Uncertainty For People Research Articles

Supporting the support person: Oncologists' roles in reducing support people's uncertainty and facilitating psychological adjustment.

Support people of cancer patients are at significant risk for psychological distress. Additionally, cancer patients' well-being is reciprocally associated with support peoples' psychological well-being. Informed by Uncertainty in Illness Theory, this study tests whether support person psychological well-being is influenced by provider communication and uncertainty reduction. We tested a multiple mediation model to investigate how empathic communication facilitates psychological adjustment in support people of cancer patients and how this process is mediated by support peoples' illness uncertainty and caregiver burden. Support people of cancer patients (N=121; including spouses, adult children, etc.) completed an online questionnaire about their perceptions of oncologists' empathy, uncertainty about the cancer patients' illness, perceived caregiving burden, and their psychological adjustment to diagnoses. Path analysis revealed that (1) more perceived oncologist empathy was associated with less illness uncertainty, (2) more illness uncertainty was associated with worse psychological adjustment and more perceived caregiver burden, and (3) more burden was associated with worse adjustment (χ2 (2)=1.19, p=0.55; RMSEA < 0.01; CFI=1.00; SRMR=0.02). Given the reciprocal nature of well-being between cancer patients and their support people, it is critical to understand and bolster support people's psychological well-being. Results demonstrated how empathic provider communication can support psychological well-being for support people of cancer patients. Additionally, this study offers theoretical contributions to understandings of illness uncertainty in caregiver populations.

Type 1 Diabetes Mellitus, Psychopathology, Uncertainty and Alexithymia: A Clinical and Differential Exploratory Study.

Type 1 diabetes mellitus (T1DM) represents a complex pathology affecting a large number of people. Research suggests that psychological factors influence coping with T1DM. This study aimed to investigate the presence and role of psychopathology, alexithymia and uncertainty in people affected by T1DM. The sample consisted of 137 patients (88 females, 49 males) affected by T1DM aged from 11 to 19 years old (Mean: 13.87; SD: 2.40). The diagnostic protocol consisted of a sociodemographic questionnaire, Self-administration Psychiatric Scales for Children and Adolescents (SAFA), Toronto Alexithymia Scale-20 (TAS-20) and Intolerance to Uncertainty Scale-12 (IUS-12). Descriptive, differential, correlational and regression analyses were performed in order to examine the relationships between these variables. The results suggested the sample had high levels of psychopathological indexes, alexithymia and intolerance of uncertainty. Also, there were significant differences between TAS-20 and IUS-12 distributions with respect to psychopathology. Correlations and multivariate linear regressions indicated age, gender and education significantly predicted alexithymia and intolerance of uncertainty. This data suggest the presence of elevated psychopathology, alexithymia and uncertainty in people with diabetes.

The cross-border e-commerce platform selection based on the probabilistic dual hesitant fuzzy generalized dice similarity measures

Abstract Cross-border e-commerce platform (CBECP) plays a very important role in the development of a cross-border e-commerce (CBEC). How to select the best CBECP scientifically and reasonably is a very critical multi-attribute group decision-making (MAGDM) issue. With the uncertainty of people’s cognition of the objective world, the decision-making process is full of a lot of fuzzy information. In view of the great advantages of probabilistic dual hesitation fuzzy set (FS) in expressing decision-making information, and in combination with the very extensive use of the Dice similarity measure (DSM), a new MAGDM method is proposed for the optimal CBECP selection (CBECPS) under the probabilistic dual hesitation fuzzy (PDHF) environment. First, on the basis of reviewing a large number of documents on the CBECPS for CBEC, the evaluation index system for the CBECPS is constructed; second, several new DSMs are proposed in the PDHF environment; third, based on the two newly proposed probabilistic dual hesitant weighted generalized Dice similarity measures, two novel MAGDM methods are provided for CBECPS, which are used for CBECPS; finally, the two established MAGDM techniques are compared with the existing decision-making methods, and the parameter analysis is carried out to illustrate the effectiveness and superiority of the two established MAGDM techniques. The two established techniques can not only be used for CBECPS of CBEC, but also be extended to similar related research.

