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https://www.readbyqxmd.com/read/28637096/uncovering-the-decision-making-work-of-transferring-dying-patients-home-from-critical-care-units-an-integrative-review
#1
REVIEW
Yanxia Lin, Michelle Myall, Nikki Jarrett
AIMS: To understand how decisions are made to transfer dying patients home from critical care units. BACKGROUND: Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. DESIGN: Integrative review. DATA SOURCES: Seven bibliographic databases (origin - 2015), grey literature and reference lists were searched...
June 21, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28633678/variation-in-empiric-coverage-versus-detection-of-methicillin-resistant-staphylococcus-aureus-and-pseudomonas-aeruginosa-in-hospitalizations-for-community-onset-pneumonia-across-128-us-veterans-affairs-medical-centers
#2
Barbara E Jones, Kevin Antoine Brown, Makoto M Jones, Benedikt D Huttner, Tom Greene, Brian C Sauer, Karl Madaras-Kelly, Michael A Rubin, Matthew Bidwell Goetz, Matthew H Samore
OBJECTIVE To examine variation in antibiotic coverage and detection of resistant pathogens in community-onset pneumonia. DESIGN Cross-sectional study. SETTING A total of 128 hospitals in the Veterans Affairs health system. PARTICIPANTS Hospitalizations with a principal diagnosis of pneumonia from 2009 through 2010. METHODS We examined proportions of hospitalizations with empiric antibiotic coverage for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAER) and with initial detection in blood or respiratory cultures...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28633469/a-framework-illustrating-care-seeking-among-older-adults-in-a-hospital-emergency-department
#3
Barbara J Lutz, Allyson G Hall, Sean B Vanhille, Andrea L Jones, Jessica R Schumacher, Phyllis Hendry, Jeffrey S Harman, Donna L Carden
Background and Objectives: Older adults seeking emergency department (ED) care often have multiple, complex chronic conditions. We sought to understand factors that influence ED care-seeking by older adults and present a theoretical framework illustrating this process. Research Design and Methods: In this grounded theory study, we interviewed 40 older adults with chronic illness within 90 days of an ED visit to explore their decision-making about seeking ED care...
June 17, 2017: Gerontologist
https://www.readbyqxmd.com/read/28628782/incorporation-of-a-health-economic-modelling-tool-into-public-health-commissioning-evidence-use-in-a-politicised-context
#4
Tom Sanders, Amy Grove, Sarah Salway, Susan Hampshaw, Elizabeth Goyder
This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency...
June 12, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28627945/-model-concept-of-the-health-economic-evaluation-of-low-dose-ct-lung-cancer-screening-in-hungary
#5
Zoltán Vokó, Magdolna Barra, Anett Molnár, Anna Kerpel-Fronius, Gábor Bajzik, Ildikó Horváth, Mariann Moizs, Balázs Nagy
INTRODUCTION: Lung cancer is a rapidly progressing, often life-threatening disease that constitutes a huge societal burden. Because of the scarce resources of the Hungarian health care system, the cost-effectiveness of introducing low-dose computed tomography screening is a relevant health policy matter. AIM: The aim of this study is to design a model concept for assessing the cost-effectiveness of low-dose computed tomography lung cancer screening in Hungary, and to define the required steps for performing the analysis...
June 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28623941/development-of-a-program-theory-for-shared-decision-making-a-realist-review-protocol
#6
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
https://www.readbyqxmd.com/read/28623557/proving-value-in-radiology-experience-developing-and-implementing-a-shareable-open-source-registry-platform-driven-by-radiology-workflow
#7
Judy Wawira Gichoya, Marc D Kohli, Paul Haste, Elizabeth Mills Abigail, Matthew S Johnson
Numerous initiatives are in place to support value based care in radiology including decision support using appropriateness criteria, quality metrics like radiation dose monitoring, and efforts to improve the quality of the radiology report for consumption by referring providers. These initiatives are largely data driven. Organizations can choose to purchase proprietary registry systems, pay for software as a service solution, or deploy/build their own registry systems. Traditionally, registries are created for a single purpose like radiation dosage or specific disease tracking like diabetes registry...
