PubMed · 11622875
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T Eggerickx, M Debuisson. 1990. [Not Available].. https://pubmed.ncbi.nlm.nih.gov/11622875/
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PURPOSE: Precision medicine, also known as personalized medicine, enables the provision of tailored health services to patients. In the prevention, early detection, and treatment of cancers, precision medicine is highly promising, given the increasing use of genomic profiling for diagnosis and adapting therapies in several tumor types. Artificial Intelligence (AI) can support this process by analyzing vast amounts of relevant data. However, high-quality data and financial investments in the health system are essential for the implementation of precision medicine and AI solutions in routine cancer care. DESIGN/METHODOLOGY/APPROACH: Building on the quantitative outcomes of a foresight exercise published in another study, this article collects qualitative data to gain more detailed insights into the future of precision oncology in Belgium and discusses the role of AI in this field. It reports the results of a series of expert workshops, focusing on four hypothetical future scenarios that are centered around technological and economic issues that must be overcome for the widespread use of precision oncology in Belgium. FINDINGS: The study concludes that all four scenarios discussed in the workshops would require supportive policy measures in Belgium, which should go beyond mere technological and economic considerations, such as involving patient associations and the public in policy design or creating multi-disciplinary expert groups for precision medicine. ORIGINALITY/VALUE: To the best of our knowledge, this is the first study to employ foresight methodology to illustrate possible future scenarios, scrutinize feasible approaches for implementing precision oncology in Belgium, and discuss the use of AI in this context.
BACKGROUND AND OBJECTIVES: Occupational stress in nursing has frequently been considered in nursing literature. The operationalization of job demands in different work settings and its relation to distress have been discussed to identify significant interactions with job resources. In this study, job demands were defined as recurrent changes in the work environment of nurses (i.e. changing colleagues, supervisors, workplaces, working hours and tasks). In particular, we focused on the 'negative appraisal' (i.e. 'threat') of these changes. The interaction between 'threat' and job resources (i.e. timing control, method control and supervisor support) and its relation to distress among Registered Nurses was examined. METHODS: The study was part of a larger cross-sectional survey among 7863 (response rate 51%) employees belonging to 10 general hospitals in Belgium. The results are based on self-administered questionnaires of 1094 Registered Nurses employed in intensive care units (ICU) (n = 416) and surgery/medical wards (non-ICU) (n = 678). General Linear Modelling was used to test the moderating effects. RESULTS: In both study samples, 'threat' was positively associated with distress (P < 0.001). However, in contrast with non-ICU nurses, ICU nurses only considered 'supervisor support' as a significant moderator in the positive relationship between 'threat' and distress (P = 0.023). 'Timing and method control', instead of supervisor support, moderated this relation among non-ICU nurses (P = < 0.001 and 0.018, respectively). CONCLUSION: These findings provide additional evidence to consider negative appraisal of recurrent changes as occupational specific stressor in nursing. Moreover, the buffering effects which were found between 'threat' and the measured job resources in relation to distress, and the difference of these interactions in ICU and non-ICU health care settings, confirmed the suggestion to consider particular job characteristics in job stress research. Finally, the findings of our study may be of importance for nursing administrators who are dealing with distress among nurses.
BACKGROUND: Emergency medical service (EMS) systems in Europe have developed differently due to legal, educational and organisational aspects. The aim of the present study was to compare cardiopulmonary resuscitation (CPR) outcomes and characteristics in three differently organised and staffed EMS systems in close vicinity. METHODS: We analysed the charts of patients treated in the EMS systems of the cities of Aachen (Germany), Heerlen (The Netherlands) and Eupen (Belgium), retrospectively. Main outcome measures were the rate of return of spontaneous circulation (ROSC), hospital discharge and cerebral performance after 1 year. Furthermore, factors influencing neurological outcome and the incidence of cross-border emergency assistance were assessed. RESULTS: Of 852 patients found unresponsive with no palpable pulse and/or the absence of breathing, CPR was performed in 322 patients. The overall rate of ROSC was 44.1 and 13.7% of patients were discharged alive. A good neurological outcome was observed in 95.5% of survivors. The rate of ventricular fibrillation was significantly higher (46.9% versus 21.9 and 21.2%, p < 0.05) and the total amount of epinephrine given during CPR significantly lower (4.5+/-5.2 mg versus 9.8+/-10.8 and 8.4+/-6.2 mg, p < 0.05) in the Dutch system. No significant differences in outcome variables were observed between the systems. Neurological outcome was favourable when the arrest was witnessed, occurred in a public place, the initial rhythm was shockable, a low total amount of adrenaline (epinephrine) was given and the call-response interval was short. In 1.2% of the cases cross-border emergency care was provided. CONCLUSIONS: Despite medical and organisational discrepancies, outcomes of CPR in three neighbouring EMS systems are comparable. Neurological outcome is influenced by demographical, organisational and medical factors. Cross-border emergency assistance for CPR is almost undetectable and needs improvement.