text stringlengths 247 7.99k | conversation_id int64 77.2k 898k | embedding list | cluster int64 74 74 |
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Please summerize the given abstract to a title
Assessing the effect of Independent Prescribing for community optometrists and referral rates to Hospital Eye Services in Scotland
INTRODUCTION: Since 2010, General Ophthalmic Services (GOS) legislation and Independent Prescribing (IP) enable community optometrists to manage primary eye conditions. No studies have assessed the effect of IP. We wished to determine the distribution of IP optometrists and associated hospital referral rates across Scotland. METHODS: In 2019, FOI requests (General Optical Council and NHS Education Scotland) identified all registered IP optometrists in Scotland and their registered postcodes. Data regarding community eye examinations and referrals to HES since 2010 were gathered via Information Services Division of NHS Scotland. RESULTS: As of March 2019, there were 278 IP optometrists in Scotland (278/1189; 23.4%). Two hundred eighteen IP optometrists work in 293 practices across 11 of Scotland's 14 health boards. There was a strong correlation (r = +0.96) between population density and number of IP optometrists. Fifty-six percent of IP optometrists work in the two most deprived quintiles. Since IP's introduction, there has been a marked increase in anterior segment supplementary visits (+290%). Optometry referrals to GPs have reduced by 10.5%, but referrals to HES have increased by 118% (to 96,315). There was no correlation between quantity of IP optometrists and referral rates to HES (r = -0.06, 95% CI -0.64 to 0.56, p = 0.86). CONCLUSIONS: This is the first analysis of IP optometrists and associated referral rates in Scotland. Despite good geographical distribution and increased supplementary attendances, optometric referrals to HES have doubled and continue to rise. We propose a ratio of primary, supplementary, non-referral and referral rates to discern the true impact of IP versus non-IP community optometric behaviour.
| 77,235 | [
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-0.1655273437... | 74 |
Please summerize the given abstract to a title
A Review of Web-Based Tools for Value-of-Information Analysis.
Value-of-information analysis (VOI) is a decision-theoretic approach that is used to inform reimbursement decisions, optimise trial design and set research priorities. The application of VOI analysis for informing policy decisions in practice has been limited due, in part, to the perceived complexity associated with the calculation of VOI measures. Recent efforts have resulted in the development of efficient methods to estimate VOI measures and the development of user-friendly web-based tools to facilitate VOI calculations. We review the existing web-based tools including Sheffield Accelerated Value of Information (SAVI), the web interface to the BCEA (Bayesian Cost-Effectiveness Analysis) R package (BCEAweb), Rapid Assessment of Need for Evidence (RANE), and Value of Information for Cardiovascular Trials and Other Comparative Research (VICTOR). We describe what each tool is designed to do, the inputs they require, and the outputs they produce. Finally, we discuss how tools for VOI calculations might be improved in the future to facilitate the use of VOI analysis in practice.
| 77,268 | [
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Please summerize the given abstract to a title
Public opinion on sharing data from health services for clinical and research purposes without explicit consent: an anonymous online survey in the UK
OBJECTIVES: UK National Health Service/Health and Social Care (NHS/HSC) data are variably shared between healthcare organisations for direct care, and increasingly de-identified for research. Few large-scale studies have examined public opinion on sharing, including of mental health (MH) versus physical health (PH) data. We measured data sharing preferences. DESIGN/SETTING/INTERVENTIONS/OUTCOMES: Pre-registered anonymous online survey, measuring expressed preferences, recruiting February to September 2020. Participants were randomised to one of three framing statements regarding MH versus PH data. PARTICIPANTS: Open to all UK residents. Participants numbered 29 275; 40% had experienced an MH condition. RESULTS: Most (76%) supported identifiable data sharing for direct clinical care without explicit consent, but 20% opposed this. Preference for clinical/identifiable sharing decreased with geographical distance and was slightly less for MH than PH data, with small framing effects. Preference for research/de-identified data sharing without explicit consent showed the same small PH/MH and framing effects, plus greater preference for sharing structured data than de-identified free text. There was net support for research sharing to the NHS, academic institutions, and national research charities, net ambivalence about sharing to profit-making companies researching treatments, and net opposition to sharing to other companies (similar to sharing publicly). De-identified linkage to non-health data was generally supported, except to data held by private companies. We report demographic influences on preference. A majority (89%) supported a single NHS mechanism to choose uses of their data. Support for data sharing increased during COVID-19. CONCLUSIONS: Support for healthcare data sharing for direct care without explicit consent is broad but not universal. There is net support for the sharing of de-identified data for research to the NHS, academia, and the charitable sector, but not the commercial sector. A single national NHS-hosted system for patients to control the use of their NHS data for clinical purposes and for research would have broad support. TRIAL REGISTRATION NUMBER: ISRCTN37444142.
| 77,279 | [
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0.0... | 74 |
Please summerize the given abstract to a title
Effective management of patients with diabetes foot ulcers: outcomes of an Interprofessional Diabetes Foot Ulcer Team.
A longitudinal observational study on a convenience sample was conducted between 4 January and 31 December of 2010 to evaluate clinical outcomes that occur when a new Interprofessional Diabetes Foot Ulcer Team (IPDFUT) helps in the management of diabetes-related foot ulcers (DFUs) in patients living in a small urban community in Ontario, Canada. Eighty-three patients presented to the IPDFUT with 114 DFUs of average duration of 19·5 ± 2·7 weeks. Patients were 58·4 ± 1·4 years of age and 90% had type 2 diabetes, HbA1c of 8·3 ± 2·0%, with an average diabetes duration of 22·3 ± 3·4 years; in 69% of patients, 78 DFUs healed in an average duration of 7·4 ± 0·7 weeks, requiring an average of 3·8 clinic visits. Amputation of a toe led to healing in three patients (4%) and one patient required a below-knee amputation. Six patients died and three withdrew. Adding a skilled IPDFUT that is trained to work together resulted in improved healing outcomes. The rate of healing, proportion of wounds closed and complication rate were similar if not better than the results published previously in Canada and around the world. The IPDFUT appears to be a successful model of care and could be used as a template to provide effective community care to the patients with DFU in Ontario, Canada.
| 77,293 | [
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... | 74 |
Please summerize the given abstract to a title
Vertical integration of primary care practices with acute hospitals in England and Wales: why, how and so what? Findings from a qualitative, rapid evaluation
OBJECTIVES: To understand the rationale, implementation and early impact of vertical integration between primary care medical practices and the organisations running acute hospitals in the National Health Service in England and Wales. DESIGN AND SETTING: A qualitative, cross-comparative case study evaluation at two sites in England and one in Wales, consisting of interviews with stakeholders at the sites, alongside observations of strategic meetings and analysis of key documents. RESULTS: We interviewed 52 stakeholders across the three sites in the second half of 2019 and observed four meetings from late 2019 to early 2020 (further observation was prevented by the onset of the COVID-19 pandemic). The single most important driver of vertical integration was found to be to maintain primary care local to where patients live and thereby manage demand pressure on acute hospital services, especially emergency care. The opportunities created by maintaining local primary care providers—to develop patient services in primary care settings and better integrate them with secondary care—were exploited to differing degrees across the sites. There were notable differences between sites in operational and management arrangements, and in organisational and clinical integration. Closer organisational integration was attributed to previous good relationships between primary and secondary care locally, and to historical planning and preparation towards integrated working across the local health economy. The net impact of vertical integration on health system costs is argued by local stakeholders to be beneficial. CONCLUSIONS: Vertical integration is a valuable option when primary care practices are at risk of closing, and may be a route to better integration of patient care. But it is not the only route and vertical integration is not attractive to all primary care physicians. A future evaluation of vertical integration is intended; of patients’ experience and of the impact on secondary care service utilisation.
| 77,306 | [
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0... | 74 |
Please summerize the given abstract to a title
How do community pharmacies in Ontario manage drug shortage problems? Results of an exploratory qualitative study.
Background Pharmacists report spending a considerable amount of time dealing with drug shortages. There is no research in Canada identifying and describing the strategies and resources that pharmacists use to minimize disruption and continuity of care for patients. Methods An exploratory qualitative methodology was used. Community pharmacists and technicians in Ontario were interviewed using a semi-structured protocol. Verbatim transcripts were generated and coded by at least 2 independent reviewers using content analysis methods to identify management strategies. Results and Discussion A total of 14 pharmacists and 7 regulated pharmacy technicians participated in this study. The following 5 main strategies for managing drug shortages were identified: (1) using the supplier, (2) generic options, (3) brand options, (4) contacting other pharmacies and (5) switching to a different medication. Conclusion The strategies identified through this research can provide pharmacists with some guidance in approaching the real-world problem of drug shortages. It also highlights opportunities for organizations, government and manufacturers to provide additional support for pharmacists to minimize disruptions for patients and to ensure current ad hoc practices do not further compound shortage issues. Can Pharm J (Ott) 2020;153:xx-xx.
| 77,329 | [
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Please summerize the given abstract to a title
Towards an open and effective dialogue on complementary medicine in oncology: protocol of patient participatory study ‘COMMON’
INTRODUCTION: Approximately half of patients with cancer use some form of complementary medicine alongside conventional cancer treatment. The topic of complementary medicine often remains undiscussed in consultations between patients with cancer and their healthcare providers. This results in increased risks for adverse or interaction effects and decreased access to the benefits of evidence-based complementary medicine for patients with cancer. This paper describes the design of patient participatory study titled ‘COMMON’ that aims to explore and enhance open and effective communication about complementary medicine in oncology. The study is carried out in collaboration with 12 (former) patients with breast cancer as coresearchers. METHODS AND ANALYSIS: The study complies with the six steps of the intervention mapping framework. Three non-academic hospitals recruit participants (patients with cancer, oncology healthcare providers and managers) for interviews about the organisation, experiences and needs regarding complementary medicine. To assess communication about complementary medicine, recorded oncology consultations are analysed. For an overview of evidence-based complementary medicine available to patients with cancer, a review of reviews is conducted on the evidence on cancer patient-reported outcomes of complementary medicine frequently used by patients with cancer, supplemented with an online search and survey among organisations and persons providing complementary medicine to patients with cancer. Together, these steps generate input for the development of a toolbox that supports an open and effective discussion on complementary medicine in oncology. In a pilot study, acceptability and usability of the toolbox are assessed among patients with cancer and oncology healthcare providers. Dissemination of the toolbox is covered by the commitment of stakeholder parties. ETHICS AND DISSEMINATION: The Medical Ethics Committee Arnhem-Nijmegen declared the study was exempted from formal approval under the Dutch Medical Research Involving Human Subjects Act. The results will be disseminated through open-access, peer-reviewed publications, stakeholder-reporting and presentations at relevant conferences.
| 77,525 | [
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... | 74 |
Please summerize the given abstract to a title
Implementation of a fracture liaison service for patients with hip fracture cared for on a hospital medicine service.
OBJECTIVE Hip fracture is a common and morbid condition. Prior studies have shown that the majority of patients with fragility fracture are not treated for underlying osteoporosis. Our hospitalist-led co-management service for patients with acute hip fracture had no system for evaluating and treating osteoporosis in this cohort. Our objective was to implement a fracture liaison service (FLS) to assist patients with acute hip fracture and assess subsequent impact on diagnosis and treatment of osteoporosis. METHODS We conducted a pre-post study design at our tertiary academic center, including patients >50 years old hospitalized with acute hip fracture. We implemented a FLS, whereby all patients received endocrinology consultation. Outcome measures included the proportion of patients evaluated for osteoporosis by time of hospital discharge, comparing pre-implementation (12 months) and post-implementation (9 months) cohorts. We also measured the proportions of patients evaluated for and offered treatment for osteoporosis within three months of discharge for patients with post-discharge encounters visible in the medical record. RESULTS We identified 167 patients before and 124 after FLS implementation. In univariate analysis, the proportion of patients evaluated for osteoporosis before discharge increased from 0.6% to 72.6% (p<0.001) pre- vs. post-implementation. The proportion of patients offered osteoporosis treatment within three months after discharge increased from 25.3% to 46.3% (p=0.01). In multivariate analysis, post-implementation patients had higher odds of osteoporosis evaluation while hospitalized (OR = 470.4, p < 0.001) and higher odds of being offered osteoporosis treatment within three months (OR = 2.8, p = 0.008). CONCLUSIONS Establishment of a FLS partnered with a hospitalist-led co-management service for patients with hip fracture was associated with significant improvements in the proportions of patients evaluated and offered treatment for osteoporosis. Wider adoption of this model has the potential to improve care for patients with hip fracture by narrowing the osteoporosis treatment gap.
| 77,608 | [
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... | 74 |
Please summerize the given abstract to a title
Qualified Nurses’ Perceptions of Cultural Competence and Experiences of Caring for Culturally Diverse Patients: A Qualitative Study in Four European Countries
Background: European nurses are expected to provide appropriate care for patients from diverse cultural backgrounds. However, there is limited knowledge and understanding of this process. The aim of this study was to analyse the perceptions of culture and experiences of caring for patients from diverse cultural backgrounds of a purposive sample of qualified nurses from four European countries, namely Belgium, Portugal, Spain and Turkey. Methods: A qualitative phenomenological approach was selected in order to understand complex phenomena through the participants’ lived experiences, meanings and perspectives. Individual interviews and focus groups took place with 28 staff nurses and 11 nurse managers from four European countries. The sociodemographic and cultural characteristics of the sample were described and analysed using descriptive statistics. Qualitative data were transcribed verbatim, translated into English and analysed following Braun and Clark’s phases for thematic analysis. Results: Five themes and twelve subthemes emerged from thematic analysis of the transcripts. The themes included: (1) relevance of culture for nursing; (2) culture in the healthcare service; (3) qualities of the healthcare professionals; (4) challenges to culturally competent care; (5) becoming a culturally competent nurse. Conclusions: There are challenges to the delivery of culturally congruent care, namely language and communication difficulties, prejudices and stereotyping in the health service, a tendency for ethnocentrism, a lack of education and training in cultural competence and a lack of support from the health service to facilitate new ways of acting.
| 77,714 | [
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Please summerize the given abstract to a title
The protocol of a clinical quality registry for dementia and mild cognitive impairment (MCI): the Australian dementia network (ADNeT) Registry
BACKGROUND: Dementia was identified as a priority area for the development of a Clinical Quality Registry (CQR) in Australia in 2016. The Australian Dementia Network (ADNeT) Registry is being established as part of the ADNeT initiative, with the primary objective of collecting data to monitor and enhance the quality of care and patient outcomes for people diagnosed with either dementia or Mild Cognitive Impairment (MCI). A secondary aim is to facilitate the recruitment of participants into dementia research and trials. This paper describes the Registry protocol. METHODS: The ADNeT Registry is a prospective CQR of patients newly diagnosed with either dementia or MCI. Eligible patients will be identified initially from memory clinics and individual medical specialists (e.g., geriatricians, psychiatrists and neurologists) involved in the diagnosis of dementia. Participants will be recruited using either an opt-out approach or waiver of consent based on three key determinants (capacity, person responsible, and communication of diagnosis). Data will be collected from four sources: participating sites, registry participants, carers, and linkage with administrative datasets. It is anticipated that the Registry will recruit approximately 10,000 participants by the end of 2023. The ADNeT registry will be developed and implemented to comply with the national operating principles for CQRs and governed by the ADNeT Registry Steering Committee. DISCUSSION: The ADNeT Registry will provide important data on current clinical practice in the diagnosis, treatment and care of people with dementia and MCI in Australia as well as long-term outcomes among these people. These data will help to identify variations in clinical practice and patient outcomes and reasons underlying these variations, which in turn, will inform the development of interventions to improve care and outcomes for people with dementia and MCI.
| 77,756 | [
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Please summerize the given abstract to a title
Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial
Non-adherence after heart transplantation (HTx) is a significant problem. The main objective of this study was to evaluate if a mHealth strategy is more effective than standard care in improving adherence and patients’ experience in heart transplant recipients. Methods: This was a single-center, randomized controlled trial (RCT) in adult recipients >1.5 years post-HTx. Participants were randomized to standard care (control group) or to the mHeart Strategy (intervention group). For patients randomized to the mHeart strategy, multifaceted theory-based interventions were provided during the study period to optimize therapy management using the mHeart mobile application. Patient experience regarding their medication regimens were evaluated in a face-to-face interview. Medication adherence was assessed by performing self-reported questionnaires. A composite adherence score that included the SMAQ questionnaire, the coefficient of variation of drug levels and missing visits was also reported. Results: A total of 134 HTx recipients were randomized (intervention N = 71; control N = 63). Mean follow-up was 1.6 (SD 0.6) years. Improvement in adherence from baseline was significantly higher in the intervention group versus the control group according to the SMAQ questionnaire (85% vs. 46%, OR = 6.7 (2.9; 15.8), p-value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), p-value = 0.001). Patients’ experiences with their drug therapy including knowledge of their medication timing intakes (p-value = 0.019) and the drug indications or uses that they remembered (p-value = 0.003) significantly improved in the intervention versus the control group. Conclusions: In our study, the mHealth-based strategy significantly improved adherence and patient beliefs regarding their medication regimens among the HTx population. The mHeart mobile application was used as a feasible tool for providing long-term, tailor-made interventions to HTx recipients to improve the goals assessed.
| 77,802 | [
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Please summerize the given abstract to a title
Mitigating the impact of the 'silos' between the disability and aged-care sectors in Australia: Development of a Best Practice Framework
BACKGROUND: Although a 'person-centred focus' is a legislated objective for both aged-care and disability services sectors in Australia, evidence suggests limited translation into systems and practices due to entrenched silos. This paper proposes a Best Practice Framework to mitigate these silos. METHODS: Mixed-methods research comprising key informant interviews with major stakeholders across both sectors; a survey of people with/without intellectual disability aged 60+ years; qualitative in-depth interviews; and survey of health professionals. RESULTS: There is an urgent need to develop inter-sectoral 'integrated care systems'. Key components include choice in accommodation; regular assessment of health and well-being indicators; development and adoption of nationally consistent policies/standards across integrated aged- and disability-care sectors; improved strategies for workforce planning; and upskilling of existing staff including place-based collaboration. CONCLUSIONS: An integrated service model requires collaboration on broader public policy instruments, appropriate planning and resourcing. A strategic shift is required to ensure better quality person-centred support systems.
| 77,907 | [
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Please summerize the given abstract to a title
A Mobile App for Self-management of Urgency and Mixed Urinary Incontinence in Women: Randomized Controlled Trial
Background: Many women experience urgency (UUI) and mixed (MUI) urinary incontinence but commonly hesitate to seek care Treatment access and self-management for these conditions can be supported through eHealth approaches Objective: This study aimed to investigate the efficacy of the mobile app Tät II for self-management of UUI and MUI in women Methods: This randomized controlled trial included women ≥18 years old with UUI or MUI and ≥2 leakages per week Those with red-flag symptoms were excluded Participants were recruited via analog and digital advertisements and screened for initial selection through a web-based questionnaire Data were collected using another questionnaire and a 2-day bladder diary A telephone interview confirmed the symptom diagnosis Participants were randomized (1:1) to receive access to a treatment app (including pelvic floor muscle training, bladder training, psychoeducation, lifestyle advice, tailored advice, exercise log, reinforcement messages, and reminders) or an information app (control group), with no external treatment guidance provided The primary outcome was incontinence symptoms at the 15-week follow-up, measured using the International Consultation on Incontinence Questionnaire (ICIQ)−Urinary Incontinence Short Form (ICIQ-UI SF) Urgency symptoms were assessed using the ICIQ−Overactive Bladder Module (ICIQ-OAB) and quality of life using the ICIQ−Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSqol) Incontinence episode frequency (IEF) was calculated per bladder diary entries Improvement was measured using the Patient’s Global Impression of Improvement All outcomes were self-reported Cure was defined as no leakages per the bladder diary Intention-to-treat analysis was performed Results: Between April 2017 and March 2018, 123 women (mean age 58 3, SD 9 6 years) were randomized to the treatment (n=60, 2 lost to follow-up) or information (n=63) group Of these, 35 (28%) women had UUI, and 88 (72%) had MUI Mean ICIQ-UI SF score at follow-up was lower in the treatment group than in the information group (estimated difference −3 1, 95% CI −4 8 to −1 3) The estimated between-group difference was −1 8 (95% CI −2 8 to −0 99) for mean ICIQ-OAB score and −6 3 (95% CI −10 5 to −2 1) for the mean ICIQ-LUTSqol score at follow-up IEF reduction from baseline to follow-up was greater in the treatment group (−10 5, IQR −17 5 to −3 5) than in the information group (P< 001) Improvement was reported by 87% (52/60) of treatment group participants and by 30% (19/63) of information group participants The cure rate was 32% in the treatment group, and 6% in the information group (odds ratio 5 4, 95% CI 1 9-15 6;P= 002) About 67% (40/60) of the treatment group participants used the app more than thrice a week Conclusions: The treatment app was effective for improving urgency and mixed incontinence in women When self-management is appropriate, this app may be a good alternative to pharmacological treatment or other conservative management, thus increasing access to care Trial Registration: ClinicalTrials gov NCT03097549;https://clinicaltrials gov/ct2/show/NCT03097549
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Please summerize the given abstract to a title
Responding to the Under-Utilisation of Necessary Health Care in the Time of COVID-19: A Precision Public Health intervention.
