14,644 results
Search Results
102. Nursing research: a position paper.
- Author
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Greenwood J
- Subjects
NURSING research ,SICK people ,MEDICINE ,MEDICAL care ,PUBLIC health ,THERAPEUTICS - Published
- 1984
- Full Text
- View/download PDF
103. ADEA Position Paper: Statement on the Roles and Responsibilities of Academic Dental Institutions in Improving the Oral Health Status of All Americans.
- Subjects
MEDICAL care ,DENTAL care ,DENTAL hygiene ,PUBLIC health ,ASSOCIATIONS, institutions, etc. - Abstract
The article describes the American Dental Association's (ADEA) official statement and recommendations on the roles and responsibilities of academic dental institutions in improving the oral health in the U.S. ADEA believes that with the collaboration of communities of dental education and dental practice and other health professions, the oral health care needs of the poor will be met. The association's believes that academic dental institutions are the fundamental of the country's oral health.
- Published
- 2009
104. ADEA Position Papers: Statements on Peer Review, Freedoms and Responsibilities of Individuals and Institutions, Health Care Programs, and Due Process for Students in Dental Education.
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ASSOCIATIONS, institutions, etc. ,DENTAL care ,MEDICAL care ,DENTAL health education - Abstract
The article describes the American Dental Association's (ADEA) official statement and recommendations on peer review activities, freedoms and responsibilities of individuals and institutions, health care programs and due process for students in dental education in the U.S. It illustrates the principles for peer review instruction. For health care program, ADEA believes on the importance of access to affordable health care.
- Published
- 2009
105. Editorial: The importance of place in older people's care: three papers developing the geographies of nursing work.
- Author
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Andrews, Gavin J., McCormack, Brendan, and Reed, Jan
- Subjects
NURSING ,ELDER care ,NURSES ,OLDER people ,MEDICAL care ,GERONTOLOGY - Abstract
Comments on the articles on the importance of place in older people nursing, published in the September 2, 2005 issue of the "International Journal of Older People Nursing." Contextual information provided by geographical gerontology; Potential of geographical gerontology to provide critical and direct evidence for practice; Role of place in the concepts of gerontological nursing practice.
- Published
- 2005
- Full Text
- View/download PDF
106. Anniversary Paper: A sampling of novel technologies and the role of medical physicists in radiation oncology.
- Author
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Balter, Stephen and Balter, James M.
- Subjects
PHYSICISTS ,MEDICAL care ,RADIOTHERAPY ,ONCOLOGY ,PHYSICAL scientists - Abstract
Physicists have and continue to play a major role in the creation and introduction of novel technology into medical care. This review covers some of the highlights of contributions of medical physicists to the field of radiation oncology during the history of the AAPM. While not comprehensive, the broad scope of developments and their impact hints at the importance of the medical physicist in advancing the field in the past, present, and future. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
107. Paper Abstracts of the APOS 5th Annual Conference.
- Subjects
CANCER patients ,MEDICAL care ,PSYCHOLOGY ,CANCER - Abstract
The article presents abstracts on topics related to cancer which include the psychological impact of stigma in lung cancer patients, research on differential patient-family opinion of treatment and care for advanced lung cancer patients, and understanding cancer patients' psychological needs at the end-of-life.
- Published
- 2008
- Full Text
- View/download PDF
108. Anniversary Paper: Role of medical physicists and the AAPM in improving geometric aspects of treatment accuracy and precision.
- Author
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Yorke, Ellen D., Keall, Paul, and Verhaegen, Frank
- Subjects
RADIOTHERAPY ,MEDICINE ,THERAPEUTICS ,MEDICAL care - Abstract
The last 50 years have seen great advances in the accuracy of external beam radiation therapy. Geometrical uncertainties have been reduced from a centimeter or more in presimulation, skin-mark guided days to 1–2 mm in today’s image-guided radiation therapy treatments. Medical physicists, with the support and guidance of the American Association of Physicists in Medicine (AAPM), have been, and continue to be, at the forefront of research, development and clinical implementation in this area. This article reviews some of the major contributions of physicists to the improvement of treatment accuracy and precision, and speculates as to what the future may bring. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
109. Anniversary Paper: Evaluation of medical imaging systems.
- Author
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Krupinski, Elizabeth A. and Yulei Jiang
- Subjects
MEDICAL imaging systems ,MEDICAL radiology ,PATHOLOGY ,MEDICAL care ,MEDICAL physics - Abstract
Medical imaging used to be primarily within the domain of radiology, but with the advent of virtual pathology slides and telemedicine, imaging technology is expanding in the healthcare enterprise. As new imaging technologies are developed, they must be evaluated to assess the impact and benefit on patient care. The authors review the hierarchical model of the efficacy of diagnostic imaging systems by Fryback and Thornbury [Med. Decis. Making11, 88–94 (1991)] as a guiding principle for system evaluation. Evaluation of medical imaging systems encompasses everything from the hardware and software used to acquire, store, and transmit images to the presentation of images to the interpreting clinician. Evaluation of medical imaging systems can take many forms, from the purely technical (e.g., patient dose measurement) to the increasingly complex (e.g., determining whether a new imaging method saves lives and benefits society). Evaluation methodologies cover a broad range, from receiver operating characteristic (ROC) techniques that measure diagnostic accuracy to timing studies that measure image-interpretation workflow efficiency. The authors review briefly the history of the development of evaluation methodologies and review ROC methodology as well as other types of evaluation methods. They discuss unique challenges in system evaluation that face the imaging community today and opportunities for future advances. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
110. PAPER ABSTRACTS.
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MEDICAL care ,QUALITY of life ,OLDER people ,ALZHEIMER'S disease ,CAREGIVERS - Abstract
The article presents abstracts of medical research. They include "Health Care Transitions and Incident Feeding Tube Insertion Among Persons with Advanced Cognitive Impairment: Lost in Transition," "Changes in Quality of Life over Time among Older Persons with Advanced Illness" and "Patient and Caregiver Quality of Life in Alzheimer's Disease in Relation to Cognitive Severity."
- Published
- 2007
- Full Text
- View/download PDF
111. Paper Abstracts.
- Subjects
MEDICAL records ,GERIATRICS ,MEDICAL education ,MEDICAL research ,MEDICAL care - Abstract
The article presents abstracts of medical research including "Chief Resident Immersion Training in Geriatrics (Crit)," "Development of a Standardized Patient Instructor to Teach Functional Assessment and Communication Skills to Medical Students and House Officers," " Achieving Class-Wide Medical Student Competency in Mobility Assessment: Results From a Curriculum Using Online and Tradition Instruction," and more.
- Published
- 2006
- Full Text
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112. Discrimination in Healthcare and LGBTQ+ Information and Care‐seeking Behaviors.
- Author
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Brown, Lindsay K. and Veinot, Tiffany C.
- Subjects
MEDICAL care ,LGBTQ+ communities ,INFORMATION sharing ,DECISION making ,STATISTICS - Abstract
Members of the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, plus (LGBTQ+) community may face discrimination in healthcare, which can subsequently impact information and care‐seeking patterns. A tendency to avoid or delay health care is particularly concerning for LGBTQ+ people who face both physical and mental health disparities. This paper presents a literature review of literature on healthcare discrimination, LGBTQ+ care‐seeking, and associated information behaviors in order to generate a preliminary model of LGBTQ+ decision‐making around care and well‐being, called the Model of the Pathways to LGBTQ+ Well‐Being. This model can be used to investigate links between information behavior and relevant health behaviors and outcomes in a marginalized population. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
113. Using Symptoms and Healthcare Encounters to Capture a Rare Disease: A Study of Clinical Notes of the Alpha‐Gal Meat Allergy.
