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PURPOSE: Although interventions can increase advance care planning (ACP) engagement, it remains unclear which interventions to choose in primary care settings. This study compares a passive intervention (mailed materials) to an interactive intervention (group visits) on participant ACP engagement and experiences. METHODS: We used mixed methods to examine ACP engagement at baseline and six months following two ACP interventions. Eligible patients were randomized to receive mailed materials or participate in two ACP group visits. We administered the 4-item ACP Engagement survey (n = 110) and conducted interviews (n = 23). We compared mean scores and percent change in ACP engagement, analyzed interviews with directed content analysis to understand participants ACP experiences, and integrated the findings based on mailed materials or group visits intervention. RESULTS: All participants demonstrated increased ACP engagement scores. At six months, group visit participants reported higher percent change in mean overall score compared with mailed materials participants (+8% vs +3%, P

Background Internationally, Mobile Stroke Unit (MSU) ambulances have changed pre-hospital acute stroke care delivery. MSU clinical and cost-effectiveness studies are emerging, but little is known about important factors for achieving sustainability of this innovative model of care.Methods Mixed-methods study from the Melbourne MSU (operational since November 2017) process evaluation. Participant purposive sampling included clinical, operational and executive/management representatives from Ambulance Victoria (AV) (emergency medical service provider), the MSU clinical team, and receiving hospitals. Sustainability was defined as ongoing MSU operations, including MSU workforce and future model considerations. Theoretically-based on-line survey with Unified Theory of Acceptance and Use of Technology (UTAUT), Self Determination Theory (SDT, Intrinsic Motivation), and open-text questions targeting barriers and benefits was administered (June-September 2019). Individual/group interviews were conducted, eliciting improvement suggestions and requirements for ongoing use. Descriptive and regression analyses (quantitative data) and directed content and thematic analysis (open text and interview data) were conducted.Results There were 135 surveys completed. Identifying that the MSU was beneficial to daily work (β = 0.61), not experiencing pressure/tension about working on the MSU (β = 0.17) and thinking they did well working within the team model (β = 0.17) were significantly associated with wanting to continue working within the MSU model [R2 = 0.76; F(15, 60) = 12.76, P < .001]. Experiences varied between those on the MSU team and those working with the MSU. Advantages were identified for patients (better, faster care) and clinicians (interdisciplinary learning). Disadvantages included challenges integrating into established systems, and establishing working relationships. Themes identified from 35 interviews were MSU team composition, MSU vehicle design and layout, personnel recruitment and rostering, communication improvements between organisations, telemedicine options, MSU operations and dispatch specificity.Conclusion Important factors affecting the sustainability of the MSU model of stroke care emerged. A cohesive team approach, with identifiable benefits and good communication between participating organisations is important for clinical and operational sustainability.

Abstract Background Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people’s health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. Methods In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. Discussion Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety.

Abstract Systematic reviews (SRs) provide a solution to handle information overload for busy clinicians by summarising and synthesizing studies on a specific issue. However, because SRs are complicated and often boring to read, the busy or reluctant reader may make do with the abstract. When, as it has been shown, many authors overstate efficacy or understate harm in their abstracts, not consulting the underlying article could be misleading. This means that the prudent reader must have the ability to identify the ‘tender points’ of SRs to avoid falling for ‘spin’. To this end we briefly review the method of SRs and ways to relatively quickly determine trustworthiness.

Aim To organize a cross-cultural adaptation study and analyze the reproducibility and test-retest reliability of a Brazilian version of the Toddler Sensory Profile 2 (TSP2Br) for children aged 7-35 months. Methods The English language version of the profile was translated and culturally adapted into Brazilian Portuguese, administered to 168 caregivers of toddlers aged 7-35 months, and then re-administered to a portion of the sample (39 caregivers; 23%) for 7-14 days for test-retest reliability. The internal consistency and test-retest reliability was analyzed using the Cronbach's alpha and kappa coefficient, respectively. As it is a norm-referenced standardized assessment, the cut-off scores used were 1.0 and 2.0 standard deviations above and below the mean for each group of items established as the preliminary cut-off scores for the Brazilian children. Results The TSP2Br showed good internal consistency (>0.70) when measured on the total scale; however, when it was analyzed for sensory areas, five to seven areas presented alpha values <.70. By quadrants, alpha was <.70, for all items. The test-retest values fell into the category of near-perfect agreement (.89-.97). The preliminary cut-off points of the Brazilian scores were distinct from those of the Americans. Conclusions The TSP2Br showed preliminary reliability and validity in the identification of sensory processing problems in Brazilian children aged 7--35 months; however, it would be necessary to increase the sample size to generalize our findings to the general Brazilian population. [ABSTRACT FROM AUTHOR]

Background: Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people's health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. Methods: In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. Discussion: Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety. [ABSTRACT FROM AUTHOR]

BACKGROUND: Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following the pilots success, a formal dental care advocate (DCA) role was integrated system-wide. The goal of this new role is to improve care, patient engagement, and health outcomes while integrating staff into the clinical care team. We aim to describe the process of DCA role implementation and assess staff and clinician perceptions about the role pre- and post-implementation. METHODS: Guided by the Consolidated Framework for Implementation Research, semi-structured interviews with clinical and operational administrative staff and observation at the company-wide training session were combined with pre- and post-implementation electronic surveys. Descriptive statistics and mean scores were tested for significance between each survey sample (t-tests), and qualitative data were thematically analyzed. RESULTS: With preliminary evidence from the pilot and strong executive support, a dedicated leadership team executed a stepwise rollout of the DCA role over 6 months. Success was facilitated by an organizational culture of frequent interventions deployed rapidly through a centralized system, along with supportive buy-in from managerial teams and high staff acceptance and enthusiasm for the DCA role before implementation. Following implementation, significant changes in attitudes and beliefs about the role were measured, though managers held stronger positive impressions than DCAs. DCAs reported high confidence in new skills and dental knowledge post-implementation, including motivational interviewing and the ability to confidently answer patients questions about their oral health. Overall, the fast-paced implementation of this new role was well received, although consistent and significant differences in mean attitudes between managers and DCAs indicate more work to fine-tune the role is needed. CONCLUSIONS: Successful implementation of the new DCA role was facilitated by a strong organizational commitment to team-based dentistry and positive impressions of care coordination among staff and managers. Upskilling existing administrative staff with the necessary training to manage some high-risk patient needs is one method that can be used to implement care coordination efforts in dentistry.

