User-centred prototyping solutions to solve adult critical care issues: a scoping review

BMJ Health & Care Informatics · 2026-01-01

BACKGROUND: How user-centred prototyping is carried out to solve adult critical care issues depends on the unique characteristics of this context. This review aimed to characterise prototyping in the context of critical care in terms of the types of prototypes developed, activities used to generate prototypes and settings in which prototypes were generated. METHODS: Four databases (PubMed, CINAHL, SCOPUS and IEEExplore) were searched for articles published from inception to 25 September 2025, in English, that involved prototyping to address issues in adult critical care. Two reviewers independently screened the search results to identify eligible articles and reviewed retained articles. RESULTS: 22 of 860 articles met the eligibility criteria. Role, look and feel, implementation and integration prototype types which combined two or more of these prototypes were identified. Prototypes addressing both role and look and feel were most common. 10 prototyping activities were reported, namely sketching, storyboarding, interactivity simulation, digitalising and adapting paper-based forms, rank ordering, building a functional device model, survey for item selection, card sorting, adapting a predeveloped high-tech prototype to a low-tech version, and revising existing workflow. Six of 22 articles reported multiple activities. Sketching was the most often used activity, and the in-person hospital setting was the most reported. CONCLUSIONS: Overall, there was a lack of reporting on the details of the prototyping processes. Such details could help future researchers anticipate the unique challenges of prototyping to develop solutions to solve adult critical care issues, learn from prior successful experiences and better plan strategies to address these challenges.

User-centred prototyping solutions to solve adult critical care issues: a scoping review

UNC Libraries · 2026-01-16

BACKGROUND: How user-centred prototyping is carried out to solve adult critical care issues depends on the unique characteristics of this context. This review aimed to characterise prototyping in the context of critical care in terms of the types of prototypes developed, activities used to generate prototypes and settings in which prototypes were generated. METHODS: Four databases (PubMed, CINAHL, SCOPUS and IEEExplore) were searched for articles published from inception to 25 September 2025, in English, that involved prototyping to address issues in adult critical care. Two reviewers independently screened the search results to identify eligible articles and reviewed retained articles. RESULTS: 22 of 860 articles met the eligibility criteria. Role, look and feel, implementation and integration prototype types which combined two or more of these prototypes were identified. Prototypes addressing both role and look and feel were most common. 10 prototyping activities were reported, namely sketching, storyboarding, interactivity simulation, digitalising and adapting paper-based forms, rank ordering, building a functional device model, survey for item selection, card sorting, adapting a predeveloped high-tech prototype to a low-tech version, and revising existing workflow. Six of 22 articles reported multiple activities. Sketching was the most often used activity, and the in-person hospital setting was the most reported. CONCLUSIONS: Overall, there was a lack of reporting on the details of the prototyping processes. Such details could help future researchers anticipate the unique challenges of prototyping to develop solutions to solve adult critical care issues, learn from prior successful experiences and better plan strategies to address these challenges.

Risk factors for child abuse and neglect: Systematic review and meta-analysis

Public Health · 2025-02-16 · 13 citations

OBJECTIVES: Child maltreatment is a major public health issue associated with adverse outcomes and societal costs, yet its risk factors lack contemporary quantitative synthesis. This review aims to identify and quantify individual, familial, community, and societal risk factors associated with different types of child maltreatment and explore patterns across maltreatment types. STUDY DESIGN: Systematic review and meta-analysis. METHODS: This study followed PRISMA guidelines and reviewed literature on child maltreatment from 2013 to 2023. Eligible studies focused on physical, sexual, emotional abuse, neglect, and multi-type maltreatment in children under 18. Databases used included PubMed, PsycINFO, and Web of Science. Data was extracted and analyzed using meta-analysis with fixed and random effects models. Risk of bias was assessed using the ROBINS-I tool, and sensitivity and subgroup analyses were performed. Certainty of evidence was evaluated using the GRADE approach. RESULTS: Of 5554 identified studies, 42 met inclusion criteria. Significant results include: male children showed higher odds of physical abuse (OR:1.49). Employed families, higher family education, older parental age, and higher family income had lower odds of maltreatment (OR from 0.51 for income to 0.99 for parental age). Larger family size, parental mental health, maltreatment history, and substance use had higher odds of maltreatment (OR from 1.07 for family size to 5.21 for mental health). Urban areas had lower odds of physical abuse (OR: 0.88). CONCLUSIONS: Findings underscore the importance of addressing identified risk factors at multiple levels, with implications for practice, policy, and future research to refine prevention strategies and promote child well-being.