- Author
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Ma, Yuanye and Flaherty, Mary Grace
- Subjects
MEDICAL care ,RARE diseases ,CLINICAL trials ,GASTROINTESTINAL agents ,PATIENTS - Abstract
This paper examines clinical notes to identify reported symptoms and investigate patient‐provider communication processes in alpha‐gal syndrome (AGS). Clinical notes appear to be a credible and stable source of research where the researcher can find information regarding both symptoms and environmental factors of AGS. Compilation of notes could be used for a checklist to aid in diagnosis. This study analyzed clinicians' notes in patient records retrieved from the Electronic Medical Record Search Engine (EMERSE). The most reported symptoms fell into four general categories: skin (42%), inflammation (17%), gastrointestinal (20%), and anaphylaxis (21%). Environmental triggers were also commonly reported. This in‐depth analysis of clinical notes of AGS can serve as a basis for future automation of rare disease analysis; moreover, it provides a basic understanding of the granularity of information that an electronic health record (EHR) may provide for rare disease identification. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
114. Highlights of recent clinically relevant papers.
- Author
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MAYALL, ED
- Subjects
- *
MEDICAL care , *OSTEAL manifestations of general diseases , *COLLATERAL ligament , *GENITALIA ,ABSTRACTS - Abstract
The article presents abstracts on medical topics which include measurement of reproductive performance among thoroughbred mares, osseous abnormalities associated with collateral ligament and effects of endotoxaemia and carbohydrate overload on glucose and insulin dynamics in horses.
- Published
- 2010
- Full Text
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115. Highlights of Papers in the Clinical Investigations Section.
- Subjects
- *
MEDICAL care , *DEMENTIA , *CARDIOVASCULAR diseases , *NURSING home patients , *DEPRESSED persons - Abstract
Presents several articles related to medical care. Sex differences in the relationship between depressive symptoms and dementia incidence; Prevalence, clinical characteristics, and association with cardiovascular risk factors in community-dwelling older persons; Organizational characteristics and restraint use for hospitalized nursing home residents.
- Published
- 2003
- Full Text
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116. Highlights of Papers in the Clinical Investigations Section.
- Subjects
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CLINICAL trials , *THERAPEUTICS , *MEDICAL care - Abstract
Presents developments related to clinical trials of various diseases and their treatment. Role of delirium in the mortality rate of hospitalized older adults.
- Published
- 2003
- Full Text
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117. What does it take to facilitate the integration of clinical practice guidelines for the management of low back pain into practice? Part 2: A strategic plan to activate dissemination.
- Author
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Longtin, Christian, Décary, Simon, Cook, Chad E., and Tousignant‐Laflamme, Yannick
- Subjects
LUMBAR pain ,STRATEGIC planning ,HEALTH services accessibility ,MEDICAL care ,EVIDENCE-based medicine ,MEDICAL protocols ,CONCEPTUAL structures ,PAIN management ,DIFFUSION of innovations - Abstract
Low back pain (LBP) is the leading cause of disability worldwide among all musculoskeletal disorders despite an intense focus in research efforts. Researchers and decision makers have produced multiple clinical practice guidelines for the rehabilitation of LBP, which contain specific recommendations for clinicians. Adherence to these recommendations may have several benefits, such as improving the quality of care for patients living with LBP, by ensuring that the best evidence‐based care is being delivered. However, clinicians' adherence to recommendations from these guidelines is low and numerous implementation barriers and challenges, such as complexity of information and sheer volume of guidelines have been documented. In a previous paper, we performed a systematic review of the literature to identify high‐quality clinical practice guidelines on the management of LBP, and developed a concise yet comprehensive infographic that summarizes the recommendations from these guidelines. Considering the wealth of scientific evidence, passive dissemination alone of this research knowledge is likely to have limitations to help clinicians implement these recommendations into routine practice. Thus, an active and engaging dissemination strategy, aimed at improving the implementation and integration of specific recommendations into practice is warranted. In this paper, we argue that a conceptual framework, such as the theoretical domains framework, could facilitate the implementation of these recommendations into clinical practice. Specifically, we present a systematic approach that could serve to guide the development of a theory‐informed knowledge translation intervention as a means to overcome implementation challenges in rehabilitation of LBP. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
118. Quality indicators for dementia and older people nearing the end of life: A systematic review.
- Author
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Yorganci, Emel, Sampson, Elizabeth L., Gillam, Juliet, Aworinde, Jesutofunmi, Leniz, Javiera, Williamson, Lesley E., Cripps, Rachel L., Stewart, Robert, and Sleeman, Katherine E.
- Subjects
KEY performance indicators (Management) ,TERMINAL care ,ACQUISITION of data methodology ,SYSTEMATIC reviews ,MEDICAL care ,PATIENTS ,DEMENTIA patients ,PSYCHOMETRICS ,CLINICAL medicine ,AGING ,MEDICAL records ,DESCRIPTIVE statistics ,CULTURAL competence ,ELECTRONIC health records ,ELDER care ,SPIRITUAL care (Medical care) - Abstract
Background: Robust quality indicators (QIs) are essential for monitoring and improving the quality of care and learning from good practice. We aimed to identify and assess QIs for the care of older people and people with dementia who are nearing the end of life and recommend QIs for use with routinely collected electronic data across care settings. Methods: A systematic review was conducted, including five databases and reference chaining. Studies describing the development of QIs for care of older people and those with dementia nearing the end of life were included. QIs were categorized as relating to processes or outcomes, and mapped against six care domains. The psychometric properties (acceptability, evidence base, definition, feasibility, reliability, and validity) of each QI were assessed; QIs were categorized as robust, moderate, or poor. Results: From 12,980 titles and abstracts screened, 37 papers and 976 QIs were included. Process and outcome QIs accounted for 780 (79.7%) and 196 (20.3%) of all QIs, respectively. Many of the QIs concerned physical aspects of care (n = 492, 50.4%), and very few concerned spiritual and cultural aspects of care (n = 19, 1.9%). Three hundred and fifteen (32.3%) QIs were robust and of those 220 were measurable using routinely collected electronic data. The final shortlist of 71 QIs came from seven studies. Conclusions: Of the numerous QIs developed for care of older adults and those with dementia nearing the end of life, most had poor or moderate psychometric properties or were not designed for use with routinely collected electronic datasets. Infrastructure for data availability, combined with use of robust QIs, is important for enhancing understanding of care provided to this population, identifying unmet needs, and improving service provision. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
119. Religious preferences in healthcare: A welfarist approach.
- Author
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Crisp, Roger
- Subjects
HUMAN rights ,HISTORY of religion ,ATTITUDES of medical personnel ,PRACTICAL politics ,MEDICAL care ,PATIENTS' attitudes ,MEDICAL ethics ,HEALTH ,SOCIAL skills ,RESPECT ,RELIGION ,MORALE - Abstract
This paper offers a general approach to ethics before considering its implications for the question of how to respond to religious preferences in healthcare, especially those of patients and healthcare workers. The first section outlines the two main components of the approach: (1) demoralizing, that is, seeking to avoid moral terminology in the discussion of reasons for action; (2) welfarism, the view that our ultimate reasons are grounded solely in the well‐being of individuals. Section 2 elucidates the notion of religious preferences and describes the history and importance of their protection by human rights legislation. The following section defends the 'Preference Principle', according to which there is a reason to satisfy any preference (in so far as that satisfaction advances well‐being). Section 4 discusses the implications of this principle for religious preferences in healthcare, again seeking to bring out the special social and political importance of respect, and respect for such preferences in particular. The paper ends with a brief description of how to approach such problems from the perspective of a demoralized welfarism. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
