Interactive Journal of Medical Research最新文献

{"title":"Perceptions and Experiences of Caregiver-Employees, Employers, and Health Care Professionals With Caregiver-Friendly Workplace Policy in Hong Kong: Thematic Analysis.","authors":"Maggie Man-Sin Lee, Eng-Kiong Yeoh, Eliza Lai-Yi Wong, Xue Bai, Nelson Chun-Yiu Yeung, Catherine French, Henock Taddese","doi":"10.2196/58528","DOIUrl":"10.2196/58528","url":null,"abstract":"<p><strong>Background: </strong>Caregiver-employees (CEs) for older adults experience a high burden to fulfill their dual roles. Caregiver-friendly workplace policy (CFWP) has been used in many countries to balance employment and caregiving duties, but it is a relatively new concept in Hong Kong.</p><p><strong>Objective: </strong>This study explored the views and experiences of CEs, employers, and health care professionals regarding CFWP (specifically for older adult caregivers) in Hong Kong.</p><p><strong>Methods: </strong>This study explored the CFWP-related views and experiences in Hong Kong using 15 in-depth interviews with purposively sampled CEs for older adults, employers, and health care professionals.</p><p><strong>Results: </strong>Two context-related themes (\"lacking leadership\" and \"unfavorable culture\") were identified with thematic analysis. They explain the absence of CFWP in Hong Kong due to the lack of governmental and organizational leadership, and the additional burden experienced by CEs because of the working culture that underpins work-life separation, overprizing business interest, and unsympathetic corporate attitude. Implicit voice theory was applicable in explaining CEs' nondisclosure about their status at work due to potential risks. In addition, the two facilitation-related themes (\"role struggle\" and \"inadequate support\") identified in this study exhibit how the dual role had positive and negative spillover effects on each other and the inadequacy of social welfare and health care support systems.</p><p><strong>Conclusions: </strong>We strongly recommend exploring and adopting potential CFWP in Hong Kong, considering the complexity of factors identified in this study.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e58528"},"PeriodicalIF":1.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Process Evaluations of Interventions for the Prevention of Type 2 Diabetes in Women With Gestational Diabetes Mellitus: Systematic Review.","authors":"Iklil Iman Mohd Sa'id, Natasha Hotung, Madeleine Benton, Iliatha Papachristou Nadal, Anisah Baharom, Matthew Prina, Barakatun Nisak Mohd Yusof, Kimberley Goldsmith, Samantha Birts, Ching Siew Mooi, Angus Forbes, Khalida Ismail, Boon How Chew","doi":"10.2196/51718","DOIUrl":"10.2196/51718","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is characterized by hyperglycemia in pregnancy and typically resolves after birth. Women with GDM have an increased risk of developing type 2 diabetes mellitus (T2DM) later in life compared to those with normoglycemic pregnancy. While diabetes prevention interventions (DPIs) have been developed to delay or prevent the onset of T2DM, few studies have provided process evaluation (PE) data to assess the mechanisms of impact, quality of implementation, or contextual factors that may influence the effectiveness of the intervention.</p><p><strong>Objective: </strong>This study aims to identify and evaluate PE data and how these link to outcomes of randomized controlled trials (RCTs) of T2DM prevention interventions for women with GDM.</p><p><strong>Methods: </strong>A systematic review was conducted to identify studies published from 2005 to 2020 aiming to capture the most recent DPIs. Five electronic bibliographic databases (Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, Embase, PubMed, and MEDLINE) were searched to identify relevant studies. Inclusion criteria were published (peer-reviewed) RCTs of DPIs in women with a current diagnosis or history of GDM. Exclusion criteria were studies not published in English; studies where the target population was women who had a family history of T2D or women who were menopausal or postmenopausal; and gray literature, including abstracts in conference proceedings. The Medical Research Council's PE framework of complex interventions was used to identify key PE components. The Mixed Method Appraisal Tool was used to assess the quality of included studies.</p><p><strong>Results: </strong>A total of 24 studies were included; however, only 5 studies explicitly reported a PE theoretical framework. The studies involved 3 methods of intervention delivery, including in person (n=7), digital (n=7), and hybrid (n=9). Two of the studies conducted pilot RCTs assessing the feasibility and acceptability of their interventions, including recruitment, participation, retention, program implementation, adherence, and satisfaction, and 1 study assessed the efficacy of a questionnaire to promote food and vegetable intake. While most studies linked PE data with study outcomes, it was unclear which of the reported PE components were specifically linked to the positive outcomes.</p><p><strong>Conclusions: </strong>While the Medical Research Council's framework is a valuable source for conducting systematic reviews on PEs, it has been criticized for lacking practical advice on how to conduct them. The lack of information on PE frameworks in our review also made it difficult to categorize individual PE components against the framework. We need clearer guidance and robust frameworks for conducting PEs for the development and reporting of DPIs for women with GDM.