Suchergebnisse

1. Producing public opinion : how the insurance industry shaped US health care / Wendell Potter -- 2. The break-up of the NHS : implications for information systems / Allyson Pollock and David Price -- 3. Rethinking problems surrounding access to care : the moral economies shaping health care workforces in Russia and the USA / Michele Rivkin-Fish -- 4. Human oriented? Angels and monsters in China's healthcare reform / Mei Zhan -- 5. We are all in this together : European policies and health systems change / Meri Koivusalo -- 6. Catastrophic citizenship and discourses of disguise : aspects of health care change in Poland / Peggy Watson -- 7. The making of health care policy in contemporary Hungary / Terry Cox and Sandor Gallai -- 8. Community health services in urban China : a geographical case study of access to care / Yu Wang. [et al.] -- 9. 'Health care and change' : popular protest and building alternative visions of health systems at the end of empire / Howard Waitzkin and Rebeca Jasso-Aguilar.

Objective: The aim of this study is to assess the effect of proximity and time pressure on accurate and effective visual search during medication selection from a computer screen. Background: The presence of multiple similar objects in proximity to a target object increases the difficulty of a visual search. Visual similarity between drug names can also lead to selection error. The proximity of several similarly named drugs within a visual field could, therefore, adversely affect visual search. Method: In Study 1, 60 nonpharmacy participants selected a target drug name from an array of mock drug packets shown on a computer screen, where one or four similarly named nontargets might be present. Of the participants, 30 completed the task with a time constraint, and the remainder did not. In Study 2, the same experiment was repeated with 28 pharmacy staff. Results: In Study 1, the proximity of multiple similarly named nontargets within the specified visual field reduced selection accuracy and increased reaction times in the nonpharmacists. Time constraint also had an adverse effect. In Study 2, the pharmacy participants showed increased reaction times when multiple nontargets were present, but the time constraint had no effect. There was no effect of Tall Man lettering. Conclusion: The presence of multiple similarly named medications in close proximity to a target medication increases the difficulty of the visual search for the target. Tall Man lettering has no impact on this adverse effect. Application: The widespread use of the alphabetical system in medication storage increases the risk of proximity-based errors in drug selection.

A reliable prototype index, Three Ratings of Involuntary Admissibility (TRIAD), was developed to reflect the way psychiatric emergency room clinicians apply legal criteria for involuntary commitment. The interrater reliability coefficients—Pearson's r—of the TRIAD system for rating patients are 0.94, danger-to-self score; 0.89, danger-to-others score; 0.77, grave-disability score; and 0.89, total-admissibility score. TRIAD scores accounted for 82 percent of 89 disposition decisions in two metropolitan county hospital psychiatric emergency rooms. Study results indicate that (1) psychiatric emergency room clinicians shared constructs of danger to self, danger to others, and grave disability; (2) these constructs are reliably applied in actual cases; (3) TRIAD is a valid reflection of these constructs; and (4) case disposition is predictable from the severity of the patient's status with regard to these criteria.

A reliable prototype index, Three Ratings of Involuntary Admissibility (TRIAD), was developed to reflect the way psychiatric emergency room clinicians apply legal criteria for involuntary commitment. The interrater reliability coefficients -- Pearson's r -- of the TRIAD system for rating patients are 0.94, danger-to-self score; 0.89, danger-to-others score; 0.77, grave-disability score; & 0.89, total-admissibility score. TRIAD scores accounted for 82% of 89 disposition decisions observed & rated in 2 metropolitan county hospital psychiatric emergency rooms. Study results indicate that: (1) psychiatric emergency room clinicians shared constructs of danger to self, danger to others, & grave disability; (2) these constructs are reliably applied in actual cases; (3) TRIAD is a valid reflection of these constructs; & (4) case disposition is predictable from the severity of the patient's status with regard to these criteria. 2 Tables. HA

AbstractPsychiatric emergency service clinicians employ shared concepts of danger to self, danger to others, and grave disability that are identifiable across the great variety of cases they encounter, but increased environmental pressures may interfere with equitable application of this professional standard.

Background: In 2018, the Scottish Government made the Pharmacy Additional Cost of Teaching (ACTp) funding available to support the development of Experiential Learning (EL) in undergraduate pharmacy education. To inform the further expansion of EL in the pharmacy degree evaluation of new EL sites was required. Aim and method: A mixed-methods study was undertaken to determine students' perceptions of four new areas included in an EL pilot: primary care, out-of-hours, specialist sites, and remote and rural. Results: There were 43 survey respondents (response rate 72%). Majority agreed the pilot had developed their clinical (n=28, 74%) and communication skills (n=31, 82%), and prepared them for future practice (n=30, 79%). One third felt the EL did not permit them to interact with patients. Focus group and interview participants were positive about their experience and the opportunity to experience new pharmacy roles in non-traditional settings. Many highlighted the lack of hands-on experience and facilitator feedback. Facilitator training and quality assurance of sites are warranted. Conclusions: Future work should focus on assessment of and feedback for students, and interprofessional opportunities within EL.