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https://www.readbyqxmd.com/read/28637180/participatory-design-of-probability-based-decision-support-tools-for-in-hospital-nurses
#1
Alvin D Jeffery, Laurie L Novak, Betsy Kennedy, Mary S Dietrich, Lorraine C Mion
Objective: To describe nurses' preferences for the design of a probability-based clinical decision support (PB-CDS) tool for in-hospital clinical deterioration. Methods: A convenience sample of bedside nurses, charge nurses, and rapid response nurses ( n  = 20) from adult and pediatric hospitals completed participatory design sessions with researchers in a simulation laboratory to elicit preferred design considerations for a PB-CDS tool. Following theme-based content analysis, we shared findings with user interface designers and created a low-fidelity prototype...
June 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28637128/maximizing-gait-and-balance-behaviors-and-decision-making-processes-of-persons-with-multiple-sclerosis-and-physical-therapists
#2
Elissa Held Bradford, Marcia Finlayson, Andrea White Gorman, Joanne Wagner
PURPOSE: To describe the behavioral decisions used by persons with multiple sclerosis (MS) and physical therapists to maximize gait and balance following outpatient physical therapy. METHODS: A multi-method case series with seven matched pairs (persons with MS-physical therapists). Quota sampling maximized variability among persons with MS (disease steps score range 3-6). Three of the four physical therapists were MS or neurology certified. Persons with MS completed a phone survey, follow-up interview, and standardized questionnaires...
February 7, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28636280/getting-on-the-same-page-communication-patient-involvement-and-shared-understanding-of-decisions-in-oncology
#3
Aaron L Leppin, Marleen Kunneman, Julie Hathaway, Cara Fernandez, Victor M Montori, Jon C Tilburt
BACKGROUND: Patients and clinicians do not often agree on whether a decision has been made about cancer care. This could be explained by factors related to communication quality and/or the type of decision being made. METHODS: We used a self-developed coding scheme to code a random sample of 128 encounters in which patients and clinicians either agreed (n=64) or disagreed (n=64) that a cancer care decision was made and tested for associations between concordance and key communication behaviours...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28636186/views-of-general-practice-staff-about-the-use-of-a-patient-oriented-treatment-decision-aid-in-shared-decision-making-for-patients-with-type-2-diabetes-a-mixed-methods-study
#4
Anita Wildeboer, Esther du Pon, Jan Schuling, Flora M Haaijer-Ruskamp, Petra Denig
BACKGROUND: Decision aids can be used to support shared decision making (SDM). A patient-oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited. OBJECTIVES: To explore views of practice staff towards SDM and the DA. DESIGN: A mixed-methods study within the Dutch PORTDA-diab trial. SETTING AND PARTICIPANTS: Included were 17 practices with staff members who were responsible for routine diabetes care and had worked with the DA, and 209 of their patients...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28636108/understanding-the-influences-and-impact-of-patient-clinician-communication-in-cancer-care
#5
Jennifer Elston Lafata, Laura A Shay, Jodi M Winship
BACKGROUND: Patient-clinician communication is thought to be central to care outcomes, but when and how communication affects patient outcomes is not well understood. OBJECTIVE: We propose a conceptual model and classification framework upon which the empirical evidence base for the impact of patient-clinician communication can be summarized and further built. DESIGN: We use the proposed model and framework to summarize findings from two recent systematic reviews, one evaluating the use of shared decision making (SDM) on cancer care outcomes and the other evaluating the role of physician recommendation in cancer screening use...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28634769/decision-making-capacity-and-unusual-beliefs-two-contentious-cases-australasian-association-of-bioethics-and-health-law-john-mcphee-law-student-essay-prize-2016
#6
Brent Hyslop
Decision-making capacity is a vital concept in law, ethics, and clinical practice. Two legal cases where capacity literally had life and death significance are NHS Trust v Ms T [2004] and Kings College Hospital v C [2015]. These cases share another feature: unusual beliefs. This essay will critically assess the concept of capacity, particularly in relation to the unusual beliefs in these cases. Firstly, the interface between capacity and unusual beliefs will be examined. This will show that the "using and weighing of information" is the pivotal element in assessment...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28633915/patient-centered-care-in-obstructive-sleep-apnea-a%C3%A2-vision%C3%A2-for%C3%A2-the%C3%A2-future
#7
REVIEW
Janet Hilbert, Henry K Yaggi
Obstructive sleep apnea is a common condition, with multiple potential neurocognitive, cardiovascular, and metabolic consequences. Efficacious treatment is available, but patient engagement is typically required for treatment to be effective. Patients with sleep apnea are phenotypically diverse and have individual needs, preferences, and values that impact treatment decisions. There has been a shift in obstructive sleep apnea management from diagnosis to chronic care management. Making treatment decisions that incorporate an individual patient's values and preferences and are personalized for that patient's biology has the potential to improve patient outcomes...
