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Health decision making

Johanna Tell, Ewy Olander, Peter Anderberg, Johan Sanmartin Berglund
AIM: The aim of this study was to investigate child health-care coordinators' experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. METHODS: The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. RESULTS: The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives...
February 2018: Scandinavian Journal of Public Health
Nikhil Satchidanand, Timothy J Servoss, Ranjit Singh, Angela M Bosinski, Penny Tirpak, Linda L Horton, Bruce J Naughton
BACKGROUND: Early, data-driven discussion surrounding palliative care can improve care delivery and patient experience. OBJECTIVE: To develop a 30-day mortality prediction tool for older patients in intensive care unit (ICU) with pneumonia that will initiate palliative care earlier in hospital course. DESIGN: Retrospective Electronic Health Record (EHR) review. SETTING: Four urban and suburban hospitals in a Western New York hospital system...
January 1, 2018: American Journal of Hospice & Palliative Care
Jun-Hua Zhang, You-Ping Li, Bo-Li Zhang
The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine...
January 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Angela Ju, Mark Unruh, Sara Davison, Juan Dapueto, Mary Amanda Dew, Richard Fluck, Michael Germain, Sarbjit V Jassal, Gregorio Obrador, Donal O'Donoghue, Michelle A Josephson, Jonathan C Craig, Andrea Viecelli, Emma O'Lone, Camilla S Hanson, Braden Manns, Benedicte Sautenet, Martin Howell, Bharathi Reddy, Caroline Wilkie, Claudia Rutherford, Allison Tong
Fatigue is one of the most highly prioritized outcomes for patients and clinicians, but remains infrequently and inconsistently reported across trials in hemodialysis. We convened an international Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) consensus workshop with stakeholders to discuss the development and implementation of a core outcome measure for fatigue. 15 patients/caregivers and 42 health professionals (clinicians, researchers, policy makers, and industry representatives) from 9 countries participated in breakout discussions...
March 15, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Linda Aimée Hartford Kvæl, Jonas Debesay, Anne Langaas, Asta Bye, Astrid Bergland
OBJECTIVE: Although the concept of patient participation has been discussed for a number of years, there is still no clear definition of what constitutes the multidimensional concept, and the application of the concept in an intermediate care (IC) context lacks clarity. Therefore this paper seeks to identify and explore the attributes of the concept, to elaborate ways of understanding the concept of patient participation for geriatric patients in the context of IC. METHODS: Walker and Avant's model of Concept analysis [1] based on a literature review...
March 5, 2018: Patient Education and Counseling
Bradley M Appelhans, Simone A French, Tamara Olinger, Michael Bogucki, Imke Janssen, Elizabeth F Avery-Mamer, Lisa M Powell
Delay discounting, the tendency to choose smaller immediate rewards over larger delayed rewards, is theorized to promote consumption of immediately rewarding but unhealthy foods at the expense of long-term weight maintenance and nutritional health. An untested implication of delay discounting models of decision-making is that selectively delaying access to less healthy foods may promote selection of healthier (immediately available) alternatives, even if they may be less desirable. The current study tested this hypothesis by measuring healthy versus regular vending machine snack purchasing before and during the implementation of a 25-s time delay on the delivery of regular snacks...
March 15, 2018: Appetite
Megan C Roberts, Rebecca A Ferrer, Katharine A Rendle, Sarah C Kobrin, Stephen H Taplin, Bradford W Hesse, William M P Klein
INTRODUCTION: Appreciating the accuracy and value of cancer screening is essential to informed decision making about screening. This study's objectives were to (1) examine people's beliefs about the accuracy and value of cancer screening, and (2) determine whether sociodemographics, cancer beliefs, and shared decision making are associated with these beliefs. METHODS: Data from the National Cancer Institute's Health Information National Trends Survey (cycle 4, August-November 2014) were used...
March 15, 2018: American Journal of Preventive Medicine
Robert W McConkey, Catherine Holborn
PURPOSE: Gay men with prostate cancer are an 'invisible species' in the research literature despite concerns that the impact of treatment may be more profound and in some ways unique compared to heterosexual men. The aim of this research is to explore the lived experience of gay men with prostate cancer. METHOD: In-depth interviews were recorded and transcribed verbatim from a purposive sample of eight gay men treated for prostate cancer in Ireland. A qualitative methodological approach employing Giorgi's descriptive phenomenological method was used to collect and analyse data...
April 2018: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Geoff Hackett, Mike Kirby, Kevan Wylie, Adrian Heald, Nick Ossei-Gerning, David Edwards, Asif Muneer
BACKGROUND: This is an update of the 2008 British Society for Sexual Medicine (BSSM) guidelines. AIM: To provide up-to-date guidance for U.K. (and international) health care professionals managing male sexual dysfunction. METHODS: Source information was obtained from peer-reviewed articles, meetings, and presentations. A search of Embase, MEDLINE, and Cochrane Reviews was performed, covering the search terms "hypogonadism," "eugonadal or hypogonadism or hypogonadal or gonadal," and "low or lower testosterone," starting from 2009 with a cut-off date of September 2017...
March 14, 2018: Journal of Sexual Medicine
Justin C Brown, Michael O Harhay, Meera N Harhay
OBJECTIVE: To quantify the prevalence of self-reported major mobility disability (SR-MMD) and its association with mortality in a nationally-representative sample of cancer survivors. MATERIALS AND METHODS: This study included patients with a history of cancer who participated in the National Health and Nutrition Examination Survey 19992010. SR-MMD was defined as self-reported difficulty or inability to walk a quarter of a mile. Vital status through December 15, 2011 was ascertained from the United States National Center for Health Statistics...
