, Katja

    2018-01-01

    Hospitals in Germany employ increasing numbers of foreign-born and foreign-trained (FB&FT) physicians. Studies have investigated how FB&FT physicians experience their professional integration into the German healthcare system, however, the perspectives of stakeholders working with and shaping the work experiences of FB&FT physicians in German hospitals have so far been neglected. This study explores relevant stakeholders’ opinions and attitudes towards FB&FT physicians—which likely influence how these physicians settle in—and how these opinions were formed. We conducted a qualitative interview study with 25 stakeholders working in hospitals or in health policy development. The interviews were analyzed within a constructivist research paradigm using methods derived from Grounded Theory (situational analysis as well as open, axial and selective coding). We found that stakeholders tended to focus on problems in FB&FT physicians’ work performance. Participants criticized FB&FT physicians’ work for deviating from presumably shared professional standards (skill or knowledge and behavioral standards). The professional standards invoked to justify problem-focused statements comprised the definition of an ideal behavior, attitude or ability and a tolerance range that was adapted in a dynamic process. Behavior falling outside the tolerance range was criticized as unacceptable, requiring action to prevent similar deviations in the future. Furthermore, we derived three strategies (minimization, homogenization and quality management) proposed by participants to manage deviations from assumed professional standards by FB&FT physicians. We critically reflect on the social processes of evaluation and problematization and question the legitimacy of professional standards invoked. We also discuss discriminatory tendencies visible in evaluative statements of some participants as well as in some of the strategies proposed. We suggest it will be key to develop and implement

  7. Behavior of the physician in the case of fetal exposition to ionising radiations due to medical indication

    International Nuclear Information System (INIS)

    Leppin, W.

    1982-01-01

    The 3-tier Concept presented here should contribute to the formation of a consensus of opinion concerning the hazards of radiation dose to pregnant women. It is applicable in the first instance to those directly involved, namely radiologists, gynaecologists and pregnant women. The physician-in-charge should be be responsible for all treatment up to the dose of 20 Cy, which is in one opinion a harmless level of in-utero exposure. Even if errors in dose estimation are taken into account, there exist sufficient safety reserves for the protection of the fetus. Omission of enquiry would mean that the feelings of insecurity, fear and anxiety in pregnant women would no longer arise. This procedure could also make a positive and objective contribution towards the lessening of fear of radiation in other areas. In addition it is our view that, given this sole responsibility, physicians would become more aware of and concerned with the problems of radiological protection. In no way should this concept make light of clearly present hazards. (orig.) [de

  8. Exploring public sector physicians' resilience, reactions and coping strategies in times of economic crisis; findings from a survey in Portugal's capital city area.

    Science.gov (United States)

    Russo, Giuliano; Pires, Carlos André; Perelman, Julian; Gonçalves, Luzia; Barros, Pedro Pita

    2017-03-15

    Evidence is accumulating on the impact of the recent economic crisis on health and health systems across Europe. However, little is known about the effect this is having on physicians - a crucial resource for the delivery of healthcare services. This paper explores the adaptation to the crisis of public sector physicians and their ability to keep performing their functions, with the objective of gaining a better understanding of health workers' resilience under deteriorating conditions. We conducted a survey among 484 public primary care and hospital physicians in Portugal's capital city area and explored their perceptions of the crisis, adaptation and coping strategies. We used ordinal and logistic regression models to link changes in hours worked and intentions to migrate with physicians' characteristics and specific answers. We found little evidence of physicians changing their overall allocation of working time before and after the crisis, with their age, types of specialisation, valuation of job flexibility and independence significantly associated with changes in public sector hours between 2010 and 2015. Being divorced, not Portuguese, of younger age, and working a high number of hours per week, were found to increase the probability of physicians considering migration, the same as having a poor opinion of recent government health policies. On the other hand, enjoying their current working environment, not wanting to disrupt provision of service, and leisure time were found to protect against scaling down public sector hours or considering migration. Our work on Portuguese physicians contributes to the debate on health workers' resilience, showing the value of understanding the influence of personal characteristics and opinions on their adaptation to changing circumstances, before designing policies to improve their working conditions and retention.

  9. Physicians' intentions and use of three patient decision aids

    Science.gov (United States)

    Graham, Ian D; Logan, Jo; Bennett, Carol L; Presseau, Justin; O'Connor, Annette M; Mitchell, Susan L; Tetroe, Jacqueline M; Cranney, Ann; Hebert, Paul; Aaron, Shawn D

    2007-01-01

    Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270) returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80%) also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians (<60%) felt the decision aid would improve the quality of patient visits or be easily implemented into practice and very few (27%) felt that the decision aid would save time. Physicians' intentions to use the decision aid were related to their comfort with offering it to patients, the decision aid topic, and the perceived ease of implementing it into practice. While 54% of the surveyed physicians indicated they would use the decision aid, less than a third followed through with this

  10. Construction and preliminary validation of a dictionary for cognitive rigidity: linguistic markers of overconfidence and overgeneralization and their concomitant psychological distress.

    Science.gov (United States)

    Cohen, Shuki J

    2012-10-01

    Fanaticism and extremism are increasingly recognized as seminal to psychopathology and distress, especially considering the increase in political unrest and violence over the last decade. In the psychopathological literature, however, the cognitive style associated with extremism and overgeneralization has long been recognized as a risk factor for emotional distress, leading to both externalizing behavior (e.g. aggression) and internalizing pathology (e.g. depression). Despite its recognized importance, however, virtually no standardized measures of this cognitive style exist. Since direct inquiry about a respondent's Cognitive Rigidity, is likely to be biased, a text-analytical measure of extremism in spontaneous autobiographical narratives is proposed. In contrast to self-reports, naturally occurring speech often suggests cognitive proclivities towards overgeneralization, overconfidence or extremization. In this study, spoken autobiographical narratives were elicited from 483 participants, and contrasted with extensive mental health information using a hierarchical concordanced-keyword technique. The resulting corpus-based dictionary is context-sensitive, and exhibits significant correlations with measures of negative emotionality, with minimal association with response bias measures.

  11. Expert opinion vs. empirical evidence

    OpenAIRE

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years sp...

  12. Expert opinion vs. empirical evidence

    Science.gov (United States)

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  13. Workplace violence against physicians in Turkey’s emergency departments: a cross-sectional survey

    Science.gov (United States)

    Bayram, Başak; Çetin, Murat; Çolak Oray, Neşe; Can, İsmail Özgür

    2017-01-01

    Objective We aimed to determine the prevalence of violence directed at emergency department (ED) physicians in Turkey and confirm the factors influencing such violence. Design Cross-sectional survey study. Setting Country of Turkey. Participants Physicians currently practising in EDs in Turkey. Main outcome measures The prevalence of violence directed at physicians and factors that may influence it, such as physicians’ personal characteristics, ED characteristics and physicians’ opinions regarding the causes of and suggested methods of preventing violence. Results A total of 713 physicians participated. Of these, 78.1% reported being subjected to violence in the past year and 65.9% reported more than one such incident. Being subjected to violence was related to age (p=0.008), working in an ED with a high patient admission rate (p=0.018), current position (pviolence. The present safety precautions against violence do not appear to influence the prevalence of violence. Conclusions Our results indicated that ED physicians’ experience of violence is related to personal characteristics such as age and level of expertise, and hospital and ED characteristics such as high patient admission rates. Presently, no measures taken to reduce this violence have been proven effective. PMID:28663323

  14. TOOL: The Open Opinion Layer

    OpenAIRE

    Masum, Hassan

    2002-01-01

    Shared opinions drive society: what we read, how we vote, and where we shop are all heavily influenced by the choices of others. However, the cost in time and money to systematically share opinions remains high, while the actual performance history of opinion generators is often not tracked. This article explores the development of a distributed open opinion layer, which is given the generic name of TOOL. Similar to the evolution of network protocols as an underlying layer for many comput...

  15. Physician advocacy in Western medicine: a 21st century challenge.

    Science.gov (United States)

    Bagshaw, Philip; Barnett, Pauline

    2017-12-01

    Physician advocacy occurs when doctors speak up for the health and healthcare of patients and communities. Historically, this was strong in some Western countries with doctors finding that it enhanced their authority, prestige and power. But it weakened in the 20th century when the biomedical model of heath triumphed and medicine became a dominant profession. In the second part of the 20th century, this dominance was threatened by political, technological and socioeconomic forces. These weakened medicine's state support, brought it under managerial control and undermined the social contract on which trust between doctors and the community was based. Defence of the profession was assumed by medical colleges, societies and associations. They had some success in retaining professional autonomy but did not undertake open advocacy, particularly on social justice issues, and did not therefore enhance their standing in the community. Opinion is divided on the level of advocacy that it is ethically proper for the medical profession to employ. Some contend doctors should only advise authorities when expert opinion is requested. Others contend doctors should speak out proactively on all health issues, and that collective action of this type is a hallmark of professionalism. This lack of consensus needs to be debated. Recent developments such as clinical leadership have not revitalised physician advocacy. However, continued deterioration of the UK National Health Service has led some English medical colleges to take up open advocacy in its defence. It is to be seen whether medical colleges elsewhere follow suit, as and when their healthcare systems are similarly threatened.

  16. Mistress Joyce Jeffreys and her physician, Dr Bridstock Harford (1607-1695).

    Science.gov (United States)

    Connor, Henry

    2016-11-01

    The notebooks of Joyce Jeffreys, a wealthy Hereford businesswoman in the mid-17th century, provide information about the medicines she purchased and the fees she paid to her medical advisors. Her physician, Dr Bridstock Harford, was a successful doctor but a troublesome neighbour, who was often the subject of litigation. As an ardent parliamentarian, he held public offices during the Commonwealth. Later his opinions mellowed and he ended his days as a loyal subject of the king and a benefactor to his city. © The Author(s) 2014.

  17. Survey of the Satisfaction and Dissatisfaction of Referring Physicians Concerning the Radiologic Report of Plain Radiography Except for Chest Plain Radiography

    International Nuclear Information System (INIS)

    Moon, Soon Young; Park, Noh Hyuck; Kim, Mi Sung; Park, Chan Sub; Park, Ji Yeon; Park, Hee Jin; Kim, Sam Soo; Jeon, Hyun Jun

    2011-01-01

    To assess the satisfaction, attitude, dissatisfaction and general opinion of radiologic reports on the plain radiography, except for chest plain radiographs. A questionnaire was distributed to the 63 physicians of our hospital. The questionnaire aimed to investigate physician's general attitude, dissatisfaction and opinions. The responses elicited, as well as discrepancies among residents, staff, medical clinicians and surgical clinicians were assessed. Chi-square and t-tests were used to determine the value of the data. The mean rate of satisfaction for the reading report by medical clinicians (64%) was higher than surgical clinicians (25%) (p < 0.001). The mean satisfaction score was 3.1 (2.8-3.61). The main cause for dissatisfaction was the absence of reports when they were needed, especially for residents. The medical clinician's dependence on radiologic reports was higher than that of the surgical clinicians. The satisfaction score was in the middle range and the main cause of dissatisfaction was absence of the reports when they were needed.

  18. Opiniones de los gestores de la atención primaria sobre las fuentes de influencia en la práctica médica: Diferencias con la opinión de los médicos asistenciales Opinions of primary care managers on sources of influence on medical practice: Differences with physicians' opinions

    Directory of Open Access Journals (Sweden)

    L.A. López

    2002-10-01

    informes científicos. Las instituciones o colectivos con mayor legitimidad para influir en la práctica médica son: los usuarios o ciudadanos, las auditorías internas, los compañeros de trabajo médicos, las organizaciones científicas y los propios gestores. Conclusiones: Las fuentes de influencia que se consideran más importantes y legitimadas para influir en la práctica médica se sitúan en torno al denominado «sistema profesional médico». Respecto a las principales diferencias entre la opinión de los gestores y la de los médicos asistenciales, hay que señalar que entre los primeros cuentan con una mayor aceptación los mecanismos de gestión empresarial y las influencias en la práctica médica procedentes de los distintos actores del contexto social. Este hecho podría expresar la existencia de diferencias en los sistemas de valores entre los profesionales asistenciales y los gestores de la atención primaria.Objectives: To determine the opinion of primary healthcare managers on the importance and legitimacy of different sources of influence in medical practice, and to compare the results with the opinions of physicians in healthcare teams. Material and methods: Design: cross-sectional study. Population: primary healthcare managers in the Spanish public health system (area managers, medical and nursing directors and in the Andalusian health service (district director, nursing coordinators and epidemiology and program coordinators. The sample comprised the total population of 302. As dependent variables, a series of questions was designed to gather the interviewees' opinions on different strategies, institutions and/or collectives that exert some kind of influence on medical practice. The degree of «importance» of each factor was summarized into a set of 9 items. The subjects were asked to score each item from 1 (most important to 9 (least important. To assess the «legitimacy» of these scores, 16 items were presented measured using a Likert-type 7

  19. Opinion competition dynamics on multiplex networks

    Science.gov (United States)

    Amato, R.; Kouvaris, N. E.; San Miguel, M.; Díaz-Guilera, A.

    2017-12-01

    Multilayer and multiplex networks represent a good proxy for the description of social phenomena where social structure is important and can have different origins. Here, we propose a model of opinion competition where individuals are organized according to two different structures in two layers. Agents exchange opinions according to the Abrams-Strogatz model in each layer separately and opinions can be copied across layers by the same individual. In each layer a different opinion is dominant, so each layer has a different absorbing state. Consensus in one opinion is not the only possible stable solution because of the interaction between the two layers. A new mean field solution has been found where both opinions coexist. In a finite system there is a long transient time for the dynamical coexistence of both opinions. However, the system ends in a consensus state due to finite size effects. We analyze sparse topologies in the two layers and the existence of positive correlations between them, which enables the coexistence of inter-layer groups of agents sharing the same opinion.

  20. Competing opinion diffusion on social networks.

    Science.gov (United States)

    Hu, Haibo

    2017-11-01

    Opinion competition is a common phenomenon in real life, such as with opinions on controversial issues or political candidates; however, modelling this competition remains largely unexplored. To bridge this gap, we propose a model of competing opinion diffusion on social networks taking into account degree-dependent fitness or persuasiveness. We study the combined influence of social networks, individual fitnesses and attributes, as well as mass media on people's opinions, and find that both social networks and mass media act as amplifiers in opinion diffusion, the amplifying effect of which can be quantitatively characterized. We analytically obtain the probability that each opinion will ultimately pervade the whole society when there are no committed people in networks, and the final proportion of each opinion at the steady state when there are committed people in networks. The results of numerical simulations show good agreement with those obtained through an analytical approach. This study provides insight into the collective influence of individual attributes, local social networks and global media on opinion diffusion, and contributes to a comprehensive understanding of competing diffusion behaviours in the real world.

  1. Non-consensus Opinion Models on Complex Networks

    Science.gov (United States)

    Li, Qian; Braunstein, Lidia A.; Wang, Huijuan; Shao, Jia; Stanley, H. Eugene; Havlin, Shlomo

    2013-04-01

    Social dynamic opinion models have been widely studied to understand how interactions among individuals cause opinions to evolve. Most opinion models that utilize spin interaction models usually produce a consensus steady state in which only one opinion exists. Because in reality different opinions usually coexist, we focus on non-consensus opinion models in which above a certain threshold two opinions coexist in a stable relationship. We revisit and extend the non-consensus opinion (NCO) model introduced by Shao et al. (Phys. Rev. Lett. 103:01870, 2009). The NCO model in random networks displays a second order phase transition that belongs to regular mean field percolation and is characterized by the appearance (above a certain threshold) of a large spanning cluster of the minority opinion. We generalize the NCO model by adding a weight factor W to each individual's original opinion when determining their future opinion (NCO W model). We find that as W increases the minority opinion holders tend to form stable clusters with a smaller initial minority fraction than in the NCO model. We also revisit another non-consensus opinion model based on the NCO model, the inflexible contrarian opinion (ICO) model (Li et al. in Phys. Rev. E 84:066101, 2011), which introduces inflexible contrarians to model the competition between two opinions in a steady state. Inflexible contrarians are individuals that never change their original opinion but may influence the opinions of others. To place the inflexible contrarians in the ICO model we use two different strategies, random placement and one in which high-degree nodes are targeted. The inflexible contrarians effectively decrease the size of the largest rival-opinion cluster in both strategies, but the effect is more pronounced under the targeted method. All of the above models have previously been explored in terms of a single network, but human communities are usually interconnected, not isolated. Because opinions propagate not

  2. Attitudes of young neurosurgeons and neurosurgical residents towards euthanasia and physician-assisted suicide.

    Science.gov (United States)

    Broekman, M L D; Verlooy, J S A

    2013-11-01

    Euthanasia and physician assisted suicide (PAS) are two controversial topics in neurosurgical practice. Personal attitudes and opinions on these important issues may vary between professionals, and may also depend on their location since current legislation differs between European countries. As these issues may have significant impact on clinical practice, the goal of the present study was to survey the opinions of neurosurgical residents and young neurosurgeons across Europe with respect to euthanasia and physician assisted suicide. We performed a survey among the participants of the European Association of Neurosurgical Societies (EANS) training courses (2011-2012), asking residents and young neurosurgeons nine questions on euthanasia and PAS. For the analysis of this survey, we divided all 295 participants into four European regions (North, South, East, West). We found that even though most residents are aware of regulations about euthanasia or PAS in their country or hospital, a substantial number were not aware of the regulations. We observed no significant differences in terms of their opinions on euthanasia and PAS among the four European regions. While most are actually in favor of euthanasia or PAS, if legally allowed, under appropriate circumstances, very few neurosurgeons would be willing to actively participate in these end-of-life practices. The results of this first survey on neurosurgical residents' attitudes towards euthanasia and PAS show that a significant number of residents is not familiar with national and/or local regulations regarding euthanasia and PAS. If legally allowed, most residents would be in favor of euthanasia and PAS, but only a minority would be willing to actively participate in these practices. We did not observe a difference in stances on euthanasia and PAS among residents from different regions in Europe.

  3. Acceptance of induced abortion amongst medical students and physicians in Mexico.

    Science.gov (United States)

    Lisker, Rubén; Carnevale, Alessandra; Villa, Antonio R

    2006-01-01

    Abortion is illegal in most of Mexico, except in the case of rape or physical risk to the mother, but there are several indicators that suggest that at least in Mexico City, society would like to have a more liberal law. The present study was performed to learn what several groups of physicians and medical students residing outside of Mexico City think in this regard. Seven colleagues working in different cities agreed to apply a questionnaire to physicians and or medical students available to them, to learn their opinions regarding the acceptability of induced abortion in several scenarios. Questions one to tree inquires if abortion is acceptable up to week 20 of pregnancy at the simple request of the parents, if the fetus has a severe malformation or anencephaly. Questions four to six personalize the situations by supposing that the physician or spouse have a high risk of having a malformed child. Question seven asks if they would offer prenatal diagnosis to a mother who would abort a malformed fetus. Statistical procedure includes multivariate analysis. The inter-city physicians-students composition was very heterogeneous. The majority of respondents disagreed with abortion on demand of the parents, but clearly agrees to it in the presence of severe malformations. In general males, above 30 years old physicians and less religious individuals, are more in favor to abortion than their respective counterparts. The proportion of acceptance is over 70% in most cases. We believe that this work shows a preliminary indication of a national trend amongst physicians and medical students favoring induced early abortion if the fetus has a severe malformation.

  4. Fashion clothing involvement, opinion leadership and opinion seeking amongst black generation Y students / Pulaki Joseph Tshabalala

    OpenAIRE

    Tshabalala, Pulaki Joseph

    2014-01-01

    Opinion leadership and opinion seeking are central constructs in academic studies of new product innovations. Fashion opinion leaders as those individuals who accelerate the fashion maturity process by legitimising a fashionable trend and influence other consumers to adopt the new innovative style as a replacement for the current accepted one. Consumers who accept information and adopt new style innovations are called opinion seekers and are important to the diffusion of new fashions because ...

  5. Plutonium - the ultrapoison? An expert's opinion about an expert opinion

    International Nuclear Information System (INIS)

    Stoll, W.; Becker, K.

    1989-01-01

    In an expert opinion written by Professor H. Kuni, Marburg, for the North Rhine-Westphalian state government, plutonium is called by far the most dangerous element in the Periodic Table. The Marburg medical expert holds that even improved legal instruments are unable to warrant effective protection of the workers handling this material, in the light of the present standards of industrial safety, because of radiological conditions and measuring problems with plutonium isotopes. In this article by an internationally renowned expert in the field, the ideas expressed in the expert opinion about the toxicity of plutonium, the cause-and-effect relationship in radiation damage by plutonium, and recent findings about the toxicity are subjected to a critical review. On the basis of results of radiation protection and of case studies, the statements in the expert opinion are contrasted with facts which make them appear in a very different light. (orig./RB) [de

  6. Self-Reported Rationing Behavior Among US Physicians: A National Survey.

    Science.gov (United States)

    Sheeler, Robert D; Mundell, Tim; Hurst, Samia A; Goold, Susan Dorr; Thorsteinsdottir, Bjorg; Tilburt, Jon C; Danis, Marion

    2016-12-01

    Rationing is a controversial topic among US physicians. Understanding their attitudes and behaviors around rationing may be essential to a more open and sensible professional discourse on this important but controversial topic. To describe rationing behavior and associated factors among US physicians. Survey mailed to US physicians in 2012 to evaluate self-reported rationing behavior and variables related to this behavior. US physicians across a full spectrum of practice settings. A total of 2541 respondents, representing 65.6 % of the original mailing list of 3872 US addresses. The study was a cross-sectional analysis of physician attitudes and self-reported behaviors, with neutral language representations of the behaviors as well as an embedded experiment to test the influence of the word "ration" on perceived responsibility. Overall percentage of respondents reporting rationing behavior in various contexts and assessment of attitudes toward rationing. In total, 1348 respondents (53.1 %) reported having personally refrained within the past 6 months from using specific clinical services that would have provided the best patient care, because of health system cost. Prescription drugs (n = 1073 [48.3 %]) and magnetic resonance imaging (n = 922 [44.5 %]) were most frequently rationed. Surgical and procedural specialists were less likely to report rationing behavior (adjusted odds ratio [OR] [95 % CI], 0.8 [0.9-0.9] and 0.5 [0.4-0.6], respectively) compared to primary care. Compared with small or solo practices, those in medical school settings reported less rationing (adjusted OR [95 % CI], 0.4 [0.2-0.7]). Physicians who self-identified as very or somewhat liberal were significantly less likely to report rationing (adjusted OR [95 % CI], 0.7 [0.6-0.9]) than those self-reporting being very or somewhat conservative. A more positive opinion about rationing tended to align with greater odds of rationing. More than one-half of respondents engaged in

  7. Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students.

    Science.gov (United States)

    McKenna, Mindi K; Gartland, Myles P; Pugno, Perry A

    2004-01-01

    Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.

  8. Professional satisfaction of family physicians in Pakistan--results of a cross-sectional postal survey.

    Science.gov (United States)

    Ashraf, Hiba; Shah, Nasir; Anwer, Fahad; Akhtar, Hina; Abro, Mairaj Anwar; Khan, Asma

    2014-04-01

    To assess the level of professional satisfaction amongst family physicians of Pakistan and to identify the factors associated with professional dissatisfaction. The study was part of a larger national survey for "Status of PostgraduateTraining and Continuing Medical Education of Family Physicians in Pakistan" which was a cross-sectional, postal survey of family physicians conducted over 10 months between November 2009 and September 2010. The main outcome variables were professional satisfaction, as well as reasons for professional satisfaction and dissatisfaction. SPSS 17 was used for data analysis. Multivariable logistic regression was used to determine factors associated with professional dissatisfaction. Of the total 1200 survey forms distributed, 288 (24%) were received back. The mean age of the participants was 37 +/- 9 years with a range between 26 and 72 years. Of the total, 226 (78.5%) were males. Overall, 213 (74%) family physicians were satisfied with their profession. The factors significantly associated with professional dissatisfaction included the participants opinion that they were not respected by the public (OR: 11.6, C.I: 1.9-71.5); as well as regretting being a doctor (OR:62.9, C.I: 8.4-469.8). Most of the family physicians had professional satisfaction, but a minority had regrets about being a doctor and were dissatisfied over how their profession affected their family life. Further research may be needed to study work-life balance amongst family physicians of Pakistan.

  9. Physician and stakeholder perceptions of conflict of interest policies in oncology.

    Science.gov (United States)

    Lockhart, A Craig; Brose, Marcia S; Kim, Edward S; Johnson, David H; Peppercorn, Jeffrey M; Michels, Dina L; Storm, Courtney D; Schuchter, Lynn M; Rathmell, W Kimryn

    2013-05-01

    The landscape of managing potential conflicts of interest (COIs) has evolved substantially across many disciplines in recent years, but rarely are the issues more intertwined with financial and ethical implications than in the health care setting. Cancer care is a highly technologic arena, with numerous physician-industry interactions. The American Society of Clinical Oncology (ASCO) recognizes the role of a professional organization to facilitate management of these interactions and the need for periodic review of its COI policy (Policy). To gauge the sentiments of ASCO members and nonphysician stakeholders, two surveys were performed. The first asked ASCO members to estimate opinions of the Policy as it relates to presentation of industry-sponsored research. Respondents were classified as consumers or producers of research material based on demographic responses. A similar survey solicited opinions of nonphysician stakeholders, including patients with cancer, survivors, family members, and advocates. The ASCO survey was responded to by 1,967 members (1% of those solicited); 80% were producers, and 20% were consumers. Most respondents (93% of producers; 66% of consumers) reported familiarity with the Policy. Only a small proportion regularly evaluated COIs for presented research. Members favored increased transparency about relationships over restrictions on presentations of research. Stakeholders (n = 264) indicated that disclosure was "very important" to "extremely important" and preferred written disclosure (77%) over other methods. COI policies are an important and relevant topic among physicians and patient advocates. Methods to simplify the disclosure process, improve transparency, and facilitate responsiveness are critical for COI management.

  10. Workers' opinions on the effect of contact with health care providers on sickness absence duration.

    Science.gov (United States)

    Steenbeek, Romy

    2014-01-01

    Because of the aging working population and the increasing age of retirement the number of workers with chronic illnesses and disabilities is growing. It is important that workers with health complaints receive efficient health care in order to remain fully or at least partly productive. To explore workers' opinions about the effectiveness of contact with health care providers in shortening sickness absence duration. Data come from a four-wave study from 2005 to 2008 among Dutch workers (n=1,424). Data were obtained on visits to health care providers, sickness absence and workers' opinions on whether and how their absence could have been shortened. A third of the workers were of the opinion that the health care provider (most often the general practitioner, GP) had played a role in preventing sickness absence and 35% were of the opinion that the health care provider had limited their absence. Most often the physical therapist (71%) and mental health therapist (61%) shortened sickness absence duration, in contrast to the occupational physician (OP, 25%) and GP (32%). The effectiveness of the health care providers' treatment was associated with the cause of sickness absence. Approximately 15% of the workers reported that their sickness absence could have been shortened if health care providers had provided the proper treatment and if waiting times had been reduced. Health care providers differ in their potential to shorten sickness absence duration. Health care providers can further reduce sickness absence and health care costs by providing the proper treatment and by reducing waiting times.

  11. Opinions of students from a Brazilian medical school regarding online professionalism.

    Science.gov (United States)

    Rocha, Paulo Novis; de Castro, Naara Alethéa Azael

    2014-05-01

    Unprofessional online behavior by medical students or physicians may damage individual careers, and the reputation of institutions and the medical profession. What is considered unprofessional online behavior, however, is not clearly defined and may vary in different cultures. To determine the frequency with which students from a Brazilian Medical School come across ten given examples of unprofessional online behavior by medical students or physicians, and gather the opinions of participants regarding the appropriateness of these behaviors. A cross-sectional survey of 350 students from the Medical School of Bahia, Brazil. Only those who had a profile in social media were included in the final analyses. 336/350 (96.0%) medical students kept a profile in social media. Only 13.5% reported having discussions about online professionalism during ethics classes. They reported witnessing the investigated examples of unprofessional online behavior with varying frequencies, ranging from 13.7% for "violation of patient's privacy" to 85.4% for "photos depicting consumption of alcoholic beverages". Most participants felt neutral about posting "pictures in bathing suits", whereas the vast majority rated "violation of patient's privacy" as totally inappropriate. When presented with a case vignette illustrating violation of patients' privacy (publication of pictures of hospitalized children or neonates in social media), however, most participants felt neutral about it. Participants considered all investigated examples of unprofessional online behavior more inappropriate if carried out by doctors rather than by students. Medical students are witnessing a high frequency of unprofessional online behavior by their peers and physicians. Most investigated behaviors were considered inappropriate, especially if carried out by physicians. Participants were not able to recognize the publication of pictures of hospitalized children or neonates in social media as cases of violation of

  12. Physician-industry relations. Part 1: individual physicians.

    Science.gov (United States)

    Coyle, Susan L

    2002-03-05

    This is part 1 of a 2-part paper on ethics and physician-industry relationships. Part 1 offers advice to individual physicians; part 2 gives recommendations to medical education providers and medical professional societies. Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician is to promote the patient's best interests, while the primary ethic of industry is to promote profitability. Although partnerships between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavorable public perceptions. Many physicians and physicians-in-training think they are impervious to commercial influence. However, recent studies show that accepting industry hospitality and gifts, even drug samples, can compromise judgment about medical information and subsequent decisions about patient care. It is up to the physician to judge whether a gift is acceptable. A very general guideline is that it is ethical to accept modest gifts that advance medical practice. It is clearly unethical to accept gifts or services that obligate the physician to reciprocate. Conflicts of interest can arise from other financial ties between physicians and industry, whether to outside companies or self-owned businesses. Such ties include honorariums for speaking or writing about a company's product, payment for participating in clinic-based research, and referrals to medical resources. All of these relationships have the potential to influence a physician's attitudes and practices. This paper explores the ethical quandaries involved and offers guidelines for ethical business relationships.

  13. Is change in health behavior of Dutch medical students related to change in their ideas on how a physician's lifestyle influences their patient's lifestyle?

    NARCIS (Netherlands)

    Ketelaar, Sarah M.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2014-01-01

    A change of medical students' health behavior over time may be related to a change in their opinion regarding the relationship between physicians' own health behavior and effective healthy lifestyle counseling in patients. To investigate Dutch medical students' (1) change of health behavior over

  14. Public opinions and antinuclear contestations

    International Nuclear Information System (INIS)

    Silveira, P.R.N. da

    1978-01-01

    With the aim of demonstrating the importance of public opinion in the development of a nuclear program, a historical analysis of the different forms of anti-technological reactions is shown, starting with a study of the general aspects of mass communication and public opinion. The world-wide communication strategy adopted in the implantation of nuclear programs is discussed and, finally, the nuclear energy issue and public opinion in Brazil are analysed. (F.E.) [pt

  15. Choice Shift in Opinion Network Dynamics

    Science.gov (United States)

    Gabbay, Michael

    Choice shift is a phenomenon associated with small group dynamics whereby group discussion causes group members to shift their opinions in a more extreme direction so that the mean post-discussion opinion exceeds the mean pre-discussion opinion. Also known as group polarization, choice shift is a robust experimental phenomenon and has been well-studied within social psychology. In opinion network models, shifts toward extremism are typically produced by the presence of stubborn agents at the extremes of the opinion axis, whose opinions are much more resistant to change than moderate agents. However, we present a model in which choice shift can arise without the assumption of stubborn agents; the model evolves member opinions and uncertainties using coupled nonlinear differential equations. In addition, we briefly describe the results of a recent experiment conducted involving online group discussion concerning the outcome of National Football League games are described. The model predictions concerning the effects of network structure, disagreement level, and team choice (favorite or underdog) are in accord with the experimental results. This research was funded by the Office of Naval Research and the Defense Threat Reduction Agency.

  16. Opinion dynamics with confirmation bias.

    Directory of Open Access Journals (Sweden)

    Armen E Allahverdyan

    Full Text Available Confirmation bias is the tendency to acquire or evaluate new information in a way that is consistent with one's preexisting beliefs. It is omnipresent in psychology, economics, and even scientific practices. Prior theoretical research of this phenomenon has mainly focused on its economic implications possibly missing its potential connections with broader notions of cognitive science.We formulate a (non-Bayesian model for revising subjective probabilistic opinion of a confirmationally-biased agent in the light of a persuasive opinion. The revision rule ensures that the agent does not react to persuasion that is either far from his current opinion or coincides with it. We demonstrate that the model accounts for the basic phenomenology of the social judgment theory, and allows to study various phenomena such as cognitive dissonance and boomerang effect. The model also displays the order of presentation effect-when consecutively exposed to two opinions, the preference is given to the last opinion (recency or the first opinion (primacy -and relates recency to confirmation bias. Finally, we study the model in the case of repeated persuasion and analyze its convergence properties.The standard Bayesian approach to probabilistic opinion revision is inadequate for describing the observed phenomenology of persuasion process. The simple non-Bayesian model proposed here does agree with this phenomenology and is capable of reproducing a spectrum of effects observed in psychology: primacy-recency phenomenon, boomerang effect and cognitive dissonance. We point out several limitations of the model that should motivate its future development.

  17. Trendwatch combining expert opinion

    NARCIS (Netherlands)

    Hendrix, E.M.T.; Kornelis, M.; Pegge, S.M.; Galen, van M.A.

    2006-01-01

    In this study, focus is on a systematic way to detect future changes in trends that may effect the dynamics in the agro-food sector, and on the combination of opinions of experts. For the combination of expert opinions, the usefulness of multilevel models is investigated. Bayesian data analysis is

  18. An empirical investigation of physicians' attitudes toward intrasibling kidney donation by minor twins.

    Science.gov (United States)

    Joseph, Josh W; Thistlethwaite, J Richard; Josephson, Michelle A; Ross, Lainie Friedman

    2008-05-15

    A United States consensus group on the live donor concluded that minors (international guidelines reject this position. Recent United Network of Organ Sharing data show that minors serve as living donors, albeit infrequently. We examined the attitudes of US physicians toward minors as living donors. Four hundred members of the American Society of Transplantation and 160 physicians from the American Academy of Pediatrics Section of Nephrology or Bioethics were surveyed. The physicians were asked whether minors should be permitted to serve as living donors and how their opinion would change depending on the twins' zygosity, age, and increased waitlist time. One hundred seventy of 436 eligible participants (39%) returned surveys. Thirty-two and 39% of respondents would permit a kidney donation between 15-year-old fraternal and identical twins, respectively (P=NS). If the wait time increased from 1 to 6 years, willingness increased to 39% and 45%, respectively (P=NS). Pediatric bioethicists were the most reluctant to prohibit minors as living donors. Approximately one-third of US physicians would permit children to serve as donors. Lengthening the wait time is associated with a trend toward greater willingness to permit minor donations. Current policies that give preferential status for a deceased donor organ to minors may help minimize donations by their minor siblings. Nontransplant physicians need education about donor risks to ensure that donations are in the best interest of pediatric donors and recipients.

  19. OpinionSeer: interactive visualization of hotel customer feedback.

    Science.gov (United States)

    Wu, Yingcai; Wei, Furu; Liu, Shixia; Au, Norman; Cui, Weiwei; Zhou, Hong; Qu, Huamin

    2010-01-01

    The rapid development of Web technology has resulted in an increasing number of hotel customers sharing their opinions on the hotel services. Effective visual analysis of online customer opinions is needed, as it has a significant impact on building a successful business. In this paper, we present OpinionSeer, an interactive visualization system that could visually analyze a large collection of online hotel customer reviews. The system is built on a new visualization-centric opinion mining technique that considers uncertainty for faithfully modeling and analyzing customer opinions. A new visual representation is developed to convey customer opinions by augmenting well-established scatterplots and radial visualization. To provide multiple-level exploration, we introduce subjective logic to handle and organize subjective opinions with degrees of uncertainty. Several case studies illustrate the effectiveness and usefulness of OpinionSeer on analyzing relationships among multiple data dimensions and comparing opinions of different groups. Aside from data on hotel customer feedback, OpinionSeer could also be applied to visually analyze customer opinions on other products or services.

  20. Measuring clinical management by physicians and nurses in European hospitals: development and validation of two scales.

    Science.gov (United States)

    Plochg, Thomas; Arah, Onyebuchi A; Botje, Daan; Thompson, Caroline A; Klazinga, Niek S; Wagner, Cordula; Mannion, Russell; Lombarts, Kiki

    2014-04-01

    Clinical management is hypothesized to be critical for hospital management and hospital performance. The aims of this study were to develop and validate professional involvement scales for measuring the level of clinical management by physicians and nurses in European hospitals. Testing of validity and reliability of scales derived from a questionnaire of 21 items was developed on the basis of a previous study and expert opinion and administered in a cross-sectional seven-country research project 'Deepening our Understanding of Quality improvement in Europe' (DUQuE). A sample of 3386 leading physicians and nurses working in 188 hospitals located in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. Validity and reliability of professional involvement scales and subscales. Psychometric analysis yielded four subscales for leading physicians: (i) Administration and budgeting, (ii) Managing medical practice, (iii) Strategic management and (iv) Managing nursing practice. Only the first three factors applied well to the nurses. Cronbach's alpha for internal consistency ranged from 0.74 to 0.86 for the physicians, and from 0.61 to 0.81 for the nurses. Except for the 0.74 correlation between 'Administration and budgeting' and 'Managing medical practice' among physicians, all inter-scale correlations were measurement instrument can be used for international research on clinical management.

