scholarly journals Development of models of care coordination for rare conditions: A qualitative study

2021 ◽  
Author(s):  
Holly Walton ◽  
Amy Simpson ◽  
Angus IG Ramsay ◽  
Amy Hunter ◽  
Jennifer Jones ◽  
...  
Keyword(s):  
Care Coordination ◽  
Healthcare Professionals ◽  
Models Of Care ◽  
Roles And Responsibilities ◽  
Societal Factors ◽  
Healthcare Environment ◽  
Patient Organisations ◽  
Key Stakeholders ◽  
Different Types ◽  
The Individual

Introduction: Improving care coordination for people with rare conditions may help to reduce burden on patients and carers and improve the care that patients receive. We recently developed a taxonomy of different ways of coordinating care for rare conditions. It is not yet known which models of care coordination are appropriate in different situations. This study aimed to: i) explore what types of care coordination may be appropriate in different situations, and ii) use these findings to develop hypothetical models of care coordination for rare conditions. Methods: To explore appropriateness of different types of care coordination, we conducted interviews (n=30), four focus groups (n=22) and two workshops (n=27) with patients, carers, healthcare professionals, commissioners, and charity representatives. Participants were asked about preferences, benefits and challenges, and the factors influencing coordination. Thematic analysis was used to develop hypothetical models of care coordination. Models were refined following feedback from workshop participants. Results: Stakeholders prefer models of care that: are nationally centralised or a hybrid of national and local care, involve professionals collaborating to deliver care, have clear roles and responsibilities outlined (including administrative, coordinator, clinical and charity roles), provide access to records and offer flexible appointments (in terms of timing and mode). Many factors influenced coordination, including those relating to the patient (e.g., condition complexity, patient's location and ability to coordinate their own care), the healthcare professional (e.g., knowledge and time), the healthcare environment (e.g., resources) and societal factors (e.g., availability of funding). We developed and refined ten illustrative hypothetical models of care coordination for rare conditions. Conclusion: Findings underline that different models of care coordination may be appropriate in different situations. It is possible to develop models of care coordination which are tailored to the individual in context. Findings may be used to facilitate planning around which models of care coordination may be appropriate in different services or circumstances. Findings may also be used by key stakeholders (e.g. patient organisations, clinicians and service planners) as a decision-making tool.

scholarly journals Developing a taxonomy of care coordination for people living with rare conditions: A qualitative study

2021 ◽  
Author(s):  
Holly Walton ◽  
Amy Simpson ◽  
Angus Ramsay ◽  
Emma Hudson ◽  
Amy Hunter ◽  
...  
Keyword(s):  
Focus Groups ◽  
Care Coordination ◽  
Health Care Professionals ◽  
Administrative Support ◽  
Models Of Care ◽  
Face To Face ◽  
Roles And Responsibilities ◽  
The United Kingdom ◽  
New Models ◽  
Taxonomy Development

Background: Improving care coordination is particularly important for individuals with rare conditions (who may experience multiple inputs into their care, across different providers and settings). To develop and evaluate strategies to potentially improve care coordination, it is necessary to develop a method for organising different ways of coordinating care for rare conditions. Developing a taxonomy would help to describe different ways of coordinating care and in turn facilitate development and evaluation of pre-existing and new models of care coordination for rare conditions. To the authors' knowledge, no studies have previously developed taxonomies of care coordination for rare conditions. This research aimed to develop and refine a care coordination taxonomy for people with rare conditions. Methods: This study had a qualitative design and was conducted in the United Kingdom. To develop a taxonomy, six stages of taxonomy development were followed. We conducted interviews (n=30 health care professionals/charity representatives/commissioners) and focus groups (n=4 focus groups, 22 patients/carers with rare/ultra-rare/undiagnosed conditions). Interviews and focus groups were audio-recorded with consent, and professionally transcribed. Findings were analysed using thematic analysis. Themes were used to develop a taxonomy, and to identify which types of coordination may work best in which situations. To refine the taxonomy, we conducted two workshops (n=12 patients and carers group; n=15 professional stakeholder group). Results: Our taxonomy has six domains, each with different options. The six domains are: 1) Ways of organising care (local, hybrid, national), 2) Ways of organising professionals involved in care (collaboration between many or all professionals, collaboration between some professionals, a lack of collaborative approach), 3) Responsibility for coordination (administrative support, formal roles and responsibilities, supportive roles and no responsibility), 4) How often appointments and coordination take place (regular, on demand, hybrid), 5) Access to records (full or filtered access), and 6) Mode of care coordination (face-to-face, digital, telephone). Conclusions: Findings indicate that there are different ways of coordinating care across the six domains outlined in our taxonomy. This may help to facilitate the development and evaluation of existing and new models of care coordination for people living with rare conditions.

