Promoting Rigorous Interdisciplinary Research and Building an Evidence Base to Inform Health Care Learning, Practice, and Policy

2013 ◽  
Vol 3 (11) ◽  
Author(s):  
Mary D. Naylor
Keyword(s):  
Health Care ◽  
Interdisciplinary Research ◽  
Evidence Base

scholarly journals Community Pharmacy Response in the Aftermath of Natural Disasters: Time-Sensitive Opportunity for Research and Evaluation

2018 ◽  
Vol 9 ◽  
pp. 215013271881349 ◽  
Author(s):  
Kyle Melin ◽  
Carlos E. Rodríguez-Díaz
Keyword(s):  
Health Care ◽  
Puerto Rico ◽  
Community Pharmacy ◽  
Natural Disaster ◽  
Community Pharmacists ◽  
Evidence Base ◽  
Third Party ◽  
Future Research ◽  
Prescription Medications ◽  
Collaborative Practice Agreement

One year ago, Hurricane Maria passed over the archipelago of Puerto Rico, leaving widespread disruption of nearly all human services, including the health care sector. In the aftermath of the hurricane, limited access to medical care and prescription medications presented a serious challenge to maintaining control of preexisting chronic diseases. Many patients did not have access to refrigeration for heat-sensitive medications. Significant dietary changes due to the limited availability of shelf-stable foods further exacerbated chronic conditions such as heart failure and diabetes. The role of community pharmacists following a natural disaster has previously been documented, and may include the triage of evacuees, assessment of immunization needs, and provision of prescription medications under a collaborative practice agreement. However, our experience in Puerto Rico demonstrated a variety of barriers limited pharmacists’ ability to adequately respond to the magnitude of this disaster. These included medication shortages, extended loss of power, and limited telecommunications for contacting prescribers, disaster relief agencies, and third-party payers. Ultimately, the lack of preexisting emergency protocols made overcoming such barriers difficult. As the first and sometimes only accessible health care provider to many patients following a natural disaster, we must build a solid evidence base and better understanding of the individual, interpersonal, and environmental factors that contribute to the community pharmacist response. To date, however, a paucity of data exists on both the pharmacist and patient factors, which may contribute to an effective immediate response to patient needs at the community pharmacy following a natural disaster. Future research must focus on these multi-level factors to better inform public policy and effective disaster planning. Ultimately, such research and planning will lead to increased resiliency in our primary health care systems in the face of future disasters.

View From the Penthouse: Epistemological Bumps and Emergent Metaphors as Method for Team Reflexivity

2017 ◽  
Vol 28 (3) ◽  
pp. 408-417 ◽  
Author(s):  
Melissa Park ◽  
Hiba Zafran
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Interdisciplinary Research ◽  
Interdisciplinary Teams ◽  
Reflexive Attention ◽  
Complex Processes ◽  
Collaborative Analysis

Research in health care occurs within interdisciplinary teams that include clinician–researchers who have multiple epistemological orientations. Rigor in collaborative projects requires reflexive attention to how the paradigmatic questions raised by diverse epistemological orientations, and the ethical stances of each researcher, shape findings. This methodological article draws on three events during an ethnography of stigma in psychiatry to define and illustrate how we used double hermeneutics in data analysis. This allowed us to examine the metaphors that emerged from what we are conceptualizing as “epistemological bumps.” This heightened the team’s awareness of the epistemological horizons and mixing that occurred, as well as revealing what mattered to each researcher, during the crafting of our research decisions and findings. We argue that interdisciplinary research on complex processes in health care requires this close examination of team experiences and moral stakes during collaborative analysis, and offer conceptual suggestions for reflexivity and rigor.

scholarly journals International and Russian Experience in Primary Health Care Organization

2018 ◽  
pp. 146-148
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Health Care Organization ◽  
The United States ◽  
Evidence Base ◽  
Care Organization ◽  
Care Provision ◽  
Primary Health ◽  
Effective Instrument

In this study, they presented the analysis of current views on the important link in medical care provision to the population, namely, primary health care. According to the Alma-Ata Declaration on the organization of primary health care this type of medical assistance has made it possible to carry out reforms within this area in many countries, which has led to effective results (the reduction of infant mortality, the increase of life expectancy and a number of other indicators). In this paper, they performed the analysis of Russian and foreign sources of literature on the topic under study between 1978 and 2018. It has been established that primary health care is regarded as the most effective instrument of health protection than specialized medical care according to the experience of Russian Federation, a number of countries in Europe, Asia and the African continent, Australia and the United States. The performed analysis clearly shows that the experience of some countries demonstrates the correlation between the general coverage of primary health care and the achievement of public health indicative indicators. At the same time, the question is raised about the expediency of certain aspect replacement concerning the provision of specialized medical care by the doctors of general practice, i.e. primary health care. The obtained results can be interpreted as an evidence base for the necessity and an undeniable effectiveness of primary health care as a central link in the health care system.

scholarly journals Alternative medicine under the Mental Health Care Act, 2017: Future implications and concerns

2022 ◽  
Vol 07 (01) ◽  
pp. 37-41
Author(s):  
Ramdas Ransing ◽  
Sujita Kumar Kar ◽  
Vikas Menon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Alternative Medicine ◽  
Mental Healthcare ◽  
Evidence Base ◽  
Evidence Based ◽  
Insufficient Evidence ◽  
Indian Government ◽  
Evidence Based Care

In recent years, the Indian government has been promoting healthcare with an insufficient evidence base, or which is non-evidence-based, alongside delivery of evidence-based care by untrained practitioners, through supportive legislation and guidelines. The Mental Health Care Act, 2017, is a unique example of a law endorsing such practices. In this paper, we aim to highlight the positive and negative implications of such practices for the delivery of good quality mental healthcare in India.

