scholarly journals Impact of group practices on patients, physicians and healthcare systems: protocol for a scoping review

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022164 ◽  
Author(s):  
Terry M Zwiep ◽  
Joshua A Greenberg ◽  
Fady Balaa ◽  
Daniel I McIsaac ◽  
Reilly P Musselman ◽  
...  
Keyword(s):  
Scoping Review ◽  
Healthcare Systems ◽  
Economic Benefits ◽  
Group Practices ◽  
Key Stakeholders ◽  
Potential Benefits ◽  
Quantitative Analyses ◽  
Care Satisfaction ◽  
The Impact

IntroductionGroup practices have potential benefits for patients, physicians and healthcare systems. Although group practices have been around for many years, research in this area is lacking and generally is centred around the economic benefits that may be realised from group practice. The aim of this scoping review is to identify the impact that group practices have on patients, physicians and healthcare systems to guide further research in this area.Methods and analysisA scoping review will be performed based on the methodology proposed by Arksey and O’Malley and refined by Levac and colleagues. MEDLINE, EMBASE, Cochrane Central and Cochrane Economic Database will be searched from inception to present day to identify relevant studies that assess the impact of group practices on patient care, satisfaction and outcomes; physician quality of life, satisfaction and income and healthcare systems. Titles and abstracts will be screened by two members and the abstraction results charted and verified. Qualitative and quantitative analyses will be performed to identify key themes.Ethics and disseminationResearch ethics board approval is not required for this scoping review. A consultation phase will be used to discuss the results with key stakeholders followed by dissemination at local and national levels. We will also publish the results in a peer-reviewed journal.

scholarly journals Group practice impacts on patients, physicians and healthcare systems: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041579
Author(s):  
Terry Zwiep ◽  
San (Hilalion) Ahn ◽  
Jamie Brehaut ◽  
Fady Balaa ◽  
Daniel I McIsaac ◽  
...  
Keyword(s):  
Interpersonal Relationships ◽  
Scoping Review ◽  
Research Question ◽  
Descriptive Analysis ◽  
Final Analysis ◽  
Healthcare Systems ◽  
Group Practice ◽  
Advantages And Disadvantages ◽  
Group Practices

ObjectiveTo identify the advantages and disadvantages that group practices have on patients, physicians and healthcare systems.Study designA scoping review was performed based on the methodology proposed by Arksey and O’Malley, and refined by Levac et al. Titles and abstracts were screened by two reviewers. A quantitative analysis was performed to assess the type, year and region of publication, as well as the population studied. A qualitative descriptive analysis was performed to identify common themes.Study settingMEDLINE, EMBASE and Cochrane databases were searched from database inception to October 2018 for papers which assessed outcomes relevant to the research question.ResultsOur search strategy returned 2408 papers and 98 were included in the final analysis. Most papers were from the USA, were surveys and assessed physician outcomes. Advantages of group practices for patients included improved satisfaction and quality of care. Studies of physicians reported improved quality of life and income, while disadvantages included increased stress due to poor interpersonal relationships. Studies of healthcare systems reported improved efficiency and better utilisation of resources.ConclusionsGroup practices have many benefits for patients and physicians. However, further work needs to be done assessing patient outcomes and establishing the elements that make a group practice successful.

scholarly journals Preventing disproportionate mortality in ICU overload situations: Empirical evidence from the first COVID-19 wave in Europe

2021 ◽  
Author(s):  
Paul Buijs ◽  
Rodolfo Catena ◽  
Matthias Holweg ◽  
Taco van der Vaart
Keyword(s):  
Critical Care ◽  
The Netherlands ◽  
Patient Outcomes ◽  
Healthcare Systems ◽  
Long Run ◽  
Key Stakeholders ◽  
Quantitative Analyses ◽  
The Common ◽  
Improve Patient

