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https://www.readbyqxmd.com/read/29771210/variables-affecting-hospital-length-of-stay-a-scoping-review
#1
Sandra C Buttigieg, Lorraine Abela, Adriana Pace
Purpose Tertiary hospitals have registered an incremental rise in expenditure mostly because of the increasing demands by ageing populations. Reducing the length of stay (LOS) of patients within tertiary hospitals is one of the strategies, which has been used in the last decades to ensure health care systems' sustainability. Furthermore, LOS is one of the key performance indicators, which is widely used to assess hospital efficiency. Hence, it is crucial that policy makers use evidence-based practices in health care to aim for optimal LOS...
May 21, 2018: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/29760781/understanding-aneuploidy-in-cancer-through-the-lens-of-system-inheritance-fuzzy-inheritance-and-emergence-of-new-genome-systems
#2
REVIEW
Christine J Ye, Sarah Regan, Guo Liu, Sarah Alemara, Henry H Heng
Background: In the past 15 years, impressive progress has been made to understand the molecular mechanism behind aneuploidy, largely due to the effort of using various -omics approaches to study model systems (e.g. yeast and mouse models) and patient samples, as well as the new realization that chromosome alteration-mediated genome instability plays the key role in cancer. As the molecular characterization of the causes and effects of aneuploidy progresses, the search for the general mechanism of how aneuploidy contributes to cancer becomes increasingly challenging: since aneuploidy can be linked to diverse molecular pathways (in regards to both cause and effect), the chances of it being cancerous is highly context-dependent, making it more difficult to study than individual molecular mechanisms...
2018: Molecular Cytogenetics
https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#3
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
May 6, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29706132/when-complexity-science-meets-implementation-science-a-theoretical-and-empirical-analysis-of-systems-change
#4
Jeffrey Braithwaite, Kate Churruca, Janet C Long, Louise A Ellis, Jessica Herkes
BACKGROUND: Implementation science has a core aim - to get evidence into practice. Early in the evidence-based medicine movement, this task was construed in linear terms, wherein the knowledge pipeline moved from evidence created in the laboratory through to clinical trials and, finally, via new tests, drugs, equipment, or procedures, into clinical practice. We now know that this straight-line thinking was naïve at best, and little more than an idealization, with multiple fractures appearing in the pipeline...
April 30, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29705839/stress-and-systemic-inflammation-yin-yang-dynamics-in-health-and-diseases
#5
Qing Yan
Studies in psychoneuroimmunology (PNI) would provide better insights into the "whole mind-body system." Systems biology models of the complex adaptive systems (CASs), such as a conceptual framework of "Yin-Yang dynamics," may be helpful for identifying systems-based biomarkers and targets for more effective prevention and treatment. The disturbances in the Yin-Yang dynamical balance may result in stress, inflammation, and various disorders including insomnia, Alzheimer's disease, obesity, diabetes, cardiovascular diseases, skin disorders, and cancer...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29704777/promoting-evaluation-capacity-building-in-a-complex-adaptive-system
#6
Frances Lawrenz, Elizabeth Kunz Kollmann, Jean A King, Marjorie Bequette, Scott Pattison, Amy Grack Nelson, Sarah Cohn, Christopher L B Cardiel, Stephanie Iacovelli, Gayra Ostgaard Eliou, Juli Goss, Lauren Causey, Anne Sinkey, Marta Beyer, Melanie Francisco
This study provides results from an NSF funded, four year, case study about evaluation capacity building in a complex adaptive system, the Nanoscale Informal Science Education Network (NISE Net). The results of the Complex Adaptive Systems as a Model for Network Evaluations (CASNET) project indicate that complex adaptive system concepts help to explain evaluation capacity building in a network. The NISE Network was found to be a complex learning system that was supportive of evaluation capacity building through feedback loops that provided for information sharing and interaction...
April 10, 2018: Evaluation and Program Planning
https://www.readbyqxmd.com/read/29695268/scaling-up-art-adherence-clubs-in-the-public-sector-health-system-in-the-western-cape-south-africa-a-study-of-the-institutionalisation-of-a-pilot-innovation
#7
Hayley MacGregor, Andrew McKenzie, Tanya Jacobs, Angelica Ullauri
BACKGROUND: In 2011, a decision was made to scale up a pilot innovation involving 'adherence clubs' as a form of differentiated care for HIV positive people in the public sector antiretroviral therapy programme in the Western Cape Province of South Africa. In 2016 we were involved in the qualitative aspect of an evaluation of the adherence club model, the overall objective of which was to assess the health outcomes for patients accessing clubs through epidemiological analysis, and to conduct a health systems analysis to evaluate how the model of care performed at scale...