  1. Freedom of choice of specialist physicians is important to Swiss resident: a cross-sectional study.

    Science.gov (United States)

    Peytremann-Bridevaux, Isabelle; Ruffieux, Christiane; Burnand, Bernard

    2011-12-19

    To assess how important the possibility to choose specialist physicians is for Swiss residents and to determine which variables are associated with this opinion. This cross-sectional study used data from the 2007 Swiss population-based health survey and included 13,642 non-institutionalised adults who responded to the telephone and paper questionnaires. The dependent variable included answers to the question "How important is it for you to be able to choose the specialist you would like to visit?" Independent variables included socio-demographics, health and past year healthcare use measures. Crude and adjusted logistic regressions for the importance of being able to choose specialist physicians were performed, accounting for the survey design. 45% of participants found it very important to be able to choose the specialist physician they wanted to visit. The answers "rather important", "rather not important" and "not important" were reported by 28%, 20% and 7% of respondents. Women, individuals in middle/high executive position, those with an ordinary insurance scheme, those reporting ≥2 chronic conditions or poorer subjective health, or those who had had ≥2 outpatient visits in the preceding year were more likely to find this choice very important. In 2007, almost half of all Swiss residents found it very important to be able to choose his/her specialist physician. The further development of physician networks or other chronic disease management initiatives in Switzerland, towards integrated care, need to pay attention to the freedom of choice of specialist physicians that Swiss residents value. Future surveys should provide information on access and consultations with specialist physicians.

  2. U.S. physicians' views on financing options to expand health insurance coverage: a national survey.

    Science.gov (United States)

    McCormick, Danny; Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H; Himmelstein, David U

    2009-04-01

    Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. To assess physician views on financing options for expanding health care coverage and on access to health care. Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians.

  3. Opinion formation models on a gradient.

    Directory of Open Access Journals (Sweden)

    Michael T Gastner

    Full Text Available Statistical physicists have become interested in models of collective social behavior such as opinion formation, where individuals change their inherently preferred opinion if their friends disagree. Real preferences often depend on regional cultural differences, which we model here as a spatial gradient g in the initial opinion. The gradient does not only add reality to the model. It can also reveal that opinion clusters in two dimensions are typically in the standard (i.e., independent percolation universality class, thus settling a recent controversy about a non-consensus model. However, using analytical and numerical tools, we also present a model where the width of the transition between opinions scales proportional g(-1/4, not proportional g(-4/7 as in independent percolation, and the cluster size distribution is consistent with first-order percolation.

  4. Swiss physicians' attitudes to assisted suicide: A qualitative and quantitative empirical study.

    Science.gov (United States)

    Brauer, Susanne; Bolliger, Christian; Strub, Jean-Daniel

    2015-01-01

    In Switzerland, assisted suicide is legal as long as it does not involve self-serving motives. Physician-assisted suicide is regulated by specific guidelines issued by the Swiss Academy of Medical Sciences (SAMS). This article summarises the results of an empirical study of physicians' attitudes to assisted suicide in Switzerland, which was commissioned by the SAMS. The study (in German) is available online at: www.samw.ch. Twelve qualitative interviews and a written survey were conducted, involving a disproportional, stratified random sample of Swiss physicians (4,837 contacted, 1,318 respondents, response rate 27%). Due to the response rate and the wide variation of respondents from one professional speciality to another, the findings and interpretations presented should be regarded as applying only to the group of physicians who are interested in or are particularly affected by the issue of assisted suicide. They cannot be generalised to the whole body of physicians in Switzerland. Of the respondents, 77% considered physician-assisted suicide to be justifiable in principle, while 22% were fundamentally opposed to it. Although 43% could imagine situations where they would personally be prepared to perform assisted suicide, it is clear from the study that this potential readiness does not mean that all respondents would automatically be prepared to perform it in practice as soon as the legal criteria are met. The vast majority of respondents emphasised that there should be no obligation to perform physician-assisted suicide. Opinions differed as to whether physician-assisted suicide should remain restricted to cases where the person concerned is approaching the end of life. While a large majority of respondents considered physician-assisted suicide also to be justifiable in principle in non-end-of-life situations, 74% supported the maintenance of the end-of-life criterion in the SAMS Guidelines as a necessary condition for physician-assisted suicide. Over 50% of

  5. Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island.

    Science.gov (United States)

    Wylie, Matthew C; Baier, Rosa R; Gardner, Rebekah L

    2014-10-01

    Although electronic health record use improves healthcare delivery, adoption into clinical practice is incomplete. We sought to identify the extent of adoption in Rhode Island and the characteristics of physicians and electronic health records associated with positive experience. We performed a cross-sectional study of data collected by the Rhode Island Department of Health for the Health Information Technology Survey 2009 to 2013. Survey questions included provider and practice demographics, health record information, and Likert-type scaled questions regarding how electronic health record use affected clinical practice. The survey response rate ranged from 50% to 65%, with 62% in 2013. Increasing numbers of physicians in Rhode Island use an electronic health record. In 2013, 81% of physicians used one, and adoption varied by clinical subspecialty. Most providers think that electronic health record use improves billing and quality improvement but has not improved job satisfaction. Physicians with longer and more sophisticated electronic health record use report positive effects of introduction on all aspects of practice examined (P electronic health record introduction (P electronic health record vendors most frequently used in Rhode Island, 5 were associated with improved job satisfaction. We report the largest statewide study of electronic health record adoption to date. We found increasing physician use in Rhode Island, and the extent of adoption varies by subspecialty. Although older physicians are less likely to be positive about electronic health record adoption, longer and more sophisticated use are associated with more positive opinions, suggesting acceptance will grow over time. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Life-sustaining treatment decisions in Portuguese intensive care units: a national survey of intensive care physicians.

    Science.gov (United States)

    Cardoso, Teresa; Fonseca, Teresa; Pereira, Sofia; Lencastre, Luís

    2003-12-01

    The objective of the present study was to evaluate the opinion of Portuguese intensive care physicians regarding 'do-not-resuscitate' (DNR) orders and decisions to withhold/withdraw treatment. A questionnaire was sent to all physicians working on a full-time basis in all intensive care units (ICUs) registered with the Portuguese Intensive Care Society. A total of 266 questionnaires were sent and 175 (66%) were returned. Physicians from 79% of the ICUs participated. All participants stated that DNR orders are applied in their units, and 98.3% stated that decisions to withhold treatment and 95.4% stated that decisions to withdraw treatment are also applied. About three quarters indicated that only the medical group makes these decisions. Fewer than 15% of the responders stated that they involve nurses, 9% involve patients and fewer than 11% involve patients' relatives in end-of-life decisions. Physicians with more than 10 years of clinical experience more frequently indicated that they involve nurses in these decisions (P atheist doctors more frequently involve patients' relatives in decisions to withhold/withdraw treatment (P religious beliefs of the respondents influences the way in which these decisions are made.

  7. [Medical data security in medico-legal opinioning].

    Science.gov (United States)

    Susło, Robert; Swiatek, Barbara

    2005-01-01

    Medical data security can be approached in medico-legal opinioning in three main situations: security of medical data, on which the opinion should be based, opinioning itself and whether the medical data security was properly ensured and ensuring medical data security during medico-legal opinion giving. The importance of medical data security, during collecting, processing and storing, as well in medical as in legal institutions, is of major importance for the possibility of providing a proper medico-legal opinion. Theoretically speeking, it is possible to give a proper medico-legal opinion using incorrect data, but the possibility is low. When the expert is given improper, unreadable, incomplete or even bogus in part or in the whole medical data it is extremely possible, that he fails in giving his opinion. The term "medical data" was defined and subsequently there was a brief review of medical data storing methods made and specific threats bound with them, based on modern literature. The authors also pointed out possible methods of preventing the threats. They listed Polish as well as international regulations and laws concerning the problem, accenting the importance of preserving medical data for the purposes of medico-legal opinioning.

  8. Opinion evolution in different social acquaintance networks

    Science.gov (United States)

    Chen, Xi; Zhang, Xiao; Wu, Zhan; Wang, Hongwei; Wang, Guohua; Li, Wei

    2017-11-01

    Social acquaintance networks influenced by social culture and social policy have a great impact on public opinion evolution in daily life. Based on the differences between socio-culture and social policy, three different social acquaintance networks (kinship-priority acquaintance network, independence-priority acquaintance network, and hybrid acquaintance network) incorporating heredity proportion ph and variation proportion pv are proposed in this paper. Numerical experiments are conducted to investigate network topology and different phenomena during opinion evolution, using the Deffuant model. We found that in kinship-priority acquaintance networks, similar to the Chinese traditional acquaintance networks, opinions always achieve fragmentation, resulting in the formation of multiple large clusters and many small clusters due to the fact that individuals believe more in their relatives and live in a relatively closed environment. In independence-priority acquaintance networks, similar to Western acquaintance networks, the results are similar to those in the kinship-priority acquaintance network. In hybrid acquaintance networks, similar to the Chinese modern acquaintance networks, only a few clusters are formed indicating that in modern China, opinions are more likely to reach consensus on a large scale. These results are similar to the opinion evolution phenomena in modern society, proving the rationality and applicability of network models combined with social culture and policy. We also found a threshold curve pv+2 ph=2.05 in the results for the final opinion clusters and evolution time. Above the threshold curve, opinions could easily reach consensus. Based on the above experimental results, a culture-policy-driven mechanism for the opinion dynamic is worth promoting in this paper, that is, opinion dynamics can be driven by different social cultures and policies through the influence of heredity and variation in interpersonal relationship networks. This

  9. Survey Methods, Traditional, Public Opinion Polling

    DEFF Research Database (Denmark)

    Elmelund-Præstekær, Christian; Hopmann, David Nicolas; Pedersen, Rasmus Tue

    2017-01-01

    Traditional public opinion polls are surveys in which a random sample of a given population is asked questions about their attitudes, knowledge, or behavior. If conducted properly, the answers from such surveys are approximately representative of the entire population. Traditional public opinion...... polling is typically based on four different methods of data gathering, or combinations hereof: face-to-face, postal surveys, phone surveys, and web surveys. Given that opinion polls are based on a sample, we cannot be sure that the sample reflects public opinion perfectly, however—even if randomness...... is perfect. Moreover, responses may be highly dependent on the contextual information provided with the question. Also, it may be difficult to capture past or complex causes of attitudes or behavior. In short, surveys are a precise way of measuring public opinion, but they do not come without challenges....

  10. Play-back theatre, theatre laboratory, and role-playing: new tools in investigating the patient-physician relationship in the context of continuing medical education courses.

    Science.gov (United States)

    Piccoli, G; Rossetti, M; Dell'Olio, R; Perrotta, L; Mezza, E; Burdese, M; Maddalena, E; Bonetto, A; Jeantet, A; Segoloni, G P

    2005-06-01

    The aim of this study was to report on the validation of a role-playing approach, using play-back and theatre laboratory in the context of a continuing medical education (CME) course on predialysis and transplantation, to discuss the patient-physician relationship. The course was developed with the help of a theatre director. The role-playing 2-day course was designed to be highly interactive for a small group (15-20 participants), based on a core of case reports (dialysis, transplantation, and return to dialysis after graft failure). Two stages were included: play-back theatre in which experiences told by the participants were mimed by a group of actors, and theatre laboratory in which different aspects of voice and touch were explored. Opinions were gathered by an anonymous semistructured questionnaire completed by all participants. The course obtained a high score from The Ministry of Health (14 credits, 1 per teaching hour). The opinions of the 18 participants were highly positive; all liked the courses. Sixteen of 18 asked to repeat the experience. The strong emotional involvement was an advantage for 15 of 18, sharing emotional aspects of the profession for 10 of 18, and usefulness in clarifying opinions on "dark sides" of our profession for 10 of 18. The positive opinions recorded during this experience, the first experiment with a "psycho-theatrical approach" developed in a CME course in our country, suggest the benefit of implementing nonconventional, educational approaches in a multidisciplinary discussion of the patient-physician relationship in transplantation medicine.

  11. Opinion Change: Information or Partisanship?

    DEFF Research Database (Denmark)

    Justesen, Mogens K.; Klemmensen, Robert; Leavitt, Thomas

    Currently two paradigms seek to explain how voters change their opinion when they are confronted with new information. One school argues that voters are bayesian updaters who rationally change their opinion. Another school argues that voters are inherently biased in their evaluation of new...... information. According to this line of thought voters are more likely to accept information that con_rms their opinion compared to information that contradict their point of view. Using a quasi experiment we investigate the extent to which voters rely on bayesian updating or on motivated reasoning when...

  12. The Evolving Treatment Patterns of NCAA Division I Football Players by Orthopaedic Team Physicians Over the Past Decade, 2008-2016.

    Science.gov (United States)

    Carver, Trevor J; Schrock, John B; Kraeutler, Matthew J; McCarty, Eric C

    Previous studies have analyzed the treatment patterns used to manage injuries in National Collegiate Athletic Association (NCAA) Division I football players. Treatment patterns used to manage injuries in NCAA Division I football players will have changed over the study period. Descriptive epidemiology study. Level 5. The head orthopaedic team physicians for all 128 NCAA Division I football teams were asked to complete a survey containing questions regarding experience as team physician, medical coverage of the team, reimbursement issues, and treatment preferences for some of the most common injuries occurring in football players. Responses from the current survey were compared with responses from the same survey sent to NCAA Division I team physicians in 2008. Responses were received from 111 (111/119, 93%) NCAA Division I orthopaedic team physicians in 2008 and 115 (115/128, 90%) orthopaedic team physicians between April 2016 and April 2017. The proportion of team physicians who prefer a patellar tendon autograft for primary anterior cruciate ligament reconstruction (ACLR) increased from 67% in 2008 to 83% in 2016 ( P football players over the study period. In particular, physicians have changed their preferred techniques for ACLR, anterior shoulder stabilization, and PCL reconstruction. Physicians have also become more conservative with pregame Toradol injections. These opinions may help guide treatment decisions and lead to better care of all athletes.

  13. Opinion Summarizationof CustomerComments

    Science.gov (United States)

    Fan, Miao; Wu, Guoshi

    Web 2.0 technologies have enabled more and more customers to freely comment on different kinds of entities, such as sellers, products and services. The large scale of information poses the need and challenge of automatic summarization. In many cases, each of the user-generated short comments implies the opinions which rate the target entity. In this paper, we aim to mine and to summarize all the customer comments of a product. The algorithm proposed in this researchis more reliable on opinion identification because it is unsupervised and the accuracy of the result improves as the number of comments increases. Our research is performed in four steps: (1) mining the frequent aspects of a product that have been commented on by customers; (2) mining the infrequent aspects of a product which have been commented by customers (3) identifying opinion words in each comment and deciding whether each opinion word is positive, negative or neutral; (4) summarizing the comments. This paper proposes several novel techniques to perform these tasks. Our experimental results using comments of a number of products sold online demonstrate the effectiveness of the techniques.

  14. Physician practice management companies: should physicians be scared?

    Science.gov (United States)

    Scott-Rotter, A E; Brown, J A

    1999-01-01

    Physician practice management companies (PPMCs) manage nonclinical aspects of physician care and control physician groups by buying practice assets. Until recently, PPMCs were a favorite of Wall Street. Suddenly, in early 1998, the collapse of the MedPartners-PhyCor merger led to the rapid fall of most PPMC stock, thereby increasing wariness of physicians to sell to or invest in PPMCs. This article explores not only the broken promises made by and false assumptions about PPMCs, but also suggests criteria that physicians should use and questions would-be PPMC members should ask before joining. Criteria include: demonstrated expertise, a company philosophy that promotes professional autonomy, financial stability, freedom from litigation, and satisfied physicians already in the PPMC. The authors recommend that physicians seek out relatively small, single-specialty PPMCs, which hold the best promise of generating profits and permitting professional control over clinical decisions.

  15. Breast Cancer Screening and Social Media: a Content Analysis of Evidence Use and Guideline Opinions on Twitter.

    Science.gov (United States)

    Nastasi, Anthony; Bryant, Tyler; Canner, Joseph K; Dredze, Mark; Camp, Melissa S; Nagarajan, Neeraja

    2018-06-01

    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.). The primary outcomes were how users are tweeting about breast cancer screening, the quality of evidence they are using, and their opinions regarding guidelines. The most frequent user type of the 1345 tweets was "non-healthcare" with 323 tweets (32.5%). Physicians had 1.87 times higher odds (95% CI, 0.69-5.07) of providing explicit support with a reference and 11.70 times higher odds (95% CI, 3.41-40.13) of posting a tweet likely to be supported by the scientific community compared to non-healthcare users. Only 2.9% of guideline tweets approved of the guidelines while 14.6% claimed to be confused by them. Non-healthcare users comprise a significant proportion of participants in mammography conversations, with tweets often containing claims that are false, not explicitly backed by scientific evidence, and in favor of alternative "natural" breast cancer prevention and treatment. Furthermore, users appear to have low approval and confusion regarding

  16. The relationship between physician humility, physician-patient communication, and patient health.

    Science.gov (United States)

    Ruberton, Peter M; Huynh, Ho P; Miller, Tricia A; Kruse, Elliott; Chancellor, Joseph; Lyubomirsky, Sonja

    2016-07-01

    Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical visit. Primary care physician-patient interactions (297 patients across 100 physicians) were rated for the physician's humility and the effectiveness of the physician-patient communication. Additionally, patients reported their overall health and physicians and patients reported their satisfaction with the interaction. Within-physician fluctuations in physician humility and self-reported patient health positively predicted one another, and mean-level differences in physician humility predicted effective physician-patient communication, even when controlling for the patient's and physician's satisfaction with the visit and the physician's frustration with the patient. The results suggest that humble, rather than paternalistic or arrogant, physicians are most effective at working with their patients. Interventions to improve physician humility may promote better communication between health care providers and patients, and, in turn, better patient outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription

    Directory of Open Access Journals (Sweden)

    Francisco Caamaño

    2005-02-01

    Full Text Available Objective: To assess the influence of pharmacists' opinions on their dispensing medicines with a «medical prescription only» label without requiring a doctor's prescription. Methods: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a physicians' prescribing practices; b the pharmacist's qualifications to prescribe; c the responsibility of the pharmacist regarding the dispensed drugs; d the customer' qualifications for self-medication; and e the pharmacist's perception of his or her own work. The dependent variable was the pharmacist's demand for a medical prescription for 5 drugs, which in Spain require a prescription. Multiple linear regression models were constructed. Results: The response rate was 98.8%. A total of 65.9% of pharmacists reported dispensing antibiotics without a prescription. This percentage was 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for angiotensin-converting enzyme inhibitors, 13.4% for benzodiazepines, and 84.8% for oral contraceptives. Further results showed that pharmacists with a heavier workload and those who underestimated the physicians' qualifications to prescribe but overestimated their own qualifications to prescribe less frequently demanded medical prescriptions. In contrast, pharmacists who stressed the importance of their duty in rationalizing the consumption of drugs more frequently demanded medical prescriptions. Conclusion: Our results suggest that to increase the quality of dispensing: a the importance of the pharmacist's duty in controlling drug consumption should be stressed; b pharmacies' workload should be optimized; and c perceptions of physicians' prescribing practices among pharmacists should be improved.Objetivo: Evaluar la influencia de las opiniones de los farmacéuticos que no solicitan receta médica para dispensar fármacos que la

  18. Attitudes of pediatric intensive care unit physicians towards the use of cognitive aids: a qualitative study.

    Science.gov (United States)

    Weiss, Matthew J; Kramer, Chelsea; Tremblay, Sébastien; Côté, Luc

    2016-05-21

    Cognitive aids are increasingly recommended in clinical practice, yet little is known about the attitudes of physicians towards these tools. We employed a qualitative, descriptive design to explore physician attitudes towards cognitive aids in pediatric intensive care units (PICUs). Semi-structured interviews elicited the opinions of a convenience sample of practicing PICU physicians towards the use of cognitive aids. We analyzed interview data for thematic content to examine the three factors of intention to use cognitive aids as defined by the Theory of Planned Behavior (TPB), attitudes, social norms, and perceived control. Analysis of 14 interviews suggested that in the PICU setting, cognitive aids are widely used. Discovered themes related to their use touched on all three TPB factors of intention and included: aids are perceived to improve team communication; aids may improve patient safety; aids may hinder clinician judgment; physicians may resist implementation if it occurs prior to demonstration of benefit; effective adoption requires cognitive aids to be integrated into local workplace culture; and implementation should take physician concerns into account. Our sample of PICU physicians were open to cognitive aids in their practice, as long as such aids preserve the primacy of clinical judgment, focus on team communication, demonstrate effectiveness through preliminary testing, and are designed and implemented with the local culture and work environment in mind. Future knowledge translation efforts to implement cognitive aids would benefit from consideration of these issues.

  19. A Self-Categorization Explanation for Opinion Consensus Perceptions

    Science.gov (United States)

    Zhang, Jinguang; Reid, Scott A.

    2013-01-01

    The public expression of opinions (and related communicative activities) hinges upon the perception of opinion consensus. Current explanations for opinion consensus perceptions typically focus on egocentric and other biases, rather than functional cognitions. Using self-categorization theory we showed that opinion consensus perceptions flow from…

  20. Experience with physician assistants in a Canadian arthroplasty program.

    Science.gov (United States)

    Bohm, Eric R; Dunbar, Michael; Pitman, David; Rhule, Chris; Araneta, Jose

    2010-04-01

    Recent increases in orthopedic surgical services in Canada have added further demand to an already stretched orthopedic workforce. Various initiatives have been undertaken across Canada to meet this demand. One successful model has been the use of physician assistants (PAs) within the Winnipeg Regional Health Authority (WRHA). This study documents the effect of PAs working in an arthroplasty practice from the perspective of patients and health care providers. We also describe the costs, time savings for surgeons and the effects on surgical throughput and waiting times. We calculated time savings by the use of a daily diary kept by the PAs. Surgeons', residents', nurses' and patients' opinions about PAs were recorded by use of a self administered questionnaire. We calculated costs using forgone general practitioner (GP) surgical assist fees and salary costs for PAs. We obtained information about surgical throughput and wait times from the WRHA waitlist database. In this study, PAs "saved" their supervising physician about 204 hours per year; this time can be used for other clinical, administrative or research duties. Physician assistants are regarded as important members of the health care team by surgeons, nurses, orthopedic residents and patients. When we compared the billing costs with those that would have been generated by the use of GP surgical assists, PAs were essentially cost neutral. Furthermore, they potentially freed GPs from the operating room to spend more time delivering primary care. We found that use of the double operating room model facilitated by PAs increased the surgical throughput of primary hip and knee replacements by 42%, and median wait times decreased from 44 weeks to 30 weeks compared with the preceding year. Physician assistants integrate well into the care team and can increase surgical volumes to reduce wait times in a cost-effective manner.

  1. Telemanagement of hypertension: A qualitative assessment of patient and physician preferences

    Science.gov (United States)

    Halifax, Nancy VD; Cafazzo, Joseph A; Irvine, M Jane; Hamill, Melinda; Rizo, Carlos A; McIsaac, Warren J; Rossos, Peter G; Logan, Alexander G

    2007-01-01

    BACKGROUND: Prevalence surveys have consistently found that the blood pressure control rate among people with hypertension is less than 25%. Studies of telemedicine as a means of providing care to hypertensive patients have shown that this approach is effective in lowering blood pressure. Major design flaws and high operating costs, however, have hindered its adoption by physicians and patients. OBJECTIVES: In the present commentary, the field of telemedicine, as it pertains to hypertension management, is reviewed, and the investigators’ experiences in developing a new telemedicine system are outlined. METHODS: An applied qualitative case study approach was used to determine the information needs for the design of a telemedicine system. Opinions were elicited separately from type 2 diabetic patients with hypertension (n=24) and family practitioners in active clinical practice (n=18). RESULTS: Physician and patient focus group meetings provided key information that led to changes in the prototype system. The low level of computer and Internet use by patients in everyday life and by physicians in practice-related activities precluded their inclusion in the design of the system for information retrieval and receiving clinical alerts. For patients, the mobile phone appeared to be an acceptable alternative. The only practical, automated means to disseminate reports and alerts to physicians was by fax, which was the most universally available device in a doctor’s office. CONCLUSION: This tightly focused qualitative study led to the development of design principles for a prototype system, increasing the likelihood of user acceptance and improving its effectiveness. PMID:17534469

  2. Anisotropic opinion dynamics

    Science.gov (United States)

    Neirotti, Juan

    2016-07-01

    We consider the process of opinion formation in a society of interacting agents, where there is a set B of socially accepted rules. In this scenario, we observed that agents, represented by simple feed-forward, adaptive neural networks, may have a conservative attitude (mostly in agreement with B ) or liberal attitude (mostly in agreement with neighboring agents) depending on how much their opinions are influenced by their peers. The topology of the network representing the interaction of the society's members is determined by a graph, where the agents' properties are defined over the vertexes and the interagent interactions are defined over the bonds. The adaptability of the agents allows us to model the formation of opinions as an online learning process, where agents learn continuously as new information becomes available to the whole society (online learning). Through the application of statistical mechanics techniques we deduced a set of differential equations describing the dynamics of the system. We observed that by slowly varying the average peer influence in such a way that the agents attitude changes from conservative to liberal and back, the average social opinion develops a hysteresis cycle. Such hysteretic behavior disappears when the variance of the social influence distribution is large enough. In all the cases studied, the change from conservative to liberal behavior is characterized by the emergence of conservative clusters, i.e., a closed knitted set of society members that follow a leader who agrees with the social status quo when the rule B is challenged.

  3. Opinion evolution in different social acquaintance networks.

    Science.gov (United States)

    Chen, Xi; Zhang, Xiao; Wu, Zhan; Wang, Hongwei; Wang, Guohua; Li, Wei

    2017-11-01

    Social acquaintance networks influenced by social culture and social policy have a great impact on public opinion evolution in daily life. Based on the differences between socio-culture and social policy, three different social acquaintance networks (kinship-priority acquaintance network, independence-priority acquaintance network, and hybrid acquaintance network) incorporating heredity proportion p h and variation proportion p v are proposed in this paper. Numerical experiments are conducted to investigate network topology and different phenomena during opinion evolution, using the Deffuant model. We found that in kinship-priority acquaintance networks, similar to the Chinese traditional acquaintance networks, opinions always achieve fragmentation, resulting in the formation of multiple large clusters and many small clusters due to the fact that individuals believe more in their relatives and live in a relatively closed environment. In independence-priority acquaintance networks, similar to Western acquaintance networks, the results are similar to those in the kinship-priority acquaintance network. In hybrid acquaintance networks, similar to the Chinese modern acquaintance networks, only a few clusters are formed indicating that in modern China, opinions are more likely to reach consensus on a large scale. These results are similar to the opinion evolution phenomena in modern society, proving the rationality and applicability of network models combined with social culture and policy. We also found a threshold curve p v +2p h =2.05 in the results for the final opinion clusters and evolution time. Above the threshold curve, opinions could easily reach consensus. Based on the above experimental results, a culture-policy-driven mechanism for the opinion dynamic is worth promoting in this paper, that is, opinion dynamics can be driven by different social cultures and policies through the influence of heredity and variation in interpersonal relationship networks. This

  4. Medical and pharmacy students’ attitudes towards physician-pharmacist collaboration in Kuwait

    Directory of Open Access Journals (Sweden)

    Katoue MG

    2017-09-01

    Full Text Available Objective: To assess and compare the attitudes of medical and pharmacy students towards physician-pharmacist collaboration and explore their opinions about the barriers to collaborative practice in Kuwait. Methods: A cross-sectional survey of pharmacy and medical students (n=467 was conducted in Faculties of Medicine and Pharmacy, Kuwait University. Data were collected via self-administered questionnaire from first-year pharmacy and medical students and students in the last two professional years of the pharmacy and medical programs. Descriptive and comparative analyses were performed using SPSS, version 22. Statistical significance was accepted at p<0.05. Results: The response rate was 82.4%. Respondents had overall positive attitudes towards physician-pharmacist collaboration. Pharmacy students expressed significantly more positive attitudes than medical students (p< 0.001. Medical students rated the three most significant barriers to collaboration to be: pharmacists’ separation from patient care areas (n=100, 70.0%, lack of pharmacists’ access to patients’ medical record (n=90, 63.0% and physicians assuming total responsibility for clinical decision-making (n=87, 60.8%. Pharmacy students’ top three perceived barriers were: lack of pharmacists’ access to patients’ medical record (n=80, 84.2%, organizational obstacles (n=79, 83.2%, and pharmacists’ separation from patient care areas (n=77, 81.1%. Lack of interprofessional education was rated the fourth-largest barrier by both medical (n=79, 55.2% and pharmacy (n=76, 80.0% students. Conclusions: Medical and pharmacy students in Kuwait advocate physician-pharmacist collaborative practice, but both groups identified substantial barriers to implementation. Efforts are needed to enhance undergraduate/postgraduate training in interprofessional collaboration, and to overcome barriers to physician-pharmacist collaboration to advance a team approach to patient care.

  5. Patient preferences versus physicians' judgement: does it make a difference in healthcare decision making?

    Science.gov (United States)

    Mühlbacher, Axel C; Juhnke, Christin

    2013-06-01

    Clinicians and public health experts make evidence-based decisions for individual patients, patient groups and even whole populations. In addition to the principles of internal and external validity (evidence), patient preferences must also influence decision making. Great Britain, Australia and Germany are currently discussing methods and procedures for valuing patient preferences in regulatory (authorization and pricing) and in health policy decision making. However, many questions remain on how to best balance patient and public preferences with physicians' judgement in healthcare and health policy decision making. For example, how to define evaluation criteria regarding the perceived value from a patient's perspective? How do physicians' fact-based opinions also reflect patients' preferences based on personal values? Can empirically grounded theories explain differences between patients and experts-and, if so, how? This article aims to identify and compare studies that used different preference elicitation methods and to highlight differences between patient and physician preferences. Therefore, studies comparing patient preferences and physician judgements were analysed in a review. This review shows a limited amount of literature analysing and comparing patient and physician preferences for healthcare interventions and outcomes. Moreover, it shows that methodology used to compare preferences is diverse. A total of 46 studies used the following methods-discrete-choice experiments, conjoint analyses, standard gamble, time trade-offs and paired comparisons-to compare patient preferences with doctor judgements. All studies were published between 1985 and 2011. Most studies reveal a disparity between the preferences of actual patients and those of physicians. For most conditions, physicians underestimated the impact of intervention characteristics on patients' decision making. Differentiated perceptions may reflect ineffective communication between the provider

  6. Information exchange using a prescribed form and involvement of occupational health nurses promotes occupational physicians to collaborate with attending physicians for supporting workers with illness in Japan.

    Science.gov (United States)

    Muto, Go; Nakamura, Rina Ishii; Yokoyama, Kazuhito; Kitamura, Fumihiko; Omori, Yuki; Saito, Masahiko; Endo, Motoki

    2017-12-19

    The maintenance of a balance between work and disease treatment is an important issue in Japan. This study explored factors that affect collaboration between occupational physicians (OPs) and attending physicians (APs). A questionnaire was mailed to 1,102 OPs. The questionnaire assessed the demographic characteristics of OPs; their opinions and behaviors related to collaboration, including the exchange of medical information with APs; and the occupational health service system at their establishments. In total, 275 OPs completed the questionnaire (25.0% response rate). Over 80% of respondents believed OPs should collaborate with APs. After adjusting for company size, collaboration >10 times/year (with regard to both returning to work following sick leave and annual health check-ups for employees) was significantly associated with environmental factors, such as the presence of occupational health nurses (odds ratio (OR): 5.56 and 5.01, respectively, p0.05). The majority of OPs believed that collaboration with APs is important for supporting workers with illnesses. Support systems including prescribed forms of information exchange and occupational health nurses, play pivotal roles in promoting this collaboration.

  7. How Public Opinion is Formed

    Science.gov (United States)

    Block, Edward M.

    1977-01-01

    Investigates the evolution of the definition of public relations by examining cultural and personal determinants of public opinion. Outlines functions of communicators and opinionmakers in forming and influencing public opinion. Available from: Public Relations Review, Ray Hiebert, Dean, College of Journalism, University of Maryland, College Park,…

  8. Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity.

    Science.gov (United States)

    Contratto, Erin; Romp, Katherine; Estrada, Carlos A; Agne, April; Willett, Lisa L

    2017-05-01

    To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning. Physician satisfaction, productivity, timeliness with EHR documentation, and physician attitudes toward the intervention were measured. Four months after the intervention, physicians reported improvements in overall quality of life (good quality, 71%-100%), personal balance (43%-71%), and burnout (weekly, 43%-14%; callousness, 14%-0%). Matched for quarter, productivity increased: work relative value unit (wRVU) per session increased by 20.5% (before, April-June 2014; after, April-June 2015; range -9.2% to 27.5%). Physicians reported feeling more supported, more focused on patient care, and less stressed and fatigued after the intervention. This study supports the use of physician order entry clerical personnel as a simple, cost-effective intervention to improve the work lives of primary care physicians.

  9. 28 CFR 80.8 - Attorney General opinion.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Attorney General opinion. 80.8 Section 80.8 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) FOREIGN CORRUPT PRACTICES ACT OPINION PROCEDURE § 80.8 Attorney General opinion. The Attorney General or his designee shall, within 30 days after...

  10. Identifying Opinion Leaders to Promote Behavior Change

    Science.gov (United States)

    Valente, Thomas W.; Pumpuang, Patchareeya

    2007-01-01

    This article reviews 10 techniques used to identify opinion leaders to promote behavior change. Opinion leaders can act as gatekeepers for interventions, help change social norms, and accelerate behavior change. Few studies document the manner in which opinion leaders are identified, recruited, and trained to promote health. The authors categorize…

  11. UK Public Opinion Review - Working Paper - An overview of public opinion polls since the Edward Snowden revelations in June 2013

    OpenAIRE

    Cable, Jonathan

    2015-01-01

    This document charts public opinion of the Edward Snowden leaks and associated issues\\ud since June 2013. This includes people’s opinions on surveillance, the intelligence services\\ud and personal privacy. Since the Snowden leaks there have been 38 opinion polls on these\\ud topics concerning public opinion in the UK and conducted by large polling organisations,\\ud such as YouGov, ComRes and Ipsos MORI among others.

  12. Patients' and physicians' needs, experiences and preferences in the treatment of right ventricular outflow tract dysfunction

    Directory of Open Access Journals (Sweden)

    Luciana Scalone

    2012-06-01

    Full Text Available

    Background: patients with congenital heart defects, developing right ventricular outflow tract (rVoT dysfunction, can face repeated open chest interventions over their lifetime. repeating surgery increases difficulties and procedural risks, and exposes patients to burdensome and long recovery times that may induce them to postpone the treatment, with possible severe and irreversible consequences for their health. The percutaneous procedure was introduced to delay the need for open chest surgery. uncertainties still exist regarding the lifelong consequences that may result from adopting different treatment strategies. current decisions on treatment depend on patients’ clinical needs, but also on physicians’ experience and opinion, patients’ preferences, and procedural costs. The objective is to identify which treatment characteristics influence decisions on how to treat patients with rVoT dysfunction.

    Methods: a literature review was conducted, followed by a discussion with a panel of experts. Ten treatment characteristics, potentially relevant for treatment, were identified and rated in a survey, according to the importance assigned to each characteristic by specialist physicians, patients and/or their caregivers.

    Results: while some characteristics appear to be more important (risk of severe complications associated with intervention delays or less important (scar to both physicians and patients/caregivers, other characteristics are rated differently in importance depending on subjects consulted, e.g., risk of complications during the months post intervention was among the most important characteristics for patients/caregivers, but the fifth most important characteristic for physicians.

    Conclusions: to optimize benefits and efficiency of the treatment strategies, perceptions and opinions from the different subjects involved, together with patients

  13. [First results of a German second opinion program show high patient satisfaction and large discrepancies between initial therapy recommendations and second opinion].

    Science.gov (United States)

    Weyerstraß, Jan; Prediger, Barbara; Neugebauer, Edmund; Pieper, Dawid

    2018-02-23

    Although legally anchored, there are no empirical results from German second opinion programs. In this study, various aspects within a population of a second opinion program are examined. In this study patients were analyzed who sought a second opinion in the period from August 2011 to December 2016. Differences in patient characteristics, differentiated by agreement of first and second opinion, were analyzed using multivariate logistic regression. Patients' satisfaction and quality of life were examined one, three and six months after obtaining the second opinion. In total, 1,414 patients sought a second opinion. Most frequent medical indications were the knee (38.7 %), the back (26.8 %), the hip (11.7 %), and the shoulder (10.2 %). Except for the indication (p=0.035), no patient characteristic had influence on the conformation of the second opinion. Approximately two out of three initial recommendations were not confirmed by the specialists. 89 % of the patients were satisfied or very satisfied with the second opinion and the service offered. The second opinion offers patients the opportunity to seek an additional independent medical opinion and thus provide support for decision making. Further research is needed to examine the reasons for the high discrepancies between the first and second opinions. Copyright © 2018. Published by Elsevier GmbH.

