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Search Results: 1 - 10 of 8232 matches for " Alan Schwartz "
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A survey of individual preference for colorectal cancer screening technique
Richard L Nelson, Alan Schwartz
BMC Cancer , 2004, DOI: 10.1186/1471-2407-4-76
Abstract: A cross-sectional survey was performed of healthy ambulatory adults in a pediatrics primary care office and neighboring church. Overall preference was ranked for each of four colorectal cancer screening modalities: Faecal Occult Blood, Fiberoptic Sigmoidoscopy, Barium Enema and Colonoscopy. Four additional domains of preference also were ranked: suspected discomfort, embarrassment, inconvenience and danger of each exam.80 surveys were analyzed, 57 of which were received from participants who had experienced none of the screening tests. Fecal Occult Blood Testing is significantly preferred over each other screening modality in overall preference and every domain of preference, among all subjects and those who had experienced none of the tests.Efforts to increase public participation in colorectal cancer screening may be more effective if undertaken in the context of public perceptions of screening choices.Screening for colorectal cancer lessens the risk of dying from that disease [1]. Knowledge of this fact has not solved all the problems related to screening. The optimal modality of screening is still the subject of debate [1-3]. More problematic is the very low participation of the general public in recommended screening [4]. In contrast to breast cancer screening, in which the Healthy People 2000 Goal of the U.S. National Institutes of Health was surpassed, at 64% participation by women over 40 years of age, only 20% of Americans over age 50 had fecal occult blood testing within the past year (This is the best estimate of actual screening, rather than diagnostic endeavors for symptoms for which endoscopy or radiologic imaging might be done.), and 34% had a sigmoidoscopy within the past 5 years [5,6] Even if screening is appropriately performed, it is far from certain that a positive screen will be followed by appropriate diagnostic testing, as has been shown in follow-up surveys of fecal occult blood testing [7].Most publication concerning colorectal cancer screen
A web-based library consult service for evidence-based medicine: Technical development
Alan Schwartz, Gregory Millam, the UIC LCS Investigators
BMC Medical Informatics and Decision Making , 2006, DOI: 10.1186/1472-6947-6-16
Abstract: To improve support for evidence-based practice, we have developed a web-based EBM library consult service application (LCS). Librarians use the LCS system to provide full text evidence-based literature with critical appraisal in response to a clinical question asked by a remote physician. LCS uses an entirely Free/Open Source Software platform and will be released under a Free Software license. In the first year of the LCS project, the software was successfully developed and a reference implementation put into active use. Two years of evaluation of the clinical, educational, and attitudinal impact on physician-users and librarian staff are underway, and expected to lead to refinement and wide dissemination of the system.A web-based EBM library consult model may provide a useful way for informationists to assist clinicians, and is feasible to implement.Despite the growing availability of evidence-based medicine (EBM) training programs for practicing physicians and increasing emphasis on EBM in medical student and resident education, research indicates that even those clinicians who are most enthusiastic about EBM generally rely more on traditional information sources, such as consultation with respected colleagues, than on EBM-related sources [1]. In reviewing the teaching of EBM as an educational endeavor, several reviews have concluded that evidence-based practice may be difficult for physicians [2-6].EBM requires that clinicians learn new skills, including how to formulate questions about their patients that can be answered in the medical literature, how to search the clinical research literature for potentially relevant research reports, how to critically appraise the research design and analysis methods in order to determine the validity of reported results and their applicability to their patients, and how to use valid results appropriately in making clinical decisions. Such skills, the foundations of which lie in biostatistics, epidemiology, and library and in
Assessment of the usefulness of a diagnostic test: A survey of patient preference for diagnostic techniques in the evaluation of intestinal inflammation
Richard L Nelson, Alan Schwartz, Dan Pavel
BMC Medical Research Methodology , 2001, DOI: 10.1186/1471-2288-1-5
Abstract: Significant differences were seen in overall preference for white cell scan over barium enema and colonoscopy (p < 0.01) in both survey groups. Perceived discomfort and embarrassment demonstrated similar rankings.This patient preference combined with the reported accuracy of white cell scanning further establishes the usefulness of this means of IBD diagnosis.The radio labeled white cell scan has been shown to be an accurate means of detecting intestinal inflammation [1]. Our initial report of the use of Indium111 radiolabeled white cell scanning in the diagnosis of inflammatory bowel disease described a sensitivity and specificity of 97% and 100% respectively in 49 scans in 39 patients in all of whom confirmatory studies were done. Since that time, 1130 scans have been performed at our institution. Clinical follow-up of these patients has revealed only three cases of confirmed false negative scans. No cases of false positive scans have been encountered. This accuracy, it should be stressed, is not in the grading of disease activity, but in the dichotomous determination of disease presence and its anatomic location. The lack of confirmatory testing of all subsequent patients certainly results in the overestimation of accuracy [2], but not greatly so, since all patients have been available for clinical follow-up and diagnostic errors would become apparent with the passage of time. Even if it is a ten fold overestimate, the white cell scan still compares well with other diagnostic modalities. In 1993 Indium111 became unavailable in Chicago and we switched to the use of Technetium99. We found that the higher radiation dose of Technetium injected (20 mCI versus 0.5 mCI Indium) resulted in clearer images with less motion artifact, yet its shorter half life resulted in the total radiation dose to the patient being similar to Indium111. First images are available within 5 hours from the patient's arrival using Technetium, compared with 30 hours for Indium, making this appl
Prospect theory, reference points, and health decisions
Alan Schwartz,Julie Goldberg,Gordon Hazen
Judgment and Decision Making , 2008,
Abstract: In preventative health decisions, such as the decision to undergo an invasive screening test or treatment, people may be deterred from selecting the test because its perceived disutility relative to not testing is greater than the utility associated with prevention of possible disease. The prospect theory editing operation, by which a decision maker's reference point is determined, can have important effects on the disutility of the test. On the basis of the prospect theory value function, this paper develops two approaches to reducing disutility by directing the decision maker's attention to either (actual) past or (expected) future losses that result in shifted reference points. After providing a graphical description of the approaches and a mathematical proof of the direction of their effect on judgment, we briefly illustrate the potential value of these approaches with examples from qualitative research on prostate cancer treatment decisions.