Particularities regarding Clinical-biological and Evolutive Parameters of Immune-mediated Rheumatic Diseases in Patients with COVID-19 – systematic literature review

Background: Since its outbreak in 2019, Coronavirus disease 2019 (COVID-19)/Severe Acu-te Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was a serious medical threat and was declared Global Pandemic, triggering fear, panic and uncertainty for people around the Globe. Among those individuals, there is a specific category of patients – the ones with immune-mediated rheumatic diseases (IMIDs) – whose mantra from the diagnosis was to avoid infections at all costs because of the additional negative impact on the immune sys-tem and overall reactivity. Objective: Considering the aforementioned, our objective is to understand the in-depth relation of the immune system of patients with IMIDs in the set-ting of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the real bur-den of the disease and vaccination against COVID-19. Materials and Methods: In this res-pect, we have conducted a thoroughly systematic literature review according to the “Prefer-red Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” concept. Following its five-steps algorithm, we first selected 745 articles that were published in re-putable international medical databases, ISI-indexed, for the period 1 January, 2021–31 December, 2022. After consequent elimination of duplicates, of articles that were not En-glish-written and “open access” and then applying PEDro classification/scoring-inspired, only 58 articles were selected for in-depth full qualitative reading. In the last stage,20 arti-cles were “excluded with reasons”, because they didn’t offer significant information. The-refore, in our systematic literature review, 38 articles were included.Results: In the data gathered in this review we described the molecular pathways of activation of the immune system triggered by COVID-19, with significance on the clinical and paraclinical aspects of IMID patients infected with the new Coronavirus. Patients with IMIDs are at higher risk for hospitalization if diagnosed with SARS-CoV2 and more prone to severe outcomes and death. Risk factors associated with severe outcomes and death are: age, comorbidities, un-derlying disease activity, therapies used (“the good” being anti-tumor necrosis factor α, “the bad” – Methotrexate, Sulfasalazine, Azathioprine and “the ugly” – anti CD20 mono-clonal antibodies). There were several reports of flares and new-onset of IMIDs after CO-VID-19 and after vaccination against this disease, but data from larger studies and registri-es do not confirm higher incidence of flare-ups or new-onset IMIDs. Regarding vaccination, of mounting importance is the timing between immunomodulatory and immunosuppres-sive agents and the administration of the vaccine. And last but not the least, we discussed about Long COVID and the role of artificial intelligence in the pandemic and related-drug development. Discussion and Conclusion: The data in our systematic literature review is consistent with the expertise from our clinical practice. This article is the first part of the doctoral study that is centralized on the same topics, with the current objective of deepe-ning the knowledge about the intersection of COVID-19/SARS-CoV2 and immune-mediated rheumatic diseases and a future objective: to compare information we have synthetized here with our database of almost 170 Romanian patients with a IMID and COVID-19/SARS-CoV2. The next objective is to extend the study to a multicenter control one. Keywords: SARS-CoV2, COVID-19, Immune Mediated Rheumatic Diseases, Rheumatoid Arthri-tis, Systemic Lupus Erythematosus, COVID-19 Vaccine, Long COVID

The Media in the Times of the Coronavirus (COVID-19) Pandemic

The media became a strong driver of either reliable information or misinformation. The trends of issues during the pandemic indicate that media has been targeted by global health authorities, national governments, and health agencies, among other developmental vital stakeholders, in mobilizing the public at all levels to communicate the preventive measures, symptoms, and non-surgical and hygiene practices that would help in stemming the spread of the virus. The paper indicates that knowledge plays a significant role in driving public health practices. Another critical role the media plays in influencing public perception, opinions, attitudes, and behaviors during the peak of the public health emergency. Media also performed the responsibility of being the watchdog of society through consistent follow-ups on contact tracing, daily broadcasts of the infected, recoveries, and fatalities in different countries across the globe, including Nigeria. The paper recommends that the media should be more watchful in the information they disseminate to the public to avoid jeopardizing the primary aim of reducing people's uncertainty. This can be done by controlling information overload by deploying more instruments of gatekeeping to titrate the kinds of information they send through their channels

What we need to know about uncertainty in illness among people with primary malignant brain tumours: A mixed-methods systematic review.