The Veterans' Medicines Advice and Therapeutics Education Services (MATES) program is a national data driven, behaviorally informed, health intervention to improve the use of medicines among Australian veterans. The program, which has been operating since 2004, has led the way in the use of government held data assets to generate evidenced-based health information, which, when provided to clinicians alongside educational materials, can make demonstrable improvements in health and promote practice change.
| 78,026 | [
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Please summerize the given abstract to a title
Advanced practice providers in the infectious disease workforce: A Nationwide utilization survey
Background Shortages of infectious disease (ID) physicians is an identified workforce problem. The COVID-19 pandemic has exacerbated this care gap, leaving many communities without access to an ID physician. More advanced practice providers (APPs), nurse practitioners/physician assistants, work as healthcare extenders, yet are not well described in ID. Purpose Evaluate collaboration between ID physicians and APPs, and potential barriers to utilization of APPs. Methods Anonymous and voluntary surveys;one for physicians, another for APPs. We collected experience, practice setting, familiarity regarding APPs in ID, use of APPs, and perceived barriers/concerns for utilization of APPs. Discussion Nationwide, 218 ID physicians and 93 APPs in ID responded. 71% (155) of ID physicians use APPs. Of APPs, 53% (49) had > 5 years ID experience. Responses highlighted opportunities for dedicated ID education, collaboration, and clarification of practice scope. Conclusion APPs are an experienced group who provide ID care, working alongside physicians to meet ID workforce needs.
| 78,135 | [
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... | 74 |
Please summerize the given abstract to a title
Patients’ Perspectives on User Involvement in General Practice. A Qualitative Analysis of Free-Text Comments
Background: : General practice plays a core role in managing the pathways of patients with chronic diseases. Despite the increased focus on patient involvement in healthcare practice and well-established knowledge of the benefits of involvement and personalized care, involvement in general practice appears to be challenged. This study aimed to explore patient involvement in general practice from the patients’ perspectives. Method: : The study involved a questionnaire survey investigating patient involvement in general practice from the patients’ perspectives. The validated questionnaire includes an open-ended question encouraging responders to provide additional comments regarding their involvement in general practice. The results from these comments are presented in this paper. A thematic analysis was applied. Results: : Of the 468 responses, 139 included additional comments to the free-text question. Through our analysis, six analytic themes were generated— To be seen, met, or heard , To feel safe or not , To be involved or dictated to , Accessibility , COVID-19 , and For the resourceful— across 116 codings and 25 descriptive themes. The themes’ interwovenness underscores the complexity of both involvement and how it is to live with a chronic disease. Our analysis indicates that involvement in general practice is for the resourceful. Conclusion: : The six themes describing involvement in general practice from the perspectives of patients with T2DM and/or COPD were deeply intertwined. Involvement is dependent on being seen, met, and heard, all of which contribute to the patients’ sense of feeling safe (or not). These aspects are dependent on accessibility to a general practitioner;thus, COVID-19 was a barrier during the data-collection period. Furthermore, it appeared that being resourceful not only contributed to a sense of being involved in general practice but was perhaps even a prerequisite for being involved.
| 78,297 | [
0.37353515625,
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0.37890625,
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0... | 74 |
Please summerize the given abstract to a title
Hospice@Home to palliative response team
BackgroundOur Hospice at Home (H@H) service supports 31 GP practices (population 315,000 patients).Pre- COVID-19 pandemic service provision of seven-days 9am-5pm was reviewed.Enhanced model developed supporting people wishing to die at home. (DIUPR local CCG 45.9 vs 46.6 England 2017 ONS).DIUPR increased during the pandemic.AimsIncrease ease of access to care provision at home through increased service hours.Increase medical support to develop a specialist palliative care virtual beds model.Uphold hospice’s strategic aims and values of ‘widening access’ and ‘reaching more people’.Uphold ‘Ambitions for Palliative Care’ - ‘each person gets fair access to care’ (National Palliative and End of Life Care Partnership, 2015).MethodsCollaborative appointment (Hospice and NHS) of new community palliative consultant.Use of triage priority rating.Agreed a rapid service pathway for those unstable/dying.New service launched September 2020 with increased hours (8 am to 10 pm) and ability to review patients same day.Supported out of hours by on-call palliative consultants.Virtual beds model supported by daily ‘ward rounds’ and updated plan of care.Data collection – number of referrals, referral source, diagnosis, place of death.Results Nov 20-May 21 Referrals 362 Patients seen 144 Died 166 Discharged 221 Death Location% Hospital 4% Patient‘s own home 80% Hospice 11% Care Home 4% ConclusionService activity increased. 84% of patients died in their usual place of residence. Daily review of patient plans enabled continuity of care. Clear contact information required for patients and families as different service involvement can be confusing. Referral process between partner organisations needed re-discussion and review.Future planningPriority ratings to be reviewed.Strengthen relationships with GP practices by attending Gold Standards Framework meetings.Increase use of data collection including user feedback to support the development of service to enable more patients to be reached in line with identified growing demand.
| 78,338 | [
0.1961669921875,
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-0... | 74 |
Please summerize the given abstract to a title
Collaborative improvement in Scottish GP clusters after the Quality and Outcomes Framework: a qualitative study
BACKGROUND: Scotland abolished the Quality and Outcomes Framework (QOF) in April 2016, before implementing a new Scottish GP contract in April 2018. Since 2016, groups of practices (GP clusters) have been incentivised to meet regularly to plan and organise quality improvement (QI) as part of this new direction in primary care policy. AIM: To understand the organisation and perceived impact of GP clusters, including how they use quantitative data for improvement. DESIGN AND SETTING: Thematic analysis of semi-structured interviews with key stakeholders (n = 17) and observations of GP cluster meetings (n = 6) in two clusters. METHOD: This analytical strategy was combined with a purposive (variation) sampling approach to the sources of data, to try to identify commonalities across diverse stakeholder experiences of working in or on the idea of GP clusters. Variation was sought particularly in terms of stakeholders’ level of involvement in improvement initiatives, and in their disciplinary affiliations. RESULTS: There was uncertainty as to whether GP clusters should focus on activities generated internally or externally by the wider healthcare system (for example, from Scottish Health Boards), although the two observed clusters generally generated their own ideas and issues. Clusters operated with variable administrative/managerial and data support, and variable baseline leadership experience and QI skills. Qualitative approaches formed the focus of collaborative learning in cluster meetings, through sharing and discussion of member practices’ own understandings and experiences. Less evidence was observed of data analytics being championed in these meetings, partly because of barriers to accessing the analytics data and existing data quality. CONCLUSION: Cluster development would benefit from more consistent training and support for cluster leads in small-group facilitation, leadership, and QI expertise, and data analytics access and capacity. While GP clusters are up and running, their impact is likely to be limited without further investment in developing capacity in these areas.
| 78,417 | [
-0.056549072265625,
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0.61669921875,
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-0.450683593... | 74 |
Please summerize the given abstract to a title
Clinical exercise provision in the UK: comparison of staff job titles, roles and qualifications across five specialised exercise services
OBJECTIVES: In the UK, the National Health Service long-term plan advocates exercise as a key component of clinical services, but there is no clearly defined workforce to deliver the plan. We aimed to provide an overview of current UK clinical exercise services, focusing on exercise staff job titles, roles and qualifications across cardiovascular, respiratory, stroke, falls and cancer services. METHODS: Clinical exercise services were identified electronically between May 2020 and September 2020 using publicly available information from clinical commissioning groups, national health boards and published audit data. Data relating to staff job titles, roles, qualifications and exercise delivery were collected via electronic records and telephone/email contact with service providers. RESULTS: Data were obtained for 731 of 890 eligible clinical services (216 cardiac, 162 respiratory, 129 stroke, 117 falls, 107 cancer). Cardiac rehabilitation services provided both clinical (phase III) and community (phase IV) exercise interventions delivered by physiotherapists, exercise physiologists (exercise specific BSc/MSc) and exercise instructors (vocationally qualified with or without BSc/MSc). Respiratory, stroke and falls services provided a clinical exercise intervention only, mostly delivered by physiotherapists and occupational therapists. Cancer services provided a community exercise service only, delivered by vocationally qualified exercise instructors. Job titles of ‘exercise physiologists’ (n=115) bore little alignment to their qualifications, with a large heterogeneity across services. CONCLUSION: In the UK, clinical exercise services job titles, roles and qualifications were inconsistent. Regulation of exercise job titles and roles is required to remove the current disparities in this area.
| 78,456 | [
-0.20068359375,
-0.52197265625,
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0.60107421875,
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0.1328125,
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0.2222900390625,
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... | 74 |
Please summerize the given abstract to a title
Digital Health Technology in Asthma: A Comprehensive Scoping Review.
BACKGROUND A variety of digital intervention approaches have been investigated for asthma therapy during the last decade, with different levels of interactivity and personalization, with a range of impacts on different outcome measurements. OBJECTIVE To assess the effectiveness of digital interventions in asthma with regards to acceptability and outcomes and evaluate the potential of digital initiatives for monitoring or treating patients with asthma. METHODS We evaluated digital interventions using a scoping review methodology via literature search and review. Of 871 articles identified, 121 were evaluated to explore intervention characteristics, the perception and acceptability of digital interventions to patients and physicians, and effects on asthma outcomes. Interventions were categorized by their level of interactivity with the patient. RESULTS Interventions featuring non-individualized content sent to patients appeared capable of promoting improved adherence to inhaled corticosteroids, but with no identified improvement in asthma burden, and data-gathering interventions appeared to have little effect on adherence or asthma burden. Evidence of improvement in both adherence and patients' impairment due to asthma were seen only with interactive interventions involving two-way responsive patient communication. Digital interventions were generally positively perceived by patients and physicians. Implementation was considered feasible, with certain preferences for design and features important to drive usage. CONCLUSIONS Digital health interventions show substantial promise for asthma disease monitoring and personalization of treatment. To be successful, future interventions will need to include both inhaler device and software elements, combining accurate measurement of clinical parameters with careful consideration of ease of use, personalization and patient engagement aspects.
| 78,503 | [
-0.1221923828125,
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0.454345703125,
0.454345703125,
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0.233642578125,
0.1607666015625,
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-0.349365234375,
0.2110595703125,
-0.65576171875,
-0.63671875,
0.0... | 74 |
Please summerize the given abstract to a title
Bereavement Support for Siblings after Neonatal Loss: an Online Survey of U.S. Training Centers
OBJECTIVE: The aim of this study was to examine bereavement support for siblings of patients who die in the neonatal intensive care unit (NICU) given the adverse effects of unprocessed grief and the paucity of information on children whose newborn siblings die STUDY DESIGN: This was an anonymous online original survey assessing pre-COVID-19 pandemic bereavement services for NICU families, clinicians' attitudes toward support interventions, challenges, and center characteristics. In spring 2020, nurse managers at 81 U.S. centers with neonatology and maternal-fetal medicine fellowship programs were asked to identify the individual most knowledgeable in their NICU's bereavement support services; these individuals were invited by email to complete an original online survey. Chi testing and odds ratios (ORs) compared responses from centers reporting involvement of palliative care teams (PCT) in NICU sibling bereavement versus no PCT. RESULTS: Fifty-six percent (45 of 80) of invitees responded. Most (77%) NICUs permitted perimortem sibling visitation. Challenges included sparse community resources and limited direct sibling contact. Sixty-nine percent (n = 31) of centers were grouped as PCT. PCT respondents reported eightfold higher chances of providing direct education to the sibling (OR, 7.7; 95% confidence interval, 1.7-34; p = 0.01). Views on appropriateness of sharing educational information with extended family, babysitters, and teachers did not differ. While notifying pediatricians of families experiencing NICU death was more common in PCT (p = 0.02), most respondents reported having "no individual responsible for such communications" (52% PCT vs. 100%, p = 0.001). CONCLUSION: Despite limited direct contact with siblings of NICU patients who die, efforts are made to involve them in bereavement activities. Opportunities to support these children were identified. Where available, palliative care teams can help provide bereaved siblings with direct education. We recommend formalizing communication mechanisms to ensure that if a NICU patient dies and has surviving siblings, the outpatient physicians caring for these siblings are informed. KEY POINTS: · Palliative care enhanced sibling support.. · Resource and visitation limits hinder support.. · Teams sporadically briefed siblings' physicians..
| 78,554 | [
0.287841796875,
0.28857421875,
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0.32470703125,
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0.1387939453125,
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-0.1708984375,
-... | 74 |
Please summerize the given abstract to a title
How to embed qualitative research in trials: insights from the feasibility study of the SAFER trial programme
Qualitative research can enhance the design, conduct and interpretation of trials. Despite this, few trials incorporate qualitative methods, and those that do may not realise their full potential. In this commentary, we highlight how qualitative research can contribute to the design, conduct and day-to-day running of a trial, outlining the working arrangements and relationships that facilitate these contributions. In doing so, we draw on (i) existing frameworks on the role of qualitative research alongside trials and (ii) our experience of integrated qualitative research conducted as part of the feasibility study of the SAFER trial (Screening for Atrial Fibrillation with ECG to Reduce stroke), a cluster randomised controlled trial of screening people aged 70 and above for atrial fibrillation in primary care in England. The activities and presence of the qualitative team contributed to important changes in the design, conduct and day-to-day running of the SAFER feasibility study, and the subsequent main trial, informing diverse decisions concerning trial documentation, trial delivery, timing and content of measures and the information given to participating patients and practices. These included asking practices to give screening results to all participants and not just to ‘screen positive’ participants, and greater recognition of the contribution of practice reception staff to trial delivery. These changes were facilitated by a ‘one research team’ approach that underpinned all formal and informal working processes from the outset and maximised the value of both qualitative and trial coordination expertise. The challenging problems facing health services require a combination of research methods and data types. Our experience and the literature show that the benefits of embedding qualitative research in trials are more likely to be realised if attention is given to both structural factors and relationships from the outset. These include sustained and sufficient funding for qualitative research, embedding qualitative research fully within the trial programme, providing shared infrastructure and resources and committing to relationships based on mutual recognition of and respect for the value of different methods and perspectives. We outline key learning for the planning of future trials. Trial registration: Screening for atrial fibrillation with ECG to reduce stroke ISRCTN16939438 (feasibility study); Screening for atrial fibrillation with ECG to reduce stroke – a randomised controlled trial ISRCTN72104369.
| 78,582 | [
0.07940673828125,
0.0712890625,
-0.7373046875,
0.263671875,
-0.307373046875,
-0.63818359375,
-0.2486572265625,
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0.258544921875,
0.323486328125,
0.3037109375,
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0.60888671875,
-0.55322265625,
-0.2369384765625,
0.52392578125,
-0.5205078125,
-0.8813476562... | 74 |
Please summerize the given abstract to a title
A prospective assessment of the Medicaid Web portal for admission medication reconciliation at a community hospital in Montana
DISCLAIMER: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: Medication reconciliation (MR) is a complicated and tedious process but is crucial to prevent errors when ordering patients' discharge medications during a hospital admission. Our institution currently uses a variety of methods to gather a patient's medication history, including review of the medical records and electronic pharmaceutical claims data (EPCD) from a commercial health information exchange organization, as well as a patient or caregiver interview. Occasionally, more information is needed to obtain the most accurate history. To augment current methods, EPCD can also be accessed for patients with Medicaid insurance using a state Medicaid Web portal. We aimed to evaluate the utility of the Medicaid Web portal for reducing medication errors during the MR process at hospital admission. SUMMARY: A single-center, prospective, quality improvement initiative was conducted to evaluate 100 patient medication lists for all nonobstetric Medicaid patients admitted to our institution to identify discrepancies in medication lists when the state Medicaid Web portal was used in addition to standard MR methods. We found that, when EPCD from commercial organizations were available, they matched the patient's current medication list 64% of the time. One in 4 patients had at least 1 discrepancy on their verified medication list that was identified using the Medicaid Web portal. The discrepancies identified were addressed and corrected in real time to improve patient care. CONCLUSION: EPCD from the state Medicaid Web portal could supplement the use of current methods to obtain a more accurate medication history and reduce the number of erroneously ordered discharge medications during hospital admission.
| 78,629 | [
-0.042205810546875,
-0.220703125,
-0.44921875,
1.0048828125,
-0.5458984375,
-0.64697265625,
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0.25341796875,
0.8525390625,
0.360107421875,
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0.52392578125,
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-0.54833984375,
0.... | 74 |
Please summerize the given abstract to a title
Development and validation of a multiple-choice question-based delirium care knowledge quiz for critical care nurses
Aims: To develop and psychometrically test a multiple choice questions (MCQs) based quiz of delirium care knowledge for critical care nurses. Design: Instrument development and psychometric evaluation study. Methods: The development and validation process including two phases. Phase I focused on the quiz development, conducted by the following steps: (1) generated initial 20 items pool; (2) examined content validity and (3) face validity; (4) conducted pilot testing, data were collected from 217 critical care nurses via online survey during 01 October to 07 November, 2020; (5) performed item analysis and eliminated items based on the item difficulty and discrimination indices. The MCQs quiz was finalised through the development process. Then, phases II emphasised the quiz validation, to estimate the internal consistency, split half and test-retest reliability, and construct validity using parallel analysis with the exploratory factor analysis (EFA). Results: A final 16 items MCQs quiz was emerged from the item analysis. The Kuder Richardson Formula 20 coefficient for the overall quiz showed good internal consistency (0.85), and the intraclass correlation coefficient with a 30 days interval also indicated that the questionnaire had satisfactory stability (0.96). The EFA confirmed appropriate construct validity for the quiz, four factors could explain the total variance of 60.87%. Conclusion: This study developed the first MCQs quiz for delirium care knowledge and it is a reliable and valid tool that can be implemented to assess the level of delirium care knowledge. Impact: This study offers an evidence based quiz designed for future research and education purposes in delirium care that has significant implications for knowledge test by using MCQs in clinical practice.
| 78,736 | [
0.55078125,
-0.1285400390625,
-0.71630859375,
0.59619140625,
-0.71826171875,
-0.2117919921875,
0.1253662109375,
0.056671142578125,
0.0943603515625,
0.86279296875,
0.52978515625,
-0.02606201171875,
0.58447265625,
-0.87451171875,
-0.446044921875,
0.4287109375,
-0.60595703125,
-0.5375... | 74 |
Please summerize the given abstract to a title
How Denmark, England, Estonia, France, Germany, and the USA Pay for Variable, Specialized and Low Volume Care: A Cross-country Comparison of In-patient Payment Systems.
BACKGROUND Diagnosis-related group (DRG)-based hospital payment can potentially be inadequately low (or high) for highly variable, highly specialized, and/or low volume care. DRG-based payment can be combined with other payment mechanisms to avoid unintended consequences of inadequate payment. The aim of this study was to analyze these other payment mechanisms for acute inpatient care across six countries (Germany, Denmark, England, Estonia, France, the United States [Medicare]). METHODS Information was collected about elements excluded from DRG-based payment, the rationale for exclusions, and payment mechanisms complementing DRG-based payment. A conceptual framework was developed to systematically describe, visualise and compare payment mechanisms across countries. RESULTS Results show that the complexity of exclusion mechanisms and associated additional payment components differ across countries. England and Germany use many different additional mechanisms, while there are only few exceptions from DRG-based payment in the Medicare program in the United States. Certain areas of care are almost always excluded (eg, certain areas of cancer care or specialized pediatrics). Denmark and England use exclusion mechanisms to steer service provision for highly complex patients to specialized providers. CONCLUSION Implications for researchers and policy-makers include: (1) certain areas of care might be better excluded from DRG-based payment; (2) exclusions may be used to incentivize the concentration of highly specialized care at specialized institutions (as in Denmark or England); (3) researchers may apply our analytical framework to better understand the specific design features of DRG-based payment systems.
| 78,775 | [
-0.07562255859375,
-0.062164306640625,
-0.5068359375,
0.95068359375,
-0.357666015625,
-0.479248046875,
0.35498046875,
-0.1387939453125,
-0.368408203125,
0.83642578125,
0.39453125,
0.64306640625,
0.6669921875,
-0.6044921875,
-0.6650390625,
0.23486328125,
-0.3828125,
-0.5322265625,
... | 74 |
Please summerize the given abstract to a title
A multidisciplinary approach to online support for device research translation: regulatory change and clinical engagement
OBJECTIVES: To promote medical device EU regulatory understanding in the biomedical research community and encourage greater levels of clinical engagement to further medical device research innovation, translation and effective clinical trials. METHODS: An interdisciplinary, iterative, needs-based design approach was used to develop medical device regulatory training, information and clinical expertise resources. RESULTS: A multimedia based self-paced e-Learning course focusing on the ‘Fundamentals of Medical Device Design and Regulation’ was produced in tandem with an interactive online web portal: Medtech Translate. CONCLUSIONS: Health research translation relies on both clinical input and regulation to drive progress and to ensure quality and safety standards from concept development to clinical investigation. A lack of regulatory awareness and access to clinical expertise has the potential to significantly impact on health research translation and ambition for market. Our interdisciplinary academic-regulator-clinical-industry led approach meets the need for a coordinated stakeholder response to support innovation and promote growth in the medical technology sector.
| 78,850 | [
-0.1043701171875,
-0.380615234375,
-0.52685546875,
0.249755859375,
-0.166748046875,
-0.1533203125,
0.15625,
-0.136962890625,
0.05145263671875,
0.779296875,
0.183349609375,
0.2271728515625,
0.53369140625,
-0.533203125,
-0.103759765625,
0.380126953125,
-0.262939453125,
-0.8291015625,... | 74 |
Please summerize the given abstract to a title
Workload and prevalence of open wounds in the community: French Vulnus initiative.