Objective: To evaluate tertiary drug information databases in terms of scope, consistency of content, and completeness of COVID-19 drug information. Methods: Five electronic drug information databases: Clinical Pharmacology, Lexi-Drugs, AHFS DI (American Hospital Formulary Service Drug Information), eFacts and Comparisons, and Micromedex In-Depth Answers, were evaluated in this cross-sectional evaluation study, with data gathered from October 2021 through February 2022. Two study investigators independently extracted data (parallel extraction) from each resource. Descriptive statistics were primarily used to evaluate scope (i.e., whether the resource addresses use of the medication for treatment or prevention of COVID-19) and completeness of content (i.e., whether full information is provided related to the use of the medication for treatment or prevention of COVID-19) based on a 10-point scale. To analyze consistency among resources for scope, the Fleiss multi-rater kappa was used. To analyze consistency among resources for type of recommendation (i.e., in favor, insufficient evidence, against), a two-way mixed effects intraclass coefficient was calculated. Results: A total of 46 drug monographs, including 3 vaccination monographs, were evaluated. Use of the agents for treatment of COVID-19 was most frequently addressed in Lexi-Drugs (73.9%), followed by eFacts and Comparisons (71.7%), and Micromedex (54.3%). The highest overall median completeness score was held by AHFS DI followed by Micromedex, and Clinical Pharmacology. There was moderate consistency in terms of scope (kappa 0.490, 95% CI 0.399-0.581, p

Systematic reviews (SRs) provide a solution to handle information overload for busy clinicians by summarising and synthesizing studies on a specific issue. However, because SRs are complicated and often boring to read, the busy or reluctant reader may make do with the abstract. When, as it has been shown, many authors overstate efficacy or understate harm in their abstracts, not consulting the underlying article could be misleading. This means that the prudent reader must have the ability to identify the 'tender points' of SRs to avoid falling for 'spin'. To this end we briefly review the method of SRs and ways to relatively quickly determine trustworthiness. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this research is to assess the Qom University website using information architecture indicators to determine the website's status and conduct a qualitative review. Regularly reviewing and evaluating websites for their structural and content aspects, and then identifying their strengths and weaknesses, will provide a suitable strategy for policy and decision making. Method: This research utilized a survey method to investigate the Qom University website, using the evaluation checklist optimized by Sediqi (1400) in June 1402. In this study, four sub-systems of website organization -- tagging, navigation, and search -- were evaluated based on three fundamental aspects of information architecture: context, user, and content. The evaluation list included two parts: descriptive questions and yes-or-no questions, designed to assess the presence or absence of the investigated characteristics. Finally, the checklist was prepared by the researcher based on the indicators and evaluation criteria, presented in the form of tables, and completed. Findings: The analysis of these lists revealed that Qom University's website achieved 22 out of 37 points in the information organization section, 30 out of 57 points in the labeling section, 42 out of 78 points in the navigation section, and 5 out of 78 points in the search section. He has obtained a total of 46. Therefore, compared to the ideal state, the website under study scored 64% in the organization section, 45% in the tagging section, 81% in the navigation section, and 10% in the search field. Good at organization and navigation, but very poor at search. Conclusion: Websites are an effective tool for communication between organizations and their audiences. This research aimed to evaluate the Qom University website and to identify its strengths and weaknesses. Based on the research findings, the organization system of the website is in good condition. However, the weaknesses of the university website's organizational plan are primarily related to its structure. Specifically, it lacks an alphabetical organization plan and does not utilize an audience-oriented or social organization plan, as indicated by the organizational chart. While the website navigation system indicates the current page, it does not clearly display all the levels of navigation that the user has traversed. The website's main navigation system must be integrated with the local system. The website search system must be implemented. In addition, integrating a recommender system into the website search system is one method that can be utilized to enhance the performance of the search system. [ABSTRACT FROM AUTHOR]

Mindfulness based interventions (MBIs) have potential to support wellbeing in workplaces and have attracted a great deal of attention from researchers and Human Resources Practitioners. This paper reviews some of the evidence for their effectiveness and limitations. While MBIs may help with some physical and mental health challenges, they are more likely to improve self-reported than objectively measured health indicators, and it is not yet clear how well positive outcomes persist over time. Effectiveness seems to depend on whether, and how much, participants engage with the training and continue to use the mindfulness practices that are introduced. Positive outcomes may be smaller and less lasting than expected, and some adverse effects have been reported. The diversity of MBIs available in terms of duration, method of delivery and content means HR practitioners have many options to explore but makes evaluation and comparisons difficult. Suggestions for the use of MBIs in organisations are outlined. [ABSTRACT FROM AUTHOR]

Abstract Objectives Little direction exists on how to effectively implement palliative care for patients with COPD. In the COMPASSION study, we developed, executed, and evaluated a multifaceted implementation strategy to improve the uptake of region-tailored palliative care intervention components into routine COPD care. We evaluated the implementation strategy and assessed the implementation process, barriers, and facilitators. Methods A mixed methods process evaluation was performed. Primary and secondary healthcare providers in four hospital regions in the Netherlands were trained. Patients identified during hospitalisation for an acute exacerbation received palliative care and were followed for a year. Various sources were used: process data, questionnaires including the End-of-life Professional Caregiver Survey (EPCS), medical records, monitoring meetings, and interviews. The Consolidated Framework of Implementation Research (CFIR) was used to categorize implementation determinants. Results The training sessions with roleplay were positively evaluated and increased professionals’ self-efficacy in providing palliative care statistically significantly. Of 98 patients identified, 44 (44.9%) received one or more palliative care conversations at the outpatient clinic. Having those conversations was highly valued by healthcare providers because it led to clarity and peace of mind for the patient and higher job satisfaction. Coordination and continuity remained suboptimal. Most important barriers to implementation were time constraints, the COVID-19 pandemic, and barriers related to transmural and interdisciplinary collaboration. Facilitators were the systematic screening of patients for palliative care needs, adapting to the patient’s readiness, conducting palliative care conversations with a pulmonologist and a COPD nurse together, and meeting regularly with a small team led by a dedicated implementation leader. Conclusions Providing integrated palliative care for patients with COPD is highly valued by healthcare providers but remains challenging. Our findings will guide future implementation efforts. Future research should focus on how to optimize transmural and interdisciplinary collaboration. Trial registration The COMPASSION study is registered in the Netherlands Trial Register (NTR): NL7644. Registration date: 07/04/2019.

PurposeTo validate SHOMRI gradings in preoperative hip magnetic resonance imaging (MRI) with intra-arthroscopic evaluation of intraarticular hip abnormalities.MethodsPreoperative non-arthrographic 3.0-T MRIs of 40 hips in 39 patients (1 patient with bilateral hip surgery) with femoroacetabular impingement (FAI) syndrome (mean age, 34.7 years ± 9.0; n = 16 females), refractory to conservative measures, that underwent hip arthroscopy were retrospectively assessed by two radiologists for chondrolabral abnormalities and compared with intra-arthroscopic findings as the standard of reference. Arthroscopically accessible regions were compared with the corresponding SHOMRI subregions and assessed for the presence and grade of cartilaginous pathologies in the acetabulum and femoral head. The acetabular labrum was assessed for the presence or absence of labral tears. For the statistical analysis sensitivity and specificity as well as intraclass correlation (ICC) for interobserver agreement were calculated.ResultsRegarding chondral abnormalities, 58.8% of the surgical cases showed chondral defects. SHOMRI scoring showed a sensitivity of 95.7% and specificity of 84.8% in detecting cartilage lesions. Moreover, all cases with full-thickness defects (n = 9) were identified correctly, and in n = 6 cases (out of n = 36 with partial-thickness defects) the defective cartilage was identified but the actual depth overestimated. Labral tears were present in all cases and the MR readers identified 92.5% correctly. ICC showed a good interobserver agreement with 86.3% (95% CI 80.0, 90.6%) CONCLUSION: Using arthroscopic correlation, SHOMRI grading of the hip proves to be a reliable and precise method to assess chondrolabral hip joint abnormalities.Key points• Assessment of hip abnormalities using MRI with surgical correlation. • Comparing surgery and MRI by creating a hybrid anatomic map that covers both modalities. • Non-arthrographic use of 3.0-T MRI provides detailed information on cartilage and labral abnormalities in hip joints.

