Evidence-based medicine : an overview

Evidence-Based Medicine (EBM) is about combining the best clinical expertise with the best available clinical information in the literature. At face value, this statement may seem simplistic, but closer scrutiny will lead to a reappraisal. The medical literature has increased exponentially to the point where the individual clinician can no longer keep abreast. The development and practice of EBM is a long-term, self-directed process which requires 5 sequential steps .In this article the author describes in the detail the searching process.peer-reviewe

A systematic review of lesbian, gay, bisexual and transgender health in the West Midlands region of the UK compared to published UK research

It is estimated that approximately 3-8% of the UK population identify as lesbian, gay, bisexual or trans (LGBT). Until now, most health research on gay and bisexual men has been around HIV, AIDS and sexually transmitted diseases and for trans people has been on the transitioning process only. However, it has been apparent to the LGBT community that that there are a wide variety of other physical and mental health issues that are also important and that the proportion of gay and bisexual men who have HIV/AIDS is relatively small. Very little general LGBT health research has been published so far and there are very few health services that specifically address the general health concerns of the LGBT community. This systematic review presents all available research conducted in the West Midlands on LGBT health since 2000. Local health research is compared to UK national, peer reviewed and published LGBT health research in order to determine whether the local results are unusual compared to national LGBT data, and to routinely collected data on the UK population, where appropriate, in order to determine whether and where the LGBT population differ from the general population. Only UK research has been included because there was no previous UK specific systematic review so it was unclear how generalisable foreign research would be to the UK

Usefulness and Usability of a Personal Health Record and Survivorship Care Plan for Colorectal Cancer Survivors: Survey Study

Background: As a result of improvements in cancer screening, treatment, and supportive care, nearly two-thirds of individuals diagnosed with colorectal cancer (CRC) live for 5 years after diagnosis. An ever-increasing population of CRC survivors creates a need for effective survivorship care to help manage and mitigate the impact of CRC and its treatment. Personal health records (PHRs) and survivorship care plans provide a means of supporting the long-term care of cancer survivors. Objective: The purpose of this study is to characterize the usefulness of a CRC PHR and survivorship care plan and to describe the usability of these technologies in a population of CRC survivors. To our knowledge, this is the first study to assess a PHR and survivorship care plan specifically targeting CRC survivors. Methods: Twenty-two patients with CRC were recruited from surgery clinics of an academic medical center and Veterans Affairs hospital in Indianapolis and provided access to an online Colorectal Cancer Survivor’s Personal Health Record (CRCS-PHR). Survey data were collected to characterize the usefulness of the CRCS-PHR and describe its usability in a population of CRC survivors. CRC survivors were surveyed 6 months after being provided online access. Means and proportions were used to describe the usefulness and ease of using the CRC website. Open-ended questions were qualitatively coded using the constant comparative method. Results: CRC survivors perceived features related to their health care (ie, summary of cancer treatment history, follow-up care schedule, description of side effects, and list of community resources) to be more useful than communication features (ie, creating online relationships with family members or caregivers, communicating with doctor, and secure messages). CRC survivors typically described utilizing traditional channels (eg, via telephone or in person) to communicate with their health care provider. Participants had overall positive perceptions with respect to ease of use and overall satisfaction. Major challenges experienced by participants included barriers to system log-in, lack of computer literacy or experience, and difficulty entering their patient information. Conclusions: For CRC, survivors may find the greater value in a PHR’s medical content than the communication functions, which they have available elsewhere. These findings regarding the usefulness and usability of a PHR for the management of CRC survivorship provide valuable insights into how best to tailor these technologies to patients’ needs. These findings can inform future design and development of PHRs for purposes of both cancer and chronic disease management

Assistive robotics: research challenges and ethics education initiatives

Assistive robotics is a fast growing field aimed at helping healthcarers in hospitals, rehabilitation centers and nursery homes, as well as empowering people with reduced mobility at home, so that they can autonomously fulfill their daily living activities. The need to function in dynamic human-centered environments poses new research challenges: robotic assistants need to have friendly interfaces, be highly adaptable and customizable, very compliant and intrinsically safe to people, as well as able to handle deformable materials. Besides technical challenges, assistive robotics raises also ethical defies, which have led to the emergence of a new discipline: Roboethics. Several institutions are developing regulations and standards, and many ethics education initiatives include contents on human-robot interaction and human dignity in assistive situations. In this paper, the state of the art in assistive robotics is briefly reviewed, and educational materials from a university course on Ethics in Social Robotics and AI focusing on the assistive context are presented.Peer ReviewedPostprint (author's final draft

An exploratory study into the factors that influence patients' perceptions of cleanliness in an acute NHS trust hospital

Purpose – If NHS hospitals wish to influence patients to choose them and, as the literature review suggests, cleanliness will be a key-influencing factor in making that choice, it would seem important for hospitals to understand what factors lead people to decide whether a hospital is clean or dirty. The research aims to identify what the key factors are that influence patients' perceptions of cleanliness and to rank these factors in order of importance. Design/methodology/approach – The project utilised a mixed methodology to collect the data. The hospital staff and people who had been recent patients took part in focus groups in order to gather their views. The current hospital in-patients were surveyed through the use of a paper questionnaire. Findings – The main themes that influence the perceptions of cleanliness emerging from the analysis can be summarised under three broad headings – appearance of the environment, physical cleanliness and staff behaviour. The findings suggest that this subject is much more complex than the production of a list. The appearance of the environment is a complex set of perceptions based on what individuals believe to be important, what they observe and what they expect. The research suggests that the appearance of the environment is the most important factor. Originality/value – The paper starts to explore the factors that influence patient perception of cleanliness and provides practical information to NHS estates and facilities managers.</p

The impact of information and communication technology on family carers of older people and professionals in Sweden

Government policy in Sweden, as in other developed countries, pays increasing attention as to how best to support the family carers of older people. New and innovative means of support, such as information and communication technology, are emerging. This paper explores the perceived benefits of, and barriers to, information technology as a means of supporting family carers of older people. Following a brief overview of the care-giving literature, with particular reference to the Swedish context, interview and questionnaire data collected from 34 families who took part in the Swedish ACTION project are used to explore the role of user-friendly information and communication technology to inform and enable family carers of older people to exercise choice, to care more effectively and to work in partnership with professionals. Interview data from two groups of professionals that utilised ACTION are also examined to throw light on its potential benefits for both carers and professionals. Consideration is given to the barriers to using information technology, and to identifying those carers most likely to benefit. Areas for further development are the need for practitioners' education and a wider range of programmes to address carers' diverse needs. Clearly, lessons learned from the Swedish project have wider relevance, given that new forms of support are being developed in most technically advanced countries