OBJECTIVE To calculate the prevalence of open cutaneous wounds presented on a routine working day in community settings in metropolitan France, and to estimate the workload associated with the care of these wounds by nurses, GPs and specialists (dermatologists, diabetologists and phlebologists). METHOD A transversal epidemiological survey was conducted on a randomly selected sample of the above practitioners between June and July 2008. The percentage of patients presenting on a routine working day with open a cutaneous lesion of any origin, location, size and duration was assessed. All local and systemic care performed on the patient during that day because of the wound was also recorded. RESULTS In total, 475 GPs, 453 specialists and 238 nurses participated (n=1166) and saw a total of 29 663 patients, of whom 3037 presented with one or more cutaneous wound. The overall non-weighted prevalence of patients with a wound was 10.2% (95%CI: 9.9%;10.6%). This prevalence was similar for GPs (6.0%) and for specialists (6.9%), but was higher for nurses (22.0%). Forty-three per cent of all wounds had a duration of over 6 weeks. These chronic wounds were predominantly leg ulcers, diabetic foot ulcers or pressure ulcers, but also included wounds of all aetiologies. For 33% of all patients with wounds, the impact on their health status was serious to severe. The overwhelming majority of wounds (95%) required local care, including in 65% of cases cleansing and debridement. CONCLUSION Despite its limitations, this initiative, the first of its type in France, strongly suggests that wound care constitutes an important part of routine care given by health professionals in the community, and for a substantial number of these patients, wounds represent a serious morbidity. DECLARATION OF INTEREST The non-profit organisation 'Association Vivre avec une Plaie' financially supported this study. This association received unrestricted grants from the French Wound Healing Society (SFFPC) and a consortium of private companies (main sponsors: ConvaTec, Genevrier, Hartmann, KCI, Mölnycke, Smith & Nephew, Urgo; minor sponsors: Coloplast, Covidien, HNE) to fund the costs incurred by the methodological process and statistical analysis but had no input into the findings. The National Health Insurance Organisation provided non-financial support to this initiative. J.C. Kerihuel received support for the submitted work from 'Association Vivre avec une Plaie'. S. Meaume, I. Fromantin and L. Téot have no financial relationship with 'Association Vivre avec une Plaie', for either this or any work submitted in the previous 3 years. The authors have no non-financial interests that may be relevant to the submitted work, and their spouses, partners, or children have no financial relationships that may be relevant to the submitted work
| 78,851 | [
-0.044158935546875,
-0.156005859375,
-0.53125,
0.40185546875,
-0.6298828125,
-0.231201171875,
0.059417724609375,
0.04534912109375,
0.253173828125,
0.52392578125,
0.1453857421875,
-0.3515625,
0.83935546875,
-0.398681640625,
-0.4052734375,
0.368896484375,
-0.2626953125,
-0.9892578125... | 74 |
Please summerize the given abstract to a title
Knowledge of pharmacy workers on antihypertensive and anticonvulsant drugs for managing pre-eclampsia and eclampsia in Bangladesh.
BACKGROUND Pharmacy workers in Bangladesh play an important role in managing pregnancy complications by dispensing, counselling and selling drugs to pregnant women and their families. This study examined pharmacy workers' drug knowledge and practice for pre-eclampsia and eclampsia (PE/E) management, including antihypertensives and anticonvulsants, and determine factors associated with their knowledge. METHODS A cross-sectional survey with 382 pharmacy workers in public facilities (government) and private pharmacies and drug stores assessed their knowledge of antihypertensive and anticonvulsant drugs. 'Pharmacy workers' include personnel who work at pharmacies, pharmacists, family welfare visitors (FWVs), sub-assistant community medical officers (SACMOs), drug storekeepers. Exploratory and multivariate logistic models were used to describe association between knowledge of medicines used in pregnancy and demographic characteristics of pharmacy workers. RESULTS Overall, 53% pharmacy workers interviewed were drug store owners in private pharmacies while 27% FWVs/SACMOs, who are government service providers also work as drug prescribers and/or dispensers in public facility pharmacies. Majority of pharmacy workers had poor knowledge compared to correct knowledge on both antihypertensive (77.8% vs 22.3%; p < 0.001) and anticonvulsant drugs (MgSO4) (82.2% vs 17.8%; p < 0.001). Multivariate analysis showed SACMOs and FWVs were greater than 4 times more likely to have correct knowledge on anti-hypertensives (AOR = 4.2, 95% CI:1.3-12.3, P < 0.01) and anticonvulsant drugs (AOR = 4.9, 95% CI:1.3-18.1, P < 0.01) compared to pharmacists. Pharmacy workers who had received training were more likely to have correct knowledge on antihypertensive and anticonvulsant drugs than those who had no training. CONCLUSIONS Pharmacy workers' knowledge and understanding of antihypertensive and anticonvulsant drugs, particularly for prevention and management of PE/E is limited in Bangladesh. Most pharmacies surveyed are private and staffed with unskilled workers with no formal training on drugs. Expansion of maternal and newborn health programs should consider providing additional skills training to pharmacy workers, as well as regulating these medicines at informal pharmacies to mitigate any harmful practices or adverse outcomes of unauthorized and incorrectly prescribed and used drugs. It is important that correct messaging and medicines are available as drug stores are often the first point of contact for most of the women and their families.
| 78,911 | [
-0.2420654296875,
0.167236328125,
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0.31591796875,
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0.40087890625,
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-0.3916015625,
... | 74 |
Please summerize the given abstract to a title
Experiences and Perspectives of Marketing Authorisation Holders towards Medication Safety Monitoring during Pregnancy: A Pan-European Qualitative Analysis
Although marketing authorisation holders (MAHs) are involved in monitoring medication safety, it was unclear how they experience their role and current monitoring activities in pregnancy. Therefore, a qualitative study using online focus groups with MAHs and the Belgian umbrella organisation of MAHs was conducted in June–July 2021. In total, 38 representatives of nine organisations participated. Overall, participants reported multiple difficulties with data collection, including underreporting, collection of incomplete information, and loss to follow-up. The limited number of high-quality data collected, the unknown denominator and the lack of comparator data complicate MAHs’ data processing activities, preventing them to timely provide evidence in the pregnancy label. Three ‘conflicts’ inherent to the specific position of MAHs were identified explaining the difficulties they experience, i.e., (1) mistrust from patients and healthcare professionals (HCPs); (2) MAHs’ legal obligations and regulatory framework; (3) MAHs’ position outside the healthcare context. To overcome these barriers, MAHs suggested that data registration should occur in close collaboration with patients and HCPs, organised within the healthcare context and performed by using a user-friendly system. In conclusion, the reported difficulties and underlying conflicts of MAHs highlight the need for more effective, collaborative data collection strategies to generate new evidence on this topic.
| 78,969 | [
-0.22900390625,
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0.5546875,
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0.68310546875,
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-0.69628... | 74 |
Please summerize the given abstract to a title
Digital health literacy as a super determinant of health: More than simply the sum of its parts
• Civic literacy refers to the ability to engage meaningfully with one's community. • Digital, health, and civic literacy are key predictors for digital health literacy. • The extent to which these three affect digital health literacy remains unclear. • Building digital health literacy is vital to limit inequalities from expanding.
| 78,974 | [
0.298095703125,
-0.035186767578125,
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0.63330078125,
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0.55517578125,
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0.19482421875,
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Please summerize the given abstract to a title
Delivering clinical trials at home: protocol, design and implementation of a direct-to-family paediatric lupus trial
INTRODUCTION: Direct-to-family clinical trials efficiently provide data while reducing the participation burden for children and their families. Although these trials can offer significant advantages over traditional clinical trials, the process of designing and implementing direct-to-family studies is poorly defined, especially in children with rheumatic disease. This paper provides lessons learnt from the design and implementation of a self-controlled, direct-to-family pilot trial aimed to evaluate the effects of a medication management device on adherence to hydroxychloroquine in paediatric SLE. METHODS: Several design features accommodate a direct-to-family approach. Participants meeting eligibility criteria from across the USA were identified a priori through a disease registry, and all outcome data are collected remotely. The primary outcome (medication adherence) is evaluated using electronic medication event-monitoring, plasma drug levels, patient questionnaires and pill counts. Secondary and exploratory endpoints include (1) lupus disease activity measured by a remote SLE Disease Activity Index examination and the Systemic Lupus Activity Questionnaire; and (2) hydroxychloroquine pharmacokinetics and pharmacodynamics. Recruitment of the initial target of 20 participants was achieved within 10 days. Due to initial recruitment success, enrolment was increased to 26 participants. Additional participants who were interested were placed on a waiting list in case of dropouts during the study. DISCUSSION AND DISSEMINATION: Direct-to-family trials offer several advantages but present unique challenges. Lessons learnt from the protocol development, design, and implementation of this trial will inform future direct-to-family trials for children and adults with rheumatic diseases. Additionally, the data collected remotely in this trial will provide critical information regarding the accuracy of teleresearch in lupus, the impact of adherence to hydroxychloroquine on disease activity and a pharmacokinetic analysis to inform paediatric-specific dosing of hydroxychloroquine. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04358302).
| 78,989 | [
-0.36572265625,
0.25244140625,
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0.6015625,
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-0.08184814453125,
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0.2900390625,
-0.78173828125,
-0... | 74 |
Please summerize the given abstract to a title
2021 ISHNE/ HRS/ EHRA/ APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/ Heart Rhythm Society/ European Heart Rhythm Association/ Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self‐management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
| 78,995 | [
-0.1298828125,
0.11151123046875,
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0.6787109375,
-0.347900390625,
0.04632568359375,
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0.1324462890625,
0.68994140625,
0.66796875,
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0.26220703125,
-0.440185546875,
-0.607421875,
0.299072265625,
-0.460205078125,
-0.860... | 74 |
Please summerize the given abstract to a title
A tale of ‘politics and stars aligning’: analysing the sustainability of scaled up digital tools for front-line health workers in India
INTRODUCTION: India has become a lighthouse for large-scale digital innovation in the health sector, particularly for front-line health workers (FLHWs). However, among scaled digital health solutions, ensuring sustainability remains elusive. This study explores the factors underpinning scale-up of digital health solutions for FLHWs in India, and the potential implications of these factors for sustainability. METHODS: We assessed five FLHW digital tools scaled at the national and/or state level in India. We conducted in-depth interviews with implementers, technology and technical partners (n=11); senior government stakeholders (n=5); funders (n=1) and evaluators/academics (n=3). Emergent themes were grouped according to a broader framework that considered the (1) digital solution; (2) actors; (3) processes and (4) context. RESULTS: The scale-up of digital solutions was facilitated by their perceived value, bounded adaptability, support from government champions, cultivation of networks, sustained leadership and formative research to support fit with the context and population. However, once scaled, embedding digital health solutions into the fabric of the health system was hampered by challenges related to transitioning management and ownership to government partners; overcoming government procurement hurdles; and establishing committed funding streams in government budgets. Strong data governance, continued engagement with FLHWs and building a robust evidence base, while identified in the literature as critical for sustainability, did not feature strongly among respondents. Sustainability may be less elusive once there is more consensus around the roles played between national and state government actors, implementing and technical partners and donors. CONCLUSION: The use of digital tools by FLHWs offers much promise for improving service delivery and health outcomes in India. However, the pathway to sustainability is bespoke to each programme and should be planned from the outset by investing in people, relationships and service delivery adjustments to navigate the challenges involved given the dynamic nature of digital tools in complex health systems.
| 79,015 | [
-0.2001953125,
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0.568359375,
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0.46142578125,
0.6884765625,
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0.07177734375,
-0.39501953125,
-0.402587890625,
0.4... | 74 |
Please summerize the given abstract to a title
Achieving change readiness for health service innovations.
Continual innovation to address emerging population needs necessitates health service ongoing redesign and transformation worldwide. Recent examples include service transformations in response to Covid-19, many of which were led and managed by nurses. Ensuring change readiness is central to delivering these transformative changes yet has been identified as a central challenge impacting nurse leaders and managers. Recent evidence indicates that affective commitment to change among healthcare staff may be an important contributor to gaining support for change implementation but understudied in healthcare. A cross-sectional survey study was used to examine the association between affective commitment to change and change readiness among 30 healthcare staff across four projects in one state-wide health system in Australia. Our findings indicate that affective commitment to change; healthcare worker's emotional and personal perception of the value of the proposed change is independently associated with individual and collective change readiness. Given that achieving change readiness is a central goal of change management strategies, this pilot work provides valuable insight to inform the change management practices of nurse leaders and managers.
| 79,207 | [
-0.1973876953125,
-0.224365234375,
-0.60498046875,
0.607421875,
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-0.912109375,
-0.08624267578125,
0.2181396484375,
0.239501953125,
0.78515625,
0.178466796875,
-0.417724609375,
0.254638671875,
-0.5224609375,
-0.2252197265625,
-0.23046875,
-0.30126953125,
-0.3681640625,... | 74 |
Please summerize the given abstract to a title
Valuing diversity in value assessment: introducing the PhRMA Foundation Health Disparities Challenge Award.
DISCLOSURES:: No funding supported the writing of this article. The author has received grants from BeiGene, Ltd., and Pfizer, Inc., and advisory board fees from PhRMA Foundation.
| 79,211 | [
0.03521728515625,
0.037689208984375,
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0.5556640625,
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0.2220458984375,
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0.41552734375,
-0.427978515625,
-0.252197265625,
0.52001953125,
-0.54150390625,
-0.5... | 74 |
Please summerize the given abstract to a title
Protocol for an implementation study of an evidence-based home cardiac rehabilitation programme for people with heart failure and their caregivers in Scotland (SCOT:REACH-HF)
INTRODUCTION: Despite evidence that cardiac rehabilitation (CR) is an essential component of care for people with heart failure, uptake is low. A centre-based format is a known barrier, suggesting that home-based programmes might improve accessibility. The aim of SCOT: Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) is to assess the implementation of the REACH-HF home-based CR intervention in the context of the National Health Service (NHS) in Scotland. This paper presents the design and protocol for this observational implementation study. Specific objectives of SCOT:REACH-HF are to: (1) assess service-level facilitators and barriers to the implementation of REACH-HF; (2) compare real-world patient and caregiver outcomes to those seen in a prior clinical trial; and (3) estimate the economic (health and social) impact of implementing REACH-HF in Scotland. METHODS AND ANALYSIS: The REACH-HF intervention will be delivered in partnership with four ‘Beacon sites’ across six NHS Scotland Health Boards, covering rural and urban areas. Health professionals from each site will be trained to facilitate delivery of the 12-week programme to 140 people with heart failure and their caregivers. Patient and caregiver outcomes will be assessed at baseline and 4-month follow-up. Assessments include the Minnesota Living with Heart Failure Questionnaire (MLHFQ), five-dimension EuroQol 5L, Hospital Anxiety and Depression Scale, and the Caregiver Burden Questionnaire. Qualitative interviews will be conducted with up to 20 health professionals involved in programme delivery (eg, cardiac nurses, physiotherapists). 65 facilitator-patient consultations will be audio recorded and assessed for fidelity. Integrative analysis will address key research questions on fidelity, context and CR participant-related outcomes. The SCOT:REACH-HF findings will inform the future potential roll-out of REACH-HF in Scotland. ETHICS AND DISSEMINATION: The study has been given ethical approval by the West of Scotland Research Ethics Service (reference 20/WS/0038, approved 25 March 2020). Written informed consent will be obtained from all participants. The study is listed on the ISRCTN registry with study ID ISRCTN53784122. The research team will ensure that the study is conducted in accordance with both General Data Protection Regulations and the University of Glasgow’s Research Governance Framework. Findings will be reported to the funder and shared with Beacon Sites, to facilitate service evaluation, planning and good practice. To broaden interest in, and understanding of REACH-HF, we will seek to publish in peer-reviewed scientific journals and present at stakeholder events, national and international conferences.
| 79,219 | [
-0.1871337890625,
0.01512908935546875,
-0.55810546875,
0.5791015625,
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-0.37548828125,
0.0228271484375,
0.47998046875,
0.10198974609375,
0.445068359375,
0.361572265625,
-0.0090179443359375,
0.446044921875,
-0.580078125,
-0.3935546875,
0.423828125,
-0.7998046875,
-0.70... | 74 |
Please summerize the given abstract to a title
Trials using deferred consent in the emergency setting: a systematic review and narrative synthesis of stakeholders’ attitudes
BACKGROUND: Patients with acute conditions often lack the capacity to provide informed consent, and narrow therapeutic windows mean there is no time to seek consent from surrogates prior to treatment being commenced. One method to enable the inclusion of this study population in emergency research is through recruitment without prior consent, often known as ‘deferred consent’. However, empirical studies have shown a large disparity in stakeholders’ opinions regarding this enrolment method. This systematic review aimed to understand different stakeholder groups’ attitudes to deferred consent, particularly in relation to the context in which deferred consent might occur. METHODS: Databases including MEDLINE, EMCare, PsychINFO, Scopus, and HMIC were searched from 1996 to January 2021. Eligible studies focussed on deferred consent processes for adults only, in the English language, and reported empirical primary research. Studies of all designs were included. Relevant data were extracted and thematically coded using a narrative approach to ‘tell a story’ of the findings. RESULTS: Twenty-seven studies were included in the narrative synthesis. The majority examined patient views (n = 19). Data from the members of the public (n = 5) and health care professionals (n =5) were also reported. Four overarching themes were identified: level of acceptability of deferred consent, research-related factors influencing acceptability, personal characteristics influencing views on deferred consent, and data use after refusal of consent or participant death. CONCLUSIONS: This review indicates that the use of deferred consent would be most acceptable to stakeholders during low-risk emergency research with a narrow therapeutic window and where there is potential for patients to benefit from their inclusion. While the use of narrative synthesis allowed assessment of the included studies, heterogeneous outcome measures meant that variations in study results could not be reliably attributed to the different trial characteristics. Future research should aim to develop guidance for research ethics committees when reviewing trials using deferred consent in emergency research and investigate more fully the views of healthcare professionals which to date have been explored less than patients and members of the public. Trial registration PROSPERO CRD42020223623 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-022-06304-x.
| 79,241 | [
0.3212890625,
-0.256103515625,
-0.8173828125,
0.27294921875,
-0.52294921875,
-0.39111328125,
-0.1480712890625,
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0.5390625,
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0.796875,
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-0.04913330078125,
0.3798828125,
-0.56884765625,
-1.013671875,
-0.16357... | 74 |
Please summerize the given abstract to a title
Factors Driving Local Health Departments' Partnerships With Other Organizations in Maternal and Child Health, Communicable Disease Prevention, and Chronic Disease Control.
OBJECTIVES To describe levels of partnership between local health departments (LHDs) and other community organizations in maternal and child health (MCH), communicable disease prevention, and chronic disease control and to assess LHD organizational characteristics and community factors that contribute to partnerships. DATA SOURCES Data were drawn from the National Association of County & City Health Officials' 2013 National Profile Study (Profile Study) and the Area Health Resources File. LHDs that received module 1 of the Profile Study were asked to describe the level of partnership in MCH, communicable disease prevention, and chronic disease control. Levels of partnership included "not involved," "networking," "coordinating," "cooperating," and "collaborating," with "collaborating" as the highest level of partnership. Covariates included both LHD organizational and community factors. Data analyses were conducted using Stata 13 SVY procedures to account for the Profile Study's survey design. RESULTS About 82%, 92%, and 80% of LHDs partnered with other organizations in MCH, communicable disease prevention, and chronic disease control programs, respectively. LHDs having a public health physician on staff were more likely to partner in chronic disease control programs (adjusted odds ratio [AOR] = 2.33; 95% confidence interval [CI], 1.03-5.25). Larger per capita expenditure was also associated with partnerships in MCH (AOR = 2.43; 95% CI, 1.22-4.86) and chronic disease prevention programs (AOR = 1.76; 95% CI, 1.09-2.86). Completion of a community health assessment was associated with partnership in MCH (AOR = 7.26; 95% CI, 2.90-18.18), and chronic disease prevention (AOR = 5.10; 95% CI, 2.28-11.39). CONCLUSION About 1 in 5 LHDs did not have any partnerships in chronic disease control. LHD partnerships should be promoted to improve care coordination and utilization of limited health care resources. Factors that might promote LHDs' partnerships include having a public health physician on staff, higher per capita expenditure, and completion of a community health assessment. Community context likely influences types and levels of partnerships. A better understanding of these contextual factors may lead to more complete and effective LHD partnerships.
| 79,328 | [
0.0167236328125,
0.07000732421875,
-0.33935546875,
0.5947265625,
-0.4091796875,
-0.2017822265625,
-0.278564453125,
0.1826171875,
-0.0161590576171875,
0.69921875,
-0.051239013671875,
-0.159912109375,
0.369873046875,
-0.289306640625,
-0.41748046875,
0.509765625,
-0.476318359375,
-0.3... | 74 |
Please summerize the given abstract to a title
NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention
BACKGROUND: Nursing homes are likely to become increasingly important as end-of-life care facilities. Previous studies indicate that individuals residing in these facilities have a high prevalence of end-of-life symptoms and a significant need for palliative care. The aim of this study was to develop an end-of-life care program for nursing homes in Spain based on previous models yet adapted to the specific context and the needs of staff in nursing homes in the country. METHODS: A descriptive study of a complex intervention procedure was developed. The study consisted of three phases. The first phase was a prospective study assessing self-efficacy in palliative care (using the SEPC scale) and attitudes towards end-of-life care (using the FATCOD-B scale) among nursing home staff before and after the completion of a basic palliative care training program. In the second phase, objectives were selected using the Delphi consensus technique, where nursing home and primary care professionals assessed the relevance, feasibility, and level of attainment of 42 quality standards. In phase 3, interventions were selected for these objectives through two focus group sessions involving nursing home, primary care, and palliative care professionals. RESULTS: As a result of the training, an improvement in self-efficacy and attitudes towards end-of-life care was observed. In phase 2, 14 standards were selected and grouped into 5 objectives: to conduct a comprehensive assessment and develop a personalized care plan adapted to the palliative needs detected; to provide information in a clear and accessible way; to request and record advance care directives; to provide early care with respect to loss and grief; to refer patients to a specialized palliative care unit if appropriate, depending on the complexity of the palliative care required. Based on these objectives, the participants in the focus group sessions designed the 22 interventions that make up the program. CONCLUSIONS: The objectives and interventions of the NUHELP program constitute an end-of-life care program which can be implemented in nursing homes to improve the quality of end-of-life care in these facilities by modifying their clinical practice, organization, and relationship with the health system as well as serving as an example of an effective health intervention program. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-021-00788-1.