120. The effectiveness of ūloa as a model supporting Tongan people experiencing mental distress.
- Author
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Vaka, Sione, Hamer, Helen Paris, and Mesui‐Henry, Anau
- Subjects
CULTURE ,COMMUNITY life ,SPIRITUALITY ,MEDICAL care ,PSYCHOLOGY ,INTERVIEWING ,FISHING ,PSYCHOSOCIAL factors ,CONCEPTUAL models ,INDIGENOUS peoples ,JUDGMENT sampling ,THEMATIC analysis ,PSYCHOLOGICAL distress ,MENTAL health services - Abstract
This article is based on a larger research project, which investigates the effectiveness of a culturally appropriate model, namely ūloa, when working with Tongan people. Ūloa is a communal method of fishing in Tonga, which includes all members of the community. A previous paper described the three phases of ūloa: presenting the concept to health providers and community groups; phase two amended the model based on phase one. This paper reports on phase three and findings related to the increased awareness of ūloa model within the mental health services and to raise awareness of how to work with Pacific people and adjust the health service to suit the needs of this population to test its effectiveness. Using reflexive thematic analysis, results highlighted a number of patterns both across the groups, described as napanapangamālie (harmony, balance), ngāue fakataha (working together/oneness), and toutai (fisher). These findings continue to support that the conventional biomedical approach employed in the mental health services overlooks elements of Tongan constructions of mental illness and the intersections between Tongan and biopsychosocial themes. Care that is based only on the 'medicine' rather than bringing the spiritual aspect into care planning (fake leaves) will not serve the needs of the Tongan community. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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121. Rejoinder to Bradley: Patient preferences and clinical trial design and interpretation: appreciation and critique of a paper by Feine, Awad & Lund.
- Author
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Feine, Jocelyne S., Awad, Manal A., and Lund, James P.
- Subjects
CLINICAL trials ,HEALTH outcome assessment ,PATIENT satisfaction ,MEDICAL care - Abstract
This article comments on the issue of patient preferences and clinical trial design. There has been much discussion in the literature concerning the effect of preference for treatment on outcome in clinical trials. The article discusses researcher C. Bardley's views regarding some of the disadvantages that are inherent in randomized controlled trials (RCTs), especially in cases where the outcome of interest is satisfaction with care. This concern led researchers C.R. Brewin and Bardley to propose a design, the partially randomized preference trial, that takes patient preferences into consideration by allowing patients with preferences to choose their treatment and randomly allocating those who have no preference.
- Published
- 1999
- Full Text
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122. Barriers and enablers of coordination across healthcare system levels.
- Author
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Gadolin, Christian and Eriksson, Erik
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INTERPERSONAL relations ,MEDICAL care - Abstract
Coordination across healthcare system levels is a global imperative to ensure efficient resource utilization and provide high‐quality care. The substantial body of research on coordination in healthcare mainly concerns coordination across professional and organizational domains. Consequently, there is a dearth of empirical research aimed at delineating the determinants of coordination across healthcare system levels. This paper describes and analyses the barriers and enablers of healthcare coordination across national, regional, and local system levels in a populous Swedish region. Individual interviews and focus group discussions, encompassing a total of 63 individuals, were conducted with managers, administrators, and politicians. The findings of the paper underscore that the barriers identified were most often of a structural or institutional character, whereas the enablers of the studied cross‐level coordination were mostly relational. Therefore, we propose that future research should aim to further delineate the prerequisites for personal relationships to emerge, as well as how they may act as enablers of coordination across healthcare system levels. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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123. Increasing capacity by moving away from one‐to‐one clinical supervision: using peer‐assisted learning and a group model of student placements in community paediatric speech and language therapy to enable student‐led service delivery
- Author
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Allison, Catherine and Thompson, Katie
- Subjects
AFFINITY groups ,COMMUNITY services ,SPEECH therapy ,HEALTH occupations students ,MEDICAL care ,PEDIATRICS ,LEARNING strategies ,INTERNSHIP programs ,CLINICAL supervision ,QUALITATIVE research ,SPEECH therapy education ,DESCRIPTIVE statistics ,DATA analysis software ,SPEECH therapists - Abstract
Background: Health Education England (HEE) and the Royal College of Speech and Language Therapists (RCSLT) have identified the need to increase placement capacity. Speech and language therapy is a shortage profession in the UK, so services need to consider innovative placement models to increase their placement offers without increasing the time burden on speech and language therapists (SLTs). Aims: To increase capacity for pre‐registration practice‐based learning by using peer‐assisted learning (PAL) in a group model of student placement to enable student‐led service delivery which provides high standards of clinical care and student experience and is an efficient use of SLT time. Methods & Procedures: A paediatric speech and language therapy service hosted eight student speech and language therapists (SSLTs) for their final pre‐registration placement. SSLTs completed pre‐ and post‐placement confidence ratings for a range of clinical skills; SSLTs and SLTs rated how useful different types of support were, and education settings provided feedback about working with the SSLTs. The number of clinical sessions completed by the SSLTs and the percentage of outcomes achieved for children with speech, language and communication needs were calculated. SLTs completed time‐trackers for placement‐related activities. Outcomes & Results: The impact of the placements was assessed using a tri‐vector methodology consisting of: self‐reporting by the student (using an evaluation form), feedback from the placement sites (schools) and analysis of targets set for individual children. SSLTs reported increased confidence in all clinical areas in their post‐placement evaluation form. SLTs reported increased confidence in SSLTs working independently and an increase in the perceived benefit to the service for having SSLTs in comparison with the time invested in supporting SSLTs. SSLTs and SLTs found all types of support provided during the placement useful. Schools reported high levels of satisfaction for working with SSLTs. SSLTs completed more clinical sessions than an SLT would have been able to in the time SLTs invested in placement‐related activities. Children achieved 60% of the targets set by SSLTs. Conclusions & Implications: This placement model increased the capacity for SSLT placements by using PAL in a group model of student placement to enable student‐led service delivery. The model provided high standards of clinical care and student experience and was an efficient use of SLT time. Wider use of this placement model would increase placement capacity and could also address vacancies in services. WHAT THIS PAPER ADDS: What is already known on the subject: SSLTs and SLTs are positive about the benefits of paired placements in comparison with individual placements. Other allied health professions have demonstrated that larger placements can be an effective way to support students and have used students to deliver student‐led services. What this study adds to existing knowledge: This paper is the first to look at whether PAL in a group model of student placements can be used in speech and language therapy to enable student‐led service delivery which provides high standards of clinical care, maintains high standards of student experience and is an efficient use of SLT time. What are the potential or actual clinical implications of this work?: This paper demonstrates that PAL can be used effectively in a group model of student placements in a paediatric SLT service to increase student capacity and enable student‐led service delivery. The proposed placement model provides a high‐quality placement for SSLTs and the children they work with, and is also an efficient use of SLT time. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
124. Developing a prehospital care service in a low‐resource setting: Barriers and solutions.
- Author
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Takoutsing, Berjo D. and Zolo, Yvan
- Subjects
RESOURCE-limited settings ,EMERGENCY medical services ,MEDICAL care ,COMMUNICABLE diseases ,EPIDEMIOLOGICAL transition ,NON-communicable diseases - Abstract
Prehospital care (PHC) is critical to the comprehensive and effective functioning of a healthcare system. Given the disproportionate burden of both communicable and non‐communicable diseases in low‐income nations, its significance cannot be understated. In spite of this, many of these nations lack a comprehensive PHC system. Setting up a cost‐effective PHC system in this environment can be difficult and necessitate a variety of stakeholders at various healthcare delivery system levels. Therefore, it is necessary to consider these anticipated barriers and identify feasible solutions for its execution. This will assist in creating a PHC system that is suited to the local needs and achieve sustainable and global health goals. This paper describes the challenges and solutions to establishing a prehospital care service in a low‐resource setting. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
125. Dental hygiene and direct access to care: Past and present.
- Author
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Gadbury‐Amyot, Cynthia C., Simmer‐Beck, Melanie L., Lynch, Ann, and Rowley, Lisa J.
