Chapter 13: The Emotion of ‘Doing Ethics’ in Healthcare Research: A Researcher’s Reflexive Account

2018 ◽  
pp. 213-228
Author(s):  
Geraldine Latchem-Hastings
Keyword(s):  
Healthcare Research

The demographic development of the Finno-Ugric peoples in the modern world

2020 ◽  
Vol 16 (4) ◽  
pp. 759-779
Author(s):  
E.V. Molchanova
Keyword(s):  
Healthcare Research ◽  
Current Situation ◽  
World Health ◽  
Modern World ◽  
Demographic Development ◽  
Russian State ◽  
Regional Medical ◽  
Demographic Processes ◽  
Special Information ◽  
Health Organization

Subject. This study focuses on the Finno-Ugric peoples carrying unique cultural customs and traditions. Objectives. I evaluate how various factors influence the demographic development of the Finno-Ugric peoples. Methods. Analyzing the current situation, I refer to official statistics and the Health for All database of the World Health Organization, statistical yearbooks of the Russian State Statistics Service. All data were organized as a special information system including several related blocks, such as economic development of locations, demographic situation, health and healthcare. Research was based on the comparative analysis of key medical-demographic and socio-economic indicators, and economic-mathematical apparatus. Results. I comprehensively evaluated the current situation macro- and mesoeconomically by gradually shifting from the comparison of countries to regional trends. I traced patterns of medical and demographic processes in the Finno-Ugric countries, such as Hungary, Finland and Estonia, and national autonomies across Russia. Conclusions and Relevance. I discovered that there is a certain relationship between a man and environment that translate into physical and physical health of people. They should be taken into consideration when outlining demographic development programs. The findings can be used to prepare regional medical and demographic documents, including the prevention of suicidal behavior and alcoholism and general medical services.

Uric Acid in Metabolic and Cerebrovascular Disorders: A Review

2020 ◽  
Vol 18 (6) ◽  
pp. 610-618
Author(s):  
Francesca Cortese ◽  
Pietro Scicchitano ◽  
Anna M. Cortese ◽  
Giovanni Meliota ◽  
Andrea Andriani ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Uric Acid ◽  
Cerebrovascular Disorders ◽  
Haemorrhagic Stroke ◽  
Cerebrovascular Diseases ◽  
Healthcare Research ◽  
Cochrane Library ◽  
Close Link ◽  
Mesh Terms ◽  
Active Inflammation

Background: Several studies showed a close link between metabolic syndrome (MetS), type 2 diabetes (T2DM) and cerebrovascular diseases. There is considerable debate regarding the role of uric acid (UA) as a risk factor in these conditions. Objective: The aim of this narrative review is to discuss the links between UA, MetS, T2DM and cerebrovascular disease. Methods: An extensive review has been conducted based on the scientific literature published in English, and indexed in MEDLINE (through PubMed), EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and Google Scholar from January to May 2019. Additional relevant studies published after the initial review were also considered during the period of June 2019-October 2019, during which, this manuscript was written. The Mesh Terms considered were: uric acid, antioxidant, oxidant, metabolic syndrome, diabetes, cerebrovascular diseases, stroke, haemorrhagic stroke, neurocognitive disorders, and their combinations. Results: The literature review shows a dose-dependent inflammatory action of UA, which occurs with serum concentrations >4 mg/dl (>0.24 mmol/l), representing one of the contributors to the chronic inflammatory process that underlies metabolic and cerebrovascular diseases. Conclusion: UA, which is associated with arterial hypertension and cardiovascular diseases, represents one of the indicators of oxidative homeostasis. Increasing concentrations represent a status of active inflammation which is observed with metabolic and cerebrovascular diseases.

The Use of Claims Data in Healthcare Research

2009 ◽  
Vol 2 (1) ◽  
pp. 11-24 ◽  
Author(s):  
Kari Ferver ◽  
Bryan Burton ◽  
Paul Jesilow
Keyword(s):  
Claims Data ◽  
Healthcare Research

A review of mHealth depression apps: Assessing app functions for the Self-Determination Theory (Preprint)

2020 ◽  
Author(s):  
Luke Brownlow
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Basic Needs ◽  
Health Behavior Change ◽  
Self Determination Theory ◽  
Healthcare Research ◽  
The Self ◽  
Self Determination ◽  
Ideal Tool ◽  
Google Play