In order to justify the investments made in research in the field of sports medicine, the outcomes and impacts of these investments should be assessed. The purpose of this study was to investigate the status and impact of sports medicine studies on the production and development of knowledge. In this descriptive study bibliometric and scientometric methods were used on 1145 scientific productions of sports medicine indexed in the Web of Science database. Data were analyzed through Excel Software, and cooperation maps were drawn using VOSviewer Software. According to the findings, the ratio of citations to the articles on the scientific productions of sports medicine was 23.17, which is higher than the clinical medicine area (6.8). The ratio of citations to the authors was 5.46% and 52 articles (4.54%) of the articles appeared without citations. The average impact factor of journals publishing papers was 3.9. Most of the articles were published with the collaboration of five authors. The results of the present study, based on a selected model and a combination of indicators of the UK’s and Canadian Capital Return frameworks (from the production and development dimension), generally highlighted the validity and effectiveness of all indicators, including activity, quality, and development. The results revealed the most significant impact of the number and quality of each of the indicators in sports medicine in this area.

Objective: Identifying the status of Iranian digital library software in terms of the use of various content management and user portlets.Methodology: This is an applied research done as a heuristic survey. The research was conducted to evaluate the capabilities of various portlets in the field of digital library management in two general areas of content management (collection process management, content production management, classification management, documentation management, loading management, content indexing management, link management and news management) and user management (user management, staff management and user security management) are used in digital library software. Statistical population of the study consists of five Digital Library Softwares Pars Azarsa, Simorgh, Tebyan, and Parwan Farakavash produced by five major library software companies in Iran (Pars Azarakhsh, Nosa, Tebyan, kavash, and Parvanpajooh). Their software products and know-how have matured over time in tandem with technological advancements in their field, with critical inputs from field experts, associated companies, organizations and institutions. They, in the recent ten years, have undertaken many landmark projects that include database and archive automation for their clients. Their knowledge base and software products are unsurpassed in the field of digital data management for libraries and document centers, and this includes the full spectrum of related requirements. All their software products are web based, integrated and user friendly Some of their major clients include the governmental institutions, private companies, national libraries and universities. The needed data was collected using a researcher-made check-list. Different types of descriptive statistical techniques in collaboration with Kolmogorov–Smirnov test, Shapiro-Wilk test and Kruskal-Wallis H test were used for analyzing the data.Findings: In terms of content management, Simorgh had the best performance. The statistical population had the best performance in the "category management" section of the content management field and the weakest performance in the "link management" section. In the field of user management, "Azarsa" had the best performance. The statistical community had the weakest performance in this area in the "forum management" section. Test of research hypotheses showed that there is no significant difference between the digital library software in the use of content management portals and user management.Conclusion: The performance of the statistical population was evaluated for 114 management portlets. The statistical population in the field of content management according to the check-list had an average performance of 80 percent and the average performance of the statistical population in the field of user management was below 63 percent, among which even "Farakavash" and "Parvan" had a performance below 50 percent. Therefore, in general comparison, it was concluded that the statistical community in the field of content management has performed better than user management.

In addition to online questionnaires, many medical schools use supplemental evaluation tools such as focus groups to evaluate their courses. Although some benefits of using focus groups in program evaluation have been described, it is unknown whether these in-person data collection methods provide sufficient additional information beyond online evaluations to justify them. In this study we analyze recommendations gathered from student evaluation team (SET) focus group meetings and analyzed whether these items were captured in open-ended comments within the online evaluations. Our results indicate that online evaluations captured only 49% of the recommendations identified via SETs. Surveys to course directors identified that 74% of the recommendations exclusively identified via the SETs were implemented within their courses. Our results indicate that SET meetings can provide information not easily captured in online evaluations and that these recommendations result in actual course changes.

Objectives: Little direction exists on how to effectively implement palliative care for patients with COPD. In the COMPASSION study, we developed, executed, and evaluated a multifaceted implementation strategy to improve the uptake of region-tailored palliative care intervention components into routine COPD care. We evaluated the implementation strategy and assessed the implementation process, barriers, and facilitators. Methods: A mixed methods process evaluation was performed. Primary and secondary healthcare providers in four hospital regions in the Netherlands were trained. Patients identified during hospitalisation for an acute exacerbation received palliative care and were followed for a year. Various sources were used: process data, questionnaires including the End-of-life Professional Caregiver Survey (EPCS), medical records, monitoring meetings, and interviews. The Consolidated Framework of Implementation Research (CFIR) was used to categorize implementation determinants. Results: The training sessions with roleplay were positively evaluated and increased professionals' self-efficacy in providing palliative care statistically significantly. Of 98 patients identified, 44 (44.9%) received one or more palliative care conversations at the outpatient clinic. Having those conversations was highly valued by healthcare providers because it led to clarity and peace of mind for the patient and higher job satisfaction. Coordination and continuity remained suboptimal. Most important barriers to implementation were time constraints, the COVID-19 pandemic, and barriers related to transmural and interdisciplinary collaboration. Facilitators were the systematic screening of patients for palliative care needs, adapting to the patient's readiness, conducting palliative care conversations with a pulmonologist and a COPD nurse together, and meeting regularly with a small team led by a dedicated implementation leader. Conclusions: Providing integrated palliative care for patients with COPD is highly valued by healthcare providers but remains challenging. Our findings will guide future implementation efforts. Future research should focus on how to optimize transmural and interdisciplinary collaboration. Trial registration The COMPASSION study is registered in the Netherlands Trial Register (NTR): NL7644. Registration date: 07/04/2019. [ABSTRACT FROM AUTHOR]

Orally dissolving films are one of the prevailing oral dosage form as these drug delivery systems release the active pharmaceutical ingredient quickly in oral cavity as soon as it comes in contact with the saliva. The advantages like rapid melting in the mouth to give immediate release, avoiding first pass metabolism makes orally dissolving films a predominant dosage form. The current study emphasis about the fundamental understanding of formulation of films, use of various polymers, standard measurements of basic types of films. In the present review compiled evaluation procedures and some of the marketed products to show the demant of the market for orally dissolving films. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this research is to assess the Qom University website using information architecture indicators to determine the website's status and conduct a qualitative review. Regularly reviewing and evaluating websites for their structural and content aspects, and then identifying their strengths and weaknesses, will provide a suitable strategy for policy and decision making. Method: This research utilized a survey method to investigate the Qom University website, using the evaluation checklist optimized by Sediqi (1400) in June 1402. In this study, foursub-systems of website organization — tagging, navigation, and search — were evaluated based on three fundamental aspects of information architecture: context, user, and content. The evaluation list included two parts: descriptive questions and yes-or-no questions, designed to assess the presence or absence of the investigated characteristics. Finally, the checklist was prepared by the researcher based on the indicators and evaluation criteria, presented in the form of tables, and completed. Findings: The analysis of these lists revealed that Qom University's website achieved 22 out of 37 points in the information organization section, 30 out of 57 points in the labeling section, 42 out of 78 points in the navigation section, and 5 out of 78 points in the search section. He has obtained a total of 46. Therefore, compared to the ideal state, the website under study scored 64% in the organization section, 45% in the tagging section, 81% in the navigation section, and 10% in the search field. Good at organization and navigation, but very poor at search. Conclusion: Websites are an effective tool for communication between organizations and their audiences. This research aimed to evaluate the Qom University website and to identify its strengths and weaknesses. Based on the research findings, the organization system of the website is in good condition. However, the weaknesses of the university website's organizational plan are primarily related to its structure. Specifically, it lacks an alphabetical organization plan and does not utilize an audience-oriented or social organization plan, as indicated by the organizational chart. While the website navigation system indicates the current page, it does not clearly display all the levels of navigation that the user has traversed. The website's main navigation system must be integrated with the local system. The website search system must be implemented. In addition, integrating a recommender system into the website search system is one method that can be utilized to enhance the performance of the search system.

