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https://www.readbyqxmd.com/read/29150472/are-food-and-drink-retailers-within-nhs-venues-adhering-to-nice-quality-standard-94-guidance-on-childhood-obesity-a-cross-sectional-study-of-two-large-secondary-care-nhs-hospitals-in-england
#1
Alice James, Laura Birch, Peter Fletcher, Sally Pearson, Catherine Boyce, Andy R Ness, Julian P Hamilton-Shield, Fiona E Lithander
OBJECTIVE: To assess whether the food and drink retail outlets in two major National Health Service (NHS) district general hospitals in England adhere to quality statements 1-3 of the UK National Institute for Health and Care Excellence (NICE) quality standard 94. DESIGN: Cross-sectional, descriptive study to assess the food and drink options available in vending machines, restaurants, cafes and shops in two secondary care hospitals. MAIN OUTCOME MEASURES: Adherence to quality statement 1 whereby the food and drink items available in the vending machines were classified as either healthy or less healthy using the Nutrient Profiling Model (NPM)...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29143547/from-individual-to-global-human-rights-and-aphasia
#2
Deborah Hersh
This commentary marks the 70th anniversary of the Universal Declaration of Human Rights by examining Article 19 and its application to people with aphasia. This group of people still face lack of access, stigmatisation, exclusion, disadvantage and social withdrawal as well as poor public awareness of aphasia and inadequate prioritisation of support and resources. Nevertheless, a range of creative initiatives at individual, healthcare, local community, national and global levels have helped to connect and empower people with aphasia...
November 16, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/29133314/decisional-needs-assessment-of-patients-with-complex-care-needs-in-primary-care-a-participatory-systematic-mixed-studies-review-protocol
#3
Mathieu Bujold, Pierre Pluye, France Légaré, Jeannie Haggerty, Genevieve C Gore, Reem El Sherif, Marie-Eve Poitras, Marie-Claude Beaulieu, Marie-Dominique Beaulieu, Paula L Bush, Yves Couturier, Beatrice Débarges, Justin Gagnon, Anik Giguère, Roland Grad, Vera Granikov, Serge Goulet, Catherine Hudon, Bernardo Kremer, Edeltraut Kröger, Irina Kudrina, Bertrand Lebouché, Christine Loignon, Marie-Therese Lussier, Cristiano Martello, Quynh Nguyen, Rebekah Pratt, Benoit Rihoux, Ellen Rosenberg, Isabelle Samson, Nicolas Senn, David Li Tang, Masashi Tsujimoto, Isabelle Vedel, Bruno Ventelou, Michel Wensing
INTRODUCTION: Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners)...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29122975/efficiency-and-thoroughness-trade-offs-in-high-volume-organisational-routines-an-ethnographic-study-of-prescribing-safety-in-primary-care
#4
Suzanne Grant, Bruce Guthrie
BACKGROUND: Prescribing is a high-volume primary care routine where both speed and attention to detail are required. One approach to examining how organisations approach quality and safety in the face of high workloads is Hollnagel's Efficiency and Thoroughness Trade-Off (ETTO). Hollnagel argues that safety is aligned with thoroughness and that a choice is required between efficiency and thoroughness as it is not usually possible to maximise both. This study aimed to ethnographically examine the efficiency and thoroughness trade-offs made by different UK general practices in the achievement of prescribing safety...
November 9, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29079394/optimising-the-introduction-of-multiple-childhood-vaccines-in-japan-a-model-proposing-the-introduction-sequence-achieving-the-highest-health-gains
#5
Baudouin Standaert, Nadia Schecroun, Olivier Ethgen, Oleksandr Topachevskyi, Yoriko Morioka, Ilse Van Vlaenderen
BACKGROUND: Many countries struggle with the prioritisation of introducing new vaccines because of budget limitations and lack of focus on public health goals. A model has been developed that defines how specific health goals can be optimised through immunisation within vaccination budget constraints. METHODS: Japan, as a country example, could introduce 4 new pediatric vaccines targeting influenza, rotavirus, pneumococcal disease and mumps with known burden of disease, vaccine efficacies and maximum achievable coverages...
September 21, 2017: Health Policy
https://www.readbyqxmd.com/read/29073654/the-outcomes-of-patients-returned-to-general-practitioner-after-being-declined-hip-and-knee-replacement
#6
Toni Anitelea, David Gwynne-Jones, Ayaaz Ebramjee, Ella Iosua
AIM: To determine the outcome of patients waitlisted for hip and knee replacement surgery who were returned to GP due to resource constraints. METHODS: Prospectively gathered data of all patients returned to GP was analysed, including demographics, clinical prioritisation scores and patient-reported scores. Subsequent outcome was collected from departmental records and the National Joint Registry. RESULTS: Between November 2013 and December 2015, 374 patients were returned to GP care...
