China
Africa
Explore chapters and articles related to this topic
Palliative Medicine
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
The assessment and treatment of patients with palliative care needs can be challenging. There is a clear imperative to assess patients accurately and speedily attend to their physical symptoms. This requires specialist skills in managing patients with complex illness. The picture is made more difficult when one takes into account the considerable emotional and social problems that patients and families face when trying to cope with life-threatening illness. All physicians will treat patients who have palliative care needs and so they should be familiar with the palliative approach to patient care and be able to respond to the diverse needs of such patients.
Sparking and Sustaining the Essential Functions of Research
Published in Thomas S. Inui, Richard M. Frankel, Enhancing the Professional Culture of Academic Health Science Centers, 2022
Eric B. Larson, Christine Tachibana, Edward H. Wagner
Our health-care problems are national in scope, so our solutions must be as well. The problems and challenges facing US health care are complex, requiring multidisciplinary input from traditional researchers as well as experts on health-related communication, economics, informatics, and dissemination. As Barbara Alving points out in her foreword to this book, creative collaboration and networking between the public and private sectors, research institutions, universities, and funders can amplify the advantages of each contributor. At the same time, individual partners must have autonomy in conducting health research and implementing findings, since they are in the best position to work with their scientists, clinical staff, and served population. These factors must be considered in establishing collaborations and networks, whether they are of health research organizations or academic research centers.
Interprofessional team working
Published in Frances Rapport, Robyn Clay-Williams, Jeffrey Braithwaite, Implementation Science, 2022
Kris Vanhaecht, Ellen Coeckelberghs
Optimizing interprofessional team working is a complex intervention. It is both complex in terms of difficulty and complex as defined by the UK’s Medical Research Council (MRC) (Moore et al. 2015). MRC defines complex as multicomponent interventions (Moore et al. 2015). One of the methods and pragmatic approaches to enhance collaboration within and between teams, by making the care process transparent and standardized, is the development, implementation, and evaluation of care pathways. Care pathways, also known as clinical pathways or critical pathways, were first introduced in healthcare in the late 1980s and are now used worldwide to standardize care processes and align the roles of the multidisciplinary team members (Pearson, Goulart-Fisher, and Lee 1995, Deneckere et al. 2013). Care pathways are defined as “a complex intervention for the mutual decision-making and organization of care processes for a well-defined group of patients during a well-defined period” (Vanhaecht et al. 2010, 118). The ultimate goal is to improve outcomes by providing a mechanism to better coordinate care and reduce fragmentation and ultimately costs (Panella, Marchisio, and Di 2003). Based on research of the European Pathway Association, we know that, although teams think that they provide optimal and standardized care, unwarranted variation within and between teams persists (van Zelm et al. 2017, Seys et al. 2017).
Chaplains Work in Primary Care
Published in Journal of Health Care Chaplaincy, 2023
Austyn Snowden, Iain Telfer, Anne Vandenhoeck, Joost Verhoef, Alan Gibbon
Complexity of presentation has also increased, with more than two in every three consultations rated as “complex” by GPs (Merrifield, 2021). The term “complex” here refers to patients with concomitant comorbidities or bio-psycho-socio-economic (Edwards & Loprinzi, 2017) issues. McSherry, Boughey, and Kevern (2016) suggested that people suffering spiritually can present with physical and mental distress, often expressed as addiction or obesity, associated with loss, isolation and loneliness. G. W. Macdonald (2018) broadly agrees with this and also includes relationship issues, job and financial problems (see Box 1). G. Macdonald (2017) refers to these presentations, that are usually accompanied by generalised loss of wellbeing, as “modern maladies.” It is people presenting with these issues that may benefit from healthcare chaplaincy in primary care.
The Eyes Have It: How Critical are Ophthalmic Findings to the Diagnosis of Pediatric Abusive Head Trauma?
Published in Seminars in Ophthalmology, 2023
Cynthia K Harris, Anna M Stagner
AHT emerged as an explanation for subdural hemorrhage, cerebral edema, and extensive retinal hemorrhages and retinoschisis in a child with no or minimal head trauma. While an infant who fell 11 meters30 or an infant crushed by a large object55 might have extensive retinal hemorrhages, there is a competing and more compelling explanation for these retinal hemorrhages other than shaking/impact. Similarly, an infant with leukemia56 or a ruptured vascular malformation27 might have extensive retinal hemorrhages, but there is a competing and more compelling explanation for these retinal hemorrhages. A medical diagnosis, whether of abusive head trauma or uveitis or insomnia, is never made in a vacuum. There are always clinical, radiologic, pathologic, and laboratory correlations, especially for a diagnosis as complex and fraught as AHT.
Series: Practical guidance to qualitative research. Part 6: Longitudinal qualitative and mixed-methods approaches for longitudinal and complex health themes in primary care research
Published in European Journal of General Practice, 2022
Primary care encounters challenges in providing high quality, accessible and affordable care for an increasingly ageing, complex, and multi-morbid population, while the relationship between patients and general practitioners is transforming towards partnership, personalised healthcare and supported self-management [6]. Europe has some of the world’s oldest populations – with the most rapidly ageing populations in Southern Europe – and is dealing with elderly people who may experience transitions to functional disability, frailty, and dependence on long-term care [7]. The diverse health problems and complex needs of these patients lead to frequent interactions with multiple health care professionals in different clinical settings. These challenging developments require more and more interprofessional collaboration from general practitioners [8]. Appropriate research approaches are needed to support them in dealing with the complex health issues of current day-to-day practice. In this paper, we will discuss two of these approaches.