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PSYCHOLOGY of dentists ,ORAL hygiene ,HEALTH services accessibility ,ORAL health ,DENTAL care ,CURRICULUM ,MEDICAL care ,OCCUPATIONS ,HEALTH insurance reimbursement ,MEDICAL practice ,MEDICAID - Abstract
The American Dental Hygienists' Association (ADHA) defines direct access as the ability of a dental hygienist to initiate treatment based on their assessment of patient's needs without the specific authorization of a dentist, treat the patient without the physical presence of a dentist and maintain a provider–patient relationship. In 2000, there were nine direct access states; currently, there are 42 states that have authorized some form of direct access. The ADHA has been instrumental in these legislative initiatives through strong advocacy efforts. While research and data support the benefits of direct preventive/therapeutic care provided by dental hygienists, many barriers remain. This paper chronicles key partnerships that have influenced and advocated for direct access and the recognition of dental hygienists as primary healthcare providers. The National Governors Association released a report in 2014 suggesting that dental hygienists be 'deployed' outside of dental offices as one strategy to increase access to oral health care along with reducing restrictive dental practice acts and increasing the scope of practice for dental hygienists. The December 2021 release of the National Institutes of Health report, Oral Health in America, further supports greater access to dental hygiene preventive/therapeutic care. This paper also reflects on opportunities and barriers as they relate to workforce policy, provides examples of effective state policies and illustrates an educational curriculum specifically created to prepare dental hygienists to provide oral health services in settings outside of the dental office. Dental hygiene education must ensure that graduates are future‐ready as essential healthcare providers, prepared to deliver direct access to dental hygiene care. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
126. Nursing in deathworlds: Necropolitics of the life, dying and death of an unhoused person in the United States healthcare industrial complex.
- Author
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Jenkins, Danisha, Chechel, Laura, and Jenkins, Brian
- Subjects
PALLIATIVE care nursing ,HEALTH care industry ,TERMINAL care ,HEALTH services accessibility ,TERMINALLY ill ,PRACTICAL politics ,EXTRACORPOREAL membrane oxygenation ,MEDICAL care ,SOCIOECONOMIC factors ,PSYCHOSOCIAL factors ,CRITICAL care medicine ,HOMELESS persons ,DEATH - Abstract
This paper begins with the lived accounts of emergency and critical care medical interventions in which an unhoused person is brought to the emergency department in cardiac arrest. The case is a dramatised representation of the extent to which biopolitical forces via reduction to bare life through biopolitical and necropolitical operations are prominent influences in nursing and medical care. This paper draws on the scholarship of Michel Foucault, Giorgio Agamben, and Achille Mbembe to offer a theoretical analysis of the power dynamics that influence the health care and death care of patients who are caught in the auspices of a neoliberal capitalist healthcare apparatus. This paper offers analysis of the overt displays of biopower over those individuals cast aside as generally unworthy of access to healthcare in a postcolonial capitalist system, in addition to the ways in which humans are reduced to 'bare life' in their dying days. We analyse this case study through Agamben's description of thanatopolitics, a 'regime of death', and the technologies that accompany the dying process, particularly in that of the homo sacer. Additionally, this paper illustrates the ways in which necropolitics and biopower are integral to understanding how the most advanced and expensive medical interventions make visible the political values of the healthcare system and how nurses and healthcare functions in these deathworlds. The purpose of this paper is to develop a greater understanding of biopolitical and necropolitical operations in acute and critical care environments, and to offer guidance to nurses in these spaces as they work to uphold ethical duties in a system that increasingly dehumanises. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
127. Telehealth in PM&R: Past, present, and future in clinical practice and opportunities for translational research.
- Author
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Tenforde, Adam S., Alexander, Joshua J., Alexander, Marcalee, Annaswamy, Thiru M., Carr, Conley J., Chang, Philip, Díaz, Monique, Iaccarino, Mary A., Lewis, Stephen B., Millett, Carolyn, Pandit, Sindhu, Ramirez, Claudia P., Rinaldi, Robert, Roop, Megan, Slocum, Chloe S., Tekmyster, Gene, Venesy, Deborah, Verduzco‐Gutierrez, Monica, Zorowitz, Richard D., and Rowland, Todd R.
- Subjects
TRANSLATIONAL research ,TELEMEDICINE ,MEDICAL care ,TELENURSING ,PHYSICAL medicine ,PHYSICAL diagnosis - Abstract
Telehealth refers to the use of telecommunication devices and other forms of technology to provide services outside of the traditional in‐person health care delivery system. Growth in the use of telehealth creates new challenges and opportunities for implementation in clinical practice. The American Academy of Physical Medicine and Rehabilitation (AAPM&R) assembled an expert group to develop a white paper to examine telehealth innovation in Physical Medicine and Rehabilitation (PM&R). The resultant white paper summarizes how telehealth is best used in the field of PM&R while highlighting current knowledge deficits and technological limitations. The report identifies new and transformative opportunities for PM&R to advance translational research related to telehealth and enhance patient care. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
128. A special section: Recruiting and retaining couples from underrepresented backgrounds in intervention research.
- Author
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Mitchell, Erica A. and Gordon, Kristina Coop
- Subjects
HUMAN research subjects ,PATIENT participation ,MINORITIES ,HEALTH services accessibility ,PATIENT selection ,COUPLES therapy ,MEDICAL care ,INTERPERSONAL relations ,MEDICAL research - Abstract
This special section represents a collection of papers on recruitment and retention of couples from underrepresented backgrounds in couple intervention research. Research shows that couples from underrepresented backgrounds tend to be missing from intervention research. This gap is concerning; conclusions about the effectiveness of these interventions are not being drawn from diverse and representative samples and it may be that scholars are inadvertently creating inappropriate and inaccessible services for these couples. Recruiting and retaining these couples require specialized efforts and attention. In this summary paper, we describe (a) the origins of this special section, (b) the existing research on recruitment and retention in couple intervention research, (c) an overview of the papers in this special section, and (d) future recommendations and directions for this aspect of methodology in couple research. This collection of papers elevates the need to involve community members from the beginning, reduce barriers to access, and create recruitment materials and a service delivery environment that is specific for the target population. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