April 25, 2018: Globalization and Health
https://www.readbyqxmd.com/read/29687756/improvement-attributes-in-healthcare-implications-for-integrated-care
#8
Patrick John Harnett
Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care...
April 16, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29659003/state-of-science-bridging-the-science-practice-gap-in-aging-dementia-and-mental-health
#9
Christopher M Callahan, Daniel R Bateman, Sophia Wang, Malaz A Boustani
The workforce available to care for older adults has not kept pace with the need. In response to workforce limitations and the growing complexity of healthcare, scientists have tested new models of care that redesign clinical practice. This article describes why new models of care in aging, dementia, and mental health diffuse inadequately into the healthcare systems and communities where they might benefit older adults. We review a general framework for the diffusion of innovations and highlight the importance of other features of innovations that deter or facilitate diffusion...
April 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29595443/engagement-capable-environments-no-less-challenging-than-other-large-system-changes
#10
Carole A Estabrooks
Kuluski et al.'s (2017) argument for including a more advanced form of health system performance management centred on "the experience of care," raises the major challenge of creating and sustaining engagement-capable environments. Here I briefly address frameworks that may be useful in meeting this challenge - Complex Adaptive Systems, Innovation Diffusion, Whole System Change. I also offer a personal perspective drawn from a successful citizen engagement experience, concluding with a perspective on the numerous challenges we have or are in the process of overcoming compared to the challenges of engagement-capable environments...
October 2017: HealthcarePapers
https://www.readbyqxmd.com/read/29589876/complex-adaptive-systems-approaches-in-health-care-a-slow-but-real-emergence
#11
EDITORIAL
Carmel M Martin
No abstract text is available yet for this article.
February 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29582740/physician-extenders-on-surgical-services-the-need-for-a-systems-perspective
#12
Heather Smith, Craig Kuziemsky, Caitlin Champion
Adding physician extenders (PEs) to surgical teams has the potential to affect care delivery in multiple ways. To develop evidence-based recommendations on integrating PEs into surgical teams, we must recognize that patient care is a complex, adaptive system and requires a health systems perspective to understand how changes will affect outcomes. It is the best method of assessing the system adaptations and trade-offs of adding PEs prior to implementation. Such work would help to optimize research and management of limited health care resources...
April 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29564250/time-for-the-two-spirits-shaping-the-inclusive-policy-environment-for-hispanics-and-transgenders-through-global-health-diplomacy
#13
Vijay Kumar Chattu, Mario O Laplume, Soosanna Kumary
Minority populations in the world are permanently challenged with unequal living and working conditions in their daily lives that compromise their access to needed clinical and preventive services. When we discuss the health-care conditions for minorities, we must address the social determinants of access that are ultimately determined by the policies and politics of the governments. Renowned experts of quality in healthcare have been critical of the current design and implementation of randomized clinical trials, the gold standard of clinical research because they believe that they often, but not always, presume a linear, mechanistic system when in fact improvement in health care takes place within complex adaptive systems that evolve...
October 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29562898/embracing-uncertainty-managing-complexity-applying-complexity-thinking-principles-to-transformation-efforts-in-healthcare-systems
#14
Sobia Khan, Ashley Vandermorris, John Shepherd, James W Begun, Holly Jordan Lanham, Mary Uhl-Bien, Whitney Berta
BACKGROUND: Complexity thinking is increasingly being embraced in healthcare, which is often described as a complex adaptive system (CAS). Applying CAS to healthcare as an explanatory model for understanding the nature of the system, and to stimulate changes and transformations within the system, is valuable. MAIN TEXT: A seminar series on systems and complexity thinking hosted at the University of Toronto in 2016 offered a number of insights on applications of CAS perspectives to healthcare that we explore here...