To identify the characteristics of uncertainty in illness (UI) among people with primary malignant brain tumours (PMBT). High recurrence rates and complex symptoms cause uncertainty in people with PMBT. Given the characteristics of PMBT, reviewing UI among people with PMBT will benefit future research and clinical intervention development. A mixed-methods systematic review. We performed a mixed-methods systematic review (PubMed, CINAHL, Embase, PsycINFO, Scopus and Cochrane Library), including studies on UI among people with PMBT, searched from the databases' inception to the search date. The initial search was conducted in July 2021, with an additional search in March 2022. The major search terms were PMBT and UI, and no limitations were placed on the study design. The Cochrane tool was used to evaluate the risk of bias in randomised controlled trials, and JBI checklists were used to evaluate quasi-experimental studies, survey methodology studies and a case study. This review was reported using the PRISMA 2020 checklist. Both quantitative and qualitative research data were extracted, analysed and then integrated in three stages of a mixed-methods systematic review. Eleven studies were included. Due to physical, psychological and social risk factors, the UI progression of people with PMBT was complex and ambiguous, although they adapted to the PMBT diagnosis and treatment process. Subsequently, we proposed a model of UI among people with PMBT. UI has multidimensional characteristics, and healthcare providers need to consider these aspects for people with PMBT. The proposed model provides directions for nursing practice and future research. Nurses caring for people with PMBT should comprehend their UI and intervene accordingly. This review incorporated data including people with PMBT in hospitals and communities. This analysis contributes to the clinical-to-community nursing transition process for people with PMBT.

Uncertainty and Well-Being amongst Homeworkers in the COVID-19 Pandemic: A Longitudinal Study of University Staff.

The COVID-19 pandemic heightened uncertainties in people’s lives—and was itself a source of fresh uncertainty. We report a study of homeworkers on whether such uncertainties, and particularly those related to their work environment, are associated with lower levels of well-being and whether this association is exacerbated by prior poor well-being. We focus on five uncertainties surrounding the pandemic and employment—the virus, the job quality, workload, logistics of work lives, and support from the employer. Our empirical tests show that uncertainties around the virus, employer support, and their job quality have the strongest negative associations with well-being. These are based on data collected over three time periods in the first year of the pandemic from a sample of university staff (academics and non-academics) and well-being is measured on two continua, anxiety–contentment and depression–enthusiasm. The effects of uncertainties around workload and logistics are less pronounced, but more apparent among employees with better (not poorer) past well-being, at various times of the recession. The study adds to our understanding of the pandemic and highlights the need to link uncertainty to mental health more than it has in the past.

Mindpill: A Mental Health Prediction Application

Abstract: During the outbreak of Covid-19 people suffered a lot to maintain their psychomotor equilibrium. Covid -19 beinga global threat has made the life of people miserable. Stress, fear, worry, depression and many more causes uncertainty in people’s minds. They have faced unemployment, working from home, online education, insufficient physical communication withfriends, family members, colleagues etc caused physical as well as mental retardation. They have faced the problem of how to maintain the unstable state of mental health. Apart from all these it also caused the shortage of Psychiatrist and Psychologist and the taint related to mental health problems downhearted people from personal consultation, it led to the dependency of mobile apps for their take over from mental health issues. This raised the idea of developing a mental health tracking app which provides the preventive measures of intellectual difficulties. It could be used by both children as well as adults and also any category of age group.

Decision-making under Uncertainty: A Cognitive Approach

Conventional economics believes that individuals are rational in their decisions based on five factors such as: considering all known options; using the maximum amount of available information; determining the precise weight -albeit subjective- of the costs and potential benefits of each option; accurate calculation -albeit subjective- of the various possible consequences; and the maximum amount of common sense considering all factors; are seeking to make sensible decisions. However, these factors have not always been fully established, perhaps even Individuals may be exposed to the uncertainty that jeopardizes decision-making. This is an applied and developmental research, with the type of library study and using the new findings of cognitive science, he explains how to make decisions under uncertainty. The findings of this study indicate the role of OPFC in decision-making, especially in the face of emotional factors and complex decisions that are all made by the PFC. In the face of risks of uncertainty, both of VPFC and VS sectors are active. The striatum is associated with loss aversion of people. Also, the role of the striatum in learning and habit formation can also be mentioned; so that information about uncertainty transmits through the striatum to the PFC section, and because the striatum transmits information to the brain via dopamine neurons, so by repeating behavior and receiving a reward, that behavior has become a habit, then belief Systems and mental models have been formed. Repeating uncertainty ultimately disrupts an individual's cognitive system, creates irrational beliefs, and increases people's uncertainty.