| 79,423 | [
0.2198486328125,
-0.181640625,
-0.64892578125,
0.283935546875,
-0.50146484375,
-0.2734375,
0.0579833984375,
0.20751953125,
-0.1658935546875,
0.77685546875,
0.8349609375,
0.0543212890625,
0.250732421875,
-0.49853515625,
-0.442138671875,
-0.212158203125,
-0.176513671875,
-0.649414062... | 74 |
Please summerize the given abstract to a title
Non-pharmacological interventions to improve the patient experience of colonoscopy under moderate or no sedation: a systematic review protocol
INTRODUCTION: The patient experience is a critical dimension of colonoscopy quality. Sedative and analgesic drugs are commonly used to improve the patient experience of colonoscopy, with predominant regimens being deep sedation, typically achieved with propofol, and moderate sedation, typically achieved with an opioid and a benzodiazepine. However, non-pharmacological interventions exist that may be used to improve patient experience. Furthermore, by identifying non-pharmacological interventions to increase the quality of patient experience under moderate sedation, jurisdictions facing rising use of deep sedation for colonoscopy and its significant associated costs may be better able to encourage patients and clinicians to adopt moderate sedation. Advancing either of these aims requires synthesising the evidence and raising awareness around these non-pharmacological interventions to improve the patient experience of colonoscopy. METHODS AND ANALYSIS: A systematic review will be conducted that searches multiple electronic databases from inception until 2020 to identify randomised controlled trials evaluating what, if any, non-pharmacological interventions are effective compared with placebo or usual care for improving the patient experience of routine colonoscopy under moderate or no sedation. Two reviewers will independently perform a three-stage screening process and extract all study data using piloted forms. Study quality will be assessed using the Cochrane Risk of Bias Tool V.2.0. Where multiple studies evaluate a single intervention, evidence will be quantitatively synthesised using pairwise meta-analysis, otherwise narrative syntheses will be undertaken. ETHICS AND DISSEMINATION: This is a review of existing literature not requiring ethics approval. The review findings will be included in future efforts to develop an implementation strategy to reduce the use of deep sedation for routine colonoscopy. They will also be published in a peer-reviewed journal, presented at conferences and contribute to a doctoral thesis. PROSPERO REGISTRATION NUMBER: CRD42020173906.
| 79,486 | [
0.403076171875,
-0.330810546875,
-0.38232421875,
0.458984375,
-0.418212890625,
-0.662109375,
-0.375732421875,
0.3720703125,
-0.306884765625,
0.74462890625,
0.67626953125,
-0.50341796875,
0.3935546875,
-0.412353515625,
-0.16943359375,
0.466064453125,
-0.408447265625,
-0.77001953125,... | 74 |
Please summerize the given abstract to a title
Factors impacting the access and use of formal health and social services by caregivers of stroke survivors: an interpretive description study
BACKGROUND: Evidence has shown that family and friend caregivers of stroke survivors are significantly and negatively impacted by caregiving. The negative effects of caregiving may persist over time suggesting that caregivers might benefit from ongoing engagement with supportive services. However, little is known about caregivers’ use of formally funded health and social services, or the factors influencing their access to and use of these services. The aim of this study is to increase understanding of the factors that influence stroke caregivers’ access and use of formal health and social services, from the perspective of stroke caregivers and healthcare providers. METHODS: A qualitative study was conducted with stroke caregivers and health providers in Ontario, Canada using interpretive description. In-depth interviews were conducted with caregivers of survivors who experienced a stroke between six months to five years previous and healthcare providers who support caregivers and stroke survivors. All participants provided written informed consent. Interview data were analyzed using constant comparison to identify codes and develop key thematic constructs. RESULTS: A total of 40 interviews were conducted with 22 stroke caregivers at an average 30-months post-stroke and 18 health providers. Factors that influenced stroke caregivers’ access and use of services included: finances and transportation; challenges caregivers faced in caring for their health; trust that they could leave their family member and trust in health providers; limited information pertaining to services and a lack of suitable services; and the response of their social networks to their caregiving situation. CONCLUSION: Stroke caregivers experience significant challenges in accessing and using formal health and social services. These challenges could be addressed by increasing availability of subsidized community-based supports such as respite and counselling tailored to meet the ongoing needs of caregivers. Systemic change is needed by the health system that readily includes and supports caregivers throughout the stroke recovery continuum, particularly in the community setting. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07804-x.
| 79,492 | [
-0.0623779296875,
0.0115814208984375,
-0.7421875,
1.0419921875,
-0.2939453125,
-0.69970703125,
0.031463623046875,
0.6611328125,
0.034332275390625,
0.69921875,
0.01336669921875,
-0.2318115234375,
0.1728515625,
-0.57470703125,
-0.31982421875,
0.49658203125,
-0.73583984375,
-0.4902343... | 74 |
Please summerize the given abstract to a title
Digital Technology in Clinical Trials for Multiple Sclerosis: Systematic Review
Clinical trials in multiple sclerosis (MS) have been including digital technology tools to overcome limitations in treatment delivery and disease monitoring. In March 2020, we conducted a systematic search on pubmed.gov and clinicaltrials.gov databases (with no restrictions) to identify all relevant published and unpublished clinical trials, in English language, including MS patients, in which digital technology was applied. We used “multiple sclerosis” and “clinical trial” as the main search words, and “app”, “digital”, “electronic”, “internet” and “mobile” as additional search words, separately. Digital technology is part of clinical trial interventions to deliver psychotherapy and motor rehabilitation, with exergames, e-training, and robot-assisted exercises. Digital technology has been used to standardise previously existing outcome measures, with automatic acquisitions, reduced inconsistencies, and improved detection of symptoms (e.g., electronic recording of motor performance). Other clinical trials have been using digital technology for monitoring symptoms that would be otherwise difficult to detect (e.g., fatigue, balance), for measuring treatment adherence and side effects, and for self-assessment purposes. Collection of outcome measures is progressively shifting from paper-based on site, to internet-based on site, and, in the future, to internet-based at home, with the detection of clinical and treatment features that would have remained otherwise invisible. Similarly, remote interventions provide new possibilities of motor and cognitive rehabilitation.
| 79,517 | [
-0.03436279296875,
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Please summerize the given abstract to a title
Rotating between day and night shifts: Factors influencing sleep patterns of hospital nurses
AIMS AND OBJECTIVES: This study aimed to investigate sleep patterns of hospital nurses using a wearable electronic device and determine the influence of rotating day and night shifts and lifestyle factors on their sleep efficiency. BACKGROUND: Nurses working in shifts are vulnerable to sleep disturbances. However, little is known about the influence of rotating day and night shift schedules and healthy lifestyle on nurses' daily sleep patterns. DESIGN: Descriptive correlational design. METHODS: Thirty-two hospital nurses working in shifts and 32 hospital nurses not working in shifts participated in data collection. Their sleep patterns were measured for six consecutive days using Fitbit Charge 3™ , and information on alcohol consumption, exercise, and eating habits were assessed using a questionnaire. Data were analysed using repeated measures analysis of variance with post hoc Scheffe's test and hierarchical multiple regression analysis. The study was conducted in accordance with the STROBE guideline. RESULTS: Overall, nurses working on rotating day and night shifts had significantly shorter total sleep time, longer sleep onset latency, and lower sleep efficiency than those not working in shifts. In particular, nurses working for 3 or 4 consecutive night shifts had significantly shorter total sleep time, lower sleep efficiency and longer sleep onset latency than those working for 0-2 consecutive night shifts. Rotating day and night shifts and alcohol consumption significantly influenced sleep efficiency. CONCLUSIONS: A work schedule of ≥3 consecutive night shifts and the habit of alcohol consumption before bed time influence nurses' sleep efficiency. RELEVANCE TO CLINICAL PRACTICE: Given the poor sleep pattern among nurses working in shifts, particularly those working on ≥2 consecutive night shifts, it is necessary to develop an optimal shift schedule and a program to promote healthy lifestyle among hospital nurses.
| 79,601 | [
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0.5078125,
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Please summerize the given abstract to a title
Using Patient Engagement Platforms in the Postoperative Management of Patients
PURPOSE OF REVIEW: The purpose of this review is to contextualize the topic of patient engagement in orthopedic surgery. There will be a specific focus on patient engagement platforms and the impact on outcomes and orthopedic clinical workflows. RECENT FINDINGS: In an attempt to engage patients and optimize the orthopedic perioperative surgical home, patient engagement platforms have emerged in the form of portals, mobile health applications, and chatbots. Collectively, these platforms have improved patient satisfaction scores and outcomes. Patient portals, mobile health applications, and chatbots can engage orthopedic patients and improve the effectiveness of the perioperative orthopedic surgical home. There are specific differences in these applications that should be noted and accounted for. When deciding to incorporate one of these systems into your practice, it is paramount to identify what you are looking to improve upon within your health system and choose a platform accordingly.
| 79,607 | [
0.1656494140625,
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0.4345703125,
-0.26611328125,
-0.45507812... | 74 |
Please summerize the given abstract to a title
Consumer Health Informatics: Promoting Patient Self-care Management of Illnesses and Health.
Consumer health informatics (CHI) is propelling important changes for medical providers and the lives of patients through information and communications technology. Independently, medical consumers seek, collect, and use health information for decision making. However, when constructing a CHI-based medical platform, high technology must be applied in a fully understandable and usable format for both health care providers and consumers. This study examines the present status of CHI and its effect on medical consumers. For the development of CHI, we discuss the need for tailored health communications and capacity building with chronic patients at the medical center. First, empowerment is a key characteristic needed for medical consumer health care management. However, promoting patient self-care management of illnesses and health is necessary to create conjugation where cooperation with medical service providers is possible. Also, establishing a health care delivery system that will support cooperation is necessary. Second, tailored health communications can uniquely construct the health information of patients, which prevents unnecessary or excessive information from leading patients to confused and inappropriate decisions. Ultimately, through the present environment of health communication, the innovation of a consumer health care information system has become the tide of the times and the positive effect of improved health can be expected.
| 79,612 | [
-0.0968017578125,
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0.53369140625,
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-0.... | 74 |
Please summerize the given abstract to a title
Is patient identification of 'comfortable' print size a useful clinical parameter for low vision reading assessment?
PURPOSE The purpose of this study was to determine what a person with vision loss considers a 'comfortable' print size to read, and examine whether this reflects any of three currently used parameters for identifying print size required for sustained reading tasks: minimum size to achieve maximum reading speed (the critical print size (CPS)); minimum size for functional reading at 80 wpm and/or a size that is double the reading acuity (representing an acuity reserve of 2:1). METHODS Forty-seven participants entering low vision rehabilitation (mean age 77 years, 24 with macular degeneration) were assessed using MNREAD charts to determine reading acuity, maximum reading speed, CPS and the minimum size allowing functional (80 wpm) reading. Comfortable print size was assessed by asking participants to identify 'the smallest print size that you would find comfortable using' on the MNREAD chart. RESULTS There was little difference between comfortable print size and CPS (mean difference 0.05 logMAR (SD 0.18); p = 0.08, limits of agreement ±0.35 logMAR), and no trend for the difference between values to differ across the functional range. Size for functional reading could only be assessed for 41 participants, and the difference between this and comfortable print size varied across the functional range. Comfortable print size was consistently smaller than twice the reading acuity size (mean difference 0.11 logMAR (SD 0.17); p < 0.001), with an average acuity reserve of 1.74:1. CONCLUSIONS Asking people with visual impairment to identify a print size that is comfortable to read provides a print size similar to the CPS. This can be used as a guide in selecting magnification for sustained reading without having to undertake further analyses. Identification of perceived comfortable print size may offer a time-efficient clinical method of estimating magnification requirements, and be relevant for undertaking effective remote consultations.
| 79,662 | [
0.479248046875,
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0.92236328125,
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0.252685546875,
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0.77392578125,
0.56005859375,
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0.290283203125,
-0.436279296875,
-0.040863037109375,
0.392822265625,
-0.52099609375,
-0.4628... | 74 |
Please summerize the given abstract to a title
Study Data Element Mapping: Feasibility of Defining Common Data Elements Across COVID-19 Studies
Background: Numerous clinical studies are now underway investigating aspects of COVID-19. The aim of this study was to identify a selection of national and/or multicentre clinical COVID-19 studies in the United Kingdom to examine the feasibility and outcomes of documenting the most frequent data elements common across studies to rapidly inform future study design and demonstrate proof-of-concept for further subject-specific study data element mapping to improve research data management. Methods: 25 COVID-19 studies were included. For each, information regarding the specific data elements being collected was recorded. Data elements collated were arbitrarily divided into categories for ease of visualisation. Elements which were most frequently and consistently recorded across studies are presented in relation to their relative commonality. Results: Across the 25 studies, 261 data elements were recorded in total. The most frequently recorded 100 data elements were identified across all studies and are presented with relative frequencies. Categories with the largest numbers of common elements included demographics, admission criteria, medical history and investigations. Mortality and need for specific respiratory support were the most common outcome measures, but with specific studies including a range of other outcome measures. Conclusion: The findings of this study have demonstrated that it is feasible to collate specific data elements recorded across a range of studies investigating a specific clinical condition in order to identify those elements which are most common among studies. These data may be of value for those establishing new studies and to allow researchers to rapidly identify studies collecting data of potential use hence minimising duplication and increasing data re-use and interoperability
| 79,688 | [
0.00948333740234375,
0.061798095703125,
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0.497802734375,
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0.2303466796875,
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0.2939453125,
-0.73486328125,
-0.33251953125,
0.0526123046875,
-0.6142578125,
-0... | 74 |
Please summerize the given abstract to a title
The Effect of Using Peer on Self-Care, Quality of Life, and Adherence in Elderly People with Coronary Artery Disease
INTRODUCTION: Coronary artery disease is one of the most common diseases and the cause of death among elderly people. Due to the chronic nature of this disease, regular follow-up, lifestyle changes, and adherence to recommendations can reduce the complications and improve the quality of life among elderly individuals. Given the importance of using educational methods that are based on the patient's age and disease stage, the present study aimed to investigate the effect of using a peer group on self-care, adherence, and quality of life in elderly people. METHOD: This single-blind clinical trial was conducted on 30 old patients with coronary artery disease aged 60 years in Shiraz from March to June 2021. The patients were selected using simple random sampling and were then randomly assigned to the peer education and control groups (15 participants in each group) via permuted block randomization. The patients in the peer education group received the necessary education about medications, lifestyle, daily activities, self-care, and adherence through three educational clips by educated peer. The patients in the control group received routine education using two clips by the ward nurses. The levels of self-care, adherence, and quality of life were assessed in the intervention and control groups before and one month after the intervention. Data analysis was performed by SPSS 20 software using an independent t-test, paired sample t-test, and chi-square test. P < 0.05 was considered statistically significant. Findings. The results showed no statistically significant difference between the two groups with respect to the mean scores of self-care and quality of life before the intervention (P > 0.05). Following the educational intervention, however, a statistically significant difference was found between the two groups concerning the mean scores of self-care and adherence (P < 0.05). Moreover, the mean differences between the two groups regarding the three variables were statistically significant before and after the intervention (P < 0.05). CONCLUSION: Education based on multimedia clips by peer was effective in increasing the mean scores of self-care, adherence, and quality of life among the elderly people with coronary artery disease. Given the low cost, high effectiveness, and decrease in the nurses' workload, this method is recommended to be used alongside other methods in order to educate elderly individuals suffering from coronary artery disease.
| 79,722 | [
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0.7705078125,
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-0.394775390625,
-0.162841796875,
0.357421875,
0.434814453125,
0.5576171875,
0.52978515625,
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0.6171875,
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-0.30029296875,
0.0809326171875,
-0.5390625,
-0.7734375,
-0.560... | 74 |
Please summerize the given abstract to a title
Needs to Create Healthy Living Environments—A Two-Stage Delphi Survey in Europe to Identify Facilitating Factors and Barriers in Municipal Health Promotion
(1) In the field of health promotion, municipalities offer opportunities to reduce SES-based health inequalities by addressing vulnerable communities. This research project aims to identify facilitating and inhibiting factors for the creation of healthy living environments. (2) After preliminary literature and qualitative research work, an online-based Delphi survey was conducted (December 2020–March 2021). This included the rating and commentating of 22 theses at two times, whereby the results of the first round of rating were visible to the participants the second time. (3) Twelve experts from seven European countries participated in the Delphi survey across both rounds (1st round: n = 37; 12 countries). The consensus was particularly clear with regard to providing resources, which, in turn, are especially necessary for involving target groups in health promotion. (4) The results illustrate the relevance of further cross-national exchange. Certain aspects however, such as the HiAP approach or strategies to reach disadvantaged groups, are still challenging in practice. In order to develop concrete recommendations, the theses need to be further operationalised. The Delphi method offers a suitable possibility to map international expertise in this field and with a focus on health equity.
| 79,810 | [
-0.1793212890625,
0.25146484375,
-0.7900390625,
0.37890625,
-0.7763671875,
-0.438720703125,
-0.002628326416015625,
0.27783203125,
0.0987548828125,
0.6318359375,
-0.0223236083984375,
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0.421142578125,
-0.436767578125,
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0.25439453125,
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-0... | 74 |
Please summerize the given abstract to a title
Perspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder
IMPORTANCE: Emergency departments (EDs) are increasingly initiating treatment for patients with untreated opioid use disorder (OUD) and linking them to ongoing addiction care. To our knowledge, patient perspectives related to their ED visit have not been characterized and may influence their access to and interest in OUD treatment. OBJECTIVE: To assess the experiences and perspectives regarding ED-initiated health care and OUD treatment among US patients with untreated OUD seen in the ED. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study, conducted as part of 2 studies (Project ED Health and ED-CONNECT), included individuals with untreated OUD who were recruited during an ED visit in EDs at 4 urban academic centers, 1 public safety net hospital, and 1 rural critical access hospital in 5 disparate US regions. Focus groups were conducted between June 2018 and January 2019. MAIN OUTCOMES AND MEASURES: Data collection and thematic analysis were grounded in the Promoting Action on Research Implementation in Health Services (PARIHS) implementation science framework with evidence (perspectives on ED care), context (ED), and facilitation (what is needed to promote change) elements. RESULTS: A total of 31 individuals (mean [SD] age, 43.4 [11.0] years) participated in 6 focus groups. Twenty participants (64.5%) identified as male and most 13 (41.9%) as White; 17 (54.8%) reported being unemployed. Themes related to evidence included patients’ experience of stigma and perceived minimization of their pain and medical problems by ED staff. Themes about context included the ED not being seen as a source of OUD treatment initiation and patient readiness to initiate treatment being multifaceted, time sensitive, and related to internal and external patient factors. Themes related to facilitation of improved care of patients with OUD seen in the ED included a need for on-demand treatment and ED staff training. CONCLUSIONS AND RELEVANCE: In this qualitative study, patients with OUD reported feeling stigmatized and minimized when accessing care in the ED and identified several opportunities to improve care. The findings suggest that strategies to address stigma, acknowledge and treat pain, and provide ED staff training should be implemented to improve ED care for patients with OUD and enhance access to life-saving treatment.
| 79,824 | [
-0.1495361328125,
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-0.9501953125,
0.8857421875,
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0.39111328125,
0.2178955078125,
0.896484375,
0.281005859375,
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0.36328125,
0.0208740234375,
-0.282958984375,
0.51318359375,
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-0.6474609375,
-0... | 74 |
Please summerize the given abstract to a title
Interventions to improve the quality of cataract services: protocol for a global scoping review.
INTRODUCTION Cataract is the leading cause of blindness globally and a major cause of vision impairment. Cataract surgery is an efficacious intervention that usually restores vision. Although it is one of the most commonly conducted surgical interventions worldwide, good quality services (from being detected with operable cataract to undergoing surgery and receiving postoperative care) are not universally accessible. Poor quality understandably reduces the willingness of people with operable cataract to undergo surgery. Therefore, it is critical to improve the quality of care to subsequently reduce vision loss from cataract. This scoping review aims to summarise the nature and extent of the published literature on interventions to improve the quality of services for primary age-related cataract globally. METHODS AND ANALYSIS We will search MEDLINE, Embase and Global Health for peer-reviewed manuscripts published since 1990, with no language, geographic or study design restrictions. To define quality, we have used the elements adopted by the WHO-effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency-to which we have added the element of planetary health. We will exclude studies focused on the technical aspects of the surgical procedure and studies that only involve children (<18 years). Two reviewers will screen all titles/abstracts independently, followed by a full-text review of potentially relevant articles. For included articles, data regarding publication characteristics, study details and quality-related outcomes will be extracted by two reviewers independently. Results will be synthesised narratively and presented visually using a spider chart. ETHICS AND DISSEMINATION Ethical approval was not sought, as our review will only include published and publicly accessible information. We will publish our findings in an open-access peer-reviewed journal and develop an accessible summary of the results for website posting. A summary of the results will be included in the ongoing Lancet Global Health Commission on Global Eye Health. REGISTRATION DETAILS Open Science Framework (https://osf.io/8gktz).
| 79,926 | [
-0.311279296875,
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0.79052734375,
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-0.318115234375,
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0.1580810546875,
0.0667724609375,
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-0.394775390625,
0.271728515625,
-0.353515625,
-0.7... | 74 |
Please summerize the given abstract to a title
Thematic Analysis of Hospice Mentions in the Health Records of Veterans with Advanced Kidney Disease.