October 27, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29046725/clinical-photographic-observation-of-plantar-corns-and-callus-associated-with-a-nominal-scale-classification-and-inter-observer-reliability-study-in-a-student-population
#7
David R Tollafield
BACKGROUND: The management of plantar corns and callus has a low cost-benefit with reduced prioritisation in healthcare. The distinction between types of keratin lesions that forms corns and callus has attracted limited interest. Observation is imperative to improving diagnostic predictions and a number of studies point to some confusion as to how best to achieve this. The use of photographic observation has been proposed to improve our understanding of intractable keratin lesions. METHODS: Students from a podiatry school reviewed photographs where plantar keratin lesions were divided into four nominal groups; light callus (Grade 1), heavy defined callus (Grade 2), concentric keratin plugs (Grade 3) and callus with deeper density changes under the forefoot (Grade 4)...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29042387/nature-based-care-opportunities-and-barriers-in-oncology-contexts-a-modified-international-e-delphi-survey
#8
Sarah Blaschke, Clare C O'Callaghan, Penelope Schofield
OBJECTIVE: To develop recommendations regarding opportunities and barriers for nature-based care in oncology contexts using a structured knowledge generation process involving relevant healthcare and design experts. DESIGN: Four-round modified electronic Delphi study. Oncology patients' nature-based recommendations, uncovered in preceding qualitative investigation, were included in the first round for the expert participants' consideration. Key items (opportunities and barriers) were developed using data aggregation and synthesis, followed by item prioritisation and 10-point Likert scale ranking (1=not important, 10=very important)...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29034096/evaluating-the-impact-of-brexit-on-the-pharmaceutical-industry
#9
REVIEW
Fawz Kazzazi, Cleo Pollard, Paul Tern, Alejandro Ayuso-Garcia, Jack Gillespie, Inesa Thomsen
INTRODUCTION: The UK Pharmaceutical Industry is arguably one of the most important industries to consider in the negotiations following the Brexit vote. Providing tens of thousands of jobs and billions in tax revenue and research investment, the importance of this industry cannot be understated. At stake is the global leadership in the sector, which produces some of the field's most influential basic science and translation work. However, interruptions and losses may occur at multiple levels, affecting patients, researchers, universities, companies and government...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/29031616/factors-affecting-the-selection-of-an-inhaler-device-for-copd-and-the-ideal-device-for-different-patient-profiles-results-of-epoca-delphi-consensus
#10
Marc Miravitlles, Juan José Soler-Cataluña, Bernardino Alcázar, José Luis Viejo, Francisco García-Río
BACKGROUND: This study aimed to identify the relevant factors for the choice of an inhaler device by physicians and the selection of the most important characteristics of a device according to different characteristics of patients with COPD. METHOD: In this two-round Delphi survey, 96 Spanish COPD-expert pulmonologists completed an internet-based, self-administered questionnaire, which consisted of a first part with 19 items related to the prioritization of the drug or the device, the experience, ability and preference of the patient, and the experience and preferences of the healthcare professional...
October 12, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29027512/challenges-associated-with-missing-data-in-electronic-health-records-a-case-study-of-a-risk-prediction-model-for-diabetes-using-data-from-slovenian-primary-care
#11
Gregor Stiglic, Primoz Kocbek, Nino Fijacko, Aziz Sheikh, Majda Pajnkihar
The increasing availability of data stored in electronic health records brings substantial opportunities for advancing patient care and population health. This is, however, fundamentally dependant on the completeness and quality of data in these electronic health records. We sought to use electronic health record data to populate a risk prediction model for identifying patients with undiagnosed type 2 diabetes mellitus. We, however, found substantial (up to 90%) amounts of missing data in some healthcare centres...
October 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29025455/the-burden-of-gunshot-injuries-on-orthopaedic-healthcare-resources-in-south-africa
#12
Case Martin, Gerhard Thiart, Graham McCollum, Stephen Roche, Sithombo Maqungo
BACKGROUND: Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29020846/patients-and-caregivers-needs-experiences-preferences-and-research-priorities-in-spiritual-care-a-focus-group-study-across-nine-countries
#13
Lucy Ellen Selman, Lisa Jane Brighton, Shane Sinclair, Ikali Karvinen, Richard Egan, Peter Speck, Richard A Powell, Ewa Deskur-Smielecka, Myra Glajchen, Shelly Adler, Christina Puchalski, Joy Hunter, Nancy Gikaara, Jonathon Hope
BACKGROUND: Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Evidence to inform spiritual care practices in palliative care is limited. AIM: To explore spiritual care needs, experiences, preferences and research priorities in an international sample of patients with life-limiting disease and family caregivers. DESIGN: Focus group study. SETTING/PARTICIPANTS: Separate patient and caregiver focus groups were conducted at 11 sites in South Africa, Kenya, South Korea, the United States, Canada, the United Kingdom, Belgium, Finland and Poland...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28985242/development-of-an-international-undergraduate-curriculum-for-delirium-using-a-modified-delphi-process
#14
Claire Copeland, James Fisher, Andrew Teodorczuk
Background: delirium is a medical emergency affecting approximately 30% of hospitalised older patients. Recent work examining UK undergraduate medical curricula highlighted inconsistencies in the delivery of teaching on delirium. The aim of this project was to develop consensus agreement on a delirium curriculum for medical undergraduates. Methods: a modified Delphi process was used to determine consensus amongst experts in an iterative manner. Experts at the European Delirium Association Conference (London, 2015) were invited to participate...
