Journal of evaluation in clinical practice
-
Few data on the impact of specific interventions against Emergency Rooms 'or Hospitals overcrowding are available in France. ⋯ The reduced number of Internal Medicine bed-spaced patients, the reduced LOS of patients in short-stay observation unit when associated with the admitter-rounder model and the increase of LOS among some of the in-patient internal medicine units observed in this study should be evaluated elsewhere.
-
Established coronary artery disease (CAD) patients are at increased risk for recurrence of cardiovascular events and mortality due to non-attainment of recommended risk factor control targets. ⋯ These findings emphasize the urgent need for effective management and heightened awareness, particularly for controlling LDL-C in the CAD population. Action to address this issue is crucial for mitigating the CVD burden, particularly in low- and middle-income countries such as Indonesia.
-
Responses to experimental pain have suggested central and peripheral sensitisation in adult patients with sickle cell disease (SCD). Recent studies have proposed an algometry-derived dynamic measure of pain sensitisation, slowly repeated evoked pain (SREP), which is useful in the discrimination of painful conditions related to central sensitisation. Pain and fatigue are two symptoms that affect the general functioning of patients with SCD most significantly, however, research about experimental dynamic pain measures and their relation to the main symptoms of SCD (pain and fatigue) is still scarce. ⋯ Pain threshold and tolerance did not discriminate between patients and healthy individuals, but were useful for predicting fatigue severity in SCD. The SREP protocol provides a useful dynamic measure of pain for the discrimination and detection of enhanced pain sensitisation in patients with SCD, which could contribute to more personalised pain evaluations and treatment for these patients.
-
Telehealth has been consistently viewed as a viable solution for addressing healthcare inaccessibility and mitigating the impact of health workforce shortages in rural areas. However, despite high utilisation in rural areas, little is known about the unintended consequences of telehealth in terms of unexpected benefits and drawbacks. ⋯ This study provides insights into the unintended consequences of telehealth. While telehealth has improved certain aspects of healthcare in rural areas such as the improved support for rural clinicians and the reduced disruption to patients' daily routines, it has also introduced unforeseen challenges such as the transfer of medicolegal burden to local clinicians in rural emergency care facilities to compensate for the absence of physical examinations. These findings feed into decision-making useful for informing and improving telehealth implementation in rural Australia to maximise unexpected benefits, minimise risks, and ensure the long-term viability of telehealth services.
-
As the global population ages, there is a growing need for tools to assess lifestyle factors that impact the health and quality of life of older adults. The Yonsei Lifestyle Profile (YLP), originally developed in South Korea, is a comprehensive tool for evaluating key lifestyle domains. However, cultural and linguistic differences between countries necessitate the adaptation of such tools for use in diverse populations. This study addresses the gap by developing an English version of the YLP (YLP-E) for older adults in the United States. ⋯ The final YLP-E tool, which incorporated feedback on linguistic and cultural adequacy, consisted of 3 lifestyle domains (physical activity, activity participation and nutrition) with 62 items. The second round improved the content validity, with the linguistic content validity ratio (CVR) and cultural CVR reaching 0.86 and 0.94, respectively. The YLP-E is a valuable tool for comprehensively assessing and monitoring the lifestyle of older American adults and holds promise for further refinement and validation across diverse demographic settings. Future research needs to focus on utilizing the YLP-E to develop personalized interventions aimed at improving the health and quality of life of older adults and evaluating the tool's efficacy in promoting healthy aging.