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Healthcare prioritisation

Jessica Stevenson, Allison Tong, Katrina L Campbell, Jonathan C Craig, Vincent W Lee
OBJECTIVE: To describe the perspectives of healthcare providers on the nutritional management of patients on haemodialysis, which may inform strategies for improving patient-centred nutritional care. DESIGN: Face-to-face semistructured interviews were conducted until data saturation, and thematic analysis based on principles of grounded theory. SETTING: 21 haemodialysis centres across Australia. PARTICIPANTS: 42 haemodialysis clinicians (nephrologists and nephrology trainees (15), nurses (12) and dietitians (15)) were purposively sampled to obtain a range of demographic characteristics and clinical experiences...
March 8, 2018: BMJ Open
C Bermúdez Tamayo, A Olry de Labry Lima, L García Mochón
OBJECTIVE: To identify good practices in order to develop and implement indicators of health outcomes for clinical and healthcare management, as well as the characteristics for an indicator to be considered adequate. METHODOLOGY: A scoping review was performed, with the following phases: 1) Search and identification of bibliography. 2) Selection of relevant documents. Including those studies that discussed issues related to good practices for the use of health indicators in the management field...
March 6, 2018: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
Alan de Lima Pereira, Rosamund Southgate, Hikmet Ahmed, Penelope O'Connor, Vanessa Cramond, Annick Lenglet
Introduction: In 2015, following an influx of population into Kobanê in northern Syria, Médecins Sans Frontières (MSF) in collaboration with the Kobanê Health Administration (KHA) initiated primary healthcare activities. A vaccination coverage survey and vaccine-preventable disease (VPD) risk analysis were undertaken to clarify the VPD risk and vaccination needs. This was followed by a measles Supplementary Immunization Activity (SIA). We describe the methods and results used for this prioritisation activity around vaccination in Kobanê in 2015...
February 2, 2018: PLoS Currents
Michal Pruski
Medical resource allocation is a controversial topic, because in the end it prioritises some peoples' medical problems over those of others. This is less controversial when there is a clear clinical reason for such a prioritisation, but when such a reason is not available people might perceive it as deeming certain individuals more important than others. This article looks at the role of social utility in medical resource allocation, in a situation where the clinical outcome would be identical if either person received the treatment...
March 1, 2018: Medicine, Health Care, and Philosophy
Rebecca Lauren Morris, Susan Jill Stocks, Rahul Alam, Sian Taylor, Carly Rolfe, Steven William Glover, Joanne Whitcombe, Stephen M Campbell
OBJECTIVES: To identify the top 10 unanswered research questions for primary care patient safety research. DESIGN: A modified nominal group technique. SETTING: UK. PARTICIPANTS: Anyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions. MAIN OUTCOMES: A top 10, and top 30, future research questions for primary care patient safety...
February 28, 2018: BMJ Open
Christiane Muth, Lorenz Uhlmann, Walter E Haefeli, Justine Rochon, Marjan van den Akker, Rafael Perera, Corina Güthlin, Martin Beyer, Frank Oswald, Jose Maria Valderas, J André Knottnerus, Ferdinand M Gerlach, Sebastian Harder
OBJECTIVES: Investigate the effectiveness of a complex intervention aimed at improving the appropriateness of medication in older patients with multimorbidity in general practice. DESIGN: Pragmatic, cluster randomised controlled trial with general practice as unit of randomisation. SETTING: 72 general practices in Hesse, Germany. PARTICIPANTS: 505 randomly sampled, cognitively intact patients (≥60 years, ≥3 chronic conditions under pharmacological treatment, ≥5 long-term drug prescriptions with systemic effects); 465 patients and 71 practices completed the study...
February 24, 2018: BMJ Open
Andi Hermansyah, Dyah Pitaloka, Erica Sainsbury, Ines Krass
INTRODUCTION: The nature of community pharmacy in many countries has changed. Despite the significant efforts made to change practice, there is a paucity of literature that highlights consensus on the approaches that should be prioritised for advancing practice particularly in the context of developing countries. OBJECTIVE: To systematically identify and prioritise a range of potential recommendations to improve practice in Indonesian community pharmacy from the perspective of pharmacy stakeholders...