  14. Opinion survey on energy and climate in 2013

    International Nuclear Information System (INIS)

    Martin, Jean-Philippe

    2013-08-01

    This issue comments the results of a survey on the opinion of French people on the reality of climate change (for the whole population and with respect to age), on the opinion of French people on nuclear energy (in relationship with the opinion on climate change, globally in terms of benefit or drawback with evolution of the opinion since 1994), on the feeling of having suffered from the cold during the winter of 2012-2013, on the dwelling temperature in winter, and on the opinion on energy price

  15. Applications of flow-networks to opinion-dynamics

    Science.gov (United States)

    Tupikina, Liubov; Kurths, Jürgen

    2015-04-01

    Networks were successfully applied to describe complex systems, such as brain, climate, processes in society. Recently a socio-physical problem of opinion-dynamics was studied using network techniques. We present the toy-model of opinion-formation based on the physical model of advection-diffusion. We consider spreading of the opinion on the fixed subject, assuming that opinion on society is binary: if person has opinion then the state of the node in the society-network equals 1, if the person doesn't have opinion state of the node equals 0. Opinion can be spread from one person to another if they know each other, or in the network-terminology, if the nodes are connected. We include into the system governed by advection-diffusion equation the external field to model such effects as for instance influence from media. The assumptions for our model can be formulated as the following: 1.the node-states are influenced by the network structure in such a way, that opinion can be spread only between adjacent nodes (the advective term of the opinion-dynamics), 2.the network evolution can have two scenarios: -network topology is not changing with time; -additional links can appear or disappear each time-step with fixed probability which requires adaptive networks properties. Considering these assumptions for our system we obtain the system of equations describing our model-dynamics which corresponds well to other socio-physics models, for instance, the model of the social cohesion and the famous voter-model. We investigate the behavior of the suggested model studying "waiting time" of the system, time to get to the stable state, stability of the model regimes for different values of model parameters and network topology.

  16. Legalisation of euthanasia or physician-assisted suicide: survey of doctors' attitudes.

    Science.gov (United States)

    Seale, C

    2009-04-01

    This study reports UK doctors' opinions about legalisation of medically assisted dying (euthanasia and physician-assisted suicide), comparing this with the UK general public. A postal survey of 3733 UK medical practitioners was done. The majority of UK doctors are opposed to legalisation, contrasting with the UK general public. Palliative medicine specialists are particularly opposed. A strong religious belief is independently associated with opposition to assisted dying. Frequency of treating patients who die is not independently associated with attitudes. Many doctors supporting legalisation also express reservations and advocate safeguards; many doctors opposing legalisation believe and accept that treatment and nontreatment decisions may shorten life. It is hoped that future debates about legalisation can proceed with this evidence in mind.

  17. Physician perceptions of primary prevention: qualitative base for the conceptual shaping of a practice intervention tool

    Directory of Open Access Journals (Sweden)

    Kuo Christina L

    2002-08-01

    Full Text Available Abstract Background A practice intervention must have its basis in an understanding of the physician and practice to secure its benefit and relevancy. We used a formative process to characterize primary care physician attitudes, needs, and practice obstacles regarding primary prevention. The characterization will provide the conceptual framework for the development of a practice tool to facilitate routine delivery of primary preventive care. Methods A focus group of primary care physician Opinion Leaders was audio-taped, transcribed, and qualitatively analyzed to identify emergent themes that described physicians' perceptions of prevention in daily practice. Results The conceptual worth of primary prevention, including behavioral counseling, was high, but its practice was significantly countered by the predominant clinical emphasis on and rewards for secondary care. In addition, lack of health behavior training, perceived low self-efficacy, and patient resistance to change were key deterrents to primary prevention delivery. Also, the preventive focus in primary care is not on cancer, but on predominant chronic nonmalignant conditions. Conclusions The success of the future practice tool will be largely dependent on its ability to "fit" primary prevention into the clinical culture of diagnoses and treatment sustained by physicians, patients, and payers. The tool's message output must be formatted to facilitate physician delivery of patient-tailored behavioral counseling in an accurate, confident, and efficacious manner. Also, the tool's health behavior messages should be behavior-specific, not disease-specific, to draw on shared risk behaviors of numerous diseases and increase the likelihood of perceived salience and utility of the tool in primary care.

  18. Discrepancy and Disliking Do Not Induce Negative Opinion Shifts

    Science.gov (United States)

    Flache, Andreas; Mäs, Michael

    2016-01-01

    Both classical social psychological theories and recent formal models of opinion differentiation and bi-polarization assign a prominent role to negative social influence. Negative influence is defined as shifts away from the opinion of others and hypothesized to be induced by discrepancy with or disliking of the source of influence. There is strong empirical support for the presence of positive social influence (a shift towards the opinion of others), but evidence that large opinion differences or disliking could trigger negative shifts is mixed. We examine positive and negative influence with controlled exposure to opinions of other individuals in one experiment and with opinion exchange in another study. Results confirm that similarities induce attraction, but results do not support that discrepancy or disliking entails negative influence. Instead, our findings suggest a robust positive linear relationship between opinion distance and opinion shifts. PMID:27333160

  19. Utilization and Impact of Electronic and Print Media on the Patients' Health Status: Physicians' Perspectives.

    Science.gov (United States)

    Shakeel, Sadia; Nesar, Shagufta; Rahim, Najia; Iffat, Wajiha; Ahmed, Hafiza Fouzia; Rizvi, Mehwish; Jamshed, Shazia

    2017-01-01

    Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors' opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients. The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence. Physicians' perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL). The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance. In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource. Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about the extended usage of print/electronic media.

  20. What should be the basis for compulsory and optional health insurance premiums? Opinions of Swiss doctors.

    Science.gov (United States)

    Jannot, Anne-Sophie; Perneger, Thomas V

    2014-02-04

    Little is known about doctors' opinions on how to finance health services. In Switzerland, mandatory basic health insurance currently uses regional flat fees that are unrelated to health and ability to pay, and optional complementary insurance uses risk-based premiums. Our objective was to assess Swiss physicians' opinions on what should determine health insurance premiums. We surveyed doctors in the canton of Geneva, Switzerland, about the desirable funding mechanism for mandatory health insurance and complementary health insurance. The proposed determinants of insurance premiums were current health and past medical history, lifestyle, healthcare costs in the previous year, genetic susceptibility to disease, regional average healthcare costs, household income, and wealth and demographic characteristics. Among the 1,516 respondents, only a few (insurance premium should depend on health risk (health status, previous costs, genetics, and age and sex). More than 30% of respondents supported premiums based on lifestyle (34.6%), regional average health expenditures (31.2%), and household income and wealth (39.6%). For complementary health insurance, most respondents supported premiums based on lifestyle (74.6%) and on health risk (46.4%), but surprisingly also on household income and wealth (44.9%) and regional average health expenditures (39.4%). The characteristic most influencing the answers was the medical specialty. Doctors' opinions about healthcare financing mechanisms varied considerably, for both mandatory and complementary health insurance. Lifestyle was a surprisingly frequent choice, even though this criterion is not currently used in Switzerland. Ability to pay was not supported by the majority.

  1. Physicians' perceptions of physician-nurse interactions and information needs in China.

    Science.gov (United States)

    Wen, Dong; Guan, Pengcheng; Zhang, Xingting; Lei, Jianbo

    2018-01-01

    Good communication between physicians and nurses is important for the understanding of disease status and treatment feedback; however, certain issues in Chinese hospitals could lead to suboptimal physician-nurse communication in clinical work. Convenience sampling was used to recruit participants. Questionnaires were sent to clinical physicians in three top tertiary Grade-A teaching hospitals in China and six hundred and seventeen physicians participated in the survey. (1) Common physician-nurse interactions were shift-change reports and provisional reports when needed, and interactions expected by physicians included face-to-face reports and communication via a phone or mobile device. (2) Most respondents believed that the need for information in physician-nurse interactions was high, information was moderately accurate and timely, and feedback regarding interaction time and satisfaction indicated that they were only average and required improvement. (3) Information needs in physician-nurse interactions differed significantly according to hospital category, role, workplace, and educational background (p < .05). There was a considerable need for information within physician-nurse interactions, and the level of satisfaction with the information obtained was average; requirements for the improvement of communication differed between physicians and nurses because of differences in their characteristics. Currently, the use of information technology in physician-nurse communication was less common but was highly expected by physicians.

  2. 'Quicksand' of public opinion - trust in nuclear after Fukushima

    International Nuclear Information System (INIS)

    Gieci, Adam; Maly, Stanislav; Palecek, Milos

    2012-01-01

    The following public opinion surveys are described: public opinion on nuclear power plants by the end of 2010; first public opinion polls after Fukushima in the US, UK and France; and public opinion and the future of nuclear in Japan. The following issues are discussed: Has nuclear any perspective after Fukushima? Will public opinion change after the Fukushima accident like it did after the TMI event? Will public opinion change after the Fukushima accident like it did after the oil spill accident in the Gulf of Mexico? In conclusion the new approaches to the fight for public confidence after Fukushima are described. (orig.)

  3. Inter-doctor variations in the assessment of functional incapacities by insurance physicians

    Directory of Open Access Journals (Sweden)

    Schellart Antonius JM

    2011-11-01

    Full Text Available Abstract Background The aim of this study was to determine the - largely unexplored - extent of systematic variation in the work disability assessment by Dutch insurance physicians (IPs of employees on long-term sick leave, and to ascertain whether this variation was associated with the individual characteristics and opinions of IPs. Methods In March 2008 we conducted a survey among IPs on the basis of the 'Attitude - Social norm - self-Efficacy' (ASE model. We used the ensuing data to form latent variables for the ASE constructs. We then linked the background variables and the measured constructs for IPs (n = 199 working at regional offices (n = 27 to the work disability assessments of clients (n = 83,755 and their characteristics. These assessments were carried out between July 2003 and April 2008. We performed multilevel regression analysis on three important assessment outcomes: No Sustainable Capacity or Restrictions for Working Hours (binominal, Functional Incapacity Score (scale 0-6 and Maximum Work Disability Class (binominal. We calculated Intra Class Correlations (ICCs at IP level and office level and explained variances (R2 for the three outcomes. A higher ICC reflects stronger systematic variation. Results The ICCs at IP level were approximately 6% for No Sustainable Capacity or Restrictions for Working Hours and Maximum Work Disability Class and 12% for Functional Incapacity Score. Background IP variables and the measured ASE constructs for physicians contributed very little to the variation - at most 1%. The ICCs at office level ranged from 0% to around 1%. The R2 was 11% for No Sustainable Capacity or Restrictions for Working Hours, 19% for Functional Incapacity Score and 37% for Maximum Work Disability Class. Conclusion Our study uncovered small to moderate systematic variations in the outcome of disability assessments in the Netherlands. However, the individual characteristics and opinions of insurance physicians have very

  4. Discrete Opinion Dynamics on Online Social Networks

    International Nuclear Information System (INIS)

    Hu Yan-Li; Bai Liang; Zhang Wei-Ming

    2013-01-01

    This paper focuses on the dynamics of binary opinions {+1, −1} on online social networks consisting of heterogeneous actors. In our model, actors update their opinions under the interplay of social influence and self- affirmation, which leads to rich dynamical behaviors on online social networks. We find that the opinion leading to the consensus features an advantage of the initially weighted fraction based on actors' strength over the other, instead of the population. For the role of specific actors, the consensus converges towards the opinion that a small fraction of high-strength actors hold, and individual diversity of self-affirmation slows down the ordering process of consensus. These indicate that high-strength actors play an essential role in opinion formation with strong social influence as well as high persistence. Further investigations show that the initial fraction of high-strength actors to dominate the evolution depends on the heterogeneity of the strength distribution, and less high-strength actors are needed in the case of a smaller exponent of power-law distribution of actors' strength. Our study provides deep insights into the role of social influence and self-affirmation on opinion formation on online social networks. (general)

  5. Discrete Opinion Dynamics on Online Social Networks

    Science.gov (United States)

    Hu, Yan-Li; Bai, Liang; Zhang, Wei-Ming

    2013-01-01

    This paper focuses on the dynamics of binary opinions {+1, -1} on online social networks consisting of heterogeneous actors. In our model, actors update their opinions under the interplay of social influence and self- affirmation, which leads to rich dynamical behaviors on online social networks. We find that the opinion leading to the consensus features an advantage of the initially weighted fraction based on actors' strength over the other, instead of the population. For the role of specific actors, the consensus converges towards the opinion that a small fraction of high-strength actors hold, and individual diversity of self-affirmation slows down the ordering process of consensus. These indicate that high-strength actors play an essential role in opinion formation with strong social influence as well as high persistence. Further investigations show that the initial fraction of high-strength actors to dominate the evolution depends on the heterogeneity of the strength distribution, and less high-strength actors are needed in the case of a smaller exponent of power-law distribution of actors' strength. Our study provides deep insights into the role of social influence and self-affirmation on opinion formation on online social networks.

  6. Opinion data mining based on DNA method and ORA software

    Science.gov (United States)

    Tian, Ru-Ya; Wu, Lei; Liang, Xiao-He; Zhang, Xue-Fu

    2018-01-01

    Public opinion, especially the online public opinion is a critical issue when it comes to mining its characteristics. Because it can be formed directly and intensely in a short time, and may lead to the outbreak of online group events, and the formation of online public opinion crisis. This may become the pushing hand of a public crisis event, or even have negative social impacts, which brings great challenges to the government management. Data from the mass media which reveal implicit, previously unknown, and potentially valuable information, can effectively help us to understand the evolution law of public opinion, and provide a useful reference for rumor intervention. Based on the Dynamic Network Analysis method, this paper uses ORA software to mine characteristics of public opinion information, opinion topics, and public opinion agents through a series of indicators, and quantitatively analyzed the relationships between them. The results show that through the analysis of the 8 indexes associating with opinion data mining, we can have a basic understanding of the public opinion characteristics of an opinion event, such as who is important in the opinion spreading process, the information grasping condition, and the opinion topics release situation.

  7. A Rasch analysis of patients' opinions of primary health care professionals' ethical behaviour with respect to communication issues.

    Science.gov (United States)

    González-de Paz, Luis; Kostov, Belchin; López-Pina, Jose A; Solans-Julián, Pilar; Navarro-Rubio, M Dolors; Sisó-Almirall, Antoni

    2015-04-01

    Patients' opinions are crucial in assessing the effectiveness of the ethical theories which underlie the care relationship between patients and primary health care professionals. To study the ethical behaviour of primary health care professionals with respect to communication issues according to patients' opinions. Cross-sectional study using a self-administered questionnaire in patients from a network of 15 urban primary health centres. Participants were patients attended at the centres when the study was conducted. We used a Rasch analysis to verify the structure of the 17 questionnaire items, and to calculate interval level measures for patients and items. We analysed differences according to patient subgroups using analysis of variance tests and differences between the endorsement of each item. We analysed 1013 (70.34%) of questionnaires. Data fit to the Rasch model was achieved after collapsing two categories and eliminating five items. Items with the lowest degree of endorsement were related to the management of differences in conflictive situations between patients and health care professionals. We found significant differences (P communication skills were respected by family physicians and nurses. However, opinions on endorsement were lower when patients disagreed with health care professionals. The differences found between patient subgroups demonstrated the importance of trust and confidence between patients and professionals. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Getting a Second Opinion Before Surgery

    Science.gov (United States)

    ... for a second opinion before surgery. When your doctor says you have a health problem that needs surgery, you have the right to: • Know and understand your treatment choices • Have another doctor look at those choices with you (second opinion) • ...

  9. Addressing the primary care physician shortage in an evolving medical workforce

    Directory of Open Access Journals (Sweden)

    Lakhan Shaheen E

    2009-05-01

    resources, some of the problems being faced by this nation's healthcare industry may be ameliorated. Summary To improve our nation's heath and healthcare, it is our opinion in this commentary that we must determine a comprehensive approach to increase the number of practicing physicians in primary care which may include minority and underserved medical student recruitment, and acceptance of international medical graduates and osteopathic physicians. Although overtime some of the more underlying causes of primary care under-representation must be addressed, these previous options may offer more immediate aid, while recognizing and augmenting populations who already contribute greatly to our nation's medical system.

  10. Social opinion dynamics is not chaotic

    Science.gov (United States)

    Lim, Chjan; Zhang, Weituo

    2016-08-01

    Motivated by the research on social opinion dynamics over large and dense networks, a general framework for verifying the monotonicity property of multi-agent dynamics is introduced. This allows a derivation of sociologically meaningful sufficient conditions for monotonicity that are tailor-made for social opinion dynamics, which typically have high nonlinearity. A direct consequence of monotonicity is that social opinion dynamics is nonchaotic. A key part of this framework is the definition of a partial order relation that is suitable for a large class of social opinion dynamics such as the generalized naming games. Comparisons are made to previous techniques to verify monotonicity. Using the results obtained, we extend many of the consequences of monotonicity to this class of social dynamics, including several corollaries on their asymptotic behavior, such as global convergence to consensus and tipping points of a minority fraction of zealots or leaders.

  11. Are public opinion polls self-fulfilling prophecies?

    Directory of Open Access Journals (Sweden)

    David Rothschild

    2014-08-01

    Full Text Available Psychologists have long observed that people conform to majority opinion, a phenomenon sometimes referred to as the ‘bandwagon effect’. In the political domain people learn about prevailing public opinion via ubiquitous polls, which may produce a bandwagon effect. Newer types of information – published probabilities derived from prediction market contract prices and aggregated polling summaries – may have similar effects. Consequently, polls can become self-fulfilling prophecies whereby majorities, whether in support of candidates or policies, grow in a cascading manner. Despite increased attention to whether the measurement of public opinion can itself affect public opinion, the existing empirical literature is surprisingly limited on the bandwagon effects of polls. To address this gap, we conducted an experiment on a diverse national sample in which we randomly assigned people to receive information about different levels of support for three public policies. We find that public opinion as expressed through polls affects individual-level attitudes, although the size of the effect depends on issue characteristics.

  12. [Abortion and physicians in training: the opinion of medical students in Mexico City

    Science.gov (United States)

    González De León Aguirre D; Salinas Urbina AA

    1997-04-01

    This research project explores doctors' views regarding induced abortion. Abortion's penalization in Mexico greatly conditions its relevance as a social and public health problem. Physicians constitute a professional sector that can play an important role in reforming current laws on abortion. As a professional group, they have taken a conservative stance towards abortion. Their attitudes are to a great extent influenced by the medical training they receive. In this article we present results from a survey of 96 medical students from the Universidad Autónoma Metropolitana Xochimilco, in Mexico City. Data were processed with the SPSS program. Simple frequencies show that students have limited knowledge concerning the legal status of abortion and that they tolerate it with restrictions and in limited situations. Women students apparently take a more conservative stance, but statistical analysis with the c-square test did not show significant differences by gender. The article poses the need to modify doctors' training in the reproductive health field, allowing future doctors to acquire a broader view of health problems related to sexuality and reproduction. In the long run, this should also promote a kind of comprehensive health care practice in medical services, thus responding more satisfactorily to women's needs.

  13. Monte Carlo simulations of a model for opinion formation

    Science.gov (United States)

    Bordogna, C. M.; Albano, E. V.

    2007-04-01

    A model for opinion formation based on the Theory of Social Impact is presented and studied by means of numerical simulations. Individuals with two states of opinion are impacted due to social interactions with: i) members of the society, ii) a strong leader with a well-defined opinion and iii) the mass media that could either support or compete with the leader. Due to that competition, the average opinion of the social group exhibits phase-transition like behaviour between different states of opinion.

  14. Public opinion on atomic energy after JCO accident

    International Nuclear Information System (INIS)

    Okamoto, Koichi; Miyamoto, Sosuke; Ishikawa, Masayori; Shimomura, Hideo; Hori, Hiromoto; Suzuki, Yasuko; Kamise, Yumiko

    2004-04-01

    JCO accident happened on September 30, 1999. This book deals with the public opinion of atomic energy after JCO accident in Japan and comparison with that of USA and France. The analysis of public opinion structure is also shown. The important chapter is the eighth chapter a n opinion survey after the accident , of which sampling areas consisted of three areas such as JCO accident area, the nuclear power plants and the general cities. The analytical results of data showed that the public opinion in Tokai-mura and Naka-machi, the JCO accident area, indicated moderate opinions. It is the interesting results were obtained that the moderate tendency of opinion was in order JCO accident area, the nuclear power plants and the general cities. People's attitude toward nuclear energy related to their social values. Abstract of JCO accident, JCO structure, the effects of accident on the environment and news stories about the accident are reported. (S.Y.)

  15. Social media: physicians-to-physicians education and communication.

    Science.gov (United States)

    Fehring, Keith A; De Martino, Ivan; McLawhorn, Alexander S; Sculco, Peter K

    2017-06-01

    Physician to physician communication is essential for the transfer of ideas, surgical experience, and education. Social networks and online video educational contents have grown exponentially in recent years changing the interaction among physicians. Social media platforms can improve physician-to-physician communication mostly through video education and social networking. There are several online video platforms for orthopedic surgery with educational content on diagnosis, treatment, outcomes, and surgical technique. Social networking instead is mostly centered on sharing of data, discussion of confidential topics, and job seeking. Quality of educational contents and data confidentiality represent the major drawbacks of these platforms. Orthopedic surgeons must be aware that the quality of the videos should be better controlled and regulated to avoid inaccurate information that may have a significant impact especially on trainees that are more prone to use this type of resources. Sharing of data and discussion of confidential topics should be extremely secure according the HIPAA regulations in order to protect patients' confidentiality.

  16. OPINION GIVING SERVICES AS A SOURCE OF CONSUMER INFORMATION

    Directory of Open Access Journals (Sweden)

    Joanna Wyrwisz

    2015-09-01

    Full Text Available The goal of the article is to determine the place and role of opinion giving services in consumer behaviours. The discussion is conducted around the thesis saying that in the information society, opinion giving services constitute an important source of information for consumers in the process of selecting and purchasing both products and services. In the article the research approach based on the theoretical and empirical examinations was presented. The discussion starts with presenting a defi nition and types of opinion giving services which constitute the base for the characteristics of activities and usefulness of web portals collecting consumers opinions. The use of opinion giving services provided in the purchase process was evaluated. An essential interest in other consumers opinions, placed in Internet, was observed together with perceiving them as credible. Positive assessment of the functionality of opinion giving services was noticed.

  17. Referring physicians' experiences of outsourcing radiological examinations – A variety of views on the consequences

    International Nuclear Information System (INIS)

    Olofsson, P.T.; Blomqvist, L.; Fridell, K.; Aspelin, P.

    2016-01-01

    Introduction: There are strengths, weaknesses, opportunities and challenges when outsourcing advanced radiological examinations such as magnetic resonance examinations from university hospitals to external private institutions. Aim: The aim of this study was to explore the experiences of referring physicians when their referrals for radiological examinations are outsourced from a university hospital in Stockholm, Sweden. Method: This qualitative study is a part of a larger study investigating the consequences of outsourcing referrals for radiological examinations from a university hospital to private external units. Ten referring physicians from orthopedic and oncology departments, representing clinics with large volumes of radiological referrals at a university hospital, were interviewed. Results: The results showed that the requirements for radiological services differ between these specialties. The overall opinion was that examinations performed by external radiology departments needed additional re-assessment work which causes higher costs for their clinics. This indicates that there is insufficient communication between referring physicians and the radiological department at the University Hospital. Conclusions: For better planning of radiological services, radiology departments must consider the referring physicians' needs and develop suitable contract when organizing the practice of outsourcing. The management structure in radiology departments and communication between referring physicians and radiologists in the radiology departments should be studied further, to promote better understanding and improve the efficiency of the outsourcing process. - Highlights: • The requirements for radiological services differ between specialties. • Outsourced examinations need more frequent re-assessment. • Outsourced examinations cause higher costs for referring departments. • Outsourcing radiological examinations entail more administrative work.

  18. Medical tourism in India: perceptions of physicians in tertiary care hospitals.

    Science.gov (United States)

    Qadeer, Imrana; Reddy, Sunita

    2013-12-17

    Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians' however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

  19. Physician self-referral and physician-owned specialty facilities.

    Science.gov (United States)

    Casalino, Lawrence P

    2008-06-01

    Physician self-referral ranges from suggesting a follow-up appointment, to sending a patient to a facility in which the doctor has an ownership interest or financial relationship. Physician referral to facilities in which the physicians have an ownership interest is becoming increasingly common and not always medically appropriate. This Synthesis reviews the evidence on physician self-referral arrangements, their effect on costs and utilization, and their effect on general hospitals. Key findings include: the rise in self-referral is sparked by financial, regulatory and clinical incentives, including patient convenience and doctors trying to preserve their income in the changing health care landscape. Strong evidence suggests self-referral leads to increased usage of health care services; but there is insufficient evidence to determine whether this increased usage reflects doctors meeting an unmet need or ordering clinically inappropriate care. The more significant a physician's financial interest in a facility, the more likely the doctor is to refer patients there. Arrangements through which doctors receive fees for patient referrals to third-party centers, such as "pay-per-click," time-share, and leasing arrangements, do not seem to offer benefits beyond increasing physician income. So far, the profit margins of general hospitals have not been harmed by the rise in doctor-owned facilities.

  20. THE LAWYER`S OPINION IN MODERN CIVIL LAW

    Directory of Open Access Journals (Sweden)

    Elena Evgenyevna Dubovaya

    2015-12-01

    Full Text Available Purpose to define value of freedom and fight of opinions, views and lawyer’s positions in development of science of civil law.Methodology theoretical analysis, inductive and deductive methods.Results It is established that fight of opinions, collision of various positions allows to understand more deeply the discussed problem, to come nearer to truth. So, free expression of opinions is the engine of development of civil law.Practical implications introduction in educational process on disciplines of civil jurisprudence, further research of fight of opinions in civil law.Tendencies of the present stage of development of legal system are characterized by aspiration to fix in the Russian legal system of the beginning of private law, where at the head of a corner – people as a legal entity. Opinions of lawyers on various legal problems, and the attitudes towards these opinions are subject to considerable dynamics. The centuries-old history of development of the right showed that fight of opinions, collision of various positions allows to understand more deeply the discussed problem, to come nearer to truth. The modern civil law widely uses a method of comparative jurisprudence, studying experience of the civilized countries which promoted in development of the civil legislation.

  1. Continuous Opinion Dynamics Under Bounded Confidence:. a Survey

    Science.gov (United States)

    Lorenz, Jan

    Models of continuous opinion dynamics under bounded confidence have been presented independently by Krause and Hegselmann and by Deffuant et al. in 2000. They have raised a fair amount of attention in the communities of social simulation, sociophysics and complexity science. The researchers working on it come from disciplines such as physics, mathematics, computer science, social psychology and philosophy. In these models agents hold continuous opinions which they can gradually adjust if they hear the opinions of others. The idea of bounded confidence is that agents only interact if they are close in opinion to each other. Usually, the models are analyzed with agent-based simulations in a Monte Carlo style, but they can also be reformulated on the agent's density in the opinion space in a master equation style. The contribution of this survey is fourfold. First, it will present the agent-based and density-based modeling frameworks including the cases of multidimensional opinions and heterogeneous bounds of confidence. Second, it will give the bifurcation diagrams of cluster configuration in the homogeneous model with uniformly distributed initial opinions. Third, it will review the several extensions and the evolving phenomena which have been studied so far, and fourth it will state some open questions.

  2. Opinion Dynamics with Heterogeneous Interactions and Information Assimilation

    Science.gov (United States)

    Mir Tabatabaei, Seydeh Anahita

    2013-01-01

    In any modern society, individuals interact to form opinions on various topics, including economic, political, and social aspects. Opinions evolve as the result of the continuous exchange of information among individuals and of the assimilation of information distributed by media. The impact of individuals' opinions on each other forms a network,…

  3. Conciliatory and contradictory dynamics in opinion formation

    OpenAIRE

    Boudin , Laurent; Mercier , Aurore; Salvarani , Francesco

    2012-01-01

    International audience; In this article, we study, via a kinetic description, the effect of different psychologies on the evolution of the opinion with respect to a binary choice, in a closed group. We show that the interaction between individuals with different reactions regarding the exchange of opinion induces some phenomena, such as the concentration of opinions or the cyclic-in-time behaviour of the distribution function. We provide an existence and uniqueness result for the model and nu...

  4. Perceived risks from radiation and nuclear testing near Semipalatinsk, Kazakhstan: a comparison between physicians, scientists, and the public.

    Science.gov (United States)

    Purvis-Roberts, Kathleen L; Werner, Cynthia A; Frank, Irene

    2007-04-01

    Determining the difference in perception of risk between experts, or more educated professionals, and laypeople is important so that a potential hazard can be effectively communicated to the public. Many surveys have been conducted to better understand the difference between expert and public opinions, and often laypeople exhibit higher perceptions of risk to hazards in comparison to experts. This is especially true when health risk is due to radiation, nuclear power, and nuclear waste. This article focuses on one section of a risk perception survey given to two groups of individuals with a more specialized education (scientists and physicians) and laypeople (villagers) in the Semipalatinsk region of Kazakhstan. All of these groups live near the former Soviet nuclear test site. Originally, it was expected that the scientists and physicians would have similar perceptions of radiation risk, while the public perceptions would be higher, but this was not always the case. For example, when perceptions of risk pertain to the health impacts of nuclear testing or the dose-response nature of radiation exposure, the physicians tend to agree with the laypeople, not the scientists. The villagers are always the most risk-averse group, followed by the physicians and then the scientists. These differences are likely due to different frames of reference for each of the populations.

  5. Assessing response to therapy in idiopathic pulmonary arterial hypertension: a consensus survey of Canadian pulmonary hypertension physicians.

    Science.gov (United States)

    Borrie, Adrienne E; Ostrow, David N; Levy, Robert D; Swiston, John R

    2011-01-01

    Many treatment options are now available for patients with idiopathic pulmonary arterial hypertension (IPAH). Data regarding the optimal combination of therapies are lacking, as is consensus on how to assess response to therapy and when to change therapeutic regimens. To gather the opinions of Canadian pulmonary hypertension (PH) experts regarding standard practice in the care of IPAH patients after therapy is initiated. Canadian PH physicians were surveyed using short questionnaires to assess their opinions and practices in the care of IPAH patients. A Delphi forecasting approach was used to gain consensus among Canadian physicians on the most important clinical parameters to consider when assessing patients after the initiation of therapy. Twenty-six of 37 Canadian PH experts who were invited to participate completed the study. All endorsed the use of combination therapy for IPAH patients despite the lack of universal provincial coverage for this approach. By consensus, WHO functional class, 6 min walk distance and hospitalization for right heart failure were the most important clinical parameters. The most highly rated physical examination parameters were jugular venous pressure, peripheral edema, the presence of ascites and body weight. The overall approach to care of IPAH patients is similar across PH centres in Canada. A limited number of clinical and physical examination parameters were considered to be most important to reassess patients after therapy is initiated. These parameters, along with definition of threshold values, will facilitate the development of standard practice guidelines for IPAH patients in Canada.

  6. Analysis and application of opinion model with multiple topic interactions.

    Science.gov (United States)

    Xiong, Fei; Liu, Yun; Wang, Liang; Wang, Ximeng

    2017-08-01

    To reveal heterogeneous behaviors of opinion evolution in different scenarios, we propose an opinion model with topic interactions. Individual opinions and topic features are represented by a multidimensional vector. We measure an agent's action towards a specific topic by the product of opinion and topic feature. When pairs of agents interact for a topic, their actions are introduced to opinion updates with bounded confidence. Simulation results show that a transition from a disordered state to a consensus state occurs at a critical point of the tolerance threshold, which depends on the opinion dimension. The critical point increases as the dimension of opinions increases. Multiple topics promote opinion interactions and lead to the formation of macroscopic opinion clusters. In addition, more topics accelerate the evolutionary process and weaken the effect of network topology. We use two sets of large-scale real data to evaluate the model, and the results prove its effectiveness in characterizing a real evolutionary process. Our model achieves high performance in individual action prediction and even outperforms state-of-the-art methods. Meanwhile, our model has much smaller computational complexity. This paper provides a demonstration for possible practical applications of theoretical opinion dynamics.

  7. Opinions of Spanish pig producers on the role, the level and the risk to public health of antimicrobial use in pigs.

    Science.gov (United States)

    Moreno, Miguel A

    2014-08-01

    Antimicrobial use is a major driver of antimicrobial resistance and prescribers (physicians and veterinarians) and end users (patients, food producers and pet owners) are the cornerstones of this scenario. Intensive pig farming is a livestock activity that has a high antimicrobial use. This study is based on the opinions of pig producers. The study was done at national level and comprised two independent cross-sectional surveys using a questionnaire-based methodology and face-to-face interviews carried out between April and October, 2010. The collected data, which consisted of opinions of producers on 48 farrow-to-finish farms and 62 finisher farms, showed that, irrespective of farm type, pig producers in Spain have an imperfect knowledge of the main use of antimicrobials. Antimicrobials are perceived as valuable cost-effective tools for animal health and husbandry and there is little concern among pig producers about the harmful effects on public health of on-farm antimicrobial use. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Explaining the de-prioritization of primary prevention: Physicians' perceptions of their role in the delivery of primary care

    Directory of Open Access Journals (Sweden)

    Kuo Christina L

    2003-05-01

    Full Text Available Abstract Background While physicians are key to primary preventive care, their delivery rate is sub-optimal. Assessment of physician beliefs is integral to understanding current behavior and the conceptualization of strategies to increase delivery. Methods A focus group with regional primary care physician (PCP Opinion Leaders was conducted as a formative step towards regional assessment of attitudes and barriers regarding preventive care delivery in primary care. Following the PRECEDE-PROCEED model, the focus group aim was to identify conceptual themes that characterize PCP beliefs and practices regarding preventive care. Seven male and five female PCPs (family medicine, internal medicine participated in the audiotaped discussion of their perceptions and behaviors in delivery of primary preventive care. The transcribed audiotape was qualitatively analyzed using grounded theory methodology. Results The PCPs' own perceived role in daily practice was a significant barrier to primary preventive care. The prevailing PCP model was the "one-stop-shop" physician who could provide anything from primary to tertiary care, but whose provision was dominated by the delivery of immediate diagnoses and treatments, namely secondary care. Conclusions The secondary-tertiary prevention PCP model sustained the expectation of immediacy of corrective action, cure, and satisfaction sought by patients and physicians alike, and, thereby, de-prioritized primary prevention in practice. Multiple barriers beyond the immediate control of PCP must be surmounted for the full integration of primary prevention in primary care practice. However, independent of other barriers, physician cognitive value of primary prevention in practice, a base mediator of physician behavior, will need to be increased to frame the likelihood of such integration.

  9. Rise of an alternative majority against opinion leaders

    Science.gov (United States)

    Tucci, K.; González-Avella, J. C.; Cosenza, M. G.

    2016-03-01

    We investigate the role of opinion leaders or influentials in the collective behavior of a social system. Opinion leaders are characterized by their unidirectional influence on other agents. We employ a model based on Axelrod's dynamics for cultural interaction among social agents that allows for non-interacting states. We find three collective phases in the space of parameters of the system, given by the fraction of opinion leaders and a quantity representing the number of available states: one ordered phase having the state imposed by the leaders; another nontrivial ordered phase consisting of a majority group in a state orthogonal or alternative to that of the opinion leaders, and a disordered phase, where many small groups coexist. We show that the spontaneous rise of an alternative group in the presence of opinion leaders depends on the existence of a minimum number of long-range connections in the underlying network. This phenomenon challenges the common idea that influentials are fundamental to propagation processes in society, such as the formation of public opinion.

  10. Effects of Groups’ Spatial Segregation on Processes of Opinion Polarization

    NARCIS (Netherlands)

    Feliciani, Thomas; Flache, Andreas

    2015-01-01

    We contribute to the literature about processes of opinion formation, investigating theoretically how the spatial segregation of two groups affects opinion polarization as a possible outcome of opinion formation. We focus on two processes of opinion polarization (negative influence and persuasive

  11. [Examination of factors for promoting cooperation using documents between occupational health physicians and psychiatrists].

