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Health decision making

J Ellison, C Nagamuthu, S Vanderloo, B McRae, C Waters
INTRODUCTION: Chronic disease rates are produced from the Public Health Agency of Canada's Canadian Chronic Disease Surveillance System (CCDSS) using administrative health data from provincial/territorial health ministries. Denominators for these rates are based on estimates of populations derived from health insurance files. However, these data may not be accessible to all researchers. Another source for population size estimates is the Statistics Canada census. The purpose of our study was to calculate the major differences between the CCDSS and Statistics Canada's population denominators and to identify the sources or reasons for the potential differences between these data sources...
October 2016: Health Promotion and Chronic Disease Prevention in Canada
Ariane Laplante-Lévesque, Harvey Abrams, Maja Bülow, Thomas Lunner, John Nelson, Søren Kamaric Riis, Filiep Vanpoucke
Purpose: This article describes the perspectives of hearing device manufacturers regarding the exciting developments that the Internet makes possible. Specifically, it proposes to join forces toward interoperability and standardization of Internet and audiology. Method: A summary of why such a collaborative effort is required is provided from historical and scientific perspectives. A roadmap toward interoperability and standardization is proposed. Results: Information and communication technologies improve the flow of health care data and pave the way to better health care...
October 1, 2016: American Journal of Audiology
Mary Anne Purtzer, Carol J Hermansen-Kobulnicky
PURPOSE/OBJECTIVES: To investigate oncology professionals' perspectives about, experience with, and envisioned feasibility of incorporating patient self-monitoring as a patient-centered practice. 
. RESEARCH APPROACH: An interpretive, descriptive study.
. SETTING: Four health systems and five cancer centers in three states. 
. PARTICIPANTS: 38 nurses, nurse practitioners, oncologists, physician assistants, and radiation therapists...
November 1, 2016: Oncology Nursing Forum
Heidi Preis, Yael Benyamini
INTRODUCTION: Basic beliefs about birth as a natural and safe or a medical and risky process are central in the decisions on where and how to birth. Despite their importance, they have not been studied separately from other childbirth-related constructs. Our aim was to develop a measure to assess these beliefs. METHOD: Pregnant Israeli women (N = 850, gestational week ≥14) were recruited in women's health centers, in online natural birth forums, and through home midwives...
October 21, 2016: Journal of Psychosomatic Obstetrics and Gynaecology
Matthew S Lebowitz, Woo-Kyoung Ahn
People with mental disorders are strongly stigmatized. Among mental-health professionals, stigmatizing attitudes often manifest as desire for social distance from people with mental disorders. Currently ascendant biomedical conceptualizations of psychopathology could exacerbate this problem by engendering dehumanization, which is linked to prejudice. Given the clinical implications of such an occurrence, the present research tested a possible mitigation strategy. In an online study of 216 U.S. mental-health clinicians, two strategies for mitigating dehumanization in healthcare were tested-personification, highlighting personal traits of people with mental disorders rather than presenting them as malfunctioning brains, and agency reorientation, underscoring people's ability to make choices and decisions...
August 2016: Stigma Health
Nirav H Amin, Alex Volpi, T Sean Lynch, Ronak M Patel, Douglas L Cerynik, Mark S Schickendantz, Morgan H Jones
BACKGROUND: Anatomic reinsertion of the distal biceps is critical for restoring flexion and supination strength. Single- and double-incision surgical techniques have been reported, analyzing complications and outcomes measures. Which technique results in superior clinical outcomes and the lowest associated complications remains unclear. HYPOTHESIS: We hypothesized that rerupture rates would be similar between the 2 techniques, while nerve complications would be higher for the single-incision technique and heterotopic ossification would be more frequent with the double-incision technique...
October 2016: Orthopaedic Journal of Sports Medicine
Adele Diederich
Most of the parties involved in healthcare decisions - governments, politicians, healthcare professionals, pharmaceutical companies, special interest groups - actively work to make their desires known. In Israel the public is part of the decision committee; in Germany health care decision are made more or less without the public being involved. In a recently published IJHPR article, Giora Kaplan and Orna Baron-Epel raise the question of how well acquainted senior decision makers in the Israeli health system are with the public's priorities regarding the services being considered for inclusion in the public funding list...
2016: Israel Journal of Health Policy Research
Jane Mills, Jennifer Chamberlain-Salaun, Helena Harrison, Karen Yates, Andrea O'Shea
BACKGROUND: A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce...
2016: BMC Nursing
Charlotte L Allan, Sophie Behrman, Nina Baruch, Klaus P Ebmeier
Most people with mild dementia can continue to drive, but dementia is progressive and many patients and clinicians will be faced with questions about driving safety in the course of their illness. Determining when this happens is a complex decision, with risks of personal and public safety needing to be weighed against individual patient benefits of driving in terms of autonomy, independence and well-being. Decisions need to make reference to cognitive abilities, as well as other factors including physical comorbidity, vision, mobility, insight and history of driving errors and accidents...
October 20, 2016: Evidence-based Mental Health
Young Hak Roh, Beom Koo Lee, Min Ho Park, Jung Ho Noh, Hyun Sik Gong, Goo Hyun Baek
STUDY DESIGN: Prospective cohort. INTRODUCTION: Patient comprehension of their injury, its treatment, and health care provider's instructions plays an important role in health management and recovery from trauma. PURPOSE OF THE STUDY: This study investigates the effects of health literacy (the ability to obtain, process, and understand health information needed to make appropriate health decisions) on treatment outcomes and satisfaction in patients with mallet finger injuries...
