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2.
Nurs Leadersh (Tor Ont) ; 32(SP): 29-40, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31099745

RESUMEN

Background: Mobile health (mHealth) is a rapidly growing field with the potential to transform healthcare delivery. Smartphone technologies have been developed and integrated into the patient call bell system for healthcare staff to receive calls; however, there is a lack of high-quality evidence to support the implementation and evaluate the effectiveness of these devices in a healthcare setting. Aim: The aim of this study is to explore nurses' perceptions of smartphone technology devices in enhancing the nurse-patient relationship and improving nursing workflows. Methods: A semi-structured focus group and interviews were used to illicit nurses' experiences with smartphone technology. Interviews were audio recorded, transcribed and subjected to a content analysis to identify emerging themes from the data. Results: Interviews with nurses provided insight into the benefits and challenges of smartphone use in the clinical setting. Multiple benefits were identified by nurse participants, including time management and convenience, prioritization, patient safety and enhancement of the nurse-patient relationship. Conclusion: There are multiple benefits of smartphone technology for both nurses and patients. Hospitals proposing to introduce smartphone technology need to educate patients and families about the clinical use of smartphones to avoid unfavourable perceptions. Smartphone technology must be interoperable with the electronic medical record to optimize interprofessional communication and exchange of patient information.


Asunto(s)
Prioridades en Salud , Evaluación de Necesidades/tendencias , Relaciones Enfermero-Paciente , Teléfono Inteligente/tendencias , Adulto , Comunicación , Femenino , Grupos Focales/métodos , Humanos , Masculino , Seguridad del Paciente , Investigación Cualitativa , Teléfono Inteligente/instrumentación
4.
Artículo en Inglés | MEDLINE | ID: mdl-30950432

RESUMEN

Current ambitious reforms in India mean that public health professionals (PHPs) will become an increasingly vital component of the health workforce. Despite a rapid growth in schools of public health in India, uptake of places by students without a medical background is low. This paper reports the results of an exercise to estimate the baseline supply of, and need for, PHPs in India in 2017 and to forecast possible supply-need scenarios up to 2026. Supply was estimated using the stock and flow approach and the service-target approach was used to estimate need. The additional need resulting from development of a new public health cadre, as stated in the National Health Policy 2017, was also included. Supply-need gaps were forecast according to three scenarios, which varied according to the future intensity of policy intervention to increase occupancy of training places for PHPs from a non-medical background: "best guess" (no intervention), "optimistic" (feasible intervention), and "aspirational" (significant intervention) scenarios. In the best guess scenario in 2017, i.e. with a low non-medical place occupancy of 60%, there is a supply-need gap of around 28 000 PHPs. In the absence of any intervention to increase place occupancy, this shortfall is forecast to increase to 45 000 PHPs by the year 2026. By contrast, in the aspirational scenario, i.e. with a high place occupancy of 75% for non-medical places, the baseline gap for 2017 of almost 26 000 PHPs reduces by 2026 to around 21 000 PHPs. By 2026, most new PHPs will be produced by public health training programmes offered by institutions other than medical colleges. Without significant interventions, India is likely to have a significant shortfall in PHPs in 2026. Policy-makers will have to carefully examine issues surrounding the current low uptake of non-medical public health seats and review the current framework regulating training of PHPs, in order to respond adequately to future requirements.


Asunto(s)
Predicción/métodos , Evaluación de Necesidades/tendencias , Estudiantes de Salud Pública/estadística & datos numéricos , Recursos Humanos/normas , Política de Salud/tendencias , Humanos , India , Salud Pública/métodos , Salud Pública/estadística & datos numéricos , Recursos Humanos/tendencias
6.
Acta Derm Venereol ; 99(4): 370-374, 2019 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-30666336

RESUMEN

Understanding of the epidemiology and healthcare service utilization related to atopic dermatitis is necessary to inform the use of new treatments. This cross-sectional study was based on a group of patients with atopic dermatitis and a matched control group comprised of age- and sex- matched enrolees without atopic dermatitis from a large medical database. Healthcare service utilization usage data were extracted and compared between groups. The study included 116,816 patients with atopic dermatitis and 116,812 controls. Atopic dermatitis was associated with an increased burden of healthcare utilization across the entire spectrum of healthcare services compared with controls. For patients severely affected by atopic dermatitis, the increased burden correlated with disease severity: a high-er frequency of emergency room visits (odd ratio (OR) 1.7; 95% confidence interval (CI) 1.6-1.9), dermatology wards hospitalizations (OR 315; 95% CI 0-7,342), and overall hospitalizations (OR 3.6; 95% CI 3.3-3.9). In conclusion, this study demonstrates an increased burden of healthcare utilization in atopic dermatitis.