    Science.gov (United States)

    Okawara, Makoto; Kajiki, Shigeyuki; Kusumoto, Akira; Fujino, Yoshihisa; Shinkai, Takahiro; Morimoto, Hideki; Hino, Yoshiyuki; Yamashita, Satoshi; Hattori, Michihiro; Mori, Koji

    2018-02-01

    There is little specific information concerning the method and the efficacy of sharing information between occupational health physicians and psychiatrists regarding the employment status and medical history of their patients with mental illnesses. To promote cooperation between occupational health physicians and psychiatrists, we examined the points necessary to be included on medical information request forms exchanged between them. We conducted focused group discussion (FGD) to identify the points that need to be described on the request form and the concerns in cooperation between occupational health physicians and psychiatrists. We conducted FGDs twice, with two different groups of nine psychiatrists participating in each round. We extracted and organized FGD results and determined the necessary request form points. Next, we assumed two different cases of workers with mental illnesses and created three request form templates with differing item descriptions and lengths. We also conducted a questionnaire survey among clinical psychiatrists to determine their impression of the templates. We performed logistic regression analysis on the obtained results. On the basis of the FGD results we extracted the situation in the workplace, clarification of points to be confirmed, representation of the occupational health physician's position, and handling of information provided by the doctor as points required for the request form. On the basis of these results and the opinions of occupational health specialists, we created a new request form using these points. Additionally, the results from the questionnaire survey about the prescribed items revealed the proportion of favorable answers regarding sufficient information written on the request form and a feeling of security for information provision increased (p situation by providing their personal medical information and believe the clinical information required by the occupational health physicians is unclear. This

  12. Factors associated with compliance and non-compliance by physicians in a large-scale randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Rahman Mahbubur

    2006-08-01

    Full Text Available Abstract Background In order to minimize the amount of incomplete follow-up data, reducing the non-compliance of participating physicians is one of the key issues for the data coordinating center in a multi-center trial. Identifying the physicians' non-compliance in advance is considered to be an important strategy for more efficient conduct of trials. In this study, we identified physicians' characteristics and factors associated with the need for individual visits to institutions to collect data or to complete information during two years of follow-up in a large Japanese investigator-initiated trial related to cardiovascular disease. Methods We categorized the physicians into two groups, "complier" and "non-complier". Odds ratios and corresponding 95% confidence intervals were calculated for 11 factors related to the characteristics of and compliance by physicians. Multiple logistic regression analysis was also performed. In addition, we evaluated the incremental cost for obtaining additional information of the non-compliant physicians. Results Three factors were identified in multiple logistic regression analysis as being significantly associated with compliance status: 1 prior participation in clinical trials (OR = 0.40 95%CI = 0.21–0.74; 2 physician opinion that the support system for case registration and follow-up was well organized (OR = 0.41 95%CI = 0.22–0.75; and 3 number of patients recruited (OR = 2.25 95%CI = 1.01–5.02. The actual incremental cost was about US $112,000 (14.4% of total routine follow-up costs for the non-compliant physicians during the 2 years, or about US $570 per patient. Conclusion Investigator-initiated clinical trials have recently attracted great interest, but they often suffer from insufficient funding. If trial networks are to be well organized, it is important that trials are conducted more efficiently. We believe that our findings will be useful for reducing the additional burden associated with

  13. More than 30 years of opinion of French people on nuclear risks - Special release of the 2012 IRSN opinion survey

    International Nuclear Information System (INIS)

    El Jammal, Marie-Helene; Rollinger, Francois; Mur, Emmanuelle; Schuler, Matthieu; Tchernia, Jean-Francois

    2013-01-01

    Illustrated by many graphs and tables, this report comments and discusses the evolution of opinion surveys performed in France on the perception of nuclear risks through thirty annual IRSN opinion surveys. It appears that the opinion on nuclear is rather steady, and that French people have a rather rational perception of risk hierarchy. The first part outlines that unemployment is the main concern for French people, and that environmental concerns depend on current events. The second part analyses the perception of the nuclear risk with respect to other societal concerns and to other risks, and discusses the evolution of opinion from a quantitative to a qualitative sensitivity. The third part addresses the representations people have of nuclear activities and how they challenge the reality: perception of nuclear plants and of radioactive wastes, fear of a serious accident. The last part deals with issues related to responsibilities, abilities and governance: how actors of nuclear risk management are perceived, and expectations in terms of transparency and opinion plurality

  14. On the opinion formation of mobile agents with memory

    Science.gov (United States)

    Zhang, Yunhong; Liu, Qipeng; Wang, Zhenling; Zhang, Siying

    2018-02-01

    This paper studies the opinion formation problem in a group of mobile agents using a multi-agent modeling method. Suppose that all agents move in a two-dimensional space following a certain rule. The interaction range of each agent is determined by its physical location and its opinion similarity with other agents. Moreover, agents have memory of the opinions of their previous interactive neighbors. We investigate the influence of three factors on the formation of group opinion: moving probability, interactive radius, and population density. Using simulations, we find that an opinion consensus can be achieved easily under a small moving probability and a small interactive radius, which is a relatively counterintuitive phenomenon. We also find that a large interactive radius or the model with memory can facilitate the convergence of opinions in a group to either consensus or clusters.

  15. Death on demand? An analysis of physician-administered euthanasia in The Netherlands.

    Science.gov (United States)

    Preston, Robert

    2018-03-01

    Physician-administered euthanasia (PAE) was legalized, along with physician-assisted suicide (PAS), in The Netherlands in 2001. Annual reports of the Dutch Regional Euthanasia Review Committees, the committees' 2015 published Code of Practice and research studies. There is a general openness about the practice of PAE/PAS in The Netherlands and an avoidance of misleading euphemisms. The 2001 law also includes arrangements for post-event review of PAE/PAS decisions. Rising numbers of annually reported deaths from PAE and uncertainty over actual numbers. Movement away from the principle that euthanasia must take place within an established doctor-patient relationship. Increasing extension of the 2001 law to people with mental health conditions, dementia and multiple co-morbidities. Nature of the post-event scrutiny applied to reported cases. The predominance of PAE over PAS where both are legalized raises questions over how these two acts are perceived and whether there are implications for such laws. Are the criteria for PAE/PAS in the 2001 law appropriate for a law of this nature? What should be the respective roles of the second-opinion doctors and the review committees?

  16. How do physicians discuss e-health with patients? the relationship of physicians' e-health beliefs to physician mediation styles.

    Science.gov (United States)

    Fujioka, Yuki; Stewart, Erin

    2013-01-01

    A survey of 104 physicians examined the role of physicians' evaluation of the quality of e-health and beliefs about the influence of patients' use of e-health in how physicians discuss e-health materials with patients. Physicians' lower (poor) evaluation of the quality of e-health content predicted more negative mediation (counter-reinforcement of e-health content). Perceived benefits of patients' e-health use predicted more positive (endorsement of e-health content). Physician's perceived concerns (negative influence) regarding patients' e-health use were not a significant predictor for their mediation styles. Results, challenging the utility of restrictive mediation, suggested reconceptualizing it as redirective mediation in a medical interaction. The study suggested that patient-generated e-health-related inquiries invite physician mediation in medical consultations. Findings and implications are discussed in light of the literature of physician-patient interaction, incorporating the theory of parental mediation of media into a medical context.

  17. The National Day for the Libyan Physician

    Directory of Open Access Journals (Sweden)

    Elmahdi A. Elkhammas

    2007-03-01

    Libyan society. We hope the idea will find its way to the legislators to adopt and designate a day to celebrate the Libyan Physician.This day can be any time; however, I would propose selecting a day in the summer to enable the participation of most Libyan physicians while children are out of school. Such participation could be in the form of public health screenings and information about major diseases such as diabetes, high blood pressure, strokes and breast cancer. Informational discussions of socio-medical problems such as substance abuse and drug addiction could also be included. It is my hope that my colleagues will discuss this issue, voice their opinions, and provide suggestions of other activities to commemorate our physicians on this day.

  18. Topological evolution of the internet public opinion

    Science.gov (United States)

    Lian, Ying; Dong, Xuefan; Liu, Yijun

    2017-11-01

    The Internet forms a platform featured with high liquidity, accessibility and concealment for the public to express their respective views on certain events, thus leading to a large network graph. Due to such environmental features, the public opinions formed on the Internet are different from those on traditional media. Studies focusing on the former area are relatively fewer. In addition, the majority of existing methods proposed for constructing the Internet public opinion topological structure are based on the classic BA model, thus resulting in drawbacks in the range of simplicity and a lack of strict deduction. Therefore, based on the complex networks theory, a model applied to describe the topology of the Internet public opinion is deduced with rigorous derivation in the present paper. Results show that the proposed expression could well reflect the degree distribution of Internet public opinion which follows an analogous power law distribution, and that the peak value and the degree distribution are not correlative to each other. Moreover, it has been also proved that compared to the classic BA model, the proposed model has better accuracy performance in the description of the degree distribution of the Internet public opinion, which contributes to future studies focusing on this area. Thus, an attempt has been made to give the first theoretical description of the Internet public opinion topology in the present paper. In addition, it is also the first paper focusing on the solution of networks degree distribution with an exponential growth form.

  19. 42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

    Science.gov (United States)

    2010-10-01

    ... teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.172 Physician fee schedule payment for services of teaching physicians. (a...

  20. Objectification of injuries and consequences in expert medical opinions

    Directory of Open Access Journals (Sweden)

    Miran Vrabl

    2007-04-01

    Full Text Available Background: Only unequivocal evidence confirming the total extent of injury. Biomechanical analysis, objectifications of permanent consequences after injury and objectification, whether such injuries influence life activities of an injured person, should be the basics for preparation of expert medical opinion. To make a necessary distinction from the previous injuries or illnesses that might have influence on current health state of a patient and its treatment, analysis of all medical records of a certain injured person is needed. Therefore this are inevitable steps in preparation of an expert medical opinion. In cases when medical opinion should explain disability of a patient as a consequence of a certain contractual relationship, the contract should be taken into consideration when such opinions is prepared.Methods: 500 opinions have been retrospectively analysed, selected at random out of 3452 opinions, submitted in claims for damages at Zavarovalnica Maribor, d. d., in the period from January 2001 until January 2006. Thirteen typical data have been analysed and evaluated on the basis of objective evidences.Results: On the basis of analyses it has been established that there is a great difference between principles of objectification and the data in analysed opinions. It has been noticed the most obvious deviation in biomechanical analysis (95 %, in records of decreased life activities (90 %, in all medical records of an injured person (65 % and in objectification of permanent consequences after injuries (55 %.Conclusions: As results of analysis demonstrate, there are significant differences in preparations of expert and medical opinions in Slovenia, particularly when basic principles are analysed that need to be considered when writing such opinions. Irrational avoidance of basic principle of objectification, nomination of experts without licence in certain fields of medicine, avoidance of objectification of subjective statements of injured

  1. Does the physician's emotional intelligence matter? Impacts of the physician's emotional intelligence on the trust, patient-physician relationship, and satisfaction.

    Science.gov (United States)

    Weng, Hui-Ching

    2008-01-01

    Much of the literature pertinent to management indicates that service providers with high emotional intelligence (EI) receive higher customer satisfaction scores. Previous studies offer limited evidence regarding the impact of physician's EI on patient-physician relationship. Using a multilevel and multisource data approach, the current study aimed to build a model that demonstrated the impact of a physician's EI on the patient's trust and the patient-physician relationship. The survey sample included 983 outpatients and 39 physicians representing 11 specialties. Results of path analyses demonstrated that the ratio of patient's follow-up visits (p impact of patient's trust on patient's satisfaction was mediated by the patient-physician relationship at a significant level (p relationship had a significantly positive effect on patient's satisfaction (p relationship; however, mutual trust and professional respect between nurses and physicians play a critical role in reinforcing the patient-physician relationship to effect improvements in the provision of patient-centered care.

  2. Perception of risks by opinion leaders 2011

    International Nuclear Information System (INIS)

    2011-01-01

    The authors report a survey made just after the Fukushima accident on a panel of opinion leaders (belonging to political, economical or media sector) in order to compare their perception of risks with that of the public. The questions addressed the perception of risks, the role of scientific experts, the usefulness and breaks on the diffusion of expertise results, the perception of pluralist bodies, and the Fukushima accident. The answers are analysed and discussed with respect to fifteen hazardous situations, to their opinion of expertise, and to their opinion on safety audit and information

  3. cultural variations regarding the nature and determinants of opinion ...

    African Journals Online (AJOL)

    p2333147

    Keywords: Opinion leaders, cultural influence, diffusion and determinants of opinion leadership. ABSTRACT. This paper compares the findings from different countries regarding the nature and determinants of opinion leadership. ..... agricultural production among male and female farmers of the Kusenge. Parish in the ...

  4. Selective mutism: are primary care physicians missing the silence?

    Science.gov (United States)

    Schwartz, Richard H; Freedy, Alicia S; Sheridan, Michael J

    2006-01-01

    To survey parents of children with selective mutism (SM) in regard to (1) the role of the primary care physician in the diagnosis of SM; (2) the social and school consequences of SM; and (3) their opinion of the effectiveness of different treatment modalities, a 39-item written survey was mailed to 27 parents with at least one child diagnosed with SM on the basis of diagnostic and statistical manual IV-text revision (DSM IV-TR) criteria. Twenty-seven parents (100%), with a total of 33 children with SM, completed the survey. There were 24 girls and 9 boys. The mean age when parents had strong concerns about symptoms of SM was 3.8 years, but diagnosis did not occur until nearly a year later. Twenty-three (69.7%) of the children with SM were never diagnosed accurately or referred by their primary care physicians. SM caused important school/social problems for 17 (51.5%) of the children. Speech therapy was provided for 36.4% of children and was thought to have been helpful for 30% of them. Behavior modification was the treatment for 45.5% of children and perceived to be helpful for 66.7% of them. Selective serotonin re-uptake inhibitor pharmacotherapy was prescribed for 17 (51.5%) of the children and believed to be effective for 11 (65%) of them. Primary care physicians in this study rarely diagnosed accurately or referred children with SM in a timely fashion, even though symptoms of the condition were generally very apparent and parents had expressed concern. Behavioral modification, pharmacotherapy with SSRIs, and early intervention are viable treatment options. Early diagnosis is key to preventing long-term effects of this condition.

  5. Social influence and the collective dynamics of opinion formation.

    Science.gov (United States)

    Moussaïd, Mehdi; Kämmer, Juliane E; Analytis, Pantelis P; Neth, Hansjörg

    2013-01-01

    Social influence is the process by which individuals adapt their opinion, revise their beliefs, or change their behavior as a result of social interactions with other people. In our strongly interconnected society, social influence plays a prominent role in many self-organized phenomena such as herding in cultural markets, the spread of ideas and innovations, and the amplification of fears during epidemics. Yet, the mechanisms of opinion formation remain poorly understood, and existing physics-based models lack systematic empirical validation. Here, we report two controlled experiments showing how participants answering factual questions revise their initial judgments after being exposed to the opinion and confidence level of others. Based on the observation of 59 experimental subjects exposed to peer-opinion for 15 different items, we draw an influence map that describes the strength of peer influence during interactions. A simple process model derived from our observations demonstrates how opinions in a group of interacting people can converge or split over repeated interactions. In particular, we identify two major attractors of opinion: (i) the expert effect, induced by the presence of a highly confident individual in the group, and (ii) the majority effect, caused by the presence of a critical mass of laypeople sharing similar opinions. Additional simulations reveal the existence of a tipping point at which one attractor will dominate over the other, driving collective opinion in a given direction. These findings have implications for understanding the mechanisms of public opinion formation and managing conflicting situations in which self-confident and better informed minorities challenge the views of a large uninformed majority.

  6. Ethics in medicine: students' opinions on disclosure of true diagnosis.

    Science.gov (United States)

    Pulanić, Drazen; Vrazić, Hrvoje; Cuk, Mario; Petrovecki, Mladen

    2002-02-01

    To determine students opinions about diagnosis disclosure to the patient and other interested parties. During 2000/2001 academic year, an anonymous survey was conducted among the first-year (200 questionnaires) and sixth-year medical students (200 questionnaires) at the Zagreb University School of Medicine. Students were asked what they would say about the diagnosis to the patient, patients family, friend, employer, colleague from work, health insurance agent, another physician, or medical student, if the diagnosis was inoperable lung carcinoma in a 20- and 66-year-old patient vs bacterial pneumonia in patients of the same age. The possibilities were to tell the truth, lie, or refuse to disclose the diagnosis. The response rate was 55%. Students would disclose the true diagnosis to the patient, patients family, friend, and employer in case of benign disease more often than in case of malignant disease (pemployer, and rarely to the patient's colleague from work. First-year students would generally tell the truth more often than sixth-year students (pethical issues should be discussed during the studies.

  7. First and foremost, physicians: the clinical versus leadership identities of physician leaders.

    Science.gov (United States)

    Quinn, Joann Farrell; Perelli, Sheri

    2016-06-20

    Purpose - Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach - Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings - These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications - Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications - These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications - This work points to a broader and more fundamental need - a modified mindset about the nature and value of physician leadership. Originality/value - This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer

  8. Public opinion on water reuse options

    International Nuclear Information System (INIS)

    Bruvold, W.H.

    1988-01-01

    Public policy on waste water reuse options must be informed by public opinion because it is the public who must pay the cost of developing the option and who will be served by the option in the future. For public policy on reuse, guidance for innovative reuse is not as simple as first believed. It seems that public opinion regarding actual community reuse options is affected by the linkage of several factors, including water conservation, health protection, treatment and distribution costs, and environmental enhancement. Probability sampling was used in 7 studies to select respondents who were queried regarding their opinions on various reclaimed water uses such as ranging from cooling tower water to full domestic use. These 7 are briefly reviewed

  9. Physicians' messages in problematic sickness certification: a narrative analysis of case reports

    Directory of Open Access Journals (Sweden)

    Rudebeck Carl

    2011-04-01

    Full Text Available Abstract Background Many physicians find sickness certification tasks problematic. There is some knowledge about situations that are experienced as problematic, whereas less is understood about how physicians respond to the problems they face. One way to acquire such knowledge is to consider "reflection-in-action", aspects of which are expressed in the physician's interpretation of the patient's story. The aim of this study was to gain knowledge about the meaning content of case reports about problematic sickness certification. Specifically, we looked for possible messages to the colleagues intended to read the reports. Methods A narrative approach was used to analyse reports about problematic sickness certification cases that had been written by GPs and occupational health service physicians as part of a sickness insurance course. The analysis included elements from both thematic and structural analysis. Nineteen case reports were used in the actual analysis and 25 in the validation of the results. Main narrative qualities and structural features of the written case reports were explored. Results Five types of messages were identified in the case reports, here classified as "a call for help", "a call for understanding", "hidden worries", "in my opinion", and "appearing neutral". In the reports, the physicians tried to achieve neutrality in their writing, and the patients' stories tended to be interpreted within a traditional biomedical framework. In some cases there was an open request for help, in others it was not obvious that the physician had any problems. Overall, the messages were about having problems as such, rather than the specific features of the problems. Conclusions The case reports clearly demonstrated different ways of writing about problems that arise during sickness certification, from being neutral and not mentioning the problems to being emotionally involved and asking for help. The general character of the messages suggests

  10. Conformity, Anticonformity and Polarization of Opinions: Insights from a Mathematical Model of Opinion Dynamics

    Directory of Open Access Journals (Sweden)

    Tyll Krueger

    2017-07-01

    Full Text Available Understanding and quantifying polarization in social systems is important because of many reasons. It could for instance help to avoid segregation and conflicts in the society or to control polarized debates and predict their outcomes. In this paper, we present a version of the q-voter model of opinion dynamics with two types of responses to social influence: conformity (like in the original q-voter model and anticonformity. We put the model on a social network with the double-clique topology in order to check how the interplay between those responses impacts the opinion dynamics in a population divided into two antagonistic segments. The model is analyzed analytically, numerically and by means of Monte Carlo simulations. Our results show that the system undergoes two bifurcations as the number of cross-links between cliques changes. Below the first critical point, consensus in the entire system is possible. Thus, two antagonistic cliques may share the same opinion only if they are loosely connected. Above that point, the system ends up in a polarized state.

  11. Drivers of going concern audit opinions: empirical evidence from Indonesia

    Directory of Open Access Journals (Sweden)

    Suroto Lina Rahmawati

    2017-08-01

    Full Text Available The study of the going concern audit opinions is an important component within the enhancement of firms’ responsibility and stewardship. A going concern audit opinions implies that the independent auditor doubt the future of the firm. This study aimed to examine the drivers of the likelihood of the going-concern audit opinions. Previous studies revealed that there were inconsistent drivers influencing the going-concern audit opinion. This study shows similar results to prior works. The result indicates that firms’ financial condition and profitability significantly affect the likelihood of the going-concern audit opinion, while firms’ size and leverage are not the determinants of the intensity of the going concern audit opinion.

  12. [Perceptions on electronic prescribing by primary care physicians in madrid healthcare service].

    Science.gov (United States)

    Villímar Rodríguez, A I; Gangoso Fermoso, A B; Calvo Pita, C; Ariza Cardiel, G

    To investigate the opinion of Primary Care physicians regarding electronic prescribing. Descriptive study by means of a questionnaire sent to 527 primary care physicians. June 2014. The questionnaire included closed questions about interest shown, satisfaction, benefits, weaknesses, and barriers, and one open question about difficulties, all of them referred to electronic prescribing. Satisfaction was measured using 1-10 scale, and benefits, weaknesses, and barriers were evaluated by a 5-ítems Likert scale. Interest was measured using both methods. The questionnaire was sent by e-mail for on line response through Google Drive® tool. A descriptive statistical analysis was performed. The response rate was 47% (248/527). Interest shown was 8.7 (95% CI; 8.5-8.9) and satisfaction was 7.9 (95% CI; 7.8-8). The great majority 87.9% (95% CI; 83.8-92%) of respondents used electronic prescribing where possible. Most reported benefits were: 73.4% (95% CI; 67.8-78.9%) of respondents considered that electronic prescribing facilitated medication review, and 59.3% (95% CI; 53.1-65.4) of them felt that it reduced bureaucratic burden. Among the observed weaknesses, they highlighted the following: 87.9% (95% CI; 83.8-92%) of respondents believed specialist care physicians should also be able to use electronic prescribing. Concerning to barriers: 30.2% (95% CI; 24.5-36%) of respondents think that entering a patient into the electronic prescribing system takes too much time, and 4% (95% CI; 1.6-6.5%) of them perceived the application as difficult to use. Physicians showed a notable interest in using electronic prescribing and high satisfaction with the application performance. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. EMOTION BASED ANALYSIS OF TURKISH CUSTOMER OPINIONS

    Directory of Open Access Journals (Sweden)

    E. Kahya-Ozyirmidokuz

    2016-12-01

    Full Text Available Firms should manage their customer feedback so they can adapt to rapid changes in the environment. They have to interact with their customers to understand them and to turn their opinions into useful knowledge. Understanding customers' feelings about a product gives firmS competitive advantage through continuous market monitoring. They can thus generate improving strategies about the system to change perceptions that drive the behaviours of the customers. Firms can view their customers' happiness as a key tool for decision-making. This study calculates online product happiness by using the average emotional valence values of customer opinions. We analyse Turkish opinions about a product over a period of 3 months. We find the averages of the online emotional valence values of the product per month. We also determined the increase in happiness over time. According to the opinion valence values, we found the relations between the documents.

  14. Opinion Analysis on Rohingya using Twitter Data

    Science.gov (United States)

    Rochmawati, N.; Wibawa, S. C.

    2018-04-01

    Rohingya is an ethnicity in Myanmar. Recently there was a conflict in the area between the Rakhine population and the Myanmar army. Many opinions are pro and contra in addressing this issue. There is a critic, there is a support and there is a neutral. The purpose of this paper is to analyze the world public opinion about the case of Rohingya. The opinion data to be processed is taken from twitter. the reason for using twitter is because twitter has become one of the popular social media and includes the most frequently visited social media. Therefore, it would be a lot of data that can be taken from twitter to be processed in the process of sentiment analysis. The grouping of opinions will be divided into 3 parts of positive, negative and neutral. the method used in grouping is the naïve Bayes method.

  15. Physician Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in...

  16. Correlation between information diffusion and opinion evolution on social media

    Science.gov (United States)

    Xiong, Fei; Liu, Yun; Zhang, Zhenjiang

    2014-12-01

    Information diffusion and opinion evolution are often treated as two independent processes. Opinion models assume the topic reaches each agent and agents initially have their own ideas. In fact, the processes of information diffusion and opinion evolution often intertwine with each other. Whether the influence between these two processes plays a role in the system state is unclear. In this paper, we collected more than one million real data from a well-known social platform, and analysed large-scale user diffusion behaviour and opinion formation. We found that user inter-event time follows a two-scaling power-law distribution with two different power exponents. Public opinion stabilizes quickly and evolves toward the direction of convergence, but the consensus state is prevented by a few opponents. We propose a three-state opinion model accompanied by information diffusion. Agents form and exchange their opinions during information diffusion. Conversely, agents' opinions also influence their diffusion actions. Simulations show that the model with a correlation of the two processes produces similar statistical characteristics as empirical results. A fast epidemic process drives individual opinions to converge more obviously. Unlike previous epidemic models, the number of infected agents does not always increase with the update rate, but has a peak with an intermediate value of the rate.

  17. Correlation between information diffusion and opinion evolution on social media

    International Nuclear Information System (INIS)

    Xiong, Fei; Liu, Yun; Zhang, Zhenjiang

    2014-01-01

    Information diffusion and opinion evolution are often treated as two independent processes. Opinion models assume the topic reaches each agent and agents initially have their own ideas. In fact, the processes of information diffusion and opinion evolution often intertwine with each other. Whether the influence between these two processes plays a role in the system state is unclear. In this paper, we collected more than one million real data from a well-known social platform, and analysed large-scale user diffusion behaviour and opinion formation. We found that user inter-event time follows a two-scaling power-law distribution with two different power exponents. Public opinion stabilizes quickly and evolves toward the direction of convergence, but the consensus state is prevented by a few opponents. We propose a three-state opinion model accompanied by information diffusion. Agents form and exchange their opinions during information diffusion. Conversely, agents' opinions also influence their diffusion actions. Simulations show that the model with a correlation of the two processes produces similar statistical characteristics as empirical results. A fast epidemic process drives individual opinions to converge more obviously. Unlike previous epidemic models, the number of infected agents does not always increase with the update rate, but has a peak with an intermediate value of the rate. (paper)

  18. Public opinion factors regarding nuclear power

    Energy Technology Data Exchange (ETDEWEB)

    Benson, B.

    1991-12-31

    This paper is an effort to identify, as comprehensively as possible, public concerns about nuclear power, and to assess, where possible, the relative importance of these concerns as they relate to government regulation of and policy towards nuclear power. It is based on some two dozen in-depth interviews with key communicators representing the nuclear power industry, the environmental community, and government, as well as on the parallel efforts in our research project: (1) review of federal court case law, (2) a selective examination of the Nuclear Regulatory Commission (NRC) administrative process, and (3) the preceding George Mason University research project in this series. The paper synthesizes our findings about public attitudes towards nuclear power as expressed through federal court case law, NRC administrative law, public opinion surveys, and direct personal interviews. In so doing, we describe the public opinion environment in which the nuclear regulatory process must operate. Our premise is that public opinion ultimately underlies the approaches government agencies take towards regulating nuclear power, and that, to the degree that the nuclear power industry`s practices are aligned with public opinion, a more favorable regulatory climate is possible.

  19. Public opinion factors regarding nuclear power

    Energy Technology Data Exchange (ETDEWEB)

    Benson, B.

    1991-01-01

    This paper is an effort to identify, as comprehensively as possible, public concerns about nuclear power, and to assess, where possible, the relative importance of these concerns as they relate to government regulation of and policy towards nuclear power. It is based on some two dozen in-depth interviews with key communicators representing the nuclear power industry, the environmental community, and government, as well as on the parallel efforts in our research project: (1) review of federal court case law, (2) a selective examination of the Nuclear Regulatory Commission (NRC) administrative process, and (3) the preceding George Mason University research project in this series. The paper synthesizes our findings about public attitudes towards nuclear power as expressed through federal court case law, NRC administrative law, public opinion surveys, and direct personal interviews. In so doing, we describe the public opinion environment in which the nuclear regulatory process must operate. Our premise is that public opinion ultimately underlies the approaches government agencies take towards regulating nuclear power, and that, to the degree that the nuclear power industry's practices are aligned with public opinion, a more favorable regulatory climate is possible.

  20. Public opinion factors regarding nuclear power

    International Nuclear Information System (INIS)

    Benson, B.

    1991-01-01

    This paper is an effort to identify, as comprehensively as possible, public concerns about nuclear power, and to assess, where possible, the relative importance of these concerns as they relate to government regulation of and policy towards nuclear power. It is based on some two dozen in-depth interviews with key communicators representing the nuclear power industry, the environmental community, and government, as well as on the parallel efforts in our research project: (1) review of federal court case law, (2) a selective examination of the Nuclear Regulatory Commission (NRC) administrative process, and (3) the preceding George Mason University research project in this series. The paper synthesizes our findings about public attitudes towards nuclear power as expressed through federal court case law, NRC administrative law, public opinion surveys, and direct personal interviews. In so doing, we describe the public opinion environment in which the nuclear regulatory process must operate. Our premise is that public opinion ultimately underlies the approaches government agencies take towards regulating nuclear power, and that, to the degree that the nuclear power industry's practices are aligned with public opinion, a more favorable regulatory climate is possible

  1. Attitudes to brain death and organ procurement among university students and critical care physicians in poland.

    Science.gov (United States)

    Kubler, A; Lipinska-Gediga, M; Kedziora, J; Kubler, M

    2009-06-01

    The practice of retrieving vital organs from brain-dead heart-beating donors is legally and medically accepted in Poland, but public beliefs and opinions regarding these matters have not been sufficiently explored. The purpose of this study was to evaluate the attitude of university students to the concepts of brain death and organ retrieval, compared with the attitude of critical care physicians. The cohorts of 989 students and 139 physicians completed a questionnaire based on a survey instrument developed in an earlier reported study on Ohio residents. Participants assessed 3 scenarios: (1) brain death, (2) coma, and (3) vegetative state. More than 48% of students classified the patient from the brain death scenario as alive, and 51% of them were willing to donate organs of this patient. Ninety percent of students classified the patients in coma and in a vegetative state as alive, but still 34% of them would donate organs of those patients. The group of physicians properly determined the patients' diagnoses, but 10% of them accepted organ procurement from patients in coma and in a vegetative state. Our results supported the earlier observations of low public knowledge and inadequate understanding of brain death criteria and organ procurement processes. The majority of students were willing to accept organ procurement from severely ill but alive patients, in contrast with physicians. A considerable increase in public educational activity in this field is urgently recommended.

  2. the nature and determinants of opinion leadership in lesotho

    African Journals Online (AJOL)

    p2333147

    opinion leadership, 39 percent have been nominated and thus qualify ... It obviously cannot be ruled out that with increased consultations more fields of ... 30. 40. 50. 60. 70. 80. 90. 100. %. >3. 3. 2. 1. Opinion leadership (No. of nominations) .... Frequency distribution per gender. Male. Female. Total. Opinion leadership.

  3. Gathering Opinions on Depression Information Needs and Preferences: Samples and Opinions in Clinic Versus Web-Based Surveys.

    Science.gov (United States)

    Bernstein, Matthew T; Walker, John R; Sexton, Kathryn A; Katz, Alan; Beatie, Brooke E

    2017-04-24

    important. Those who had received or thought they would have benefited in the past from medication treatment saw fewer topics as important. Participants in both groups expressed an interest in receiving information through discussion with a counselor or a physician, through written brochures, or through a recommended website. The recruitment strategies were helpful in obtaining opinions from members of the public with different concerns and perspectives, and the results from the two methods were complementary. Persons coping with emotional distress and individuals not specifically seeking help for depression would be interested in information to answer a wide range of important questions about depression treatment. The Clinic sample yielded more cultural diversity that is a closer match to the population. The Web sample was less costly to recruit and included persons who were most interested in receiving information. ©Matthew T Bernstein, John R Walker, Kathryn A Sexton, Alan Katz, Brooke E Beatie, Mobilizing Minds Research Group. Originally published in JMIR Mental Health (http://mental.jmir.org), 24.04.2017.

  4. A Website to Improve Asthma Care by Suggesting Patient Questions for Physicians: Qualitative Analysis of User Experiences

    Science.gov (United States)

    Sciamanna, Christopher N; Blanch, Danielle C; Mui, Sarah; Lawless, Heather; Manocchia, Michael; Rosen, Rochelle K; Pietropaoli, Anthony

    2007-01-01

    Background Asthma is one of the most prevalent chronic conditions in the United Sates, yet despite the existence of national guidelines, nearly three fourths of patients with asthma do not have adequate control and clinical adherence to guidelines is low. While there are many reasons for this, physician inertia with respect to treatment change is partly to blame. Research suggests that patients who ask for specific tests and treatments are more likely to receive them. Objectives This study investigated the impact and experience of using an interactive patient website designed to give patients individual feedback about their condition and to suggest tailored questions for patients to ask their physician. The website was designed to be used prior to a physician visit, to increase the likelihood that patients would receive recommended tests and treatments. Methods A total of 37 adult patients with asthma participated in semi-structured telephone interviews aimed at eliciting information about their experiences with the website. Transcripts were coded using qualitative data analysis techniques and software. Themes were developed from subsets of codes generated through the analysis. In addition, 26 physicians were surveyed regarding their impressions of the website. Results Opportunities exist for improving website feedback, although the majority of both patient and physician respondents held favorable opinions about the site. Two major themes emerged regarding patients’ experiences with the website. First, many patients who used the website had a positive shift in their attitudes regarding interactions with their physicians. Second, use of the website prompted patients to become more actively involved in their asthma care. No patient reported any negative experiences as a result of using the website. Physicians rated the website positively. Conclusions Patients perceived that the interactive website intervention improved communication and interaction with their

  5. Discrete opinion dynamics on networks based on social influence

    International Nuclear Information System (INIS)

    Hu Haibo; Wang Xiaofan

    2009-01-01

    A model of opinion dynamics based on social influence on networks was studied. The opinion of each agent can have integer values i = 1, 2, ..., I and opinion exchanges are restricted to connected agents. It was found that for any I ≥ 2 and self-confidence parameter 0 ≤ u i ) of the population that hold a given opinion i is a martingale, and the fraction q i of opinion i will gradually converge to (q i ). The tendency can slow down with the increase of degree assortativity of networks. When u is degree dependent, (q i ) does not possess the martingale property, however q i still converges to it. In both cases for a finite network the states of all agents will finally reach consensus. Further if there exist stubborn persons in the population whose opinions do not change over time, it was found that for degree-independent constant u, both q i and (q i ) will converge to fixed proportions which only depend on the distribution of initial obstinate persons, and naturally the final equilibrium state will be the coexistence of diverse opinions held by the stubborn people. The analytical results were verified by numerical simulations on Barabasi-Albert (BA) networks. The model highlights the influence of high-degree agents on the final consensus or coexistence state and captures some realistic features of the diffusion of opinions in social networks

  6. Sentiment Analysis and Opinion Mining

    CERN Document Server

    Liu, Bing

    2012-01-01

    Sentiment analysis and opinion mining is the field of study that analyzes people's opinions, sentiments, evaluations, attitudes, and emotions from written language. It is one of the most active research areas in natural language processing and is also widely studied in data mining, Web mining, and text mining. In fact, this research has spread outside of computer science to the management sciences and social sciences due to its importance to business and society as a whole. The growing importance of sentiment analysis coincides with the growth of social media such as reviews, forum discussions

  7. Tropospheric ozone. Formation, properties, effects. Expert opinion

    International Nuclear Information System (INIS)

    Elstner, E.F.

    1996-01-01

    The formation and dispersion of tropospheric ozone are discussed only marginally in this expert opinion; the key interest is in the effects of ground level ozone on plants, animals, and humans. The expert opinion is based on an analysis of the available scientific publications. (orig./MG) [de

  8. U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

    Science.gov (United States)

    Dickinson, George E; Lancaster, Carol J; Clark, David; Ahmedzai, Sam H; Noble, William

    2002-01-01

    A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

  9. Impotent science, omnipotent public opinion

    International Nuclear Information System (INIS)

    Guillaume, Nathalie

    2001-01-01

    Full text: Nowadays public opinion has become prominent when political leaders have themselves to vote. Even scientific or economical decisions are often taken more in accordance to these trends than to rational reasons. For a long time it has been widely accepted that a clear and pedagogical explanation was enough to make scientific issues understandable. For nearly 20 years, a true scientific and professional communication has been developed in France towards the general public to make nuclear industry acceptable. Nevertheless today, we notice that the acceptance of the nuclear option has lost many points in public polls. An accident, in the nuclear fields or in another fields, in one point or another of the planet can ruin the work of many years in communication. 1) In order to draw a more precise picture of public opinion, to follow these trends and make them more understandable, the CEA communication direction has built a 'public opinion barometer' dealing with the following fields: - Information on nuclear fields; - The nuclear actors; - The future of nuclear option; - Radioactive waste; - Risks perception; - Nuclear energy and other sources of energy; - Economy and nuclear power; - Image of nuclear. 2) Come and visit our labs to make up your own opinion: As communication methods through the classical media has, up to now, failed in changing public opinion regarding nuclear, the decision was made to offer to people the opportunity to meet searchers at work.400 'Communicating researchers' to day are volunteers to receive the public .They are trained to be able to explain their work to non specialists; they receive documents dealing with current events to help them answer to questions and they are invited to an annual general meeting (last one in January 2001). 85 laboratories are opened (civil and military ones). In 2000, nearly 10,000 visitors have come to us. In 2001, new additional operations will be lead toward young people, teachers, associations. (author)

  10. Physician heal thyself

    African Journals Online (AJOL)

    Compared to overweight or obese physicians, normal‑weight physicians were significantly more likely to discuss weight loss with their obese patients, according to a study among. 500 primary care physicians, undertaken by researchers at the Johns Hopkins Bloomberg School of Public Health.[4]. A recent, highly accessed ...