February 15, 2018: Research in Social & Administrative Pharmacy: RSAP
D Jeffrey
The medical profession has adopted a cognitive model of empathy, or detached concern, in its professionalism and practice. As a consequence there is now an empathy gap which has been demonstrated by lapses in patient care in the UK. There may also be an empathy gap developing in medical students during their training. This paper argues for the adoption of a relational view of empathy which embraces emotional and moral dimensions of the concept, acknowledges the importance of the clinical context and prioritises the relationship between the doctor and patient...
September 2017: Journal of the Royal College of Physicians of Edinburgh
Arunaz Kumar, Sam Sturrock, Euan M Wallace, Debra Nestel, Donna Lucey, Sally Stoyles, Jenny Morgan, Peter Neil, Michelle Schlipalius, Philip Dekoninck
OBJECTIVES: The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice. STUDY DESIGN: Mixed methods approach with a pre-test/post-test design...
February 17, 2018: BMJ Open
Virginia Minogue, Mary Cooke, Anne-Laure Donskoy, Penny Vicary, Bill Wells
Plain English summary: As much as 85 % of health research is believed to be wasted because it is not published or reported, the design is poor or does not consider what is already known in the topic area. Although a great deal of work has been done in the UK to reduce research waste, the role of patients and the public has not been discussed.This paper describes a survey, on the role of patients in reducing research waste, which was carried out as part of a larger piece of work on reducing waste in healthcare...
2018: Research Involvement and Engagement
Grace M Turner, Ruth Backman, Christel McMullan, Jonathan Mathers, Tom Marshall, Melanie Calvert
Plain English summary: What is the problem and why is this important? Mini-strokes are similar to full strokes, but symptoms last less than 24 h. Many people (up to 70%) have long-term problems after a mini-stroke, such as anxiety; depression; problems with brain functioning (like memory loss); and fatigue (feeling tired). However, the current healthcare pathway only focuses on preventing another stroke and care for other long-term problems is not routinely given. Without proper treatment, people with long-term problems after a mini-stroke could have worse quality of life and may find it difficult to return to work and their social activities...
2018: Research Involvement and Engagement
Susannah Ahern, Sue Evans, Ingrid Hopper, John Zalcberg
The healthcare value of Australian clinical quality registries (CQRs) has recently been highlighted by the Australian Commission of Safety and Quality in Health Care (ACSQHC) as being similar to the benefits of CQRs reported internationally. However, the development of CQRs in Australia is currently limited by a lack of coordination and strategic planning, leading to governance and funding processes that are varied and non-sustainable. Despite this, Australia has achieved recognised success with exemplar clinical registries where funding has been sustained at least partly by public funds...
February 8, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Melanie E Gibson-Helm, Jodie Bailie, Veronica Matthews, Alison F Laycock, Jacqueline A Boyle, Ross S Bailie
INTRODUCTION: Adverse pregnancy outcomes are more common among Aboriginal and Torres Strait Islander populations than non-Indigenous populations in Australia. Later in life, most of the difference in life expectancy between Aboriginal and Torres Strait Islander women and non-Indigenous women is due to non-communicable diseases (NCDs). Most Aboriginal and Torres Strait Islander women attend health services regularly during pregnancy. Providing high-quality care within these appointments has an important role to play in improving the current and future health of women and babies...
2018: PloS One
Benet Reid, Nina Laurie, Matt Baillie Smith
Trans-national medicine, historically associated with colonial politics, is now central to discourses of global health and development, thrust into mainstream media by catastrophic events (earthquakes, disease epidemics), and enshrined in the 2015 Sustainable Development Goals. Volunteer human-resource is an important contributor to international health-development work. International Voluntary Health Networks (IVHNs, that connect richer and poorer countries through healthcare) are situated at a meeting-point between geographies and sociologies of health...