As the largest group of health professionals, nurses have a tremendous potential to help curb the tobacco epidemic. However, studies conducted across a range of global settings continue to indicate that both practicing nurses and nursing student have limited knowledge, skills and confidence needed to implement evidence-based tobacco cessation interventions. A contributing factor is the limited inclusion of tobacco control content in nursing curricula. Additionally, there is limited understanding of nurse educators' knowledge and perceptions about teaching tobacco dependence content. This paper presents the Loma Linda University School of Nursing's concurrent experience with both faculty development and curriculum redesign in the area of tobacco dependence prevention and treatment. An internal survey was administered at baseline and at 2-year follow-up to assess faculty's knowledge, perceptions and practices related to teaching tobacco dependence content and skills (n = 42). Faculty and curriculum development strategies and resources utilized, evaluation findings and subsequent lessons learned are described. The findings have implications for nursing programs seeking to enhance their curricula and commitment to ensuring that their graduates are prepared to provide evidence-based tobacco cessation interventions with each patient they encounter.

Abstract Background Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following the pilot’s success, a formal “dental care advocate” (DCA) role was integrated system-wide. The goal of this new role is to improve care, patient engagement, and health outcomes while integrating staff into the clinical care team. We aim to describe the process of DCA role implementation and assess staff and clinician perceptions about the role pre- and post-implementation. Methods Guided by the Consolidated Framework for Implementation Research, semi-structured interviews with clinical and operational administrative staff and observation at the company-wide training session were combined with pre- and post-implementation electronic surveys. Descriptive statistics and mean scores were tested for significance between each survey sample (t-tests), and qualitative data were thematically analyzed. Results With preliminary evidence from the pilot and strong executive support, a dedicated leadership team executed a stepwise rollout of the DCA role over 6 months. Success was facilitated by an organizational culture of frequent interventions deployed rapidly through a centralized system, along with supportive buy-in from managerial teams and high staff acceptance and enthusiasm for the DCA role before implementation. Following implementation, significant changes in attitudes and beliefs about the role were measured, though managers held stronger positive impressions than DCAs. DCAs reported high confidence in new skills and dental knowledge post-implementation, including motivational interviewing and the ability to confidently answer patients’ questions about their oral health. Overall, the fast-paced implementation of this new role was well received, although consistent and significant differences in mean attitudes between managers and DCAs indicate more work to fine-tune the role is needed. Conclusions Successful implementation of the new DCA role was facilitated by a strong organizational commitment to team-based dentistry and positive impressions of care coordination among staff and managers. Upskilling existing administrative staff with the necessary training to manage some high-risk patient needs is one method that can be used to implement care coordination efforts in dentistry.

In order to justify the investments made in research in the field of sports medicine, the outcomes and impacts of these investments should be assessed. The purpose of this study was to investigate the status and impact of sports medicine studies on the production and development of knowledge. In this descriptive study bibliometric and scientometric methods were used on 1145 scientific productions of sports medicine indexed in the Web of Science database. Data were analyzed through Excel Software, and cooperation maps were drawn using VOSviewer Software. According to the findings, the ratio of citations to the articles on the scientific productions of sports medicine was 23.17, which is higher than the clinical medicine area (6.8). The ratio of citations to the authors was 5.46% and 52 articles (4.54%) of the articles appeared without citations. The average impact factor of journals publishing papers was 3.9. Most of the articles were published with the collaboration of five authors. The results of the present study, based on a selected model and a combination of indicators of the UK's and Canadian Capital Return frameworks (from the production and development dimension), generally highlighted the validity and effectiveness of all indicators, including activity, quality, and development. The results revealed the most significant impact of the number and quality of each of the indicators in sports medicine in this area. [ABSTRACT FROM AUTHOR]

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Objectives: This study was conducted to investigate the current status of handoffs, perception of patient safety culture, and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation. Methods: This is a descriptive study. 425 nurses who work at small and medium-sized hospitals in South Korea were included in our study. They completed a set of self-reporting questionnaires that evaluated demographic data, handoff-related characteristics, perception of patient safety culture, and handoff evaluation. Results: Results showed that the overall score of awareness of a patient safety culture was 3.65 ± 0.45, the level was moderate. The score of handoff evaluation was 5.24 ± 0.85. Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward. Handoff evaluation differed significantly according to the level of education, work patterns, duration of hospital employment, handoff method, degree of satisfaction with the current handoff method, errors occurring at the time of handoff, handoff guidelines, and appropriateness of handoff education time (P

Objectives: to identify in the scientific literature how the assessment of knowledge of the nursing team about pressure injuries is conducted, which instruments are used, and their psychometric properties. Methods: integrative review conducted with 44 scientific articles. The search was conducted between October and December 2021 in the following data sources: BDENF, Cinahl, Lilacs, MEDLINE, Scopus, Google Scholar, and Web of Science, using the strategy in Portuguese: ("lesão por pressão" OR "úlcera por pressão" OR "úlcera de decúbito" OR "escara de decúbito") AND enfermagem AND conhecimento, and, in English, ("pressure ulcer" OR "bed sore" OR "bed sores" OR bedsore OR bedsores) AND nursing AND knowledge. Articles published between 2012 and November 2021 were included, with text available in full, in open access, in English, Portuguese, or Spanish, resulting from original research related to care in the hospital area. Results: The most used knowledge assessment instrument was the P-PUKT and its versions, used in 50% of the studies, followed by the PUKAT and its versions. Three studies also used instruments constructed and validated by the authors, five qualitative studies, and four studies used non-validated instruments. Conclusion: Valid instruments to assess knowledge are essential to identify possible failures in patient care. Heterogeneity in the samples and in the classification criteria of the participants' level of knowledge made it impossible to compare the results obtained in the studies, constituting a limitation.