March 14, 2018: Journal of Geriatric Oncology
Maarten Vermorgen, Aline De Vleminck, Luc Deliens, Dirk Houttekier, Nele Spruytte, Chantal Van Audenhove, Joachim Cohen, Kenneth Chambaere
OBJECTIVE: Deaths from chronic illness are often preceded by a potentially life-shortening end-of-life decision (ELD). Involving family in these ELDs may have psychosocial benefits for them and the dying person. This study aims to examine how often ELDs are discussed with relatives of the dying person and which characteristics determine their involvement in those ELDs. METHODS: A questionnaire survey was conducted in 2013 among physicians attending a large, stratified and representative sample of deaths (n = 6188) in Flanders...
March 2, 2018: Patient Education and Counseling
Jose-Manuel Carrascosa, Ira Jacobs, Danielle Petersel, Robert Strohal
Psoriasis is a chronic, inflammatory, lifelong disease with a high prevalence (afflicting approximately 1-5% of the population worldwide) and is associated with significant morbidity. The introduction of biologic therapies has improved the management of this disease. Multiple biologic medicines that block cytokine signaling, including tumor necrosis factor (TNF) antagonists (adalimumab, etanercept, and infliximab) and inhibitors of interleukin (IL)-17 (brodalumab, ixekizumab, and secukinumab), IL-23 (guselkumab), or IL-12/23 (ustekinumab), are approved for the treatment of psoriasis...
March 16, 2018: Dermatology and Therapy
Franziska A Herbst, Maria Heckel, Johanna M Tiedtke, Thomas Adelhardt, Alexander Sturm, Stephanie Stiel, Christoph Ostgathe
BACKGROUND: There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life care. Knowledge of their experiences, workload, and needs should be considered in dealing with hospitalized carriers of multidrug-resistant organisms as well as staff education...
March 16, 2018: Zeitschrift Für Gerontologie und Geriatrie
Rebecca J Mullen, James Duhig, Andrea Russell, Linda Scarazzini, Fabio Lievano, Michael S Wolf
OBJECTIVE: To present evidence supporting best-practices for prescription drug labeling and educational materials. METHODS: Articles were selected from three online databases (PubMed, Embase, CINAHL). Eligible manuscripts were: 1) English-language, 2) randomized, controlled trials, and 3) focused on improving prescription drug labeling practices. RESULTS: Forty-nine articles were reviewed, and included both regulated label materials and pharmacy or health systems-generated tools...
March 8, 2018: Patient Education and Counseling
P Kushalnagar, A Engleman, G Sadler
OBJECTIVE: To assess whether mode of communication and patient centered communication (PCC) with physicians were associated with the likelihood of deaf smokers inquiring about lung cancer screening. METHODS: An accessible health survey including questions about PCC, modes of communication, smoking status and lung cancer screening was administered in American Sign Language (HINTS-ASL) to a nationwide sample of deaf adults from February to August 2017. Of 703 deaf adults who answered the lung screening question, 188 were 55-80 years old...
March 5, 2018: Patient Education and Counseling
M Escobar-Ballesta, M García-Ramírez, C De Freitas
Roma health inequities are a wicked problem. Despite concerted efforts to reduce them under the Decade of Roma Inclusion initiative, the health gap between Roma and non-Roma populations in Europe persists. To address this problem, the European Commission devised the National Roma Integration Strategies (NRIS). This paper provides a critical assessment of the implementation of the NRIS' health strand (NRIS-H) in Spain and proposes an evaluation tool to monitor Roma health policies - the Roma Health Integration Policy Index (RHIPEX)...
March 8, 2018: Health Policy
Terhi Toivo, Maarit Dimitrow, Juha Puustinen, Eeva Savela, Katariina Pelkonen, Valtteri Kiuru, Tuula Suominen, Sirkka Kinnunen, Mira Uunimäki, Sirkka-Liisa Kivelä, Saija Leikola, Marja Airaksinen
BACKGROUND: The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. METHODS: Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy...
March 16, 2018: BMC Geriatrics
Bronwyn Myers, Crick Lund, Carl Lombard, John Joska, Naomi Levitt, Christopher Butler, Susan Cleary, Tracey Naledi, Peter Milligan, Dan J Stein, Katherine Sorsdahl
BACKGROUND: In low- and middle-income countries (LMIC), it is uncertain whether a "dedicated" approach to integrating mental health care (wherein a community health worker (CHW) has the sole responsibility of delivering mental health care) or a "designated" approach (wherein a CHW provides this service in addition to usual responsibilities) is most effective and cost-effective. This study aims to compare the effectiveness and cost-effectiveness of these two models of service integration relative to treatment as usual (TAU) for improving mental health and chronic disease outcomes among patients with HIV or diabetes...
March 16, 2018: Trials
Oren Schwartz, Itzik Malka, Cara H Olsen, Israel Dudkiewicz, Tarif Bader
Introduction: Integration of females in combat units poses a unique challenge for army commanders around the world. The purpose of this study is to provide a detailed up-to-date situation report regarding overuse injuries among combat female warriors in the IDF (Israeli Defense Forces) in order to enable evidence-based decision-making, prevention policy, and further research of this highly significant military public health issue. Methods: A cross-sectional descriptive study was conducted including 2,519 females recruited to combat duties during the year of 2013...
March 14, 2018: Military Medicine
Suzanne Grant, Bruce Guthrie
Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings...
March 2, 2018: Social Science & Medicine
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