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[PMID]:29496807
[Au] Autor:Reinke RE; Enright T; Love R; Patel SA; Ali AO; Horvath Z
[Ad] Endereço:Dr. Reinke is Associate Professor, School of Dental Medicine, University of Nevada, Las Vegas; Ms. Enright is Director, Bachelor of Health Science in Dental Hygiene, Allen College; Dr. Love is Assistant Professor of Dental Medicine, College of Dental Medicine, Roseman University of Health Sciences;
[Ti] Título:Methods and Purposes for Conducting Students' Course Evaluations Reported by North American Dental School and Dental Hygiene Program Leaders: A Preliminary Survey Study.
[So] Source:J Dent Educ;82(3):286-290, 2018 Mar.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this preliminary survey study was to determine the perceptions of leaders of dental schools and dental hygiene programs regarding methods of and purposes for conducting students' course evaluations and their role in course improvement, curriculum design, and faculty assessment. A short electronic survey was distributed in 2016 to the academic deans of all 76 dental schools in the U.S. and Canada and a convenience sample of program directors of 232 of the total 332 accredited dental hygiene programs. Individuals from 93 institutions responded for an overall response rate of 30%: 30 of 76 dental schools (39.5% response rate) and 63 of the 232 dental hygiene programs (27% response rate). All of the respondents (100%) reported that their institutions' full-time faculty members were assessed by students in course evaluations for each course and semester they taught. However, only 78% reported that their part-time faculty members were evaluated by students. Course evaluations were mandatory in 62% (n=58) of the responding institutions, with the remaining 38% (n=35) optional. Respondents indicated course directors received the evaluation results for purposes of annual review (n=73, 78%) and instructional review (n=70, 75%). Further investigation of the use and effects of student evaluations is needed to better understand their role in faculty assessment and other aspects of the administration of dental schools and dental hygiene programs.
[Mh] Termos MeSH primário: Currículo/normas
Higiene Bucal/educação
Faculdades de Odontologia/organização & administração
[Mh] Termos MeSH secundário: Canadá
Educação em Odontologia/organização & administração
Educação em Odontologia/normas
Avaliação Educacional/métodos
Seres Humanos
Faculdades de Odontologia/normas
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:180303
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.018.027


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[PMID]:29447291
[Au] Autor:Tanuseputro P; Beach S; Chalifoux M; Wodchis WP; Hsu AT; Seow H; Manuel DG
[Ad] Endereço:Bruyère Research Institute, Ottawa, Ontario, Canada.
[Ti] Título:Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study.
[So] Source:PLoS One;13(2):e0191322, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: While most individuals wish to die at home, the reality is that most will die in hospital. AIM: To determine whether receiving a physician home visit near the end-of-life is associated with lower odds of death in a hospital. DESIGN: Observational retrospective cohort study, examining location of death and health care in the last year of life. SETTING/PARTICIPANTS: Population-level study of Ontarians, a Canadian province with over 13 million residents. All decedents from April 1, 2010 to March 31, 2013 (n = 264,754). RESULTS: More than half of 264,754 decedents died in hospital: 45.7% died in an acute care hospital and 7.7% in complex continuing care. After adjustment for multiple factors-including patient illness, home care services, and days of being at home-receiving at least one physician home visit from a non-palliative care physician was associated with a 47% decreased odds (odds-ratio, 0.53; 95%CI: 0.51-0.55) of dying in a hospital. When a palliative care physician specialist was involved, the overall odds declined by 59% (odds ratio, 0.41; 95%CI: 0.39-0.43). The same model, adjusting for physician home visits, showed that receiving palliative home care was associated with a similar reduction (odds ratio, 0.49; 95%CI: 0.47-0.51). CONCLUSION: Location of death is strongly associated with end-of-life health care in the home. Less than one-third of the population, however, received end-of-life home care or a physician visit in their last year of life, revealing large room for improvement.