March 21, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29537479/strengthening-primary-care-through-family-medicine-around-the-world-collaborating-toward-promising-practices
#15
Katherine Rouleau, Monique Bourget, Patrick Chege, Francois Couturier, Paula Godoy-Ruiz, Paul H Grand'Maison, Melanie Henry, Kerling Israel, Videsh Kapoor, Hendra Kurniawan, Louella Lobo, Mahamane Maiga, Samantha Pereira Franca, Lynda Redwood-Campbell, Jamie Rodas, Raman Sohal, Dawit Wondimagegn, Robert Woolard
BACKGROUND AND OBJECTIVES: There is a limited evidentiary base on the development of family medicine in different contexts and countries. The lack of evidence impedes our ability to compare and characterize family medicine models and identify areas of success that have led to the effective provision of care. This paper offers a comparative compilation and analysis of the development of family medicine training programs in seven countries: Brazil, Canada, Ethiopia, Haiti, Indonesia, Kenya, and Mali...
March 8, 2018: Family Medicine
https://www.readbyqxmd.com/read/29489837/how-does-language-change-as-a-lexical-network-an-investigation-based-on-written-chinese-word-co-occurrence-networks
#16
Heng Chen, Xinying Chen, Haitao Liu
Language is a complex adaptive system, but how does it change? For investigating this process, four diachronic Chinese word co-occurrence networks have been built based on texts that were written during the last 2,000 years. By comparing the network indicators that are associated with the hierarchical features in language networks, we learn that the hierarchy of Chinese lexical networks has indeed evolved over time at three different levels. The connections of words at the micro level are continually weakening; the number of words in the meso-level communities has increased significantly; and the network is expanding at the macro level...
2018: PloS One
https://www.readbyqxmd.com/read/29483348/what-is-the-natural-measurement-unit-of-temperament-single-traits-or-profiles
#17
REVIEW
C Robert Cloninger, Igor Zwir
There is fundamental doubt about whether the natural unit of measurement for temperament and personality corresponds to single traits or to multi-trait profiles that describe the functioning of a whole person. Biogenetic researchers of temperament usually assume they need to focus on individual traits that differ between individuals. Recent research indicates that a shift of emphasis to understand processes within the individual is crucial for identifying the natural building blocks of temperament. Evolution and development operate on adaptation of whole organisms or persons, not on individual traits or categories...
April 19, 2018: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/29468832/becoming-breastfeeding-friendly-index-development-and-application-for-scaling-up-breastfeeding-programmes-globally
#18
Rafael Pérez-Escamilla, Amber J Hromi-Fiedler, Muriel Bauermann Gubert, Katie Doucet, Sara Meyers, Gabriela Dos Santos Buccini
Global efforts to further improve exclusive breastfeeding rates have not been successful, in part because effective scaling-up frameworks and roadmaps have not been developed. The Becoming Breastfeeding Friendly (BBF) toolbox includes an evidence-based index, the BBF Index (BBFI), to guide the development and tracking of large scale, well-coordinated, multisector national breastfeeding promotion programmes. This paper describes the development of the BBFI, which is grounded in the Breastfeeding Gear Model complex adaptive systems framework...
February 22, 2018: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/29459228/factors-associated-with-the-implementation-of-community-based-peer-led-health-promotion-programs-a-scoping-review
#19
Agathe Lorthios-Guilledroit, Lucie Richard, Johanne Filiatrault
Peer education is growing in popularity as a useful health promotion strategy. However, optimal conditions for implementing peer-led health promotion programs (HPPs) remain unclear. This scoping review aimed to describe factors that can influence implementation of peer-led HPPs targeting adult populations. Five databases were searched using the keywords "health promotion/prevention", "implementation", "peers", and related terms. Studies were included if they reported at least one factor associated with the implementation of community-based peer-led HPPs...
February 3, 2018: Evaluation and Program Planning
https://www.readbyqxmd.com/read/29448834/single-occupancy-patient-rooms-a-systematic-review-of-the-literature-since-2006
#20
Ellen Taylor, Alan J Card, Melissa Piatkowski
AIM: Our review evaluated both the effects of single-occupancy patient rooms (SPRs) on patient outcomes for hospitalized adults and user opinion related to SPRs. BACKGROUND: In 2006, a requirement for SPRs in hospitals was instituted in the United States. This systematic literature review evaluates research published since that time to evaluate the impact of SPRs. METHODS: The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement...
January 2018: HERD
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