Transitional care for patients with acute stroke—A priority‐setting project

BackgroundThe scope of this priority‐setting process is communication and collaboration in transitional care for patients with acute stroke. Actively involving persons with stroke and their family caregivers is important both in transitional care and when setting priorities for research. Established priority‐setting methods are time‐consuming and require extensive resources. They are therefore not feasible in small‐scale research. This article describes a pragmatic priority‐setting process to identify a prioritized top 10 list of research needs regarding transitional care for patients with acute stroke.MethodsA pragmatic priority‐setting approach inspired by the James Lind Alliance was developed. It involves establishing a user group, identifying the research needs through an online survey, analysing and checking the research needs against systematic reviews, culminating in an online prioritization of the top 10 list.ResultsThe process was completed in 7 months. A total of 122 patients, family caregivers, health personnel and caseworkers submitted 484 research needs, and 19 users prioritized the top 10 list. The list includes the categories ‘patients and caregivers’ needs and health literacy’, ‘health personnel''s common understanding’, ‘information flow between health personnel and patients and caregivers’, ‘available interventions and follow‐up of patients and caregivers’, ‘interaction and collaboration between health personnel and caseworkers across hospital and primary healthcare’ and ‘disabilities after stroke’.ConclusionThis paper outlines a pragmatic approach to identifying and prioritizing users'' research needs that was completed in 7 months. The top 10 list resulting from this priority setting process can guide future research relating to communication and collaboration during the transition from hospital to the community for patients with stroke.Patient and Public ContributionMembers of three stroke organizations participated in the advisory group. They gave feedback on the scope and the process, distributed the surveys and prioritized the top 10 list. Persons with stroke and their caregivers submitted research needs in the survey.     

电话回访出院患者服务满意度分析

目的通过电话回访出院患者,给予后续服务,提高群众满意度。方法患者出院后一个月内临床科室主管医师电话回访出院患者,进行生理健康、心理安抚的服务。患者出院后一个月内由医院行风办专职人员负责电话回访,进行服务满意度的调查。结果 2012年3月-2014年2月8个传染病区住院患者共18340例次,实际回访总数为7854例,回访成功率为42.82%;2012年3月-2014年2月全院病区住院患者共89534例次,实际回访总数为43138例,回访成功率为48.18%。2013年3月1日-2014年2月28日与2012年3月1日-2013年2月28日比较,其中8个临床科室有4个比较项有提高,其他科室各项满意率都在96%以上,患者满意度较高,全院总满意率为97.23%,亦有提高。结论电话回访体现了医院服务内涵的社会延续,是医院实现人本理念管理、优化患者服务的便捷平台,提高了患者对医院服务的满意度。     

我国图书情报机构舆情分析服务模式

简述了舆情分析服务模式的相关概念,结合我国图书情报机构开展舆情分析服务的典型案例,归纳总结了舆情分析服务的4种模式,指出了未来舆情分析服务模式的发展趋势,旨在为医学情报研究机构开展舆情分析服务提供借鉴.     

PREFERENCES FOR THE NORMATIVE BASIS OF HEALTH CARE PRIORITY SETTING: SOME EVIDENCE FROM TWO COUNTRIES

The present paper concerns the criteria people would prefer for prioritising health programmes. It differs from most empirical studies as subjects were not asked about their personal preferences for programmes per se. Rather, they were asked about the principles that should guide the choice of programmes. Four different principles were framed as arguments for alternative programmes. The results from population surveys in Australia and Norway suggest that people are least supportive of the principle that decision makers should follow the stated preferences of the public. Rather, respondents expressed more support for decisions based upon health maximisation, equality and urgency. Copyright © 2012 John Wiley & Sons, Ltd.     