Confiscation by Consent: The Warped Economics of Price Regulation for Pharmaceuticals under the Inflation Reduction Act

SSRN Electronic Journal · 2025-01-01

Nudges, preferences and competences: a critique of both neoclassical and behavioral economics

Behavioural Public Policy · 2025-05-06 · 2 citations

Abstract For all their differences, the two rival theories of human behavior have many unfortunate similarities. Standard rational choice theory posits that individuals use rational techniques to pick ends that meet their set of private preferences. Modern theories of behavioral economics point to systematic deviations from those principles. Both approaches assume that all preferences are individually based. However, the evolutionary principle of inclusive fitness insists that in family situations, it is the welfare of the unit, not of any of single individual, that explains various forms of natural love and affection that arise because of the interdependence of − and the redistribution of − wealth it requires. Likewise, both standard theories ignore variations in tastes and in competence levels that allow for gains from trade across competence levels. This paper then reinterprets the common treatment of nudges and the various legal doctrines dealing with disabilities, product liability, and firm structure where the standard assumptions of uniform behavior miss the salient features of human behavior and social interactions.

Analysis of longitudinal patterns of child maltreatment reports in the United States

Child Abuse & Neglect · 2024-12-24

BACKGROUND: Child maltreatment is a continuous and prevalent issue, and victims of maltreatment often suffer adverse effects well into adulthood. Since child maltreatment rates tend to be clustered geographically and temporally, intervention programs are best implemented at a local level, targeting local risk factors for sustained and effective reduction over time. OBJECTIVE: Quantifying geographic variation in child maltreatment rate trajectories can help states identify local risk factors to guide program development and resource allocation. PARTICIPANTS AND SETTING: National child maltreatment data from 2011 to 2020 from the National Child Abuse and Neglect Data System (NCANDS) was used to quantify child maltreatment rates (overall and substantiated) over time. METHODS: Latent trajectory analysis was conducted to identify groups of states in the United States that share distinct temporal patterns of child maltreatment rates. Child maltreatment data was linked to the American Community Survey data to obtain community-level characteristics. RESULTS: Three groups of states with distinct child maltreatment trajectories were identified: 43 states with stable trajectory, 4 states with increasing number of reports over time, and 5 states with decreasing reports over time. Although states with a stable trajectory had some characteristics associated with higher socioeconomic status, such as lower percentage of families below poverty level, and lower percentage of unemployed laborers, there was not a consistent trend in socioeconomic characteristics between the three groups. CONCLUSIONS: Our results indicate there to be three groups of states with distinct child maltreatment trajectories, with majority of the states following a stable trajectory over time. There was not a consistent trend in socioeconomic characteristics between the three groups. While the results do not allow us to draw firm conclusions about socioeconomic characteristics associated with maltreatment trajectories, it does provide data-driven evidence for the existing assumption of a national average maltreatment trajectory.

Cost, Quality, and Utilization After Hospital-Physician and Hospital-Post Acute Care Vertical Integration: A Systematic Review

Medical Care Research and Review · 2024-05-06 · 9 citations

Vertical integration of health systems—the common ownership of different aspects of the health care system—continues to occur at increasing rates in the United States. This systematic review synthesizes recent evidence examining the association between two types of vertical integration—hospital-physician ( n = 43 studies) and hospital-post-acute care (PAC; n = 10 studies)—and cost, quality, and health services utilization. Hospital-physician integration is associated with higher health care costs, but the effect on quality and health services utilization remains unclear. The effect of hospital-PAC integration on these three outcomes is ambiguous, particularly when focusing on hospital-SNF integration. These findings should raise some concern among policymakers about the trajectory of affordable, high-quality health care in the presence of increasing hospital-physician vertical integration but perhaps not hospital-PAC integration.

