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991.
Jay C. Buckey Abigail M. Fellows Odile H. Clavier Lindsay V. Allen Chris A. Brooks Jesse A. Norris Jiang Gui Deanna K. Meinke 《Noise & health》2015,17(78):263-272
Distortion product otoacoustic emission (DPOAE) level mapping provides a comprehensive picture of cochlear responses over a range of DP frequencies and f2/f1 ratios. We hypothesized that individuals exposed to high-level sound would show changes detectable by DPOAE mapping, but not apparent on a standard DP-gram. Thirteen normal hearing subjects were studied before and after attending music concerts. Pure-tone audiometry (500-8,000 Hz), DP-grams (0.3-10 kHz) at 1.22 ratio, and DPOAE level maps were collected prior to, as soon as possible after, and the day after the concerts. All maps covered the range of 2,000-6,000 Hz in DP frequency and from 1.3 to -1.3 in ratio using equi-level primary tone stimuli. Changes in the pure-tone audiogram were significant (P ≤ 0.01) immediately after the concert at 1,000 Hz, 4,000 Hz, and 6,000 Hz. The DP-gram showed significant differences only at f2 = 4,066 (P = 0.01) and f2 = 4,348 (P = 0.04). The postconcert changes were readily apparent both visually and statistically (P ≤ 0.01) on the mean DP level maps, and remained statistically significantly different from baseline the day after noise exposure although no significant changes from baseline were seen on the DP-gram or audiogram the day after exposure. Although both the DP-gram and audiogram showed recovery by the next day, the average DPOAE level maps remained significantly different from baseline. The mapping data showed changes in the cochlea that were not detected from the DP-gram obtained at a single ratio. DPOAE level mapping provides comprehensive information on subtle cochlear responses, which may offer advantages for studying and tracking noise-induced hearing loss (NIHL). 相似文献
992.
The Consumer Quality Index in an accident and emergency department: internal consistency,validity and discriminative capacity
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Nanne Bos PhD Leontien M. Sturms PhD Rebecca K. Stellato MSc Augustinus J.P. Schrijvers PhD Henk F. van Stel PhD 《Health expectations》2015,18(5):1426-1438
Background
Patients’ experiences are an indicator of health‐care performance in the accident and emergency department (A&E). The Consumer Quality Index for the Accident and Emergency department (CQI A&E), a questionnaire to assess the quality of care as experienced by patients, was investigated. The internal consistency, construct validity and discriminative capacity of the questionnaire were examined.Methods
In the Netherlands, twenty‐one A&Es participated in a cross‐sectional survey, covering 4883 patients. The questionnaire consisted of 78 questions. Principal components analysis determined underlying domains. Internal consistency was determined by Cronbach''s alpha coefficients, construct validity by Pearson''s correlation coefficients and the discriminative capacity by intraclass correlation coefficients and reliability of A&E‐level mean scores (G‐coefficient).Results
Seven quality domains emerged from the principal components analysis: information before treatment, timeliness, attitude of health‐care professionals, professionalism of received care, information during treatment, environment and facilities, and discharge management. Domains were internally consistent (range: 0.67–0.84). Five domains and the ‘global quality rating’ had the capacity to discriminate among A&Es (significant intraclass correlation coefficient). Four domains and the ‘global quality rating’ were close to or above the threshold for reliably demonstrating differences among A&Es. The patients’ experiences score on the domain timeliness showed the largest range between the worst‐ and best‐performing A&E.Conclusions
The CQI A&E is a validated survey to measure health‐care performance in the A&E from patients’ perspective. Five domains regarding quality of care aspects and the ‘global quality rating’ had the capacity to discriminate among A&Es. 相似文献993.
Supporting public involvement in research design and grant development: a case study of a public involvement award scheme managed by a National Institute for Health Research (NIHR) Research Design Service (RDS)
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Jonathan D. Boote MA MSc PhD Maureen Twiddy BSc MSc PhD Wendy Baird BSc MSc PhD Yvonne Birks BSc DPhil RGN Clare Clarke BSc Daniel Beever LLB 《Health expectations》2015,18(5):1481-1493
Background
It is good practice for the public to be involved in developing health research. Resources should be available for researchers to fund the involvement of the public in the development of their grants.Objective
To describe a funding award scheme to support public involvement in grant development, managed by an NIHR Research Design Service (RDS). Case examples of how the award contributed to successful grant applications and findings from a recent evaluation of the scheme are presented.Design
A case study of resource provision to support public involvement activities in one region of England.Participants
University and NHS‐based researchers, and members of the public.Findings
Between 2009 and 2012, the RDS approved 45 public involvement funding awards (totalling nearly £19 000). These awards contributed to 27 submitted applications at the time of writing, of which 11 were successful (totalling over £7.5 million). The evaluation revealed difficulties encountered by some researchers when involving the public in grant development, which led to suggestions about how the scheme could be improved.Conclusion
This award scheme represents an efficient method of providing researchers with resources to involve the public in grant development and would appear to represent good value for money. 相似文献994.
