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Perception, Planning, and Scoping, Problem Formulation, and Hazard Identification
Published in Ted W. Simon, Environmental Risk Assessment, 2019
At its heart, problem formulation is a set of hypotheses and a plan for interpreting the available information to rank the likelihood of these hypotheses. Problem formulation is applicable to all phases of risk assessment, including the characterization of both exposure and hazard. Conducting a credible problem formulation requires a systematic approach to identify all the factors critical to the goal of the particular phase of the assessment, including the depth and scope of analysis, available resources, and possible outcomes.40,41 In short, the NATO description of problem formulation as a voyage of discovery was spot on!26
Communicating Our Thoughts with Peers and Patients—Mostly Oral Clinical Communication, Its Content, Objectives, and Vehicles 1
Published in Milos Jenicek, How to Think in Medicine, 2018
Ideally, cases are discussed in the Socratic manner summarized in Section 11.1.6. Through the morning report, questions focused on problem formulation, diagnosis, and management of patients are addressed to the staff,91 and their understanding is reached through a mutual exchange of proposals and statements (premises) using a modern argumentation process. In this context, morning reports are an important teaching tool during clinical training.92,93 Amin et al.94 offer a valuable review and proposal for how morning reports should be structured.
Management of feeding problems in children with a chronic illness
Published in Southall Angela, Feeding Problems in Children, 2017
Anthony. Schwartz, Zuzana. Rothlingova
Practice would indicate that psychological management of feeding problems should comprise both an 'individual perspective' and a 'meta-view'. Individual focus may encompass behavioural, cognitive and psychodynamic frameworks, and an overarching perspective can be taken by using systemic approaches. Kendall and Norton-Ford (1982) clearly set out the need for proper assessment, problem formulation, treatment and evaluation of the approach used.
Integration of behavioral medicine competencies into physiotherapy curriculum in an exemplary Swedish program: rationale, process, and review
Published in Physiotherapy Theory and Practice, 2020
Maria Sandborgh, Elizabeth Dean, Eva Denison, Maria Elvén, Johanna Fritz, Petra von Heideken Wågert, Johan Moberg, Thomas Overmeer, Åsa Snöljung, Ann-Christin Johansson, Anne Söderlund
To integrate behavioral medicine content and competencies effectively into the curriculum, it was important to present a coherent structure and process that would allow the requisite core content to be taught, theoretically and practically, within a 3-year timeframe. Consequently, a multi-step structure was identified in the area of cognitive behavioral therapy (Turk, 2003; Turk and Okifuji, 1993), adapted to physiotherapy practice through a process model (Åsenlöf, 2005; Johansson, 1999; Sandborgh, 2008; Söderlund, 2001). This structured process model allowed for teaching requisite competencies in patient/client examination/assessment, analysis, intervention, and evaluation was evidence based and relevant to the primary areas of physiotherapist practice (Denison and Åsenlöf, 2012). The steps in the process model included: problem formulation; collection of biopsychosocial data relevant to the presenting problem (s); functional behavior analysis and shared goal setting as well as the development; generalization and maintenance of behavioral skills (i.e. physical, psychological and organizational skills); and the achievement of behavioral goals (Denison and Åsenlöf, 2012; Turk, 2003). A systematic process model for integrating behavioral medicine into physiotherapist practice was outlined, which described the final integration of germane behavioral medicine content and competencies within physiotherapist practice.
Using mechanistic information to support evidence integration and synthesis: a case study with inhaled formaldehyde and leukemia
Published in Critical Reviews in Toxicology, 2020
Robinan Gentry, Chad M. Thompson, Allison Franzen, Joshua Salley, Richard Albertini, Kun Lu, Tracy Greene
Applying the IPCS framework highlights the lack of formaldehyde-specific dose-response information to support multiple key events for the four postulated MOAs. The integration of the epidemiological, animal toxicity, and in vitro mechanistic data that support the MOAs indicated that the weight of the evidence is inconsistent with, or contradicts, the postulated MOAs. Results of the study quality and study relevance (to the problem formulation questions) assessment helped ensure that those studies with the highest quality scores that are directly relevant to the problem formulation were used in drawing conclusions.
Overview on legislation and scientific approaches for risk assessment of combined exposure to multiple chemicals: the potential EuroMix contribution
Published in Critical Reviews in Toxicology, 2018
S. Rotter, A. Beronius, A. R. Boobis, A. Hanberg, J. van Klaveren, M. Luijten, K. Machera, D. Nikolopoulou, H. van der Voet, J. Zilliacus, R. Solecki
As indicated in Section 2, most regulatory authorities and organizations require some assessment of human health risks associated with combined exposure to multiple chemicals, whereas only a few propose and use existing frameworks. Table 2 provides a structured overview and comparison of 14 frameworks identified for review, in terms of the scope, purpose and some general principles applied. These frameworks have been developed by different organizations under different jurisdictions and regulatory settings. Some are meant to be general approaches applicable for different purposes (e.g. EFSA 2018a focused on the food and feed safety areas, but can be broadened to other regulatory areas and across regulatory sectors), while others have been developed for assessment of chemical mixtures from a specific exposure source (e.g. ATSDR 2018) or belonging to a group of chemicals with a specific use and/or regulated under product-specific legislation (e.g. US EPA 2002b; EFSA 2008; Stein et al. 2014; ECHA 2015; US EPA 2016a). Although, the purpose, scope, considerations for problem formulation and principles applied vary to some extent between the existing frameworks, they also show many similarities. EFSA has previously conducted a review to summarize the terminology, methodologies and frameworks developed by national and international agencies and to provide recommendations for future activities at EFSA in this area (EFSA 2013a). Some additional frameworks have been presented by the German Federal Institute for Risk Assessment (Stein et al. 2014), ECHA (2015), the European Chemical Industry Council, CEFIC (Price et al. 2012) and the Health and Environmental Sciences Institute (HESI) (Moretto et al. 2017), as well as an updated approach from the US Agency for Toxic Substances and Disease Registry (ATSDR 2018).