Background: Approximately 57 million physician appointments annually in the United Kingdom are for minor ailments. These illnesses could be self-cared for, which would potentially lower patients' anxiety, increase their confidence, and be more convenient. In a randomized controlled trial of the Internet Dr digital intervention, patients with access to the intervention had fewer consultations for respiratory tract infections (RTIs). Having established intervention efficacy, further examination of trial data is required to understand how the intervention works. Objective: This paper reports a process evaluation of Internet Dr usage by the intervention group. The evaluation aims to demonstrate how meaningful usage metrics (ie, interactions that are specific and relevant to the intervention) can be derived from the theoretical principles underlying the intervention, then applied to examine whether these interactions are effective in supporting self-care for RTIs, for whom, and at what time. Methods: The Internet Dr trial recorded patients' characteristics and usage data over 24 weeks. At follow-up, users reported whether their levels of enablement to cope with their illness changed over the trial period. The Medical Research Council process evaluation guidance and checklists from the framework for Analyzing and Measuring Usage and Engagement Data were applied to structure research questions examining associations between usage and enablement. Results: Viewing pages containing advice on caring for RTIs were identified as a meaningful metric for measuring intervention usage. Almost half of the users (616/1491, 42.31%) viewed at least one advice page, with most people (478/616, 77.6%) accessing them when they initially enrolled in the study. Users who viewed an advice page reported increased enablement to cope with their illness as a result of having participated in the study compared with users who did not (mean 2.12, SD 2.92 vs mean 1.65, SD 3.10; mean difference 0.469, 95% CI 0.082-0.856). The target population was users who had visited their general practitioners for an RTI in the year before the trial, and analyses revealed that this group was more likely to access advice pages (odds ratio 1.35, 95% CI 1.159-1.571; P<.001). Conclusions: The process evaluation identifies viewing advice pages as associated with increased enablement to self-care, even when accessed in the absence of a RTI, meaning that dissemination activities need not be restricted to targeting users who are ill. The intervention was effective at reaching the target population of users who had previously consulted their general practitioners. However, attrition before reaching advice pages was high, highlighting the necessity of prioritizing access during the design phase. These findings provide guidance on how the intervention may be improved and disseminated and have wider implications for minor ailment interventions. [ABSTRACT FROM AUTHOR]

This paper provides results of an investigation into the research literature of intercultural mediation and how intercultural mediation has been implemented in Europe. To this end, a systematic quantitative literature review was conducted, which identified 77 conceptual and empirical manuscripts for this study. The review showed that little agreement exists on precisely what intercultural mediation is and how it should be structured and supported as a profession. The empirical works identified in this study can be characterized as ad hoc in nature, capitalizing on circumstances. The result is a patchwork of concepts and studies that collectively do not provide sufficient support or foundation for the use of intercultural mediation. In order to move the field forward, we argue that an immediate next step should be the development of a well-thought, systematic research program, grounded in the existing literature. A strong recommendation found in the literature is the use of evaluation to illustrate the value of intercultural mediation. Evaluation can provide data that could help those in authority make defensible decisions about policy support for intercultural mediation. Finally, considering the current situation in European schools, we propose that in the field of mediation the intercultural approach be implemented.

Abstract Objectives To analyze the functional outcomes in patients submitted to videoarthroscopic surgical treatment for compleat rotator cuff tears of the shoulder, with a minimum follow-up of 10 years. Methods A total of 63 patients (63 shoulders) underwent videoarthroscopic surgical repair for compleat rotator cuff tears with a minimum follow-up of 10 years. The postoperative functional outcomes of these patients were evaluated using the Constant and University of California at Los Angeles (UCLA) scores. Results The functional evaluation revealed mean UCLA and Constant scores of 26 and 93 points, respectively. Ninety-one percent of the subjects had satisfactory Constant scores, whereas 62% presented satisfactory UCLA scores. Conclusion The arthroscopic repair of rotator cuff complete tear was effective even in the long term (minimum follow-up period of 10 years). The age of the patients before surgery, size of the lesion, the degree of fatty infiltration, and evaluation of muscle trophism are important predictors of prognosis.

Congda Zhang, Qingyue Li, Fangqi Li, Yuanhao Zhang, Yiyong Tang, Jingyi Hou, Rui Yang Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaCorrespondence: Rui Yang; Jingyi Hou Tel +86 13694200667; +86 18102769380Fax +86 81332199Email yangr@mail.sysu.edu.cn; houjy7@mail.sysu.edu.cnBackground: Lack of physical therapists has led to increment of self-managed rehabilitations in post-arthroscopic rotator cuff repair (ARCR) in the forms of booklets or leaflets.Purpose: The aim of study is to investigate 1) the acceptance of post-ARCR patients towards an education booklet, and 2) whether it could be a timesaving and laborsaving tool to physical therapists.Methods: An education booklet was established through a systematic review. Patients who underwent ARCR in our hospital were included and randomly assigned to the intervention or control group (27 women, 21 men, mean age= 57.06 years old). Patients in the intervention group received educational booklets, and an evaluation was also obtained after they finished reading. Patients’ understanding of the booklet was determined by asking patients to re-enact training presented in the booklet. Then, a therapist blinded to allocations would personally demonstrate training to patients until patients fully understood the protocol. For the control group, the same therapist coached patients until the whole protocol was clearly understood. The coaching time for patients in both groups was recorded.Results: Out of 48 patients, 24 (50%) were randomly assigned to the intervention group, and 21 (87.50%) completed their questionnaire. Out of these 21 patients, 20 (95.24%) rated the booklet as “excellent and easy to read”, and 17 (80.95%) felt that the booklet was helpful. The re-enaction accuracy was for strengthening training and specific training (71.43% and 61.90%, respectively). As compared to the control group, the time of coaching for the patients to fully master the protocol in the intervention group was significantly less (P< 0.01).Conclusion: Patients highly applauded this booklet, and they cherished the information and support it contained. Nevertheless, the re-enaction accuracy was not high, suggesting that the high level of acceptance does not guarantee full understanding of information sent to patients.Keywords: rotator cuff injuries, arthroscopy, rehabilitation, pamphlets, evaluation studies

Abstract Background The inadequate follow-up of test results is a key patient safety concern, carrying severe consequences for care outcomes. Patients discharged from the emergency department are at particular risk of having test results pending at discharge due to their short lengths of stay, with many hospitals acknowledging that they do not have reliable systems for managing such results. Health information technology hold the potential to reducing errors in the test result management process. This study aimed to measure changes in the proportion of acknowledged radiology reports pre and post introduction of an electronic result acknowledgement system and to determine the proportion of reports with abnormal results, including clinically significant abnormal results requiring follow-up action. Methods A before and after study was conducted in the emergency department of a 450-bed metropolitan teaching hospital in Australia. All radiology reports for discharged patients for a one-month period before and after implementation of the electronic result acknowledgement system were reviewed to determine; i) those that reported abnormal results; ii) evidence of test result acknowledgement. All unacknowledged radiology results with an abnormal finding were assessed by an independent panel of two senior emergency physicians for clinical significance. Results Of 1654 radiology reports in the pre-implementation period 70.6% (n = 1167) had documented evidence of acknowledgement by a clinician. For reports with abnormal results, 71.6% (n = 396) were acknowledged. Of 157 unacknowledged abnormal radiology reports reviewed by an independent emergency physician panel, 34.4% (n = 54) were identified as clinically significant and 50% of these (n = 27) were deemed to carry a moderate likelihood of patient morbidity if not followed up. Electronic acknowledgement occurred for all radiology reports in the post period (n = 1423), representing a 30.4% (95% CI: 28.1–32.6%) increase in acknowledgement rate, and an increase of 28.4% (95% CI: 24.6–32.2%) for abnormal radiology results. Conclusions The findings of this study demonstrate the potential of health information technology to improve the safety and effectiveness of the diagnostic process by increasing the rate of follow up of results pending at hospital discharge.