June 16, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28606031/how-socioeconomic-status-affects-patient-perceptions-of-health-care-a-qualitative-study
#8
Nicholas C Arpey, Anne H Gaglioti, Marcy E Rosenbaum
INTRODUCTION: Clinician perceptions of patients with low socioeconomic status (SES) have been shown to affect clinical decision making and health care delivery in this group. However, it is unknown how and if low SES patients perceive clinician bias might affect their health care. METHODS: In-depth interviews with 80 enrollees in a state Medicaid program were analyzed to identify recurrent themes in their perceptions of care. RESULTS: Most subjects perceived that their SES affected their health care...
July 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28606005/group-assessment-of-key-indicators-of-sustainable-waste-management-in-developing-countries
#9
Bojana Tot, Goran Vujić, Zorica Srđević, Dejan Ubavin, Mário Augusto Tavares Russo
Decision makers in developing countries are struggling to solve the present problems of solid waste management. Prioritisation and ranking of the most important indicators that influence the waste management system is very useful for any decision maker for the future planning and implementation of a sustainable waste management system. The aim of this study is to evaluate key indicators and their related sub-indicators in a group decision-making environment. In order to gain insight into the subject it was necessary to obtain the qualified opinions of decision makers from different countries who understand the situation in the sector of waste management in developing countries...
June 1, 2017: Waste Management & Research
https://www.readbyqxmd.com/read/28603095/traditional-surgical-planning-of-liver-surgery-is-modified-by-3d-interactive-quantitative-surgical-planning-approach-a-single-center-experience-with-305-patients
#10
Xue-Dong Wang, Hong-Guang Wang, Jun Shi, Wei-Dong Duan, Ying Luo, Wen-Bin Ji, Ning Zhang, Jia-Hong Dong
BACKGROUND: Decision making and surgical planning are to achieve the precise balance of maximal removal of target lesion, maximal sparing of functional liver remnant volume, and minimal surgical invasiveness and therefore, crucial in liver surgery. The aim of this prospective study was to validate the accuracy and predictability of 3D interactive quantitative surgical planning approach (IQSP), and to evaluate the impact of IQSP on traditional surgical plans based on 2D images. METHODS: A total of 305 consecutive patients undergoing hepatectomy were included in this study...
June 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28603078/gatekeepers-in-the-healthcare-sector-knowledge-and-bourdieu-s-concept-of-field
#11
Fran M Collyer, Karen F Willis, Sophie Lewis
Choice is an imperative for patients in the Australian healthcare system. The complexity of this healthcare 'maze', however, means that successfully navigating and making choices depends not only on the decisions of patients, but also other key players in the healthcare sector. Utilising Bourdieu's concepts of capital, habitus and field, we analyse the role of gatekeepers (i.e., those who control access to resources, services and knowledge) in shaping patients' experiences of healthcare, and producing opportunities to enable or constrain their choices...
June 3, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28601112/the-role-of-dysfunctional-myths-in-a-decision-making-process-under-bounded-rationality-a-complex-dynamical-systems-perspective
#12
Dimitrios Stamovlasis, Julie Vaiopoulou
The present study examines the factors influencing a decision-making process, with specific focus on the role of dysfunctional myths (DM). DM are thoughts or beliefs that are rather irrational, however influential to people's decisions. In this paper a decision-making process regarding the career choice of university students majoring in natural sciences and education (N=496) is examined by analyzing survey data taken via Career Decision Making Difficulties Questionnaire (CDDQ). The difficulty of making the choice and the certainty about one's decision were the state variables, while the independent variables were factors related to the lack of information or knowledge needed, which actually reflect a bounded rationality...
July 2017: Nonlinear Dynamics, Psychology, and Life Sciences
https://www.readbyqxmd.com/read/28598741/toward-a-research-agenda-for-competency-based-medical-education
#13
Larry Gruppen, Jason R Frank, Jocelyn Lockyer, Shelley Ross, M Dylan Bould, Peter Harris, Farhan Bhanji, Brian D Hodges, Linda Snell, Olle Ten Cate
Competency-based medical education (CBME) is both an educational philosophy and an approach to educational design. CBME has already had a broad impact on medical schools, residency programs, and continuing professional development in health professions around the world. As the CBME movement evolves and CBME programs are implemented, a wide range of emerging research questions will warrant scholarly examination. In this paper, we describe a proposed CBME research agenda developed by the International CBME Collaborators...