Images of the Hospice

2017 ◽  
Author(s):  
Alan Baron ◽  
John Hassard ◽  
Fiona Cheetham ◽  
Sudi Sharifi
Keyword(s):  
General Public ◽  
Palliative Medicine ◽  
Healthcare Professionals ◽  
Hospice Care ◽  
Care Work ◽  
Dirty Work ◽  
Key Stakeholders ◽  
Host Organization ◽  
Local Healthcare

This chapter looks ‘outside’ the Hospice at issues of the organization’s image. The authors talked to staff, volunteers, and members of the general public, as well as to a number of key stakeholders in the local healthcare community, in order to gauge their views on the host organization. The analysis examines the problems associated with the image of hospices and discusses attempts of staff and volunteers to ‘dispel the myths’ about the nature of hospice care work—a form of labour which potentially runs the risk of being characterized as ‘dirty work’. The chapter then examines how the Hospice is seen in the eyes of other healthcare professionals and discusses the choice of palliative medicine as a career for junior medics. Finally it discusses a degree of ‘confusion’ that staff and volunteers claim exists in the minds of GPs and consultants in specialist cancer hospitals about the role of hospices.

Experience report about the regional internship of the UFSM's medicine course in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M N Silva ◽  
M A Maas ◽  
D A Barreto ◽  
M V P Costa ◽  
D S Vargas ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Knowledge Exchange ◽  
Constant Acceleration ◽  
Quality Healthcare ◽  
Primary Health ◽  
The Individual ◽  
Quantitative Indicators ◽  
Different Cultures ◽  
Santa Maria ◽  
General Community

Abstract Background The Regional Internship (RI) is an extension project provided by the Federal University of Santa Maria (Brazil) that gives the medicine students a real experience of how the Primary Health Care (PHC) works, offering them a chance to grow as professionals, gaining self-trust and autonomy while being supervised by the preceptors. The cities where the program operates are small and they suffer with lack of high-quality healthcare professionals, which makes this internship also important for these communities. Worldwide, mainly in developing countries, the deficiency of proper PHC is a problem that can be attenuated by this proposal of introducing updated doctors eager to improve their skills and benefit the society. Objective The aim of the present study is to report, through the interns' exposition, how the internship was capable of contributing for the life and formation of the medicine student. Results Based on an extension project that gives the students an opportunity of a more embracing experience with the community, it is possible to notice the importance of the extension on the curricular complementation. Moreover, with the interaction between students and community, the knowledge exchange and the experience with different cultures benefit and contribute to the medical formation of these students, as well as in the population health context. Conclusions This is a part of the portfolio delivered by an academic: 'At the end of the two months of Regional Internship I have the sensation of mission accomplished and satisfaction. The experience offered by this phase of the course is incomparable, I feel more secure, more autonomous, it's like the growth that was in a constant acceleration before now suffered an exponential improve.' Key messages The benefits of Regional Internship cannot be evaluated only by quantitative indicators, but also by the individual experiences lived by interns, preceptors and a general community. After the internship period, academics conclude that they feel more confident and encouraged to face the challenges of medical life.

scholarly journals Selected In Situ Hybridization Methods: Principles and Application