Cervical cancer and the global health agenda: Insights from multiple policy-analysis frameworks

Cervical cancer is the second leading cause of cancer deaths for women globally, with an estimated 88% of deaths occurring in the developing world. Available technologies have dramatically reduced mortality in high-income settings, yet cervical cancer receives considerably little attention on the global health policy landscape. The authors applied four policy-analysis frameworks to literature on global cervical cancer to explore the question of why cervical cancer may not be receiving the international attention it may otherwise warrant. Each framework explores the process of agenda setting and discerns factors that either facilitate or hinder policy change in cases where there is both a clear problem and a potential effective solution. In combination, these frameworks highlight a number of crucial elements that may be needed to raise the profile of cervical cancer on global health agendas, including improving local (national or sub-national) information on the condition; increasing mobilisation of affected civil society groups; framing cervical cancer debates in ways that build upon its classification as a non-communicable disease (NCD) and an issue of women's rights; linking cervical cancer screening to well-funded services such as those for HIV treatment in some countries; and identifying key global policy windows of opportunity to promote the cervical cancer agenda, including emerging NCD global health discussions and post-2015 reviews of the Millennium Development Goals.     

Palliative Care

Over 4 million American Indians and Alaskan Natives live in communities that receive health care primarily from the federal Indian Health Service or tribal health programs. Palliative care has only recently been formally addressed for these communities. An Indian Health Service program introduced the topic and several programs are ongoing. Needs for and barriers to palliative care in native peoples' communities are discussed and several successful programs at various stages of development and implementation are described.     

Palliative dilation of esophageal carcinoma

The authors' experience with palliative dilation of 46 consecutive patients evaluated for squamous cell carcinoma of the esophagus was retrospectively reviewed. Thirty-nine of 46 patients (85%) underwent dilation in order to palliate symptoms, enable endoscopy and biopsy, or prepare for placement of an esophageal prosthesis. Thirty-two of the 46 patients (70%) were treated with radiation therapy and seven (15%) underwent placement of an esophageal prosthesis. Thirty-five of the 39 patients dilated (90%) noted improvement in swallowing, allowing resumption of a soft or regular diet. Complications were noted in three of the 39 patients dilated (8%). The authors conclude that peroral dilation is a safe, effective, and probably underutilized method of palliation in patients with squamous cell esophageal carcinoma.     

Failure of the urinalysis and quantitative urine culture in diagnosing symptomatic urinary tract infections in patients with long-term urinary catheters

Since urine culture and urinalysis are both of uncertain reliability in diagnosing symptomatic urinary tract infections in patients with chronic urinary catheters, we performed sequential quantitative cultures and urinalyses on 177 urine specimens from 14 patients with long-term urinary catheters during a 12-month period. We found high concentrations of greater than or equal to 2 species of aerobic bacteria or fungi in most specimens examined. Pyuria was common even during asymptomatic periods; hematuria was less common. During symptomatic urinary tract infections, neither urinalyses nor quantitative urine cultures exhibited changes specific for such infections. Thus neither urinalysis nor urine culture appears to be a reliable test for symptomatic urinary tract infections in patients with chronic urinary catheters.     

Reward association facilitates distractor suppression in human visual search

Although valuable objects are attractive in nature, people often encounter situations where they would prefer to avoid such distraction while focusing on the task goal. Contrary to the typical effect of attentional capture by a reward‐associated item, we provide evidence for a facilitation effect derived from the active suppression of a high reward‐associated stimulus when cuing its identity as distractor before the display of search arrays. Selection of the target is shown to be significantly faster when the distractors were in high reward‐associated colour than those in low reward‐associated or non‐rewarded colours. This behavioural reward effect was associated with two neural signatures before the onset of the search display: the increased frontal theta oscillation and the strengthened top‐down modulation from frontal to anterior temporal regions. The former suggests an enhanced working memory representation for the reward‐associated stimulus and the increased need for cognitive control to override Pavlovian bias, whereas the latter indicates that the boost of inhibitory control is realized through a frontal top‐down mechanism. These results suggest a mechanism in which the enhanced working memory representation of a reward‐associated feature is integrated with task demands to modify attentional priority during active distractor suppression and benefit behavioural performance.