Abstract Background Realizing patient partnership in research requires a shift from patient participation in ancillary roles to engagement as contributing members of research teams. While engaging patient partners is often discussed, impact is rarely measured. Objective Our primary aim was to conduct a scoping review of the impact of patient partnership on research outcomes. The secondary aim was to describe barriers and facilitators to realizing effective partnerships. Search Strategy A comprehensive bibliographic search was undertaken in EBSCO CINAHL, and Embase, MEDLINE and PsycINFO via Ovid. Reference lists of included articles were hand‐searched. Inclusion Criteria Included studies were: (a) related to health care; (b) involved patients or proxies in the research process; and (c) reported results related to impact/evaluation of patient partnership on research outcomes. Data Extraction and Synthesis Data were extracted from 14 studies meeting inclusion criteria using a narrative synthesis approach. Main Results Patient partners were involved in a range of research activities. Results highlight critical barriers and facilitators for researchers seeking to undertake patient partnerships to be aware of, such as power imbalances between patient partners and researchers, as well as valuing of patient partner roles. Discussion Addressing power dynamics in patient partner‐researcher relationships and mitigating risks to patient partners through inclusive recruitment and training strategies may contribute towards effective engagement. Further guidance is needed to address evaluation strategies for patient partnerships across the continuum of patient partner involvement in research. Conclusions Research teams can employ preparation strategies outlined in this review to support patient partnerships in their work.

Objective: Identifying the status of Iranian digital library software in terms of the use of various content management and user portlets. Methodology: This is an applied research done as a heuristic survey. The research was conducted to evaluate the capabilities of various portlets in the field of digital library management in two general areas of content management (collection process management, content production management, classification management, documentation management, loading management, content indexing management, link management and news management) and user management (user management, staff management and user security management) are used in digital library software. Statistical population of the study consists of five Digital Library Softwares Pars Azarsa, Simorgh, Tebyan, and Parwan Farakavash produced by five major library software companies in Iran (Pars Azarakhsh, Nosa, Tebyan, kavash, and Parvanpajooh). Their software products and know-how have matured over time in tandem with technological advancements in their field, with critical inputs from field experts, associated companies, organizations and institutions. They, in the recent ten years, have undertaken many landmark projects that include database and archive automation for their clients. Their knowledge base and software products are unsurpassed in the field of digital data management for libraries and document centers, and this includes the full spectrum of related requirements. All their software products are web based, integrated and user friendly. Some of their major clients include the governmental institutions, private companies, national libraries and universities. The needed data was collected using a researcher-made check-list. Different types of descriptive statistical techniques in collaboration with Kolmogorov-Smirnov test, Shapiro-Wilk test and Kruskal-Wallis H test were used for analyzing the data. Findings: hl terms of content management, Simorgh had the best performance. The statistical population had the best performance in the "category management" section of the content management field and the weakest performance in the "link management" section. In the field of user management, "Azarsa" had the best performance. The statistical community had the weakest performance in this area in the "forum management" section. Test of research hypotheses showed that there is no significant difference between the digital library software in the use of content management portals and user management. Conclusion: The performance of the statistical population was evaluated for 114 management portlets. The statistical population in the field of content management according to the check-list had an average performance of 80 percent and the average performance of the statistical population in the field of user management was below 63 percent, among which even "Farakavash" and "Parvan" had a performance below 50 percent. Therefore, in general comparison, it was concluded that the statistical community in the field of content management has performed better than user management. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background As citizens, patients and family members are participating in numerous and expanding roles in health system organizations, attention has turned to evaluating these efforts. The context‐specific nature of engagement requires evaluation tools to be carefully designed for optimal use. We sought to address this need by assessing the appropriateness and feasibility of a generic tool across a range of health system organizations, engagement activities and patient groups. Methods We used a mixed‐methods implementation research design to study the implementation of an engagement evaluation tool in seven health system organizations in Ontario, Canada focusing on two key implementation outcome variables: appropriateness and feasibility. Data were collected through respondent feedback questions (binary and open‐ended) at the end of the tool's three questionnaires as well as interviews and debriefing discussions with engagement professionals and patient partners from collaborating organizations. Results The three questionnaires comprising the evaluation tool were collectively administered 29 times to 405 respondents yielding a 52% response rate (90% and 53% of respondents respectively assessed the survey's appropriateness and feasibility [quantitatively or qualitatively]). The questionnaires' basic properties were rated highly by all respondents. Concrete suggestions were provided for improving the appropriateness and feasibility of the questionnaires (or components within) for different engagement activity and organization types, and for enhancing the timing of implementation. Discussion and Conclusions Our study findings offer guidance for health system organizations and evaluators to support the optimal use of engagement evaluation tools across a variety of health system settings, engagement activities and respondent groups.

Objective: The purpose of this research is evaluating heuristic usability of mobile website of Iranian university libraries and comparing it to top universities in the world. Methodology: This is an applied research, in which the usability of libraries’ mobile website has been investigated by heuristic evaluation method. In this research, 20top universities affiliated to the MSRT, and 20top Islamic Azad university listed in ISC and 3 world top universities listed in webometric ranking have been chosen. Data collection is based on Nielsen (1994) and Fung (2016) usability checklist. Data analysis was done by SPSS software at both descriptive statistics and nonparametric inferential statistics including Friedman and Spearman correlation coefficient.Findings: Mobile website of the universities affiliated to the MSRT is good in terms of usability. IAU’s are average in terms of usability. Furthermore, the universities affiliated to the MSRT in comparing to the top universities of the world are very good in terms of usability. IAU’s in comparing to the top universities of world are good.In terms of usability, the final ranking was this: 1. Mazandaran University 2. Shahid Bahonar University of Kerman, and 3. Harvard University. Results demonstrate that there is no correlation between the ranking of ISC/webometric and ranking according to the evaluation of usability of the university libraries of the mentioned universities.Originality: It seems that paying more attention to concepts such as usability in designing the mobile website of libraries by the designers regarding wide range of users causes better communication of users with it.

Introduction Obesity is a serious health problem in nearly all regions of Europe. During the last four decades, the percentage of obese people increased four times among men and twice among women, reaching a global epidemic scale as the biggest health-related issue in the developed and developing countries. Objective The aim was to assess the epidemiological situation of obesity, according to gender among adults in Europe, compared with other regions and selected worldwide countries, as well as to devise a forecast for the near future based on analysis results. Material and methods An overview was performed of the World Health Organization (WHO) statistical database in 1999–2016, concerning obesity prevalence among people over the age of 20 across 28 countries of the European Union. A forecast for the years 2020 and 2030 was prepared by evaluation of gradients for trendline equations. Moreover, some of the world regions, as well as individual countries, five per region, were collated and analyzed to prepare the forecast. Results The percentage of obese people in the countries of the European Union continues to increase every year. The dynamics of obesity growth in Europe is greater for men than for women (3.09% per year vs. 1.92% per year). With the growth rate remaining at the estimated level, in 2030 there will probably be more obese men (38.1%) than women (32.7%) in Poland, and in Europe likewise – 36.6% and 32.0%, respectively. Conclusions Obesity has become a major epidemiological problem and an undisputable health problem not only in Poland and other European countries, but worldwide.