129. A randomized study of parent‐ versus child‐directed intervention for Dutch toddlers with DLD.
- Author
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Zwitserlood‐Nijenhuis, Margo A., Wiefferink, Carin H., and Gerrits, Ellen
- Subjects
SPEECH therapy ,TREATMENT of language disorders ,MOTHERS ,MEDICAL care ,HEALTH outcome assessment ,FATHERS ,RANDOMIZED controlled trials ,SELF-efficacy ,COMPARATIVE studies ,TREATMENT effectiveness ,RESEARCH funding ,STATISTICAL sampling ,PARENTS ,CHILD development deviations ,CHILDREN ,ADULTS - Abstract
Background: Indirect speech and language therapy, such as parent‐implemented intervention, has been shown to be an effective approach for young children with speech and language disorders. However, relatively few studies have compared outcomes of parent‐directed therapy with child‐directed intervention, that is, individual therapy of a child delivered by a speech and language therapist (SLT). Although speech and language therapists (SLTs) regard parental engagement as imperative for successful intervention, currently they predominantly use child‐directed intervention. Aim: To evaluate the effect of parent‐ versus child‐directed speech–language therapy embedded in usual care intervention for young children with developmental language disorder (DLD). Methods & Procedures: In a randomized trial, forty‐six 3‐year‐old monolingual children with DLD were assigned to parent‐directed intervention or child‐directed intervention groups. In addition, all children received usual care in special‐language daycare centres. Outcomes included children's language development and functional communication, parents' language output, parents' perceptions and their self‐efficacy. These were assessed at three time intervals, that is, at baseline, immediately after 6 months of treatment, and 1 year after baseline. The parent‐directed intervention consisted of twelve 50‐min sessions every 2 weeks with parent and child, consisting of parental training with immediate feedback by (SLTs. Children in the child‐directed intervention group received individual speech–language therapy in weekly 30‐min sessions for 6 months. Outcomes & Results: Intervention in both groups was equally effective. All children improved significantly in receptive and expressive language measures as well as in functional communication at all intervals. All parents used significantly more language support strategies and were less concerned about their child's participation in communication. Parents in the parent‐directed intervention group reported increased self‐efficacy in stimulating their child's language development. In contrast, parents in the child‐directed intervention group reported a decrease in self‐efficacy. Though modest, these group differences were significant in both the short and long terms. Both parents and SLTs were positive about the parent‐directed intervention. Conclusions & Implications: The effects of parent‐ and child‐directed intervention for young children with DLD are similar. The parent‐directed intervention adds to treatment options for parents as well as for SLTs and creates choices for shared decision‐making. WHAT THIS PAPER ADDS: What is already known on the subject: Language therapy for young children with DLD comprises various delivery models. Two of these are child‐ and parent‐directed therapy by SLTs. Compared with no treatment, both delivery models are effective, but it is unclear if one of these results in better language outcomes than the other. SLTs value child‐directed intervention more highly than indirect approaches where treatment is delivered by others. This study aims to compare the relative effectiveness of parent‐directed intervention with child‐directed intervention, both parts of multi‐component usual care intervention. What this paper adds to existing knowledge: This randomized trial indicates that a parent‐directed intervention model is as effective as child‐directed intervention by SLTs for children's language development and functional communication. Parents' use of language support strategies was also similar in both intervention models, in the short and long terms. Like in child‐directed therapy, parent‐directed intervention reduces parents' concerns. Contrary to child‐directed treatment, parent‐directed intervention increases parents' self‐efficacy, that is, supporting their child's language development. What are the potential or actual clinical implications of this work?: Though SLTs predominantly choose a child‐directed intervention model, the study results show that they can consider parent‐directed approaches too. There are no significant differences in children's language outcomes as a function of parent‐ or child‐directed intervention. Furthermore, parents and SLTs were positive about the parent‐directed intervention program and the SLTs evaluated it as valuable and feasible. [ABSTRACT FROM AUTHOR]
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- 2023
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130. Experiences of South African speech–language therapists providing telepractice during the COVID‐19 pandemic: A qualitative survey.
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Gallant, Agnetha, Watermeyer, Jennifer, and Sawasawa, Cynthia
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PILOT projects ,RESEARCH ,ATTITUDES of medical personnel ,MEDICAL care ,QUALITATIVE research ,SURVEYS ,PATIENTS' attitudes ,PSYCHOSOCIAL factors ,DESCRIPTIVE statistics ,RESEARCH funding ,PATIENT care ,THEMATIC analysis ,COVID-19 pandemic ,SPEECH therapists ,TELEMEDICINE ,TRUST - Abstract
Background: The COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs' experiences of implementing telepractice in the Global South during this time is available. Aims: To explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic. Methods & Procedures: SLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles. Outcomes & Results: We describe participants' reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online. Conclusions & Implications: Telepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs' confidence in providing telepractice whilst delivering quality services in an accessible and safe manner. WHAT THIS PAPER ADDS: What is already known on the subject: Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs' experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners. What this paper adds to existing knowledge: Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic. What are the potential or actual clinical implications of this work?: Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients. [ABSTRACT FROM AUTHOR]
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- 2023
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131. Design and usability evaluation of a mobile‐based‐self‐management application for caregivers of children with severe burns.
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Toolaroud, Parissa Bagheri, Nabovati, Ehsan, Mobayen, Mohammadreza, Akbari, Hossein, Feizkhah, Alireza, Farrahi, Razieh, and Jeddi, Fatemeh Rangraz
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USER-centered system design ,FOCUS groups ,BURNS & scalds ,MOBILE apps ,SELF-management (Psychology) ,USER interfaces ,PEDIATRICS ,MEDICAL care ,SURVEYS ,SOFTWARE architecture ,PSYCHOLOGY of caregivers ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,RESEARCH funding ,PROGRAMMING languages ,DISCHARGE planning ,HEALTH self-care ,CHILDREN - Abstract
Paediatric burns are a major public health issue because of long‐term physical, psychological and social consequences and the high cost of treatment. The aim of this study was to design and evaluate a mobile‐based self‐management application for caregivers of children with severe burns. A participatory design technique was employed to develop the Burn application, which included three main phases: the determination of application requirements, the design and evaluation of the low‐fidelity prototype, and the design and evaluation of the high‐fidelity prototypes. In the first phase, application requirements were determined via validated paper questionnaires using the Delphi technique. In the second step, a low‐fidelity prototype was prepared using conceptual models and evaluated through a focus group with specialists. Seven specialists reviewed the application and evaluated how this prototype meets functional requirements and objectives. The third phase was performed in three stages. First, the high‐fidelity prototype was designed and developed by the JAVA programming language. Second, a cognitive walk‐through was carried out to show how users can interact with the mobile application and how it works. Third, this program was installed on the mobile phones of 28 caregivers of burned children, eight IT experts, and two general surgeries, and the prototype's usability was evaluated. In the present study, most caregivers of children with burns stated that after discharge, they face problems regarding infection control and wound care (4.07) and how to perform physical activity (4.12). User registration, educational materials, caregiver‐clinician communication, chat box, and appointment booking, safe login were the most important characteristic of the Burn application. Mean usability evaluation scores were in the range of 7.92 ± 0.238 to 8.10 ± 0.103, which is considered at a "good" level. From the Burn program design experience, it can be concluded that co‐design with health care specialists can significantly support and meet the specialists' and patients' needs and ensure the program's usefulness. In addition, application evaluation by users involved and not involved in the application design process can help enhance usability. [ABSTRACT FROM AUTHOR]
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- 2023
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132. Position paper of the European Federation of IASP Chapters (EFIC) on the subject of pain management
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Niv, David and Devor, Marshall
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PAIN management ,EUROPEAN integration ,MEDICAL care ,MEDICAL research - Abstract
Abstract: Among the complaints that bring patients to see their physician, pain in its various manifestations is the most frequent. In spite of this, pain is often not adequately addressed or managed. The aim of this position paper is to present the viewpoint and recommendations of EFIC on the subject of pain management. Our overall objective is to encourage adoption by architects of healthcare systems in Europe and worldwide of a set of specific recommendations. Every patient is entitled to the implementation of these recommendations in a professional, accessible and timely manner. [Copyright &y& Elsevier]
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- 2007
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133. John J. Sciarra Prize Paper Award for 2014.