February 1, 2018: Health & Place
David T Loveday, Lynne V Barr, Constantinos L Loizou, Garry Barton, George Smith
BACKGROUND: This study assessed the health economics and outcomes of three common foot and ankle operations. METHODS: Between July 2013 and October 2014 all patients undergoing ankle fusion (AF) for osteoarthritis, first metatarsophalangeal joint fusion for osteoarthritis (MF) or hallux valgus surgery (HV) were included. Patients having additional procedures were excluded. Patients completed the Manchester-Oxford Foot Questionnaire (MOX-FQ), the EuroQol EQ-5D-5L questionnaire and the EQ-VAS on presentation and at least 6 months post-operatively...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Alia Luz, Benjarin Santatiwongchai, Juntana Pattanaphesaj, Yot Teerawattananon
BACKGROUND: The use of economic evaluation in healthcare policies and decision-making, which is limited in low- and middle-income countries (LMICs), might be promoted through the improvement of the conduct and reporting of studies. Although the literature indicates that there are many issues affecting the conduct, reporting and use of this evidence, it is unclear which factors should be prioritised in finding solutions. This study aims to identify the top priority issues that impede the conduct, reporting and use of economic evaluation as well as potential solutions as an input for future research topics by the international Decision Support Initiative and other movements...
February 5, 2018: Health Research Policy and Systems
Donata Medaglini, Magdalena R De Azero, Odile Leroy, Florence Bietrix, Philippe Denoel
A clear vision for vaccines research and development (R&D) is needed if Europe is to continue to lead the discovery of next generation vaccines. Innovation Partnership for a Roadmap on Vaccines in Europe (IPROVE) is a collaboration between leading vaccine experts to develop a roadmap setting out how Europe can best invest in the science and technology essential for vaccines innovation. This FP7 project, started in December 2013, brought together more than 130 key public and private stakeholders from academia, public health institutes, regulators, industry and small and medium-sized enterprises to determine and prioritise the gaps and challenges to be addressed to bolster innovation in vaccines and vaccination in Europe...
January 29, 2018: Vaccine
Marek Lalli, Harriet Ruysen, Hannah Blencowe, Kristen Yee, Karen Clune, Mary DeSilva, Marissa Leffler, Emily Hillman, Haitham El-Noush, Jo Mulligan, Jeffrey C Murray, Karlee Silver, Joy E Lawn
BACKGROUND: Grand Challenges for international health and development initiatives have received substantial funding to tackle unsolved problems; however, evidence of their effectiveness in achieving change is lacking. A theory of change may provide a useful tool to track progress towards desired outcomes. The Saving Lives at Birth partnership aims to address inequities in maternal-newborn survival through the provision of strategic investments for the development, testing and transition-to-scale of ground-breaking prevention and treatment approaches with the potential to leapfrog conventional healthcare approaches in low resource settings...
January 29, 2018: Globalization and Health
Mojtaba Mirzaei, Mahboobehsadat Mirzadeh, Mohsen Mirzaei
Objectives: Prostate cancer is a leading cause of cancer-related deaths. The number of deaths and years of life lost (YLL) due to a disease can be used to monitor health status, assess healthcare needs and determine the prioritisation and allocation of health resources within a population; in addition, the latter calculation can serve as a baseline indicator of premature mortality. This study aimed to measure prostate cancer-related mortality and YLL in Yazd Province, Iran. Methods: This study included all prostate cancer-related deaths in Yazd Province reported between March 2001 and March 2010...
November 2017: Sultan Qaboos University Medical Journal
Zoe Belshaw, Natalie J Robinson, Rachel S Dean, Marnie L Brennan
Dog and cat vaccination consultations are a common part of small animal practice in the United Kingdom. Few data are available describing what happens during those consultations or what participants think about their content. The aim of this novel study was to investigate the attitudes of dog and cat owners and veterinary surgeons towards the content of small animal vaccination consultations. Telephone interviews with veterinary surgeons and pet owners captured rich qualitative data. Thematic analysis was performed to identify key themes...
January 18, 2018: Veterinary Sciences
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