Asunto(s)
Dermatitis Atópica/terapia , Fármacos Dermatológicos/uso terapéutico , Servicio de Urgencia en Hospital/tendencias , Recursos en Salud/tendencias , Hospitalización/tendencias , Adolescente , Adulto , Niño , Preescolar , Estudios Transversales , Bases de Datos Factuales , Dermatitis Atópica/diagnóstico , Dermatitis Atópica/etiología , Femenino , Necesidades y Demandas de Servicios de Salud/tendencias , Humanos , Lactante , Israel/epidemiología , Masculino , Persona de Mediana Edad , Evaluación de Necesidades/tendencias , Prevalencia , Sistema de Registros , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Factores de Tiempo , Adulto Joven
7.
Emerg Med Australas ; 31(1): 29-34, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-29609203

RESUMEN

In this series we address important topics for clinicians who participate in research as part of their work in the ED. The overarching goal of clinical research is to improve care and determine which treatment is best. Yet, defining and measuring outcomes - what is 'best' - can be one of the most difficult steps in the design of a study, in particular when answers to research questions cannot be captured in simple binary results. This article addresses how to choose outcome measures and highlights the increasingly important concept of core outcome sets.


Asunto(s)
Medicina de Emergencia/métodos , Proyectos de Investigación/normas , Medicina de Emergencia/normas , Humanos , Evaluación de Necesidades/normas , Evaluación de Necesidades/tendencias , Investigación/instrumentación , Investigación/tendencias , Proyectos de Investigación/tendencias , Pesos y Medidas/instrumentación , Pesos y Medidas/normas
8.
Transplantation ; 103(1): 140-148, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30451739

RESUMEN

BACKGROUND: With increasing US adiposity, nonalcoholic steatohepatitis (NASH) is now a leading liver transplant (LT) indication. Given its association with hepatocellular carcinoma (HCC), the burden of NASH is substantial. We analyzed birth cohort effects among NASH LT registrants, with and without HCC. METHODS: All new LT registrants in United Network for Organ Sharing (1995-2015) were identified. Birth cohorts were defined as: 1936-1940, 1941-1945, 1946-1950, 1951-1955, 1956-1960, 1961-1965, 1966-1970, 1971-2015. Poisson regression examined trends in LT registration, by disease etiology (NASH, hepatitis C virus [HCV], other liver disease etiologies [OTHER]), and HCC. RESULTS: We identified 182 368 LT registrants with median age of 52 years (range, 0-86 years). Nine percent (n = 16 160) had NASH, 38% (n= 69 004) HCV, 53% (n = 97 204) OTHER. HCC was present in: 13% (n = 2181), 27% (n = 18 295), and 11% (n = 10 902), of NASH, HCV, and OTHER, respectively. Liver transplant registration for HCC increased significantly from 2002 to 2015 across all etiologies (NASH, 6%-18%; HCV, 19%-51%; OTHER, 9%-16%; P < 0.0001 for all). NASH LT registrations, with and without HCC, increased sharply in patients born from 1945 to 2015. This upward NASH trend is in stark contrast to HCV LT registrations, which showed a general decline. Notably, a sharp rise in LT registrations is occurring among younger NASH patients (35-55 years), mirroring the increasing adiposity across all age groups in the US population. CONCLUSIONS: NASH LT registrants, with and without HCC, have increased over time, and are projected to increase unabated in the future, notably among younger birth cohorts ("Adipose Wave Effect"). HCC LT registration patterns demonstrate that, compared with HCV, NASH patients encompass younger birth cohorts. These data illustrate that the full impact of NASH on demand for LT is yet to be realized.


