Kooperativer Bibliotheksverbund

Berlin Brandenburg

and
and

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
  • Gruen, Russell  (26)
  • Male
Type of Medium
Language
Year
  • 1
    Language: English
    In: JAMA, 22 November 2006, Vol.296(20), pp.2467-75
    Description: Whether physicians have a professional responsibility to address health-related issues beyond providing care to individual patients has been vigorously debated. Yet little is known about practicing physicians' attitudes about or the extent to which they participate in public roles, which we defined as community participation, political involvement, and collective advocacy. To determine the importance physicians assign to public roles, their participation in related activities, and sociodemographic and practice factors related to physicians' rated levels of importance and activity. Mail survey conducted between November 2003 and June 2004 of 1662 US physicians engaged in direct patient care selected from primary care specialties (family practice, internal medicine, pediatrics) and 3 non-primary care specialties (anesthesiology, general surgery, cardiology). Rated importance of community participation, political involvement, collective advocacy, and relevant self-reported activities encompassing the previous 3 years; rated importance of physician action on different issues. Community participation, political involvement, and collective advocacy were rated as important by more than 90% of respondents, and a majority rated community participation and collective advocacy as very important. Nutrition, immunization, substance abuse, and road safety issues were rated as very important by more physicians than were access-to-care issues, unemployment, or illiteracy. Two thirds of respondents had participated in at least 1 of the 3 types of activities in the previous 3 years. Factors independently related to high overall rating of importance (civic-mindedness) included age, female sex, underrepresented race/ethnicity, and graduation from a non-US or non-Canadian medical school. Civic mindedness, medical specialty, practice type, underrepresented race/ethnicity, preceptors of physicians in training, rural practice, and graduation from a non-US or non-Canadian medical school were independently related to civic activity. Public roles are definable entities that have widespread support among physicians. Civic-mindedness is associated primarily with sociodemographic factors, but civic action is associated with specialty and practice-based factors.
    Keywords: Community Participation ; Consumer Advocacy ; Physician'S Role ; Politics ; Public Health
    ISSN: 00987484
    E-ISSN: 1538-3598
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    Language: English
    In: Journal of Clinical Epidemiology, May 2013, Vol.66(5), pp.496-502.e2
    Description: We present a multistep process for identifying priority research areas in rehabilitation and long-term care of traumatic brain-injured (TBI) patients. In particular, we aimed to (1) identify which stakeholders should be involved; (2) identify what methods are appropriate; (3) examine different criteria for the generation of research priority areas; and (4) test the feasibility of linkage and exchange among researchers, decision makers, and other potential users of the research. Potential research questions were identified and developed using an initial scoping meeting and preliminary literature search, followed by a facilitated mapping workshop and an online survey. Identified research questions were then prioritized against specific criteria (clinical importance, novelty, and controversy). Existing evidence was then mapped to the high-priority questions using usual processes for search, screening, and selection. A broad range of stakeholders were then brought together at a forum to identify priority research themes for future research investment. Using clinical and research leaders, smaller targeted planning workshops prioritized specific research projects for each of the identified themes. Twenty-six specific questions about TBI rehabilitation were generated, 14 of which were high priority. No one method identified all high-priority questions. Methods that relied solely on the views of clinicians and researchers identified fewer high-priority questions compared with methods that used broader stakeholder engagement. Evidence maps of these high-priority questions yielded a number of evidence gaps. Priority questions and evidence maps were then used to inform a research forum, which identified 12 priority themes for future research. Our research demonstrates the value of a multistep and multimethod process involving many different types of stakeholders for prioritizing research to improve the rehabilitation outcomes of people who have suffered TBI. Enhancing stakeholder representation can be augmented using a combination of methods and a process of linkage and exchange. This process can inform decisions about prioritization of research areas.