BACKGROUND Patients with advanced kidney disease are less likely than many patients with other types of serious illness to enroll in hospice. Little is known about real-world clinical decision-making related to hospice for members of this population. METHODS We used a text search tool to conduct a thematic analysis of documentation pertaining to hospice in the electronic medical record system of the Department of Veterans Affairs, for a national sample of 1000 patients with advanced kidney disease between 2004 and 2014 who were followed until October 8, 2019. RESULTS Three dominant themes emerged from our qualitative analysis of the electronic medical records of 340 cohort members with notes containing hospice mentions: (1) hospice and usual care as antithetical care models: clinicians appeared to perceive a sharp demarcation between services that could be provided under hospice versus usual care and were often uncertain about hospice eligibility criteria. This could shape decision-making about hospice and dialysis and made it hard to individualize care; (2) hospice as a last resort: patients often were referred to hospice late in the course of illness and did not so much choose hospice as accept these services after all treatment options had been exhausted; and (3) care complexity: patients' complex care needs at the time of hospice referral could complicate transitions to hospice, stretch the limits of home hospice, and promote continued reliance on the acute care system. CONCLUSIONS Our findings underscore the need to improve transitions to hospice for patients with advanced kidney disease as they approach the end of life.
| 79,928 | [
0.1446533203125,
-0.1649169921875,
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0.65673828125,
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0.11187744140625,
0.449462890625,
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-0.00722503662109375,
-0.49267578125,
-... | 74 |
Please summerize the given abstract to a title
Toward a theory-led meta-framework for implementing health system resilience analysis studies: a systematic review and critical interpretive synthesis
INTRODUCTION: The variety of frameworks and models to describe resilience in the health system has led researchers and policymakers to confusion and the inability to its operationalization. Therefore, the purpose of this study was to create a meta-framework using the Critical Interpretive Synthesis method. METHOD: For this purpose, studies that provide theories, models, or frameworks for organizational or health system resilience in humanitarian or organizational crises were systematically reviewed. The search strategy was conducted in PubMed, Web of Science, Embase, and Scopus databases. MMAT quality appraisal tool was applied. Data were analysed using MAXQDA 10 and the Meta-ethnography method. RESULTS: After screening based on eligibility criteria, 43 studies were reviewed. Data analysis led to the identification of five main themes which constitute different framework dimensions. Health system resilience phases, attributes, tools, and strategies besides health system building blocks and goals are various dimensions that provide a systematic framework for health system resilience analysis. DISCUSSION: This study provides a systemic, comprehensive framework for health system resilience analysis. This meta-framework makes it possible to detect the completeness of resilience phases. It examines the system’s resilience by its achievements in intermediate objectives (resilience system attributes) and health system goals. Finally, it provides policy solutions to achieve health system resilience using tools in the form of absorptive, adaptive, and transformative strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-12496-3.
| 79,943 | [
-0.498046875,
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-0.6181640625,
0.537109375,
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0.1719970703125,
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1.1708984375,
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0.05645751953125,
-0.175048828125,
-0.043365478515625,
0.3330078125,
-0.5927734375,
-0.535644531... | 74 |
Please summerize the given abstract to a title
The Effect of Perceived Value, Trust, and Commitment on Patient Loyalty in Taiwan
Increasing patient loyalty through improved health care quality and patient–provider relationships becomes the key factor in medical providers’ successes. This study explored the mediated relationship of patients’ perceived value, patient commitment, and patient loyalty and the moderating effect of patient trust on the mediated relationship. A cross-sectional research design was adopted. Mediation and moderated mediation were tested using the PROCESS macro v3.5 for the SPSS supplement. Convenience sampling was used for the distribution of questionnaires to members of the public with experience of seeking medical attention in Taiwan. Among the 254 valid questionnaires recovered, 59.4% of the respondents were male, 38.6% were married, 90.2% were in the 20 to 49 year age range, and 54.7% had a bachelor’s degree or above. This study indicated a significant mediated relationship among patients’ perceived value of medical services, commitment to the patient–provider relationship, and patient loyalty. Furthermore, when the patient demonstrated higher levels of trust in a healthcare provider, the relationship of perceived value, commitment, and patient loyalty was also enhanced. This study discussed and demonstrated the effect of perceived value, trust, and commitment on patient loyalty. The research suggests that improving patient loyalty benefits sustainable operation of medical providers and the treatment effects for patients.
| 79,983 | [
-0.1685791015625,
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0.55419921875,
-0.59375,
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0.335205078125,
0.299560546875,
0.0198822021484375,
0.33740234375,
0.254150390625,
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0.3447265625,
-0.2313232421875,
-0.4755859375,
-0.2322998046875,
-0.04766845703125,
-0.452... | 74 |
Please summerize the given abstract to a title
The PostStroke-Manager – combining mobile, digital and sensor-based technology with personal assistance: protocol of the feasibility study
INTRODUCTION: Post stroke management has moved into the focus as it represents the only way to secure acute treatment effects in the long term. Due to individual courses, post stroke management appears rather challenging and is hindered by existing barriers between treatment sectors. As a novel concept, the PostStroke-Manager combines digital and sensor-based technology with personal assistance to enable intersectoral cooperation, best possible reduction of stroke-related disability, optimal secondary prevention, and detection of physical and psychological comorbidities. METHODS: This prospective single-center observational study aims to investigate the feasibility of the PostStroke-Manager concept in an outpatient setting. Ninety patients who have suffered an ischemic or hemorrhagic stroke or transient ischemic attack will be equipped with a tablet and mobile devices recording physical activity, blood pressure, and electrocardiographic signals. Through a server-based platform, patients will be connected with the primary care physician, a stroke pilot and, if necessary, other specialists who will use web-based platforms. Via the tablet, patients will have access to an application with 10 newly designed components including, for instance, a communication tool, medication schedule, medical records platform, and psychometric screenings (e.g., depression, anxiety symptoms, quality of life, adherence, cognitive impairment). During the 1-year follow-up period, clinical visits are scheduled at three-month intervals. In the interim, communication will be secured by an appropriate tool that includes text messenger, audio, and video telephony. As the primary endpoint, feasibility will be measured by a 14-item questionnaire that addresses digital components, technical support, and personal assistance. The PostStroke-Manager will be judged feasible if at least 50% of these aspects are rated positively by at least 75% of patients. Secondary endpoints include feedback from professionals and longitudinal analyses on clinical and psychometric parameters. PERSPECTIVE: This study will answer the question of whether combined digital and personal support is a feasible approach to post stroke management. Furthermore, the patient perspective gained regarding digital support may help to specify future applications. This study will also provide information regarding the potential use of remote therapies and mobile devices in situations with limited face-to-face contacts. TRIAL REGISTRATION: German Register for Clinical Trials (DRKS00023213.), registered 27 April 2021.
| 80,044 | [
-0.1573486328125,
-0.10552978515625,
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0.57666015625,
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0.6513671875,
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-0.62939453125,
... | 74 |
Please summerize the given abstract to a title
“It’s given me confidence”: a pragmatic qualitative evaluation exploring the perceived benefits of online end‐of‐life education on clinical care
BACKGROUND: Hospital admissions for end-of-life care are increasing exponentially across the world. Significant numbers of health professionals are now required to provide end-of-life care with minimal training. Many health professionals report they lack confidence to provide this care, particularly those in acute hospital settings. This study explored the perceived benefits of online education on health professionals’ capacity to provide end-of-life care. METHODS: This qualitative study adopted a pragmatic approach. Thirty semi-structured interviews were conducted with allied health professionals, nurses and doctors who had completed a minimum of three End-of-Life Essentials online education modules. Interviews were held on line and face-to-face, audio-recorded and transcribed verbatim. Demographic data were also collected. Three major themes and one minor theme were constructed from the data using inductive thematic analysis. RESULTS: Themes were (1). Perceptions of preparedness to provide end-of-life care, (2). Shifts in approaching end-of-life discussions and (3). Motivation for engagement with online modules. Participants reported validation of knowledge and improved confidence to have end-of-life discussions with patients, carers and team members. They also noted improved ability to recognise the dying process and improved conversations with team members about patient and carer needs. Videos portraying a novice and then more able end-of-life discussions were particularly valued by participants. Modules provided practical guidance on how to engage in discussions about the end of life and care needs. Participants were self-motivated to improve their knowledge and skills to enhance end-of-life care provision. Continuing professional development requirements were also a motivator for module completion. CONCLUSIONS: This study explored health professionals’ perspectives about the perceived benefits of online education modules on their clinical practice. Module completion enhanced participant confidence and self-reported improved competence in end-of-life care provision. Findings build on existing research that supports the valuable role online education plays in supporting confidence and ability to actively engage with patients, carers and colleagues about provision of end-of-life care; however, self-report cannot be used as a proxy for improved clinical competence.
| 80,045 | [
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Please summerize the given abstract to a title
A feasibility study to assess the design of a multicentre randomized controlled trial of the clinical and cost-effectiveness of a caregiving intervention for people following hip fracture surgery
AIMS: This study aims to assess the feasibility of conducting a pragmatic, multicentre randomized controlled trial (RCT) to test the clinical and cost-effectiveness of an informal caregiver training programme to support the recovery of people following hip fracture surgery. METHODS: This will be a mixed-methods feasibility RCT, recruiting 60 patients following hip fracture surgery and their informal caregivers. Patients will be randomized to usual NHS care, versus usual NHS care plus a caregiver-patient dyad training programme (HIP HELPER). This programme will comprise of three, one-hour, one-to-one training sessions for the patient and caregiver, delivered by a nurse, physiotherapist, or occupational therapist. Training will be delivered in the hospital setting pre-patient discharge. It will include practical skills for rehabilitation such as: transfers and walking; recovery goal setting and expectations; pacing and stress management techniques; and introduction to the HIP HELPER Caregiver Workbook, which provides information on recovery, exercises, worksheets, and goal-setting plans to facilitate a ‘good’ recovery. After discharge, patients and caregivers will be supported in delivering rehabilitation through three telephone coaching sessions. Data, collected at baseline and four months post-randomization, will include: screening logs, intervention logs, fidelity checklists, quality assurance monitoring visit data, and clinical outcomes assessing quality of life, physical, emotional, adverse events, and resource use outcomes. The acceptability of the study intervention and RCT design will be explored through qualitative methods with 20 participants (patients and informal caregivers) and 12 health professionals. DISCUSSION: A multicentre recruitment approach will provide greater external validity across population characteristics in England. The mixed-methods approach will permit in-depth examination of the intervention and trial design parameters. The findings will inform whether and how a definitive trial may be undertaken to test the effectiveness of this caregiver intervention for patients after hip fracture surgery. Cite this article: Bone Jt Open 2021;2(11):909–920.
| 80,066 | [
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-... | 74 |
Please summerize the given abstract to a title
Helping Patients Understand and Cope with BRCA Mutations
PURPOSE OF REVIEW: Individuals carrying germline mutations in BRCA1/2 have unique psychosocial and educational needs that must be met to ensure informed clinical decision-making. In this review, we highlight the strategies used in clinical practice to support patients’ needs as well as currently available pre- and post-disclosure support interventions. RECENT FINDINGS: Clinical risk communication is complicated by the uncertainty associated with gene penetrance, inconclusive results, variable effectiveness of surgical and screening interventions, and inadequate awareness of clinical genetics. Interventions to support patients’ psychosocial needs, and strategies for effective and scalable clinical risk communication are in routine use and largely effective at meeting patients’ needs. Research is underway to develop newer supportive resources; however, the inadequate representation of all mutation carriers persists. SUMMARY: Effective clinical risk communication strategies, decision support aids, written educational materials, and supportive psychosocial tools can together have a large impact on meeting BRCA carriers’ supportive needs.
| 80,103 | [
0.1864013671875,
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Please summerize the given abstract to a title
Respiratory disease, and treatment / thematic poster session a novel approach to medical monitoring during the sars-cov-2 pandemic supporting the activ 4b outpatient anticoagulation trial
Rationale The ACTIV 4B (OWS/NHLBI supported) clinical trial addresses the use of anti-platelet and anticoagulant agents in symptomatic COVID-19 positive non-hospitalized patients with regards to safety and prevention of macro- and micro-thrombotic events using a composite outcome (symptomatic DVT/PE, arterial thromboembolism, MI, CVA, hospitalization for CV/pulmonary events, mortality). Concerns regarding SARS-CoV- 2 transmission risk to research staff and overburdened institutional environments create challenges for standard event monitoring. In addition, safety or outcome events often occur at other institutions rather than the enrollment site. Therefore, research methodology was adapted to effectively evaluate and categorize safety events using a remote low touch approach. Methods Trial over can be found at NCT04498273. Potential adverse events identified through patient electronic data capture survey or call center assessments are handled remotely by central clinical study staff. If an event is identified as a possible endpoint or SAE by the central study staff the electronic data collection (EDC) system notifies the central medical monitoring team, and the enrolling site coordinator if patient enrolled from an acute care setting, that additional source documents are necessary. The medical coordinator works with the site coordinator, or will reach out independently to treating institutions to obtain necessary source documents. Based on a review of clinical data from the EDC and all available source documents, final arbitration of seriousness, relatedness and expectedness is be made by the study's Medical Monitor, and appropriate study entities (NIH, FDA, IRB, study leadership, pharmaceutical co.) are notified.Results The process as described has been successfully and effectively implemented in >50 patients with anticipation of 7000 patient eventual enrollment. Events have been captured, source documentation has been procured and events have been reported as per established protocol processes. Conclusion We have effectively implemented a medical safety event monitoring methodology in a “low touch” study design to assess events in the complex COVID-19 outpatient space. Elements of our system can be effectively replicated in other COVID and non-COVID clinical trials. .
| 80,118 | [
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... | 74 |
Please summerize the given abstract to a title
Intrinsic capacity of older people in the community using WHO Integrated Care for Older People (ICOPE) framework: a cross-sectional study
BACKGROUND: The World Health Organization (WHO) published the Integrated Care for Older People (ICOPE) framework to guide assessing and promoting intrinsic capacity of older adults. This study, adopting the WHO ICOPE framework, assessed the intrinsic capacity impairment and investigated the relationship among intrinsic capacity, social engagement, and self-care capacity on performing activities of daily living. It also assessed the sensitivity of the initial brief screening and the detailed full assessment. METHODS: This is a cross-sectional study conducted in 11 community centers in Hong Kong. Intrinsic capacity was assessed in two steps identical to WHO ICOPE handbook: using WHO ICOPE brief screening tool (step 1) and detailed full assessment (step 2) to assess the intrinsic capacity domains of locomotion, cognition, vitality, psychological well-being, and sensory capacity (hearing and vision). Structural equational modeling analysis was used to examine the relationship among intrinsic capacity, social engagement, and self-care capacity, and the mediating role of intrinsic capacity in the relationships. RESULTS: A total of 304 older adults with a mean age 76.73 (SD = 7.25) years participated in WHO ICOPE Step 1 brief screening, and 221 participants (72.7%) showed intrinsic capacity impairment. After completing Step 2 full assessment, 202 participants (66.4%) had one or more impaired intrinsic capacity domains. The overall sensitivity and specificity of the screening tool were 95% and 57.6% respectively, whereas the sensitivity of each domain ranged from 74.7% to 100%. The percentage of impairment in locomotion (117, 39.8%), cognition (75, 25.5%), psychological well-being (34, 11.6%), vision (75, 24.7%), hearing capacity (82, 27.9%), and vitality (8, 2.7%). People in younger old age (β = -0.29, p < 0.001), with more education (β = 0.26, p < 0.001), and absence of hypertension (β = -0.11, p < 0.05) were more likely to have better intrinsic capacity. Intrinsic capacity was positively associated with self-care capacity in performing activities of daily living (β = 0.21, p < 0.001) and social engagement (β = 0.31, p < 0.001). CONCLUSIONS: The ICOPE screening tool is a sensitive instrument to detect intrinsic capacity impairment among community-dwelling older adults and it does not demand substantial workforce; its use is worthy to be supported. The intrinsic capacity impairment in community-dwelling older adults are prevalent, in particular, in locomotor and cognitive capacity. Actions should be taken to slow or prevent the impairment, support self-care and social engagement in old age.
| 80,132 | [
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-0.4370117187... | 74 |
Please summerize the given abstract to a title
Rapid reviews and the methodological rigor of evidence synthesis: a JBI position statement.
ABSTRACT The demand for rapid reviews has exploded in recent years. A rapid review is an approach to evidence synthesis that provides timely information to decision-makers (eg, health care planners, providers, policymakers, and patients) by simplifying the evidence synthesis process. A rapid review is particularly appealing for urgent decisions.JBI is a world-renowned international collaboration for evidence synthesis and implementation methodologies. The principles for JBI evidence synthesis include comprehensiveness, rigor, transparency, and a focus on applicability to clinical practice. As such, JBI has not yet endorsed a specific approach for rapid reviews.In this paper, we compare rapid reviews versus other types of evidence synthesis, provide a range of rapid evidence products, outline how to appraise the quality of rapid reviews, and present the JBI position on rapid reviews. JBI-affiliated Centers conduct rapid reviews for decision-makers in specific circumstances, such as limited time or funding constraints. A standardized approach is not used for these cases; instead, the evidence synthesis methods are tailored to the needs of the decision-maker.The urgent need to deliver timely evidence to decision-makers poses challenges to JBI's mission to produce high quality, trustworthy evidence. However, JBI recognizes the value of rapid reviews as part of the evidence synthesis ecosystem. As such, it is recommended that rapid reviews be conducted with the same methodological rigor and transparency expected of JBI reviews. Most importantly, transparency is essential, and the rapid review should clearly report where any simplification in the steps of the evidence synthesis process have been taken.
| 80,140 | [
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... | 74 |
Please summerize the given abstract to a title
Comparing Deceased Organ Donation Performance in Two Countries that Use Different Metrics: Comparing Apples With Apples
Organ donation networks audit and report on national or regional organ donation performance, however there are inconsistencies in the metrics and definitions used, rendering comparisons difficult or inappropriate. This is despite multiple attempts exploring the possibility for convergently evolving audits so that collectives of donation networks might transparently share data and practice and then target system interventions. This paper represents a collaboration between the United Kingdom and Australian organ donation organisations which aimed to understand the intricacies of our respective auditing systems, compare the metrics and definitions they employ and ultimately assess their level of comparability. This point of view outlines the historical context underlying the development of the auditing tools, demonstrates their differences to the Critical Pathway proposed as a common tool a decade ago and presents a side-by-side comparison of donation definitions, metrics and data for the 2019 calendar year. There were significant differences in donation definition terminology, metrics and overall structure of the audits. Fitting the audits to a tiered scaffold allowed for reasonable comparisons however this required substantial effort and understanding of nuance. Direct comparison of international and inter-regional donation performance is challenging and would benefit from consistent auditing processes across organisations.
| 80,174 | [
-0.01239013671875,
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0.462158203125,
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0.217041015625,
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0.149169921875,
-0.456298828125,
-0.4... | 74 |
Please summerize the given abstract to a title
Utilization, satisfaction and barriers to access of health services for Arabic-speaking refugees resettled in Connecticut, USA after completion of Refugee Medical Assistance (RMA)
Background: Arabic-speaking refugees are the largest group of resettled persons in the United States since 2008, yet little is known about their rates of healthcare access, utilization and satisfaction. Methods: From January to December 2019, a household survey was conducted of Arabic-speaking refugees resettled in CT. Data collected included demographics, prevalence of chronic conditions, patterns of health seeking behavior, insurance status and patient satisfaction using the Patient Satisfaction Questionnaire (PSQ-18). Results: Sixty-five households responded to the survey representing 295 Arabic-speaking refugees-of which 141 (48%) were children. Forty-seven households (72%) reported members with chronic conditions, 62 persons (21%) needed daily medication, 285 (97%) persons were insured. Respondents reported high median patient satisfaction with wide variation. Conclusion: Arabic-speaking refugees resettled in CT are young but have similar adult rates of chronic medical conditions as the host community. They majority remained insured after RMA lapsed. They expressed median high satisfaction with health services but with wide variation. Inaccessibility of health services in Arabic and difficulty obtaining medications remain areas in need of improvement.
| 80,301 | [
-0.284423828125,
-0.1654052734375,
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0.6064453125,
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-0.6025390625,
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0.515625,
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0.355224609375,
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-0.363037109... | 74 |
Please summerize the given abstract to a title
Reporting stAndards for research in PedIatric Dentistry (RAPID): an expert consensus-based statement
BACKGROUND: Reporting guidelines for different study designs are currently available to report studies with accuracy and transparency. There is a need to develop supplementary guideline items that are specific to areas within Pediatric Dentistry. This study aims to develop Reporting stAndards for research in PedIatric Dentistry (RAPID) guidelines using a pre-defined expert consensus-based Delphi process. METHODS: The development of the RAPID guidelines was based on the Guidance for Developers of Health Research Reporting Guidelines. Following a comprehensive search of the literature, the Executive Group identified ten themes in Pediatric Dentistry and compiled a draft checklist of items under each theme. The themes were categorized as: General, Oral Medicine, Pathology and Radiology, Children with Special Health Care Needs, Sedation and Hospital Dentistry, Behavior Guidance, Dental Caries, Preventive and Restorative Dentistry, Pulp Therapy, Traumatology, and Interceptive Orthodontics. A RAPID Delphi Group (RDG) was formed comprising of 69 members from 15 countries across six continents. Items were scored using a 9-point rating Likert scale. Items achieving a score of seven and above, marked by at least 70% of RDG members were accepted into the RAPID checklist items. Weighted mean scores were calculated for each item. Statistical significance was set at p < 0.05 and one-way ANOVA was used to calculate the difference in the weighted mean scores between the themes. RESULTS: The final RAPID checklist comprised of 128 items that were finalized and approved by the RDG members in the online consensus meeting. The percentage for high scores (scores 7 to 9) ranged from 69.57 to 100% for individual items. The overall weighted mean score of the final items ranged from 7.51 to 8.28 (out of 9) and the difference was statistically significant between the themes (p < 0.05). CONCLUSIONS: The RAPID statement provides guidance to researchers, authors, reviewers and editors, to ensure that all elements relevant to particular studies are adequately reported. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12903-021-01698-7.
| 80,341 | [
-0.470947265625,
0.1409912109375,
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0.7021484375,
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0.0406494140625,
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0.9013671875,
0.06201171875,
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-0.5625,
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0.0875244140625,
-0.449462890625,
-0.85644531... | 74 |
Please summerize the given abstract to a title
Information and Communication Technologies for the Dissemination of Clinical Practice Guidelines to Health Professionals: A Systematic Review.
