Understanding Barriers to Medical Instruction Access for Older Adults: Implications for AI-Assisted Tools

Recalling medical instructions provided during a doctor's visit can be difficult due to access barriers, primarily for older adults who visit doctors multiple times per year and rely on their memory to act on doctor's recommendations. There are several interventions that aid patients in recalling information after doctors' visits; however, some have been proven ineffective, and those that are effective can present additional challenges for older adults. In this paper, we explore the challenges that older adults with chronic illnesses face when collecting and recalling medical instructions from multiple doctors' visits and discuss implications for AI-assisted tools to enable older adults better access medical instructions. We interviewed 12 older adults to understand their strategies for gathering and recalling information, the challenges they face, and their opinions about automatic transcription of their conversations with doctors to help them recall information after a visit. We found that participants face accessibility challenges such as hearing information and recalling medical instructions that require additional time or follow-up with the doctor. Therefore, patients saw potential value for a tool that automatically transcribes and helps with recall of medical instructions, but desired additional features to summarize, categorize, and highlight critical information from the conversations with their doctors

Interventions to Influence Consulting and Antibiotic Use for Acute Respiratory Tract Infections in Children: A Systematic Review and Meta-Analysis

BACKGROUND: Respiratory tract infections (RTIs) are common in children and generally self-limiting, yet often result in consultations to primary care. Frequent consultations divert resources from care for potentially more serious conditions and increase the opportunity for antibiotic overuse. Overuse of antibiotics is associated with adverse effects and antimicrobial resistance, and has been shown to influence how patients seek care in ensuing illness episodes. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a systematic review and meta-analysis to assess the effectiveness of interventions directed towards parents or caregivers which were designed to influence consulting and antibiotic use for respiratory tract infections (RTIs) in children in primary care. Main outcomes were parental consulting rate, parental knowledge, and proportion of children subsequently consuming antibiotics. Of 5,714 references, 23 studies (representing 20 interventions) met inclusion criteria. Materials designed to engage children in addition to parents were effective in modifying parental knowledge and behaviour, resulting in reductions in consulting rates ranging from 13 to 40%. Providing parents with delayed prescriptions significantly decreased reported antibiotic use (Risk Ratio (RR) 0.46 (0.40, 0.54); moreover, a delayed or no prescribing approach did not diminish parental satisfaction. CONCLUSIONS: IN ORDER TO BE MOST EFFECTIVE, INTERVENTIONS TO INFLUENCE PARENTAL CONSULTING AND ANTIBIOTIC USE SHOULD: engage children, occur prior to an illness episode, employ delayed prescribing, and provide guidance on specific symptoms. These results support the wider implementation of interventions to reduce inappropriate antibiotic use in children

Chemical evolution of atmospheric organic carbon over multiple generations of oxidation

The evolution of atmospheric organic carbon as it undergoes oxidation has a controlling influence on concentrations of key atmospheric species, including particulate matter, ozone and oxidants. However, full characterization of organic carbon over hours to days of atmospheric processing has been stymied by its extreme chemical complexity. Here we study the multigenerational oxidation of α-pinene in the laboratory, characterizing products with several state-of-the-art analytical techniques. Although quantification of some early generation products remains elusive, full carbon closure is achieved (within measurement uncertainty) by the end of the experiments. These results provide new insights into the effects of oxidation on organic carbon properties (volatility, oxidation state and reactivity) and the atmospheric lifecycle of organic carbon. Following an initial period characterized by functionalization reactions and particle growth, fragmentation reactions dominate, forming smaller species. After approximately one day of atmospheric aging, most carbon is sequestered in two long-lived reservoirs—volatile oxidized gases and low-volatility particulate matter.National Science Foundation (U.S.). Graduate Research Fellowship Program (AGS-PRF 1433432)National Science Foundation (U.S.). Graduate Research Fellowship Program (Grant AGS-1536939)National Science Foundation (U.S.). Graduate Research Fellowship Program (Grant AGS-1537446)National Science Foundation (U.S.). Graduate Research Fellowship Program (Grant AGS-1536551