    Keywords: Prioritization ; Traumatic Brain Injury ; Research Funding ; Evidence Mapping ; Research Gaps ; Rehabilitation ; Medicine
    ISSN: 0895-4356
    E-ISSN: 1878-5921
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    Language: English
    In: Journal of Clinical Epidemiology, May 2013, Vol.66(5), pp.503-510.e4
    Description: To identify high-priority research questions for osteoarthritis systematic reviews with consideration of health equity and the social determinants of health (SDH). We consulted with experts and conducted a literature search to identify a priority-setting method that could be adapted to address the health equity and SDH. We selected the Global Evidence Mapping priority-setting method, and through consultations and consensus, we adapted the method to meet our objectives. This involves developing an evidence map of the existing systematic reviews on osteoarthritis; conducting one face-to-face workshop with patients and another one with clinicians, researchers, and patients; and conducting an online survey of patients to rank the top 10 research questions. We piloted the adapted method with the Cochrane Musculoskeletal Review Group to set research priorities for osteoarthritis. Our focus was on systematic reviews: we identified 34 high-priority research questions for osteoarthritis systematic reviews. Prevention and self-management interventions, mainly diet and exercise, are top priorities for osteoarthritis systematic reviews. Evaluation against our predefined objectives showed that this method did prioritize SDH (50% of the research questions considered SDH). There were marked gaps: no high-priority topics were identified for access to care until patients had advanced disease–lifestyle changes once the disease was diagnosed. This method was felt feasible if conducted annually. We confirmed the utility of an adapted priority-setting method that is feasible and considers SDH. Further testing of this method is needed to assess whether considerations of health equity are prioritized and involve disadvantaged groups of the population.
    Keywords: Priority Setting ; Health Equity ; Osteoarthritis ; Social Determinants of Health ; Systematic Reviews ; Methods ; Methodology ; Research Priorities ; Medicine
    ISSN: 0895-4356
    E-ISSN: 1878-5921
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    Language: English
    In: The Lancet, 2006, Vol.368(9530), pp.130-138
    Description: Visiting-specialist clinics (specialist outreach) have the potential to overcome some of the substantial access barriers faced by disadvantaged rural, remote, and Indigenous communities, but the effectiveness of outreach clinics has not been assessed outside urban and non-disadvantaged settings. We aimed to assess the effects of outreach clinics on access, referral patterns, and care outcomes in remote communities in Australia. We undertook a population-based observational study of regular surgical, ophthalmological, gynaecological, and ear, nose, and throat outreach visits, compared with hospital clinics alone, on access, referral practices, and outcomes for the populations of three remote Indigenous communities in northern Australia for 11 years. We assessed all new non-emergency potential specialist surgical cases who presented initially between Jan 1, 1990, and Jan 1, 2001. The effects of outreach clinics on the proportion of patients referred, the time from referral to initial specialist consultation, and the rates of community-based and hospital-based procedures were analysed using logic regression and Cox proportional hazard models. 2339 new surgical problems presented in 2368 people between 1990 and 2001. Outreach improved the rate of referral completion (adjusted hazard ratio 1·41, 95% CI 1·07–1·86) and the risk of timely completion according to the urgency of referral (adjusted relative risk 1·30, 1·05–1·53). Outreach had no significant effect on initiation of elective referrals, but there were 156 opportunistic presentations on outreach clinic days. Specialist investigations and procedures in community clinics removed the need for many patients to travel to hospital, and outreach consultations were associated with a reduced rate of procedures that needed hospital admission (adjusted hazard ratio 0·67, 0·43–1·03). Specialist outreach visits to remote disadvantaged Indigenous communities in Australia improve access to specialist consultations and procedures without increasing elective referrals or demands for hospital inpatient services.
    Keywords: Medicine
    ISSN: 0140-6736
    E-ISSN: 1474-547X
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    Language: English
    In: Injury, June 2013, Vol.44(6), pp.713-721
    Description: The burden of injury is greatest in developing countries. Trauma systems have reduced mortality in developed countries and trauma registries are known to be integral to monitoring and improving trauma care. There are relatively few trauma registries in developing countries and no reviews describing the experience of each registry. The aim of this study was to examine the collective published experience of trauma registries in developing countries. A structured review of the literature was performed. Relevant abstracts were identified by searching databases for all articles regarding a trauma registry in a developing country. A tool was used to abstract trauma registry details, including processes of data collection and analysis. There were 84 articles, 76 of which were sourced from 47 registries. The remaining eight articles were perspectives. Most were from Iran, followed by China, Jamaica, South Africa and Uganda. Only two registries used the Injury Severity Score (ISS) to define inclusion criteria. Most registries collected data on variables from all five variable groups (demographics, injury event, process of care, injury severity and outcome). Several registries collected data for less than a total of 20 variables. Only three registries measured disability using a score. The most commonly used scores of injury severity were the ISS, followed by Revised Trauma Score (RTS), Trauma and Injury Severity Score (TRISS) and the Kampala Trauma Score (KTS). Amongst the small number of trauma registries in developing countries, there is a large variation in processes. The implementation of trauma systems with trauma registries is feasible in under-resourced environments where they are desperately needed.