BACKGROUND Smartphone applications (apps) are an ideal tool that is highly accessible to people who wish to begin self-treatment for depression. While many studies have performed content analyses on healthcare apps, few studies have reviewed these apps for adherence to behavior theory. Furthermore, apps for depression management are underrepresented in healthcare research. OBJECTIVE The objective of this study is to assess mHealth depression apps using SDT as a theoretical framework for meeting needs of autonomy, competence and, relatedness METHODS All depression healthcare apps available in Australia from the iTunes and Google Play app stores that met the inclusion criteria were analyzed. Each app was reviewed based on price options, store availability, download rates, and how in-app functions met the three basic needs for motivation towards health behavior change outlined in the Self-Determination Theory (SDT). RESULTS The analysis of the apps showed that most apps were free to download (69.9%) and addressed at least one of the three needs (81.4%) of SDT. However, few apps addressed all three of the basic needs through their functions (7.7%), and no apps hosted all functions expected to stimulate motivation for health behavior change. Furthermore, neither store availability, price option nor download rate were accurate predictors that apps hosted in-app functions expected to meet the basic needs. CONCLUSIONS The results suggest that some depression healthcare apps that meet the basic needs would effectively stimulate motivation (i.e., autonomy, competence, and relatedness). However, each individual app is limited in its number of functions that meet the basic needs. People who want access to more functions would need to download a suite of apps.

GESTÃO HOSPITALAR E CULTURA DE SEGURANÇA DO PACIENTE NA PERCEPÇÃO DA EQUIPE DE ENFERMAGEM

2017 ◽  
Vol 40 ◽  
Author(s):  
Edenise Maria Santos da Silva-Batalha ◽  
Marta Maria Melleiro
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Healthcare Research

O objetivo deste estudo foi avaliar a percepção de trabalhadores de enfermagem de um hospital de ensino acerca da cultura de segurança do paciente frente à gestão hospitalar. Trata-se de uma pesquisa quantitativa desenvolvida em um hospital de 900 leitos. A amostra foi composta por 301 profissionais de enfermagem. O instrumento de coleta foi o questionário da Agency for Healthcare Research and Quality, intitulado Hospital Survey on Patient Safety Culture, traduzido para o Português e adaptado da versão original em inglês. A análise deu-se por meio de estatísticas descritivas e testes específicos. Os resultados referentes à dimensão “Apoio da gestão hospitalar para segurança do paciente” evidenciaram que 53,6% dos participantes discordavam que a administração propiciava um clima de trabalho favorável à segurança do paciente, 46% discordavam que a segurança do paciente fosse uma prioridade da administração e 58,3% concordavam que a administração apenas se interessava pela segurança após a ocorrência de eventos adversos. Tais resultados demonstram a necessidade de envolvimento maior da gestão hospitalar para com a segurança dos pacientes, favorecendo o amadurecimento da cultura de segurança. Ainda, a relação entre a enfermagem e a gestão hospitalar deve ser fortalecida, baseando-se em relações mais próximas e lineares. Conclui-se que não é apenas uma parte da organização que é responsável pela cultura de segurança, há, portanto, a necessidade de envolver a gestão e todos os trabalhadores na criação, implementação e fortalecimento dos sentimentos, valores, comportamentos, atitudes e ações que irão fomentar essa cultura. Palavras-chave: Administração hospitalar. Segurança do paciente. Enfermagem.

Measurement Issues in Dissemination and Implementation Research

2017 ◽  
Author(s):  
Cara C. Lewis ◽  
Enola K. Proctor ◽  
Ross C. Brownson
Keyword(s):  
Health Care ◽  
Implementation Research ◽  
Health Care Access ◽  
Healthcare Research ◽  
Dissemination And Implementation ◽  
Measurement Issues ◽  
Care Access ◽  
Dissemination And Implementation Science ◽  
Dissemination And Implementation Research ◽  
Access And Quality

The National Institutes of Health, the Agency for Healthcare Research and Quality, the CDC, and a number of private foundations have expressed the need for advancing the science of dissemination and implementation. Interest in dissemination and implementation research is present in many countries. Improving health care requires not only effective programs and interventions, but also effective strategies to move them into community based settings of care. But before discrete strategies can be tested for effectiveness, comparative effectiveness, or cost effectiveness, context and outcome constructs must be identified and defined in such a way that enables their manipulation and measurement. Measurement is underdeveloped, with few psychometrically strong measures and very little attention paid to their pragmatic nature. A variety of tools are needed to capture health care access and quality, and no measurement issues are more pressing than those for dissemination and implementation science.

scholarly journals Prevalence and risk factors for antibiotic utilization in Chinese children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shasha Guo ◽  
Qiang Sun ◽  
Xinyang Zhao ◽  
Liyan Shen ◽  
Xuemei Zhen
Keyword(s):  
Risk Factors ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Healthcare Research ◽  
Chinese Children ◽  
Rural Setting ◽  
Antibiotic Prescribing ◽  
Antibiotic Utilization ◽  
At Home

Abstract Background Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China. Methods English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis. Results Of 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver’s self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue. Conclusion The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.