[Mh] Termos MeSH primário: Hospitais/utilização
Visita Domiciliar/utilização
Assistência Terminal/métodos
[Mh] Termos MeSH secundário: Canadá
Estudos de Coortes
Morte
Feminino
Serviços de Assistência Domiciliar/tendências
Serviços de Assistência Domiciliar/utilização
Cuidados Paliativos na Terminalidade da Vida/tendências
Hospitalização/tendências
Hospitais/tendências
Seres Humanos
Masculino
Razão de Chances
Cuidados Paliativos
Médicos
Qualidade de Vida
Estudos Retrospectivos
Assistência Terminal/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191322


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[PMID]:29219994
[Ti] Título:Gene-drive technology needs thorough scrutiny.
[So] Source:Nature;552(7683):6, 2017 12 07.
[Is] ISSN:1476-4687
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Tecnologia de Impulso Genético/efeitos adversos
Tecnologia de Impulso Genético/legislação & jurisprudência
Edição de Genes/legislação & jurisprudência
Medição de Risco
Nações Unidas/legislação & jurisprudência
[Mh] Termos MeSH secundário: Animais
Biodiversidade
Canadá
Congressos como Assunto
Correio Eletrônico
Cooperação Internacional
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1038/d41586-017-08214-4


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[PMID]:28741747
[Au] Autor:Carroll C; Hartl B; Goldman GT; Rohlf DJ; Treves A; Kerr JT; Ritchie EG; Kingsford RT; Gibbs KE; Maron M; Watson JEM
[Ad] Endereço:Klamath Center for Conservation Research, Orleans, CA, 95556, U.S.A.
[Ti] Título:Defending the scientific integrity of conservation-policy processes.
[So] Source:Conserv Biol;31(5):967-975, 2017 10.
[Is] ISSN:1523-1739
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Government agencies faced with politically controversial decisions often discount or ignore scientific information, whether from agency staff or nongovernmental scientists. Recent developments in scientific integrity (the ability to perform, use, communicate, and publish science free from censorship or political interference) in Canada, Australia, and the United States demonstrate a similar trajectory. A perceived increase in scientific-integrity abuses provokes concerted pressure by the scientific community, leading to efforts to improve scientific-integrity protections under a new administration. However, protections are often inconsistently applied and are at risk of reversal under administrations publicly hostile to evidence-based policy. We compared recent challenges to scientific integrity to determine what aspects of scientific input into conservation policy are most at risk of political distortion and what can be done to strengthen safeguards against such abuses. To ensure the integrity of outbound communications from government scientists to the public, we suggest governments strengthen scientific integrity policies, include scientists' right to speak freely in collective-bargaining agreements, guarantee public access to scientific information, and strengthen agency culture supporting scientific integrity. To ensure the transparency and integrity with which information from nongovernmental scientists (e.g., submitted comments or formal policy reviews) informs the policy process, we suggest governments broaden the scope of independent reviews, ensure greater diversity of expert input and transparency regarding conflicts of interest, require a substantive response to input from agencies, and engage proactively with scientific societies. For their part, scientists and scientific societies have a responsibility to engage with the public to affirm that science is a crucial resource for developing evidence-based policy and regulations in the public interest.
[Mh] Termos MeSH primário: Conservação dos Recursos Naturais
Formulação de Políticas
[Mh] Termos MeSH secundário: Austrália
Canadá
Seres Humanos
Políticas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180310
[Lr] Data última revisão:
180310
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1111/cobi.12958


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[PMID]:28452711
[Au] Autor:Scott JR; Sowerby LJ; Rotenberg BW
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
[Ti] Título:Office-based rhinologic surgery: A modern experience with operative techniques under local anesthetic.