BACKGROUND The transfer of research knowledge into clinical practice can be a continuous challenge for researchers. Information and communication technologies, such as websites and email, have emerged as popular tools for the dissemination of evidence to health professionals. OBJECTIVE The objective of this systematic review was to identify research on health professionals' perceived usability and practice behavior change of information and communication technologies for the dissemination of clinical practice guidelines. METHODS We used a systematic approach to retrieve and extract data about relevant studies. We identified 2248 citations, of which 21 studies met criteria for inclusion; 20 studies were randomized controlled trials, and 1 was a controlled clinical trial. The following information and communication technologies were evaluated: websites (5 studies), computer software (3 studies), Web-based workshops (2 studies), computerized decision support systems (2 studies), electronic educational game (1 study), email (2 studies), and multifaceted interventions that consisted of at least one information and communication technology component (6 studies). RESULTS Website studies demonstrated significant improvements in perceived usefulness and perceived ease of use, but not for knowledge, reducing barriers, and intention to use clinical practice guidelines. Computer software studies demonstrated significant improvements in perceived usefulness, but not for knowledge and skills. Web-based workshop and email studies demonstrated significant improvements in knowledge, perceived usefulness, and skills. An electronic educational game intervention demonstrated a significant improvement from baseline in knowledge after 12 and 24 weeks. Computerized decision support system studies demonstrated variable findings for improvement in skills. Multifaceted interventions demonstrated significant improvements in beliefs about capabilities, perceived usefulness, and intention to use clinical practice guidelines, but variable findings for improvements in skills. Most multifaceted studies demonstrated significant improvements in knowledge. CONCLUSIONS The findings suggest that health professionals' perceived usability and practice behavior change vary by type of information and communication technology. Heterogeneity and the paucity of properly conducted studies did not allow for a clear comparison between studies and a conclusion on the effectiveness of information and communication technologies as a knowledge translation strategy for the dissemination of clinical practice guidelines.
| 80,479 | [
-0.06121826171875,
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0.09716796875,
-0.6591796875,
-0.8925... | 74 |
Please summerize the given abstract to a title
Critical care nursing role in low and lower middle-income settings: a scoping review.
OBJECTIVES A scoping review was conducted to answer the question: How is critical care nursing (CCN) performed in low-income countries and lower middle-income countries (LICs/LMICs)? DESIGN Scoping review guided by the JBI Manual for Evidence Synthesis. DATA SOURCES Six electronic databases and five web-based resources were systematically searched to identify relevant literature published between 2010 and April 2021. REVIEW METHODS The search results received two-stage screening: (1) title and abstract (2) full-text screening. For sources of evidence to progress, agreement needed to be reached by two reviewers. Data were extracted and cross-checked. Data were analysed, sorted by themes and mapped to region and country. RESULTS Literature was reported across five georegions. Nurses with a range formal and informal training were identified as providing critical care. Availability of staff was frequently reported as a problem. No reports provided a comprehensive description of CCN in LICs/LMICs. However, a variety of nursing practices and non-clinical responsibilities were highlighted. Availability of equipment to fulfil the nursing role was widely discussed. Perceptions of inadequate resourcing were common. Undergraduate and postgraduate-level preparation was poorly described but frequently reported. The delivery of short format critical care courses was more fully described. There were reports of educational evaluation, especially regarding internationally supported initiatives. CONCLUSIONS Despite commonalities, CCN is unique to regional and socioeconomic contexts. Nurses work within a complex team, yet the structure and skill levels of such teams will vary according to patient population, resources and treatments available. Therefore, a universal definition of the CCN role in LIC/LMIC health systems is likely unhelpful. Research to elucidate current assets, capacity and needs of nurses providing critical care in specific LIC/LMIC contexts is needed. Outputs from such research would be invaluable in supporting contextually appropriate capacity development programmes.
| 80,503 | [
0.12420654296875,
-0.396484375,
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0.11383056640625,
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0.02484130859375,
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... | 74 |
Please summerize the given abstract to a title
Readiness of healthcare providers for e-hospitals: a cross-sectional analysis in China before the COVID-19 period
OBJECTIVES: The growth and development of smartphones and eHealth technologies have enabled the potential for extended care hospitals (e-hospitals) in China in order to facilitate the success of a primary healthcare centre (PHC)-based integrated delivery model. Although the adoption of e-hospitals is essential, few studies have directed their research towards understanding the perspectives of healthcare providers. This study aims to identify the current readiness of healthcare providers to adopt e-hospital technologies, determine the factors influencing this adoption and describe the perceived facilitators and barriers in regard to working at e-hospitals. DESIGN: A cross-sectional study conducted in Sichuan, China, between June and September 2019. SETTINGS: Information was collected from healthcare providers who have more than 3 years of work experience from a tertiary hospital, secondary hospital, PHCs and private hospital. PARTICIPANTS: 2298 medical professionals were included in this study. OUTCOME MEASURE: This study included a self-administered questionnaire that was used to assess participants’ sociodemographic characteristics, online medical practices, willingness to use e-hospitals and perceived facilitators/barriers to working at e-hospitals. Multivariate regression analysis was performed in order to evaluate the independent factors associated with e-hospital work. RESULTS: Overall, 86.3% had a positive response towards working at e-hospitals. Age (p<0.05), familiarity with e-hospitals (p<0.001) and prior work practices in online healthcare settings (p<0.001) were associated with participants’ readiness to work at e-hospitals. Gender, education level, professional level, the tier of their affiliated hospital and workload were not statistically associated. Healthcare providers who had positive attitudes towards e-hospitals considered improved efficiency, patient satisfaction, communication among physicians, increased reputation and income, and alleviated workload to be advantages of adoption. The participants who were unwilling to work at e-hospitals perceived lack of time, insufficient authenticity/reliability and underdeveloped policies as potential barriers. CONCLUSION: Improving operative proficiency in electronic devices, accommodating to work schedules, increasing familiarity with e-hospitals and regulating practices will improve the readiness of healthcare providers to work at e-hospitals.
| 80,507 | [
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... | 74 |
Please summerize the given abstract to a title
A Review of Mortality Risk Prediction Models in Smartphone Applications
Healthcare professionals in healthcare systems need access to freely available, real-time, evidence-based mortality risk prediction smartphone applications to facilitate resource allocation. The objective of this study is to evaluate the quality of smartphone mobile health applications that include mortality prediction models, and corresponding information quality. We conducted a systematic review of commercially available smartphone applications in Google Play for Android, and iTunes for iOS smartphone applications. We performed initial screening, data extraction, and rated smartphone application quality using the Mobile Application Rating Scale: user version (uMARS). The information quality of smartphone applications was evaluated using two patient vignettes, representing low and high risk of mortality, based on critical care data from the Medical Information Mart for Intensive Care (MIMIC) III database. Out of 3051 evaluated smartphone applications, 33 met our final inclusion criteria. We identified 21 discrete mortality risk prediction models in smartphone applications. The most common mortality predicting models were Sequential Organ Failure Assessment (SOFA) (n = 15) and Acute Physiology and Clinical Health Assessment II (n = 13). The smartphone applications with the highest quality uMARS scores were Observation—NEWS 2 (4.64) for iOS smartphones, and MDCalc Medical Calculator (4.75) for Android smartphones. All SOFA-based smartphone applications provided consistent information quality with the original SOFA model for both the low and high-risk patient vignettes. We identified freely available, high-quality mortality risk prediction smartphone applications that can be used by healthcare professionals to make evidence-based decisions in critical care environments.
| 80,523 | [
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0.52392578125,
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0.1715087890625,
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1.015625,
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Please summerize the given abstract to a title
Positive deviance in infection prevention and control: A systematic literature review.
BACKGROUND Healthcare-associated infections (HAIs) remain a major challenge. Various strategies have been tried to prevent or control HAIs. Positive deviance, a strategy that has been used in the last decade, is based on the observation that a few at-risk individuals follow uncommon, useful practices and that, consequently, they experience better outcomes than their peers who share similar risks. We performed a systematic literature review to measure the impact of positive deviance in controlling HAIs. METHODS A systematic search strategy was used to search PubMed, CINAHL, Scopus, and Embase through May 2020 for studies evaluating positive deviance as a single intervention or as part of an initiative to prevent or control healthcare-associated infections. The risk of bias was evaluated using the Downs and Black score. RESULTS Of 542 articles potentially eligible for review, 14 articles were included for further analysis. All studies were observational, quasi-experimental (before-and-after intervention) studies. Hand hygiene was the outcome in 8 studies (57%), and an improvement was observed in association with implementation of positive deviance as a single intervention in all of them. Overall HAI rates were measured in 5 studies (36%), and positive deviance was associated with an observed reduction in 4 (80%) of them. Methicillin-resistant Staphylococcus aureus infections were evaluated in 5 studies (36%), and positive deviance containing bundles were successful in all of them. CONCLUSIONS Positive deviance may be an effective strategy to improve hand hygiene and control HAIs. Further studies are needed to confirm this effect.
| 80,524 | [
0.07501220703125,
0.34521484375,
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1.0205078125,
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0.044097900390625,
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-0.647949... | 74 |
Please summerize the given abstract to a title
An Analysis of Demographic Data in Irish Healthcare Domain to Support Semantic Uplift
Healthcare data in Ireland is often fragmented and siloed making it difficult to access and use, and of the data that is digitized, it is rarely standardised from the perspective of data interoperability. The Web of Data (WoD) is an initiative to make data open and interconnected, stored and shared across the World Wide Web. Once a data schema is described using an ontology and published, it resides on the web, and any data described using Linked Data can be associated with this ontology so that the semantics of the data are open and freely available to a global audience. In this article we explore the semantic uplift of demographic data in the Irish context through an analysis of Irish data catalogues, and explore how demographic data is represented in health standards internationally. Through this analysis we identify the Fast Healthcare Interoperability Resources (FHIR) ontology as a basis for managing demographic health care data in Ireland.
| 80,634 | [
-0.281005859375,
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0.38671875,
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0.287109375,
-0.73876953125,
-0.6772460937... | 74 |
Please summerize the given abstract to a title
The Distribution and Composition of Colonoscopy Providers in Australia
Introduction: Colorectal cancer is a common cause of cancer in Australia. Also, patients living in regional and rural areas are diagnosed later and have poorer outcomes compared to their metropolitan counterparts. The purpose of this study is to determine the distribution of the workforce providing colonoscopies for the Australian population. Methods: A cross-sectional observational study of the medical practitioners certified by the conjoint committee for the recognition of training in gastrointestinal endoscopy (CCRTGE) was performed. Data regarding their specialty and principal place of practice was collected. The principal place of practice was stratified with the Modified Monash Model (MMM) of rurality and the local government association’s classifications of rural and urban areas. Results: As of March 2021, there were 2698 medical practitioners listed as being recognised in the field of adult colonoscopies by the CCRTGE. Of these, 2123 were found to still have active specialist registration with the Australian Health Practitioner Regulation Agency (AHPRA). In the capital city Local Government Areas (LGAs), there was an endoscopist every 0.33 km(2) to 62.05 km(2). In the rural LGAs, there was an endoscopist every 23,382 km(2) to 267,780 km(2). In metropolitan areas, the most common specialty of the endoscopist was gastroenterology whereas in regional cities and remote towns it was general surgery. In very remote towns, general practitioners provided colonoscopy services.
| 80,664 | [
-0.0304412841796875,
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-0.... | 74 |
Please summerize the given abstract to a title
Alternative approaches to managing respiratory tract infections: a survey of public perceptions
BACKGROUND: Respiratory tract infections (RTIs) are a common reason for people to consult in primary care, and contribute to antibiotic overuse and antimicrobial resistance (AMR). Alternative approaches to supporting patients with RTIs may help, but it is important to understand public perceptions about these approaches before they are widely implemented. AIM: To describe public perceptions regarding finger-prick testing, back-up antibiotic prescriptions (BUPs), and alternatives to traditional consultations for RTIs, and identify factors associated with favouring these approaches. DESIGN & SETTING: Online national survey (HealthWise Wales) with linked primary care health record data. METHOD: Survey item response distributions were described. Associations between responses about consultation alternatives, BUP, and finger-prick point-of-care testing (POCT), and potential explanatory variables, were explored using logistic regression. RESULTS: A total of 8752 participants completed the survey between 2016 and 2018. The survey found 76.7% (n = 3807/4,966) and 71.2% (n = 3529/4,953) of responders with valid responses were in favour of being able to consult with a pharmacist or nurse in their GP surgery, or with a community pharmacist, respectively. It also showed 92.8% (n = 8034/8659) of responders indicated they would be happy to have a finger-prick test to guide antibiotic prescribing, and 31.8% (n = 2746/8646) indicated they would like to be given a BUP if their clinician thought immediate antibiotics were not required. In addition, 47.4% (n = 2342/4944) and 42.3% (n = 2095/4949) were in favour of having video and email consultations, respectively. Characteristics associated with different response options were identified. CONCLUSION: Consulting with pharmacists, using electronic communication tools, and finger-prick testing are widely acceptable approaches. BUP was described as acceptable less often, and is likely to require greater information and support when used.
| 80,762 | [
0.0540771484375,
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-0.1923828125,
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-0.6572265625,
-0.10064697265625,
0.06353759765625,
0.113525390625,
0.955078125,
0.7041015625,
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0.321044921875,
-0.58203125,
-0.6513671875,
0.11676025390625,
-0.1988525390625,
-0.5517578... | 74 |
Please summerize the given abstract to a title
Women’s perception of continuity of team midwifery care in Iran: a qualitative content analysis
BACKGROUND: Understanding the pregnant women’s perception of continuity of team midwifery care is necessary for introducing and implementing this model of midwife-led care in the Iranian maternity services. This qualitative study aims to explore women’s perception of continuity of team midwifery care in Iran. METHODS: This research is a qualitative study conducted in Iran to explore women’s perception of continuity of team midwifery care during pregnancy, birth and postpartum from October 2019 to August 2020. Fifteen semi-structured interviews were conducted with women individually in private midwifery clinic through a purposive sampling method. Interviews were digitally recorded and transcribed verbatim in Persian and analyzed using conventional content analysis. RESULTS: From the data analysis, two themes, four main categories, and nine subcategories emerged. The themes were “Maternal empowerment” and “Mother’s satisfaction during the transition from pregnancy to motherhood”. The first theme included two categories of improving self-efficacy during antenatal education classes and the effective midwife-mother interaction. The second theme composed of two categories of satisfaction with the process of pregnancy, childbirth and postpartum as well as satisfaction with motherhood. CONCLUSION: Findings of this qualitative study highlight the effectiveness of continuity of team midwifery model of care for promoting empowerment and satisfaction in women during pregnancy, birth and postpartum. The results of this study could pave the way for developing, introducing and implementing the midwife-led continuity models of care in Iran. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-021-03666-z.
| 80,774 | [
-0.059051513671875,
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0.27783203125,
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0.222412109375,
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-0.6... | 74 |
Please summerize the given abstract to a title
Optimising outcomes for complex trauma survivors: assessing the motivators, barriers and enablers for implementing trauma informed practice within a multidisciplinary health setting
BACKGROUND: Complex trauma is a significant public health issue with detrimental health, interpersonal and psychological impacts, which can impede client recovery and result in multiple representations. ‘Trauma Informed Practice’ (TIP) is an evidence-based model which ensures safe and effective services for clients and staff. This study examines health professional’s use of TIP, and the motivators, enablers and barriers to implementation in a multidisciplinary setting. METHODS: A mixed methods study with 24 front-line clinicians and managers within a community health setting in Australia. A purpose designed, expert validated TIP checklist was completed, followed by semi-structured focus groups. Survey data was reported using descriptive statistics. Focus group data was digitally recorded, transcribed and thematically analysed. RESULTS: Ten key factors were identified motivating, restricting or enabling TIP implementation. Seven were organisational factors including supportive and informed management, flexibility of service models, levels of service demands, resource availability, education opportunities, good client outcomes, and reporting requirements. Philosophical approach, team orientation, and vicarious trauma/stress management were three individual professional factors. Critically, alignment in two ways was necessary for successful implementation, that is: in knowledge and understanding across organisational role levels - clinician, manager and executive; and, in professional philosophy and team orientation of individual clinicians. CONCLUSION: Providing TIP is essential for ensuring optimum client outcomes for trauma survivors and for maintaining workforce wellbeing. Although the increasing uptake to TIP is evident within the health setting, further attention is required to address the tension between service models focused on efficiently servicing whole populations and those attuned to effectively meeting the needs of high risk groups. A complex strategy to unite therapeutic and managerial goals is necessary if client, professional and organisational needs are to be effectively met.
| 80,829 | [
0.05731201171875,
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-0.596... | 74 |
Please summerize the given abstract to a title
Designing Online Grocery Stores to Support Healthy Eating for Weight Loss.
OBJECTIVES This study aimed to identify features to include in online grocery stores to support healthful food purchasing by those striving to lose weight. DESIGN A Value Proposition Design Approach was used to gain shopper insights, devise potential online grocery store features, and obtain feedback on these features. SETTING Telephone interviews were conducted to gain insight into shoppers' needs and perceptions. Results were used by the research team to identify potential online grocery shopping features that may support healthful purchase decisions, and interviews were conducted with a different sample of shoppers to gather feedback on features. PARTICIPANTS Insight (n=25) and feedback (n=25) interviews were conducted with convenience samples of adults trying to lose weight. RESULTS Participants were primarily female, white, college educated, and with obesity or overweight. Online grocery features devised by the research team based on findings from the insight interviews included a: 1) shopping cart nutrition rating tool; 2) healthy meal planning tool; 3) interactive healthy eating inspiration aisle; and 4) healthy shopping preference settings option. Findings from the feedback interviews indicated that the healthy meal planning tool, healthy shopping preference settings option and shopping cart nutrition rating tool features were positively rated by most participants. CONCLUSIONS There are multiple features grocers should consider including in their online stores to attract and support customers striving to eat healthy for weight loss.
| 80,981 | [
-0.1431884765625,
0.0592041015625,
-0.29296875,
0.437744140625,
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-0.21875,
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0.060516357421875,
0.29296875,
-0.31787109375,
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-0.146... | 74 |
Please summerize the given abstract to a title
Ten years of implementation outcome research: a scoping review protocol.