August 9, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28971881/wisdom-of-patients-predicting-the-quality-of-care-using-aggregated-patient-feedback
#15
Alex Griffiths, Meghan P Leaver
BACKGROUND: The Care Quality Commission (CQC) is responsible for ensuring the quality of healthcare in England. To that end, CQC has developed statistical surveillance tools that periodically aggregate large numbers of quantitative performance measures to identify risks to the quality of care and prioritise its limited inspection resource. These tools have, however, failed to successfully identify poor-quality providers. Facing continued budget cuts, CQC is now further reliant on an 'intelligence-driven', risk-based approach to prioritising inspections and a new effective tool is required...
September 28, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28970748/why-collaborative-care-for-depressed-patients-is-so-difficult-a-belgian-qualitative-study
#16
Kris Van den Broeck, Frédéric Ketterer, Roy Remmen, Marc Vanmeerbeek, Marianne Destoop, Geert Dom
Although current guidelines recommend collaborative care for severely depressed patients, few patients get adequate treatment. In this study we aimed to identify the thresholds for interdisciplinary collaboration amongst practitioners when treating severely depressed patients. In addition, we aimed to identify specific and feasible steps that may add to improved collaboration amongst first and second level Belgian health care providers when treating depressed patients. In two standard focus groups (n = 8; n = 12), general practitioners and psychiatrists first outlined current practice and its shortcomings...
June 21, 2017: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28970744/analysing-a-chinese-regional-integrated-healthcare-organisation-reform-failure-using-a-complex-adaptive-system-approach
#17
Wenxi Tang, Lai Wei, Liang Zhang
INTRODUCTION: China's organised health system has remained outdated for decades. Current health systems in many less market-oriented countries still adhere to traditional administrative-based directives and linear planning. Furthermore, they neglect the responsiveness and feedback of institutions and professionals, which often results in reform failure in integrated care. Complex adaptive system theory (CAS) provides a new perspective and methodology for analysing the health system and policy implementation...
June 19, 2017: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28950835/determinants-of-uptake-of-hepatitis-b-testing-and-healthcare-access-by-migrant-chinese-in-the-england-a-qualitative-study
#18
Andrew Chee Keng Lee, Alicia Vedio, Eva Zhi Hong Liu, Jason Horsley, Amrita Jesurasa, Sarah Salway
BACKGROUND: Global migration from hepatitis B endemic countries poses a significant public health challenge in receiving low-prevalence countries. In the UK, Chinese migrants are a high risk group for hepatitis B. However, they are an underserved population that infrequently accesses healthcare. This study sought to increase understanding of the determinants of hepatitis B testing and healthcare access among migrants of Chinese ethnicity living in England. METHODS: We sought to obtain and integrate insights from different key stakeholders in the system...
September 26, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28923500/priorities-for-closing-the-evidence-practice-gaps-in-post-stroke-aphasia-rehabilitation-a-scoping-review
#19
REVIEW
Kirstine Shrubsole, Linda Worrall, Emma Power, Denise A O'Connor
OBJECTIVE: To identify implementation priorities for post-stroke aphasia management relevant to the Australian healthcare context. DATA SOURCES: Using systematized searches of databases (CINAHL, Medline), guideline and stroke websites, and other sources, evidence was identified and extracted for seven implementation criteria for 13 topic areas relevant to aphasia management. These seven priority-setting criteria were identified in the implementation literature; strength of the evidence; current evidence-practice gap; clinician preference; client preference; modifiability; measurability; and health impact...
September 15, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28916160/-sociodemographic-and-health-related-determinants-of-health-care-utilisation-and-access-to-primary-and-specialist-care-results-of-a-nationwide-population-survey-in-germany-2006-2016
#20
Florian Tille, Bernhard Gibis, Klaus Balke, Adelheid Kuhlmey, Susanne Schnitzer
BACKGROUND: The aim of this paper is to identify systematic differences due to sociodemographic and health-related determinants in outpatient healthcare utilisation and access in Germany for the period from 2006 to 2016. The study focuses on frequent users and those reporting particularly long wait times for their physician appointments and contributes to assessing the level of health equity in Germany. METHODS: The investigation draws on nine population surveys conducted by the German National Association of Statutory Health Insurance Physicians (NASHIP), which interviewed 42,925 respondents aged 18 and above...
September 12, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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