6 results
Search Results
2. Prevalence of adults with brain arteriovenous malformations: a community based study in Scotland using capture-recapture analysis
- Author
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Charles P Warlow, Steff Lewis, J S Y Fang, and Rustam Al-Shahi
- Subjects
Adult ,Intracranial Arteriovenous Malformations ,Male ,Paper ,Pediatrics ,medicine.medical_specialty ,genetic structures ,Prevalence ,MEDLINE ,brain arteriovenous malformations ,neuroscience ,Epidemiology ,medicine ,Humans ,Community Health Services ,Stroke ,Aged ,business.industry ,Brain ,Arteriovenous malformation ,Lothian health board ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Confidence interval ,Surgery ,Psychiatry and Mental health ,Scotland ,Radiological weapon ,Female ,Neurology (clinical) ,business ,Tomography, X-Ray Computed - Abstract
Objective: To conduct a population based study of brain arteriovenous malformation (AVM) prevalence. Methods: Multiple, overlapping sources of case ascertainment were used to establish the point prevalence of brain AVMs in the adult population of the Lothian health board of Scotland. Patients were sought retrospectively from all local general (family) practitioners, neurologists, neurosurgeons, stroke physicians, the specialist AVM clinic at the regional neuroscience centre, and routine coding of hospital discharge data. Case notes, brain imaging, and pathology reports were reviewed to validate each patient's diagnosis and to ensure that each was alive, over the age of 16 years, and resident in the geographical area of the study on the prevalence date of 30 June 1998. Results: Of 148 potentially eligible people, 93 adults met the inclusion criteria. There were 40 women and 53 men. Men were significantly younger than women on the prevalence date (median age 39 years v 51 years, p = 0.003). Of those included, 25 (27%) had radiological evidence of prior therapeutic obliteration of their brain AVM and 9 (10%) had coexisting aneurysms. The minimum crude brain AVM prevalence was 15 per 100 000 adults and capture-recapture analysis gave an ascertainment adjusted prevalence of 18 (95% confidence interval 16 to 24) per 100 000 adults. Conclusions: The minimum estimate of brain AVM prevalence helps to assess its burden and comparative epidemiology and stresses the importance of brain AVMs as a cause of long term disability in adults.
- Published
- 2002
3. Virtual communities of practice to improve clinical outcomes in healthcare: protocol for a 10-year scoping review
- Author
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Louise Shaw, Dana Jazayeri, Meg E. Morris, and Debra Kiegaldie
- Subjects
Research design ,Knowledge management ,protocols & guidelines ,Health Personnel ,Geriatric Medicine ,Qualitative property ,health & safety ,quality in health care ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Humans ,Medicine ,Community Health Services ,030212 general & internal medicine ,Uncategorized ,Research evidence ,Protocol (science) ,business.industry ,030503 health policy & services ,Stakeholder ,Professional support ,General Medicine ,education & training (see medical education & training) ,Review Literature as Topic ,Index (publishing) ,Research Design ,Health Facilities ,0305 other medical science ,business ,Delivery of Health Care - Abstract
IntroductionVirtual communities of practice (VCoPs) use a common online platform to provide healthcare professionals with the opportunity to access highly specialised knowledge, build a professional support network and promote the translation of research evidence into practice. There is limited reporting of how best to design and administer VCoPs within healthcare organisations. The primary aim of this scoping review is to identify the best methods used to establish and maintain VCoPs. Findings shall be used to develop a flexible framework to guide the establishment and facilitation of a VCoP for healthcare professionals to ensure the translation of falls prevention clinical guidelines into practice.Methods and analysisA five-stage scoping review process will be followed based on Arksey and O’Malley’s framework and refined by the Joanna Briggs Institute Methodology. An initial limited search of PubMed and Cumulative Index to Nursing and Allied Health Literature will identify relevant studies and assist with search term development. This will be followed by a search of five online databases to identify papers published from January 2010 until November 2020. Papers will be independently screened by two reviewers, and data extracted and analysed using a reporting framework. Qualitative data will be analysed thematically and numerical synthesis of the data will be conducted.Results and disseminationThe results of this scoping review will highlight the best ways to design and manage VCoPs in healthcare organisations. The findings will be presented at relevant stakeholder workshops, conferences and published in peer-reviewed journals.