Asunto(s)
Carcinoma Hepatocelular/cirugía , Necesidades y Demandas de Servicios de Salud/tendencias , Neoplasias Hepáticas/cirugía , Trasplante de Hígado/tendencias , Evaluación de Necesidades/tendencias , Enfermedad del Hígado Graso no Alcohólico/cirugía , Adiposidad , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/epidemiología , Niño , Preescolar , Bases de Datos Factuales , Femenino , Predicción , Humanos , Lactante , Recién Nacido , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/epidemiología , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Obesidad/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Estados Unidos/epidemiología , Adulto Joven
9.
Nurs Health Sci ; 21(2): 198-205, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30444071

RESUMEN

Basic life support instructors play an important role in the planning, implementation, and evaluation of basic life support education. However, little is known about basic life support instructors' competence. The aim of the present study was to identify basic life support instructors' competence attributes and assess their competence-based training needs according to their expertise. This was a descriptive survey study to identify the educational needs of basic life support instructors using importance and performance analysis. A Web-based survey with a 29 item Competence Importance-Performance scale was undertaken with a convenience sample of 213 Korean instructors. Factor analysis identified several important factors for the competence of instructors: assessment, professional foundations, planning and preparation, educational method and strategies and evaluation. The importance and performance analysis matrix showed that training priorities for novice instructors were communication with learners and instructors, learner motivation, educational design, and qualifications of instructors, whereas checking equipment status and educational environment had the highest training priority for experienced instructors. Assessment was the most important factor in basic life support instructor's competence. A competence-based training program is needed according to basic life support instructors' expertise.


Asunto(s)
Cuidados para Prolongación de la Vida/métodos , Evaluación de Necesidades/tendencias , Competencia Profesional/normas , Enseñanza/educación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea , Encuestas y Cuestionarios
10.
Emerg Med Australas ; 31(1): 20-28, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-29473300

RESUMEN

The aim of the study was to determine the training needs of doctors managing emergencies in rural and remote Australia. A systematic review of Australian articles was performed using MEDLINE (OVID) and INFORMIT online databases from 1990 to 2016. The search terms included 'Rural Health', 'Emergency Medicine', 'Emergency Medical Services', 'Education, Medical, Continuing' and 'Family Practice'. Only peer-reviewed articles, available in full-text that focussed on the training needs of rural doctors were reviewed. Data was extracted using pre-defined fields such as date of data collection, number of participants, characteristics of participants, location and study findings. A total of eight studies published from 1998 to 2006 were found to be suitable for inclusion in the analysis. Six studies cited the results of self-reported questionnaires and surveys, one used a telephone questionnaire on a hypothetical patient and one utilised a theoretical examination. The studies found a significant proportion of participants wanted more emergency training. Junior rural doctors were found to have deficiencies in knowledge about stroke. Emergency skills doctors wanted more training including: emergency ultrasound, paediatric/neonatal procedures and cricothyroidotomy. However, many of the studies were performed by training providers that may benefit from deficient results. Given that the data was over 10 years old and that advances have been made in knowledge, training opportunities and technology, the implications for current training needs of rural doctors in Australia could not be accurately assessed. Thus there is a need for further research to identify current training needs.


Asunto(s)
Servicios Médicos de Urgencia/normas , Evaluación de Necesidades/tendencias , Servicios de Salud Rural/tendencias , Australia , Competencia Clínica/normas , Servicios Médicos de Urgencia/tendencias , Humanos
11.
Sex Abuse ; 31(3): 270-295, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29320942