RESUMO Objetivou-se analisar a produção científica sobre a aplicação dos Estudos de Avaliabilidade na área da saúde. Trata-se de uma revisão integrativa da literatura realizada de setembro a outubro de 2017, com busca de pesquisas avaliativas com aplicação de um Estudo de Avaliabilidade, na Biblioteca Virtual em Saúde, Scopus e Web of Science. Analisaram-se 21 artigos, 57,1% publicados nos últimos cinco anos. Os resultados demonstram que há incorporação de aspectos importantes da teoria dos Estudos de Avaliabilidade nos estudos, tais como modelo teórico norteador, uso das etapas próprias de um Estudo de Avaliabilidade, realização da modelagem do programa e associação de fontes de evidências. Conclui-se que o uso do Estudo de Avaliabilidade vem aumentando na área da saúde, entretanto, há necessidade de melhorar sua qualidade, especialmente quanto ao objetivo e questão de pesquisa, descrição do envolvimento dos autores e autorização do local de pesquisa, envolvimento dos stakeholders, descrição dos procedimentos de análise dos dados, estratégias para garantir validade e confiabilidade dos dados, e contribuição para aumento do conhecimento acadêmico, explicitando as contribuições potenciais do Estudo de Avaliabilidade e da avaliação em saúde.

Abstract Background Student physicians are particularly prone to high rates of poor mental and physical quality of life, including depression, anxiety, and fatigue. We prospectively tested whether a structured, theory-based executive/life coaching program tailored to first year medical students in the United States was feasible, tolerable, and would be recommended by participants. Secondary goals included impact on coaching goals, resilience, and perceived stress. Methods This single-arm intervention study evaluated a program of two group and two private coaching sessions during the first year, second semester of the Georgetown University School of Medicine Class of 2019. Survey data (global and tailored questions, Connor-Davidson resilience scale, Friedricksson-Larsson stress question) were collected from participants at baseline and post-intervention. Results 37/40 students completed the intervention; 32 completed the pre-post surveys. Most (32/37) were willing to recommend the program (16/37 were very willing) and 29/37 recommended inclusion in the curriculum. Responses to tailored questions showed significant increases in self-efficacy regarding stress management (p

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The research evaluated point-of-care resources for scope, completeness, and consistency of information describing interactions between therapeutic drugs and drugs of abuse (DoA). Methods: A cross-sectional evaluation study was conducted focusing on seven resources: Clinical Pharmacology, Facts & Comparisons eAnswers, Lexicomp Online, Micromedex, Drug Interactions Analysis and Management, Drug Interaction Facts, and Stockley’s Drug Interactions. A sample of clinically relevant interactions was developed through review of tertiary literature and resources, and input was solicited from subject matter experts. Entries from each resource for each interaction were evaluated for scope (i.e., whether there was an entry for the interaction); completeness (i.e., whether there was information addressing mechanism; clinical effects, severity, course of action, and level of certainty, described as a median rating on a 5-point scale); and consistency (i.e., whether the information in the resource was similar to the majority) among resources with an entry. Results: Following review by subject matter experts, the final sample contained 159 interactions. Scope scores ranged from 0.6% (Drug Interactions Analysis and Management) to 43.4% (Lexicomp Online). Completeness scores ranged from 2 (interquartile range [IQR] 0 to 3, Stockley’s Drug Interactions) to 5 (IQR 5 to 5, Drug Interaction Facts, Micromedex, Facts & Comparisons eAnswers). Consistency scores ranged from 30.8% (Stockley’s Drug Interactions) to 87.1% (Clinical Pharmacology) for severity and from 15.4% (Facts & Comparisons eAnswers) to 71.4% (Drug Interaction Facts) for course of action. Conclusions: Although coverage of drug-DoA interactions was low and content was often inconsistent among resources, the provided information was generally complete.

Abstract Background To address challenges related to medication management in underserved settings, we developed a system for Prescription Management And General Inventory Control, or RxMAGIC, in collaboration with the Birmingham Free Clinic in Pittsburgh, Pennsylvania. RxMAGIC is an interoperable, web-based medication management system designed to standardize and streamline the dispensing practice and improve inventory control in a free clinic setting. This manuscript describes the processes used to design, develop, and deploy RxMAGIC. Methods We transformed data from previously performed mixed-methods needs assessment studies into functional user requirements using agile development methods. Requirements took the form of user stories that were prioritized to drive implementation of RxMAGIC as a web-application. A functional prototype was developed and tested to understand its perceived usefulness before developing a production system. Prior to deployment, we evaluated the usability of RxMAGIC with six users to diagnose potential interaction challenges that may be avoided through redesign. The results from this study were similarly prioritized and informed the final features of the production system. Results We developed 45 user stories that acted as functional requirements to incrementally build RxMAGIC. Integrating with the electronic health record at the clinic was a requirement for deployment. We utilized health data standards to communicate with the existing order entry system; an outgoing electronic prescribing framework was leveraged to send prescription data to RxMAGIC. The results of the usability study were positive, with all tested features receiving a mean score of four or five (i.e. somewhat easy or easy, respectively) on a five-point Likert scale assessing ease of completion, thus demonstrating the system’s simplicity and high learnability. RxMAGIC was deployed at the clinic in October 2016 over a two-week period. Conclusions We built RxMAGIC, an open-source, pharmacist-facing dispensary management information system that augments the pharmacist’s ability to efficiently deliver medication services in a free clinic setting. RxMAGIC provides electronic dispensing and automated inventory management and alerting capabilities. We deployed RxMAGIC at the Birmingham Free Clinic and measured its usability with potential users. In future work, we plan to continue to measure the impact of RxMAGIC on pharmacist efficiency and satisfaction.

ObjectivesThe objective of this study was to evaluate the features of diet and nutrition apps available in the Google Play Store.MethodsA search was conducted in August 2017 using the Google Play Store database to identify apps related to diet and nutrition. Terms entered into the app search engine included ‘diet apps’ and ‘nutrition apps’. The first 50 apps resulting from each search term was assessed. Duplicates were removed, and a comparative analysis was performed on the remaining diet and nutrition apps.ResultsA total of 86 diet and nutrition apps were identified. One hundred percent (n = 86) of the apps retrieved were freely available. More than half of the apps were applicable to a target user group of all ages (94%, n = 81). Stratified analysis across unique diet and nutrition apps (total, n = 72) showed a higher average rating for the diet apps (4.4) in comparison to that for the nutrition apps (4.3). Diet apps were more likely to be recently updated than the nutrition apps (72% vs. 66%), and diet apps were more likely to feature app purchase than nutrition apps (36% vs. 19%). The average rating was slightly higher for diet apps not featuring in-app purchases, but ratings were similar for the nutrition apps.ConclusionsA centralized resource is needed that can provide information on health-related apps to allow for systematic evaluation of their effectiveness. Further research needs to examine improved methods of designing app-store platforms and presenting the available apps to properly guide users in app selection.

Initiatives to engage the public in health policy decisions have been widely endorsed and used, yet agreed upon methods for systematically evaluating the effectiveness of these initiatives remain to be developed. Dukhanin, Topazian, and DeCamp have thus developed a useful taxonomy of evaluation criteria derived from a systematic review of published evaluation tools that might serve as the basis for systematic evaluation. In considering the application of such a taxonomy, it is important to appreciate the political space in which health policy decisions occur. In this context, public engagement initiatives are likely to have a modest and unpredictable impact on policy decisions. Other goals, aside from influencing policy decisions, such as informing the public about issues, identifying the public’s values, enhancing public support for decisions, and promoting public discourse, are likely to be more feasible. While Dukanan and colleagues did not aim to do so, future efforts to align guidance for planning public engagement initiatives with evaluation tools would be useful to promote the success of public engagement initiatives.