How do people interpret information about colorectal cancer screening: observations from a think‐aloud study
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Samuel G. Smith MSc Gemma Vart PhD CPsychol Michael S. Wolf PhD MPH Austin Obichere MD FRCS Helen J. Baker BEd Rosalind Raine PhD FFPH Jane Wardle PhD FMedSci Christian von Wagner PhD 《Health expectations》2015,18(5):703-714
Background
The English NHS Bowel Cancer Screening Programme biennially invites individuals aged 60–74 to participate in screening. The booklet, ‘Bowel Cancer Screening: The Facts'' accompanies this invitation. Its primary aim is to inform potential participants about the aims, advantages and disadvantages of colorectal cancer screening.Objective
To provide detailed commentary on how individuals process the information contained within ‘The Facts’ booklet.Design, setting and participants
This study comprised of 18 interviews with individuals aged 45–60 and used a ‘think‐aloud’ paradigm in which participants read aloud the booklet. Participant utterances (verbal statements made in response to researcher‐led prompts) were transcribed and analysed using a combination of content and thematic analysis.Results
A total of 776 coded utterances were analysed (mean = 43.1 per person; range = 8–95). While overall comprehension was satisfactory, several problem areas were identified such as the use of complex unfamiliar terminology and the presentation of numerical information. Specific sections such as colonoscopy risk information evoked negative emotional responses. Participants made several suggestions for ways in which comprehension might be improved.Conclusion
Public perceptions of the NHS Bowel Cancer Screening Programme information materials indicated that specific aspects of the booklet were difficult to process. These materials may be an appropriate target to improve public understanding of the aims, benefits and disadvantages of colorectal cancer screening. These findings will contribute to a broader NIHR‐funded project that aims to design a supplementary ‘gist‐based’ information leaflet suitable for low literacy populations. 相似文献995.
Do patients’ information requirements for choice in health care vary with their socio‐demographic characteristics?
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Anthony A. Laverty MSc Anna Dixon PhD Christopher Millett PhD 《Health expectations》2015,18(5):1127-1138
Objectives
This study examines whether the information used to inform hospital choice, and the sources of that information, varies with patients’ socio‐demographic characteristics. It also examines whether information used by patients to inform choice is associated with attending their local hospital.Methods
A survey of 1033 patients who were offered a choice of hospital provider for elective treatment in England. Logistic regression was used to examine associations between patient characteristics and information used to inform choice of a hospital provider and sources of information used.Results
Factors most important to patients in choosing a hospital were quality of care, cleanliness, standard of facilities and reputation. While quality of care and related factors are important to the majority of patients, those with lower levels of education were more likely to report that location and appointment times were important. Those who thought quality important were more likely to attend their local hospital provider. The main sources of information used to inform choice of hospital were own experience, family and friends and the general practitioner (GP). Patients who sought advice from their GP or booking advisors were less likely to attend their local hospitals.Conclusions
Differences among patients as to what factors are important when choosing a hospital provider and what information and support they access suggest there needs to be a variety of information sources and support available to promote choice. Greater shared decision making through active involvement and support by GPs or booking advisors may be required if they are to make choices in line with their preferences. 相似文献996.
Monique Lhussier HND MSc PhD Simon Eaton BMedSci BMBS FRCP DM CertMEd Natalie Forster BA PGCert Mathew Thomas BA Sue Roberts MBBS MSc FRCP Susan M Carr BA MSc PhD 《Health expectations》2015,18(5):605-624
Objective
This article focuses on approaches within clinical practice that seek to actively involve patients with long‐term conditions (LTCs) and how professionals may understand and implement them. Personalized care planning is one such approach, but its current lack of conceptual clarity might have impeded its widespread implementation to date. A variety of overlapping concepts coexist in the literature, which have the potential to impair both clinical and research agendas. The aim of this article is therefore to explore the meaning of the concept of care planning in relation to other overlapping concepts and how this translates into clinical practice implementation.Methods
Searches were conducted in the Cochrane database for systematic reviews, CINHAL and MEDLINE. A staged approach to conducting the concept mapping was undertaken, by (i) an examination of the literature on care planning in LTCs; (ii) identification of related terms; (iii) locating reviews of those terms. Retrieved articles were subjected to a content analysis, which formed the basis of our concept maps. (iv) We then appraised these against knowledge and experience of the implementation of care planning in clinical practice.Results and Conclusions
Thirteen articles were retrieved, in which the core importance of patient‐centredness, shared decision making and self‐management was highlighted. Literature searches on these terms retrieved a further 24 articles. Our concept mapping exercise shows that whilst there are common themes across the concepts, the differences between them reflect the context and intended outcomes within clinical practice. We argue that this clarification exercise will allow for further development of both research and clinical implementation agendas. 相似文献997.