</p><p><strong>Trial registration: </strong>PROSPERO International Prospective Register","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e51718"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Objective Habit Metrics and Objective Medication Adherence: Retrospective Study of 15,818 Participants From Clinical Studies.","authors":"Antoine Pironet, L Alison Phillips, Bernard Vrijens","doi":"10.2196/63987","DOIUrl":"10.2196/63987","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence, or how patients take their medication as prescribed, is suboptimal worldwide. Improving medication-taking habit might be an effective way to improve medication adherence. However, habit is difficult to quantify, and conventional habit metrics are self-reported, with recognized limitations. Recently, several objective habit metrics have been proposed, based on objective medication-taking data.</p><p><strong>Objective: </strong>We aim to explore the correlation between objective habit metrics and objective medication adherence on a large dataset.</p><p><strong>Methods: </strong>The Medication Event Monitoring System Adherence Knowledge Center, a database of anonymized electronic medication intake data from ambulant participants enrolled in past clinical studies, was used as the data source. Electronic medication intake data from participants following a once-daily regimen and monitored for 14 days or more were used. Further, two objective habit metrics were computed from each participant's medication intake history: (1) SD of the hour of intake, representing daily variability in the timing of medication intakes, and (2) weekly cross-correlation, representing weekly consistency in the timing of medication intakes. The implementation component of medication adherence was quantified using (1) the proportion of doses taken and (2) the proportion of correct days.</p><p><strong>Results: </strong>A total of 15,818 participants met the criteria. These participants took part in 108 clinical studies mainly focused on treatments for hypertension (n=4737, 30%) and osteoporosis (n=3353, 21%). The SD of the hour of intake was significantly negatively correlated with the 2 objective adherence metrics: proportion of correct days (Spearman correlation coefficient, ρ_S=-0.62, P<.001) and proportion of doses taken (ρ_S=-0.09, P<.001). The weekly cross-correlation was significantly positively correlated with the 2 objective adherence metrics: proportion of correct days (ρ_S=0.55, P<.001) and proportion of doses taken (ρ_S=0.32, P<.001). A lower daily or weekly variability in the timing of medication intakes is thus associated with better medication adherence. However, no variability is not the norm, as only 3.6% of participants have 95% of their intakes in a 1-hour window. Among the numerous factors influencing medication adherence, habit strength is an important one as it explains over 30% of the variance in medication adherence.</p><p><strong>Conclusions: </strong>Objective habit metrics are correlated to objective medication adherence. Such objective habit metrics can be used to monitor patients and identify those who may benefit from habit-building support.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e63987"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Artificial Intelligence in Medical Education From 2000 to 2024: Bibliometric Analysis.","authors":"Rui Li, Tong Wu","doi":"10.2196/63775","DOIUrl":"10.2196/63775","url":null,"abstract":"<p><strong>Background: </strong>Incorporating artificial intelligence (AI) into medical education has gained significant attention for its potential to enhance teaching and learning outcomes. However, it lacks a comprehensive study depicting the academic performance and status of AI in the medical education domain.</p><p><strong>Objective: </strong>This study aims to analyze the social patterns, productive contributors, knowledge structure, and clusters since the 21st century.</p><p><strong>Methods: </strong>Documents were retrieved from the Web of Science Core Collection database from 2000 to 2024. VOSviewer, Incites, and Citespace were used to analyze the bibliometric metrics, which were categorized by country, institution, authors, journals, and keywords. The variables analyzed encompassed counts, citations, H-index, impact factor, and collaboration metrics.</p><p><strong>Results: </strong>Altogether, 7534 publications were initially retrieved and 2775 were included for analysis. The annual count and citation of papers exhibited exponential trends since 2018. The United States emerged as the lead contributor due to its high productivity and recognition levels. Stanford University, Johns Hopkins University, National University of Singapore, Mayo Clinic, University of Arizona, and University of Toronto were representative institutions in their respective fields. Cureus, JMIR Medical Education, Medical Teacher, and BMC Medical Education ranked as the top four most productive journals. The resulting heat map highlighted several high-frequency keywords, including performance, education, AI, and model. The citation burst time of terms revealed that AI technologies shifted from imaging processing (2000), augmented reality (2013), and virtual reality (2016) to decision-making (2020) and model (2021). Keywords such as mortality and robotic surgery persisted into 2023, suggesting the ongoing recognition and interest in these areas.