INTRODUCTION A 2011 paper proposed a working taxonomy of implementation outcomes, their conceptual distinctions and a two-pronged research agenda on their role in implementation success. Since then, over 1100 papers citing the manuscript have been published. Our goal is to compare the field's progress to the originally proposed research agenda, and outline recommendations for the next 10 years. To accomplish this, we are conducting the proposed scoping review. METHODS AND ANALYSIS Our approach is informed by Arksey and O'Malley's methodological framework for conducting scoping reviews. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We first aim to assess the degree to which each implementation outcome has been investigated in the literature, including healthcare settings, clinical populations and innovations represented. We next aim to describe the relationship between implementation strategies and outcomes. Our last aim is to identify studies that empirically assess relationships among implementation and/or service and client outcomes. We will use a forward citation tracing approach to identify all literature that cited the 2011 paper in the Web of Science (WOS) and will supplement this with citation alerts sent to the second author for a 6-month period coinciding with the WOS citation search. Our review will focus on empirical studies that are designed to assess at least one of the identified implementation outcomes in the 2011 taxonomy and are published in peer-reviewed journals. We will generate descriptive statistics from extracted data and organise results by these research aims. ETHICS AND DISSEMINATION No human research participants will be involved in this review. We plan to share findings through a variety of means including peer-reviewed journal publications, national conference presentations, invited workshops and webinars, email listservs affiliated with our institutions and professional associations, and academic social media.
| 81,049 | [
-0.2320556640625,
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-0.9755859375,
0.390869140625,
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0.004795074462890625,
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0.283203125,
-0.71826171875,
... | 74 |
Please summerize the given abstract to a title
Social Resources for Transplanted Children and Families in European Union Hospitals of ERN TransplantChild
Social well-being is an intrinsic part of the current concept of health. In the context of chronic disease, there are many challenges we face in order to provide social well-being to patients and their families, even more if we talk about rare diseases. TransplantChild, a European Reference Network (ERN) in paediatric transplantation, works to improve the quality of life of transplanted children. It is not possible to improve the quality of life if the human and material resources are not available. With this study, we want to identify the economic aids, facilities, services, and financed products that are offered to families in different European centres. We also want to find out who provides these resources and the accessibility to them. We designed an ad hoc survey using the EU Survey software tool. The survey was sent to representatives of the 26 ERN members. In this article we present the results obtained in relation to two of the aspects analysed: long-term financial assistance and drugs, pharmaceuticals and medical devices. Some resources are equally available in all participating centres but there are significant differences in others, such as education aids or parapharmacy product financing. A local analysis of these differences is necessary to find feasible solutions for equal opportunities for all transplanted children in Europe. The experience of centres that already provide certain solutions successfully may facilitate the implementation of these solutions in other hospitals.
| 81,102 | [
0.036285400390625,
0.0516357421875,
-0.486083984375,
0.7783203125,
-0.488525390625,
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0.35009765625,
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0.490234375,
-0.401611328125,
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0.1824951171875,
-0.468994140625,
... | 74 |
Please summerize the given abstract to a title
Smart About Meds (SAM): a pilot randomized controlled trial of a mobile application to improve medication adherence following hospital discharge
OBJECTIVE: The objectives of this pilot study were (1) to assess the feasibility of a larger evaluation of Smart About Meds (SAM), a patient-centered medication management mobile application, and (2) to evaluate SAM’s potential to improve outcomes of interest, including adherence to medication changes made at hospital discharge and the occurrence of adverse events. MATERIALS AND METHODS: We conducted a pilot randomized controlled trial among patients discharged from internal medicine units of an academic health center between June 2019 and March 2020. Block randomization was used to randomize patients to intervention (received access to SAM at discharge) or control (received usual care). Patients were followed for 30 days post-discharge, during which app use was recorded. Pharmacy claims data were used to measure adherence to medication changes made at discharge, and physician billing data were used to identify emergency department visits and hospital readmissions during follow-up. RESULTS: Forty-nine patients were eligible for inclusion in the study at hospital discharge (23 intervention, 26 control). In the 30 days of post-discharge, 15 (65.2%) intervention patients used the SAM app. During this period, intervention patients adhered to a larger proportion of medication changes (83.7%) than control patients (77.8%), including newly prescribed medications (72.7% vs 61.7%) and dose changes (90.9% vs 81.8%). A smaller proportion of intervention patients (8.7%) were readmitted to hospital during follow-up than control patients (15.4%). CONCLUSION: The high uptake of SAM among intervention patients supports the feasibility of a larger trial. Results also suggest that SAM has the potential to enhance adherence to medication changes and reduce the risk of downstream adverse events. This hypothesis needs to be tested in a larger trial. TRIAL REGISTRATION: Clinicaltrials.gov, registration number NCT04676165.
| 81,117 | [
0.0653076171875,
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0.7080078125,
-0.3701171875,
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0.564453125,
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-0.2744140625,
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0.329345703125,
-0.455322265625,
-0.69140625,
0... | 74 |
Please summerize the given abstract to a title
First Year of Skilled Nursing Facility Value-based Purchasing Program Penalizes Facilities With Poorer Financial Performance
BACKGROUND: The Skilled Nursing Facility Value-based Purchasing Program (SNF-VBP) incentivizes facilities to coordinate care, improve quality, and lower hospital readmissions. However, SNF-VBP may unintentionally punish facilities with lower profit margins struggling to invest resources to lower readmissions. OBJECTIVE: The objective of this study was to estimate the SNF-VBP penalty amounts by skilled nursing facility (SNF) profit margin quintiles and examine whether facilities with lower profit margins are more likely to be penalized by SNF-VBP. RESEARCH DESIGN: We combined the first round of SNF-VBP performance data with SNF profit margins and characteristics data. Our outcome variables included estimated penalty amount and a binary measure for whether facilities were penalized by the SNF-VBP. We categorized SNFs into 5 profit margin quintiles and examined the relationship between profit margins and SNF-VBP performance using descriptive and regression analysis. RESULTS: The average profit margins for SNFs in the lowest profit margin quintile was -14.4% compared with the average profit margin of 11.1% for SNFs in the highest profit margin quintile. In adjusted regressions, SNFs in the lowest profit margin quintile had 17% higher odds of being penalized under SNF-VBP compared with facilities in the highest profit margin quintile. The average penalty for SNFs in the lowest profit margin quintile was $22,312. CONCLUSIONS: SNFs in the lowest profit margins are more likely to be penalized by the SNF-VBP, and these losses can exacerbate quality problems in SNFs with lower quality. Alternative approaches to measuring and rewarding SNFs under SNF-VBP or programs to assist struggling SNFs is warranted, particularly considering the coronavirus disease 2019 pandemic, which requires resources for prevention and management.
| 81,200 | [
-0.08636474609375,
0.2059326171875,
-0.73486328125,
0.7958984375,
-0.421142578125,
-0.47802734375,
-0.15966796875,
0.2491455078125,
-0.46826171875,
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0.1246337890625,
-0.451904296875,
... | 74 |
Please summerize the given abstract to a title
Pulmonary rehabilitation and digital applications: Patient engagement, experience and feedback
Keywords: Digital, Engagement, Pulmonary Rehabilitation Purpose: In response to the COVID-19 pandemic, the service delivery of Pulmonary Rehabilitation (PR) expanded to provide patients with the option of online digital applications for education. At Liverpool Heart and Chest Hospital, those with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD) were offered the MyCOPD app as a digital self-management tool. Initially, only 43% of patients had completed the app, therefore the Breathe Programme conducted a short survey, between September 2020 and January 2021, to gain patient feedback regarding their experiences of the app. Thus, the objective of this study was to utilise patient feedback to explore ways that digital engagement could be optimised within PR. Methods: A convenience sampling method was used to identify 227 patients with COPD who were eligible for the MyCOPD app. Eligibility was further determined by whether they had internet access via a digital device and an appropriate skill set, which was reported by the patient during triage. All patients were encouraged to visit the MyCOPD website for further information before accepting. Those who declined were offered a traditional PR programme. Each patients’ level of engagement was monitored weekly via the app's online dashboard. Weekly text messages and app notifications were sent to each patient during their time on the programme to encourage engagement. Those who accepted and completed the programme (26) completed a feedback questionnaire upon discharge. Feedback was both qualitative and quantitative. Results: 57 patients (25%) accepted the MyCOPD app whilst 170 (75%) of patients originally opted for traditional PR. The most significant reasons for declining were found to be lack of internet access and lack of skill set. 31 patients dropped out;11 were discharged due to lack of engagement and the remaining 20 patients later opted for traditional PR due to lack of digital skills. They reported finding paper educational packs easier for education. The majority of patients accessed the app via their smartphone. 92% of patients reported the app was either “Very Valuable” or “Valuable” in improving their confidence to self-manage their condition. Weekly text messages helped to improve compliance. Conclusion(s): Digital apps within PR can be useful in promoting patient self-management. However, the three issues that must be addressed and require further research are lack of internet access, poor patient digital perceptions and skill level. Reasons for this could be due to socio-economic factors, suggesting that social inequalities would need to be addressed to improve digital uptake. Some patients may require training to improve technological literacy, and overall skill set. The drop-out rate indicates that some patients had poor insight into their initial level of digital competency. Overall, a combination of traditional and digital options should be made available within the PR model to prevent exclusion, promote access to all and provide patient choice, which is paramount within healthcare. Impact: Patients within a PR cohort require more support and training in how to access and use digital technologies. Further research is required into patient digital accessibility, expectations and preferences to provide holistic and inclusive care. Funding acknowledgements: N/A
| 81,216 | [
0.314208984375,
-0.2861328125,
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0.6962890625,
-0.343505859375,
-0.190673828125,
-0.050689697265625,
0.1988525390625,
0.68359375,
0.6494140625,
0.199951171875,
0.09149169921875,
0.8154296875,
-0.4140625,
-0.321533203125,
0.205078125,
-0.31982421875,
-0.382080078125,
-0.3... | 74 |
Please summerize the given abstract to a title
Delivery of care for migraine in the Asian Oceanian region: A cross-sectional study.
OBJECTIVE To determine the current availability of care for headaches, in particular migraine in the Asian Oceanian region. METHOD A questionnaire-based, cross-sectional study from August 2020 to February 2021, surveyed country representatives from the member countries of the Asian Oceanian Association of Neurology. The items of the survey were influenced by the findings and recommendations of the 2011 Atlas of Headache by Lifting the Burden and the World Health Organization. RESULTS Respondents from all of the 21 member countries of the Asian Oceanian Association of Neurology and 3 other Asian countries participated in this survey. All countries have an established neurological association except for Brunei where there are only 6 neurologists. Thirteen countries (54%) have a dedicated council for headaches. The majority have no subspecialty training program for headaches (75%). Prevalence studies are available in 14 countries while 10 out of the 24 have clinical practice guidelines. Among the 6 countries who offer subspecialty training for headache, only 3 countries cater foreign neurologists. Most of the countries have a wide selection of non-specific migraine drugs. All countries except for Mongolia have at least 1 triptan but non-oral forms for triptans are only available in 8 countries. Monoclonal antibody for migraine prophylaxis is available in 12 out of 24 countries (50%). The majority of respondents agree that migraine is under-diagnosed and under-treated by non-neurologists and that more time should be allotted for lectures dedicated to primary headaches in medical schools. CONCLUSION The survey showed the scarcity of clinical guidelines, subspecialty training, dedicated headache clinics, and patient advocacy organization for the care of headache patients in the participating countries. Acute and prophylactic medications approved for migraine are available in most countries but approved non-pharmacologic devices are lacking. The recommendations in the 2011 Atlas of Headache Disorders are still to be achieved.
| 81,223 | [
-0.07342529296875,
0.3125,
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0.216552734375,
-1.03515625,
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0.427978515625,
0.31884765625,
0.257568359375,
0.4384765625,
0.64501953125,
-0.568359375,
0.006259918212890625,
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-0.5048828125,
0.1864013671875,
-0.6044921875,
-0.8349609375,
-0.0132751464... | 74 |
Please summerize the given abstract to a title
Policy and vision for community pharmacies in Finland: A roadmap towards enhanced integration and reduced costs
Finland’s community pharmacy system provides an example of a privately-owned regulated system being proactively developed by the profession and its stakeholders. Community pharmacists have a legal duty to promote safe and rational medicine use in outpatient care. The development of professionally oriented practice has been nationally coordinated since the 1990s with the support of a national steering group consisting of professional bodies, authorities, pharmacy schools and continuing education centers. The primary focus has been in patient counseling services and public health programs. The services have extended towards prospective medication risk management applying evidence-based tools, databases and digitalization. Research has been essential in informing progress by indicating high-risk patients, medications, practices and processes needing improvement. Despite the commitment of the profession and pharmacy owners, large-scale implementation of services has been challenging because of lack of remuneration, the pharmacy income still consisting primarily of sale of prescription and nonprescription medicines. Policy documents by the Ministry of Social Affairs and Health have supported the extension of the community pharmacists’ role beyond traditional dispensing to promote rational pharmacotherapy. The current roadmap by the Ministry of Social Affairs and Health emphasizes ensuring adequate regional availability and accessibility of medicines, regardless of the future pharmacy system. It also emphasizes the importance of strong regulation on pharmacy business operations and sale of medicines to ensure medication safety. At the same time, the roadmap requires that the regulation must enable implementation of new patient-oriented services and procedures, and further promote digitalization in service provision. Competition and balance of funding should be enhanced, e.g., through price competition, but the risk of pharmaceutical market concentration should be managed. The regulation should also consider influence of the new social and health care system on drug delivery. Year 2021 will be crucial for making long-term political decisions on the future direction of tasks and finances of Finnish community pharmacies in this framework. Government-funded studies are underway to guide decision making. Ongoing Covid-19 crisis has demonstrated the readiness of Finnish community pharmacies to adapt fast to meet the changing societal needs.
| 81,238 | [
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0.54443359375,
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-0.1907958984375,
0.7109375,
-0.677734375,
-0.464111328125,
0.00956... | 74 |
Please summerize the given abstract to a title
The Porto European Cancer Research Summit 2021
Key stakeholders from the cancer research continuum met in May 2021 at the European Cancer Research Summit in Porto to discuss priorities and specific action points required for the successful implementation of the European Cancer Mission and Europe's Beating Cancer Plan (EBCP). Speakers presented a unified view about the need to establish high‐quality, networked infrastructures to decrease cancer incidence, increase the cure rate, improve patient's survival and quality of life, and deal with research and care inequalities across the European Union (EU). These infrastructures, featuring Comprehensive Cancer Centres (CCCs) as key components, will integrate care, prevention and research across the entire cancer continuum to support the development of personalized/precision cancer medicine in Europe. The three pillars of the recommended European infrastructures – namely translational research, clinical/prevention trials and outcomes research – were pondered at length. Speakers addressing the future needs of translational research focused on the prospects of multiomics assisted preclinical research, progress in Molecular and Digital Pathology, immunotherapy, liquid biopsy and science data. The clinical/prevention trial session presented the requirements for next‐generation, multicentric trials entailing unified strategies for patient stratification, imaging, and biospecimen acquisition and storage. The third session highlighted the need for establishing outcomes research infrastructures to cover primary prevention, early detection, clinical effectiveness of innovations, health‐related quality‐of‐life assessment, survivorship research and health economics. An important outcome of the Summit was the presentation of the Porto Declaration, which called for a collective and committed action throughout Europe to develop the cancer research infrastructures indispensable for fostering innovation and decreasing inequalities within and between member states. Moreover, the Summit guidelines will assist decision making in the context of a unique EU‐wide cancer initiative that, if expertly implemented, will decrease the cancer death toll and improve the quality of life of those confronted with cancer, and this is carried out at an affordable cost.
| 81,245 | [
0.061614990234375,
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0.327392578125,
-0.408447265625,
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0.1981201171875,
0.662109375,
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0.703125,
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0.21826171875,
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... | 74 |
Please summerize the given abstract to a title
To resuscitate or not to resuscitate;a question for old age psychiatrists
Aims The inpatient population of an older adult psychiatric ward will include people with physical and mental health conditions which affect life span and quality of life. Patients may be frail, acutely unwell, or have terminal illnesses such as dementia. It is therefore essential that clinicians review resuscitation status as part of their routine practice. However, we are aware that advanced decision-making – to resuscitate or not to resuscitate – is not routine practice across older adult psychiatric wards in the UK. Our 2017 audit reflected this, demonstrating a very low rate of resuscitation decisions at NELFT. This re-audit aimed to measure the frequency and quality of resuscitation decisions on an older adult psychiatric ward. We expected improvements in these areas, subsequent to changes implemented from the initial audit. We also sought to identify which patient factors influenced clinicians’ decision-making on resuscitation. Please note, this audit was completed prior to the COVID-19 pandemic. Method In June 2017, an audit of 25 patients admitted to two older adult psychiatric acute wards was completed. In December 2019, a retrospective analysis of the last 25 admissions to one older adult ward was undertaken. Electronic patient notes and DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) orders were examined. The audit measured frequency of resuscitation decisions and quality of documentation against current standards. DNACPR orders were analysed and clinicians were interviewed to identify the reasons for such decisions. Result There was an increase in the number of patients for which resuscitation decisions were made, from 4% in 2017 to 40% (n = 10) in 2019. The majority of patients with a DNACPR decision (n = 8) had a diagnosis of dementia. Prospective quality of life, with this diagnosis, was the most frequent determinant of DNACPR decisions (n = 7). Qualitative analysis indicated that clinicians were more likely to consider a resuscitation decision for patients with an organic disorder rather than functional disorder. Adequate completion of DNACPR orders was seen in each case. Either the patient, a family member or carer was involved in every decision. The standard for recording decisions on the electronic patient record was not met. Conclusion It is good practice to consider resuscitation decisions for patients admitted to older adult psychiatric wards. This re-audit found an improvement in frequency of resuscitation decisions and also revealed differences in decision-making for patients with organic and functional disorders. Implementation of further change is indicated;decision-making can be improved through reflection, teaching, changes to practice, and technologies.
| 81,328 | [
0.1204833984375,
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0.74365234375,
-0.59228515625,
-0.93017578125,
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0.3603515625,
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0.33642578125,
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0.1839599609375,
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0.435302734375,
-0.395751953125,
-0.4792... | 74 |
Please summerize the given abstract to a title
Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context
Since the Alma Ata Declaration of 1978, countries have varied in their progress towards establishing and sustaining comprehensive primary health care (PHC) and realizing its associated vision of ‘Health for All’. International health emergencies such as the coronavirus-19 (COVID-19) pandemic underscore the importance of PHC in underpinning health equity, including via access to routine essential services and emergency responsiveness. This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework. A scoping review design was adopted to summarize evidence from a diverse body of literature with a modification to accommodate four discrete phases of searching, screening and eligibility assessment: a database search in PubMed for PHC-related literature reviews and multi-country analyses (Phase 1); a website search for key global PHC synthesis reports (Phase 2); targeted searches for peer-reviewed literature relating to specific components of PHC (Phase 3) and searches for emerging insights relating to PHC in the COVID-19 context (Phase 4). Evidence from 96 included papers were analysed across deductive themes corresponding to the three main components of PHC. Findings affirm that investments in PHC improve equity and access, healthcare performance, accountability of health systems and health outcomes. Key enablers of PHC implementation include equity-informed financing models, health system and governance frameworks that differentiate multi-sectoral PHC from more discrete service-focussed primary care, and governance mechanisms that strengthen linkages between policymakers, civil society, non-governmental organizations, community-based organizations and private sector entities. Although knowledge about, and experience in, PHC implementation continues to grow, critical knowledge gaps are evident, particularly relating to country-level, context-specific governance, financing, workforce, accountability and service coordination mechanisms. An agenda to guide future country-specific PHC research is outlined.
| 81,362 | [
-0.048919677734375,
-0.359130859375,
-0.65185546875,
0.456787109375,
-0.409423828125,
-0.260986328125,
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0.24609375,
0.13427734375,
0.48046875,
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-0.51611328125,
-0.347412109375,
0.50048828125,
-0.66552734375,
-0.510742187... | 74 |
Please summerize the given abstract to a title
"I just didn't want to trust it at all": Atrial fibrillation patient's treatment experience of rivaroxaban and warfarin.
BACKGROUND In the treatment of atrial fibrillation (AF), anticoagulant medications such as warfarin and rivaroxaban are commonly prescribed to reduce the risk of ischaemic strokes, and other thromboembolic events. Research has highlighted advantages and disadvantages of each of these medications, but there remains an absence of qualitative evidence regarding the lived experiences of AF patients. The present study helps address this gap and obtain a greater understanding of the patient experience and beliefs surrounding their anticoagulant medication. METHOD Semi-structured qualitative interviews with a purposive sample of 20 participants (10 warfarin, 10 rivaroxaban). Interviews were transcribed verbatim and thematically analysed. RESULTS Data analysis led to the generation of three key themes: positive perceptions of medication, distrust of alternatives, and inconsistencies in support experiences. CONCLUSIONS Positive perceptions of one anticoagulant medication (ACM) and distrust of alternatives may influence patients' confidence in switching medications. This is potentially problematic where there is a lack of patient engagement in medication changes, as seen during the COVID pandemic. Gaps in patient understanding of anticoagulation, including lack of clarity around medications selection and misconceptions about treatment, were evident. By addressing these misconceptions, clinicians may be better positioned to support people with AF in self-management of their ACM.
| 81,391 | [
0.37158203125,
-0.322998046875,
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0.471435546875,
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0.471923828125,
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0.67578125,
-0.677734375,
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... | 74 |
Please summerize the given abstract to a title
Dementia-related continuing education for rural interprofessional primary health care in Saskatchewan, Canada: perceptions and needs of webinar participants.
Dementia-related continuing education opportunities are important for rural primary health care (PHC) professionals given scarce specialized resources. This report explores the initial perceptions and continuing education needs of rural interprofessional memory clinic team members and other PHC professionals related to a short series of dementia-related education webinars. Three webinars on separate topics were delivered over an 8-month period in 2020 in Saskatchewan, Canada. The research design involved analysis of webinar comments and post-webinar survey data. Sixty-eight individuals participated in at least one webinar, and 46 surveys were completed. Rural memory clinic team members accounted for a minority of webinar participants and a majority of survey respondents. Initial perceptions were positive, with webinar topics and interactivity identified as the most effective aspects. Continuing education needs were mainly aligned with professional roles; however, some overlap of interests occurred. Future webinars will further explore learning needs within an interprofessional environment.
| 81,524 | [
0.1708984375,
-0.27099609375,
-0.88330078125,
0.71728515625,
-0.62060546875,
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0.210693359375,
0.399169921875,
0.082275390625,
1.0068359375,
0.68798828125,
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0.494384765625,
-0.51904296875,
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0.277587890625,
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... | 74 |
Please summerize the given abstract to a title
Education Priorities and What Matters to Those Considering Living Kidney Donation.
