Determinants of consumers' perceived trust in IT-ecosystems

Digital ecosystems, or IT-ecosystems (ITEs), are composed of multiple and independent entities such as individuals, organizations, services, software, and applications. Together, these elements create a number of new independent systems that operate and communicate with their own infrastructure (man to machine; machine to machine; person to person), sharing one or several missions. A better understanding of how ITEs and their interconnected components create benefits and added value for different types of consumers is of particular importance to the establishment of digital environments and to managing their resources. Considering different components of perceived trust in ITEs, we rely in this paper on a multi-dimensional framework of trust effects that includes system-centric as well as user-centric determinants of trust. Based on our conceptual model, we develop two sets of propositions. The first ones address technological drivers of trust in ITEs, whereas the second set of propositions considers individual as well as social drivers of trust. The model and propositions are discussed with reference to preliminary empirical results as well as to future research steps and business implications

Validation of core competencies during residency training in anaesthesiology

Background and goal: Curriculum development for residency training is increasingly challenging in times of financial restrictions and time limitations. Several countries have adopted the CanMEDS framework for medical education as a model into their curricula of specialty training. The purpose of the present study was to validate the competency goals, as derived from CanMEDS, of the Department of Anaesthesiology and Intensive Care Medicine of the Berlin Charité University Medical Centre, by conducting a staff survey. These goals for the qualification of specialists stipulate demonstrable competencies in seven areas: expert medical action, efficient collaboration in a team, communications with patients and family, management and organisation, lifelong learning, professional behaviour, and advocacy of good health. We had previously developed a catalogue of curriculum items based on these seven core competencies. In order to evaluate the validity of this catalogue, we surveyed anaesthetists at our department in regard to their perception of the importance of each of these items. In addition to the descriptive acquisition of data, it was intended to assess the results of the survey to ascertain whether there were differences in the evaluation of these objectives by specialists and registrars

The impact of contextual factors on nursing outcomes and the role of placebo/nocebo effects

Introduction: Placebo and nocebo effects represent one of the most fascinating topics in the health care field. Objectives: the aims of this discussion paper were (1) to briefly introduce the placebo and nocebo effects, (2) to elucidate the contextual factors able to trigger placebo and nocebo effects in the nursing field, and (3) to debate the impact of contextual factors on nursing education, practice, organisation, and research. Methods: a narrative review was conducted based on the available evidence. Results: Placebo responses (from Latin \u201cI shall please\u201d) are a beneficial outcome(s) triggered by a positive context. The opposite are the nocebo effects (from Latin \u201cI shall harm\u201d), which indicates an undesirable outcome(s) caused by a negative context. Both are complex and distinct psychoneurobiological phenomena in which behavioural and neurophysiological changes arise subsequent to an interaction between the patient and the health care context. Conclusion: Placebo and nocebo concepts have been recently introduced in the nursing discipline, generating a wide debate on ethical issues; however, the impact on nursing education, clinical practice, nursing administration, and research regarding contextual factors triggering nocebo and placebo effects has not been debated to date

How to prevent, minimize, or extinguish nocebo effects in pain: A narrative review on mechanisms, predictors, and interventions

Nocebo effects, such as side effects due to negative expectations regarding the pain treatment, are a concern for health care providers and come with significant costs. This narrative review focuses on underlying mechanisms and possible factors that contribute to the susceptibility to the nocebo effect on pain and related outcomes and suggests strategies that can prevent, minimize, or extinguish nocebo effects in clinical settings. Nocebo effects are the result of psychological (eg, conditioning, verbal suggestions, and observational learning) and neurobiological (eg, cholecystokinin and dopamine regulation) mechanisms. Evidence from clinical and experimental studies lead to various recommendations and strategies to alter the nocebo effect in order to optimize pain treatments, such as providing patients with enhanced information, optimizing patient–physician communication and relationships, and offering psychoeducation on coping skills in order omanage patient expectations. The current literature from both clinical and experimental studies provides a better understanding of the nocebo effect and possible factors that modulate its strength on treatment outcomes. This allows for the development of evidencebased strategies aimed at the prevention, minimization, and treatment of the nocebo effect in pain conditions and possible other somatic disorders.Health and self-regulatio

Noteworthy Articles in 2015 for the Cardiothoracic Anesthesiologist

Large multicenter, randomized controlled trials published in reputable journals had a large impact on the world of cardiothoracic anesthesia in 2015. We as cardiac anesthesiologists pride ourselves as being experts in applied physiology, physics, ultrasonography, and pharmacology/pharmacotherapy. The selected studies added to our knowledge in the fields of echocardiography, pharmacology, molecular biology, and genetics. Outcome studies shine a light on important topics that are relevant to all cardiac anesthesiologists: does surgical atrial fibrillation ablation during mitral valve surgery reduce the recurrence of atrial fibrillation at 1 year after surgery? Does remote ischemic preconditioning live up to its promise to reduce postoperative major cardiac and cerebral events? Although we still do not have the answer to all the questions, the year 2015 has been a great step toward the goal of understanding molecular mechanisms of ischemic myocardial injury and toward providing evidence-based medicine for improving patient outcome