Molecules ◽  
2021 ◽  
Vol 26 (13) ◽  
pp. 3874
Author(s):  
Dominika Veselinyová ◽  
Jana Mašlanková ◽  
Katarina Kalinová ◽  
Helena Mičková ◽  
Mária Mareková ◽  
...  
Keyword(s):  
In Situ Hybridization ◽  
Imaging Techniques ◽  
Cell Communication ◽  
Probe Design ◽  
Rapid Progress ◽  
In Situ Techniques ◽  
Different Types ◽  
Laboratory Procedures ◽  
The Individual

We are experiencing rapid progress in all types of imaging techniques used in the detection of various numbers and types of mutation. In situ hybridization (ISH) is the primary technique for the discovery of mutation agents, which are presented in a variety of cells. The ability of DNA to complementary bind is one of the main principles in every method used in ISH. From the first use of in situ techniques, scientists paid attention to the improvement of the probe design and detection, to enhance the fluorescent signal intensity and inhibition of cross-hybrid presence. This article discusses the individual types and modifications, and is focused on explaining the principles and limitations of ISH division on different types of probes. The article describes a design of probes for individual types of in situ hybridization (ISH), as well as the gradual combination of several laboratory procedures to achieve the highest possible sensitivity and to prevent undesirable events accompanying hybridization. The article also informs about applications of the methodology, in practice and in research, to detect cell to cell communication and principles of gene silencing, process of oncogenesis, and many other unknown processes taking place in organisms at the DNA/RNA level.

scholarly journals Exploring the roles and responsibilities of non-medical prescribing leads in the South West of England

2020 ◽  
Vol 2 (10) ◽  
pp. 546-554
Author(s):  
Sally Jarmain ◽  
Nicola Carey
Keyword(s):  
Healthcare Professionals ◽  
The South ◽  
Job Description ◽  
Medical Practitioners ◽  
Roles And Responsibilities ◽  
Organisational Support ◽  
South West ◽  
Support Research

The aim of this study was to explore the role and responsibilities of non-medical prescriber leads in the southwest of England. A questionnaire was completed by 22 leads in this region in 2019. A total of 2388 healthcare professionals were reported to have the prescribing qualification amongst the 22 participating organisations. Just under half (44.5%) of the leads did not have any designated time to undertake the role, and a third (31.2%) did not have the role included within their job description. The demands of the role were evident in the key areas of activities reported by leads in this study. A total of 21 (95.5%) respondents reported that governance and communication with managers/non-medical prescribers was important or essential to their role, whilst only 11 (50%) described the support of designated medical practitioners in this way. The responsibilities of the leads in the southwest of England are complex, however, many of them undertake the role with limited organisational support. Research is required in order to fully understand the role and responsibilities of the Lead role, so that it can be supported appropriately. Without this, the full benefits of non-medical prescibing are unlikely to be realised, as Leads will not have the time or capacity to undertake the role effectively.

The Nature of Political Thought

1923 ◽  
Vol 17 (2) ◽  
pp. 204-215
Author(s):  
Raymond G. Gettell
Keyword(s):  
Political Thought ◽  
Social Life ◽  
Political Organization ◽  
Present Condition ◽  
Medieval Period ◽  
Economic Interests ◽  
Different Types ◽  
Philosophy Professor ◽  
Political Conditions ◽  
The Individual

In the introduction to his readings in political philosophy, Professor Coker says, “since the time of Plato there has been, in every philosophic age, some inquiry as to the justification of political organization in general, as to the relative merits of different political forms, and as to the appropriate position and privileges of the individual as master, member, or subject of the political order of society. Why do we have political organization? What in our present condition do we owe to it? What future benefits may we properly expect to derive from it? Are its purposes characteristically manifold and changing, or are they ultimately reducible to a few limited objects or to some single end? What is its best form? Who should control it? What is its proper relation to the ideas and sentiments of the community at its basis? What spheres of individual and social life is it incompetent to enter? Philosophers and publicists of various types have sought to answer these questions in abstract terms.”If an analysis be made of the questions with which political thought has been concerned, it is found that emphasis was placed at various periods upon widely different types of problems. In the medieval period political controversy centered in the contest for supremacy between spiritual and temporal authorities; in the seventeenth and eighteenth centuries, the dominant interest was in the contest between monarchic and democratic theories of political organization; at present, the extent of state activities has come into prominence, and the connection between political and economic interests is especially close. Besides, political conditions have changed so greatly from age to age that the same problem had quite different meanings at different periods.