- Published
- 2021
4. On the importance of primary and community healthcare in relation to global health and environmental threats: lessons from the COVID-19 crisis
- Author
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Emanuele Vinci, Peter van den Hazel, Piedad Martin-Olmedo, Samantha Pegoraro, Alan Abelsohn, Catherine Bouland, Giovanni Leonardi, Mariagrazia Santamaria, Robert A Verheij, Fabrizio Bianchi, Paolo Bortolotti, Raymond Agius, Ferdinando Laghi, Ruth A. Etzel, Ariana Zeka, Francesco Romizi, Giuseppe Miserotti, Guido Giustetto, Ozden Gokdemir, Alice Serafini, Evelyn Segredo, Martie van Tongeren, Paolo Lauriola, Michel L. A. Dückers, Roberto Romizi, Tranzo, Scientific center for care and wellbeing, and Social Psychology
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medicine.medical_specialty ,Medicine (General) ,Climate Change ,Population ,prevention strategies ,environmental health ,Context (language use) ,Infectious and parasitic diseases ,RC109-216 ,Global Health ,global environmental health ,Education ,03 medical and health sciences ,0302 clinical medicine ,R5-920 ,Nursing ,sentinel doctors for the environment ,Pandemic ,Health care ,medicine ,Global health ,Humans ,030212 general & internal medicine ,Community Health Services ,education ,Health policy ,community health ,education.field_of_study ,030505 public health ,business.industry ,SARS-CoV-2 ,Public health ,Politics ,public health ,global climate change ,Public Health, Environmental and Occupational Health ,COVID-19 ,Généralités ,health policy ,primary health care ,Socioeconomic Factors ,Community health ,Business ,0305 other medical science ,health systems ,Analysis - Abstract
In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (PCHC) system's weaknesses worldwide. In many instances, PCHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of a € planetary health'. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that PCHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic., SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2021
5. A cluster randomised controlled trial to determine the effect of community mobilisation and advocacy on men’s use of violence in periurban South Africa: study protocol
- Author
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Althea Anderson, Nicola Christofides, Angelica Pino, Dean Peacock, Ruari Santiago McBride, Dumisani Rebombo, and Abigail M. Hatcher
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Alcohol Drinking ,cluster randomized controlled trial ,Transactional sex ,Gender-Based Violence ,Global Health ,03 medical and health sciences ,perpetration of violence against women ,South Africa ,Young Adult ,0302 clinical medicine ,behavioural intervention ,Intervention (counseling) ,Surveys and Questionnaires ,medicine ,Protocol ,Cluster Analysis ,Humans ,030212 general & internal medicine ,Cluster randomised controlled trial ,Community Health Services ,Baseline (configuration management) ,Protocol (science) ,030505 public health ,business.industry ,Ethics committee ,General Medicine ,working with men and boys ,Research Design ,Family medicine ,Multivariate Analysis ,Regression Analysis ,Process evaluation ,0305 other medical science ,Settlement (litigation) ,business - Abstract
ObjectiveThis paper describes the design and methods of a cluster randomised controlled trial (C-RCT) to determine the effectiveness of a community mobilisation intervention that is designed to reduce the perpetration of violence against women (VAW).Methods and analysisA C-RCT of nine intervention and nine control clusters is being carried out in a periurban, semiformal settlement near Johannesburg, South Africa, between 2016 and 2018. A community mobilisation and advocacy intervention, called Sonke CHANGE is being implemented over 18 months. It comprises local advocacy and group activities to engage community members to challenge harmful gender norms and reduce VAW. The intervention is hypothesised to improve equitable masculinities, reduce alcohol use and ultimately, to reduce VAW. Intervention effectiveness will be determined through an audio computer-assisted self-interview questionnaire with behavioural measures among 2600 men aged between 18 and 40 years at baseline, 12 months and 24 months. The primary trial outcome is men’s use of physical and/or sexual VAW. Secondary outcomes include harmful alcohol use, gender attitudes, controlling behaviours, transactional sex and social cohesion. The main analysis will be intention-to-treat based on the randomisation of clusters. A qualitative process evaluation is being conducted alongside the C-RCT. Implementers and men participating in the intervention will be interviewed longitudinally over the period of intervention implementation and observations of the workshops and other intervention activities are being carried out.Ethics and disseminationEthical approval was obtained from the University of the Witwatersrand Human Research Ethics Committee and procedures comply with ethical recommendations of the United Nations Multi-Country Study on Men and Violence. Dissemination of research findings will take place with local stakeholders and through peer-reviewed publications, with data available on request or after 5 years of trial completion.Trial registration numberNCT02823288; Pre-result.
- Published
- 2018
6. Development and validation of a casemix classification to predict costs of specialist palliative care provision across inpatient hospice, hospital and community settings in the UK: a study protocol
- Author
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Suzanne O’Brien, Kathy Eagar, Joanna M Davies, Ping Guo, Mendwas Dzingina, Sophie Pask, Fliss E M Murtagh, Cathryn Pinto, Irene J Higginson, Abdel Douiri, and Alice M. Firth
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Male ,medicine.medical_specialty ,Palliative care ,Project commissioning ,media_common.quotation_subject ,Care provision ,adult palliative care ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Optimism ,medicine ,Protocol ,Humans ,030212 general & internal medicine ,Community Health Services ,cost predictors ,Diagnosis-Related Groups ,media_common ,Protocol (science) ,validation ,Research ethics ,business.industry ,Bootstrapping ,Hospitals, Public ,Palliative Care ,Hospices ,General Medicine ,casemix classification ,United Kingdom ,030220 oncology & carcinogenesis ,Family medicine ,Costs and Cost Analysis ,Female ,business ,Delivery of Health Care ,Cohort study ,Specialization - Abstract
IntroductionProvision of palliative care is inequitable with wide variations across conditions and settings in the UK. Lack of a standard way to classify by case complexity is one of the principle obstacles to addressing this. We aim to develop and validate a casemix classification to support the prediction of costs of specialist palliative care provision.Methods and analysisPhase I: A cohort study to determine the variables and potential classes to be included in a casemix classification. Data are collected from clinicians in palliative care services across inpatient hospice, hospital and community settings on: patient demographics, potential complexity/casemix criteria and patient-level resource use. Cost predictors are derived using multivariate regression and then incorporated into a classification using classification and regression trees. Internal validation will be conducted by bootstrapping to quantify any optimism in the predictive performance (calibration and discrimination) of the developed classification. Phase II: A mixed-methods cohort study across settings for external validation of the classification developed in phase I. Patient and family caregiver data will be collected longitudinally on demographics, potential complexity/casemix criteria and patient-level resource use. This will be triangulated with data collected from clinicians on potential complexity/casemix criteria and patient-level resource use, and with qualitative interviews with patients and caregivers about care provision across difference settings. The classification will be refined on the basis of its performance in the validation data set.Ethics and disseminationThe study has been approved by the National Health Service Health Research Authority Research Ethics Committee. The results are expected to be disseminated in 2018 through papers for publication in major palliative care journals; policy briefs for clinicians, commissioning leads and policy makers; and lay summaries for patients and public.Trial registration numberISRCTN90752212.
- Published
- 2018
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