INTRODUCTION Although informed consent content elements are prescribed in detailed regulatory guidance, many live kidney donors describe feeling underprepared and under informed. The goal of this pilot study was to explore the educational components needed to support an informed decision-making process for living kidney donors. METHODS/APPROACH A qualitative description design was conducted with thematic analysis of 5 focus groups with 2 cohorts: living kidney donor candidates (n = 11) and living kidney donors (n = 8). FINDINGS The educational components needed to engage in an informed decision-making process were: 1) contingent upon, and motivated by, personal circumstances; 2) supported through explanation of risks and benefits; 3) enhanced by understanding the overall donation experience; and 4) personalized by talking to another donor. DISCUSSION Tailoring education to meet the needs for fully informed decision-making is essential. Current education requirements, as defined by regulatory bodies, remain challenging to transplant teams attempting to ensure fully informed consent of living kidney donor candidates. Information on the emotional, financial, and overall life impact is needed, along with acknowledgement of relational ties driving donor motivations and the hoped-for recipient outcomes. Discussion of care practices, and access to peer mentoring may further strengthen the informed decision-making process.
| 81,582 | [
0.203125,
0.2486572265625,
-0.78857421875,
0.6455078125,
-0.72705078125,
-0.492431640625,
0.00787353515625,
0.1961669921875,
0.302001953125,
0.3701171875,
0.359619140625,
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0.355224609375,
-0.132080078125,
-0.5419921875,
-0.1163330078125,
-0.3291015625,
-0.41235351562... | 74 |
Please summerize the given abstract to a title
Supporting Management of Noncommunicable Diseases With Mobile Health (mHealth) Apps: Experimental Study
BACKGROUND: Noncommunicable diseases (NCDs) are the leading global health problem in this century and are the principal causes of death and health care spending worldwide. Mobile health (mHealth) apps can help manage and prevent NCDs if people are willing to use them as supportive tools. Still, many people are reluctant to adopt these technologies. Implementing new apps could result in earlier intervention for many health conditions, preventing more serious complications. OBJECTIVE: This research project aimed to test the factors that facilitate the adoption of mHealth apps by users with NCDs. We focused on determining, first, what user interface (UI) qualities and complexity levels appeal to users in evaluating mHealth apps. We also wanted to determine whether people prefer that the data collected by an mHealth app be analyzed using a physician or an artificial intelligence (AI) algorithm. The contribution of this work is both theoretical and practical. We examined users’ considerations when adopting mHealth apps that promote healthy lifestyles and helped them manage their NCDs. Our results can also help direct mHealth app UI designers to focus on the most appealing aspects of our findings. METHODS: A total of 347 respondents volunteered to rate 3 models of mHealth apps based on 16 items that measured instrumentality, aesthetics, and symbolism. Respondents rated each model after reading 1 of 2 different scenarios. In one scenario, a physician analyzed the data, whereas, in the other, the data were analyzed by an AI algorithm. These scenarios tested the degree of trust people placed in AI algorithms versus the “human touch” of a human physician regarding analyzing data collected by an mHealth app. RESULTS: As shown by the responses, the involvement of a human physician in the application had a significant effect (P<.001) on the perceived instrumentality of the simple model. The complex model with more controls was rated significantly more aesthetic when associated with a physician performing data analysis rather than an AI algorithm (P=.03). CONCLUSIONS: Generally, when participants found a human touch in the mHealth app (connection to a human physician who they assumed would analyze their data), they judged the app more favorably. Simple models were evaluated more positively than complex ones, and aesthetics and symbolism were salient predictors of preference. These trends suggest that designers and developers of mHealth apps should keep the designs simple and pay special attention to aesthetics and symbolic value.
| 81,592 | [
-0.1312255859375,
-0.0762939453125,
-0.3515625,
0.212890625,
-0.27294921875,
-0.5546875,
0.2403564453125,
0.4638671875,
0.2222900390625,
1.0732421875,
0.0611572265625,
0.1695556640625,
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-0.26611328125,
0.263427734375,
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0... | 74 |
Please summerize the given abstract to a title
Perceptions of infection control practices among health professionals.
Infection control practice is a cornerstone of modern health care. However, there is minimal research into health professionals' perception of infection control practices and how those perceptions influence staff compliance with recommended protocols. The objective of this study was to explore health care professionals' perceptions of infection control practices in relation to the management of infectious diseases. A grounded theory approach was used as the research framework. Semi-structured interviews were completed with a sample of 16 nurses and doctors working at hospitals in Western Australia. Four major categories emerged from the data. These were: knowledge, culture, conflict, and risk assessment. The findings indicate the importance of both individual and organisational factors in determining clinicians' levels of compliance with recommended infection control practices. Identification of the factors that influence health professionals' level of compliance can be used to develop strategies to support long-term compliance with infection control practices.
| 81,613 | [
-0.039459228515625,
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-0.58056640625,
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0.07049560546875,
0.35498046875,
0.0491943359375,
0.9365234375,
0.5595703125,
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0.4169921875,
-0.286865234375,
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0.017120361328125,
-0.119384765625... | 74 |
Please summerize the given abstract to a title
Systematic Analysis of Literature on the Marketing of Healthcare Systems. Challenges for Russian and Romanian Healthcare Systems
This paper aims at finding the most dominant ideas about the marketing of healthcare systems highlighted in the mainstream literature, with a focus on Russia and Romania. To reach this goal, a systematic analysis of literature was conducted and various competitive advantages and disadvantages of the medical models that require special attention from the governments are considered. In this respect we examined 106 papers published during 2006 to 2020 found on four scientific databases. They were selected using inclusion and exclusion criteria according to PRISMA methodology. The main findings of the research consist of the opportunity to use marketing tools in order to improve the quality of healthcare systems in the named countries. Thus, using market orientation, the managers of healthcare systems could stimulate the innovation, the efficiency of funds allocation and the quality of medical services. The results will lead to a better quality of population life and to an increasing of life expectancy. As this paper reviews some articles from Russian literature, it can add a new perspective to the topic. These outcomes have implications for government, business environment, and academia, which should cooperate in order to develop the healthcare system using marketing strategies.
| 81,620 | [
-0.08660888671875,
-0.1890869140625,
-0.44873046875,
0.42333984375,
-0.71435546875,
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0.1270751953125,
0.00534820556640625,
1.130859375,
0.60986328125,
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0.14111328125,
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0.0875244140625,
-0.63232421875... | 74 |
Please summerize the given abstract to a title
Rapid implementation of a modular clinical trial informatics solution for COVID-19 research
Veterans Health Administration (VHA) services are most frequently used by patients 65 years and older, an age group that is disproportionally affected by COVID-19. Here we describe a modular Clinical Trial Informatics Solution (CTIS) that was rapidly developed and deployed to support a multi-hospital embedded pragmatic clinical trial in COVID-19 patients within the VHA. Our CTIS includes tools for patient eligibility screening, informed consent tracking, treatment randomization, EHR data transformation for reporting and interfaces for patient outcome and adverse event tracking. We hope our CTIS component descriptions and practical lessons learned will serve as a useful building block for others creating their own clinical trial tools and have made application and database code publicly available.
| 81,698 | [
0.1673583984375,
-0.2149658203125,
-0.65380859375,
0.7607421875,
-0.493408203125,
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0.1507568359375,
0.1424560546875,
0.61474609375,
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0.0743408203125,
0.1578369140625,
-0.57568359375,
-0.049407958984375,
0.302734375,
-0.6640625,
-0.654785... | 74 |
Please summerize the given abstract to a title
Experience and satisfaction of outpatients in the development of a programme for home medication delivery
Background and importance Faced with the lockdown caused by COVID-19 since March 2020, we have been reorganising the external patients department to get medicines to our patients To avoid the displacement of patients to the hospital during the state of alarm, we developed a drug delivery system Aim and objectives To analyse the opinion of patients about the new home delivery programme of their medication during the COVID-19 pandemic Material and methods Retrospective surveys were conducted with our patients between April and July (they had received their medication between 15 March and 30 June) with the following questions: sex and age, distance from their home to our hospital, employment situation, score for status of the medication at the time of delivery, punctuality of delivery, willingness to pay for transportation for new shipments and general satisfaction Results 1123 medication deliveries to 751 patients took place, of which 123 surveys were conducted with our patients (63% men, with the following age ranges: 18-40 years (23 6%), 41-64 years (49 6%) and >65 years (20 8%) Most patients (69 1%) lived between 10 and 50 km away from our hospital A high percentage of patients did not have a job: students, pensioners or unemployed (49 6%) Our patients scored an average of 9 87 out of 10 for the status of the medication (correct temperature, correct expiration date and correct packaging) given to them Regarding punctuality, the patients scored an average of 9 86 out of 10 for punctuality of delivery We also asked our patients if they would be willing to pay the transportation costs for shipping their medication The result was that 74% of patients strongly or fairly agreed to cover these costs Finally, regarding the general satisfaction of our patients in this new system, the result was that 91% were totally satisfied and 9% were quite satisfied No survey was returned with the result quite dissatisfied or not at all satisfied Conclusion and relevance Based on the results, our new outpatient drug delivery programme obtained very good scores in these surveys and it could be an alternative for patients with mobility problems who live far away Also, many patients would be willing to pay for transportation
| 81,723 | [
0.2327880859375,
-0.068359375,
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0.65283203125,
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-0.58837890625,
0.240966796875,
0.52294921875,
0.1337890625,
0.6708984375,
0.509765625,
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-0.7275390625,
0.358154296875,
-0.71240234375,
-0.77587890625,
0.081... | 74 |
Please summerize the given abstract to a title
Effectiveness of person- and family-centred care transition interventions on patient- oriented outcomes: A systematic review.
AIM The aim was to critically analyse the body of evidence regarding the effectiveness of PFCC transition interventions on the quality of care and the experience of patients. DESIGN We conducted a systematic review using the Cochrane Handbook's guidelines and adhered to a standardized reporting format: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). METHODS Four databases and grey literature were searched. Following a two-step screening process, data from the eligible studies were extracted. Risk of bias and quality of the studies were also assessed. Narrative synthesis and vote counting were used for the data analysis. RESULTS A total of 28 articles met our inclusion criteria. Interventions varied in regards to the extent of the PFCC focus and the comprehensiveness of the transition of care. Educating patients to promote self-management was the most commonly included component and it was described in all 28 interventions.
| 81,755 | [
0.060455322265625,
-0.258056640625,
-0.38037109375,
0.73681640625,
-0.6220703125,
-0.69873046875,
0.16162109375,
0.40869140625,
0.15087890625,
0.65771484375,
0.69287109375,
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0.332763671875,
-0.465576171875,
-0.42041015625,
-0.09130859375,
-0.51611328125,
-0.6489257... | 74 |
Please summerize the given abstract to a title
Care Pathway of RPE65-Related Inherited Retinal Disorders from Early Symptoms to Genetic Counseling: A Multicenter Narrative Medicine Project in Italy
PURPOSE: Timely detection and multidisciplinary management of RPE65-related inherited retinal disorders (IRDs) can significantly improve both disease management and patient care. Thus, this Narrative Medicine (NM) project aimed to investigate the evolution of the care pathway and the expectations on genetic counseling and gene therapy by patients, caregivers, and healthcare professionals. PATIENTS AND METHODS: This project was conducted between July and December 2020, involving five Italian eye clinics specialized in IRDs, targeted pediatric and adult patients, their caregivers, attending retinologists and multidisciplinary healthcare professionals. Narratives and parallel charts, together with a sociodemographic survey, were collected through the project webpage. In-depth interviews were conducted with Patient Association (PA) members and multidisciplinary healthcare professionals. All data were entered into the Nvivo Software for coding and analysis. RESULTS: Three pediatric and five adult patients with early-onset RPE65-related IRDs as well as eight caregivers were enrolled; 11 retinologists globally wrote 27 parallel charts; in-depth interviews were done with five multidisciplinary healthcare professionals and one PA member. Early diagnosis remains challenging, and patients reported to have changed up to 10 healthcare professionals before accessing their specialized center. Despite the oftentimes lack of awareness of patients and caregivers on the purpose of genetic testing, participants generally consider gene therapy as a therapeutic chance and a historic breakthrough for the management of RPE65-related IRDs. Well-organized networks to support the patient’s referral to specialized centers – as well as a proper communication of the clinical and genetic diagnosis and the multidisciplinary approach – emerge as crucial aspects in facilitating an early diagnosis and management and a timely initiation of the rehabilitation pathway. CONCLUSION: The project investigated the RPE65-related IRDs care pathway while integrating the different perspectives involved through NM. The analysis explored the patient’s pathway in Italy and confirmed the need for a well-organized network and multidisciplinary care while highlighting several preliminary areas of improvement in the management of RPE65-related IRDs.
| 81,933 | [
-0.007091522216796875,
-0.17041015625,
-0.465576171875,
0.85009765625,
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-0.744140625,
-0.35205078125,
-0.0303192138671875,
0.277099609375,
0.6708984375,
0.41015625,
-0.420166015625,
0.441650390625,
-0.364501953125,
-0.30859375,
0.2435302734375,
-0.68896484375,
-0.662... | 74 |
Please summerize the given abstract to a title
Evidence synthesis software.
It can be challenging to decide which evidence synthesis software to choose when doing a systematic review. This article discusses some of the important questions to consider in relation to the chosen method and synthesis approach. Software can support researchers in a range of ways. Here, a range of review conditions and software solutions. For example, facilitating contemporaneous collaboration across time and geographical space; in-built bias assessment tools; and line-by-line coding for qualitative textual analysis. EPPI-Reviewer is a review software for research synthesis managed by the EPPI-centre, UCL Institute of Education. EPPI-Reviewer has text mining automation technologies. Version 5 supports data sharing and re-use across the systematic review community. Open source software will soon be released. EPPI-Centre will continue to offer the software as a cloud-based service. The software is offered via a subscription with a one-month (extendible) trial available and volume discounts for 'site licences'. It is free to use for Cochrane and Campbell reviews. The next EPPI-Reviewer version is being built in collaboration with National Institute for Health and Care Excellence using 'surveillance' of newly published research to support 'living' iterative reviews. This is achieved using a combination of machine learning and traditional information retrieval technologies to identify the type of research each new publication describes and determine its relevance for a particular review, domain or guideline. While the amount of available knowledge and research is constantly increasing, the ways in which software can support the focus and relevance of data identification are also developing fast. Software advances are maximising the opportunities for the production of relevant and timely reviews.
| 81,949 | [
0.11407470703125,
-0.276123046875,
-0.61572265625,
0.28271484375,
-0.35888671875,
-0.71875,
-0.30078125,
0.298583984375,
0.40673828125,
0.68701171875,
-0.01300811767578125,
-0.4521484375,
0.434326171875,
-0.603515625,
0.1202392578125,
0.2000732421875,
-0.421142578125,
-1.0361328125... | 74 |
Please summerize the given abstract to a title
Factors contributing to the patient safety culture in Saudi Arabia: a systematic review.
BACKGROUND Patient safety, concerned with the prevention of harm to patients, has become a fundamental component of the global healthcare system. The evidence regarding the status of the patient safety culture in Arab countries in general shows that it is at a suboptimal level due to a punitive approach to errors and deficits in the openness of communications. OBJECTIVES To identify factors contributing to the patient safety culture in Saudi Arabia. DESIGN Systematic review. METHODS A systematic search was carried out in May 2018 in five electronic databases and updated in July 2020-MEDLINE, CINAHL, Embase, PsycINFO and the Cochrane Database of Systematic Reviews. Relevant journals and reference lists of included studies were also hand-searched. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of studies and extracted their relevant characteristics. The Yorkshire Contributory Factors Framework (YCFF) was used to categorise factors affecting safety culture in the included papers. RESULTS 14 papers were included and the majority of studies were appraised as being of good quality. Strength and weakness factors that contribute to patient safety culture were identified. Ineffective leadership, a blame culture, workload/inadequate staffing and poor communication are reported as the main factors hindering a positive patient safety culture in Saudi Arabia. Conversely, 'strength' factors contributing to a positive patient safety culture included supportive organisational attitudes to learning/continuous improvement, good teamwork within units and support from hospital management for patient safety. There is an absence of patient perspectives regarding patient safety culture in Saudi Arabia. CONCLUSION Policymakers in the Saudi healthcare system should pay attention to the factors that may contribute to a positive patient safety culture, especially establishing a blame-free culture, improving communications and leadership capacity, learning from errors and involving patient perspectives in safety initiatives. Further research is required to understand in depth the barriers and facilitators to the implementation of a positive patient safety culture in Saudi Arabia.
| 82,038 | [
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0.689453125,
-0.1962890625,
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0.1854248046875,
0.317138671875,
0.3115234375,
0.662109375,
0.346435546875,
-0.2017822265625,
0.20166015625,
-0.6630859375,
-0.77783203125,
0.266845703125,
-0.29150390625,
-0.371826171875... | 74 |
Please summerize the given abstract to a title
PNS192 Defining the New Age of Digital Health? Results of a Systematic Scoping Literature Review
Objectives: COVID-19 has accelerated the use of digital health, however, there is no universally accepted definition The objective of this scoping review was to provide an overview of definitions in the literature including the context in which it exists e g public health organization, supplier organization, etc to derive those which are aligned with the ISPOR mission of outcomes research Methods: A literature search was undertaken for the past 5 years (2015-2020) on the major specific terms used in digital health (n=38) where these exist with synonyms of definition as a key term Databases searched included Embase, PubMed/Medline, Cochrane Library and EconLit A team of 2 volunteers independently reviewed each abstract to identify those which were likely to contain a definition or taxonomy and then reconciled any misalignment between the authors or referred the abstract to a third-party reviewer Independent review by 2 volunteers was also employed to extract the relevant parameters in a recording spreadsheet from the full paper review Results: From 2966 hits in the four different databases (Embase: n=2263;PubMed: n=657, Cochrane n=35, EconLit: n=11), the scoping review identified 2,610 original abstracts Fifteen teams of two independent volunteers undertook the review of the abstracts The agreement between the initial assessments of rater pairs was between 97 1% and 36 2% Cohen’s kappa ranged from 0 91 to 0 11 A third reviewer reconciled disagreement in 73 (2 8%) citations The number of abstracts taken through to the full paper review was 545 (20 9%) Conclusions: This timely work indicates that definitions included in the literature cover several terms which can be grouped under different applications of digital health An overview of the different terms and their context to identify options which align with the ISPOR Mission will be presented
| 82,039 | [
-0.169189453125,
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0.640625,
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-0.1328125,
0.028289794921875,
0.34033203125,
0.7451171875,
0.490478515625,
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0.318115234375,
0.018035888671875,
-0.1876220703125,
0.05078125,
-0.52783203125,
-0.77392578125,
... | 74 |
Please summerize the given abstract to a title
Effects of a Midwife-Coordinated Maternity Care Intervention (ChroPreg) vs. Standard Care in Pregnant Women with Chronic Medical Conditions: Results from a Randomized Controlled Trial
The proportion of childbearing women with pre-existing chronic medical conditions (CMC) is rising. In a randomized controlled trial, we aimed to evaluate the effects of a midwife-coordinated maternity care intervention (ChroPreg) in pregnant women with CMC. The intervention consisted of three main components: (1) Midwife-coordinated and individualized care, (2) Additional ante-and postpartum consultations, and (3) Specialized known midwives. The primary outcome was the total length of hospital stay (LOS). Secondary outcomes were patient-reported outcomes measuring psychological well-being and satisfaction with maternity care, health utilization, and maternal and infant outcomes. A total of 362 women were randomized to the ChroPreg intervention (n = 131) or Standard Care (n = 131). No differences in LOS were found between groups (median 3.0 days, ChroPreg group 0.1% lower LOS, 95% CI −7.8 to 7%, p = 0.97). Women in the ChroPreg group reported being more satisfied with maternity care measured by the Pregnancy and Childbirth Questionnaire (PCQ) compared with the Standard Care group (mean PCQ 104.5 vs. 98.2, mean difference 6.3, 95% CI 3.0–10.0, p < 0.0001). In conclusion, the ChroPreg intervention did not reduce LOS. However, women in the ChroPreg group were more satisfied with maternity care.
| 82,080 | [
0.135498046875,
0.043365478515625,
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0.35400390625,
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-0.69775390625,
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... | 74 |
Please summerize the given abstract to a title
How do middle-aged and older adults with chronic hip pain view their health problem and its care? A protocol for a systematic review and qualitative evidence synthesis.
INTRODUCTION Chronic hip pain in middle-aged and older adults is common and disabling. Patient-centred care of chronic hip pain requires a comprehensive understanding of how people with chronic hip pain view their health problem and its care. This paper outlines a protocol to synthesise qualitative evidence of middle-aged and older adults' views, beliefs, expectations and preferences about their chronic hip pain and its care. METHODS AND ANALYSIS We will perform a qualitative evidence synthesis using a framework approach. We will conduct this study in accord with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and the Enhancing Transparency in Reporting the synthesis of Qualitative research checklist. We will search MEDLINE, CINAHL, The Cochrane Central Register of Controlled Trials, EMBASE and PsycINFO using a comprehensive search strategy. A priori selection criteria include qualitative studies involving samples with a mean age over 45 and where 80% or more have chronic hip pain. Two or more reviewers will independently screen studies for eligibility, assess methodological strengths and limitations using the Critical Appraisal Skills Programme qualitative studies checklist, perform data extraction and synthesis and determine ratings of confidence in each review finding using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research approach. Data extraction and synthesis will be guided by the Common-Sense Model of Self-Regulation. All authors will contribute to interpreting, refining and finalising review findings. This protocol is registered on PROSPERO and reported according to the PRISMA Statement for Protocols (PRISMA-P) checklist. ETHICS AND DISSEMINATION Ethics approval is not required for this systematic review as primary data will not be collected. The findings of the review will be disseminated through publication in an academic journal and scientific conferences. PROSPERO REGISTRATION NUMBER PROSPERO registration number: CRD42021246305.
| 82,115 | [
0.1796875,
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0.4033203125,
0.78076171875,
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0.362060546875,
-0.1610107421875,
0.0243072509765625,
0.310791015625,
-0.27734375,
-0.73974609375,... | 74 |
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