October 17, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Magnolia Cardona-Morrell, Gustavo Benfatti-Olivato, Jesse Jansen, Robin M Turner, Diana Fajardo-Pulido, Ken Hillman
OBJECTIVE: To describe the range of decision aids (DAs) available to enable informed choice for older patients at the end of life and assess their effectiveness or acceptability. METHODS: Search strategy covered PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews, CINAHL and PsycInfo between 1995 and 2015. The quality criteria framework endorsed by the International Patient Decision Aids Standards (IPDAS) was used to assess usefulness. RESULTS: Seventeen DA interventions for patients, their surrogates or health professionals were included...
October 11, 2016: Patient Education and Counseling
Sofian Berrouiguet, Maria Luisa Barrigón, Sara A Brandt, Santiago Ovejero-García, Raquel Álvarez-García, Juan Jose Carballo, Philippe Lenca, Philippe Courtet, Enrique Baca-García
PURPOSE: The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS. METHOD: A web application ( was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014...
2016: PloS One
Catriona Mill, Joanne Enders, Cynthia Montanaro, Kieran Michael Moore
The trend toward delayed parenthood is on the rise across Canada. Societal emphasis on attaining higher education, career advancement and financial security may be some reasons why individuals delay becoming a parent; whatever the reason, this trend is linked to significant health and economic impacts. Many Canadians are unaware of the impact this may have on their fertility and potential birth outcomes. It is important that health care professionals apprise individuals in their reproductive years about these issues and the steps they can take to mitigate these risks...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Sanath Allampati, Kevin D Mullen
Hepatic Encephalopathy (HE) is a complex neuropsychiatric syndrome associated with decompensated liver disease. The spectrum of disease ranges from trivial abnormalities in complex decision making and prolonged reaction time to coma in its most severe form1. The very initial stages, recently termed covert Hepatic Encephalopathy (CHE), can only be diagnosed with the help of neuropsychiatric testing while the later and more severe forms, termed overt Hepatic Encephalopathy (OHE), can be diagnosed clinically. Severity of HE is graded based on West Haven Criteria and please refer to table 1 for more details2...
October 20, 2016: Minerva Gastroenterologica e Dietologica
Shaniece Criss, Dahiana Rodriguez, Roberta E Goldman
Our qualitative study examined how stresses of daily life affected substance use and perceived risk among Black and Hispanic adolescents. We conducted 11 focus groups with students aged 13-25 in public and alternative schools in Providence, Rhode Island, using Bourdieu's Social Practice theoretical approach to guide questioning and data analysis. Despite participants' frequent marijuana use, they perceived the emphasis society places on substance use as misguided, obfuscating the persistence of more critical problems such as stress and reduced opportunity resulting from neighborhood violence, poor schools, financial difficulties, and home troubles...
2016: Journal of Health Care for the Poor and Underserved
Charrissa Makowharemahihi, Justin Wall, Greg Keay, Cheryl Britton, Minnie McGibbon, Patrick LeGeyt, Joyce Maipi, Virginia Signal
A Quality Improvement Group for Māori oral health providers [Indigenous New Zealand oral health services] has been an effective and necessary mechanism for engaging Indigenous oral health expertise in decision-making for Indigenous oral health policy and sector developments to reduce oral health inequalities and improve Indigenous oral health outcomes.
2016: Journal of Health Care for the Poor and Underserved
S Malfait, K Eeckloo, J Hellings, G De Bodt, A Van Hecke
INTRODUCTION: In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hospital's board of directors on themes of strategic importance. OBJECTIVES: To study the internal hospital's decision processes in order to identify the impact of a stakeholder involvement committee on strategic themes in the hospital decision processes...
October 20, 2016: Acta Clinica Belgica
S A Kulkarni, E Benfenati, T S Barton-Maclaren
One of the key challenges of Canada's Chemicals Management Plan (CMP) is assessing chemicals with limited/no empirical hazard data for their risk to human health. In some instances, these chemicals have not been tested broadly for their toxicological potency; as such, limited information exists on their potential to induce human health effects following exposure. Although (quantitative) structure activity relationship ((Q)SAR) models are able to generate predictions to address data gaps for certain toxicological endpoints, the confidence in predictions also needs to be addressed...
October 20, 2016: SAR and QSAR in Environmental Research
Maria Agapova, Brian B Bresnahan, Mitchell Higashi, Larry Kessler, Louis P Garrison, Beth Devine
The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is disagreement about a technology's appropriateness and the evidence base is weak or for special circumstances. It is not clear how expert consensus merges with the evidence base to arrive at an equivocal rating...
October 19, 2016: Journal of Evaluation in Clinical Practice
Amy Blake, Bryan T Carroll
OBJECTIVE: This paper analyses how game theory can provide a framework for understanding the strategic decision-making that occurs in everyday scenarios in medical training and practice, and ultimately serves as a tool for improving the work environment and patient care. Game theory has been applied to a variety of fields outside of its native economics, but has not been thoroughly studied in the context of health care provision. METHODS: The paper discusses four of the most common 'games' and applies each to a scenario in medicine to provide new insight on the incentives and drivers for certain types of behaviour and a deeper understanding of why certain results are valued more strongly than others...
November 2016: Medical Education
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