scholarly journals Comparison of open versus endovascular surgical treatment of abdominal aortic aneurysm

2020 ◽  
Vol 6 (3) ◽  
pp. 477-480
Author(s):  
Sabine Kischkel ◽  
Carsten M. Bünger
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Treatment Options ◽  
Prosthetic Graft ◽  
Healthcare Research ◽  
Vascular Medicine ◽  
Related Complication ◽  
Abdominal Aortic ◽  
Open Aortic Repair ◽  
Risk Of Rupture

AbstractAbdominal aortic aneurysm (AAA) is a common condition of increasing prevalence, particularly among older men. An AAA is defined as a permanent dilation of the abdominal aorta, with a diameter greater than 30 mm or a diameter greater than 50% of the aortic diameter at the level of the diaphragm. As the size of the aneurysm increases, so does the risk of rupture. Therefore, prophylactic repair with insertion of a prosthetic graft is offered. Since 1951 traditional open aneurysm repair (OAR) was reported and minimally invasive endovascular repair (EVAR) was first reported in 1986. Data from four randomized controlled trials (EVAR-1, DREAM, OVER, ACE) for abdominal aortic aneurysm, which enrolled almost 3000 patients, in a period from 1999 to 2008, were summarized. In addition, registry databases on the treatment of AAA of average 4000 patients per year, based from 2015 to 2018 of the German Institute for Vascular Medicine Healthcare Research of the German Society for Vascular Surgery and Vascular Medicine, were compared. The EVAR procedure for AAA showed a lower risk of perioperative mortality but was associated with a higher cardiovascular and aneurysm-related complication rate. In particular, patients aged 80 years or older benefited from EVAR since the 30-day mortality of patients receiving OAR was higher. In mid-term and long-term follow-up there were no differences in survival after endovascular and open aortic repair. Overall, it depends on the respective underlying disease and anatomy which of the two approaches is to be preferred. In conclusion, both treatment options can be considered as equal and can be offered to patients.

scholarly journals An Environmental Scan of Ambulatory Care Quality Indicators for Patients With Advanced Kidney Disease Currently Used in Canada

2021 ◽  
Vol 8 ◽  
pp. 205435812199109
Author(s):  
Jay Hingwala ◽  
Amber O. Molnar ◽  
Priyanka Mysore ◽  
Samuel A. Silver
Keyword(s):  
Kidney Disease ◽  
Ambulatory Care ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Healthcare Research ◽  
Care Quality ◽  
Institute Of Medicine ◽  
Environmental Scan ◽  
Number Of Patients ◽  
Ambulatory Patients

Background: Quality indicators can be used to identify gaps in care and drive frontline improvement activities. These efforts are important to prevent adverse events in the increasing number of ambulatory patients with advanced kidney disease in Canada, but it is unclear what indicators exist and the components of health care quality they measure. Objective: We sought to identify, categorize, and evaluate quality indicators currently in use across Canada for ambulatory patients with advanced kidney disease. Design: Environmental scan of quality indicators currently being collected by various organizations. Setting: We assembled a 16-member group from across Canada with expertise in nephrology and quality improvement. Patients: Our scan included indicators relevant to patients with chronic kidney disease in ambulatory care clinics. Measurements: We categorized the identified quality indicators using the Institute of Medicine and Donabedian frameworks. Methods: A 4-member panel used a modified Delphi process to evaluate the indicators found during the environmental scan using the American College of Physicians/Agency for Healthcare Research and Quality criteria. The ratings were then shared with the full panel for further comments and approval. Results: The environmental scan found 28 quality indicators across 7 provinces, with 8 (29%) rated as “necessary” to distinguish high-quality from poor-quality care. Of these 8 indicators, 3 were measured by more than 1 province (% of patients on a statin, number of patients receiving a preemptive transplant, and estimated glomerular filtration rate at dialysis start); no indicator was used by more than 2 provinces. None of the indicators rated as necessary measured timely or equitable care, nor did we identify any measures that assessed the setting in which care occurs (ie, structure measures). Limitations: Our list cannot be considered as an exhaustive list of available quality indicators at hand in Canada. Our work focused on quality indicators for nephrology providers and programs, and not indicators that can be applied across primary and specialty providers. We also focused on indicator constructs and not the detailed definitions or their application. Last, our panel does not represent the views of other important stakeholders. Conclusions: Our environmental scan provides a snapshot of the scope of quality indicators for ambulatory patients with advanced kidney disease in Canada. This catalog should inform indicator selection and the development of new indicators based on the identified gaps, as well as motivate increased pan-Canadian collaboration on quality measurement and improvement. Trial registration: Not applicable as this article is not a systematic review, nor does it report results of a health intervention on human participants.

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