[So] Source:Am J Rhinol Allergy;31(2):135-138, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Office-based rhinologic procedures have become popularized in recent years with the advent of several minimally invasive techniques. There is a paucity of literature, however, that supports more robust in-clinic procedures, e.g., true endoscopic sinus surgery (ESS). There is a high volume of this work being done at our center, and the objective of this article was to review the safety and tolerability of in-clinic surgeries. METHODS: A retrospective chart review was conducted. All the adult patients who underwent in-clinic sinonasal procedures and surgery with a minimum of 3 months of follow-up were included. Information regarding intra- and postoperative complications and revision procedures were recorded. For the ESS procedures, the indication, sinuses operated on, and type of revision were also collected. RESULTS: A total of 315 patients met the inclusion criteria. There were 166 turbinoplasties, 118 ESS, 35 septoplasties, 34 rhinoplasties, and 4 septorhinoplasties performed. For the ESS procedures, 74 (62.7%) were bilateral, and experience was had operating in all paranasal sinuses. All ESS work involved opening diseased ostia and was more than just polypectomies. The mean follow-up for the ESS cases was 13.4 months (range, 12-65 months). Complication rates and tolerability measures were comparable with those of other reported in-office sinonasal procedures performed with the patient under local anesthetic. CONCLUSION: Office-based rhinologic surgery was safe and well tolerated by the patients. The need for revision ESS in our series was low when considering the extent of surgery that was performed. An in-clinic procedure may avoid a general anesthetic in the operating room for appropriately selected patients.
[Mh] Termos MeSH primário: Anestésicos Locais/uso terapêutico
Endoscopia
Obstrução Nasal/epidemiologia
Dor/prevenção & controle
Seios Paranasais/cirurgia
Complicações Pós-Operatórias/prevenção & controle
Rinoplastia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Animais
Canadá/epidemiologia
Feminino
Seguimentos
Hospitalização
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos
Obstrução Nasal/cirurgia
Dor/etiologia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4414


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[PMID]:29458556
[Au] Autor:Abdel-Moneim AS; Soliman MS; Kamel MM; El-Kholy AA
[Ad] Endereço:1​Microbiology Department, College of Medicine, Taif University, Al-Taif 21944, Saudi Arabia.
[Ti] Título:Sequence analysis of the G gene of hRSVA ON1 genotype from Egyptian children with acute respiratory tract infections.
[So] Source:J Med Microbiol;67(3):387-391, 2018 Mar.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Human respiratory syncytial virus causes severe lower respiratory tract infection in neonates and children. Genotype ON1, with duplication of 72-nt in the G gene, was first detected in Canada and then recorded in other countries. In the current study, we describe the first detection of the ON1 genotype among children in Egypt in 2014/2015. Sequence analysis of the full-attachment G gene revealed that the majority of the strains examined were related to the ON1 genotype and only one sample related to N1 genotype. The Egyptian ON1 strains showed unique non-silent mutations in addition to variable mutations near the antigenic sites in comparison to the original ON1 ancestor strain. Continuous surveillance of hRSV regionally and globally is needed to understand the evolutionary mechanisms and strategies adopted by hRSV and their inducers for better adaption to the host.
[Mh] Termos MeSH primário: Infecções por Vírus Respiratório Sincicial/virologia
Vírus Sincicial Respiratório Humano/genética
Infecções Respiratórias/virologia
Proteínas Virais de Fusão/genética
[Mh] Termos MeSH secundário: Canadá/epidemiologia
Pré-Escolar
Egito/epidemiologia
Evolução Molecular
Feminino
Genótipo
Seres Humanos
Lactente
Masculino
Mutação
Nasofaringe/virologia
Filogenia
Infecções por Vírus Respiratório Sincicial/epidemiologia
Vírus Sincicial Respiratório Humano/isolamento & purificação
Infecções Respiratórias/epidemiologia
Alinhamento de Sequência
Análise de Sequência de DNA
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (G glycoprotein, Respiratory syncytial virus); 0 (Viral Fusion Proteins)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000699


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[PMID]:28461066
[Au] Autor:Gilbert NL; Rotondo J; Shapiro J; Sherrard L; Fraser WD; Ward BJ
[Ad] Endereço:Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Canada; École de santé publique de l'Université de Montréal, Montreal, Canada. Electronic address: nicolas.gilbert@phac-aspc.gc.ca.
[Ti] Título:Seroprevalence of rubella antibodies and determinants of susceptibility to rubella in a cohort of pregnant women in Canada, 2008-2011.
[So] Source:Vaccine;35(23):3050-3055, 2017 05 25.
