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End of Life Care and Decision Making: How Far We Have Come, How Far We Have to Go
Published in Inge B. Corless, Zelda Foster, The Hospice Heritage: Celebrating Our Future, 2020
Connie Zuckerman, David Wollner
In many ways, Rose was unusual in her advance consideration of death and dying. Only a small percentage of patients execute such directives in advance of incapacity (Lynn & Teno, 1993). Prompted by the experiences endured by her loved ones, Rose was able to reflect upon and express her own wishes concerning some of the more dramatic choices that might arise as life drew to a close: Her health care proxy was in place, a DNR order was on her chart, and she had articulated a philosophy that suggested that quality of life, rather than length of life, was most important to her. Only a small minority of patients have the ability or foresight to consider such concerns in advance. According to current models of end of life decision making, Rose had taken all the right steps to help ensure that her autonomous wishes would be respected. Yet ultimately this advance planning did not lead to a peaceful, dignified death for Rose, an all too common fate for patients in such circumstances.
Predictive Markers for Targeted Breast Cancer Treatment
Published in Brian Leyland-Jones, Pharmacogenetics of Breast Cancer, 2020
Hans Christian B. Pedersen, John M. S. Bartlett
Cancer is a disease that involves the complex interplay of multiple genes in a framework of mutations in the cancer cell. In addition, tumor cells have interactions with other cells, thereby further promoting growth and invasiveness. Patients respond differently to treatment based on their tumor characteristics. Despite recent challenges, we foresee the strong likelihood that current research and drug development will introduce more predictive markers into IHC laboratories in the same fashion as trastuzumab has resulted in HER2/neu being routinely tested for (see above). This foresight is based on the premise that more care and more robust approaches are applied to the development of predictive biomarkers. It is likely that within two to five years, a panel of markers will be tested on every tumor sample in order to decide optimal therapy regimen. Currently only three predictive IHC markers (ERa, PR, and HER2/neu) are tested for routinely in breast, but already some pathologists use additional markers to inform decisions, e.g., p53, Ki67, and TOP2A. As more and more predictive IHC markers are introduced in clinical laboratories, this will lead to an increased pressure on pathology laboratories to deliver fast and accurate decisions. How can this be achieved and what technological advances can improve IHC testing?
What resource tools are available to help me in working in action learning?
Published in John Edmonstone, Action Learning in Health, Social and Community Care, 2017
How would I use it? The approach can be done on a personal basis, but sometimes a fellow set member or work colleague can be invited to do it, as sometimes others have a clearer picture of how we are than we do ourselves. The process is to remember a challenging time in the past which you found a way through. Think back to what helped to find the way through by looking at the following areas: Strategies: What were the personal strategies that were used? Asking for help? Using problem-solving approaches?Strengths: What were the strengths drawn upon in order to get through that challenging time? Courage? Foresight? Determination? A sense of humour? Flexibility? Ability to communicate?Resources: What were the resources mobilised for personal nourishment, inspiration, guidance or support? Family? Friends? Colleagues? Mentors? Support groups? Places where a sense of safety and calm prevails?Insights: Ideas, perspectives or sayings that were previously found useful. For example, the saying ‘I can't, but we can’ or the insight that personal and group resilience are powerfully intertwined.
Exploring the motivators of technology adoption in healthcare
Published in International Journal of Healthcare Management, 2021
Dana Alrahbi, Mehmood Khan, Matloub Hussain
The future foresight category is relatively modern and only a few organizations are involved in training and certifying their employees in this area. A total of 20 trained experts were approached and 15 were interviewed for this research. The analysis of future foresight experts’ opinions is a novel approach in academic research but provides a new way of directly involving the industry’s planning capacity in studying HIT adoption motivators. Nowadays, the term foresight expert engenders far more expectations than previously, although professional foresight services are still note clearly defined from the perspective of the market [69]. However, several authors have adopted the definition of foresight professionals as individuals engaged in a systematic, future-oriented, analytical and interactive process that partly contributes to shared visions concerning long-term developments within science, technology, business and society and partly facilitates the alignment of relevant stakeholder groupings around desirable developments through relevant strategies, decisions and actions. [70]Foresight is an activity focused on the cognitive part of anticipation [71]. This process enables individuals to ‘see far and wide’ to improve how they think through their decisions [72]. Hence, foresight experts modify individual representations by creating new frames for analysis [73].
COVID-19 and the epistemology of epidemiological models at the dawn of AI
Published in Annals of Human Biology, 2020
Epidemiologists are very familiar with the constraints that uncertainty and variability pose (Blower and Dowlatabadi 1994), though many adopt the view that – provided the risks of error and imprecision do not vary dramatically (or systematically); and provided there are enough data to moderate the risk of chance fluctuation – even suboptimal information can help provide insight, and can be used to generate foresight (Ashofteh and Bravo 2020; Ritchie et al. 2020; Woolf et al. 2020). It is on this basis that epidemiologists, statisticians and data analysts have – from the earliest stages of the COVID-19 pandemic – held their noses and set to work on whatever data have been available to: visualise patterns and summarise variation in the data (e.g. Lescure et al. 2020; Simeone 2020); draw comparisons between different datasets (Ritchie et al. 2020); investigate associations between different characteristics and parameters (e.g. Korber et al. 2020); generate “predictions”3 (e.g. Qin et al. 2020); and infer causal mechanisms (e.g. Williamson et al. 2020). However, this is also the basis on which some data scientists are often content to use very large quantities of deeply flawed data (so-called “Big data”; Mondal et al. 2020; Wang et al. 2020) – with little concern for error (and little regard for bias; Ayyoubzadeh et al. 2020; Qin et al. 2020; Sun et al. 2020) – to identify patterns and relationships that risk being artefacts of whatever extraneous (and intrinsic) factors determine the coverage, availability and information-value of the data available (Arnold et al. 2020).
Social Work and the Future in a Post-Covid 19 World: A Foresight Lens and a Call to Action for the Profession
Published in Journal of Technology in Human Services, 2020
The history of futures work has been a study in embracing complexity and yet devising a progressively clearer and coherent method of collectively analyzing, exploring and making emergent meaning out of the influence of the past (history matters in futures work), the present in focus, and that which is around the corner and implied, possible, plausible or beyond (Miller, 2015). Foresight practice is a set of philosophies, skills and applications that involve use of quantitative data (trend spotting and analysis), qualitative methods (speculative fiction, and use of other creative methods of imagining possible futures) and the interplay of collective intelligence and imagination development through guided group processes, exercises, design opportunities, reflection and connecting these to planning exercises and goals aimed at collective objectives to be more well-prepared for whatever may come. Utilizing scenario development approaches are common to explore various “possible” futures and interpret from them what is wanted and what is not.