June 2017: Medical Teacher
https://www.readbyqxmd.com/read/28596039/assessment-of-aortic-wall-thrombus-predicts-outcomes-of-endovascular-repair-of-complex-aortic-aneurysms-using-fenestrated-and-branched-endografts
#14
Mauricio Ribeiro, Gustavo S Oderich, Thanila Macedo, Terri J Vrtiska, Jan Hofer, Julia Chini, Bernardo Mendes, Stephen Cha
OBJECTIVE: The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden. METHODS: The clinical data of 301 patients treated for pararenal and thoracoabdominal aortic aneurysms (TAAAs) by F-BEVAR was reviewed. The study excluded 89 patients with extent I to III TAAA because of extensive laminated thrombus within the aneurysm sac...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28592277/perceived-barriers-to-effective-implementation-of-public-reporting-of-hospital-performance-data-in-australia-a-qualitative-study
#15
Rachel Canaway, Marie Bismark, David Dunt, Margaret Kelaher
BACKGROUND: Public reporting of government funded (public) hospital performance data was mandated in Australia in 2011. Studies suggest some benefit associated with such public reporting, but also considerable scope to improve reporting systems. METHODS: In 2015, a purposive sample of 41 expert informants were interviewed, representing consumer, provider and purchasers perspectives across Australia's public and private health sectors, to ascertain expert opinion on the utility and impact of public reporting of health service performance...
June 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28592187/outcomes-of-organ-donation-in-brain-dead-patient-s-families-ethical-perspective
#16
Shamsi Ahmadian, Abolfazl Rahimi, Ebrahim Khaleghi
BACKGROUND: The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28587644/current-and-future-perspectives-on-the-management-of-polypharmacy
#17
Mariam Molokhia, Azeem Majeed
BACKGROUND: Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe enough to result in hospital admission and even death...
June 6, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28586608/adherence-to-diabetes-mellitus-treatment-guidelines-from-theory-to-practice-the-missing-link
#18
Noreen Rahat Hashmi, Shahzad Ali Khan
Diabetes mellitus is a complex multisystem disease that requires high quality care. Clinical practice guidelines help physicians and patients make the best possible health care decisions and improve health care management of diabetic patients. These guidelines provide the norms for clinical management as well as monitoring of diabetes care. They are not simple algorithms but are based on structured evidence based diabetic management protocols developed from randomized controlled trials. Despite the widespread availability of this diabetic guideline, their use is suboptimal at best...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28582991/insights-into-health-care-seeking-behaviour-for-children-in-communities-in-kwazulu-natal-south-africa
#19
Lyn Haskins, Merridy Grant, Sifiso Phakathi, Aurene Wilford, Ngcwalisa Jama, Christiane Horwood
BACKGROUND: South African infant and child mortality remains high, with many deaths occurring outside the formal health services. Delayed health care seeking represents a large proportion of these deaths. AIM: To generate knowledge about the role of, and influences on, caregivers with regard to decision-making about when and where to seek care for sick children. SETTING: Two communities in KwaZulu-Natal. METHODS: A qualitative, exploratory design employing participatory research techniques was used to undertake focus group discussions with community members...
May 29, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28578757/decision-making-under-pressure-medical-errors-in-uncertain-and-dynamic-environments
#20
Alicia M Zavala, Gary E Day, David Plummer, Anita Bamford-Wade
Objective This paper provides a narrative overview of the literature concerning clinical decision-making processes when staff come under pressure, particularly in uncertain, dynamic and emergency situations.Methods Studies between 1980 and 2015 were analysed using a six-phase thematic analysis framework to achieve an in-depth understanding of the complex origins of medical errors that occur when people and systems are under pressure and how work pressure affects clinical performance and patient outcomes. Literature searches were conducted using a Summons Search Service platform; search criteria included a variety of methodologies, resulting in the identification of 95 papers relevant to the present review...
June 5, 2017: Australian Health Review: a Publication of the Australian Hospital Association
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