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- *
GYNECOLOGY , *MEDICAL publishing , *MEDICAL databases , *MEDICAL care , *LOW-income countries , *AWARDS - Published
- 2015
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134. THE GREEN PAPER.
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Dennison, S.R., McCord, Norman, Maynard, Alan, and Seldon, Arthur
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MEDICAL care ,HEALTH policy - Abstract
Comments on David Green's analysis of the need for state provision of medical care in Great Britain, previously published in volume 5, issue 1, of the periodical 'Economic Affairs.' Justification of provisioning by the state; Assumptions about the state of the health care market.
- Published
- 1985
135. Understanding and managing uncertainty in health care: revisiting and advancing sociological contributions.
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Mackintosh, Nicola and Armstrong, Natalie
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PREVENTION of alcoholism ,ALZHEIMER'S disease prevention ,CARDIOVASCULAR disease prevention ,TUMOR prevention ,AGING ,MEDICAL care ,MENTAL health ,REFLECTION (Philosophy) ,SOCIOLOGY ,OPERATIVE surgery ,UNCERTAINTY - Abstract
In this collection we revisit the enduring phenomenon of uncertainty in health care, and demonstrate how it still offers coherence and significance as an analytic concept. Through empirical studies of contemporary examples of health care related uncertainties and their management, our collection explores the different ways in which uncertainty may be articulated, enacted and experienced. The papers address a diverse range of healthcare contexts ‐ Alzheimer's disease, neonatal surgery, cardiovascular disease prevention, cancer, addiction (use of alcohol and other drugs during pregnancy), mental health/disorders and medical education – and many tackle issues of contemporary relevance, such as an ageing population, and novel medical interventions and their sequelae. These empirical papers are complemented by a further theoretical contribution, which considers the role of 'implicit normativity' in masking and containing potential ethical uncertainty. By mapping themes across the collection, in this introduction we present a number of core analytical strands: (1) conceptualising uncertainty; (2) intersections of uncertainty with aspects of care; (3) managing uncertainty; and (4) structural constraints, economic austerity and uncertainty work. We reflect on the methodological and theoretical stances used to think sociologically about uncertainty in health care, and the strengths, silences and gaps we observe in the collection. We conclude by considering the implications of the insights gained for 'synthesising certainty' in practice and for future research in this area. [ABSTRACT FROM AUTHOR]
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- 2020
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136. Beacon calls for primary care and MAT to expand opioid treatment access.
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Knopf, Alison
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BUPRENORPHINE ,CHRONIC diseases ,CONTINUUM of care ,HEALTH services accessibility ,INSURANCE companies ,MANAGED care programs ,MEDICAL care ,NARCOTICS ,PRIMARY health care ,SUBSTANCE abuse treatment ,HEALTH insurance reimbursement - Abstract
The article discusses a white paper issued by Beacon Health Options "Confronting the Crisis of Opioid Addication" calling for a focus on outpatient medication-assisted treatment by primary care. Topics discussed include its focus on the need to treat opioid addiction as chronic condition, its criticism of providers of detox who did not participate in the continuum of care needed for chronic conditions and its support for 10 levels of care of the American Society of Addiction Medicine (ASAM).
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- 2015
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137. Electronic prescribing increases uptake of clinical pharmacologists' recommendations in the hospital setting.
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Taegtmeyer, Anne B., Curkovic, Ivanka, Rufibach, Kaspar, Corti, Natascia, Battegay, Edouard, and Kullak-Ublick, Gerd A.
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DRUG prescribing ,MEDICATION error prevention ,MEDICAL care ,HOSPITAL care ,CLINICAL pharmacology - Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Electronic prescribing reduces drug prescription errors and therefore improves patient safety. • Whether electronic prescribing compared with prescribing on paper facilitates the implementation of clinical pharmacologists' recommendations in the care of patients hospitalized with medical problems is not known. WHAT THIS STUDY ADDS • The use of electronic prescriptions when compared with handwritten prescriptions increased the uptake of clinical pharmacologists' recommendations for improving drug safety in hospitalized patients. AIMS To determine whether electronic prescribing facilitates the uptake of clinical pharmacologists' recommendations for improving drug safety in medical inpatients. METHODS Electronic case records and prescription charts (either electronic or paper) of 502 patients hospitalized on medical wards in a large Swiss teaching hospital between January 2009 and January 2010 were studied by four junior and four senior clinical pharmacologists. Drug-related problems were identified and interventions proposed. The implementation and time delays of these proposed interventions were compared between the patients for whom paper drug charts were used and the patients for whom electronic drug charts were used. RESULTS One hundred and fifty-eight drug-related problems in 109 hospital admissions were identified and 145 recommendations were made, of which 51% were implemented. Admissions with an electronic prescription chart ( n= 90) were found to have 2.74 times higher odds for implementation of the change than those with a paper prescription chart ( n= 53) (95% confidence interval 1.2, 6.3, P= 0.018, adjusted for any dependency introduced by patient, ward or clinical team; follow-up for two cases missing). The time delay between recommendations being made and their implementation (if any) was minimal (median 1 day) and did not differ between the two groups. CONCLUSIONS Electronic prescribing in this hospital setting was associated with increased implementation of clinical pharmacologists' recommendations for improving drug safety when compared with handwritten prescribing on paper. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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138. Highlights of recent clinically relevant papers.
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Wright, S.
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HORSE diseases ,MEDICAL care ,STREPTOCOCCUS equi ,MELANOMA ,MUSCLE analysis - Published
- 2018
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139. Health Care Organizations' Use of Data on Race/Ethnicity to Address Disparities in Health Care.
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Nerenz, David R., Hunt, Kelly A., and Escarce, José J.
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PREFACES & forewords ,MEDICAL care - Abstract
The article presents an introduction of the articles contained in the 2006 issue of Health Services Research.
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- 2006
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140. An Australian hospital pharmacy department's pandemic response plan to coronavirus disease of 2019.
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Ziser, Kate E.D., Olding, Suzanne H., Patel, Anjali B., Batger, Mellissa R., Peng, Shiqin, Brown, Samantha L., Grieve, Fallon C., and Crane, Jennifer A.
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EVALUATION of human services programs ,COUNSELING ,ATTITUDES of medical personnel ,MEDICAL care ,HOSPITAL pharmacies ,LABOR supply ,PHARMACISTS ,COMMUNICATION ,COVID-19 pandemic - Abstract
Aim: This paper provides the main accomplishments of the Royal North Shore Hospital (RNSH) Pharmacy Department's COVID‐19 Pandemic Response Plan and key recommendations for other departments developing a remote model of care. Methods: The overall objective was to preserve the active workforce by minimising staff‐to‐staff and staff‐to‐patient contact. The response plan involved splitting the department into teams, implementing a remote ward‐based clinical pharmacy service, staff upskilling and optimising the physical environment. Results: In April 2020, 1240 clinical tasks were completed remotely compared with 1254 tasks completed on site. In May 2020, 1700 tasks were completed offsite, compared with 1544 tasks onsite. The percentage of pharmacists rating themselves 5 out of 5 (very confident) in communicating over the phone increased from 34.8% prior to remote service delivery, to 60% after completion of the service. Counselling patients over the phone increased from 17.4% to 40% while providing remote clinical service increased from 26.1% to 80%. Discussion: The paper provides key recommendations for other sites wanting to implement a remote model of care. There are details of recommendations for communication, adequate skill mix, upskilling, education, training, staff resilience, role expansion and administration. Conclusion: The formation of a team hospital pharmacy department COVID‐19 Pandemic Response Plan has provided assurance that a complete pharmacy service could continue in the event of reduced staffing. Intense, thoughtful, collaborative work was required in a short period of time to design an appropriate physical environment, create a remote working model of care, and to train and educate members of staff. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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141. Applying the Ottawa Charter to guide resilience‐building programs for health care organizations.