Effect of Lack of Endurance for Uncertainty on Health Promotion of People with Physical Disabilities

The purpose of this study was to examine the effect of lack of tolerance for uncertainty in people with physical disabilities on health promotion. Data were collected from 250 people with physical disabilities living in five regions: Seoul, Gyeonggi, Chungcheong, Jeolla, and Gyeongsang. Of these, the final 170 copies were used for the final analysis, excluding 80 copies with inconsistent responses or omissions. The survey tool was used by modifying and supplementing the questionnaire about lack of tolerance for uncertainty and health promotion used in previous studies. For the collected data, frequency analysis, exploratory factor analysis, reliability analysis, and structural equation model analysis were used using SPSS and AMOS analysis programs. The derived research results are as follows. First, mental pain and work-life dissatisfaction due to uncertainty, which are sub-factors of the disabled

Managing clinical uncertainty in older people towards the end of life: a systematic review of person-centred tools

BackgroundOlder people with multi-morbidities commonly experience an uncertain illness trajectory. Clinical uncertainty is challenging to manage, with risk of poor outcomes. Person-centred care is essential to align care and treatment with patient priorities and wishes. Use of evidence-based tools may support person-centred management of clinical uncertainty. We aimed to develop a logic model of person-centred evidence-based tools to manage clinical uncertainty in older people.MethodsA systematic mixed-methods review with a results-based convergent synthesis design: a process-based iterative logic model was used, starting with a conceptual framework of clinical uncertainty in older people towards the end of life. This underpinned the methods. Medline, PsycINFO, CINAHL and ASSIA were searched from 2000 to December 2019, using a combination of terms: “uncertainty” AND “palliative care” AND “assessment” OR “care planning”. Studies were included if they developed or evaluated a person-centred tool to manage clinical uncertainty in people aged ≥65 years approaching the end of life and quality appraised using QualSyst. Quantitative and qualitative data were narratively synthesised and thematically analysed respectively and integrated into the logic model.ResultsOf the 17,095 articles identified, 44 were included, involving 63 tools. There was strong evidence that tools used in clinical care could improve identification of patient priorities and needs (n = 14 studies); that tools support partnership working between patients and practitioners (n = 8) and that tools support integrated care within and across teams and with patients and families (n = 14), improving patient outcomes such as quality of death and dying and satisfaction with care. Communication of clinical uncertainty to patients and families had the least evidence and is challenging to do well.ConclusionThe identified logic model moves current knowledge from conceptualising clinical uncertainty to applying evidence-based tools to optimise person-centred management and improve patient outcomes. Key causal pathways are identification of individual priorities and needs, individual care and treatment and integrated care. Communication of clinical uncertainty to patients is challenging and requires training and skill and the use of tools to support practice.

TOLERANCE OF UNCERTAINTY AND EXECUTIVE DYSFUNCTION IN PEOPLE WITH PSYCHOLOGICAL TRAUMA

The aim of this study was to determine the effect of tolerance of uncertainty on the executive functions in people with psychological trauma. To study the neuropsychological correlates of tolerance of uncertainty in people with psychological trauma, 55 subjects aged 21 to 66 years (25 men and 30 women) were involved. The control sample included 56 subjects aged 22–67 years (21 men and 35 women). Research methods: "New questionnaire of tolerance-intolerance of uncertainty", "Iowa Gambling Task", Clinician-Administered PTSD Scale for DSM-IV (CAPS-DX), Method of verbal-color interference (Stroop test). Results: psychological trauma causes a decrease in the level of tolerance of uncertainty (ToU), an increase in the level of intolerance of uncertainty (IoU) and an increase in the level of interpersonal intolerance of uncertainty (IIoU). ToU can be seen as a protective factor in the case of psychological trauma. ToU can alleviate the manifestations of executive dysfunction (when treating both ambivalent and indeterminate stimuli) in people with a history of psychological trauma. IoU can be considered as a psychological construct that interferes with the normal functioning of executive functions in the control group (persons without a history of psychological trauma). Psychological trauma causes an increase in the level of IIoU in a way that is not associated with executive dysfunction.