[Is] ISSN:1873-2518
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Long term control of rubella and congenital rubella syndrome relies on high population-level immunity against rubella, particularly among women of childbearing age. In Canada, all pregnant women should be screened so that susceptible new mothers can be offered vaccination for rubella before discharge. This study was undertaken to estimate rubella susceptibility in a cohort of pregnant women in Canada and to identify associated socio-economic and demographic factors. Biobanked plasma samples were obtained from the Maternal-Infant Research on Environmental Chemicals (MIREC) study, in which pregnant women were recruited between 2008 and 2011. Socio-demographic characteristics and obstetric histories were collected. Second trimester plasma samples (n=1,752) were tested for rubella-specific IgG using an in-house enzyme-linked immunosorbent assay. The percentage of women with IgG titers <5IU/mL, 5-10IU/mL, and ≥10IU/mL were 2.3%, 10.1%, and 87.6%, respectively. Rates of seronegativity, defined as <5IU/mL, were 3.1% in women who had no previous live birth and 1.6% in women who had given birth previously. Among the latter group, seronegativity was higher in women with high school education or less (adjusted OR (aOR) 5.93, 95% CI 2.08-16.96) or with a college or trade school diploma (aOR 3.82, 95% CI 1.45-10.12), compared to university graduates, and those born outside Canada (aOR 2.60, 95% CI 1.07-6.31). In conclusion, a large majority of pregnant women were found to be immune to rubella. Further research is needed to understand inequalities in vaccine uptake or access, and more effort is needed to promote catch-up measles-mumps-rubella vaccination among socioeconomically disadvantaged and immigrant women of childbearing age.
[Mh] Termos MeSH primário: Anticorpos Antivirais/sangue
Suscetibilidade a Doenças
Complicações Infecciosas na Gravidez/imunologia
Rubéola (Sarampo Alemão)/epidemiologia
Rubéola (Sarampo Alemão)/imunologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Canadá/epidemiologia
Estudos de Coortes
Escolaridade
Ensaio de Imunoadsorção Enzimática
Feminino
Seres Humanos
Imunoglobulina G/sangue
Meia-Idade
Gravidez
Complicações Infecciosas na Gravidez/prevenção & controle
Complicações Infecciosas na Gravidez/virologia
Rubéola (Sarampo Alemão)/virologia
Síndrome da Rubéola Congênita/prevenção & controle
Estudos Soroepidemiológicos
Vacinação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antibodies, Viral); 0 (Immunoglobulin G); 0 (rubella antibodies)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28449971
[Au] Autor:Tsaban G; Ben-Shimol S
[Ad] Endereço:Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
[Ti] Título:Indirect (herd) protection, following pneumococcal conjugated vaccines introduction: A systematic review of the literature.
[So] Source:Vaccine;35(22):2882-2891, 2017 05 19.
[Is] ISSN:1873-2518
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pneumococcal diseases are major causes of morbidity among adults, especially those over 50years of age. While pneumococcal conjugated vaccines (PCV's) impact on pneumococcal disease rates among children is well established, the extent of its impact on adult pneumococcal related illness remains unclear. The aim of this systematic literature review was to describe the impact of PCV introduction to childhood national immunization programs worldwide on PCV-naive adult population. METHODS: A systematic literature search was performed using the PubMed database. The search was limited to articles written in English and published between January 2000 and February 2016. Studies evaluating pneumococcal disease rates in individuals over 5years of age were included. Independent extraction of articles was performed by the two authors. Search terms included: Pneumococcal conjugated vaccine, herd, indirect, adults, and pneumonia. RESULTS: Forty-nine articles meeting the selection criteria were identified, 39 regarding invasive pneumococcal disease (IPD, one on meningitis only), 8 regarding pneumonia, and 2 on both IPD and pneumonia. The majority of reports were from the US, UK and Canada. Considerable variability in the data sources, quality and completeness was observed. While most studies reported either statistically significant reduction or insignificant changes in IPD and pneumonia disease rates in adults following PCV nationwide implementation, few studies reported statistically significant increase in pneumococcal disease rates, these were mainly from countries with low PCV coverage rates and/or inadequate surveillance. CONCLUSION: Invasive pneumococcal diseases and pneumonia rates among the adult population decreased in most countries following PCV introduction into the NIP. This indirect effect on older population seems to be dependent on PCV coverage rates and time from PCV nationwide implementation. Adults >65years old seem to benefit the most from PCV introduction.