  11. Iranian Physicians' Perspectives Regarding Nurse-Physician Professional Communication: Implications for Nurses.

    Science.gov (United States)

    Esmaeilpour-Bandboni, Mohammad; Vaismoradi, Mojtaba; Salsali, Mahvash; Snelgrove, Sherrill; Sheldon, Lisa Kennedy

    2017-08-01

    Nurse-physician professional communication affects the effectiveness and performance of the health care team and the quality of care delivered to the patient. This study aimed to explore the perspectives and experiences of physicians on nurse-physician professional communication in an urban area of Iran. Semistructured interviews were conducted with 15 physicians selected using a purposive sampling method. Physicians from different medical specialties were chosen from 4 teaching hospitals in an urban area of Iran. The data were analyzed with content analysis and themes developed. Three themes developed during data analysis: "seeking the formal methods of communication to ensure patient care," "nurses' professional attributes for professional communication," and "patients' health conditions as the mediators of professional communication." Nurses need to be informed of the perspectives and experiences of physicians on professional communication. Our findings can improve nurses' understandings of professional communication that could inform the development of educational and training programs for nurses and physicians. There is a need to incorporate communication courses during degree education and design interprofessional training regarding communication in clinical settings to improve teamwork and patient care. Open discussions between nurses and physicians, training sessions about how to improve their knowledge about barriers to and facilitators of effective professional communication, and key terms and phrases commonly used in patient care are suggested.

  12. An intervention to increase patients' trust in their physicians. Stanford Trust Study Physician Group.

    Science.gov (United States)

    Thom, D H; Bloch, D A; Segal, E S

    1999-02-01

    To investigate the effect of a one-day workshop in which physicians were taught trust-building behaviors on their patients' levels of trust and on outcomes of care. In 1994, the study recruited 20 community-based family physicians and enrolled 412 consecutive adult patients from those physicians' practices. Ten of the physicians (the intervention group) were randomly assigned to receive a one-day training course in building and maintaining patients' trust. Outcomes were patients' trust in their physicians, patients' and physicians' satisfaction with the office visit, continuity in the patient-physician relationship, patients' adherence to their treatment plans, and the numbers of diagnostic tests and referrals. Physicians and patients in the intervention and control groups were similar in demographic and other data. There was no significant difference in any outcome. Although their overall ratings were not statistically significantly different, the patients of physicians in the intervention group reported more positive physician behaviors than did the patients of physicians in the control group. The trust-building workshop had no measurable effect on patients' trust or on outcomes hypothesized to be related to trust.

  13. Physician Appraisals: Key Challenges

    Directory of Open Access Journals (Sweden)

    Klich Jacek

    2017-06-01

    Full Text Available The main purpose of the article is to identify key criteria being used for physician appraisals and to find how communication skills of physicians are valued in those appraisals. ScienceDirect and EBSCOhost databases were used for this search. The results show that a physician appraisal is underestimated both theoretically and empirically. The particular gap exists with respect to the communication skills of physicians, which are rarely present in medical training syllabi and physician assessments. The article contributes to the theoretical discourse on physician appraisals and points out at the inconsistency between the high status of physicians as a key hospital resource on the one hand and, on the other hand, at inadequate and poorly researched assessment of their performance with a special emphasis on communication skills. The article may inspire health managers to develop and implement up-to-date assessment forms for physicians and good managerial practices in this respect in hospitals and other health care units.

  14. Medical tourism in india: perceptions of physicians in tertiary care hospitals

    Science.gov (United States)

    2013-01-01

    Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians’ however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

  15. Discrete opinion dynamics on networks based on social influence

    Energy Technology Data Exchange (ETDEWEB)

    Hu Haibo; Wang Xiaofan [Complex Networks and Control Lab, Shanghai Jiao Tong University, Shanghai 200240 (China)

    2009-06-05

    A model of opinion dynamics based on social influence on networks was studied. The opinion of each agent can have integer values i = 1, 2, ..., I and opinion exchanges are restricted to connected agents. It was found that for any I {>=} 2 and self-confidence parameter 0 {<=} u < 1, when u is a degree-independent constant, the weighted proportion (q{sub i}) of the population that hold a given opinion i is a martingale, and the fraction q{sub i} of opinion i will gradually converge to (q{sub i}). The tendency can slow down with the increase of degree assortativity of networks. When u is degree dependent, (q{sub i}) does not possess the martingale property, however q{sub i} still converges to it. In both cases for a finite network the states of all agents will finally reach consensus. Further if there exist stubborn persons in the population whose opinions do not change over time, it was found that for degree-independent constant u, both q{sub i} and (q{sub i}) will converge to fixed proportions which only depend on the distribution of initial obstinate persons, and naturally the final equilibrium state will be the coexistence of diverse opinions held by the stubborn people. The analytical results were verified by numerical simulations on Barabasi-Albert (BA) networks. The model highlights the influence of high-degree agents on the final consensus or coexistence state and captures some realistic features of the diffusion of opinions in social networks.

  16. Swedish Opinion on Nuclear Power 1986 - 2011

    Energy Technology Data Exchange (ETDEWEB)

    Holmberg, Soeren

    2012-11-01

    This report contains the Swedish opinion on Nuclear Power and European Attitudes on Nuclear Power. It also includes European Attitudes Towards the Future of Three Energy Sources; Nuclear Energy, Wind Power and Solar Power - with a focus on the Swedish opinion. Results from measurements done by the SOM Inst. are presented.

  17. French and european opinions about energy questions

    International Nuclear Information System (INIS)

    1992-03-01

    This paper presents a statistical study of french and european opinions in 1989 about energy questions. The main subjects studied are: qualities of different energy sources (coal, petroleum, natural gas, nuclear energy, renewable energies); perception in public opinion of nuclear industry; energy and environmental effects. 6 figs., 1 tab., 4 appendices

  18. Internet Censorship in Turkey: University Students' Opinions

    Science.gov (United States)

    Ozkan, Hasan; Arikan, Arda

    2009-01-01

    The aim of this paper is to study university students' opinions toward online censorship with references to their socio-political and economic variables. Considering the upwards trend and the increasing number of online restrictions in Turkey, the opinions of university students (n=138) are thought to give significant findings. The questionnaire…

  19. Information Filtering Based on Users' Negative Opinions

    Science.gov (United States)

    Guo, Qiang; Li, Yang; Liu, Jian-Guo

    2013-05-01

    The process of heat conduction (HC) has recently found application in the information filtering [Zhang et al., Phys. Rev. Lett.99, 154301 (2007)], which is of high diversity but low accuracy. The classical HC model predicts users' potential interested objects based on their interesting objects regardless to the negative opinions. In terms of the users' rating scores, we present an improved user-based HC (UHC) information model by taking into account users' positive and negative opinions. Firstly, the objects rated by users are divided into positive and negative categories, then the predicted interesting and dislike object lists are generated by the UHC model. Finally, the recommendation lists are constructed by filtering out the dislike objects from the interesting lists. By implementing the new model based on nine similarity measures, the experimental results for MovieLens and Netflix datasets show that the new model considering negative opinions could greatly enhance the accuracy, measured by the average ranking score, from 0.049 to 0.036 for Netflix and from 0.1025 to 0.0570 for Movielens dataset, reduced by 26.53% and 44.39%, respectively. Since users prefer to give positive ratings rather than negative ones, the negative opinions contain much more information than the positive ones, the negative opinions, therefore, are very important for understanding users' online collective behaviors and improving the performance of HC model.

  20. Who Is the Preferred Tutor in Clinical Skills Training: Physicians, Nurses, or Peers?

    Science.gov (United States)

    Abay, Ece Şükriye; Turan, Sevgi; Odabaşı, Orhan; Elçin, Melih

    2017-01-01

    Phenomenon: Clinical skills centers allow structured training of undergraduate medical students for the acquisition of clinical skills in a simulated environment. Physician, nurse, or peer tutors are employed for training in those centers. All tutors should have appropriate training about the methodology used in the clinical skills training. Many of the studies revealed the effectiveness of various types of tutors. The aim of our study was to evaluate medical students' satisfaction with clinical skills training, and their opinions about the differences in coaching skills among the physician, nurse, and peer tutors. This study was conducted with third-year students (467 students) in 2013-2014 academic year at Hacettepe University Faculty of Medicine. Participation rate was 85 % (397 students). The students attended the suturing skill training in groups of 40 students. First, a faculty member from the Department of Medical Education delivered a video demonstration and conducted discussion. After the demonstration, the students were divided into groups of 5-6 students. A physician, nurse, or a peer tutor facilitated each group. The students were asked to complete the Coaching Skills Evaluation Form after the practicum session. It contained 13 criteria for assessing the coaching skills. Additionally, the form included a question for rating the student's satisfaction with the tutor. The performance of the tutors at each step was rated on a three-point scale. Kruskal Wallis analysis was used to compare students' scores for their tutors. The students' satisfaction with tutors was high for all of the tutors. However, there was no difference between students' scores in suturing skill, and between physician, nurse, and peer tutors' coaching skills. Insights: In this study, we revealed that physician, nurse, and peer tutors were equally effective on the students' performances. They were also regarded as effective in their teaching role by students. But the most important

  1. Family physician perceptions of working with LGBTQ patients: physician training needs.

    Science.gov (United States)

    Beagan, Brenda; Fredericks, Erin; Bryson, Mary

    2015-01-01

    Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

  2. Family physician perceptions of working with LGBTQ patients: physician training needs

    Directory of Open Access Journals (Sweden)

    Brenda Beagan

    2015-04-01

    Full Text Available Background: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ. Understanding physician perceptions of this area of practice may aid in developing improved education. Method: In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Results: Three major themes emerged: 1 Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2 Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3 Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Conclusions: Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

  3. A Survey of Key Technology of Network Public Opinion Analysis

    Directory of Open Access Journals (Sweden)

    Li Su Ying

    2016-01-01

    Full Text Available The internet has become an important base for internet users to make comments because of its interactivity and fast dissemination. The outbreak of internet public opinion has become a major risk for network information security. Domestic and foreign researchers had carried out extensive and in-depth study on public opinion. Fruitful results have achieved in the basic theory research and emergency handling and other aspects of public opinion. But research on the public opinion in China is still in the initial stage, the key technology of the public opinion analysis is still as a starting point for in-depth study and discussion.

  4. Multi-lingual Opinion Mining on YouTube

    NARCIS (Netherlands)

    Severyn, Aliaksei; Moschitti, Alessandro; Uryupina, Olga; Plank, Barbara; Filippova, Katja

    In order to successfully apply opinion mining (OM) to the large amounts of user-generated content produced every day, we need robust models that can handle the noisy input well yet can easily be adapted to a new domain or language. We here focus on opinion mining for YouTube by (i) modeling

  5. Exploring participatory behaviour of disability benefit claimants from an insurance physician's perspective.

    Science.gov (United States)

    Sjobbema, Christiaan; van der Mei, Sijrike; Cornelius, Bert; van der Klink, Jac; Brouwer, Sandra

    2018-08-01

    In the Dutch social security system, insurance physicians (IPs) assess participatory behaviour as part of the overall disability claim assessment. This study aims to explore the views and opinions of IPs regarding participatory behaviour as well as factors related to inadequate participatory behaviour, and to incorporate these factors in the International Classification of Functioning, Disability and Health (ICF) biopsychosocial framework. This qualitative study collected data by means of open-ended questions in 10 meetings of local peer review groups (PRGs) which included a total of 78 IPs of the Dutch Social Security Institute. In addition, a concluding discussion meeting with 8 IPs was organized. After qualitative data analyses, four major themes emerged: (1) participation as an outcome, (2) efforts of disability benefit claimants in the process of participatory behaviour, (3) beliefs of disability benefit claimants concerning participation, and (4) recovery behaviour. Identified factors of inadequate participatory behaviour covered all ICF domains, including activities, environmental, and personal factors, next to factors related to health condition and body functions or structures. Outcomes of the discussion meeting indicated the impossibility of formulating general applicable criteria for quantifying and qualifying participatory behaviour. Views of IPs on disability benefit claimants' (in)adequate participatory behaviour reflect a broad biopsychosocial perspective. IPs adopt a nuanced tailor-made approach during assessment of individual disability benefit claimants' participatory behaviour and related expected activities aimed at recovery of health and RTW. Implications for Rehabilitation Within a biopsychosocial perspective, it is not possible to formulate general criteria for the assessment of participatory behaviour for each unique case. Individual disability benefit claimant characteristics and circumstances are taken into account. To optimize the return

  6. The spreading of opposite opinions on online social networks with authoritative nodes

    Science.gov (United States)

    Yan, Shu; Tang, Shaoting; Pei, Sen; Jiang, Shijin; Zhang, Xiao; Ding, Wenrui; Zheng, Zhiming

    2013-09-01

    The study of opinion dynamics, such as spreading and controlling of rumors, has become an important issue on social networks. Numerous models have been devised to describe this process, including epidemic models and spin models, which mainly focus on how opinions spread and interact with each other, respectively. In this paper, we propose a model that combines the spreading stage and the interaction stage for opinions to illustrate the process of dispelling a rumor. Moreover, we set up authoritative nodes, which disseminate positive opinion to counterbalance the negative opinion prevailing on online social networking sites. With analysis of the relationship among positive opinion proportion, opinion strength and the density of authoritative nodes in networks with different topologies, we demonstrate that the positive opinion proportion grows with the density of authoritative nodes until the positive opinion prevails in the entire network. In particular, the relationship is linear in homogeneous topologies. Besides, it is also noteworthy that initial locations of the negative opinion source and authoritative nodes do not influence positive opinion proportion in homogeneous networks but have a significant impact on heterogeneous networks. The results are verified by numerical simulations and are helpful to understand the mechanism of two different opinions interacting with each other on online social networking sites.

  7. Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians.

    Science.gov (United States)

    Eyal, Nir; Cancedda, Corrado; Kyamanywa, Patrick; Hurst, Samia A

    2015-12-30

    Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary - for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system. © 2016 by Kerman University of Medical Sciences.

  8. Same-sex marriage and other moral taboos : cultural acceptances, change in American public opinion and the evidence from the opinion polls

    OpenAIRE

    MORINI, Marco

    2017-01-01

    Published online: 25 January 2017 Creative Commons Licence This article analyzes the evolution of gay and lesbian rights and same-sex marriage in American public opinion. It describes how Obergefell v. Hodges, state-level decisions and the public opinion trends can be considered as the outcome of a grassroots coordinated campaign which began more than a decade ago and was able to conquer the majority of Americans. It also focuses on the American public opinion trends related to moral is...

  9. Attitudes toward clinical autopsy in unexpected patient deaths in Japan: a nation-wide survey of the general public and physicians.

    Science.gov (United States)

    Kamishiraki, Etsuko; Maeda, Shoichi; Starkey, Jay; Ikeda, Noriaki

    2012-12-01

    Autopsy is a useful tool for understanding the cause and manner of unexpected patient death. However, the attitudes of the general public and physicians in Japan about clinical autopsy are limited. To describe the beliefs of the general public about whether autopsy should be performed and ascertain if they would actually request one given specific clinical situations where patient death occurred with the additional variable of medical error. To compare these attitudes with previously obtained attitudes of physicians practising at Japanese teaching hospitals. We conducted a cross-sectional study of the general public. We sent standardised questionnaires in 2010 to a randomly selected non-physician adult population using a survey company for participant selection. Respondents gave their opinions about the necessity of autopsy and how they might act given various clinical scenarios of patient death. We compared these results with those of a previous survey of Japanese physicians conducted in 2009. Of the 2300 eligible general adult population, 1575 (68.5%) responded. The majority of the general public indicated they believed an autopsy was necessary. However, in cases of unclear medical error or unclear cause and effect relationship of medical care and patient death, the general public were much less likely to indicate they would actually request an autopsy than were physicians (pcase of error related to death is underway. The results from this study will be important in informing related decisions.

  10. 20 CFR 416.927 - Evaluating opinion evidence.

    Science.gov (United States)

    2010-04-01

    ... the record as a whole, the more weight we will give to that opinion. (5) Specialization. We generally... “disabled” or “unable to work” does not mean that we will determine that you are disabled. (2) Other... opinions from treating sources, nontreating sources, and other nonexamining sources who do not work for us...

  11. Modeling and Simulation of Polarization in Internet Group Opinions Based on Cellular Automata

    Directory of Open Access Journals (Sweden)

    Yaofeng Zhang

    2015-01-01

    Full Text Available Hot events on Internet always attract many people who usually form one or several opinion camps through discussion. For the problem of polarization in Internet group opinions, we propose a new model based on Cellular Automata by considering neighbors, opinion leaders, and external influences. Simulation results show the following: (1 It is easy to form the polarization for both continuous opinions and discrete opinions when we only consider neighbors influence, and continuous opinions are more effective in speeding the polarization of group. (2 Coevolution mechanism takes more time to make the system stable, and the global coupling mechanism leads the system to consensus. (3 Opinion leaders play an important role in the development of consensus in Internet group opinions. However, both taking the opinion leaders as zealots and taking some randomly selected individuals as zealots are not conductive to the consensus. (4 Double opinion leaders with consistent opinions will accelerate the formation of group consensus, but the opposite opinions will lead to group polarization. (5 Only small external influences can change the evolutionary direction of Internet group opinions.

  12. Associations Between Physician Empathy, Physician Characteristics, and Standardized Measures of Patient Experience.

    Science.gov (United States)

    Chaitoff, Alexander; Sun, Bob; Windover, Amy; Bokar, Daniel; Featherall, Joseph; Rothberg, Michael B; Misra-Hebert, Anita D

    2017-10-01

    To identify correlates of physician empathy and determine whether physician empathy is related to standardized measures of patient experience. Demographic, professional, and empathy data were collected during 2013-2015 from Cleveland Clinic Health System physicians prior to participation in mandatory communication skills training. Empathy was assessed using the Jefferson Scale of Empathy. Data were also collected for seven measures (six provider communication items and overall provider rating) from the visit-specific and 12-month Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) surveys. Associations between empathy and provider characteristics were assessed by linear regression, ANOVA, or a nonparametric equivalent. Significant predictors were included in a multivariable linear regression model. Correlations between empathy and CG-CAHPS scores were assessed using Spearman rank correlation coefficients. In bivariable analysis (n = 847 physicians), female sex (P empathy scores. In multivariable analysis, female sex (P empathy scores. Of the seven CG-CAHPS measures, scores on five for the 583 physicians with visit-specific data and on three for the 277 physicians with 12-month data were positively correlated with empathy. Specialty and sex were independently associated with physician empathy. Empathy was correlated with higher scores on multiple CG-CAHPS items, suggesting improving physician empathy might play a role in improving patient experience.

  13. [Attitudes of polish physicians towards extending competencies of nurses and midwives with respect to prescribing medicines].

    Science.gov (United States)

    Mazur, Nicole; Zarzeka, Aleksander; Dąbrowski, Filip; Panczyk, Mariusz; Gałązkowski, Robert; Gotlib, Joanna

    2017-01-01

    Due to the amendment of the Nurse and Midwife professions Act, since 1st of January 2016 Polish nurses and midwives with certain qualifications are able to prescribe medicines and referral for diagnostic tests. To analyse attitudes of physicians on new professional competencies of nurses and midwives regarding: prescribing medicines and referring patients for certain diagnostic tests. In the study took part 436 physicians (245 women, 193 man). The average age was 36,6 years old (min.: 21; max.: 76; SD: 11,65; median: 31). 274 people lived in a city with over 500 thousand citizens, 70 people - city below 100 thousand citizens, 54 people - city between 100-500 thousands citizens and 14 people lived in a country. Most of people lived in masovian district. Authors prepared and validated own questionnaire, which contained statements assessed in Likert scale (1-strongly disagree, 5-stronlgy agree). It contained 22 questions about opinions of new abilities of nurses and midwives. The questionnaire was sent three times to Regional Medical Chamber in Warsaw via an online questionnaire: https://docs.google.com/forms/d/1cxiaJFPxDVphByhBTk4gDIBsm6bQsxGLVXDK-RtpGnk/ The reliability of the questionnaire used was tested in a pilot study by the coefficient α-Cronbach, which amounted to 0.937. Due to the fact that the study was performed in a group of doctors they did not require the consent of the Bioethics Committee, of Medical University of Warsaw to carry them out. The results are presented using descriptive statistics, which were obtained through statistical analysis using Microsoft Excel and StatSoft Statistica 12.0 (license Medical University of Warsaw). 53% of doctors claim that the new powers do not improve patient care. 35% of respondents disagreed with the opinion that the new powers will raise the prestige of professional nurses and midwives. At the same time 49% believe that prescriptions for nurses and midwives reduce the responsibilities of doctors. Only 9% agreed

  14. What is competent communication behaviour of patients in physician consultations? - Chronically-ill patients answer in focus groups.

    Science.gov (United States)

    Schmidt, Erika; Schöpf, Andrea C; Farin, Erik

    2017-09-01

    Many desirable outcomes depend on good patient-physician communication. Patient-based perspectives of what constitutes competent communication behavior with physicians are needed for patient-oriented health care. Therefore it was our main aim to identify competent patient communication skills from the patient's perspective. We also wanted to reveal any differences in opinion among various groups (chronic ischemic heart disease, chronic low back pain, breast cancer). This study examined nine guideline-supported focus groups in rehabilitation centers. The criterion for study inclusion was any one of the three diagnoses. Enrolled in the study were N = 49 patients (32 women) aged M = 60.1 (SD = 12.8). The interview recordings were transcribed and subjected to content analysis. We documented 396 commentaries in these interviews that were allocated to 82 different codes; these in turn resulted in the formation of 12 main topics. Examples are: posing questions, being an active and participatory patient, being aware of emotions and communicating them. This study represents stage two ('documentation of patient and clinician views') in the seven-stage model of communication research. Findings reveal that chronically-ill patients name behaviours that contribute to successful discussion with a physician. These enable us to develop communication trainings and design-measuring tools used for patient-based communication skills.

  15. Demographic and Social Factors Influencing Public Opinion on ...

    African Journals Online (AJOL)

    macuser

    the pressing need for empirical research into these opinions, to inform and make .... understanding public opinion on the issue of prostitution has critical relevance. For ..... prostitution and presented three options for legal reform in South Africa: ...

  16. PageRank model of opinion formation on Ulam networks

    Science.gov (United States)

    Chakhmakhchyan, L.; Shepelyansky, D.

    2013-12-01

    We consider a PageRank model of opinion formation on Ulam networks, generated by the intermittency map and the typical Chirikov map. The Ulam networks generated by these maps have certain similarities with such scale-free networks as the World Wide Web (WWW), showing an algebraic decay of the PageRank probability. We find that the opinion formation process on Ulam networks has certain similarities but also distinct features comparing to the WWW. We attribute these distinctions to internal differences in network structure of the Ulam and WWW networks. We also analyze the process of opinion formation in the frame of generalized Sznajd model which protects opinion of small communities.

  17. Cross-correlation patterns in social opinion formation with sequential data

    Science.gov (United States)

    Chakrabarti, Anindya S.

    2016-11-01

    Recent research on large-scale internet data suggests existence of patterns in the collective behavior of billions of people even though each of them may pursue own activities. In this paper, we interpret online rating activity as a process of forming social opinion about individual items, where people sequentially choose a rating based on the current information set comprising all previous ratings and own preferences. We construct an opinion index from the sequence of ratings and we show that (1) movie-specific opinion converges much slower than an independent and identically distributed (i.i.d.) sequence of ratings, (2) rating sequence for individual movies shows lesser variation compared to an i.i.d. sequence of ratings, (3) the probability density function of the asymptotic opinions has more spread than that defined over opinion arising from i.i.d. sequence of ratings, (4) opinion sequences across movies are correlated with significantly higher and lower correlation compared to opinion constructed from i.i.d. sequence of ratings, creating a bimodal cross-correlation structure. By decomposing the temporal correlation structures from panel data of movie ratings, we show that the social effects are very prominent whereas group effects cannot be differentiated from those of surrogate data and individual effects are quite small. The former explains a large part of extreme positive or negative correlations between sequences of opinions. In general, this method can be applied to any rating data to extract social or group-specific effects in correlation structures. We conclude that in this particular case, social effects are important in opinion formation process.

  18. Opinion of women about elective abortion

    OpenAIRE

    ?akmak, B?lent; Metin, Fulya Zeynep; ?zsoy, Asker Zeki; ??t?l, R?za; ?nder, Yal??n; Y?lmaz Do?ru, Hatice

    2014-01-01

    Objective: The aim of this study was to investigate the opinions of women who presented to the hospital for elective abortion. Materials and Methods: This descriptive study was designed and conducted at our university hospital between March 2013-April 2013 by the method of face-to-face interviews with 500 women who presented to the hospital as patient or relatives of patients. Poll consisted of 6 questions about demographic characteristics and 14 questions evaluating the opinions and attitude...

  19. Modeling opinion dynamics: Theoretical analysis and continuous approximation

    International Nuclear Information System (INIS)

    Pinasco, Juan Pablo; Semeshenko, Viktoriya; Balenzuela, Pablo

    2017-01-01

    Highlights: • We study a simple model of persuasion dynamics with long range pairwise interactions. • The continuous limit of the master equation is a nonlinear, nonlocal, first order partial differential equation. • We compute the analytical solutions to this equation, and compare them with the simulations of the dynamics. - Abstract: Frequently we revise our first opinions after talking over with other individuals because we get convinced. Argumentation is a verbal and social process aimed at convincing. It includes conversation and persuasion and the agreement is reached because the new arguments are incorporated. Given the wide range of opinion formation mathematical approaches, there are however no models of opinion dynamics with nonlocal pair interactions analytically solvable. In this paper we present a novel analytical framework developed to solve the master equations with non-local kernels. For this we used a simple model of opinion formation where individuals tend to get more similar after each interactions, no matter their opinion differences, giving rise to nonlinear differential master equation with non-local terms. Simulation results show an excellent agreement with results obtained by the theoretical estimation.

  20. 20 CFR 404.1527 - Evaluating opinion evidence.

    Science.gov (United States)

    2010-04-01

    ... weight we will give to that opinion. (5) Specialization. We generally give more weight to the opinion of... statement that you are disabled. A statement by a medical source that you are “disabled” or “unable to work... other nonexamining sources who do not work for us. (iii) Administrative law judges may also ask for and...

  1. Job satisfaction among obstetrician-gynecologists: a comparison between private practice physicians and academic physicians.

    Science.gov (United States)

    Bell, Darrel J; Bringman, Jay; Bush, Andrew; Phillips, Owen P

    2006-11-01

    Physician job satisfaction has been the subject of much research. However, no studies have been conducted comparing academic and private practice physician satisfaction in obstetrics and gynecology. This study was undertaken to measure satisfaction levels for academic and private practice obstetrician-gynecologists and compare different aspects of their practice that contributed to their satisfaction. A survey was mailed to randomly selected obstetrician-gynecologists in Memphis, TN; Birmingham, AL; Little Rock, AR; and Jackson, MS. Physicians were asked to respond to questions concerning demographics and career satisfaction. They were also asked to assess the contribution of 13 different aspects of their practice in contributing to their job selection and satisfaction using a Likert scale. A score of 1 meant the physician completely disagreed with a statement regarding a factor's contribution or was completely dissatisfied; a score of 5 meant the physician completely agreed with a factor's contribution or was completely satisfied. Simple descriptive statistics, as well as the 2-sample t test, were used. Likert scale values were assumed to be interval measurements. Of the 297 questionnaires mailed, 129 (43%) physicians responded. Ninety-five (74%) respondents rated their overall satisfaction as 4 or 5. No significant difference was found between academic and private physicians when comparing overall job satisfaction (P = .25). When compared to private practice physicians, the aspects most likely contributing to overall job satisfaction for academic physicians were the ability to teach, conduct research, and practice variety (P = .0001, P = .0001, and P = .007, respectively). When compared with academic physicians, the aspects most likely contributing to job satisfaction for private practice physicians were autonomy, physician-patient relationship, and insurance reimbursement (P = .0058, P = .0001, and P = .0098, respectively). When choosing a practice setting

  2. [Minors visits (ages 14-18) at primary clinics without an accompanying guardian: attitudes of primary care physicians of Clalit Health Services - South District].

    Science.gov (United States)

    Hildesheimer, Efrat; Orkin, Jacob; Biderman, Aya

    2010-04-01

    According to Israeli law, for a minor to receive medical treatment, the physician is obligated to obtain informed consent from the minor's parents. In practice, minors under the age of 18 often attend the clinics on their own. In past years, only a few attempts have been made to revise the law, however, none were implemented. To evaluate the attitudes and knowledge of physicians in primary care clinics regarding the legal aspects of minors' visits at the clinics, relating to how widespread is the phenomena, the influencing factors, the physician's opinion and approach. A descriptive study based on self-administered questionnaires that were distributed by post during 2005, to primary care physicians belonging to Clalit Health Services, south district. The questionnaires included demographic details, attitudes and knowledge of minors' visits. Analysis of 103 questionnaires found that minors attending clinics without their parent is a common phenomenon. The reasons noted were: acquaintance with the parents, and that their children are "mature enough". The physician's knowledge about the Israeli law on the subject was found to be deficient: 56% answered incorrectly to questions on which the law is very clear, and in most of the other questions many claimed they did not know the correct answer. Many of the physicians think that minors should not visit the clinic by themselves; only 6% attended an educational program related to this matter. The subject of minors attending clinics without an accompanying parent warrants discussion, and clear and updated legislation. In addition, as stems from the study, there is a need to update physicians regarding this issue.

  3. Understanding public opinion regarding transit in southeast Michigan.

    Science.gov (United States)

    2015-04-01

    This report presents findings from a study on public opinion regarding transit in Southeast Michigan. The overall goals of this : study were to assess the nature of public opinion regarding regional transit and to understand its relation to socio-dem...

  4. An evidential opinion dynamics model based on heterogeneous social influential power

    International Nuclear Information System (INIS)

    Lu, Xi; Mo, Hongming; Deng, Yong

    2015-01-01

    Highlights: •We use Dempster–Shafer evidence theory to handle the uncertainty of the communication. •An ice-breaking uncertainty elimination process in opinion evolution is demonstrated. •The influential power of individuals and the feedback mechanism are considered. •The power-law characteristic of the final influential power distribution is depicted. -- Abstract: This paper introduces an evidential opinion dynamics model combing Dempster–Shafer evidence theory to explore the opinion evolution. Our model is an improvement of the Continuous Opinions and Discrete Actions (CODA) model. The process of people updating their opinions is regarded as a decision making process. The unavoidable uncertainty of the opinion evolution is handled by Dempster–Shafer evidence theory. Thereby, a new opinion group, i.e.the neutrals, is introduced into the system. Simulations show the neutral group plays a significant part in the opinion evolution. An opinion ice-breaking process at the early stage of the opinion evolution is observed. It is found that the consensus is not always reached then clusters emerge instead, which depends on the proportions of supporters, neutrals and opponents. The individual’s influential power is taken into account. With the positive feedback mechanism of people’s influential power, the obtained results are in accordance with people’s daily cognition such as the Authority Effect and the Matthew Effect. The final influential power distribution of all individuals in our model presents power-law characteristic

  5. [Sexuality in the elderly: The role of the physicians in maintaining sexual health of older men].

    Science.gov (United States)

    Chakkalakal, D; Weißbach, L

    2015-12-01

    Sexuality in the elderly is still a social taboo. A commitment by medical practices to address the topic of sexuality in later life is essential, given that the sexual health is part of the quality of life. Identification of barriers and discourse of effects in the physician's behavior when dealing with the sexuality of older people. Review and discussion of interdisciplinary literature and social discourse. Compilation of expert opinions. Although the introduction of phosphodiesterase 5 inhibitors led to a removal of taboos concerning erectile dysfunction, the sexuality of older men became narrowed to physiological aspects. The elderly still complain that consultations concerning their sexuality receives too little attention in medical practice. Problems are boundaries of shame and disregard of the sexuality of elderly. Sexuality in old age will have to become more prominent in medical practices, due to demographic changes and changing self-images of the elderly. The social role of physicians enables straightforward discussions about sexuality. Taking a sexual history and choosing an active approach proved to be practicable to discuss sexual problems with older people.

  6. Regional consensus opinion for the management of Beta thalassemia major in the Arabian Gulf area

    Science.gov (United States)

    2013-01-01

    Thalassemia syndrome has diverse clinical presentations and a global spread that has far exceeded the classical Mediterranean basin where the mutations arose. The mutations that give rise to either alpha or beta thalassemia are numerous, resulting in a wide spectrum of clinical severity ranging from carrier state to life-threatening, inherited hemolytic anemia that requires regular blood transfusion. Beta thalassemia major constitutes a remarkable challenge to health care providers. The complications arising due to the anemia, transfusional iron overload, as well as other therapy-related complications add to the complexity of this condition. To produce this consensus opinion manuscript, a PubMed search was performed to gather evidence-based original articles, review articles, as well as published work reflecting the experience of physicians and scientists in the Arabian Gulf region in an effort to standardize the management protocol. PMID:24044606

  7. Physician-patient communication in HIV disease: the importance of patient, physician, and visit characteristics.

    Science.gov (United States)

    Wilson, I B; Kaplan, S

    2000-12-15

    Although previous work that considered a variety of chronic conditions has shown that higher quality physician-patient communication care is related to better health outcomes, the quality of physician-patient communication itself for patients with HIV disease has not been well studied. To determine the relationship of patient, visit, physician, and physician practice characteristics to two measures of physician-patient communication for patients with HIV disease. Cross-sectional survey of physicians and patients. Cohort study enrolling patients from throughout eastern Massachusetts. 264 patients with HIV disease and their their primary HIV physicians (n = 69). Two measures of physician-patient communication were used, a five-item general communication measure (Cronbach's alpha = 0.93), and a four-item HIV-specific communication measure that included items about alcohol, drug use, and sexual behaviors (Cronbach's alpha = 0.92). The mean age of patients was 39. 5 years, 24% patients were women, 31.1% were nonwhite, and 52% indicated same-sex contact as their principal HIV risk factor. The mean age of physicians was 39.1 years, 33.3% were female, 39.7% were specialists, and 25.0% self-identified as gay, lesbian, or bisexual. In multivariable models relating patient and visit characteristics to general communication, longer reported visit length (pbetter communication. The interaction of patient gender and visit length was also significant (p =.02); longer visit length was more strongly associated with better general communication for male than female patients. In similar models relating patient and visit characteristics to HIV-specific communication, longer visit length (p better communication. In multivariable models relating physician and practice characteristics to general communication no variables were significant. However, both female physician gender (p =.002) and gay/lesbian/bisexual sexual preference (p =.003) were significantly associated with better HIV

  8. Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians

    Directory of Open Access Journals (Sweden)

    Nir Eyal

    2016-03-01

    Full Text Available Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs, resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.

  9. Do gender and personality traits (BFI-10) influence self-perceived opinion leadership?

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2016-01-01

    . This approach would require to identify opinion leaders. This paper investigates whether gender and personality traits can predict opinion leadership. Methodology/methods: The paper can be perceived as a replication in a loose sense of the term, since it replicates only a part of a previously published model...... and in one's own opinion (two variables). Generalized linear models (GLM) and Pearson product-moment correlation coefficient are used to analyze data. Scientific aim: The aim of the paper is to estimate impact of gender and personality traits on opinion leadership. Findings: Extraversion is the personality...... trait closest related to opinion leadership regardless whether it is self-perceived in the eyes of others or in one's own opinion. Opinion leadership in one's own opinion can be predicted even using neuroticism, and conscientiousness. The three traits are consistent with previous findings. Unlike...

  10. Expert opinion

    DEFF Research Database (Denmark)

    Ferrer, Marta; Boccon-Gibod, Isabelle; Gonçalo, Margarida

    2017-01-01

    Omalizumab (a recombinant, humanized anti-immunoglobulin-E antibody) has been shown in three pivotal Phase III trials (ASTERIA I, II and GLACIAL) and real-world studies to be effective and well-tolerated for the treatment of chronic spontaneous urticaria (CSU), and is the only licensed third......-line treatment for CSU. However, the definition of response to omalizumab treatment often differs between clinical trials, real-world studies, and daily practice of individual physicians globally. As such, a consensus definition of "complete", "partial" and "non-response" to omalizumab is required in order...... into a patient's disease burden and its changes during treatment. A potential omalizumab treatment approach based on speed and pattern of response at 1-3 and 3-6 months is suggested. In cases where there is no response during the first 1-3 months, physicians should consider reassessing the original CSU diagnosis...

  11. Burnout among physicians

    OpenAIRE

    Romani, Maya; Ashkar, Khalil

    2014-01-01

    Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work; it includes emotional exhaustion, depersonalization, and low personal accomplishment. Burnout among physicians has garnered significant attention because of the negative impact it renders on patient care and medical personnel. Physicians who had high burnout levels reportedly committed more medical errors. Stress management programs that range from relaxation to ...

  12. Does the weather influence public opinion about climate change?

    Science.gov (United States)

    Donner, S. D.; McDaniel, J.