    Keywords: Trauma Registry ; Trauma Database ; Trauma Databank ; Developing Countries, Low Income Countries, Middle Income Countries
    ISSN: 0020-1383
    E-ISSN: 1879-0267
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    In: Journal of the International Neuropsychological Society, 2014, Vol.20(6), pp.663-671
    Description: Abstract Severe traumatic brain injury (TBI) in older age is associated with high rates of mortality. However, little is known about outcome following mild TBI (mTBI) in older age. We report on a prospective cohort study investigating 3 month outcome in older age patients admitted to hospital-based trauma services. First, 50 mTBI older age patients and 58 orthopedic controls were compared to 123 community control participants to evaluate predisposition and general trauma effects on cognition. Specific brain injury effects were subsequently evaluated by comparing the orthopedic control and mTBI groups. Both trauma groups had significantly lower performances than the community group on prospective memory ( d =0.82 to 1.18), attention set-shifting ( d =−0.61 to −0.69), and physical quality of life measures ( d =0.67 to 0.84). However, there was only a small to moderate but non-significant difference in the orthopedic control and mTBI group performances on the most demanding task of prospective memory ( d =0.37). These findings indicate that, at 3 months following mTBI, older adults are at risk of poor cognitive performance but this is substantially accounted for by predisposition to injury or general multi-system trauma. ( JINS , 2014, 20 , 1–9)
    Keywords: Research Articles; Traumatic Injury; Mild Head Injury; Older Age; Orthopedic Injury; Prospective Memory; Cognition; Neuropsychological Outcome
    ISSN: 1355-6177
    E-ISSN: 1469-7661
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    Language: English
    In: Injury, December 2013, Vol.44(12), pp.1838-1842
    Description: There is a paucity of research into the outcomes and complications of cervical spine immobilisation (hard collar or halothoracic brace) in older people. To identify morbidity and mortality outcomes using geriatric medicine assessment techniques following cervical immobilisation in older people with isolated cervical spine fractures. We identified participants using an injury database. We completed a questionnaire measuring pre-admission medical co-morbidities and functional independence. We recorded the surgical plan and all complications. A further questionnaire was completed three months later recording complications and functional independence. Sixteen patients were recruited over a three month period. Eight were immobilised with halothoracic brace, 8 with external hard collar. Three deaths occurred during the study. Lower respiratory tract infection was the most common complication (7/16) followed by delirium (6/16). Most patients were unable to return home following the acute admission, requiring sub-acute care on discharge. The majority of patients were from home prior to a fall, 6/16 were residing there at 3 months. Most participants had an increase in their care needs at 3 months. There was no difference in the type or incidence of complications between the different modes of immobilisation. Geriatric medicine assessment techniques identified the morbidity and functional impairment associated with cervical spine immobilisation. This often results in a prolonged length of stay in supported care. This small pilot study recommends a larger study over a longer period using geriatric medicine assessment techniques to better define the issues.