[Mh] Termos MeSH primário: Imunidade Coletiva
Programas de Imunização
Vacinas Pneumocócicas/imunologia
Pneumonia Pneumocócica/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Canadá/epidemiologia
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Meia-Idade
Infecções Pneumocócicas/epidemiologia
Infecções Pneumocócicas/imunologia
Infecções Pneumocócicas/prevenção & controle
Vacinas Pneumocócicas/administração & dosagem
Pneumonia Pneumocócica/epidemiologia
Pneumonia Pneumocócica/microbiologia
Streptococcus pneumoniae/imunologia
Vacinação
Vacinas Conjugadas/administração & dosagem
Vacinas Conjugadas/imunologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Pneumococcal Vaccines); 0 (Vaccines, Conjugate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:28471338
[Au] Autor:Coburn PI; Chong K; Connolly DA
[Ad] Endereço:a Department of Psychology , Simon Fraser University , Burnaby , British Columbia , Canada.
[Ti] Título:The Effect of Case Severity on Sentence Length in Cases of Child Sexual Assault in Canada.
[So] Source:J Child Sex Abus;26(3):319-333, 2017 Apr.
[Is] ISSN:1547-0679
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Surprisingly, little research exists on the determination of sentence length in cases of child sexual assault. This is striking given the profound short-term and long-term consequences this crime can have on victims and their families. Previous research shows that severity of the offense commonly accounts for much of the variability in sentences in this context. A critical point, however, is that the definition of offense severity varies widely and is often confounded with the age of the complainant. The current archival study, through the examination of 1,783 judicial sentencing decisions, evaluated the effects of key variables on length of sentence in cases of child sexual assault in Canada. Length of sentence increased as intrusiveness of the offense increased, as frequency increased, and as age decreased for children who experienced the most intrusive forms of abuse. In addition, offenders who pleaded guilty received shorter sentences than offenders who pleaded not guilty.
[Mh] Termos MeSH primário: Abuso Sexual na Infância/legislação & jurisprudência
[Mh] Termos MeSH secundário: Adolescente
Fatores Etários
Canadá
Criança
Crime/legislação & jurisprudência
Feminino
Seres Humanos
Masculino
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1080/10538712.2017.1283651


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[PMID]:28453827
[Au] Autor:Gagliardi AR; Lehoux P; Ducey A; Easty A; Ross S; Bell CM; Trbovich P; Takata J; Urbach DR
[Ad] Endereço:Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, Toronto, M5G2C4, Canada.
[Ti] Título:Factors constraining patient engagement in implantable medical device discussions and decisions: interviews with physicians.
[So] Source:Int J Qual Health Care;29(2):276-282, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: Patient engagement (PE) is warranted when treatment risks and outcomes are uncertain, as is the case for higher risk medical devices. Previous research found that patients were not engaged in discussions or decisions about implantable medical devices. This study explored physician views about engaging patients in such discussions. Design: Qualitative interviews using a basic descriptive approach. Setting: Canada. Participants: Practicing cardiovascular and orthopaedic physicians. Main outcome measures: Level, processes and determinants of PE in medical device discussions and decisions. Results: Views were largely similar among 10 cardiovascular and 12 orthopaedic physicians interviewed. Most said that it was feasible to inform and sometimes involve patients in discussions, but not to partner with them in medical device decision-making. PE was constrained by patient (comfort with PE, technical understanding, physiologic/demographic characteristics, prognosis), physician (device preferences, time), health system (purchasing contracts) and device factors (number of devices on market, comparative advantage). A framework was generated to help physicians engage patients in discussions about medical devices, even when decisions may not be preference sensitive due to multiple constraints on choice. Conclusions: This study identified that patients are not engaged in discussions or decisions about implantable medical devices. This may be due to multiple constraints. Further research should establish the legitimacy, prevalence and impact of constraining factors, and examine whether and how different levels and forms of PE are needed and feasible.
[Mh] Termos MeSH primário: Tomada de Decisões
Participação do Paciente/métodos
Médicos/psicologia
Próteses e Implantes
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Canadá
Cardiologistas/psicologia
Seres Humanos
Cirugiões Ortopédicos/psicologia
Relações Médico-Paciente
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx013



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