</p><p><strong>Conclusions: </strong>This study provides valuable insights and guidance for researchers who are interested in educational technology, as well as recommendations for pioneering institutions and journal submissions. Along with the rapid growth of AI, medical education is expected to gain much more benefits.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e63775"},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinicians' Guide to Large Language Models: A General Perspective With a Focus on Hallucinations.","authors":"Dimitri Roustan, François Bastardot","doi":"10.2196/59823","DOIUrl":"10.2196/59823","url":null,"abstract":"<p><p>Large language models (LLMs) are artificial intelligence tools that have the prospect of profoundly changing how we practice all aspects of medicine. Considering the incredible potential of LLMs in medicine and the interest of many health care stakeholders for implementation into routine practice, it is therefore essential that clinicians be aware of the basic risks associated with the use of these models. Namely, a significant risk associated with the use of LLMs is their potential to create hallucinations. Hallucinations (false information) generated by LLMs arise from a multitude of causes, including both factors related to the training dataset as well as their auto-regressive nature. The implications for clinical practice range from the generation of inaccurate diagnostic and therapeutic information to the reinforcement of flawed diagnostic reasoning pathways, as well as a lack of reliability if not used properly. To reduce this risk, we developed a general technical framework for approaching LLMs in general clinical practice, as well as for implementation on a larger institutional scale.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e59823"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Uroflowmetry and Bladder Diary and the Emerging Trend of Using Home Devices From Hospital to Home.","authors":"Ming-Wei Li, Yao-Chou Tsai, Stephen Shei-Dei Yang, Yuan-Hung Pong, Yu-Ting Tsai, Vincent Fang-Sheng Tsai","doi":"10.2196/66694","DOIUrl":"10.2196/66694","url":null,"abstract":"<p><p>Although uroflowmetry and bladder diaries are widely used for noninvasive evaluation of lower urinary tract symptoms, they still have limitations in diagnostic capability and users' convenience. The aim of this paper is to discuss potential solutions by reviewing (1) the evolution and current clinical use of uroflowmetry and bladder diary, including clinical guidelines, daily practice applications, and their historical development; (2) a growing trend toward using home devices with various technologies; and (3) a comprehensive comparison of the strengths and weaknesses of these home devices. In our opinion, the following points can be highlighted: (1) the emerging trend of using home devices can enhance diagnostic capabilities through repeated measurements and the convenience of at-home testing and (2) home devices, which provide both frequency-volume and uroflowmetry information, have the potential to transform the management of lower urinary tract symptoms.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e66694"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Combining mHealth and Health Professional-Led Intervention for Improving Health-Related Outcomes in Chronic Diseases: Systematic Review and Meta-Analysis.","authors":"Masashi Kanai, Takahiro Miki, Toshiya Sakoda, Yuta Hagiwara","doi":"10.2196/55835","DOIUrl":"10.2196/55835","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic diseases such as diabetes and cardiovascular disease are global health challenges, affecting millions of people worldwide. Traditional health care often falls short in chronic disease management. This has led to the exploration of innovative solutions, such as mobile health (mHealth) technologies. mHealth, which leverages mobile and wireless technologies, has the potential to transform health care delivery by providing continuous, accessible, and personalized care. However, the effectiveness of mHealth, particularly when integrated with traditional health care interventions delivered by professionals, warrants comprehensive investigation. Understanding the combined impact of mHealth and professional-led interventions is critical to maximizing the potential of mHealth to improve patient outcomes and adherence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to investigate the effectiveness of combining mHealth and health professional-led intervention for improving health-related outcomes in chronic diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review and meta-analysis focused on randomized controlled trials. We searched Web of Science, CENTRAL, MEDLINE, and CINAHL through July 17, 2023. The study targeted patients aged 18 years and older, experiencing at least 1 chronic condition. The interventions were a combination of mHealth and the use of a health care professional. The comparison groups consisted of participants receiving either general care and follow-up or those using mHealth devices without any health care professional involvement. The outcomes measured in this review included hemoglobin A&lt;sub&gt;1c&lt;/sub&gt; (HbA&lt;sub&gt;1c&lt;/sub&gt;), quality of life (QoL), and physical activity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 26 research papers, encompassing 7360 individuals. Meta-analysis was conducted for HbA&lt;sub&gt;1c&lt;/sub&gt;, QoL, and