Therapeutic uncertainties in people with cardiometabolic diseases and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19).

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2 or COVID‐19) has been declared a pandemic by the World Health Organization and sent all countries scrambling to review emergency healthcare provisions. There is global evidence of each nation struggling to effectively manage the number of people being diagnosed with the virus. These are testing times which have not been experienced in recent generations and there are a number of insecurities regarding the management of people with COVID‐19 and cardiometabolic diseases. This review highlights the current concerns related to COVID‐19 and provides advice in terms of the therapeutic uncertainty and potential adverse harms associated with therapy when managing people, particularly those with cardiometabolic diseases, who have contracted or are at increased risk of contracting COVID‐19.

The Multiple Faces of the State: Encounters between the State and Squatters in Kathmandu

This article focuses on conditions of prolonged uncertainty for people residing in a squatter settlement, a sukumbasi basti, in Kathmandu and the role assigned to the state in this. Inspired by theoretical debates on urban governmentality and based on longitudinal ethnographic fieldwork, the article shows how the threat of eviction has resulted in a permanent state of uncertainty, but also a pragmatic acceptance of the state of affairs which, over the years, has contributed to fostering a strong sense of belonging to the area.

Level of uncertainty in people living with HIV

Introduction: Worldwide, human immunodeficiency virus (HIV) infection continues to be an emerging public health problem. With the positive screening of this chronic degenerative disease, the virus generates physical, psychological, social and spiritual changes in people, that lead to uncertainty in the face of an uncertain future. Identifying the uncertainty in the patients, allows the care professional to plan integral interventions to favour the reduction of this process and can integrate well-being in the experience with their chronic condition and thus, have quality of life. Objective: To determine the level of uncertainty in a group of people living with HIV. Method: Quantitative, descriptive and transversal study. Non-probabilistic sampling of 30 people living with HIV, from the CONVIHVE Civil Association of Morelia, Michoacán. An identification card and the scale “Uncertainty in front of the disease” (MUIS) of Merle Mishel were applied, with a reliability of (.904). The statistical package SPSS V was used to analyze the data. 22. Results: 83.3% of the total population are men and 16.7% are women, 32-39 years of age (36.6%) of whom 70% are men. Being single, 53.3% have a bachelor’s degree. 60% report being employed. 30% of the population refers to having more than 10 years of diagnosis and less than 5 years in treatment 53.3%. 76.7% are Catholic. From the total of participants, 23.3% showed a low level of uncertainty, followed by a level of regular uncertainty with 26.7%, and 50% showed a high level of uncertainty. Conclusion: The level of uncertainty in people living with HIV is high. It is necessary to carry out comprehensive interventions that favour the reduction of the level of uncertainty and thus improve the well-being and quality of life of people living with HIV.

A methodology with a distributed algorithm for large-scale trajectory distribution prediction

ABSTRACTIn this paper, we propose a method for predicting the distributions of people’s trajectories on the road network throughout a city. Specifically, we predict the number of people who will move from one area to another, their probable trajectories, and the corresponding likelihoods of those trajectories in the near future, such as within an hour. With this prediction, we will identify the hot road segments where potential traffic jams might occur and reveal the formation of those traffic jams. Accurate predictions of human trajectories at a city level in real time is challenging due to the uncertainty of people’s spatial and temporal mobility patterns, the complexity of a city level’s road network, and the scale of the data. To address these challenges, this paper proposes a method which includes several major components: (1) a model for predicting movements between neighboring areas, which combines both latent and explicit features that may influence the movements; (2) different methods to estimate corresponding flow trajectory distributions in the road network; (3) a MapReduce-based distributed algorithm to simulate large-scale trajectory distributions under real-time constraints. We conducted two case studies with taxi data collected from Beijing and New York City and systematically evaluated our method.