February 24, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28632540/a-shared-opportunity-for-improving-electronic-medical-record-data
#8
Amanda W Baier, Daniel J Snyder, Izabela C Leahy, Lance S Patak, Robert M Brustowicz
With the recent rapid adoption of electronic medical records (EMRs), studies reporting results based on EMR data have become increasingly common. While analyzing data extracted from our EMR for a retrospective study, we identified various types of erroneous data entries. This report investigates the root causes of the incompleteness, inconsistency, and inaccuracy of the medical records analyzed in our study. While experienced health information management professionals are well aware of the many shortcomings with EMR data, the aims of this case study are to highlight the significance of the negative impact of erroneous EMR data, to provide fundamental principles for managing EMRs, and to provide recommendations to help facilitate the successful use of electronic health data, whether to inform clinical decisions or for clinical research...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632425/factors-influencing-occupational-therapists-decision-to-supervise-fieldwork-students
#9
Joscelyn Varland, Elizabeth Cardell, Jeanette Koski, Molly McFadden
The purpose of this study was to identify factors that influence the decision to supervise a Level II occupational therapy fieldwork student. A survey was sent to occupational therapists identified from licensure boards and alumni rosters, including those who have and have not supervised students (n = 548). The results identified both positive and negative influences along with predictive factors of supervising a student. While positive factors included continuing education units, education on fieldwork expectations, their own fieldwork experiences, shared supervision, and access to educational resources, negative influences consisted of: job responsibilities, caseload, productivity standards, working part-time, and fear of failing a student...
June 20, 2017: Occupational Therapy in Health Care
https://www.readbyqxmd.com/read/28631275/a-typology-of-interprofessional-teamwork-in-acute-geriatric-care-a-study-in-55-units-in-belgium
#10
Ruth D Piers, Karen J J Versluys, Johan Devoghel, Sophie Lambrecht, André Vyt, Nele J Van Den Noortgate
OBJECTIVES: To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types. DESIGN: Cross-sectional multicenter study. SETTING: Acute geriatric units in Belgium. PARTICIPANTS: Team members of different professional backgrounds. MEASUREMENTS: Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision-making, patient files facilitating teamwork, members' belief in the power of teamwork, and members' comfort in reporting incidents...
June 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28629462/treatment-decisions-for-older-adults-with-advanced-chronic-kidney-disease
#11
REVIEW
Steven J Rosansky, Jane Schell, Joseph Shega, Jennifer Scherer, Laurie Jacobs, Cecile Couchoud, Deidra Crews, Matthew McNabney
Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR < 30 ml/min/1.73 m(2)) typically lose renal function slowly, often suffer from significant comorbidity and thus may die from associated comorbidities before they require dialysis.A patient's pattern of renal function loss over time in relation to their underlying comorbidities can serve as a guide to the probability of a future dialysis requirement...
June 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28629332/an-exploratory-study-of-men-s-companionship-perceptions-and-experiences-during-pregnancy-and-delivery-in-uganda
#12
H Lwanga, L Atuyambe, H Sempewo, A Lumala, R N B Byaruhanga
BACKGROUND: Globally, low involvement of men in maternal health care services remains a problem to health care providers and policy makers. Men's support is essential for making women's world better. There are increasing debates among policymakers and researchers on the role of men in maternal health programs, which is a challenge in patriarchal societies like Uganda. The aim of the study was to assess companionship during delivery; men's perception and experiences during pregnancy and delivery...
June 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28627808/evaluation-of-a-pharmaceutical-risk-sharing-agreement-when-patients-are-screened-for-the-probability-of-success
#13
Reza Mahjoub, Fredrik Ødegaard, Gregory S Zaric
We analyze a game-theoretic model of a risk-sharing agreement between a payer and a pharmaceutical firm. The drug manufacturer chooses the price while the payer sets the rebate rate and decides which patients are eligible for treatment. The manufacturer provides the payer with a rebate for nonresponding patients. We generalize on the existing literature, by making both price and rebate rate decision variables, allowing the rebate rate to be different from 100%, and incorporating 2 types of administrative costs...