Avoiding overloading the healthcare system remains a central issue during the COVID-19 pandemic. The logic of preventing such overload situations is intuitive since the level and quality of critical care is a function of the available capacity to provide it. Where this capacity is no longer available due to a surge in admissions, patient outcomes will invariably deteriorate in the long run, which ultimately leads to disproportionate mortality. In this paper, we study the three worst affected regions in Italy, the Netherlands, and Germany during the first COVID-19 wave in the spring of 2020. We report on quantitative analyses that show how mortality rises non-linearly as the proportion of COVID-19 patients in the ICU increases. We identify changes to the patient-staff ratio, increasing exhaustion and infection levels amongst staff, as well as equipment shortages as likely causes driving this rise in mortality. We explore these findings further with interviews of key stakeholders in the respective healthcare systems. Our results demonstrate that the common approach of managing COVID-19 surges by stretching ICU capacity in hotspot regions may be detrimental to patient outcomes. Instead, we posit that transferring patients proactively out of developing hotspots to less affected regions, well before high ICU workload situations emerge, will improve patient outcomes.

scholarly journals Exercise efficacy and prescription during treatment for pancreatic ductal adenocarcinoma: a systematic review

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dominic O’Connor ◽  
Malcolm Brown ◽  
Martin Eatock ◽  
Richard C. Turkington ◽  
Gillian Prue
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Pancreatic Cancer ◽  
Adjuvant Therapy ◽  
Physical Function ◽  
Meta Analysis ◽  
Ductal Adenocarcinoma ◽  
Key Stakeholders ◽  
The Impact

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.

scholarly journals Scoping review of mental health in prisons through the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046547
Author(s):  
Luke Johnson ◽  
Kerry Gutridge ◽  
Julie Parkes ◽  
Anjana Roy ◽  
Emma Plugge
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Grey Literature ◽  
Well Being ◽  
Health Impact ◽  
Poor Quality ◽  
Eligibility Criteria ◽  
Prison Staff ◽  
The Impact

ObjectiveTo examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.DesignScoping review.Data sourcesPubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.Eligibility criteria for selection of studiesAll papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.ResultsOf 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.ConclusionsIt is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.

scholarly journals Entrepreneurial Innovation: the European Union perspective

2018 ◽  
Vol 18 (2) ◽  
pp. 137-154 ◽  
Author(s):  
Augustin Ignatov
Keyword(s):  
European Union ◽  
Future Research ◽  
The European Union ◽  
Business Innovation ◽  
The North ◽  
Quantitative Analyses ◽  
Entrepreneurial Innovation ◽  
Entrepreneurial Activities ◽  
The Impact

Abstract Entrepreneurship is the driving force of economic development and progress. A successful state, first of all, provides favourable conditions motivating the businesses to grow and flourish. Presently, the European Union is developing unevenly with multiple economic misbalances across the community, the West and the North being more competitive than the South and the East. The aim of the present research is to examine the framework of interdependence between the degree to which the governance quality and economic freedom in the European Union are supporting entrepreneurial activities and the performance of the community in terms of entrepreneurial innovation. The results reached through applying both qualitative and quantitative analyses show that the interdependence between entrepreneurial innovation and regulatory efficiency is strong for many of the European Union states which is determined by multiple factors including the institutional and economic ones. Also, the present paper underlines the importance of the proper regulatory framework for the efficient development of business innovation. The future research on this matter could consider in depth the impact of socio-cultural environment, its influence on the quality of governance and the impact of both upon the European entrepreneurial innovation.

scholarly journals Impact of Anxiety and Depression on Quality of Life among Patients Undergoing Hemodialysis: A Scoping Review

2020 ◽  
Vol 2 (3) ◽  
pp. 14
Author(s):  
Fatima I. AlNashri ◽  
Hayfa H. Almutary ◽  
Elham A. Al Nagshabandi
Keyword(s):  
Quality Of Life ◽  
Scoping Review ◽  
Short Form ◽  
Hemodialysis Patients ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Life Threatening ◽  
Anxiety Depression ◽  
The Impact