physical activity. For HbA&lt;sub&gt;1c&lt;/sub&gt;, short-term improvement was significant (standardized mean difference [SMD] -0.43; 95% CI -0.64 to -0.21; I&lt;sup&gt;2&lt;/sup&gt;=69%) and medium term (SMD -0.49; 95% CI -0.49 to -0.09; I&lt;sup&gt;2&lt;/sup&gt;=21%). However, in the long term, the improvement was not significant (SMD -0.23; 95% CI -0.49 to 0.03; I&lt;sup&gt;2&lt;/sup&gt;=88%). For QoL, significant improvements were observed in the short term (SMD -0.23; 95% CI -0.42 to -0.05; I&lt;sup&gt;2&lt;/sup&gt;=62%), and in the medium term (SMD -0.16; 95% CI -0.24 to -0.07; I&lt;sup&gt;2&lt;/sup&gt;=0%). In the long term, however, the improvement was not significant (SMD -0.12; 95% CI -0.41 to 0.16; I&lt;sup&gt;2&lt;/sup&gt;=71%). For physical activity, both subjective (questionnaire) and objective (number of steps) outcomes were analyzed. In the short term, subjective outcomes showed significant improvement (SMD 0.31; 95% CI 0.12-0.50; I&lt;sup&gt;2&lt;/sup&gt;=0%), while objective outcomes did not (SMD 0.11; 95% CI -0.05 to 0.27; I&lt;sup&gt;2&lt;/sup&gt;=0%). Medium- and long-term subjective outcomes showed no significant improvement. Meta-analysis for objec","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e55835"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of Conventional and Virtual Reality Approaches in Augmented Reality for Theory-Based Psychoeducational Intervention Design for Chronic Low Back Pain: Scoping Review.","authors":"Robin Conen, Steffen Mueller, Ana Nanette Tibubos","doi":"10.2196/59611","DOIUrl":"10.2196/59611","url":null,"abstract":"<p><strong>Background: </strong>Psychoeducation positively influences the psychological components of chronic low back pain (CLBP) in conventional treatments. The digitalization of health care has led to the discussion of virtual reality (VR) interventions. However, CLBP treatments in VR have some limitations due to full immersion. In comparison, augmented reality (AR) supplements the real world with virtual elements involving one's own body sensory perception and can combine conventional and VR approaches.</p><p><strong>Objective: </strong>The aim of this study was to review the state of research on the treatment of CLBP through psychoeducation, including immersive technologies, and to formulate suggestions for psychoeducation in AR for CLBP.</p><p><strong>Methods: </strong>A scoping review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in August 2024 by using Livivo ZB MED, PubMed, Web of Science, American Psychological Association PsycINFO (PsycArticle), and PsyArXiv Preprints databases. A qualitative content analysis of the included studies was conducted based on 4 deductively extracted categories.</p><p><strong>Results: </strong>We included 12 studies published between 2019 and 2024 referring to conventional and VR-based psychoeducation for CLBP treatment, but no study referred to AR. In these studies, educational programs were combined with physiotherapy, encompassing content on pain biology, psychological education, coping strategies, and relaxation techniques. The key outcomes were pain intensity, kinesiophobia, pain catastrophizing, degree of disability, quality of life, well-being, self-efficacy, depression, attrition rate, and user experience. Passive, active, and gamified strategies were used to promote intrinsic motivation from a psychological point of view. Regarding user experience from a software development perspective, user friendliness, operational support, and application challenges were recommended.</p><p><strong>Conclusions: </strong>For the development of a framework for an AR-based psychoeducational intervention for CLBP, the combination of theories of acceptance and use of technologies with insights from health psychological behavior change theories appears to be of great importance. An example of a theory-based design of a psychoeducation intervention in AR for CLBP is proposed and discussed.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e59611"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstep Variations of Stairways and Associations of High-Contrast Striping and Fall-Related Events: Observational Study.","authors":"Sara A Harper, Chayston Brown, Shandon L Poulsen, Tyson S Barrett, Christopher J Dakin","doi":"10.2196/60622","DOIUrl":"10.2196/60622","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Interstep variations in step riser height and tread depth within a stairway could negatively impact safe stair negotiation by decreasing step riser height predictability and, consequently, increasing stair users' fall risk. Unfortunately, interstep variations in riser height and depth are common, particularly in older stairways, but its impact may be lessened by highlighting steps' edges using a high-contrast stripe on the top front edge of each step.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to determine (1) if fall-related events are associated with greater interstep riser height and depth variations and (2) if such fall-related events are reduced in the presence of contrast-enhanced step edges compared with a control stairway.