    Keywords: Cervical Spine Fracture ; Older Adults
    ISSN: 0020-1383
    E-ISSN: 1879-0267
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    Language: English
    In: World Journal of Surgery, 2009, Vol.33(8), pp.1554-1561
    Description: Byline: Russell L. Gruen (1) Abstract: Introduction Saltwater crocodiles are formidable predators in northern Australia, and crocodile attacks on humans are not rare. With recent deaths highlighting this as a public health issue, an evidence-based discourse about effective methods of minimizing the danger to humans is needed. Methods Using the Haddon Matrix for injury prevention, approaches to minimizing crocodile associated death and injury were sought. Results Possibilities for harm minimization before, during and after a crocodile attack are identified, and their merits appriased. The importance of excellent prehospital and surgical and critical care is emphasized. Conclusions A combination of behavior adaptation, mutual respect, and minimizing contact will be the key to minimizing the harm from attacks, and excellent medical and surgical care will always be necessary for those unfortunate to be victims but fortunate to survive. Author Affiliation: (1) National Trauma Research Institute, Alfred Hospital, Monash University, Level 4, 89 Commercial Road, Melbourne, VIC, 3004, Australia Article History: Registration Date: 18/05/2009 Online Date: 20/06/2009
    Keywords: Crocodiles -- Health Aspects ; Public Health -- Health Aspects;
    ISSN: 0364-2313
    E-ISSN: 1432-2323
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    Language: English
    In: Archives of ophthalmology (Chicago, Ill. : 1960), April 2011, Vol.129(4), pp.435-44
    Description: To examine how mydriasis and the medical qualifications of photographers who take retinal photographs influence the accuracy of screening for diabetic retinopathy (DR). Our meta-analysis included studies that measured the sensitivity and specificity of tests designed to detect any DR, sight-threatening DR, or macular edema. Using random-effects logistic regression, we examined the effect of variations in mydriatic status and in medical qualifications of photographers on sensitivity and specificity. Only the category of "any DR" had sufficient consistency in definition, number of studies (n = 20), and number of assessments (n = 40) for meta-analysis. Variations in mydriatic status did not significantly influence sensitivity (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.56-1.41; P = .61) or specificity (OR, 0.94; 95% CI, 0.57-1.54; P = .80). Variations in medical qualifications of photographers did not significantly influence sensitivity (OR, 1.25; 95% CI, 0.31-5.12; P = .75). Specificity of detection of any DR was significantly higher for screening methods that use a photographer with specialist medical or eye qualifications (OR, 3.86; 95% CI, 1.78-8.37; P = .001). Outreach screening is an effective alternative to on-site specialist examination. It has potential to increase screening coverage of high-risk patients with DR in remote and resource-poor settings without the risk of missing DR and the opportunity to prevent vision loss. Our analysis was confined to the presence or absence of DR. Future studies should use consistent DR classification schemes to facilitate further analysis.
    Keywords: Diagnostic Techniques, Ophthalmological ; Photography ; Diabetic Retinopathy -- Diagnosis
    ISSN: 00039950
    E-ISSN: 1538-3601
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    Language: English
    In: Journal of endourology, November 2015, Vol.29(11), pp.1321-7
    Description: To evaluate current practice in the perioperative management of antiplatelets (AP) and anticoagulants (AC) among men undergoing elective transurethral resection of the prostate (TURP), as well as the associated perioperative bleeding and thromboembolic complications. Retrospective review of consecutive elective TURP patients in a single tertiary institution from January 2011 to December 2013 (n = 293). Data on the regular use of AP/AC and the perioperative management approach were collected from patients' electronic medical records. Bleeding and thromboembolic complications were assessed up to 30 days postoperative. Association between AP/AC use and perioperative complications was assessed using the Kruskall-Wallis test (continuous variables) and the Fisher exact test (categoric variables). There were 107/293 (37%) patients receiving long-term AP while there were 25/293 (9%) patients receiving long-term AC. A total of 72/107 (67%) patients ceased AP on an average of 7.6 days preoperatively, while 35/107 (33%) continued receiving AP. Patients with coronary stents (62%) and coronary bypass graft (67%) were significantly more likely to continued receiving AP (P 〈 0.001). AC was ceased in all patients preoperatively, with 16/25 (64%) receiving enoxaparin bridging. Overall, there were 31 (10%) incidents of bleeding complications and 5 (2%) thromboembolic events. AC users who had enoxaparin bridging had significantly higher risk of bleeding complications (44%), compared with non-AP/AC users (8%), AP users who ceased AP (4%), AP users who continued receiving AP (17%), and AC users who did not receive enoxaparin bridging (0%) (P 〈 0.001). AC users who received enoxaparin bridging also reported significantly higher thromboembolic complications (17%; P 〈 0.001) and prolonged hospital stay (mean 5.4 days) (P = 0.002), compared with other patients. Perioperative management of AP/AC should be based on the indications and the American College of Chest Physicians thromboembolic risk stratification. Regular AC users who had enoxaparin bridging are at increased risk of both perioperative bleeding and thromboembolic complications.
    Keywords: Transurethral Resection of Prostate ; Anticoagulants -- Therapeutic Use ; Enoxaparin -- Therapeutic Use ; Hemorrhage -- Epidemiology ; Perioperative Care -- Methods ; Platelet Aggregation Inhibitors -- Therapeutic Use ; Postoperative Complications -- Epidemiology ; Prostatic Hyperplasia -- Surgery ; Thromboembolism -- Epidemiology
    ISSN: 08927790
    E-ISSN: 1557-900X
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. Further information can be found on the KOBV privacy pages