RESUMEN

Campus sexual assault (CSA) has received unprecedented attention over recent years, resulting in an abundance of federal guidance and mandates. In response, efforts to address and prevent CSA at Institutions of Higher Education (IHE) across the country have grown quickly, including the development and implementation of programs and policies. Because the changes on campuses have occurred at such a rapid pace, a number of gaps exist within the field of CSA research. To ensure that changes on IHE are evidence-based, there is a need to review the existing research available and the inquiry still needed, based on key areas outlined in federal guidance, the expressed needs of campus community members, survivors, and students who commit sexual offenses on college campuses. The purpose of this review is to summarize the empirical research related to CSA gained from the past two decades and identify areas in which further work is needed, specifically related to key areas identified in recent guidance provided to IHE. This article concludes with guidance for research moving forward to help strengthen response and prevention efforts.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Evaluación de Necesidades/tendencias , Violación/prevención & control , Delitos Sexuales/tendencias , Universidades/organización & administración , Humanos , Relaciones Interpersonales , Masculino , Estudiantes/estadística & datos numéricos
12.
Fam Community Health ; 42(1): 8-19, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30431465

RESUMEN

Many improvements in health equity are spearheaded by community collaborations working to change policy and social norms. But how can collective efficacy (CE), defined as the willingness and ability of a group to work toward a common good, be increased? Eight articles reporting on interventions aiming to reduce health disparities by improving CE were found for this systematic literature review. All studies showed improvements in CE and most found reduction in disparities, but operationalization of CE varied. Findings support a model of how CE can address health disparities, which can guide standardization of CE interventions and measures.


Asunto(s)
Disparidades en Atención de Salud/tendencias , Evaluación de Necesidades/tendencias , Humanos , Justicia Social
13.
Hepatobiliary Pancreat Dis Int ; 18(1): 79-86, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30583855

RESUMEN

BACKGROUND: Currently, surgical resection represents the only curative treatment for pancreatic cancer (PC), however, the majority of tumors are no longer resectable by the time of diagnosis. The aim of this study was to describe time trends and distribution of pancreaticoduodenectomies (PDs) performed for treating PC in Brazil in recent years. METHODS: Data were retrospectively obtained from Brazilian Health Public System (namely DATASUS) regarding hospitalizations for PC and PD in Brazil from January 2008 to December 2015. PC and PD rates and their mortalities were estimated from DATASUS hospitalizations and analyzed for age, gender and demographic characteristics. RESULTS: A total of 2364 PDs were retrieved. Albeit PC incidence more than doubled, the number of PDs increased only 37%. Most PDs were performed in men (52.2%) and patients between 50 and 69 years old (59.5%). Patients not surgically treated and those 70 years or older had the highest in-hospital mortality rates. The most developed regions (Southeast and South) as well as large metropolitan integrated municipalities registered 76.2% and 54.8% of the procedures, respectively. LMIM PD mortality fluctuated, ranging from 13.6% in 2008 to 11.8% in 2015. CONCLUSIONS: This study suggests a trend towards regionalization and volume-outcome relationships for PD due to PC, as large metropolitan integrated municipalities registered most of the PDs and more stable mortality rates. The substantial differences between PD and PC increasing rates reveals a limiting step on the health system resoluteness. Reduction in the number of hospital beds and late access to hospitalization, despite improvement in diagnostic methods, could at least in part explain these findings.


Asunto(s)
Neoplasias Pancreáticas/epidemiología , Neoplasias Pancreáticas/cirugía , Pancreaticoduodenectomía/tendencias , Pautas de la Práctica en Medicina/tendencias , Cirujanos/tendencias , Distribución por Edad , Anciano , Brasil/epidemiología , Femenino , Necesidades y Demandas de Servicios de Salud/tendencias , Mortalidad Hospitalaria/tendencias , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Evaluación de Necesidades/tendencias , Neoplasias Pancreáticas/mortalidad , Pancreaticoduodenectomía/efectos adversos , Pancreaticoduodenectomía/mortalidad , Sistema de Registros , Estudios Retrospectivos , Distribución por Sexo , Factores de Tiempo , Resultado del Tratamiento
14.
Rev. pesqui. cuid. fundam. (Online) ; 11(2, n. esp): 540-546, jan. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-969328