    2010-12-01

    Public opinion in North America about the science of anthropogenic climate change and the motivation for policy action has been variable over the past twenty years. The trends in public opinion over time have been attributed the general lack of pressing public concern about climate change to a range of political, economic and psychological factors. One driving force behind the variability in polling data from year to year may be the weather itself. The difference between what we “expect” - the climate - and what we “get” - the weather - can be a major source of confusion and obfuscation in the public discourse about climate change. For example, reaction to moderate global temperatures in 2007 and 2008 may have helped prompt the spread of a “global cooling” meme in the public and the news media. At the same time, a decrease in the belief in the science of climate change and the need for action has been noted in opinion polls. This study analyzes the relationship between public opinion about climate change and the weather in the U.S. since the mid-1980s using historical polling data from several major organizations (e.g. Gallup, Pew, Harris Interactive, ABC News), historical monthly air temperature (NCDC) and a survey of opinion articles from major U.S. newspapers (Washington Post, New York Times, Wall Street Journal, Houston Chronicle, USA Today). Seasonal and annual monthly temperature anomalies for the northeastern U.S and the continental U.S are compared with available national opinion data for three general categories of questions: i) Is the climate warming?, ii) Is the observed warming due to human activity?, and iii) Are you concerned about climate change? The variability in temperature and public opinion over time is also compared with the variability in the fraction of opinion articles in the newspapers (n ~ 7000) which express general agreement or disagreement with IPCC Summary for Policymakers consensus statements on climate change (“most of

  13. Effectiveness of a Unique Support Group for Physicians in a Physician Health Program.

    Science.gov (United States)

    Sanchez, Luis T; Candilis, Philip J; Arnstein, Fredrick; Eaton, Judith; Barnes Blood, Diana; Chinman, Gary A; Bresnahan, Linda R

    2016-01-01

    State Physician Health Programs (PHPs) assess, support, and monitor physicians with mental, behavioral, medical, and substance abuse problems. Since their formation in the 1970s, PHPs have offered support groups following the 12-step model for recovery from substance use disorders (SUDs). However, few programs have developed support groups for physicians without SUDs. This study at the Massachusetts PHP (Physician Health Services Inc.) represents the first effort to survey physician attitudes concerning a unique support group that goes beyond classic addiction models. The group was initiated because of the observation that physicians with problems other than SUDs did not fit easily into the 12-step framework. It was hypothesized that such a group would be effective in helping participants control workplace stress, improve professional and personal relationships, and manage medical and psychiatric difficulties. With a response rate of 43% (85 respondents), the survey identified a strong overall impact of the Physician Health Services Inc. support group, identifying positive effects in all areas of personal and professional life: family and friends, wellness, professional relationships, and career. Respondents identified the role of the facilitator as particularly important, underscoring the facilitator's capacity to welcome participants, manage interactions, set limits, and maintain a supportive emotional tone. The implications for physician health extend from supporting a broader application of this model to using a skilled facilitator to manage groups intended to reduce the stress and burnout of present-day medical practice. The results encourage PHPs, hospitals, medical practices, and physician groups to consider implementing facilitated support groups as an additional tool for maintaining physician health.

  14. Peer-to-peer and mass communication effect on opinion shifts

    Science.gov (United States)

    Kindler, A.; Solomon, S.; Stauffer, D.

    2013-02-01

    Opinion dynamics is studied through a minimal Ising model with three main influences (fields): personal conservatism (power-law distributed), inter-personal and group pressure, and a global field incorporating peer-to-peer and mass communications, which is generated bottom-up from the faction supporting the new opinion. A rich phase diagram appears separating possible terminal stages of the opinion diffusion, characterizing failure phases by the features of the individuals who had changed their opinion. An exhaustive solution of the model is produced, allowing predictions to be made on the opinion’s assimilation in the society.

  15. Physician wages across specialties: informing the physician reimbursement debate.

    Science.gov (United States)

    Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

    2010-10-25

    Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

  16. Opinion formation driven by PageRank node influence on directed networks

    Science.gov (United States)

    Eom, Young-Ho; Shepelyansky, Dima L.

    2015-10-01

    We study a two states opinion formation model driven by PageRank node influence and report an extensive numerical study on how PageRank affects collective opinion formations in large-scale empirical directed networks. In our model the opinion of a node can be updated by the sum of its neighbor nodes' opinions weighted by the node influence of the neighbor nodes at each step. We consider PageRank probability and its sublinear power as node influence measures and investigate evolution of opinion under various conditions. First, we observe that all networks reach steady state opinion after a certain relaxation time. This time scale is decreasing with the heterogeneity of node influence in the networks. Second, we find that our model shows consensus and non-consensus behavior in steady state depending on types of networks: Web graph, citation network of physics articles, and LiveJournal social network show non-consensus behavior while Wikipedia article network shows consensus behavior. Third, we find that a more heterogeneous influence distribution leads to a more uniform opinion state in the cases of Web graph, Wikipedia, and Livejournal. However, the opposite behavior is observed in the citation network. Finally we identify that a small number of influential nodes can impose their own opinion on significant fraction of other nodes in all considered networks. Our study shows that the effects of heterogeneity of node influence on opinion formation can be significant and suggests further investigations on the interplay between node influence and collective opinion in networks.

  17. Conscientious objection, barriers, and abortion in the case of rape: a study among physicians in Brazil.

    Science.gov (United States)

    Diniz, Debora; Madeiro, Alberto; Rosas, Cristião

    2014-05-01

    In Brazil, to have a legal abortion in the case of rape, the woman's statement that rape has occurred is considered sufficient to guarantee the right to abortion. The aim of this study was to understand the practice and opinions about providing abortion in the case of rape among obstetricians-gynecologists (OBGYNs) in Brazil. A mixed-method study was conducted from April to July 2012 with 1,690 OBGYNs who responded to a structured, electronic, self-completed questionnaire. In the quantitative phase, 81.6% of the physicians required police reports or judicial authorization to guarantee the care requested. In-depth telephone interviews with 50 of these physicians showed that they frequently tested women's rape claim by making them repeat their story to several health professionals; 43.5% of these claimed conscientious objection when they were uncertain whether the woman was telling the truth. The moral environment of illegal abortion alters the purpose of listening to a patient - from providing care to passing judgement on her. The data suggest that women's access to legal abortion is being blocked by these barriers in spite of the law. We recommend that FEBRASGO and the Ministry of Health work together to clarify to physicians that a woman's statement that rape occurred should allow her to access a legal abortion. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  18. Public opinion and nuclear power decision-making

    International Nuclear Information System (INIS)

    Benson, B.

    1991-01-01

    This document discusses public opinion regarding nuclear power which is particularly difficult to tie down because of five important paradoxes that characterize it: it can be based on sound reason, but also on intense emotion; it is both national and local in perspective; at varying times it has seen nuclear power as both ''clean'' and ''dirty''; it believes nuclear power is both economic, and uneconomic; and nuclear power is perceived as having a fairly safe record, but being potentially unsafe. Equally as complex as the process by which public opinion is formed is the process by which it is converted into public policy. The American political system has numerous checks and balances designed to moderate the power of public opinion. A complex series of legislative, judicial, and executive branch hurdles must be cleared before any idea, however popular, can become day-to-day operating reality in government. As a result, major changes in policy or programs are difficult, and we may expect that nuclear power will be no different; radical change in one direction or the other is unlikely. Nevertheless, carefully focused programs could achieve modest progress, and carefully designed public opinion surveys could support such programs

  19. Abbott Opinions #1-5.

    Science.gov (United States)

    Education Law Center, Inc., Newark, NJ.

    This document contains the following "Abbott Opinions": (1) "Early Childhood Education"; (2) "Adequate School Facilities"; (3) "Supplemental Programs and Whole School Reform in Elementary Schools"; (4) "Supplemental Programs in Middle and High Schools"; and (5) "Planning Programs and Budgets…

  20. Public and physician's expectations and ethical concerns about electronic health record: Benefits outweigh risks except for information security.

    Science.gov (United States)

    Entzeridou, Eleni; Markopoulou, Evgenia; Mollaki, Vasiliki

    2018-02-01

    Electronic Health Record systems (EHRs) offer numerous benefits in health care but also pose certain risks. As we progress toward the implementation of EHRs, a more in-depth understanding of attitudes that influence overall levels of EHR support is required. To record public and physicians' awareness, expectations for, and ethical concerns about the use of EHRs. A convenience sample was surveyed for both the public and physicians. The Public's Questionnaire was distributed to the public in a printed and an online version. The Physicians' Questionnaire was distributed to physicians in an online version. The questionnaires requested demographic characteristics followed by close-ended questions enquiring about awareness, perceived impact, perceived risks, and ethical issues raised by EHR use. In total, 46% of the public and 91% of physicians were aware of EHRs. Physicians' and public opinions were comparable concerning the positive impact of EHRs on better, more effective, and faster decisions on the patients' health, on better coordination between hospitals/clinics and on quality and reduced cost of health care. However, physicians were concerned that an EHR system would be a burden for their finances, for their time concerning training on the system, for their everyday workload and workflow. The majority of the public generally agreed that they would worry about the possibility that a non-authorized, third party might gain access to their personal health information (48.8%), and that they would worry about future discriminations due to possible disclosure of their health information (48.8%). Most physicians disagreed that EHRs will disrupt the doctor-patient relationship (58.1%) but they would worry about the safety of their patients' information (53.1%). Overall, both the public and physicians were in favor of the implementation of an EHR system, evaluating that possible benefits are more important than possible risks. The majority of the public believed that

  1. Report of the survey on current opinions and practice of German Society for Gynecologic Endoscopy (AGE) members regarding the laparoscopic treatment of ovarian malignancies.

    Science.gov (United States)

    Radosa, Julia Caroline; Radosa, Marc Philipp; Schweitzer, Pascal Albert; Juhasz-Boess, Ingolf; Rimbach, Stefan; Solomayer, Erich-Franz

    2018-05-01

    The purpose of this survey was to assess the opinions of members of the German Society of Gynecologic Endoscopy (AGE) regarding the laparoscopic treatment of ovarian malignancies and current practice at their institutions. Between February and October 2015, the AGE sent an anonymous online survey via mail to its members. The questionnaire solicited participants' opinions about the laparoscopic treatment of ovarian cancers according to T stage and borderline tumors, and information about current practice at their institutions. Participants were also asked their opinions on currently available data on this issue. Of 228 AGE members who completed the survey, 132 (58%) were fellows or attending physicians and 156 (68%) worked at university hospitals or tertiary referral centers. Most [212 (93%)] respondents stated that < 10% of all ovarian cancer cases were currently treated laparoscopically at their institutions. Most participants indicated that T1 (a, b, c) tumors [145 (64%)] and ovarian borderline tumors [206 (90%)], but not T2 [48 (21%)] or T3/4 [9 (4%) ovarian tumors] should or could be treated laparoscopically. One hundred seventy-two (75%) participants considered currently available data on this topic to be insufficient and 152 (66%) stated that they would take part in a clinical trial assessing a laparoscopic approach to T1/2 ovarian cancer. According to this survey, to the opinion of the majority of AGE members, laparoscopy might be a considerable option for the treatment of early ovarian malignancies and borderline tumors and should be evaluated further in future studies.

  2. (Miscommunication across the Borders: Politics, Media and Public Opinion in Turkey

    Directory of Open Access Journals (Sweden)

    Banu Baybars-Hawks

    2015-08-01

    Full Text Available The American sociologist Charles Horton Cooley defined public opinion "as a process of interaction and mutual influence rather than a state of broad agreement" in 1918. On the other hand, according to the American political scientist V.O. Key, public opinion was "opinions held by private persons which governments find it prudent to heed," in 1961. During the 1990s, advances in statistical and demographic analysis helped the development of an understanding of public opinion as the collective view of a defined population, such as a particular demographic or ethnic group. In this view, the influence of public opinion is not restricted to politics and elections. Public opinion is considered a powerful force in many other spheres, such as culture, fashion, literature and the arts, consumer spending, and marketing and public relations.1 Attitudes and values play a crucial role in the development of public opinion. Different variables embedded in the political, social and media structure of the country also have potential to make an impact on public opinion. These dynamics vary from the economics to the judicial system and democratic principles functioning in that country. On the other hand, public opinion has a power to shape politics and media's priorities in reporting. The interaction among politics, public opinion and media of one country can be better analyzed with the findings of public opinion research administered regularly. In Turkey, the research on and analysis of public opinion are most frequent during the election times. Therefore, it seems necessary to measure the public opinion more regularly to test the relationships among political, public and media agendas. Accordingly, the current study seeks to fill this gap. It is argued that in the absence of timely feedback from public surveys, decisions and policies for improving different services and institutions functioning in the country might not achieve their expected goal. The findings of

  3. Opinion formation on multiplex scale-free networks

    Science.gov (United States)

    Nguyen, Vu Xuan; Xiao, Gaoxi; Xu, Xin-Jian; Li, Guoqi; Wang, Zhen

    2018-01-01

    Most individuals, if not all, live in various social networks. The formation of opinion systems is an outcome of social interactions and information propagation occurring in such networks. We study the opinion formation with a new rule of pairwise interactions in the novel version of the well-known Deffuant model on multiplex networks composed of two layers, each of which is a scale-free network. It is found that in a duplex network composed of two identical layers, the presence of the multiplexity helps either diminish or enhance opinion diversity depending on the relative magnitudes of tolerance ranges characterizing the degree of openness/tolerance on both layers: there is a steady separation between different regions of tolerance range values on two network layers where multiplexity plays two different roles, respectively. Additionally, the two critical tolerance ranges follow a one-sum rule; that is, each of the layers reaches a complete consensus only if the sum of the tolerance ranges on the two layers is greater than a constant approximately equaling 1, the double of the critical bound on a corresponding isolated network. A further investigation of the coupling between constituent layers quantified by a link overlap parameter reveals that as the layers are loosely coupled, the two opinion systems co-evolve independently, but when the inter-layer coupling is sufficiently strong, a monotonic behavior is observed: an increase in the tolerance range of a layer causes a decline in the opinion diversity on the other layer regardless of the magnitudes of tolerance ranges associated with the layers in question.

  4. Metacognition and Confidence: Comparing Math to Other Academic Subjects

    Directory of Open Access Journals (Sweden)

    Shanna eErickson

    2015-06-01

    Full Text Available Two studies addressed student metacognition in math, measuring confidence accuracy about math performance. Underconfidence would be expected in light of pervasive math anxiety. However, one might alternatively expect overconfidence based on previous results showing overconfidence in other subject domains. Metacognitive judgments and performance were assessed for biology, literature, and mathematics tests. In Study 1, high school students took three different tests and provided estimates of their performance both before and after taking each test. In Study 2, undergraduates similarly took three shortened SAT II Subject Tests. Students were overconfident in predicting math performance, indeed showing greater overconfidence compared to other academic subjects. It appears that both overconfidence and anxiety can adversely affect metacognitive ability and can lead to math avoidance. The results have implications for educational practice and other environments that require extensive use of math.

  5. Effect of users' opinion evolution on information diffusion in online social networks

    Science.gov (United States)

    Zhu, Hengmin; Kong, Yuehan; Wei, Jing; Ma, Jing

    2018-02-01

    The process of topic propagation always interweaves information diffusion and opinion evolution, but most previous works studied the models of information diffusion and opinion evolution separately, and seldom focused on their interaction of each other. To shed light on the effect of users' opinion evolution on information diffusion in online social networks, we proposed a model which incorporates opinion evolution into the process of topic propagation. Several real topics propagating on Sina Microblog were collected to analyze individuals' propagation intentions, and different propagation intentions were considered in the model. The topic propagation was simulated to explore the impact of different opinion distributions and intervention with opposite opinion on information diffusion. Results show that the topic with one-sided opinions can spread faster and more widely, and intervention with opposite opinion is an effective measure to guide the topic propagation. The earlier to intervene, the more effectively the topic propagation would be guided.

  6. Relationships of multitasking, physicians' strain, and performance: an observational study in ward physicians.

    Science.gov (United States)

    Weigl, Matthias; Müller, Andreas; Sevdalis, Nick; Angerer, Peter

    2013-03-01

    Simultaneous task performance ("multitasking") is common in hospital physicians' work and is implicated as a major determinant for enhanced strain and detrimental performance. The aim was to determine the impact of multitasking by hospital physicians on their self reported strain and performance. A prospective observational time-and-motion study in a Community Hospital was conducted. Twenty-seven hospital physicians (surgical and internal specialties) were observed in 40 full-shift observations. Observed physicians reported twice on their self-monitored strain and performance during the observation time. Associations of observed multitasking events and subsequent strain and performance appraisals were calculated. About 21% of the working time physicians were engaged in simultaneous activities. The average time spent in multitasking activities correlated significantly with subsequently reported strain (r = 0.27, P = 0.018). The number of instances of multitasking activities correlated with self-monitored performance to a marginally significant level (r = 0.19, P = 0.098). Physicians who engage in multitasking activities tend to self-report better performance but at the cost of enhanced psychophysical strain. Hence, physicians do not perceive their own multitasking activities as a source for deficient performance, for example, medical errors. Readjustment of workload, improved organization of work for hospital physicians, and training programs to improve physicians' skills in dealing with multiple clinical demands, prioritization, and efficient task allocation may be useful avenues to explore to reduce the potentially negative impact of simultaneous task performance in clinical settings.

  7. Physicians and Physician Trainees Rarely Identify or Address Overweight/Obesity in Hospitalized Children.

    Science.gov (United States)

    King, Marta A; Nkoy, Flory L; Maloney, Christopher G; Mihalopoulos, Nicole L

    2015-10-01

    To determine how frequently physicians identify and address overweight/obesity in hospitalized children and to compare physician documentation across training level (medical student, intern, resident, attending). We conducted a retrospective chart review. Using an administrative database, Centers for Disease Control and Prevention body mass index calculator, and random sampling technique, we identified a study population of 300 children aged 2-18 years with overweight/obesity hospitalized on the general medical service of a tertiary care pediatric hospital. We reviewed admission, progress, and discharge notes to determine how frequently physicians and physician trainees identified (documented in history, physical exam, or assessment) and addressed (documented in hospital or discharge plan) overweight/obesity. Physicians and physician trainees identified overweight/obesity in 8.3% (n = 25) and addressed it in 4% (n = 12) of 300 hospitalized children with overweight/obesity. Interns were most likely to document overweight/obesity in history (8.3% of the 266 patients they followed). Attendings were most likely to document overweight/obesity in physical examination (8.3%), assessment (4%), and plan (4%) of the 300 patients they followed. Medical students were least likely to document overweight/obesity including it in the assessment (0.4%) and plan (0.4%) of the 244 hospitalized children with overweight/obesity they followed. Physicians and physician trainees rarely identify or address overweight/obesity in hospitalized children. This represents a missed opportunity for both patient care and physician trainee education. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. The Distribution of Climate Change Public Opinion in Canada.

    Directory of Open Access Journals (Sweden)

    Matto Mildenberger

    Full Text Available While climate scientists have developed high resolution data sets on the distribution of climate risks, we still lack comparable data on the local distribution of public climate change opinions. This paper provides the first effort to estimate local climate and energy opinion variability outside the United States. Using a multi-level regression and post-stratification (MRP approach, we estimate opinion in federal electoral districts and provinces. We demonstrate that a majority of the Canadian public consistently believes that climate change is happening. Belief in climate change's causes varies geographically, with more people attributing it to human activity in urban as opposed to rural areas. Most prominently, we find majority support for carbon cap and trade policy in every province and district. By contrast, support for carbon taxation is more heterogeneous. Compared to the distribution of US climate opinions, Canadians believe climate change is happening at higher levels. This new opinion data set will support climate policy analysis and climate policy decision making at national, provincial and local levels.

  9. The Distribution of Climate Change Public Opinion in Canada.

    Science.gov (United States)

    Mildenberger, Matto; Howe, Peter; Lachapelle, Erick; Stokes, Leah; Marlon, Jennifer; Gravelle, Timothy

    2016-01-01

    While climate scientists have developed high resolution data sets on the distribution of climate risks, we still lack comparable data on the local distribution of public climate change opinions. This paper provides the first effort to estimate local climate and energy opinion variability outside the United States. Using a multi-level regression and post-stratification (MRP) approach, we estimate opinion in federal electoral districts and provinces. We demonstrate that a majority of the Canadian public consistently believes that climate change is happening. Belief in climate change's causes varies geographically, with more people attributing it to human activity in urban as opposed to rural areas. Most prominently, we find majority support for carbon cap and trade policy in every province and district. By contrast, support for carbon taxation is more heterogeneous. Compared to the distribution of US climate opinions, Canadians believe climate change is happening at higher levels. This new opinion data set will support climate policy analysis and climate policy decision making at national, provincial and local levels.

  10. Studying physician effects on patient outcomes: physician interactional style and performance on quality of care indicators.

    Science.gov (United States)

    Franks, Peter; Jerant, Anthony F; Fiscella, Kevin; Shields, Cleveland G; Tancredi, Daniel J; Epstein, Ronald M

    2006-01-01

    Many prior studies which suggest a relationship between physician interactional style and patient outcomes may have been confounded by relying solely on patient reports, examining very few patients per physician, or not demonstrating evidence of a physician effect on the outcomes. We examined whether physician interactional style, measured both by patient report and objective encounter ratings, is related to performance on quality of care indicators. We also tested for the presence of physician effects on the performance indicators. Using data on 100 US primary care physician (PCP) claims data on 1,21,606 of their managed care patients, survey data on 4746 of their visiting patients, and audiotaped encounters of 2 standardized patients with each physician, we examined the relationships between claims-based quality of care indicators and both survey-derived patient perceptions of their physicians and objective ratings of interactional style in the audiotaped standardized patient encounters. Multi-level models examined whether physician effects (variance components) on care indicators were mediated by patient perceptions or objective ratings of interactional style. We found significant physician effects associated with glycohemoglobin and cholesterol testing. There was also a clinically significant association between better patient perceptions of their physicians and more glycohemoglobin testing. Multi-level analyses revealed, however, that the physician effect on glycohemoglobin testing was not mediated by patient perceived physician interaction style. In conclusion, similar to prior studies, we found evidence of an apparent relationship between patient perceptions of their physician and patient outcomes. However, the apparent relationships found in this study between patient perceptions of their physicians and patient care processes do not reflect physician style, but presumably reflect unmeasured patient confounding. Multi-level modeling may contribute to better

  11. Forming of political opinion and decision

    International Nuclear Information System (INIS)

    Urban, K.

    1980-01-01

    Taking the SNR-300 reactor in Kalkar as an example, the process of forming of political opinion and decision is reconstructed in order to get a picture of typical consensus- and conflict patterns in the discussion of safety problems. On this basis, it should be possible to derive a freedom of action for the political and administrative managing of safety matters by means of feed back with social groups. As a crucial point the aspects concerning the steps of the forming of political opinion and decision are examined. (DG) [de

  12. A study of Canadian hospice palliative care volunteers' attitudes toward physician-assisted suicide.

    Science.gov (United States)

    Claxton-Oldfield, Stephen; Miller, Kathryn

    2015-05-01

    The purpose of this study was to examine the attitudes of hospice palliative care (HPC) volunteers who provide in-home support (n = 47) and members of the community (n = 58) toward the issue of physician-assisted suicide (PAS). On the first part of the survey, participants responded to 15 items designed to assess their attitudes toward PAS. An examination of individual items revealed differences in opinions among members of both the groups. Responses to additional questions revealed that the majority of volunteers and community members (1) support legalizing PAS; (2) would choose HPC over PAS for themselves if they were terminally ill; and (3) think Canadians should place more priority on developing HPC rather than on legalizing PAS. The implications of these findings are discussed. © The Author(s) 2014.

  13. Study of the Status of Physicians-Patient Communication among Medical Interns

    Directory of Open Access Journals (Sweden)

    Sa’eedeh Farajzadeh

    2009-02-01

    Full Text Available Background and purpose: Proper communication between a physician and a patient is the key to diagnosis and management of diseases.Communication skills are essential for gathering information from patients, enhancing patients trust on physicians, relaxing them and managing them .The main purpose of this study was to determine the states of communication skills of medical interns to communicate with patients.Method: In this cross sectional study, communication skills of 72 medical interns of Kerman Medical University was assessed based on a checklist completed with direct observation and a questionnaire completed through interview with patients.The checklist included two parts: the first part for individual characteristics and the second part for 24 specifications related to initiation of an interview, conducting an interview and completion of aninterview.Another questionnaire with a similar structure was developed to gather patients’ comments about communication of medical interns with them.Results: Communication skills of medical interns were weak in 29.3%, moderate in 85.4% and good in 15.9% of interns. An agreement between observed communication skills and patients’ survey results about greeting, asking patients’ names and calling them by their names, acceptable physicians’ appearance, listening to patients’ words, friendly doctor- patient encounter, empathizing with patients (0.37, 0.26, 0.22.0.41and 0.44 respectively was seen. Results of individual variables show that relationship between age of patient and his or her opinion about communication was significant.Based on patient’s survey, the communication score given to the student increases with age of the patient.Conclusion: The study shows deficits in doctor-patient communication of medical interns in history taking. Given the importance of communication skills, the necessity to teach them in clinical skill centers before real contact with patients is obvious

  14. Do Others’ Opinion Matter?

    DEFF Research Database (Denmark)

    Liu, Fei; Xiao, Bo Sophia; Lim, Eric T. K.

    2016-01-01

    when experiencing dissonance in e-WOM, male consumers value opinionated review over numerical rating and vice versa for their female counterparts. The results of our field survey on a custom developed website with 115 college students empirically validated our hypothesized relationships and also...

  15. MindDigger: Feature Identification and Opinion Association for Chinese Movie Reviews

    Science.gov (United States)

    Zhao, Lili; Li, Chunping

    In this paper, we present a prototype system called MindDigger, which can be used to analyze the opinions in Chinese movie reviews. Different from previous research that employed techniques on product reviews, we focus on Chinese movie reviews, in which opinions are expressed in subtle and varied ways. The system designed in this work aims to extract the opinion expressions and assign them to the corresponding features. The core tasks include feature and opinion extraction, and feature-opinion association. To deal with Chinese effectively, several novel approaches based on syntactic analysis are proposed in this paper. Running results show the performance is satisfactory.

  16. [Alternative and complementary medicine from the primary care physician's viewpoint].

    Science.gov (United States)

    Soós, Sándor Árpád; Eőry, Ajándék; Eőry, Ajándok; Harsányi, László; Kalabay, László

    2015-07-12

    The patients initiate the use of complementary and alternative medicine and this often remains hidden from their primary care physician. To explore general practitioners' knowledge and attitude towards complementary and alternative medicine, and study the need and appropriate forms of education, as well as ask their opinion on integration of alternative medicine into mainstream medicine. A voluntary anonymous questionnaire was used on two conferences for general practitioners organized by the Family Medicine Department of Semmelweis University. Complementary and alternative medicine was defined by the definition of the Hungarian Academy of Sciences and certified modalities were all listed. 194 general practitioners answered the questionnaire (39.8% response rate). 14% of the responders had licence in at least one of the complementary and alternative therapies, 45% used complementary and alternative therapy in their family in case of illness. It was the opinion of the majority (91.8%) that it was necessary to be familiar with every method used by their patients, however, 82.5% claimed not to have enough knowledge in complementary medicine. Graduate and postgraduate education in the field was thought to be necessary by 86% of the responders; increased odds for commitment in personal education was found among female general practitioners, less than 20 years professional experience and personal experience of alternative medicine. These data suggest that general practitioners would like to know more about complementary and alternative medicine modalities used by their patients. They consider education of medical professionals necessary and a special group is willing to undergo further education in the field.

  17. Pharmaceutical industry gifts to physicians: patient beliefs and trust in physicians and the health care system.

    Science.gov (United States)

    Grande, David; Shea, Judy A; Armstrong, Katrina

    2012-03-01

    Pharmaceutical industry gifts to physicians are common and influence physician behavior. Little is known about patient beliefs about the prevalence of these gifts and how these beliefs may influence trust in physicians and the health care system. To measure patient perceptions about the prevalence of industry gifts and their relationship to trust in doctors and the health care system. Cross sectional random digit dial telephone survey. African-American and White adults in 40 large metropolitan areas. Respondents' beliefs about whether their physician and physicians in general receive industry gifts, physician trust, and health care system distrust. Overall, 55% of respondents believe their physician receives gifts, and 34% believe almost all doctors receive gifts. Respondents of higher socioeconomic status (income, education) and younger age were more likely to believe their physician receives gifts. In multivariate analyses, those that believe their personal physician receives gifts were more likely to report low physician trust (OR 2.26, 95% CI 1.56-3.30) and high health care system distrust (OR 2.03, 95% CI 1.49-2.77). Similarly, those that believe almost all doctors accept gifts were more likely to report low physician trust (OR 1.69, 95% CI 1.25-2.29) and high health care system distrust (OR 2.57, 95% CI 1.82-3.62). Patients perceive physician-industry gift relationships as common. Patients that believe gift relationships exist report lower levels of physician trust and higher rates of health care system distrust. Greater efforts to limit industry-physician gifts could have positive effects beyond reducing influences on physician behavior.

  18. Opinion Spreading with Mobility on Scale-Free Networks

    International Nuclear Information System (INIS)

    Qiang, Guo; Xing-Wen, Chen; Jian-Guo, Liu; Bing-Hong, Wang; Tao, Zhou; Yu-Hua, Yao

    2008-01-01

    A continuum opinion dynamic model is presented based on two rules. The first one considers the mobilities of the individuals, the second one supposes that the individuals update their opinions independently. The results of the model indicate that the bounded confidence in c , separating consensus and incoherent states, of a scale-free network is much smaller than the one of a lattice. If the system can reach the consensus state, the sum of all individuals' opinion change O c (t) quickly decreases in an exponential form, while if it reaches the incoherent state finally O c (t) decreases slowly and has the punctuated equilibrium characteristic

  19. Zealotry effects on opinion dynamics in the adaptive voter model

    Science.gov (United States)

    Klamser, Pascal P.; Wiedermann, Marc; Donges, Jonathan F.; Donner, Reik V.

    2017-11-01

    The adaptive voter model has been widely studied as a conceptual model for opinion formation processes on time-evolving social networks. Past studies on the effect of zealots, i.e., nodes aiming to spread their fixed opinion throughout the system, only considered the voter model on a static network. Here we extend the study of zealotry to the case of an adaptive network topology co-evolving with the state of the nodes and investigate opinion spreading induced by zealots depending on their initial density and connectedness. Numerical simulations reveal that below the fragmentation threshold a low density of zealots is sufficient to spread their opinion to the whole network. Beyond the transition point, zealots must exhibit an increased degree as compared to ordinary nodes for an efficient spreading of their opinion. We verify the numerical findings using a mean-field approximation of the model yielding a low-dimensional set of coupled ordinary differential equations. Our results imply that the spreading of the zealots' opinion in the adaptive voter model is strongly dependent on the link rewiring probability and the average degree of normal nodes in comparison with that of the zealots. In order to avoid a complete dominance of the zealots' opinion, there are two possible strategies for the remaining nodes: adjusting the probability of rewiring and/or the number of connections with other nodes, respectively.

  20. Perceptions of trust in physician-managers.

    Science.gov (United States)

    Cregård, Anna; Eriksson, Nomie

    2015-01-01

    The purpose of this paper is to explore the dual role of physician-managers through an examination of perceptions of trust and distrust in physician-managers. The healthcare sector needs physicians to lead. Physicians in part-time managerial positions who continue their medical practice are called part-time physician-managers. This paper explores this dual role through an examination of perceptions of trust and distrust in physician-managers. The study takes a qualitative research approach in which interviews and focus group discussions with physician-managers and nurse-managers provide the empirical data. An analytical model, with the three elements of ability, benevolence and integrity, was used in the analysis of trust and distrust in physician-managers. The respondents (physician-managers and nurse-managers) perceived both an increase and a decrease in physicians' trust in the physician-managers. Because elements of distrust were more numerous and more severe than elements of trust, the physician-managers received negative perceptions of their role. This paper's findings are based on perceptions of perceptions. The physicians were not interviewed on their trust and distrust of physician-managers. The healthcare sector must pay attention to the diverse expectations of the physician-manager role that is based on both managerial and medical logics. Hospital management should provide proper support to physician-managers in their dual role to ensure their willingness to continue to assume managerial responsibilities. The paper takes an original approach in its research into the dual role of physician-managers who work under two conflicting logics: the medical logic and the managerial logic. The focus on perceived trust and distrust in physician-managers is a new perspective on this complicated role.

  1. Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study.

    Science.gov (United States)

    Emmert, Martin; Meier, Florian; Pisch, Frank; Sander, Uwe

    2013-08-28

    Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites. To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites. This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample. In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be

  2. Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study.

    Science.gov (United States)

    Compton, Michael T; Frank, Erica

    2011-01-01

    In light of prior reports on the prevalence of stress, depression, and other mental health problems among physicians in training and practice, we examined the mental health concerns of Canadian physicians using data from the 2007-2008 Canadian Physician Health Study. Among 3213 respondents, 5 variables (depressive symptoms during the past year, anhedonia in the past year, mental health concerns making it difficult to handle one's workload in the past month, problems with work-life balance, and poor awareness of resources for mental health problems) were examined in relation to sex, specialty, practice type (solo practice vs group or other practice settings), and practice setting (inner city, urban/suburban, or rural/small town/remote). Nearly one quarter of physicians reported a 2-week period of depressed mood, and depression was more common among female physicians and general practitioners/family physicians. Anhedonia was reported by one fifth; anesthesiologists were most likely to report anhedonia, followed by general practitioners/family physicians. More than one quarter reported mental health concerns making it difficult to handle their workload, which was more common among female physicians and general practitioners/family physicians and psychiatrists. Nearly one quarter reported poor work-life balance. Lack of familiarity with mental health resources was problematic, which was more prominent among female physicians and specialists outside of general practice/family medicine or psychiatry. Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Impact of gender and personality traits (BFI-10) on opinion leadership

    DEFF Research Database (Denmark)

    Sudzina, Frantisek; Pavlicek, Antonin

    2017-01-01

    The paper studies the influence of gender and personality traits on opinion leadership. It tries to partially replicate the study about effect of Big Five Inventory (BFI) personality traits on domain-specific opinion leadership mediated through objective knowledge and generalized opinion leadership...

  4. 42 CFR 1008.31 - OIG fees for the cost of advisory opinions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false OIG fees for the cost of advisory opinions. 1008.31... SERVICES OIG AUTHORITIES ADVISORY OPINIONS BY THE OIG Advisory Opinion Fees § 1008.31 OIG fees for the cost of advisory opinions. (a) Responsibility for fees. The requestor is responsible for paying a fee...

  5. Emotional and psychological effects of physician-assisted suicide and euthanasia on participating physicians.

    Science.gov (United States)

    Stevens, Kenneth R

    2006-01-01

    This is a review and evaluation of medical and public literature regarding the reported emotional and psychological effects of participation in physician-assisted suicide (PAS) and euthanasia on the involved physicians. Articles in medical journals, legislative investigations and the public press were obtained and reviewed to determine what has been reported regarding the effects on physicians who have been personally involved in PAS and euthanasia. The physician is centrally involved in PAS and euthanasia, and the emotional and psychological effects on the participating physician can be substantial. The shift away from the fundamental values of medicine to heal and promote human wholeness can have significant effects on many participating physicians. Doctors describe being profoundly adversely affected, being shocked by the suddenness of the death, being caught up in the patient's drive for assisted suicide, having a sense of powerlessness, and feeling isolated. There is evidence of pressure on and intimidation of doctors by some patients to assist in suicide. The effect of countertransference in the doctor-patient relationship may influence physician involvement in PAS and euthanasia. Many doctors who have participated in euthanasia and/or PAS are adversely affected emotionally and psychologically by their experiences.

  6. Physicians' strikes and the competing bases of physicians' moral obligations.

    Science.gov (United States)

    MacDougall, D Robert

    2013-09-01

    Many authors have addressed the morality of physicians' strikes on the assumption that medical practice is morally different from other kinds of occupations. This article analyzes three prominent theoretical accounts that attempt to ground such special moral obligations for physicians--practice-based accounts, utilitarian accounts, and social contract accounts--and assesses their applicability to the problem of the morality of strikes. After critiquing these views, it offers a fourth view grounding special moral obligations in voluntary commitments, and explains why this is a preferable basis for understanding physicians' moral obligations in general and especially as pertaining to strikes.

  7. PENGARUH MODIFIED AUDIT OPINION TERHADAP BORROWING CASH FLOW DAN INVESTMENT CASH FLOW

    Directory of Open Access Journals (Sweden)

    Puspita Hardina Cahyaningrum

    2013-06-01

    Full Text Available This study examines and analyzes the economic consequences of modified audit opinion on borrowing cash flow and investment cash flow. Panel data model was used to observe the research. The sample of this study was 247 companies listed in Indonesia Stock Exchange for the years 2008-2010. The results show that modified audit opinion, except unqualified opinion with explanatory paragraph about going concern, did not affect borrowing cash flow because audit opinion was not the only consideration for granting credit by creditors. Companies receiving modified audit opinion were proven using more operating cash flow for investing shown in investment cash flow, especially companies receiving unqualified opinion with explanatory paragraph about going concern.

  8. An opinion formation based binary optimization approach for feature selection

    Science.gov (United States)

    Hamedmoghadam, Homayoun; Jalili, Mahdi; Yu, Xinghuo

    2018-02-01

    This paper proposed a novel optimization method based on opinion formation in complex network systems. The proposed optimization technique mimics human-human interaction mechanism based on a mathematical model derived from social sciences. Our method encodes a subset of selected features to the opinion of an artificial agent and simulates the opinion formation process among a population of agents to solve the feature selection problem. The agents interact using an underlying interaction network structure and get into consensus in their opinions, while finding better solutions to the problem. A number of mechanisms are employed to avoid getting trapped in local minima. We compare the performance of the proposed method with a number of classical population-based optimization methods and a state-of-the-art opinion formation based method. Our experiments on a number of high dimensional datasets reveal outperformance of the proposed algorithm over others.