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Wu, Chiung‐Jung and Oprescu, Florin I.
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ADAPTABILITY (Personality) ,MEDICAL quality control ,SUSTAINABILITY ,HEALTH policy ,HEALTH facilities ,CONFIDENCE ,STRATEGIC planning ,HOSPITAL health promotion programs ,MEDICAL personnel ,PATIENT-centered care ,MEDICAL care ,CONCEPTUAL structures ,SELF-efficacy ,INTELLECT ,PSYCHOLOGICAL adaptation ,PSYCHOLOGICAL resilience ,HEALTH promotion - Abstract
Resilience is situated at the core of the World Health Organization European policy framework for health and well‐being and the United Nations Sustainable Development Goals. Resilience refers to how effectively a person, group, or system deals with and recovers from challenging situations. In this paper resilience refers to the capacity of a health care professional to manage complex issues and adapt to situations successfully. This brief paper provides explicit knowledge for strengthening personal resilience in health care using the Ottawa Charter framework as a guide. Developing a resilient health care workforce should address all five Ottawa Charter areas of action, should involve multiple stakeholders, and should incorporate resilience strategies into everyday health care activities. The paper presents recommendations for future programs designed to build a resilient workforce that can provide high quality care in a sustainable manner. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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142. What's driving spending differences in medical groups and what might that mean for health policy.
- Author
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Segel, Joel E.
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HEALTH policy ,MEDICAL care costs ,MEDICAL care use ,MANAGED care programs ,ACCOUNTABLE care organizations ,MEDICAL care - Abstract
Over the past 20 years, much attention has been paid to health care prices and the role they play in driving high health care spending in the US.[1] This is in no small part due to the 2003 paper by Anderson et al. entitled "It's the Prices, Stupid: Why the United States is So Different from Other Countries",[2] and the follow-up paper in 2019 entitled "It's Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt".[3] In this issue, Mehrotra et al.[4] take on the issue of how differences in prices I at the medical group level i may contribute to differences in spending using data for the non-elderly population commercially insured by the United Health Group. With relatively limited cost sharing,[11] patients may be using other criteria to make decisions about whether and where to get inpatient and specialty care. [Extracted from the article]
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- 2023
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143. Personhood: Philosophies, applications and critiques in healthcare.
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Öhlén, Joakim, Björkman, Ida, Siira, Elin, and Kirkevold, Marit
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OCCUPATIONAL roles ,NURSING ,SERIAL publications ,INDIVIDUALITY ,MEDICAL care ,PATIENT-centered care ,PHILOSOPHY of nursing ,PATIENTS' attitudes ,NURSES - Abstract
The article analyze personhood from a range of perspectives related to philosophies conceptualizing the idea of person as they look at how such philosophies have been applied in nursing and the broader healthcare and also contribute with a critique thereof. Topics include examines aim to remedy this and advance the field of nursing philosophy as an internationally established discipline.
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- 2022
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144. "Autonomy and solidarity: Bridging the tensions": Celebrating the 15th World Congress of Bioethics.
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Ravitsky, Vardit, Eckenwiler, Lisa, and Schmidt, Harald
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SOCIAL determinants of health ,HEALTH services accessibility ,PUBLIC health ,SOCIAL justice ,CONFERENCES & conventions ,MEDICAL care ,ADVANCE directives (Medical care) ,SOCIOECONOMIC factors ,AUTONOMY (Psychology) ,RESOURCE allocation ,COVID-19 pandemic ,SOCIAL responsibility ,CONCEPTS - Abstract
An editorial is presented on presentations offered at the International Association of Bioethics' (IAB) 15th World Congress of Bioethics (WCB) hosted by the University of Pennsylvania in June 2020. Topics include expanding beyond clinical and medical ethics to encompassing public health ethics and matters of social justice; and committed to the defense of women's human rights and the eradication of violence in all interpersonal relationships.
- Published
- 2022
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145. A position paper on nursing.
- Author
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Hall, Dorothy C.
- Subjects
- *
NURSING , *MEDICAL care , *NURSE-patient relationships , *MEDICINE , *MEDICAL personnel , *REHABILITATION - Abstract
Nursing, as a profession in its own right and a discrete health discipline, is responsible for planning, organizing, implementing and evaluating nursing services as a distinct segment of health care, and for educating practitioners to provide these services. The primary responsibility of nursing is to provide care direct to the patient, client, family or community. Like medicine, it is concerned with maintaining, promoting and protecting health, treating the sick and providing rehabilitation. It deals with the psychosomatic and psychosocial aspects of life as these affect health, illness and dying. In modern health services, nursing care is often best given by a nursing care team which usually consists of two or more categories of workers. These workers together make up the nursing personnel subsystem, which is a distinct entity within the overall health personnel system of a country.
- Published
- 1977
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146. Factors influencing the success of telepractice during the COVID‐19 pandemic and preferences for post‐pandemic services: An interview study with clinicians and parents.
- Author
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Kwok, Elaine Yuen Ling, Pozniak, Kinga, Cunningham, Barbara Jane, and Rosenbaum, Peter
- Subjects
PARENT attitudes ,EVALUATION of medical care ,PATIENT participation ,ATTITUDES of medical personnel ,RESEARCH methodology ,COMMUNICATIVE disorders in children ,INTERVIEWING ,MEDICAL care ,VIDEOCONFERENCING ,MEDICAL personnel ,EXPERIENCE ,PATIENTS' families ,SOUND recordings ,COMMUNICATION ,RESEARCH funding ,MEDICAL practice ,COVID-19 pandemic ,TELEMEDICINE ,HEALTH planning ,SPEECH-language pathology assistants - Abstract
Background: There has been a significant uptake in the use of telepractice during the coronavirus SARS‐CoV‐2 (COVID‐19) pandemic. This study explored the experiences of speech and language therapists (SLTs), assistants (SLTAs) and parents with telepractice during the COVID‐19 pandemic. Aims: (1) To identify factors that influenced success of telepractice; and (2) to describe clinicians' and parents' preferences for the future mode of service delivery for preschoolers with communication disorders. Methods & Procedures: The study was conducted in partnership with one publicly funded programme in Ontario, Canada, that offered services to preschoolers with speech, language and communication needs at no cost. SLTs (N = 13), assistants (N = 3) and parents (N = 13) shared their experiences and perspectives during semi‐structured videoconference interviews. Outcomes & Results: Factors that influenced the success of telepractice were reported in three categories: the setting (i.e., where and how telepractice was being delivered); the nature of telepractice (i.e., the services that were provided via telepractice); and the individuals (i.e., who was involved in telepractice). These factors were reported to interact with each other. As the needs for each child and family are unique, parents and clinicians reported a preference for a hybrid and flexible service delivery model in the future. Conclusions & Implications: The themes identified in this study can be used by clinicians and managers to consider factors that influence the success of telepractice for children and families. WHAT THIS PAPER ADDS: What is already known on the subject?: Studies conducted before the COVID‐19 pandemic showed that telepractice was an effective and acceptable service approach. However, some clinicians and parents reported wanting to resume in‐person visits. The provision of telepractice services to families with children with communication disorders increased significantly during COVID‐19. What this paper adds to existing knowledge?: Parents and clinicians shared factors that influenced the success of telepractice during semi‐structured interviews. Factors were identified in three categories: the setting (i.e., where and how telepractice was being delivered); the nature of telepractice (i.e., the services that were provided via telepractice); and the individuals (i.e., who were involved in telepractice). As each child's and family's needs are unique, parents and clinicians reported a preference for a hybrid and flexible service delivery model in the future. What are the potential or actual clinical implications of this work?: SLTs and SLT managers can use the factors identified to discuss with parents and decide whether telepractice may be well suited to the needs of each child and family. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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147. The perspectives of Australian speech pathologists in providing evidence‐based practices to children with autism.