Reporting of Child Maltreatment During the COVID-19 Pandemic in a Southern State in the United States

Public Health Reports · 2024-05-24 · 2 citations

OBJECTIVES: COVID-19-related stay-at-home orders (SAHOs) created an immediate physical barrier between children and professionals such as pediatricians and teachers, who are often first to identify and report signs of child maltreatment. Our objective was to determine how the SAHO in a southern state was associated with reports of child maltreatment and whether this association was modified by sociodemographic characteristics. METHODS: We linked data on reports of child maltreatment from a southern state in the United States from October 1, 2018, through September 30, 2020, to data from the US Census Bureau to obtain data on county-level socioeconomic characteristics. We fit a segmented regression model to evaluate changes in reports before and after the SAHO, March 20, 2020. We evaluated potential disparities by child age, case and allegation severity, and socioeconomic characteristics. RESULTS: Of 374 885 hotline calls, 276 878 (73.9%) were made before the SAHO and 98 007 (26.1%) after it. Although an immediate decrease in reports of child maltreatment occurred on the day of the SAHO, the rates of reporting within socioeconomic groups started increasing thereafter. While we found no significant change in the overall rate of change in hotline calls after versus before the SAHO (0.23; 95% CI, -0.11 to 0.58), stratified analyses indicate that the rates at which reporting increased varied by education level, health insurance coverage, median annual household income, and unemployment. CONCLUSIONS: Evaluating these trends is important for policy makers and practitioners to understand how policies enforced during the pandemic influence child maltreatment reporting and how these policies may affect reporting differently across socioeconomic groups.

The classical liberal version of labor law: Beware of coercion dressed up as liberty

Theoretical Inquiries in Law · 2023-01-01

Abstract In this Article, I contest on both theoretical and empirical grounds the progressive agenda, as represented by Hanoch Dagan, that seeks to advance the unionization movement in the name of individual autonomy and property. Theoretically, the Article shows that the common-law account of autonomy, which stresses freedom of action from external constraints involving the use or threat of force, provides the best analytical framework, one that undermines the modern progressive case for collective bargaining by workers. The negative account of autonomy applies to all persons; its correlative duties are simple. It applies regardless of the overall level or distribution of wealth. It is scalable from small to large societies. And it forces employers to respect the full range of material and psychological needs in order to recruit and retain their workers. In contrast, the modern progressive alternative imposes no clear correlative duties on employers. It has no obvious way to constrain the dominance of union forces. And its commands are sufficiently complex that they are often not understood by the workers whom they are intended to protect. Empirically, this Article shows that the institutional rigidity of union structures in dynamic markets fails; and it rejects the claim that individual workers are wedded to their current employer, given competitive forces that allow for rapid entry and exit. Given the long-term systematic advantages of the classical liberal model, it is no surprise that unions are generally in decline in major industrial societies.