What do people appreciate in physicians' communication? An international study with focus groups using videotaped medical consultations
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Maria A. Mazzi MSc Michela Rimondini PhD Myriam Deveugele PhD Christa Zimmermann PhD Francesca Moretti PhD Liesbeth van Vliet PhD Giuseppe Deledda MSc Ian Fletcher PhD Jozien Bensing PhD 《Health expectations》2015,18(5):1215-1226
Background
The literature shows that the quality of communication is usually determined from a professional perspective. Patients or lay people are seldom involved in the development of quality indicators or communication.Objective
To give voice to the lay people perspective on what constitutes ‘good communication’ by evoking their reactions to variations in physician communication.Design
Lay people from four different countries watched the same videotaped standardized medical encounters and discussed their preferences in gender‐specific focus groups who were balanced in age groups.Setting and participants
Two hundred and fifty‐nine lay people (64 NL, 72 IT, 75 UK and 48 BE) distributed over 35 focus groups of 6–8 persons each.Main variables studied
Comments on doctors'' behaviours were classified by the GULiVer framework in terms of contents and preferences.Results
Participants prevalently discussed ‘task‐oriented expressions’ (39%: competency, self‐confident, providing solutions), ‘affective oriented/emotional expressions'' (25%: empathy, listening, reassuring) and ‘process‐oriented expressions'' (23%: flexibility, summarizing, verifying). ‘Showing an affective attitude’ was most appreciated (positive percentage within category: 93%, particularly facilitations and inviting attitude), followed by ‘providing solution’ (85%). Among disfavoured behaviour, repetitions (88%), ‘writing and reading’ (54%) and asking permission (42%) were found.Conclusions
Although an affective attitude is appreciated by nearly everybody, people may vary widely in their communication needs and preferences: what is ‘good communication’ for one person may be disliked or even a source of irritation for another. A physician should be flexible and capable of adapting the consultation to the different needs of different patients. This challenges the idea of general communication guidelines. 相似文献998.
Synthesis of two potent glucocorticoid receptor agonists labeled with carbon‐14 and stable isotopes
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Bachir Latli Jonathan T. Reeves Zhulin Tan Matt Hrapchak Jinhua J. Song Carl B. Busacca Chris H. Senanayake 《Journal of labelled compounds & radiopharmaceuticals》2015,58(11-12):445-452
Two potent glucocorticoid receptor agonists were prepared labeled with carbon‐14 and with stable isotopes to perform drug metabolism, pharmacokinetics, and bioanalytical studies. Carbon‐14 labeled (1) was obtained from an enantiopure alkyne (5) via a Sonogashira coupling to a previously reported 5‐amino‐4‐iodo‐[2‐14C]pyrimidine [14C]‐(6), followed by a base‐mediated cyclization (1) in 72% overall radiochemical yield. Carbon‐14 labeled (2) was prepared in five steps employing a key benzoic acid intermediate [14C]‐(13), which was synthesized in one pot from enolization of trifluoromethylketone (12), followed by bromine–magnesium exchange and then electrophile trapping reaction with [14C]‐carbon dioxide. A chiral auxiliary (S)‐1‐(4‐methoxyphenyl)ethylamine was then coupled to this acid to give [14C]‐(15). Propargylation and separation of diastereoisomers by crystallizations gave the desired diastereomer [14C]‐(17) in 34% yield. Sonogashira coupling to iodopyridine (10) followed by cyclization to the azaindole [14C]‐(18) and finally removal of the chiral auxiliary gave [14C]‐(2) in 7% overall yield. For stable isotope syntheses, [13C6]‐(1) was obtained in three steps using [13C4]‐(6) and trimethylsilylacetylene‐[13C2] in 26% yield, while [2H5]‐(2) was obtained by first preparing the iodopyridine [2H5]‐(10) in five steps. Then, Sonogashira coupling to chiral alkyne (24) and cyclization gave [2H5]‐(2) in 42% overall yield. 相似文献
999.
Tolley Elizabeth E. Hamilton Erica L. Eley Natalie Maragh-Bass Allysha C. Okumu Eunice Balán Iván C. Gamble Theresa Beyrer Chris Remien Robert 《AIDS and behavior》2022,26(9):3119-3130
AIDS and Behavior - Adherence to care and antiretroviral therapy is challenging, especially for people living with HIV (PLWH) with additional co-occurring risk factors. Case management... 相似文献
1000.
Ultralow temperature cryoablation: Safety and efficacy of preclinical atrial and ventricular lesions
Felix Bourier MD Masateru Takigawa MD PhD Anna Lam MD Konstantinos Vlachos MD F. Daniel Ramirez MD MSc Claire A. Martin MD Antonio Frontera MD PhD Takeshi Kitamura MD Josselin Duchateau MD Thomas Pambrun MD Nicolas Derval MD Arnaud Denis MD Jerry Cox MD David Cabrita MD Alexander Babkin PhD Marion Constantin MA Pierre Jais MD Frédéric Sacher MD PhD Rémi Dubois MD PhD Oliver Bernus PhD Michel Haissaguerre MD Mélèze Hocini MD 《Journal of cardiovascular electrophysiology》2021,32(3):570-577