Context: Chronic kidney disease (CKD) is a life-threatening problem of global concern. Living with CKD is associated with many psychological problems, including depression and anxiety, which can directly or indirectly affect the quality of life. Only one review in the existing literature has assessed these associations among CKD patients using different dialysis modalities. However, the experience of these symptoms could be higher among patients on hemodialysis therapy. In this purview, there is a need to narrow the previous work to be more focused on hemodialysis patients. Aim: This scoping review aims to determine the gaps in the knowledge about the impact of anxiety and depression concerning QOL among people undergoing hemodialysis. Methods: The studies selected were those examined the relationships between depression or/and anxiety with quality of life in adult patients on hemodialysis. The CINAHL, MEDLINE, and Pub Med databases were searched for literature published between January 2012 and December 2019. The quality of the included studies was also apprised. Eleven studies met the inclusion criteria. Results: Six studies examined the impact of depression and anxiety on the quality of life. Five studies identified from the review have examined the relationships between depression and quality of life. It was established that the prevalence of anxiety and depression was high among hemodialysis patients, and the same was associated with low quality of life. Conclusion: The literature review highlights the negative associations between anxiety, depression, and quality of life among hemodialysis patients. It is, therefore, essential to screen hemodialysis patients frequently for anxiety and depression using a short-form questionnaire. This screening would allow for providing early interventions, and the potential deterioration of quality of life could be prevented. Further longitudinal studies are needed to assess these relationships. Additionally, further research is needed to determine effective interventional programs to improve the overall quality of life.

Quality of design and reporting of animal research in peritoneal dialysis: A scoping review

2020 ◽  
Vol 40 (4) ◽  
pp. 394-404
Author(s):  
Janusz Witowski ◽  
Dorota Sikorska ◽  
András Rudolf ◽  
Izabela Miechowicz ◽  
Julian Kamhieh-Milz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Scoping Review ◽  
Animal Studies ◽  
Reporting Quality ◽  
Animal Research ◽  
Size Estimation ◽  
Quality Of Reporting ◽  
The Impact

The concerns about reproducibility and validity of animal studies are partly related to poor experimental design and reporting. Here, we undertook a scoping review of the literature to determine the extent and quality of reporting of animal studies on peritoneal dialysis (PD). Online databases were searched to identify 567 relevant original articles published between 1979 and 2018. These were analyzed with respect to bibliographic parameters and general aspects of animal experimentation. A subgroup of 120 studies was analyzed in detail in terms of the impact on the reporting quality of the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines for animal studies. The number of animal studies on PD increased continuously over the years with a thematic shift toward long-term preservation of the peritoneum as a dialyzing organ. There were significant deficiencies in research design with the lack of sample size estimation, randomization, and blinding being the commonest shortcomings. The description of animal numbers, housing conditions, use of medication, and statistical analysis was incomplete. The introduction in 2010 of the ARRIVE guidelines produced very little improvement in the completeness of reporting regardless of journal impact factor. The animal studies on PD suffer from deficits in experimental protocols and transparent reporting. These drawbacks need to be corrected to ensure high-quality and much-needed animal research in PD.

scholarly journals Quality of patient, family, caregiver and public engagement in decision-making in healthcare systems: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032788
Author(s):  
Clayon Hamilton ◽  
M Elizabeth Snow ◽  
Nancy Clark ◽  
Shannon Gibson ◽  
Maryam Dehnadi ◽  
...  
Keyword(s):  
Decision Making ◽  
Scoping Review ◽  
Family Caregiver ◽  
Research Question ◽  
Grey Literature ◽  
Healthcare Systems ◽  
Evaluation Framework ◽  
Bibliographic Databases ◽  
Scientific Article

IntroductionTo advance person- and family-centred healthcare, government initiatives have supported the engagement of patients and family caregivers in decision-making in healthcare systems. There is, however, no consensus on how to define success for such initiatives. This scoping review aims to identify the key elements for defining the quality of patient and family caregiver engagement in decision-making across the engagement domains (individual, community/organisation, system) of British Columbia’s healthcare system. We will use those elements to develop a conceptual evaluation framework.Methods and analysisThis scoping review follows Arskey and O’Malley’s methodology. (1) The research question was identified through team discussions. (2) Articles for data source will be identified using a librarian-informed search strategy for seven bibliographic databases as well as grey literature sources. (3) Selected articles will be relevant to the evaluation of patient and family caregiver engagement in healthcare systems. (4) Two researchers will independently extract data into predefined and emerging categories. (5) The researchers will reconcile and organise the identified elements. The research team’s collective perspective will then refine the elements, and select, interpret and summarise the results. (6) Persons from key stakeholder groups will be consulted to refine the emergent conceptual framework.Ethics and disseminationWe will seek ethics approval for the stakeholder consultation. This study follows an integrated knowledge translation approach. The results will inform evaluation of the Patients as Partners Initiative of the British Columbia Ministry of Health, and will be disseminated as a scientific article, a research brief, and presentations at conferences and stakeholder meetings.

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