Heart and ____ or Give and ____? An Exploration of Variables That Influence Binomial Completion for Individuals With and Without Aphasia

2018 ◽  
Vol 27 (2) ◽  
pp. 819-826 ◽  
Author(s):  
Catherine Torrington Eaton ◽  
Rochelle S. Newman
Keyword(s):  
Reaction Time ◽  
Interdisciplinary Research ◽  
Evidence Base ◽  
Linguistic Variables ◽  
Regression Analyses ◽  
Communication Disorder ◽  
Grammatical Category ◽  
Response Options ◽  
Independent Variables ◽  
Level Of Difficulty

Purpose The goal of this research was to institute an evidence base behind commonly used elicitation materials known as binomials (e.g., “day and night”) that are commonly used for persons with aphasia (PWAs). The study explored a number of linguistic variables that could influence successful binomial completion in nonaphasic adults and PWAs. Method Thirty nonaphasic adults and 11 PWAs were asked to verbally complete 128 binomials; responses were scored by accuracy and reaction time. Binomials were coded according to the following independent variables: frequency of usage, phonological (e.g., alliteration, rhyme) and semantic (i.e., antonymy) relationships, grammatical category of the response, and number of plausible binomial completions. Results Regression analyses demonstrated that, for both groups, greater accuracy was predicted by presence of antonymy and absence of a phonological relationship. Though reaction time models differed between groups, items that elicited a greater number of response options led to longer latencies across participants. Conclusion Findings suggest that clinicians consider antonymy as well as the number of plausible responses for a given prompt when adapting the level of difficulty for their clients. Results also contribute to broader interdisciplinary research on how automatic language is processed in adults with and without neurogenic communication disorder. Supplemental Material https://doi.org/10.23641/asha.6030806

What Can Feminist Epistemology Do for Surgery?

Hypatia ◽  
2014 ◽  
Vol 29 (2) ◽  
pp. 404-421 ◽  
Author(s):  
Mary Jean Walker ◽  
Wendy Rogers
Keyword(s):  
Health Care ◽  
Evidence Base ◽  
Feminist Epistemology ◽  
Cultural Barriers ◽  
Evidence Based ◽  
Surgical Practice ◽  
Lack Of Fit ◽  
What Works ◽  
Based Medicine ◽  
Contemporary Health Care

Surgery is an important part of contemporary health care, but currently much of surgery lacks a strong evidence base. Uptake of evidence‐based medicine (EBM) methods within surgical research and among practitioners has been slow compared with other areas of medicine. Although this is often viewed as arising from practical and cultural barriers, it also reflects a lack of epistemic fit between EBM research methods and surgical practice. In this paper we discuss some epistemic challenges in surgery relating to this lack of fit, and investigate how resources from feminist epistemology can help to characterize them. We point to ways in which these epistemic challenges may be addressed by gathering and disseminating evidence about what works in surgery using methods that are contextual, pluralistic, and sensitive to hierarchies.

Unhealthy Politics

2020 ◽  
Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling
Keyword(s):  
United States ◽  
Health Care ◽  
Scientific Evidence ◽  
The United States ◽  
Evidence Base ◽  
Medical Industry ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Delivery Of Medical Care ◽  
Based Medicine

The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. This book sheds new light on why the government's response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy. The book paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor's orders.” It offers vital insights into the limits of science, expertise, and professionalism in American politics. The book explains why evidence-based medicine is important. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.

Interdisciplinary Education for Research and Everyday Clinical Practice

2016 ◽  
pp. 203-235
Author(s):  
Tomasz Komendziński ◽  
Joanna Dreszer-Drogorób ◽  
Emilia Mikołajewska ◽  
Dariusz Mikołajewski ◽  
Bibianna Bałaj
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Interdisciplinary Research ◽  
Interdisciplinary Teams ◽  
Interdisciplinary Education ◽  
Neurological Deficits ◽  
Medical Sciences ◽  
Interprofessional Practice ◽  
Professional Resources ◽  
Modern Technologies

Teamwork, interprofessional practice and learning are integral to current interdisciplinary research and health care – such approach can maximize professional resources and optimize outcomes. The development of modern technologies associated with medical sciences, and the variability of possible neurological deficits, interventions, and even scales makes this task very difficult. The key problem is regarded successful transition of students to competent work-ready professionals. Current models of education and cooperation within interdisciplinary teams may be not enough flexible. This chapter, based on own experiences from InteRDoCTor project, tries to answer the question: how shape interdisciplinary education and how their results may be wider incorporated into research and clinical practice?

Conclusion: Successes Since the First Edition and Pressing Issues for the Future of Adolescent Mental and Behavioral Health

2017 ◽  
pp. 633-638
Author(s):  
Daniel Romer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Behavioral Health ◽  
Youth Development ◽  
Development Strategy ◽  
Evidence Base ◽  
Gun Violence ◽  
Delivery Of Care ◽  
Health Care Practitioners

Despite improvements in the delivery of care for adolescent mental and behavioral conditions since the first edition of this book, many challenges remain. This concluding chapter highlights some of the most pressing issues. These include the need for more mental health care practitioners, a greater evidence base for the treatment of adolescent conditions, and more focus on reducing family poverty. Given the high rates of gun violence, including homicides and suicides, efforts are needed to reduce access to these weapons. Promising directions in research and the need for a national youth development strategy are also discussed.

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