The Rhetoric of Begin: Leadership in Changing Times  [PDF]
David Schwartz
Open Journal of Leadership (OJL) , 2016, DOI: 10.4236/ojl.2016.53008
Abstract:
A precise examination of Menachem Begin’s speeches and history over the years reveals that Begin’s rhetoric constituted a political instrument that he knew to change according to the circumstances. Begin’s rhetoric was controversial, as he went from the leader of a terrorist organization, was awarded a Nobel Peace Prize, and was the Prime Minister who signed the peace treaty with Egypt. This quality study claims that begin’s rhetoric is integral part of his personality and of his leadership. The assumption is that like a typical politician his leadership changed according the winds of times. His charisma and transformational leadership made him a great leader. His rhetoric constituted just instrument for justification his political actions. Begin was revealed to be pragmatic, in contrast to the militant images that his political rivals attempted to affix to him.
The Social Doctrine of Zeev Jabotinsky, from the Fathers of Zionism  [PDF]
David Schwartz
Open Journal of Political Science (OJPS) , 2016, DOI: 10.4236/ojps.2016.64034
Abstract: Zeev Jabotinsky, in contrast to the conservative economic approach that characterizes the right parties around the world, in essence supports a social democratic approach in the economic dimension, at least in the stage of the establishment of the Jewish state that will be established. Jabotinsky considered the topic of the need to protect the person’s individualism to be very important, since “every individual is a king” and he also supports the idea of the welfare state. The state has to give the individuals there basic needs, but the new Jew has to pay contribution to building the Hebrew new nation and new society. His approach was mixed of liberalism and nationalism, and he adopted the universal attitude of the famous Russian writer Tolstoy to the human suffer, and admired Garibaldi the leader that united Italy. After the second world war and the rise of the Fascists dictatorship of Germany and the communist revolution, Jabotinsky emphasized his belief in the values of liberalism like the American approach of Abram Linkolen that gave freedom to the slaves. Jabotinsky died in New York in the United States, the land of freedom and liberalism as refugee, far away from Russian culture that he was born to.
Theoretical and Practical Notes on Vending Strategies  [PDF]
Gustav Cepciansky, Ladislav Schwartz
iBusiness (IB) , 2011, DOI: 10.4236/ib.2011.31001
Abstract: The paper deals with an application of theory of mass servicing on some cases in vending strategies. The aim of the paper is to show how the theory which is apparently applicable for scientific problems can also be utilised in practical use. First, the necessary theoretical background will have been done and then some examples applied on vending practises will be given.
Tariffication Strategies and Charging Effectivity  [PDF]
Gustav Cepciansky, Ladislav Schwartz
iBusiness (IB) , 2011, DOI: 10.4236/ib.2011.33041
Abstract: The effort of all service providers is to maximize their revenues. The ideal case would be, when a service provider obtained payment for entire services provided. But it is not always possible. Some services may not be paid for. Distribution companies (electricity power, gas, and water), transport companies (airlines, railways, buses, and taxis), telecommunication companies and companies established by the government (e.g. cash of road tax) represent such type of enterprises. Their clients pay for the volume of drawn media, distance of transmission, service duration, amount of transmitted information or travelled distance. Most services are charged fully, but certain services are only charged partly or not at all. An appropriate theory concerning the service provision effectivity and charging policy will be done on examples from telecommunication business and from road tax cashing.
Concatenated Processes in Commercial Business and in Global Economy  [PDF]
Gustav Cepciansky, Ladislav Schwartz
iBusiness (IB) , 2012, DOI: 10.4236/ib.2012.44037
Abstract: The paper deals with an application of theory stochastic processes on business practices and with consequences which the concatenated economic co-operation may have on the future economic growth. The aim of the paper is also to draw attention how the theory which is apparently applicable for solution of scientific problems can also be utilised in practical commercial and economic use. First, the necessary theoretical background will have been done and then some application examples will be given.
Excessive participation in on-line internet action games by two American teenagers: Case report, description of extent of overuse, and adverse consequences  [PDF]
Richard H. Schwartz
Open Journal of Pediatrics (OJPed) , 2013, DOI: 10.4236/ojped.2013.33035
Abstract:

In the past 15 years, there have been more than 40 articles in the medical literature about excessive participation in on-line internet action games by adolescents and young adults. The following case reports provide detailed information on two boys, ages 16 and 20 years respectively, who are compulsive and enthusiastic internet gamers, to the exclusion of family communication, school activities, academic performance, participation in sports and dating. They have not mastered any of the usual goals of adolescent development.

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