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Stair users were video recorded on 2 public stairways in a university building. One stairway had black vinyl stripes applied to the step's edges and black-and-white vertical stripes on the last and top steps' faces. The stairway with striping was counterbalanced, with the striped stairway than a control, and the control with stripes. Each stair user recorded was coded for whether they experienced a fall-related event. A total of 10,000 samples (observations) of 20 fall-related events were drawn with 0.25 probability from each condition to determine the probability of observing a distribution with the constraints outlined by the hypotheses by a computerized Monte Carlo simulation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 11,137 individual stair user observations had 20 fall-related events. The flights that had 14 mm in interstep riser height variation and 38 mm in interstep depth variation were associated with 80% (16/20) of the fall-related events observed. Furthermore, 2 fall-related events were observed for low interstep variation with no striping, and 2 fall-related events were observed during low interstep variation with striping. A total of 20 fall-related events were observed, with 4 occurring on flights of stairs with low interstep variation. For stairs with high variability in step dimensions, 13 of 16 (81%) fall-related events occurred on the control stairway (no striping) compared with 3 of 16 (19%) on the high-contrast striping stairway. The distribution of fall-related events we observed between conditions likely did not occur by chance, with a probability of 0.04.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These data support the premise that a vision-based strategy (ie, striping) may counteract fall risk associated with interstep riser height and tread depth variation. Possibly, perception and action elicited through the horizontal-vertical illusion (striping) may have a positive impact on the incidence of fall-related events in the presence of high interstep riser height and depth variation. The findings of this study suggest that contrast enhancement (ie, striping) may be a simple and effective way to reduce the risk of falls associated wit","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e60622"},"PeriodicalIF":1.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student and Physician Views of How the Dobbs Decision Affects Training and Practice Location Preferences: Cross-Sectional Questionnaire Study.","authors":"Morgan S Levy, Simone A Bernstein, Sarah M McNeilly, Abigail Liberty, Shira Fishbach, Shikha Jain, Jessica A Gold, Vineet M Arora","doi":"10.2196/55035","DOIUrl":"10.2196/55035","url":null,"abstract":"<p><strong>Background: </strong>By allowing for abortion bans and restrictions to take effect in the majority of US states, the 2022 Dobbs v Jackson Women's Health Organization decision portends to have lasting impacts on patient care and the physician workforce. Notably, it is already beginning to impact practice location preferences of US health care workers, evidenced by declining application rates to residency programs in abortion-restrictive states since 2022. Yet, there remains a gap in the literature regarding why this trend exists.</p><p><strong>Objective: </strong>This study aims to describe what factors are driving the practice location preferences of medical students and physicians after the Dobbs decision.</p><p><strong>Methods: </strong>This study analyzes qualitative data from a web-based, cross-sectional study. In August 2022, a nonprobabilistic sample of physicians and medical students were surveyed on social media about the impact of overturning Roe v Wade on practice location preferences, which included the free-text question \"Please share your thoughts about the overturning of Roe v Wade and how it will affect your decision about your (residency/job or fellowship) programs.\" A total of 3 independent team members completed an inductive thematic analysis of 524 free responses, resolving differences by discussion.</p><p><strong>Results: </strong>Approximately 1 in 4 survey respondents also completed the free-response item (524/2063, 25.4%); a total of 219 were medical students, 129 were residents and fellows, and 176 were practicing physicians. Of them, approximately half (261/524, 50.5%) resided in states where abortion bans were in place or anticipated. Those who answered the free-response item were relatively more likely to hail from states with restrictive abortion bans (P<.001) compared to those who did not, with other demographic characteristics being largely similar between the groups. Inductive thematic analysis yielded 2 broad thematic categories: patient-related and workforce-related factors influencing practice decision preferences. The 3 most common themes overall were respondent concerns regarding their patient's access to care (249/524, 47.5%), their desire not to practice or train in a state with abortion restrictions regardless of current residence (249/524, 47.5%), and their personal belief that abortion bans are human rights and/or body autonomy violation (197/524, 37.6%). Some respondents stated that the Dobbs decision would not impact their choice of practice location (41/524, 7.8%), and some supported it (35/594, 6.7%).</p><p><strong>Conclusions: </strong>This study shows that abortion restrictions are having an impact on the practice location preferences of the physician workforce due to both patient care and personal factors. It is important that state policy makers and others who are considering abortion restrictions also consider how to address these concerns of physicians and medical students, to avoid wo","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e55035"},"PeriodicalIF":1.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}