  9. The effects of information and social conformity on opinion change.

    Science.gov (United States)

    Mallinson, Daniel J; Hatemi, Peter K

    2018-01-01

    Extant research shows that social pressures influence acts of political participation, such as turning out to vote. However, we know less about how conformity pressures affect one's deeply held political values and opinions. Using a discussion-based experiment, we untangle the unique and combined effects of information and social pressure on a political opinion that is highly salient, politically charged, and part of one's identity. We find that while information plays a role in changing a person's opinion, the social delivery of that information has the greatest effect. Thirty three percent of individuals in our treatment condition change their opinion due to the social delivery of information, while ten percent respond only to social pressure and ten percent respond only to information. Participants that change their opinion due to social pressure in our experiment are more conservative politically, conscientious, and neurotic than those that did not.

  10. The effects of information and social conformity on opinion change

    Science.gov (United States)

    Hatemi, Peter K.

    2018-01-01

    Extant research shows that social pressures influence acts of political participation, such as turning out to vote. However, we know less about how conformity pressures affect one’s deeply held political values and opinions. Using a discussion-based experiment, we untangle the unique and combined effects of information and social pressure on a political opinion that is highly salient, politically charged, and part of one’s identity. We find that while information plays a role in changing a person’s opinion, the social delivery of that information has the greatest effect. Thirty three percent of individuals in our treatment condition change their opinion due to the social delivery of information, while ten percent respond only to social pressure and ten percent respond only to information. Participants that change their opinion due to social pressure in our experiment are more conservative politically, conscientious, and neurotic than those that did not. PMID:29718958

  11. Team physicians in college athletics.

    Science.gov (United States)

    Steiner, Mark E; Quigley, D Bradford; Wang, Frank; Balint, Christopher R; Boland, Arthur L

    2005-10-01

    There has been little documentation of what constitutes the clinical work of intercollegiate team physicians. Team physicians could be recruited based on the needs of athletes. A multidisciplinary team of physicians is necessary to treat college athletes. Most physician evaluations are for musculoskeletal injuries treated nonoperatively. Descriptive epidemiology study. For a 2-year period, a database was created that recorded information on team physician encounters with intercollegiate athletes at a major university. Data on imaging studies, hospitalizations, and surgeries were also recorded. The diagnoses for physician encounters with all undergraduates through the university's health service were also recorded. More initial athlete evaluations were for musculoskeletal diagnoses (73%) than for general medical diagnoses (27%) (P respiratory infections and dermatologic disorders, or multiple visits for concussions. Football accounted for 22% of all physician encounters, more than any other sport (P athletes did not require a greater number of physician encounters than did the general undergraduate pool of students on a per capita basis. Intercollegiate team physicians primarily treat musculoskeletal injuries that do not require surgery. General medical care is often single evaluations of common conditions and repeat evaluations for concussions.

  12. Physician buy-in for EMRs.

    Science.gov (United States)

    Yackanicz, Lori; Kerr, Richard; Levick, Donald

    2010-01-01

    Implementing an EMR in an ambulatory practice requires intense workflow analysis, introduction of new technologies and significant cultural change for the physicians and physician champion. This paper will relate the experience at Lehigh Valley Health Network in the implementation of an ambulatory EMR and with the physician champions that were selected to assist the effort. The choice of a physician champion involves political considerations, variation in leadership and communication styles, and a cornucopia of personalities. Physician leadership has been shown to be a critical success factor for any successful technology implementation. An effective physician champion can help develop and promote a clear vision of an improved future, enlist the support of the physicians and staff, drive the process changes needs and manage the cultural change required. The experience with various types of physician champions will be discussed, including, the "reluctant leader", the "techie leader", the "whiny leader", and the "mature leader". Experiences with each type have resulted in a valuable, "lessons learned" summary. LVHN is a tertiary academic community medical center consisting of 950 beds and over 450 employed physicians. LVHN has been named to the Health and Hospital Network's 100 Top Wired and 25 Most Wireless Hospitals.

  13. Physicians' Job Satisfaction.

    African Journals Online (AJOL)

    AmL

    doctors and retention of the existing doctors, in addition to the ... an employee's well-being Examples of job resources are job ..... increase physician job satisfaction for ensuring the .... both pay and benefits physicians at private hospitals.

  14. The role of the physician: Eugene Sanger and a standard of care at the Elmira prison camp.

    Science.gov (United States)

    Waggoner, Jesse

    2008-01-01

    The conduct of American military physicians in prisoner of war (POW) camps has been called into question by the abuse scandals at Abu Ghraib and Guantánamo Bay. This essay explores the experiences of the first U.S. military physicians to confront POW patients in large numbers-events that occurred during the American Civil War. While POWs received sub-standard care in camps north and south, the war also saw the issuance of the first document to outline the rights of POWs. This ambivalence toward the proper care and treatment of the POW is evident in the career of Dr. Eugene Sanger, the first Union surgeon at the prison camp in Elmira, New York. Sanger demonstrated both concern about the sanitary condition of the camp and pride in the deaths of POWs as furthering the overall war aims. His cruelty attracted some censure, but Sanger never faced disciplinary action. He was honorably discharged and went on to become the Surgeon General of his home state. This article places his actions at Elmira in the context of medical ethics, Army orders, and Northern opinion in 1864, and it will argue that the lack of Federal response to Eugene Sanger's poor record while serving at the prison set a precedent for inferior medical care of POWs by American military physicians.

  15. Characteristics associated with requests by pathologists for second opinions on breast biopsies.

    Science.gov (United States)

    Geller, Berta M; Nelson, Heidi D; Weaver, Donald L; Frederick, Paul D; Allison, Kimberly H; Onega, Tracy; Carney, Patricia A; Tosteson, Anna N A; Elmore, Joann G

    2017-11-01

    Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Differing professional views or opinions: 1994 Special Review Panel

    International Nuclear Information System (INIS)

    1996-09-01

    In July 1994, the Executive Director for Operations of the US Nuclear Regulatory Commission (NRC) appointed a Special Review Panel to assess the Differing Professional View or Opinion (DPV/DPO) process, including its effectiveness, how well it is understood by employees, and the organizational climate for having such views aired and properly decided. An additional area within this review was to address the effectiveness of the DPO procedures as they pertain to public access and confidentiality. Further, the Panel was charged with the review of the submittals completed since the last review to identify employees who made significant contributions to the agency or to the public health and safety but had not been adequately recognized for this contribution. The report presents the Special Review Panel's evaluation of the NRC's current process for dealing with Differing Professional Views or Opinions. Provided in this report are the results of an employee opinion survey on the process; highlights and suggestions from interviews with individuals who had submitted a Differing Professional View or Opinion, as well as with agency managers directly involved with the Differing Professional Views or Opinions process; and the Special Review Panel's recommendations for improving the DPV/DPO process

  17. Agreement between physicians and non-physician clinicians in starting antiretroviral therapy in rural Uganda

    Directory of Open Access Journals (Sweden)

    Vasan Ashwin

    2009-08-01

    Full Text Available Abstract Background The scarcity of physicians in sub-Saharan Africa – particularly in rural clinics staffed only by non-physician health workers – is constraining access to HIV treatment, as only they are legally allowed to start antiretroviral therapy in the HIV-positive patient. Here we present a pilot study from Uganda assessing agreement between non-physician clinicians (nurses and clinical officers and physicians in their decisions as to whether to start therapy. Methods We conducted the study at 12 government antiretroviral therapy sites in three regions of Uganda, all of which had staff trained in delivery of antiretroviral therapy using the WHO Integrated Management of Adult and Adolescent Illness guidelines for chronic HIV care. We collected seven key variables to measure patient assessment and the decision as to whether to start antiretroviral therapy, the primary variable of interest being the Final Antiretroviral Therapy Recommendation. Patients saw either a clinical officer or nurse first, and then were screened identically by a blinded physician during the same clinic visit. We measured inter-rater agreement between the decisions of the non-physician health workers and physicians in the antiretroviral therapy assessment variables using simple and weighted Kappa analysis. Results Two hundred fifty-four patients were seen by a nurse and physician, while 267 were seen by a clinical officer and physician. The majority (> 50% in each arm of the study were in World Health Organization Clinical Stages I and II and therefore not currently eligible for antiretroviral therapy according to national antiretroviral therapy guidelines. Nurses and clinical officers both showed moderate to almost perfect agreement with physicians in their Final Antiretroviral Therapy Recommendation (unweighted κ = 0.59 and κ = 0.91, respectively. Agreement was also substantial for nurses versus physicians for assigning World Health Organization Clinical

  18. Possible reasons why female physicians publish fewer scientific articles than male physicians - a cross-sectional study.

    Science.gov (United States)

    Fridner, Ann; Norell, Alexandra; Åkesson, Gertrud; Gustafsson Sendén, Marie; Tevik Løvseth, Lise; Schenck-Gustafsson, Karin

    2015-04-02

    The proportion of women in medicine is approaching that of men, but female physicians are still in the minority as regards positions of power. Female physicians are struggling to reach the highest positions in academic medicine. One reason for the disparities between the genders in academic medicine is the fact that female physicians, in comparison to their male colleagues, have a lower rate of scientific publishing, which is an important factor affecting promotion in academic medicine. Clinical physicians work in a stressful environment, and the extent to which they can control their work conditions varies. The aim of this paper was to examine potential impeding and supportive work factors affecting the frequency with which clinical physicians publish scientific papers on academic medicine. Cross-sectional multivariate analysis was performed among 198 female and 305 male Swedish MD/PhD graduates. The main outcome variable was the number of published scientific articles. Male physicians published significantly more articles than female physicians p articles, as was collaborating with a former PhD advisor for both female physicians (OR = 2.97; 95% CI 1.22-7.20) and male physicians (OR = 2.10; 95% CI 1.08-4.10). Control at work was significantly associated with a higher number of published articles for male physicians only (OR = 1.50; 95% CI 1.08-2.09). Exhaustion had a significant negative impact on number of published articles among female physicians (OR = 0.29; 95% CI 0.12-0.70) whilst the publishing rate among male physicians was not affected by exhaustion. Women physicians represent an expanding sector of the physician work force; it is essential that they are represented in future fields of research, and in academic publications. This is necessary from a gender perspective, and to ensure that physicians are among the research staff in biomedical research in the future.

  19. OGC Precedent Opinion 2-2010

    Data.gov (United States)

    Department of Veterans Affairs — Osborn v. Nicholson 21 Vet. App. 223 (2007) - Effect on Existing General Counsel Opinions, Application to other Benefit Programs, and Applicability to Series HH U.S....

  20. Nuclear power engineering: Public understanding and public opinion

    International Nuclear Information System (INIS)

    Kryshev, A.I.; Sazykina, T.G.

    1998-01-01

    Subjective and objective reasons for the formation of public opinion about nuclear power engineering of Russia were analyzed. Some methodological errors in work with the Russian public on the problems of nuclear energy and possible methods of their correction were discussed. The social groups of the general public, which are of greatest importance in forming the attitude towards nuclear power engineering were indicated. The conclusion was reached that opinion of the ordinary population is often indicative of real drawbacks in the work of specialists in the nuclear fuel cycle. Consequently, careful surveys of public opinion about the problems of the nuclear industry should be very useful in organizing research work properly and improving the radiation safety. (author)

  1. Box-ticking and Olympic high jumping - Physicians' perceptions and acceptance of national physician validation systems.

    Science.gov (United States)

    Sehlbach, Carolin; Govaerts, Marjan J B; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

    2018-05-24

    National physician validation systems aim to ensure lifelong learning through periodic appraisals of physicians' competence. Their effectiveness is determined by physicians' acceptance of and commitment to the system. This study, therefore, sought to explore physicians' perceptions and self-reported acceptance of validation across three different physician validation systems in Europe. Using a constructivist grounded-theory approach, we conducted semi-structured interviews with 32 respiratory specialists from three countries with markedly different validation systems: Germany, which has a mandatory, credit-based system oriented to continuing professional development; Denmark, with mandatory annual dialogs and ensuing, non-compulsory activities; and the UK, with a mandatory, portfolio-based revalidation system. We analyzed interview data with a view to identifying factors influencing physicians' perceptions and acceptance. Factors that influenced acceptance were the assessment's authenticity and alignment of its requirements with clinical practice, physicians' beliefs about learning, perceived autonomy, and organizational support. Users' acceptance levels determine any system's effectiveness. To support lifelong learning effectively, national physician validation systems must be carefully designed and integrated into daily practice. Involving physicians in their design may render systems more authentic and improve alignment between individual ambitions and the systems' goals, thereby promoting acceptance.

  2. [State school children's opinions regarding violence in the media].

    Science.gov (United States)

    Piedrahita S, Laura E

    2009-01-01

    To describe the opinion of schoolage children, from a public school, regarding the violence they perceive in the media. Descriptive-exploratory research with a sample, selected according to the child's age in a public school. Quantitative data were collected. There were found common issues related to the child's opinion about the violence present in the media such as frequent exposure to the media violence and lack of parental supervision. Social context and constant exposure to the media violence affect the children's opinion about the violence phenomenon and their predisposition to it.

  3. European dental students' opinions on their local anaesthesia education

    NARCIS (Netherlands)

    Brand, H.S.; Tan, L.L.S.; van der Spek, S.J.; Baart, J.A.

    2011-01-01

    Objective: To investigate students’ opinion about theoretical and clinical training in local anaesthesia at different European dental schools. Materials and Methods: A questionnaire was designed to collect information about local anaesthesia teaching. Students’ opinion was quantified with five-point

  4. The importance of opinion leaders in agricultural production among ...

    African Journals Online (AJOL)

    The importance of opinion leaders in agricultural production among male and ... farmers do not have adequate access to extension services due to, amongst others, the ... In view of these problems, the role of opinion leaders is important and ...

  5. Scientific Opinion on Risk Assessment of Synthetic Biology.

    Science.gov (United States)

    Epstein, Michelle M; Vermeire, Theo

    2016-08-01

    In 2013, three Scientific Committees of the European Commission (EC) drafted Scientific Opinions on synthetic biology that provide an operational definition and address risk assessment methodology, safety aspects, environmental risks, knowledge gaps, and research priorities. These Opinions contribute to the international discussions on the risk governance for synthetic biology developments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Comparison between the public opinion and the image of public opinion on nuclear power generation. From the viewpoint of risk communication

    International Nuclear Information System (INIS)

    Matsuda, Toshihiro

    2003-01-01

    One objective for risk communication is to improve the understanding of public values and concerns. This paper examined the perceptions of nuclear power plant engineers of an electric power company, about public values and concerns regarding nuclear power generation (image of public opinion), and compared them with actual public opinion. The image of public opinion was surveyed by questionnaire method. In the questionnaire, the subjects were asked to estimate the most preferred answer given to questions posed to the Japanese public. For some questions, subjects were asked to estimate the percentage of Japanese who selected a certain answer for a question or the distribution of the answers. The results showed: (1) Nuclear power plant engineers correctly recognized the existence of high anxiety in the public's mind concerning nuclear power generation. (2) Engineers were apt to underestimate the percentage of Japanese who think nuclear power generation is useful in our society. (3) The majority of Japanese assume that when nuclear power plant accidents occur radioactive leakage is so severe that it affects the health of inhabitants. However, the engineers were apt to estimate that the majority of Japanese think radioactive leakage is not so severe. (4) Engineers correctly recognized that the majority of Japanese think it is a realistic option to use the nuclear power generation. However, they incorrectly estimated that only 40% of Japanese think it is a realistic option to use the nuclear power generation when in fact 67% think so. These gaps between public opinion and the image of public opinion by the engineers were classified into two groups, one that stems from the cognitive bias when people estimate public opinion and one that is inherent in the engineers of nuclear power plants. (author)

  7. On the empirical relevance of the transient in opinion models

    International Nuclear Information System (INIS)

    Banisch, Sven; Araujo, Tanya

    2010-01-01

    While the number and variety of models to explain opinion exchange dynamics is huge, attempts to justify the model results using empirical data are relatively rare. As linking to real data is essential for establishing model credibility, this Letter develops an empirical confirmation experiment by which an opinion model is related to real election data. The model is based on a representation of opinions as a vector of k bits. Individuals interact according to the principle that similarity leads to interaction and interaction leads to still more similarity. In the comparison to real data we concentrate on the transient opinion profiles that form during the dynamic process. An artificial election procedure is introduced which allows to relate transient opinion configurations to the electoral performance of candidates for which data are available. The election procedure based on the well-established principle of proximity voting is repeatedly performed during the transient period and remarkable statistical agreement with the empirical data is observed.

  8. On the empirical relevance of the transient in opinion models

    Energy Technology Data Exchange (ETDEWEB)

    Banisch, Sven, E-mail: sven.banisch@universecity.d [Mathematical Physics, Physics Department, Bielefeld University, 33501 Bielefeld (Germany); Institute for Complexity Science (ICC), 1249-078 Lisbon (Portugal); Araujo, Tanya, E-mail: tanya@iseg.utl.p [Research Unit on Complexity in Economics (UECE), ISEG, TULisbon, 1249-078 Lisbon (Portugal); Institute for Complexity Science (ICC), 1249-078 Lisbon (Portugal)

    2010-07-12

    While the number and variety of models to explain opinion exchange dynamics is huge, attempts to justify the model results using empirical data are relatively rare. As linking to real data is essential for establishing model credibility, this Letter develops an empirical confirmation experiment by which an opinion model is related to real election data. The model is based on a representation of opinions as a vector of k bits. Individuals interact according to the principle that similarity leads to interaction and interaction leads to still more similarity. In the comparison to real data we concentrate on the transient opinion profiles that form during the dynamic process. An artificial election procedure is introduced which allows to relate transient opinion configurations to the electoral performance of candidates for which data are available. The election procedure based on the well-established principle of proximity voting is repeatedly performed during the transient period and remarkable statistical agreement with the empirical data is observed.

  9. Chaotic Modes in Scale Free Opinion Networks

    Science.gov (United States)

    Kusmartsev, Feo V.; Kürten, Karl E.

    2010-12-01

    In this paper, we investigate processes associated with formation of public opinion in varies directed random, scale free and small-world social networks. The important factor of the opinion formation is the existence of contrarians which were discovered by Granovetter in various social psychology experiments1,2,3 long ago and later introduced in sociophysics by Galam.4 When the density of contrarians increases the system behavior drastically changes at some critical value. At high density of contrarians the system can never arrive to a consensus state and periodically oscillates with different periods depending on specific structure of the network. At small density of the contrarians the behavior is manifold. It depends primary on the initial state of the system. If initially the majority of the population agrees with each other a state of stable majority may be easily reached. However when originally the population is divided in nearly equal parts consensus can never be reached. We model the emergence of collective decision making by considering N interacting agents, whose opinions are described by two state Ising spin variable associated with YES and NO. We show that the dynamical behaviors are very sensitive not only to the density of the contrarians but also to the network topology. We find that a phase of social chaos may arise in various dynamical processes of opinion formation in many realistic models. We compare the prediction of the theory with data describing the dynamics of the average opinion of the USA population collected on a day-by-day basis by varies media sources during the last six month before the final Obama-McCain election. The qualitative ouctome is in reasonable agreement with the prediction of our theory. In fact, the analyses of these data made within the paradigm of our theory indicates that even in this campaign there were chaotic elements where the public opinion migrated in an unpredictable chaotic way. The existence of such a phase

  10. The relevance of security analyst opinions for investment decisions

    NARCIS (Netherlands)

    Gerritsen, D.F.

    2014-01-01

    Security analysts analyze information regarding publicly traded companies after which they publish their opinion regarding these companies’ stocks. In this dissertation the published opinions of two different types of analysts are analyzed. Technical analysts derive a recommendation to buy, hold, or

  11. Ethical principles for physician rating sites.

    Science.gov (United States)

    Strech, Daniel

    2011-12-06

    During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites' effects on physicians' performance, patient outcomes, or the public's trust in health care, most contributions refer to normative arguments, hypothetical effects, or indirect evidence. This paper aims, first, to structure the ethical debate about the basic concept of physician rating sites: allowing patients to rate, comment, and discuss physicians' performance, online and visible to everyone. Thus, it provides a more thorough and transparent starting point for further discussion and decision making on physician rating sites: what should physicians and health policy decision makers take into account when discussing the basic concept of physician rating sites and its possible implications on the physician-patient relationship? Second, it discusses where and how the preexisting evidence from the partly related field of public reporting of physician performance can serve as an indicator for specific needs of evaluative research in the field of physician rating sites. This paper defines the ethical principles of patient welfare, patient autonomy, physician welfare, and social justice in the context of physician rating sites. It also outlines basic conditions for a fair decision-making process concerning the implementation and regulation of physician rating sites, namely, transparency, justification, participation, minimization of conflicts of interest, and openness for revision. Besides other issues described in this paper, one trade-off presents a special challenge and will play an important role when deciding about more- or less-restrictive physician rating sites regulations: the potential psychological and financial harms for

  12. Breast Imaging Second Opinions Impact Surgical Management.

    Science.gov (United States)

    Spivey, Tara Lynn; Carlson, Kjirsten Ayn; Janssen, Imke; Witt, Thomas R; Jokich, Peter; Madrigrano, Andrea

    2015-07-01

    Breast surgeons often see women for second opinions for abnormalities found on breast imaging. For second opinions, these images are submitted for review and interpretation by dedicated breast imagers. This study evaluated the conformity of results among interpretation of imaging submitted from outside hospitals both from tertiary care centers, as well as community programs, in an attempt to evaluate the utility of this practice for the sake of clinical management and resource utilization. A retrospective chart review was conducted on all breast patients that submitted outside imaging films for the years 2011 to 2013 at Rush University Medical Center (RUMC). The radiologic diagnosis and each patient's proposed management plan was collected and evaluated for concordance between the outside institutions and RUMC. A total of 380 patients who presented for second opinions with an interpretation of outside exams were evaluated. In 47.4 % [95 % confidence interval (CI) 42.4-52.4] of cases there was distinct variance in radiologic impression. For 53.5 % (95 % CI 48.4-58.5) of patients, there was a change in recommended management plan, which included recommendations for either additional imaging or need for additional biopsy. In total, this changed the overall surgical management in 27.1 % (95 % CI 22.8-31.9) of cases. In six patients, the reinterpretation of outside imaging detected new malignancies not previously identified. Overall, 83.7 % (95 % CI 79.7-87.1) of patients who submitted imaging from outside institutions chose to complete the remainder of their treatment at RUMC. The practice of second opinion review changed overall definitive management at our specialty center in more than one in four cases. In addition, the review identified six previously unrecognized malignancies. Given this data, the practice of second opinions and interpretation of outside exams should continue despite the additional resources required.

  13. Changes in alcohol policies and public opinions in Finland 2003-2013.

    Science.gov (United States)

    Österberg, Esa; Lindeman, Mikaela; Karlsson, Thomas

    2014-05-01

    There is a constant and ongoing interplay between public opinions and public policies, alcohol policies being no exception. This article describes the development of public opinions regarding alcohol policy in Finland during a 10-year period between 2003 and 2013. Fluctuations in the alcohol policy opinion climate are put in context by looking at concurrent changes in alcohol policies and in total alcohol consumption. The study is based on data from opinion surveys on alcohol policies commissioned by the National Institute for Health and Welfare and the Finnish Social and Health Association. The opinion polls include questions about the general acceptance of prevailing alcohol policies, appropriate sales channels of different alcoholic beverage categories and opinions about the legal age limits and prices of alcoholic beverages. In the study, changes in alcohol policy during 2003-2013 are surveyed, and their relationship with changes in alcohol policy opinion is examined. There seem to be a strong positive correlation during the study period between the level of alcohol consumption and the share of those wanting a more restrictive alcohol policy in Finland. It seems that an increased level of awareness of alcohol-related issues among the general public created a more restrictive opinion climate on alcohol policy issues after the big alcohol excise duty decrease in 2004. The reverse seems to happen but in a lesser degree when alcohol excise duties has been increased after the year 2007. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  14. Using Spatial, Economic, and Ecological Opinion Data to Inform Gray Wolf Conservation.

    Science.gov (United States)

    Berry, Meredith S; Nickerson, Norma P; Metcalf, Elizabeth Covelli

    2016-09-01

    Public opinion can be an influential factor in wildlife management decisions. Evaluating public opinions can help legitimize, or delegitimize, management and facilitate long-term conservation goals. This is especially true for the controversial issues surrounding the management of predators. We surveyed Montana, USA, residents during summer of 2013 to measure public opinion regarding economic and ecological impacts of the gray wolf ( Canis lupus ), and current management of this species. Although opinions were polarized in some areas, a greater percentage of Montanans think that wolves negatively affect the economy, but impact tourism (which contributes to the economy) positively. These differences may reflect the belief that rancher economic losses from wolf predation of cattle is greater than overall tourism gains related to wolves (e.g., wolf-watching), in addition to the perception of wolves negatively affecting big game (e.g., elk [ Cervus canadensis ]). Results also show that a slightly greater percentage of Montanans feel that wolves positively rather than negatively affect the ecosystem. Regarding specific practices, more Montanans than not have a positive opinion of maintaining wolves on the landscape and also support hunting of wolves. More Montanans hold negative rather than positive opinions, however, regarding wolf trapping. This result was most evident in western Montana as assessed by a spatial distribution of opinions by county and has implications for current wolf management and nontarget species. Results of ordinal regression analyses revealed that big game hunters, males, and those who held negative opinions of the effect of wolves on the Montana ecosystem and economy were significantly more likely to support both hunting and trapping practices. Living in western Montana predicted positive opinions of hunting, but alternatively, negative opinions of trapping. These results provide an understanding of public opinion of wolf management by county as

  15. Using Spatial, Economic, and Ecological Opinion Data to Inform Gray Wolf Conservation

    Science.gov (United States)

    Berry, Meredith S.; Nickerson, Norma P.; Metcalf, Elizabeth Covelli

    2018-01-01

    Public opinion can be an influential factor in wildlife management decisions. Evaluating public opinions can help legitimize, or delegitimize, management and facilitate long-term conservation goals. This is especially true for the controversial issues surrounding the management of predators. We surveyed Montana, USA, residents during summer of 2013 to measure public opinion regarding economic and ecological impacts of the gray wolf (Canis lupus), and current management of this species. Although opinions were polarized in some areas, a greater percentage of Montanans think that wolves negatively affect the economy, but impact tourism (which contributes to the economy) positively. These differences may reflect the belief that rancher economic losses from wolf predation of cattle is greater than overall tourism gains related to wolves (e.g., wolf-watching), in addition to the perception of wolves negatively affecting big game (e.g., elk [Cervus canadensis]). Results also show that a slightly greater percentage of Montanans feel that wolves positively rather than negatively affect the ecosystem. Regarding specific practices, more Montanans than not have a positive opinion of maintaining wolves on the landscape and also support hunting of wolves. More Montanans hold negative rather than positive opinions, however, regarding wolf trapping. This result was most evident in western Montana as assessed by a spatial distribution of opinions by county and has implications for current wolf management and nontarget species. Results of ordinal regression analyses revealed that big game hunters, males, and those who held negative opinions of the effect of wolves on the Montana ecosystem and economy were significantly more likely to support both hunting and trapping practices. Living in western Montana predicted positive opinions of hunting, but alternatively, negative opinions of trapping. These results provide an understanding of public opinion of wolf management by county as

  16. Nurse-physician communication - An integrated review.

    Science.gov (United States)

    Tan, Tit-Chai; Zhou, Huaqiong; Kelly, Michelle

    2017-12-01

    To present a comprehensive review of current evidence on the factors which impact on nurse-physician communication and interventions developed to improve nurse-physician communication. The challenges in nurse-physician communication persist since the term 'nurse-doctor game' was first used in 1967, leading to poor patient outcomes such as treatment delays and potential patient harm. Inconsistent evidence was found on the factors and interventions which foster or impair effective nurse-physician communication. An integrative review was conducted following a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Five electronic databases were searched from 2005 to April 2016 using key search terms: "improve*," "nurse-physician," "nurse," "physician" and "communication" in five electronic databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Science Direct and Scopus. A total of 22 studies were included in the review. Four themes emerged from the data synthesis, namely communication styles; factors that facilitate nurse-physician communication; barriers to effective nurse-physician communication; and interventions to improve nurse-physician communication. This integrative review suggests that nurse-physician communication still remains ineffective. Current interventions only address information needs of nurses and physicians in limited situations and specific settings but cannot adequately address the interprofessional communication skills that are lacking in practice. The disparate views of nurses and physicians on communication due to differing training backgrounds confound the effectiveness of current interventions or strategies. Cross-training and interprofessional educational from undergraduate to postgraduate programmes will better align the training of nurses and physicians to communicate effectively. Further research is needed to determine the

  17. Physicians' and Nurses' Perceptions of and Attitudes Toward Incident Reporting in Palestinian Hospitals.

    Science.gov (United States)

    Rashed, Anan; Hamdan, Motasem

    2015-06-22

    Underreporting of incidents that happen in health care services undermines the ability of the systems to improve patient safety. This study assessed the attitudes of physicians and nurses toward incident reporting and the factors influencing reporting in Palestinian hospitals. It also examined clinicians' views about the preferred features of incident reporting system. Cross-sectional self-administered survey of 475 participants, 152 physicians and 323 nurses, from 11 public hospitals in the West Bank; response rate, 81.3%. There was a low level of event reporting among participants in the past year (40.3%). Adjusted for sex and age, physicians were 2.1 times more likely to report incidents than nurses (95% confidence interval, 1.32-3.417; P = 0.002). Perceived main barriers for reporting were grouped under lack of proper structure for reporting, prevalence of blame, and punitive environment. The clinicians indicated fear of administrative sanctions, social and legal liability, and of their competence being questioned (P > 0.05). Getting help for patients, learning from mistakes, and ethical obligation were equally indicated motivators for reporting (P > 0.05). Meanwhile, clinicians prefer formal reporting (77.8%) of all type of errors (65.5%), disclosure of reporters (52.7%), using reports to improve patient safety (80.3%), and willingness to report to immediate supervisors (57.6%). Clinicians acknowledge the importance of reporting incidents; however, prevalence of punitive culture and inadequate reporting systems are key barriers. Improving feedback about reported errors, simplifying procedures, providing clear guidelines on what and who should report, and avoiding blame are essential to enhance reporting. Moreover, health care organizations should consider the opinions of the clinicians in developing reporting systems.

  18. Financial and Non Financial Factors on Going-Concern Opinion

    Directory of Open Access Journals (Sweden)

    Junaidi Junaidi

    2012-09-01

    Full Text Available Company's ability to survive is a fundamental uncertainty faced in the preparation and auditing financial statements. Provision of going-concern opinion on these financial statements the company is still being debated. Public Accountant Professional Standards in section 341 states that the auditor is responsible for evaluating whether there is a major doubt on the ability of entities in the continued survival of the appropriate period of time, not more than one year from the date of the financial statements being audited. This research analyzed the financial and non financial factors that affected the provision of going-concern opinion. This research used samples of 63 companies with 315 observations, taken from years 2005-2009. The logistic regression analysis showed that the company's financial condition variables, mitigating evidence, and disclosure significantly influence the acceptance of going-concern opinion. Enterprise risk was not significant at propensity of going-concern opinion.

  19. The physician leader as logotherapist.

    Science.gov (United States)

    Washburn, E R

    1998-01-01

    Today's physicians feel helpless and angry about changing conditions in the medical landscape. This is due, in large part, to our postmodernist world view and the influence of corporations on medical practice. The life and work of existentialist psychiatrist Viktor Frankl is proposed as a role model for physicians to take back control of their profession. Physician leaders are in the best position to bring the teachings and insight of Frankl's logotherapy to rank-and-file physicians in all practice settings, as well as into the board rooms of large medical corporations. This article considers the spiritual and moral troubles of American medicine, Frankl's answer to that affliction, and the implications of logotherapy for physician organizations and leadership. Physician executives are challenged to take up this task.

  20. Culture and Probability Judgment Accuracy: The Influence of Holistic Reasoning.

    Science.gov (United States)

    Lechuga, Julia; Wiebe, John S

    2011-08-01

    A well-established phenomenon in the judgment and decision-making tradition is the overconfidence one places in the amount of knowledge that one possesses. Overconfidence or probability judgment accuracy varies not only individually but also across cultures. However, research efforts to explain cross-cultural variations in the overconfidence phenomenon have seldom been made. In Study 1, the authors compared the probability judgment accuracy of U.S. Americans (N = 108) and Mexican participants (N = 100). In Study 2, they experimentally primed culture by randomly assigning English/Spanish bilingual Mexican Americans (N = 195) to response language. Results of both studies replicated the cross-cultural variation of probability judgment accuracy previously observed in other cultural groups. U.S. Americans displayed less overconfidence when compared to Mexicans. These results were then replicated in bilingual participants, when culture was experimentally manipulated with language priming. Holistic reasoning did not account for the cross-cultural variation of overconfidence. Suggestions for future studies are discussed.

  1. Analysis of 4999 online physician ratings indicates that most patients give physicians a favorable rating.

    Science.gov (United States)

    Kadry, Bassam; Chu, Larry F; Kadry, Bayan; Gammas, Danya; Macario, Alex

    2011-11-16

    Many online physician-rating sites provide patients with information about physicians and allow patients to rate physicians. Understanding what information is available is important given that patients may use this information to choose a physician. The goals of this study were to (1) determine the most frequently visited physician-rating websites with user-generated content, (2) evaluate the available information on these websites, and (3) analyze 4999 individual online ratings of physicians. On October 1, 2010, using Google Trends we identified the 10 most frequently visited online physician-rating sites with user-generated content. We then studied each site to evaluate the available information (eg, board certification, years in practice), the types of rating scales (eg, 1-5, 1-4, 1-100), and dimensions of care (eg, recommend to a friend, waiting room time) used to rate physicians. We analyzed data from 4999 selected physician ratings without identifiers to assess how physicians are rated online. The 10 most commonly visited websites with user-generated content were HealthGrades.com, Vitals.com, Yelp.com, YP.com, RevolutionHealth.com, RateMD.com, Angieslist.com, Checkbook.org, Kudzu.com, and ZocDoc.com. A total of 35 different dimensions of care were rated by patients in the websites, with a median of 4.5 (mean 4.9, SD 2.8, range 1-9) questions per site. Depending on the scale used for each physician-rating website, the average rating was 77 out of 100 for sites using a 100-point scale (SD 11, median 76, range 33-100), 3.84 out of 5 (77%) for sites using a 5-point scale (SD 0.98, median 4, range 1-5), and 3.1 out of 4 (78%) for sites using a 4-point scale (SD 0.72, median 3, range 1-4). The percentage of reviews rated ≥75 on a 100-point scale was 61.5% (246/400), ≥4 on a 5-point scale was 57.74% (2078/3599), and ≥3 on a 4-point scale was 74.0% (740/1000). The patient's single overall rating of the physician correlated with the other dimensions of care that

  2. Dynamics of bounded confidence opinion in heterogeneous social networks: Concord against partial antagonism

    Science.gov (United States)

    Kurmyshev, Evguenii; Juárez, Héctor A.; González-Silva, Ricardo A.

    2011-08-01

    Bounded confidence models of opinion dynamics in social networks have been actively studied in recent years, in particular, opinion formation and extremism propagation along with other aspects of social dynamics. In this work, after an analysis of limitations of the Deffuant-Weisbuch (DW) bounded confidence, relative agreement model, we propose the mixed model that takes into account two psychological types of individuals. Concord agents (C-agents) are friendly people; they interact in a way that their opinions always get closer. Agents of the other psychological type show partial antagonism in their interaction (PA-agents). Opinion dynamics in heterogeneous social groups, consisting of agents of the two types, was studied on different social networks: Erdös-Rényi random graphs, small-world networks and complete graphs. Limit cases of the mixed model, pure C- and PA-societies, were also studied. We found that group opinion formation is, qualitatively, almost independent of the topology of networks used in this work. Opinion fragmentation, polarization and consensus are observed in the mixed model at different proportions of PA- and C-agents, depending on the value of initial opinion tolerance of agents. As for the opinion formation and arising of “dissidents”, the opinion dynamics of the C-agents society was found to be similar to that of the DW model, except for the rate of opinion convergence. Nevertheless, mixed societies showed dynamics and bifurcation patterns notably different to those of the DW model. The influence of biased initial conditions over opinion formation in heterogeneous social groups was also studied versus the initial value of opinion uncertainty, varying the proportion of the PA- to C-agents. Bifurcation diagrams showed an impressive evolution of collective opinion, in particular, radical changes of left to right consensus or vice versa at an opinion uncertainty value equal to 0.7 in the model with the PA/C mixture of population near 50/50.