Objective: Functional evaluations establish functional and work (in-)capacities in the context of disability assessments and are increasingly recommended as a modern technique for work disability assessments. The RELY (R eliable disability E va L uation in psychiatr Y)-studies introduced semi-structured functional interviews in real-life assessments of claimants with mental disorders for evaluating their self-perceived health-related limitations and for investigating the reproducibility of work capacity (WC) estimates. Functional interviews elicit claimants' self-perceptions about their work-related limitations and capacities in the labour market. This secondary data analysis explored the coverage of work-related key topics in these interviews and investigated whether interviews with high coverage (versus low coverage) of work-related topics resulted in better reproducibility of WC estimates among experts. Methods: Thirty video-taped RELY-assessments underwent a content analysis along a predefined framework for functional interviewing, including the claimant's self-perceived work limitations and work-related health complaints as centrepieces of functional interviewing. Following transcription, interviews were segmented into coding units. Coding units were allocated to the five steps with 19 key topics of the framework. Enquiry into key topics was ascertained by summing the functional coding units per key topic. Median split grouped the interviews into high and low coverage of functional topics and compared them for inter-rater reliability (intraclass correlation coefficient, ICC) and inter-rater agreement (standard error of measurement, SEM). Results: Interviews were broken down in 40,010 coding units, 31% of which addressed functional topics. Enquiries in self-perceived work limitations and work-related health complaints were sparse (coding units medianpsychiatrist between 0 and 1.5, medianpatients between 0 and 9.5). High coverage interviews enquired on more functional topics (68% vs. 42%, chi2(1, N = 38) = 5.32, p = 0.021) and in more depth (36% vs. 16% of functional coding units, chi2(1, N = 1,314) = 141.15, p < 0.001). Interviews with higher functional coverage reached significantly higher inter-rater agreement in WC ratings among experts (mean difference in SEM, low–high coverage, 7.5% WC, 95% CI 0.2 to 15.1%WC). Inter-rater reliability was low in both groups (ICC, 0.38 versus 0.40). Conclusions: Content analysis showed little enquiry by experts on claimants' self-perceived activity limitations and work-related capacity. The association between interviews with higher functional coverage and better expert agreement on the claimants' remaining WC requires confirmation in prospective studies. [ABSTRACT FROM AUTHOR]

Background: The inadequate follow-up of test results is a key patient safety concern, carrying severe consequences for care outcomes. Patients discharged from the emergency department are at particular risk of having test results pending at discharge due to their short lengths of stay, with many hospitals acknowledging that they do not have reliable systems for managing such results. Health information technology hold the potential to reducing errors in the test result management process. This study aimed to measure changes in the proportion of acknowledged radiology reports pre and post introduction of an electronic result acknowledgement system and to determine the proportion of reports with abnormal results, including clinically significant abnormal results requiring follow-up action.Methods: A before and after study was conducted in the emergency department of a 450-bed metropolitan teaching hospital in Australia. All radiology reports for discharged patients for a one-month period before and after implementation of the electronic result acknowledgement system were reviewed to determine; i) those that reported abnormal results; ii) evidence of test result acknowledgement. All unacknowledged radiology results with an abnormal finding were assessed by an independent panel of two senior emergency physicians for clinical significance.Results: Of 1654 radiology reports in the pre-implementation period 70.6% (n = 1167) had documented evidence of acknowledgement by a clinician. For reports with abnormal results, 71.6% (n = 396) were acknowledged. Of 157 unacknowledged abnormal radiology reports reviewed by an independent emergency physician panel, 34.4% (n = 54) were identified as clinically significant and 50% of these (n = 27) were deemed to carry a moderate likelihood of patient morbidity if not followed up. Electronic acknowledgement occurred for all radiology reports in the post period (n = 1423), representing a 30.4% (95% CI: 28.1-32.6%) increase in acknowledgement rate, and an increase of 28.4% (95% CI: 24.6-32.2%) for abnormal radiology results.Conclusions: The findings of this study demonstrate the potential of health information technology to improve the safety and effectiveness of the diagnostic process by increasing the rate of follow up of results pending at hospital discharge. [ABSTRACT FROM AUTHOR]

Background: Realizing patient partnership in research requires a shift from patient participation in ancillary roles to engagement as contributing members of research teams. While engaging patient partners is often discussed, impact is rarely measured. Objective: Our primary aim was to conduct a scoping review of the impact of patient partnership on research outcomes. The secondary aim was to describe barriers and facilitators to realizing effective partnerships. Search Strategy: A comprehensive bibliographic search was undertaken in EBSCO CINAHL, and Embase, MEDLINE and PsycINFO via Ovid. Reference lists of included articles were hand‐searched. Inclusion Criteria: Included studies were: (a) related to health care; (b) involved patients or proxies in the research process; and (c) reported results related to impact/evaluation of patient partnership on research outcomes. Data Extraction and Synthesis: Data were extracted from 14 studies meeting inclusion criteria using a narrative synthesis approach. Main Results: Patient partners were involved in a range of research activities. Results highlight critical barriers and facilitators for researchers seeking to undertake patient partnerships to be aware of, such as power imbalances between patient partners and researchers, as well as valuing of patient partner roles. Discussion: Addressing power dynamics in patient partner‐researcher relationships and mitigating risks to patient partners through inclusive recruitment and training strategies may contribute towards effective engagement. Further guidance is needed to address evaluation strategies for patient partnerships across the continuum of patient partner involvement in research. Conclusions: Research teams can employ preparation strategies outlined in this review to support patient partnerships in their work. [ABSTRACT FROM AUTHOR]

Background: In Scotland, there has been significant investment in pharmacy teams in general medical practices over recent years, aligned to current government policy.Objectives: To characterize the national pharmacy workforce including activities undertaken, perceived competence and confidence, as well as perception of integration of the intervention.Methods: A cross-sectional survey of all pharmacists and pharmacy technicians in general practices. Survey items were demographics, activities undertaken and experiences. The NoMAD tool (Improving the Normalization of Complex Interventions) was included as a measure of perspectives of implementation. Post-piloting, a questionnaire link was sent to all pharmacists (n = 471) and pharmacy technicians (n = 112). A total NoMAD score was obtained by assigning 1 (strongly disagree) to 5 (strongly agree) to each item.Results: Responses were received from 393 (83.4%) pharmacists and 101 (91.8%) pharmacy technicians. Three quarters of pharmacists (74.6%) and pharmacy technicians (73.3%) had been qualified for over 10 years. Two-thirds of pharmacists (68.4%) were independent prescribers, with three quarters (72.3%) currently prescribing. Respondents worked in a median of two practices and were providing a range of activities including medication/polypharmacy reviews, medicines reconciliation, prescribing efficiencies and training. Respondents reported high levels of competence and confidence (median 8, scale 0-10 highest). Median NoMAD total score (scale 20-100 highest, Cronbach's alpha 0.89) was 80 for pharmacists and 75 for pharmacy technicians, P ≤ 0.001.Conclusions: The general practice pharmacy workforce in Scotland is experienced, well-qualified and integrated within general practices, delivering a range of activities. These findings have implications for workforce planning and future education and training. [ABSTRACT FROM AUTHOR]