How uncertainty affects career behaviour: A narrative approach

Despite increased uncertainty in the environment, the role of uncertainty in people’s careers is poorly understood. Those few theories that account for uncertainty portray it as a negative influence on people’s career and should therefore be reduced or avoided. This article presents an empirical study that investigated the impact of uncertainty on people’s career behaviour using a narrative approach. The findings reveal that people have different understandings of career uncertainty, which leads to distinct differences in subsequent career behaviour. Specifically, we identified four qualitatively different meanings of career uncertainty we have called Stabiliser, Glider, Energiser and Adventurer. The findings add to the existing literature by showing how each meaning of career uncertainty affects career decision making, criteria to gauge career success and meaning, and negotiating transitions. This significantly broadens current conceptualisation of career uncertainty and its impact on career behaviour than existing literature. JEL Classification: M10, M50, L10

Factors Associated With Uncertainty in Illness Among People With Parkinson's Disease.

People with Parkinson's disease (PD) reported to experience uncertainty because of gradually progressive disease characteristics with no cure, and variably manifesting and unpredictable symptoms. This study was designed to identify illness-related variables influencing uncertainty in PD patients and to analyze direct and indirect paths between these variables. Data were collected from 206 participants using a structured questionnaire. Path analysis revealed the direct and/or indirect effects of economic status, disease severity, social support, and resilience on uncertainty in people with PD. Disease severity, social support, and resilience were shown to have significant direct effects on uncertainty. Economic status and disease severity had indirect effects on uncertainty, which were mediated by social support. Disease severity and social support also had indirect effects on uncertainty, which were mediated by resilience. Therefore, the efforts of health care professionals should be directed not only toward managing PD symptoms, but also toward facilitating social support and resilience.

Physicians’ identification of the need for palliative care in people with intellectual disabilities

BackgroundA growing number of people with intellectual disabilities (ID) is suffering from life-threatening chronic illnesses and is therefore in need for palliative care. AimsWe aimed to explore how the need for palliative care is recognized in people with ID. Methods and proceduresWe conducted a semi-structured interview study among 10 ID-physicians in the Netherlands. Outcomes and resultsIdentification of people with ID in need for palliative care mostly results from a process in which multiple signals from different information sources converge and lead to a growing awareness. As a result, ID-physicians do not expect people to return to their prior level of health or functioning, but rather expect an irreversible decline leading to death. The presence, stage and prognosis of the disease, physician-patient interaction, and communication with proxies who provide contextual information are factors influencing the process. Conclusions and implicationsDistinctive for a population of people with ID are the frequent diagnostic uncertainty in people with ID, the patients’ communicational abilities and the reliance of ID-physicians on close proxies. We argue for a proactive attitude of physicians regarding care and support of people with ID with palliative care needs.

Second best toll pricing within the framework of bounded rationality

The network design problem is usually formulated as a bi-level program, assuming the user equilibrium is attained in the lower level program. Given boundedly rational route choice behavior, the lower-level program is replaced with the boundedly rational user equilibria (BRUE). The network design problem with boundedly rational route choice behavior is understudied due to non-uniqueness of the BRUE. In this study, thus, we mainly focus on boundedly rational toll pricing (BR-TP) with affine link cost functions. The topological properties of the lower level BRUE set are first explored. As the BRUE solution is generally non-unique, urban planners cannot predict exactly which equilibrium flow pattern the transportation network will operate after a planning strategy is implemented. Due to the risk caused by uncertainty of people’s reaction, two extreme scenarios are considered: the traffic flow patterns with either the minimum system travel cost or the maximum, which is the “risk-prone” (BR-TP-RP) or the “risk-averse” (BR-TP-RA) scenario respectively. The upper level BR-TP is to find an optimal toll minimizing the total system travel cost, while the lower level is to find the best or the worst scenario. Accordingly BR-TP can be formulated as either a min –min or a min –max program. Solution existence is discussed based on the topological properties of the BRUE and algorithms are proposed. Two examples are accompanied to illustrate the proposed methodology.