RESUMEN

Objective: The study's goal has been to identify the needs of the relatives of people hospitalized in an Intensive Care Unit from the interior of the Paraná State. Methods: Data were collected from May to September 2017, through the application of the Critical Care Family Needs Inventory (CCFNI) to 55 patients' family members. It was performed a descriptive and inferential analysis. Results: The most valued needs were those related to information, safety in knowing that the family member is receiving the best treatment and having access/ possibility of being able to talk with the physician at the visit time. Conclusion: Knowing the needs of family members is an important tool to assess the aspects related to the delivered care, and also provides subsidies for implementing actions that guarantee better quality of care for the patients and their families


Objetivo: Identificar as necessidades dos familiares de pessoas internadas em uma Unidade de Terapia Intensiva (UTI) no interior do Estado do Paraná. Método: Os dados foram coletados no período de maio à setembro de 2017, por meio da aplicação do Inventário de Necessidades e Estressores de Familiares em Terapia Intensiva (INEFTI) a 55 familiares. Realizado análise descritiva e inferencial. Resultados: As necessidades mais valorizadas foram as relacionadas com informação, segurança em saber que o familiar está recebendo o melhor tratamento e de ter acesso/possibilidade de poder conversar com o médico no momento da visita. Conclusão: Conhecer as necessidades dos familiares se faz como uma importante ferramenta de avaliação dos aspectos relacionados ao cuidado prestado e fornece subsídios para implementação de ações que garantam melhor qualidade da assistência ao paciente e a família


Objetivo: Identificar las necesidades de los familiares de personas internadas en una Unidad de Terapia Intensiva (UTI) en el interior del Estado de Paraná. Método: Los datos fueron recolectados en el período de mayo a septiembre de 2017, por medio de la aplicación del Inventario de Necesidades y Estresores de Familiares en Terapia Intensiva (INEFTI) a 55 familiares. Realizado análisis descriptivo e inferencial. Resultados: Las necesidades más valoradas fueron las relacionadas con información, seguridad en saber que el familiar está recibiendo el mejor tratamiento y de tener acceso/posibilidad de poder conversar con el médico en el momento de la visita. Conclusión: Conocer las necesidades de los familiares se hace como una importante herramienta de evaluación de los aspectos relacionados al cuidado prestado y proporciona subsidios para implementación de acciones que garanticen mejor calidad de la asistencia al paciente y la familia


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Familia/psicología , Evaluación de Necesidades/tendencias , Evaluación de Necesidades/estadística & datos numéricos , Enfermería de la Familia/tendencias , Unidades de Cuidados Intensivos
19.
Pediatrics ; 142(4)2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30224366

RESUMEN

BACKGROUND: Researchers have shown that most youth with special health care needs (YSHCN) are not receiving guidance on planning for health care transition. This study examines current transition planning among US youth with and without special health care needs (SHCN). METHODS: The 2016 National Survey of Children's Health is nationally representative and includes 20 708 youth (12-17 years old). Parents and/or caregivers were asked if transition planning occurred, based on the following elements: (1) doctor or other health care provider (HCP) discussed the eventual shift to an HCP who cares for adults, (2) an HCP actively worked with youth to gain self-care skills or understand changes in health care at age 18, and (3) youth had time alone with an HCP during the last preventive visit. Sociodemographic and health system characteristics were assessed for associations with transition planning. RESULTS: Nationally, 17% of YSHCN and 14% of youth without SHCN met the overall transition measure. Older age (15-17 years) was the only sociodemographic factor associated with meeting the overall transition measure and individual elements for YSHCN and youth without SHCN. Other sociodemographic characteristics associated with transition planning differed among the 2 populations. Receipt of care coordination and a written plan was associated with transition planning for YSHCN. CONCLUSIONS: This study reveals that few youth with and without SHCN receive transition planning support. It underscores the need for HCPs to work with youth independently and in collaboration with parents and/or caregivers throughout adolescence to gain self-care skills and prepare for adult-focused care.


Asunto(s)
Niños con Discapacidad , Encuestas de Atención de la Salud/tendencias , Personal de Salud/tendencias , Necesidades y Demandas de Servicios de Salud/tendencias , Evaluación de Necesidades/tendencias , Transición a la Atención de Adultos/tendencias , Adolescente , Niño , Estudios Transversales , Femenino , Encuestas de Atención de la Salud/métodos , Humanos , Masculino , Estados Unidos/epidemiología
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