PRAGMATIC POTENTIAL OF AUTHOR’S AND TRANSFORMED PHRASEOLOGIES IN THE WORK OF CARLOS RUIZ ZAFÓN «THE PRISONER OF HEAVEN»

2021 ◽  
pp. 18-28
Author(s):  
A. Yu. Bovsunivska A. Yu.
Keyword(s):  
Emotional State ◽  
Spanish Language ◽  
The Novel ◽  
Unique Combination ◽  
Textual Space ◽  
Different Types ◽  
General Linguistic ◽  
The Individual ◽  
Pragmatic Aspects ◽  
Individual Style

The article is devoted to the study of pragmatic aspects of the use of phraseology in the textual space of Carlos Ruiz Safón’s novel «Prisoner of Heaven». One of the defining features of the individual style of this well-known modern Spanish writer is the metaphoricity and figuration of aristic expression, the saturation of the text with phraseological units that play a significant role in creating a pragmatic charge of the work of art. Along with general linguistic phraseological units, which include commonly-used vocabulary, the author uses dialectal and authorial phraseological units, which is a feature of his individual style. All three designated groups of phraseological units mostly reflect the negative psychophysical and emotional state of the characters. The author uses dialectal, individually-authorial and modified phraseological units, which is a feature of his individual style. It is determined that transformation is one of the most productive and most effective ways to update linguistic means in works of art. Author’s modification of FU leads to a change in the semantics and structure of expression, gives it a more expressive or emotional coloring. Transformed phraseology is limited to individual usage and is subject to the context of the work. Modified FUs in the Zafón’s artistic space acquire certain aesthetic and artistic qualities. Their modification is mainly to create the desired stylistic effect – to achieve emotional or expressive expression, which increases the reader’s interest, focuses on the content, issues of the work, as well as reveals the potential expressive potential of the Spanish language. In the transformed FUs, not just a new meaning is traced, but a combination of the well-known and the occasional. The unique combination of different types of phraseological units in the novel is considered a manifestation of individual style and makes a representation of the individually-authorial linguistic picture of the world more expressive.

Conceptualizing Narrative Health and Medicine to Develop Cultural Competence to Improve Communication During the COVID-19 Pandemic

2021 ◽  
Vol 8 (1) ◽  
pp. 32-36
Author(s):  
Kent Willis ◽  
Colleen Marzilli
Keyword(s):  
Healthcare Professional ◽  
Cultural Competence ◽  
Severe Acute Respiratory Syndrome ◽  
Patient Care ◽  
Patient Outcomes ◽  
Healthcare Professionals ◽  
Important Concept ◽  
Healthcare Environment ◽  
Health Narrative ◽  
Improve Patient

Narrative health is a technique that healthcare professionals can use to connect with patients. The events of 2020, including the global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have identified that patient care is largely dependent upon relationships within the healthcare environment. Relationships in the healthcare environment are established through a trusting exchange between the patient and provider, and one technique to develop this relationship and trust is through narrative health. Narrative health provides the exchange of information between patient and provider in a discussion-like manner, or narrative health. This strategy promotes cultural competence amongst the healthcare professional team and improves communication between the patient and provider. Narrative health is an important concept for healthcare professionals to understand, and narrative health should be a part of any healthcare professional’s toolbox, especially in vulnerable times like the COVID pandemic. The inclusion of narrative health in practice has the potential to improve patient outcomes and empower healthcare professionals and patients.

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