Introduction to Special Issue on Migration

Public Affairs Quarterly · 2023-07-01

The variety and complexity of the eight papers in this Symposium issue are evidence that immigration is a tough nut to crack both as a matter of policy and application. There is no way that any short summary can do justice to these papers, which take a variety of moral, economic, historical, and empirical approaches to some of the recurrent issues in the field, so it is best in this short issue to try to situate the problem in a general classical liberal context, to show where the pressure points are most likely to appear.The initial way to approach this problem is to start with the simple proposition that the world today is divided into national territories where the practical norm is well-nigh universal: That each sovereign state has exclusive control over its own territory, which, among other things, allows it to decide which individuals are members of that state. These citizens have privileges that may be exercised, no questions asked, on such key matters as entering labor markets, owning property, voting, and otherwise participating in political affairs. All these activities may be denied or granted, at will, to any and all outsiders by the territorial sovereign.No one doubts the need for having some form of territorial control. The need to have some monopoly of force could not be achieved if the entire world, with its infinite diversity of locations and populations, were under a single sovereign. Indeed, in many cases, the divisions within a given country may be so pronounced that separation rather than aggregation is the norm. Thus, at the end of the British Raj, India split into India and Pakistan, and later Pakistan split into Pakistan and Bangladesh. Less dramatically, Czechoslovakia split into two countries, the Czech Republic and Slovakia, while the former Yugoslavia split into five nations, starting from the northwest: Slovenia, Croatia, Bosnia and Herzegovina, Serbia, and Macedonia. Clearly, these ethic differences, be they large or small, are a major obstacle to the expansion of the size of the state. And today, the territorial instinct reasserts itself as the member states of the European Union impose more restrictions on immigration.Yet at the same time, the normative foundations of this system seem elusive. There is the following deep skepticism about the importance of these borders, expressed in these essays by Jeremy Waldron and Ilya Somin, that these national boundary lines should have such a pronounced role in political economy. Michael Blake pursues this theme further by asking the extent to which classical liberals can justify exclusion through the use of violence—or is it force? The inquiry into the dominant role of territoriality can then be expanded, as by Peter Margulies, to examine all sorts of negative externalities that could be created both by easy and strict rules of admission.Taken as a whole, there is no doubt that these national barriers are a serious obstacle to the free trade in goods and services between two individuals, one inside the boundary and one outside. The general view is that these barriers block the gains from trade, which is what drives economic progress, so that ideally all tariffs and quantitative restrictions should give way to a system of free trade in which petty objections by domestic competitors of foreign firms should not dictate local policies.It should, of course, be evident that powerful conflicting forces on free trade and protectionism ebb and flow over time. It should therefore come as no surprise that the stakes are even higher where what is at stake is the movement of people across national boundaries. The loss to any given country from keeping out potential citizens can be enormous, and we see powerful political forces clamp down on open immigration, so many of these gains from trade are lost. The situation can be even more heartbreaking when the ability to leave a country exposes innocent people to imprisonment or death.So what is the explanation for so many nations closing their borders? Much of the explanation comes from old-fashioned protectionism. Your computer programmers will take the jobs of our specialists. There is all sorts of occupational licensing and other barriers to entry within a domestic economy, so there is no reason to expect that these forces will not exert even greater influence against outsiders who do not, after all, have a voice in the local economy and who, therefore, as Alex Nowrasteh, Michael Howard, and Andrew Forrester observe, have little ability to influence domestic policy even after they enter a country. In addition, as Gabriel Chin discusses, strong racial prejudices also lead to exclusions from the domestic economy. Not only are there objections in, say, the United States and much of Western Europe, of exclusion on straight racial grounds, as exemplified by Chinese exclusion acts. The force of these exclusions are also subject to political change. Thus, the Immigration Act of 1924 (the Johnson-Reed Act) was part of a white supremacist program, which gave way two decades later to a very different legal regime with the Immigration Act of 1965, which put an end to the venerable system of national-origin quotas.Yet two other reasons for exclusion are constantly at issue. Immigrants not only bring in their labor but also their families, cultures, and traditions that, in public spaces, may clash with local norms and cultures on such elementary and critical matters as to whether women should dress modestly and wear head coverings. Will freewheeling Danes and Swedes feel comfortable if large numbers of Muslims continue their traditional practices with strong barriers between men and women? There are no obvious market mechanisms that will mitigate these issues, and the situation becomes even more fraught if there are large welfare or educational costs that fall, at least in the short run, on local citizens. These are compounded by the fact that immigrants will typically gain political rights that could easily skew the balance of political power between established and newly arrived ethnic groups by altering the outcome of national and local elections. And letting people in is not just done on a simple open-borders policy. Thus, in many countries, as Lance Pritchett discusses, there is the controversial option of letting foreigners in on short-term labor visas that require them to leave after a certain period. And there are further questions about whether people should be deported if they lied on their entry applications or committed some crime while in the new country, as has occurred in the United States. The numbers of cases can be high and their complexity great, so it is fair to ask, along with Jill Family, whether some self-conscious exceptions to the Administrative Procedure Act of 1946, analogous statutes elsewhere, should be regarded as part of the new normal.It is therefore necessary to deal with the thrust and counterthrust on all these issues. It is also fair to ask whether classical liberalism has a distinctive view on these issues, or whether the combination of private gains and multidirectional externalities gives rise to empirical questions that, as always, require further reflection, even when certain situations—the major influx of illegal immigrants on the US southern border—will generate such powerful emotions that detached intellectual inquiry is ever more difficult. We cannot answer these questions, and thus offer to you a set of essays that take a stab at these difficult topics.