  3. The Validity of Online Patient Ratings of Physicians: Analysis of Physician Peer Reviews and Patient Ratings.

    Science.gov (United States)

    McGrath, Robert J; Priestley, Jennifer Lewis; Zhou, Yiyun; Culligan, Patrick J

    2018-04-09

    Information from ratings sites are increasingly informing patient decisions related to health care and the selection of physicians. The current study sought to determine the validity of online patient ratings of physicians through comparison with physician peer review. We extracted 223,715 reviews of 41,104 physicians from 10 of the largest cities in the United States, including 1142 physicians listed as "America's Top Doctors" through physician peer review. Differences in mean online patient ratings were tested for physicians who were listed and those who were not. Overall, no differences were found between the online patient ratings based upon physician peer review status. However, statistical differences were found for four specialties (family medicine, allergists, internal medicine, and pediatrics), with online patient ratings significantly higher for those physicians listed as a peer-reviewed "Top Doctor" versus those who were not. The results of this large-scale study indicate that while online patient ratings are consistent with physician peer review for four nonsurgical, primarily in-office specializations, patient ratings were not consistent with physician peer review for specializations like anesthesiology. This result indicates that the validity of patient ratings varies by medical specialization. ©Robert J McGrath, Jennifer Lewis Priestley, Yiyun Zhou, Patrick J Culligan. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 09.04.2018.

  4. Discrepancy and Disliking Do Not Induce Negative Opinion Shifts

    NARCIS (Netherlands)

    Takács, Károly; Flache, Andreas; Maes, Michael

    2016-01-01

    Both classical social psychological theories and recent formal models of opinion differentiation and bi-polarization assign a prominent role to negative social influence. Negative influence is defined as shifts away from the opinion of others and hypothesized to be induced by discrepancy with or

  5. 22 CFR 126.9 - Advisory opinions and related authorizations.

    Science.gov (United States)

    2010-04-01

    .... 126.9 Section 126.9 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS GENERAL POLICIES AND PROVISIONS § 126.9 Advisory opinions and related authorizations. (a) Advisory opinion. Any person desiring information as to whether the Directorate of Defense Trade Controls would be...

  6. 49 CFR 604.21 - Special considerations for advisory opinions.

    Science.gov (United States)

    2010-10-01

    ... Desist Orders § 604.21 Special considerations for advisory opinions. Based on new facts involving significant financial considerations, the Chief Counsel may take appropriate enforcement action contrary to an... 49 Transportation 7 2010-10-01 2010-10-01 false Special considerations for advisory opinions. 604...

  7. Interplay between media and social influence in the collective behavior of opinion dynamics

    Science.gov (United States)

    Colaiori, Francesca; Castellano, Claudio

    2015-10-01

    Messages conveyed by media act as a major drive in shaping attitudes and inducing opinion shift. On the other hand, individuals are strongly affected by peer pressure while forming their own judgment. We solve a general model of opinion dynamics where individuals either hold one of two alternative opinions or are undecided and interact pairwise while exposed to an external influence. As media pressure increases, the system moves from pluralism to global consensus; four distinct classes of collective behavior emerge, crucially depending on the outcome of direct interactions among individuals holding opposite opinions. Observed nontrivial behaviors include hysteretic phenomena and resilience of minority opinions. Notably, consensus could be unachievable even when media and microscopic interactions are biased in favor of the same opinion: The unfavored opinion might even gain the support of the majority.

  8. The Influence of Physician Communication Style on Overweight Patients’ Perceptions of Length of Encounter and Physician Being Rushed

    Science.gov (United States)

    Gulbrandsen, Pål; Østbye, Truls; Lyna, Pauline; Dolor, Rowena J.; Tulsky, James A.; Alexander, Stewart C.; Pollak, Kathryn I.

    2012-01-01

    BACKGROUND AND OBJECTIVES Little is known about how patients and physicians perceive time and the extent to which they perceive the physician being rushed during encounters. One aim of this paper is to examine whether patient and physician characteristics and physician communication influence patient perception of the duration of the encounter and their perception of physicians being rushed. Another aim is to examine the relationship between patient and physician perceptions of physicians feeling rushed. METHODS We audiorecorded 461 encounters of overweight or obese patients with 40 primary care physicians and included 320 encounters in which weight was discussed. We calculated time spent with physician and coded all communication about weight using the Motivational Interview Treatment Integrity scale (MITI). Patients completed post-visit questionnaires in which they reported the estimated duration of the encounter and how rushed they thought the physician was during the encounter. Physicians reported how rushed they felt. RESULTS Patients estimated encounters to be longer than they actually were by an average of 2.6 minutes (SD=11.0). When physicians used reflective statements when discussing weight, patients estimated the encounter to be shorter than when physicians did not use reflective statements (1.17 versus 4.56 minutes more than actual duration). Whites perceived the encounter as shorter than African Americans (1.45 versus 4.28 minutes more than actual duration). Physicians felt rushed in 66% of visits; however, most patients did not perceive this. Internists were perceived to be more rushed than family physicians. CONCLUSIONS There is wide variation in patients’ ability to estimate the length of time they spend with their physician. Some physician and patient characteristics were related to patient perceptions of the length of the encounter. Reflective statements might lead patients to perceive encounters as shorter. Physicians, especially family

  9. Sifting Through Chaos: Extracting Information from Unstructured Legal Opinions.

    Science.gov (United States)

    Oliveira, Bruno Miguel; Guimarães, Rui Vasconcellos; Antunes, Luís; Rodrigues, Pedro Pereira

    2018-01-01

    Abiding to the law is, in some cases, a delicate balance between the rights of different players. Re-using health records is such a case. While the law grants reuse rights to public administration documents, in which health records produced in public health institutions are included, it also grants privacy to personal records. To safeguard a correct usage of data, public hospitals in Portugal employ jurists that are responsible for allowing or withholding access rights to health records. To help decision making, these jurists can consult the legal opinions issued by the national committee on public administration documents usage. While these legal opinions are of undeniable value, due to their doctrine contribution, they are only available in a format best suited from printing, forcing individual consultation of each document, with no option, whatsoever of clustered search, filtering or indexing, which are standard operations nowadays in a document management system. When having to decide on tens of data requests a day, it becomes unfeasible to consult the hundreds of legal opinions already available. With the objective to create a modern document management system, we devised an open, platform agnostic system that extracts and compiles the legal opinions, ex-tracts its contents and produces metadata, allowing for a fast searching and filtering of said legal opinions.

  10. Extracting product features and opinion words using pattern knowledge in customer reviews.

    Science.gov (United States)

    Htay, Su Su; Lynn, Khin Thidar

    2013-01-01

    Due to the development of e-commerce and web technology, most of online Merchant sites are able to write comments about purchasing products for customer. Customer reviews expressed opinion about products or services which are collectively referred to as customer feedback data. Opinion extraction about products from customer reviews is becoming an interesting area of research and it is motivated to develop an automatic opinion mining application for users. Therefore, efficient method and techniques are needed to extract opinions from reviews. In this paper, we proposed a novel idea to find opinion words or phrases for each feature from customer reviews in an efficient way. Our focus in this paper is to get the patterns of opinion words/phrases about the feature of product from the review text through adjective, adverb, verb, and noun. The extracted features and opinions are useful for generating a meaningful summary that can provide significant informative resource to help the user as well as merchants to track the most suitable choice of product.

  11. Extracting Product Features and Opinion Words Using Pattern Knowledge in Customer Reviews

    Directory of Open Access Journals (Sweden)

    Su Su Htay

    2013-01-01

    Full Text Available Due to the development of e-commerce and web technology, most of online Merchant sites are able to write comments about purchasing products for customer. Customer reviews expressed opinion about products or services which are collectively referred to as customer feedback data. Opinion extraction about products from customer reviews is becoming an interesting area of research and it is motivated to develop an automatic opinion mining application for users. Therefore, efficient method and techniques are needed to extract opinions from reviews. In this paper, we proposed a novel idea to find opinion words or phrases for each feature from customer reviews in an efficient way. Our focus in this paper is to get the patterns of opinion words/phrases about the feature of product from the review text through adjective, adverb, verb, and noun. The extracted features and opinions are useful for generating a meaningful summary that can provide significant informative resource to help the user as well as merchants to track the most suitable choice of product.

  12. Extracting Product Features and Opinion Words Using Pattern Knowledge in Customer Reviews

    Science.gov (United States)

    Lynn, Khin Thidar

    2013-01-01

    Due to the development of e-commerce and web technology, most of online Merchant sites are able to write comments about purchasing products for customer. Customer reviews expressed opinion about products or services which are collectively referred to as customer feedback data. Opinion extraction about products from customer reviews is becoming an interesting area of research and it is motivated to develop an automatic opinion mining application for users. Therefore, efficient method and techniques are needed to extract opinions from reviews. In this paper, we proposed a novel idea to find opinion words or phrases for each feature from customer reviews in an efficient way. Our focus in this paper is to get the patterns of opinion words/phrases about the feature of product from the review text through adjective, adverb, verb, and noun. The extracted features and opinions are useful for generating a meaningful summary that can provide significant informative resource to help the user as well as merchants to track the most suitable choice of product. PMID:24459430

  13. What drives people's opinions of electricity infrastructure? Empirical evidence from Ireland

    International Nuclear Information System (INIS)

    Bertsch, Valentin; Hyland, Marie; Mahony, Michael

    2017-01-01

    Across the EU, significant infrastructure investment is needed in both generation from renewable energy sources (RES) and the electricity grid to meet the European targets on emission reduction and RES expansion. Experiences show, however, that citizens may object to new energy infrastructure in their localities which may cause delays in achieving the targets. To avoid delays, it is crucial to understand what drives people's opinions. To explore people's opinions of different electricity generation and transmission technologies in Ireland, we conducted a nationally-representative survey. Concerning the drivers, we distinguish between socio-demographics, technology-specific perceptions, and energy policy preferences. Our results show that people generally have positive views of RES technologies. While this indicates that Irish citizens agree to move towards cleaner electricity sources, we find reluctance amongst people to have these technologies located close to their places of residence. We find that, across most technologies, the tradeoff people make between economic and environmental policy objectives drives their opinions of, and their tendencies to oppose, technology developments. The significance of most socio-demographic variables, however, is largely technology-dependent. This highlights that policy makers need to understand how people make tradeoffs between policy objectives and how these tradeoffs relate to their opinions of different technologies. - Highlights: • Conducted a survey to understand drivers of opinions of electricity infrastructure. • Considered socio-demographic, policy-related and technology-specific drivers. • Irish citizens generally have positive opinions of renewable technologies. • Positive opinions don't rule out local opposition. • Tradeoffs on policy objectives shape opinions most consistently across technologies.

  14. Entropy based classifier for cross-domain opinion mining

    Directory of Open Access Journals (Sweden)

    Jyoti S. Deshmukh

    2018-01-01

    Full Text Available In recent years, the growth of social network has increased the interest of people in analyzing reviews and opinions for products before they buy them. Consequently, this has given rise to the domain adaptation as a prominent area of research in sentiment analysis. A classifier trained from one domain often gives poor results on data from another domain. Expression of sentiment is different in every domain. The labeling cost of each domain separately is very high as well as time consuming. Therefore, this study has proposed an approach that extracts and classifies opinion words from one domain called source domain and predicts opinion words of another domain called target domain using a semi-supervised approach, which combines modified maximum entropy and bipartite graph clustering. A comparison of opinion classification on reviews on four different product domains is presented. The results demonstrate that the proposed method performs relatively well in comparison to the other methods. Comparison of SentiWordNet of domain-specific and domain-independent words reveals that on an average 72.6% and 88.4% words, respectively, are correctly classified.

  15. Prioritizing Approaches to Engage Community Members and Build Trust in Biobanks: A Survey of Attitudes and Opinions of Adults within Outpatient Practices at the University of Maryland

    Directory of Open Access Journals (Sweden)

    Casey Lynnette Overby

    2015-07-01

    Full Text Available Background: Achieving high participation of communities representative of all sub-populations is needed in order to ensure broad applicability of biobank study findings. This study aimed to understand potentially mutable attitudes and opinions commonly correlated with biobank participation in order to inform approaches to promote participation in biobanks. Methods: Adults from two University of Maryland (UMD Faculty Physicians, Inc. outpatient practices were invited to watch a video and complete a survey about a new biobank initiative. We used: Chi-square to assess the relationship between willingness to join the biobank and participant characteristics, other potentially mutable attitudes and opinions, and trust in the UMD. We also used t-test to assess the relationship with trust in medical research. We also prioritize proposed actions to improve attitudes and opinions about joining biobanks according to perceived responsiveness. Results: 169 participants completed the study, 51% of whom indicated a willingness to join the biobank. Willingness to join the biobank was not associated with age, gender, race, or education but was associated with respondent comfort sharing samples and clinical information, concerns related to confidentiality, potential for misuse of information, trust in UMD, and perceived health benefit. In ranked order, potential actions we surveyed that might alleviate some of these concerns include: increase chances to learn more about the biobank, increase opportunities to be updated, striving to put community concerns first, including involving community members as leaders of biobank research, and involving community members in decision making. Conclusions: This study identified several attitudes and opinions that influence decisions to join a biobank, including many concerns that could potentially be addressed by engaging community members. We also demonstrate our method of prioritizing ways to improve attitudes and opinions

  16. Quantifying the Effect of Open-Mindedness on Opinion Dynamics and Advertising Optimization

    OpenAIRE

    Innes, Clinton R

    2014-01-01

    Group opinion dynamics shape our world in innumerable ways. Societal aspects ranging from the political parties we support to the economic decisions we make in our daily lives are all directly af- fected in some way by group opinion dynamics. This makes understanding and potentially being able to predict the complex inter-relationships between individuals’ opinions and group opinion dynam- ics invaluable both scientifically and economically. We propose an aggregation model incorporating ingro...

  17. The influence of persuasion in opinion formation and polarization

    Science.gov (United States)

    La Rocca, C. E.; Braunstein, L. A.; Vazquez, F.

    2014-05-01

    We present a model that explores the influence of persuasion in a population of agents with positive and negative opinion orientations. The opinion of each agent is represented by an integer number k that expresses its level of agreement on a given issue, from totally against k=-M to totally in favor k = M. Same-orientation agents persuade each other with probability p, becoming more extreme, while opposite-orientation agents become more moderate as they reach a compromise with probability q. The population initially evolves to (a) a polarized state for r=p/q\\gt 1 , where opinions' distribution is peaked at the extreme values k=+/- M , or (b) a centralized state for r < 1, with most opinions around k=+/- 1 . When r \\gg 1 , polarization lasts for a time that diverges as r^M \\ln N , where N is the population's size. Finally, an extremist consensus (k = M or -M ) is reached in a time that scales as r^{-1} for r \\ll 1 .

  18. Opinions and Knowledge About Climate Change Science in High School Students

    DEFF Research Database (Denmark)

    Harker-Schuch, Inez; Henriksen, Christian Bugge

    2013-01-01

    in national and international schools before and after a lecture in climate change science. The results show that knowledge about climate change science significantly affects opinions about climate change. Students with a higher number of correct answers are more likely to have the opinion that humans......This study investigates the influence of knowledge on opinions about climate change in the emerging adults' age group (16-17 years). Furthermore, the effects of a lecture in climate change science on knowledge and opinions were assessed. A survey was conducted in Austria and Denmark on 188 students...... are causing climate change and that both individuals and governments are responsible for addressing climate change. The lecture in climate change science significantly improved knowledge development but did not affect opinions. Knowledge was improved by 11 % after the lecture. However, the percentage...

  19. Total expenditures per patient in hospital-owned and physician-owned physician organizations in California.

    Science.gov (United States)

    Robinson, James C; Miller, Kelly

    Hospitals are rapidly acquiring medical groups and physician practices. This consolidation may foster cooperation and thereby reduce expenditures, but also may lead to higher expenditures through greater use of hospital-based ambulatory services and through greater hospital pricing leverage against health insurers. To determine whether total expenditures per patient were higher in physician organizations (integrated medical groups and independent practice associations) owned by local hospitals or multihospital systems compared with groups owned by participating physicians. Data were obtained on total expenditures for the care provided to 4.5 million patients treated by integrated medical groups and independent practice associations in California between 2009 and 2012. The patients were covered by commercial health maintenance organization (HMO) insurance and the data did not include patients covered by commercial preferred provider organization (PPO) insurance, Medicare, or Medicaid. Total expenditures per patient annually, measured in terms of what insurers paid to the physician organizations for professional services, to hospitals for inpatient and outpatient procedures, to clinical laboratories for diagnostic tests, and to pharmaceutical manufacturers for drugs and biologics. Annual expenditures per patient were compared after adjusting for patient illness burden, geographic input costs, and organizational characteristics. Of the 158 organizations, 118 physician organizations (75%) were physician-owned and provided care for 3,065,551 patients, 19 organizations (12%) were owned by local hospitals and provided care for 728,608 patients, and 21 organizations (13%) were owned by multihospital systems and provided care for 693,254 patients. In 2012, physician-owned physician organizations had mean expenditures of $3066 per patient (95% CI, $2892 to $3240), hospital-owned physician organizations had mean expenditures of $4312 per patient (95% CI, $3768 to $4857), and

  20. Opinion leadership and willingness to pay for residential photovoltaic systems

    International Nuclear Information System (INIS)

    Yamamoto, Yoshihiro

    2015-01-01

    According to diffusion theory, opinion leaders play an important role in the diffusion of new technologies through interpersonal communication with potential adopters. This study investigates the role and utility of opinion leadership in photovoltaic (PV) system diffusion. Specifically, the study proposes, examines, and considers the implications of the hypothesis that there is a positive relationship between willingness to pay (WTP) for a PV system and opinion leadership on PV-system adoption. The investigation employed an internet-based questionnaire to assess the use of interpersonal communication in decision-making on adoption, to identify opinion leaders on adoption, and to characterize their WTP. The response pool consisted of 488 individuals who lived in a detached house, owned a residential PV system, and were responsible for making the decision to adopt the system. The results support the hypothesis. Considering that subsidization preferentially incentivizes households with greater WTP to adopt PV systems, this suggests that subsidization is more effective than purchases of PV power under feed-in tariffs in promoting the diffusion of residential PV systems through interpersonal communication. -- Highlights: •Interpersonal communication about the adoption of PV systems is analyzed. •A questionnaire survey is conducted. •Opinion leaders on PV-system adoption are identified. •A relationship is confirmed between willingness to pay and opinion leadership. •Subsidization is more essential than feed-in tariffs from this point of view

  1. Sudden transitions in coupled opinion and epidemic dynamics with vaccination

    Science.gov (United States)

    Pires, Marcelo A.; Oestereich, André L.; Crokidakis, Nuno

    2018-05-01

    This work consists of an epidemic model with vaccination coupled with an opinion dynamics. Our objective was to study how disease risk perception can influence opinions about vaccination and therefore the spreading of the disease. Differently from previous works we have considered continuous opinions. The epidemic spreading is governed by an SIS-like model with an extra vaccinated state. In our model individuals vaccinate with a probability proportional to their opinions. The opinions change due to peer influence in pairwise interactions. The epidemic feedback to the opinion dynamics acts as an external field increasing the vaccination probability. We performed Monte Carlo simulations in fully-connected populations. Interestingly we observed the emergence of a first-order phase transition, besides the usual active-absorbing phase transition presented in the SIS model. Our simulations also show that with a certain combination of parameters, an increment in the initial fraction of the population that is pro-vaccine has a twofold effect: it can lead to smaller epidemic outbreaks in the short term, but it also contributes to the survival of the chain of infections in the long term. Our results also suggest that it is possible that more effective vaccines can decrease the long-term vaccine coverage. This is a counterintuitive outcome, but it is in line with empirical observations that vaccines can become a victim of their own success.

  2. Opinion-enhanced collaborative filtering for recommender systems through sentiment analysis

    Science.gov (United States)

    Wang, Wei; Wang, Hongwei

    2015-10-01

    The motivation of collaborative filtering (CF) comes from the idea that people often get the best recommendations from someone with similar tastes. With the growing popularity of opinion-rich resources such as online reviews, new opportunities arise as we can identify the preferences from user opinions. The main idea of our approach is to elicit user opinions from online reviews, and map such opinions into preferences that can be understood by CF-based recommender systems. We divide recommender systems into two types depending on the number of product category recommended: the multiple-category recommendation and the single-category recommendation. For the former, sentiment polarity in coarse-grained manner is identified while for the latter fine-grained sentiment analysis is conducted for each product aspect. If the evaluation frequency for an aspect by a user is greater than the average frequency by all users, it indicates that the user is more concerned with that aspect. If a user's rating for an aspect is lower than the average rating by all users, he or she is much pickier than others on that aspect. Through sentiment analysis, we then build an opinion-enhanced user preference model, where the higher the similarity between user opinions the more consistent preferences between users are. Experiment results show that the proposed CF algorithm outperforms baseline methods for product recommendation in terms of accuracy and recall.

  3. HMO penetration and physicians' earnings.

    Science.gov (United States)

    Hadley, J; Mitchell, J M

    1999-11-01

    The goal of this study is to estimate whether cross-sectional variations in enrollment in health maintenance organizations (HMOs) affected physicians' earnings and hourly income in 1990. Using data from a nationally representative sample of 4,577 younger physicians (penetration is endogenous and used the instrumental variables approach to obtain unbiased estimates. HMO penetration had a negative and statistically significant impact on physicians earnings in 1990. A doubling of the average level of HMO penetration in the market is estimated to reduce annual earnings by 7% to 10.7%, and hourly earnings by approximately 6% to 9%. It appears that HMOs were successful in reducing physicians' annual and per hour earnings in 1990, presumably through a combination of fewer visits and lower payment rates for people covered by HMOs. Although these results cannot be generalized to all physicians, the experience of a younger cohort of physicians may still be a good indicator of the future effects of HMOs because younger physicians may be more susceptible to market forces than older and more established physicians. Moreover, these results may be somewhat conservative because they reflect market behavior in 1990, several years before the rapid growth and more aggressive market behavior of HMOs in recent years.

  4. Motives for seeking a second opinion in orthopaedic surgery.

    NARCIS (Netherlands)

    Dalen, I. van; Groothoff, J.; Stewart, R.; Spreeuwenberg, P.; Groenewegen, P.; Horn, J. van

    2001-01-01

    The number of second opinions in orthopaedic surgery is increading rapidly, yet the grounds on which patients and their doctors decide to seek a second opinion have been little studied. The goal of the study was to identify patient and consultant factors that appeared to contribute to a second

  5. Nursing opinion leadership: a preliminary model derived from philosophic theories of rational belief.

    Science.gov (United States)

    Anderson, Christine A; Whall, Ann L

    2013-10-01

    Opinion leaders are informal leaders who have the ability to influence others' decisions about adopting new products, practices or ideas. In the healthcare setting, the importance of translating new research evidence into practice has led to interest in understanding how opinion leaders could be used to speed this process. Despite continued interest, gaps in understanding opinion leadership remain. Agent-based models are computer models that have proven to be useful for representing dynamic and contextual phenomena such as opinion leadership. The purpose of this paper is to describe the work conducted in preparation for the development of an agent-based model of nursing opinion leadership. The aim of this phase of the model development project was to clarify basic assumptions about opinions, the individual attributes of opinion leaders and characteristics of the context in which they are effective. The process used to clarify these assumptions was the construction of a preliminary nursing opinion leader model, derived from philosophical theories about belief formation. © 2013 John Wiley & Sons Ltd.

  6. Expert opinion vs. empirical evidence: the precautionary principle applied to GM crops.

    Science.gov (United States)

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops.

  7. Pregnancy Options Counseling and Abortion Referrals Among US Primary Care Physicians: Results From a National Survey.

    Science.gov (United States)

    Holt, Kelsey; Janiak, Elizabeth; McCormick, Marie C; Lieberman, Ellice; Dehlendorf, Christine; Kajeepeta, Sandhya; Caglia, Jacquelyn M; Langer, Ana

    2017-07-01

    Primary care physicians (PCPs) can play a critical role in addressing unintended pregnancy through high-quality options counseling and referrals. We surveyed a nationally representative sample of 3,000 PCPs in general, family, and internal medicine on practices and opinions related to options counseling for unintended pregnancy. We assessed predictors of physician practices using multivariable logistic regression weighted for sampling design and differential non-response. Response rate was 29%. Seventy-one percent believed residency training in options counseling should be required, and 69% believed PCPs have an obligation to provide abortion referrals even in the presence of a personal objection to abortion. However, only 26% reported routine options counseling when caring for women with unintended pregnancy compared to 60% who routinely discuss prenatal care. Among physicians who see women seeking abortion, 62% routinely provide referrals, while 14% routinely attempt to dissuade women. Family physicians were more likely to provide routine options counseling when seeing patients with unintended pregnancy than internal medicine physicians (32% vs 21%, P=0.002). In multivariable analyses, factors associated with higher odds of routine abortion referrals were more years in practice (OR=1.03 for each additional year, 95% CI: 1.00-1.05), identifying as a woman vs a man (OR=2.11, 95% CI: 1.31-3.40), practicing in a hospital vs private primary care/multispecialty setting (OR=3.17, 95% CI: 1.10-9.15), and no religious affiliation of practice vs religious affiliation (OR for Catholic affiliation=0.27, 95% CI: 0.11-0.66; OR for other religious affiliation=0.36, 95% CI: 0.15-0.83). Personal Christian religious affiliation among physicians who regularly attend religious services vs no religious affiliation was associated with lower odds of counseling (OR=0.48, 95% CI: 0.26-0.90) and referrals (OR=0.31, 95% CI: 0.15-0.62), and higher odds of abortion dissuasion (OR=4.03, 95

  8. Islamic Work Ethics and Audit Opinions: Audit Professionalism and Dysfunctional

    Directory of Open Access Journals (Sweden)

    Tulus Suryanto

    2016-02-01

    Full Text Available This study examines the relationship between Islamic work ethics and auditors' opinion, focusing on the aspects of audit professionalism and dysfunctional behavior  as intervening  variables. The research involved in Internal Auditors working of Islamic Banking industry in Sumatra Island. A questionnaire was used for data collection. The study represents the empirical test employing census sampling. The data collected were analysed using Amos.  The results of the study confirmed the three hypotheses examined: there is a positive corelation between Islamic work ethics and auditors' opinions; auditors’ professionalism is an intervening variable of the correlation between Islamic work ethics and auditors’ opinions and dysfunctional behavior is a negative intervening variable of the correlation between Islamic Work Ethics and auditors' opinionsDOI: 10.15408/aiq.v8i1.1864

  9. Phase Transitions in a Social Impact Model for Opinion Formation

    Science.gov (United States)

    Bordogna, Clelia M.; Albano, Ezequiel V.

    A model for opinion formation in a social group, based on the Theory of Social Impact developed by Latané, is studied by means of numerical simulations. Interactions among the members of the group, as well as with a strong leader competing with the mass media, are considered. The model exhibits first-order transitions between two different states of opinion, which are supported by the leader and the mass media, respectively. The social inertia of the group becomes evident when the opinion of the leader changes periodically. In this case two dynamic states are identified: for long periods of time, the group follows the changes of the leader but, decreasing the period, the opinion of the group remains unchanged. This scenery is suitable for the ocurrence of dynamic phase transitions.

  10. Democracy, the media stage and opinions evaluation. The particular case of nuclear

    International Nuclear Information System (INIS)

    Ansel, Ph.; Pages, J.P.

    1997-01-01

    The intention is pointed at the public opinion. The public debate, linked to the political system, is described in the frame where the opinions are expressed in interaction with the media. This debate has a fundamental role in the opinions structuration. Then it is shown how it is possible to introduce it in the way of measuring the opinions. Then, we arrive to the structures of public opinion. The analysis of facts registered during twenty years on nuclear energy allows to illustrate the interest of this global approach: considered from a controversy point of view, it is also a technical object and then it can be considered as a differentiation theme among others ones. (N.C.)

  11. Utah obstetricians' opinions of planned home birth and conflicting NICE/ACOG guidelines: A qualitative study.

    Science.gov (United States)

    Rainey, Emily; Simonsen, Sara; Stanford, Joseph; Shoaf, Kimberley; Baayd, Jami

    2017-06-01

    The United Kingdom's National Institute for Health and Care Excellence (NICE) recently published recommendations that support planned home birth for low-risk women. The American College of Obstetricians and Gynecologists (ACOG) remains wary of planned home birth, asserting that hospitals and birthing centers are the safest birth settings. Our objective was to examine opinions of obstetricians in Salt Lake City, Utah about home birth in the context of rising home birth rates and conflicting guidelines. Participants were recruited through online searches of Salt Lake City obstetricians and through snowball sampling. We conducted individual interviews exploring experiences with and attitudes toward planned home birth and the ACOG/NICE guidelines. Fifteen obstetricians who varied according to years of experience, location of medical training, sex, and subspecialty (resident, OB/GYN, maternal-fetal medicine specialist) were interviewed. Participants did not recommend home birth but supported a woman's right to choose her birth setting. Obstetrician opinions about planned home birth were shaped by misconceptions of home birth benefits, confusion surrounding the scope of care at home and among home birth providers, and negative transfer experiences. Participants were unfamiliar with the literature on planned home birth and/or viewed the evidence as unreliable. Support for ACOG guidelines was high, particularly in the context of the United States health care setting. Physician objectivity may be limited by biases against home birth, which stem from limited familiarity with published evidence, negative experiences with home-to-hospital transfers, and distrust of home birth providers in a health care system not designed to support home birth. © 2017 Wiley Periodicals, Inc.

  12. Indicators of opinion leadership in customer networks : self-reports and degree centrality

    NARCIS (Netherlands)

    Risselada, Hans; Verhoef, Pieter; Bijmolt, Tammo

    In this paper, we assess two alternative indicators of opinion leadership, self-reported opinion leadership and degree centrality, on the same dataset. We also investigate the interaction effect of these two indicators and the social network environment on opinion leadership. We use social network

  13. The nature and determinants of opinion leadership in Lesotho ...

    African Journals Online (AJOL)

    This research investigates the nature, the occurrence and the factors influencing opinion leadership in Lesotho. The focus is on a typical rural district where 200 maize farmers were randomly selected and their opinion leaders identified by means of sociometric methods with the number of nominations as the major indicator ...

  14. Current level of training, experience and perceptions of emergency physicians as expert witnesses: a pilot study.

    Science.gov (United States)

    Cunningham, Nicola Y; Weiland, Tracey J

    2009-12-01

    The objective of the present study was to determine emergency physicians' training, experience and perceptions as expert witnesses. Emergency physicians of an adult tertiary referral and teaching hospital participated in a pilot survey regarding their experiences in report writing and in court as expert witnesses. The 28-item survey also examined the amount of formalized forensic medical teaching that emergency physicians had received during their training. Of the participants, 41% (95% CI 21.6-64.1; 7/17) had never received any undergraduate or postgraduate training in forensic medicine, 11/17 (65%, 95% CI 41.2-82.8) had provided a written expert opinion for court, and 12/17 (71%, 95% CI 46.6-87.0) had attended court as an expert witness. All participants considered themselves 'skilled in attending an emergency resuscitation', whereas 3/13 (23%, 95% CI 7.5-50.9) considered themselves 'skilled in attending a courtroom trial'. Nearly 90% (95% CI 64.7-98.0; 15/17) thought that medical evidence training should be a requirement of emergency speciality training. The most commonly preferred forms of medical evidence training were mock court sessions (76%, 95% CI 52.2-91.0; 13/17) and forensic workshops (76%, 95% CI 52.2-91.0; 13/17). From 10 non-technical skills required of an EP, 'appearing in court as an expert witness' was perceived to be the second most difficult skill by most respondents. Emergency physicians in this pilot study have limited training for the role of expert witness and see it as one of the most difficult non-technical skills they have to perform. Further research is required regarding the current and future scope of forensic training.

  15. Family physicians' attitude and interest toward participation in urban family physician program and related factors

    Directory of Open Access Journals (Sweden)

    Masoumeh Sadeghi

    2016-01-01

    Full Text Available Introduction: Every family physician has a key role in achieving the goals of the family physician program (FPP. Low satisfaction of physicians in certain areas of Iran and their low maintenance level in the program is quite challenging. The aims of the present study were; (1 to assess the attitude of rural/rural-urban family physicians about FPP and (2 to investigate their interest toward participation in urban FPP and (3 to explore the influencing factors. Methods: This cross-sectional study was performed on 137 family physicians who were working in rural/rural-urban FPP in Mashhad University of Medical Sciences (Iran. A self-designed valid and reliable questionnaire including demographic data and thirty questions on the participants' attitudes toward the FPP in Likert scale were used. Data were analyzed by multiple logistic regression models using SPSS software. Results: 49.3% of physicians were interested in continuing their cooperation in the urban-FPP. The mean total attitude score was 62.18 out of 100. The highest agreement and positive attitude of physicians were related to achievements of the program goals dimension. Multiple analyses showed that gender (odds ratio [OR] =5.5; male vs. female and employment status (OR = 16.7 and 10.9 for permanent employment and by contract compared to legal obligation, respectively were significantly associated with physicians' willingness toward participation in the urban-FPP. Conclusion: About half of the studied physicians were interested toward participation in the urban-FPP; Male physicians more than females and permanent employees more than others were willing and interested to participate in the urban-FPP.

  16. Patient-physician communication regarding electronic cigarettes.

    Science.gov (United States)

    Steinberg, Michael B; Giovenco, Daniel P; Delnevo, Cristine D

    2015-01-01

    Smokers are likely asking their physicians about the safety of e-cigarettes and their potential role as a cessation tool; however, the research literature on this communication is scant. A pilot study of physicians in the United States was conducted to investigate physician-patient communication regarding e-cigarettes. A total of 158 physicians were recruited from a direct marketing e-mail list and completed a short, web-based survey between January and April 2014. The survey addressed demographics, physician specialty, patient-provider e-cigarette communication, and attitudes towards tobacco harm reduction. Nearly two-thirds (65%) of physicians reported being asked about e-cigarettes by their patients, and almost a third (30%) reported that they have recommended e-cigarettes as a smoking cessation tool. Male physicians were significantly more likely to endorse a harm reduction approach. Physician communication about e-cigarettes may shape patients' perceptions about the products. More research is needed to explore the type of information that physicians share with their patients regarding e-cigarettes and harm reduction.

  17. Developing a Physician׳s Professional Identity Through Medical Education.

    Science.gov (United States)

    Olive, Kenneth E; Abercrombie, Caroline L

    2017-02-01

    Professionalism represents a fundamental characteristic of physicians. Professional organizations have developed professionalism competencies for physicians and medical students. The aim of teaching medical professionalism is to ensure the development of a professional identity in medical students. Professional identity formation is a process developed through teaching principles and appropriate behavioral responses to the stresses of being a physician. Addressing lapses and critical reflection is an important part of the educational process. The "hidden curriculum" within an institution plays an important role in professional identity formation. Assessment of professionalism involves multiple mechanisms. Steps in remediating professionalism lapses include (1) initial assessment, (2) diagnosis of problems and development of an individualized learning plan, (3) instruction encompassing practice, feedback and reflection and (4) reassessment and certification of competence. No reliable outcomes data exist regarding the effectiveness of different remediation strategies. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  18. Analysing Customer Opinions with Text Mining Algorithms

    Science.gov (United States)

    Consoli, Domenico

    2009-08-01

    Knowing what the customer thinks of a particular product/service helps top management to introduce improvements in processes and products, thus differentiating the company from their competitors and gain competitive advantages. The customers, with their preferences, determine the success or failure of a company. In order to know opinions of the customers we can use technologies available from the web 2.0 (blog, wiki, forums, chat, social networking, social commerce). From these web sites, useful information must be extracted, for strategic purposes, using techniques of sentiment analysis or opinion mining.

  19. Overview of physician-hospital ventures.

    Science.gov (United States)

    Cohn, Kenneth H; Allyn, Thomas R; Rosenfield, Robert H; Schwartz, Richard

    2005-01-01

    An ongoing environment of reimbursement lagging behind escalating expenses has led physicians to explore new sources of revenue. The goal of physician-hospital ventures is to create a valuable entity that benefits patients, physicians, and the hospital. Physicians may choose to invest in healthcare facilities to improve patient care and obtain increased control over daily operations. If so, they should seek counsel to avoid violating Stark laws and anti-kickback laws. Modalities for investing in physician-hospital ventures are joint equity (stock) ventures, participating bond transactions (PBTs), and contractual integration, a new method to align the goals of specialists and hospital management without using joint equity ventures. Physicians and management should invest time in developing a shared vision of the future before beginning contract negotiations. Successful partnering requires transparency and stepwise building of trust. The greatest gain in joint ventures arises when both sides become active owners, rather than passive investors.

  20. Physician suicide.

    Science.gov (United States)

    Preven, D W

    1981-01-01

    The topic of physician suicide has been viewed from several perspectives. The recent studies which suggest that the problem may be less dramatic statistically, do not lessen the emotional trauma that all experience when their lives are touched by the grim event. Keeping in mind that much remains to be learned about suicides in general, and physician suicide specifically, a few suggestions have been offered. As one approach to primary prevention, medical school curriculum should include programs that promote more self-awareness in doctors of their emotional needs. If the physician cannot heal himself, perhaps he can learn to recognize the need for assistance. Intervention (secondary prevention) requires that doctors have the capacity to believe that anyone, regardless of status, can be suicidal. Professional roles should not prevent colleague and friend from identifying prodromal clues. Finally, "postvention" (tertiary prevention) offers the survivors, be they family, colleagues or patients, the opportunity to deal with the searing loss in a therapeutic way.