June 19, 2017: Health Economics
https://www.readbyqxmd.com/read/28625817/natural-history-of-adult-ulcerative-colitis-in-population-based-cohorts-a-systematic-review
#14
Mathurin Fumery, Siddharth Singh, Parambir S Dulai, Corinne Gower-Rousseau, Laurent Peyrin-Biroulet, William J Sandborn
INTRODUCTION: A comprehensive knowledge of the natural history of UC helps understand disease evolution, identify poor prognostic markers and impact of treatment strategies and facilitates shared decision-making. We systematically reviewed the natural history of UC in adult population-based cohort studies with long-term follow-up. MATERIALS AND METHODS: Through a systematic literature review of MEDLINE through March 31, 2016, we identified 60 studies performed in 17 population-based inception cohorts reporting the long-term course and outcomes of adult-onset UC (n=15,316 UC patients)...
June 15, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#15
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28624821/on-the-social-life-and-motivational-changes-of-aging-monkeys
#16
Julia Fischer
Although nonhuman primates have been used in biomedical research to develop a better understanding of physiological aging processes, their value as models for studying age-related differences in motivation, cognition, and decision-making has only recently been appreciated. This paper reviews the state of the art, with a focus on a recent study on Barbary macaques. A number of studies reported that with increasing age, Old World monkeys spend more time resting, have fewer social partners, and/or spend less time in social interactions, though other studies found no such effects...
June 17, 2017: Gerontology
https://www.readbyqxmd.com/read/28624395/statin-trials-cardiovascular-events-and%C3%A2-coronary-artery-calcification-implications-for-a-trial-based-approach-to-statin-therapy-in%C3%A2-mesa
#17
Martin Bødtker Mortensen, Erling Falk, Dong Li, Khurram Nasir, Michael J Blaha, Veit Sandfort, Carlos Jose Rodriguez, Pamela Ouyang, Matthew Budoff
OBJECTIVES: This study sought to determine whether coronary artery calcium (CAC) could be used to optimize statin allocation among individuals for whom trial-based evidence supports efficacy of statin therapy. BACKGROUND: Recently, allocation of statins was proposed for primary prevention of atherosclerotic cardiovascular disease (ASCVD) based on proven efficacy from randomized controlled trials (RCTs) of statin therapy, a so-called trial-based approach. METHODS: The study used data from MESA (Multi-Ethnic Study of Atherosclerosis) with 5,600 men and women, 45 to 84 years of age, and free of clinical ASCVD, lipid-lowering therapy, or missing information for risk factors at baseline examination...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28624364/decision-making-in-swiss-home-like-childbirth-a-grounded-theory-study
#18
Yvonne Meyer, Franziska Frank, Franziska Schläppy Muntwyler, Valerie Fleming, Jessica Pehlke-Milde
BACKGROUND: Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth. AIM: To increase understanding of decision-making in complex home-like birth settings by exploring midwives' and women's perspectives and to develop a dynamic model integrating participatory processes for making shared decisions...
June 14, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28624294/patient-decision-aids-for-patients-considering-total-joint-replacement-a-cost-effectiveness-analysis-alongside-a-randomised-controlled-trial
#19
Logan Trenaman, Dawn Stacey, Stirling Bryan, Monica Taljaard, Gillian Hawker, Geoff Dervin, Peter Tugwell, Nick Bansback
BACKGROUND: Shared decision-making (SDM) is a key priority to improve patient-centred care, and can play an important role in helping patients decide whether to undergo total joint arthroplasty (TJA). Patient decision aids can support SDM; however, they may incur an upfront cost. We aimed to estimate the health and economic effects of patient decision aids for TJA. METHODS: A cost-effectiveness analysis of a randomised controlled trial with 2-year follow-up. 343 patients were recruited from two orthopedic screening clinics in Ottawa, Canada...
June 14, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28623941/development-of-a-program-theory-for-shared-decision-making-a-realist-review-protocol
#20
Gary Groot, Tamara Waldron, Tracey Carr, Linda McMullen, Lori-Ann Bandura, Shelley-May Neufeld, Vicky Duncan
BACKGROUND: The practicality of applying evidence to healthcare systems with the aim of implementing change is an ongoing challenge for practitioners, policy makers, and academics. Shared decision- making (SDM), a method of medical decision-making that allows a balanced relationship between patients, physicians, and other key players in the medical decision process, is purported to improve patient and system outcomes. Despite the oft-mentioned benefits, there are gaps in the current literature between theory and implementation that would benefit from a realist approach given the value of this methodology to analyze complex interventions...
June 17, 2017: Systematic Reviews
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