- Author
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Sandham, Victoria, Hill, Anne E., and Hinchliffe, Fiona
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PROFESSIONAL practice ,RESEARCH evaluation ,FOCUS groups ,ATTITUDES of medical personnel ,EVIDENCE-based medicine ,MEDICAL care ,HEALTH outcome assessment ,SELF-efficacy ,AUTISM ,COMMUNICATION ,RESEARCH funding ,THEMATIC analysis ,STATISTICAL sampling ,SPEECH therapists ,VIDEO recording ,CHILDREN - Abstract
Background: Bridging the research–practice gap in autism communication services is an identified priority for improving services. Limited research has investigated the views of practitioners regarding this research–practice gap. Investigation of the barriers experienced and facilitators used in clinical practice may assist to identify scalable and sustainable strategies to increase use of evidence‐based practices (EBPs) in the delivery of communication services to children with autism. Aims: To elucidate how Australian speech pathologists engage with external evidence and how communication outcomes are measured to demonstrate the effectiveness of service provision to children with autism. Methods & Procedures: A total of 15 Australian speech pathologists, with experience ranging from less than 1 to more than 16 years, participated in three focus groups. Data from focus groups were analysed using reflexive thematic analysis within an interpretive phenomenological paradigm. Outcomes & Results: Seven themes were identified. Participants reported on the diversity of individuals with autism, their experiences of resource constraints, seeking collegial advice and accessing a diverse range of evidence sources, the role of clinical expertise in translating evidence to practice, the barriers experienced in outcome measurement and use of stakeholders to facilitate data collection to demonstrate outcomes. Conclusions & Implications: Individual practitioner skill and beliefs are facilitators to translating research to practice. Interventions to improve clinician use of EBP should address the skill and belief barriers, aiming to increase a clinician's EBP self‐efficacy and increasing their expectation that investing in EBP activities will result in improved services for children with autism. Modelling and reflective practice are two strategies that may have an application as interventions to improve EBP use in clinical practice. What this paper adds: What is already known on the subject: Constrained resources, especially lack of time, is a barrier to routine uptake of best available evidence in clinical services for children with autism. What this paper adds to existing knowledge: In this study, the perception that speech pathologists lacked time to engage in EBP activities was linked with the speech pathologist's research skill and their beliefs about the benefits of engaging in EBP. Speech Pathologists reported using a range of information sources, as "evidence" but also reported feeling uneasy when using evidence of disputable, or unknown quality. Accessibility and relevance to their individual client were highly prioritised in selecting evidence. Clinical expertise was an essential skill for research translation. What are the potential or actual clinical implications of this work?: Interventions which target professional beliefs and research translation capability are requisite for motivating speech pathologists to improve their use of EBP.Modelling of EBP use, individual reflective practice and collegial active listening to facilitate reflective practice, might be useful strategies which target beliefs and capability of individual speech pathologists; thereby changing their EBP use. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
148. Let's talk about the negative experiences of Black mental health service users in England: Now is the moment to consider watchful waiting to support their recovery.
- Subjects
MENTAL illness treatment ,EVALUATION of medical care ,REFERENCE books ,SOCIAL support ,CONFIDENCE ,BLACK people ,MEDICAL care ,HELP-seeking behavior ,EXPERIENCE ,CONCEPTUAL structures ,RISK assessment ,DECISION making ,QUALITY of life ,CULTURAL competence ,AUTONOMY (Psychology) ,RISK management in business ,PSYCHOLOGICAL disengagement ,MENTAL health services - Abstract
Watchful waiting is a concept that is traditionally not associated with severe and enduring mental illness. This paper, however, boldly argues that the concept could be used as a ground‐breaking and accessible antidote to the perceived inequality experienced by black service users experiencing both mild and severe mental illnesses in England. The novel concepts proposed in this paper are not intended to be consensual, but rather uncompromising to provoke critical thinking in mental health practice. A conceptual framework for watchful waiting in mental health is suggested. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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149. Evidence‐based medicine's curious path: From clinical epidemiology to patient‐centered care through decision analysis.
- Author
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Falzer, Paul R.
- Subjects
HEALTH care industry ,DEBATE ,ATTITUDE (Psychology) ,MEDICAL care ,EVIDENCE-based medicine ,PATIENT-centered care ,MEDICAL personnel ,CONFLICT (Psychology) ,DECISION making in clinical medicine - Abstract
Evidence‐based medicine (EBM), one of the most important movements in health care, has been a lightning rod for controversy. Conflicts about the meaning and value of EBM are owing in part to lack of clarity about basic questions regarding its development, the importance of expertise and intuition, and the role of evidence in clinical decision making. These issues have persisted in part because of unclarity at the outset, but also because of how EBM evolved, why it was introduced when it was, and how it was modified following its introduction. This paper traces the evolution of EBM from clinical epidemiology (CE) and the internal dispute that precipitated the developers to establish EBM as a distinct approach to clinical practice. The paper proposes that health care industrialization also had a significant role in EBM's emergence and that industrialization influenced the decision to merge EBM with the method of normative decision making known as decision analysis (DA). The paper discusses the impact of this merger, in particular how it led to EBM's identification with managed care and has added momentum to the effort at forging a connection between a normative decision model and clinical judgement. This effort would turn clinical decision making into a conduit for bringing administrative rules and regulations into the consulting room and would result in expertise becoming a surplus skill. The paper closes by discussing a challenge yet unmet by EBM's advocates and critics—to chronicle the dangers that EBM in the framework of DA during the current era of industrialization poses to health and health care, and discover ways of unhinging the relationship between model and judgement. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
150. 6.2: Invited Paper: Wearable and Printable Sensors for Human Healthcare Monitoring.
- Author
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Yang, Junliang, He, Pei, and Xu, Xiaowen
- Subjects
DETECTORS ,CONDUCTING polymers ,MEDICAL care ,MOTION capture (Human mechanics) ,STRAIN sensors ,NANOWIRE devices ,COATED textiles - Abstract
The human body ECG signal was detected successfully with the polymer/AgNWs electrode, which is comparable to the signal obtained by the commercial electrode. International Conference on Display Technology 2020 (V olume 52, Issue S1) 39 Wearable and Printable Sensors for Human Healthcare Monitoring Junliang Yang*, Pei He, Xiaowen Xu School of Physics and Electronics, Central South University, Changsha 410083, Hunan, P. R. China. The graphene textile electrode was successfully used to record ECG signals, which showed comparable performance with conventional pre-gelled Ag/AgCl electrode. [Extracted from the article]
- Published
- 2021
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