64 research outputs found
Frontal cortical thickness correlates positively with impulsivity in early psychosis male patients.
Impulsive behaviours, which are frequent in young people suffering from psychosis have been linked to risky and violent behaviours and participate to the burden of psychotic illness. Given that morphological brain correlates of impulsivity in schizophrenia have been poorly investigated especially in young adults, the aim of this study was to investigate the relationship between impulsivity and cortical thickness in early psychosis (EP) patients.
A total of 17 male subjects in the early phase of psychosis were recruited. Impulsivity was assessed with the Lecrubier Impulsivity Rating Scale. Mean cortical thickness was extracted from magnetic resonance imaging brain scans, using surface-based methods.
Mean cortical thickness in the frontal lobe correlated positively with mean impulsivity in EP male patients.
Our results suggest that psychotic subjects exhibiting higher impulsivity have larger frontal cortical thickness, which may pave the way towards the identification of patients with a higher risk to display impulsive behaviours
Scaling and super-universality in the coarsening dynamics of the 3d random field Ising model
We study the coarsening dynamics of the three-dimensional random field Ising
model using Monte Carlo numerical simulations. We test the dynamic scaling and
super-scaling properties of global and local two-time observables. We treat in
parallel the three-dimensional Edward-Anderson spin-glass and we recall results
on Lennard-Jones mixtures and colloidal suspensions to highlight the common and
different out of equilibrium properties of these glassy systems.Comment: 18 pages, 21 figure
Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation
A1 Introduction to the 8(th) Annual Conference on the Science of Dissemination and Implementation: Optimizing Personal and Population Health David Chambers, Lisa Simpson D1 Discussion forum: Population health D&I research Felicia Hill-Briggs D2 Discussion forum: Global health D&I research Gila Neta, Cynthia Vinson D3 Discussion forum: Precision medicine and D&I research David Chambers S1 Predictors of community therapists’ use of therapy techniques in a large public mental health system Rinad Beidas, Steven Marcus, Gregory Aarons, Kimberly Hoagwood, Sonja Schoenwald, Arthur Evans, Matthew Hurford, Ronnie Rubin, Trevor Hadley, Frances Barg, Lucia Walsh, Danielle Adams, David Mandell S2 Implementing brief cognitive behavioral therapy (CBT) in primary care: Clinicians' experiences from the field Lindsey Martin, Joseph Mignogna, Juliette Mott, Natalie Hundt, Michael Kauth, Mark Kunik, Aanand Naik, Jeffrey Cully S3 Clinician competence: Natural variation, factors affecting, and effect on patient outcomes Alan McGuire, Dominique White, Tom Bartholomew, John McGrew, Lauren Luther, Angie Rollins, Michelle Salyers S4 Exploring the multifaceted nature of sustainability in community-based prevention: A mixed-method approach Brittany Cooper, Angie Funaiole S5 Theory informed behavioral health integration in primary care: Mixed methods evaluation of the implementation of routine depression and alcohol screening and assessment Julie Richards, Amy Lee, Gwen Lapham, Ryan Caldeiro, Paula Lozano, Tory Gildred, Carol Achtmeyer, Evette Ludman, Megan Addis, Larry Marx, Katharine Bradley S6 Enhancing the evidence for specialty mental health probation through a hybrid efficacy and implementation study Tonya VanDeinse, Amy Blank Wilson, Burgin Stacey, Byron Powell, Alicia Bunger, Gary Cuddeback S7 Personalizing evidence-based child mental health care within a fiscally mandated policy reform Miya Barnett, Nicole Stadnick, Lauren Brookman-Frazee, Anna Lau S8 Leveraging an existing resource for technical assistance: Community-based supervisors in public mental health Shannon Dorsey, Michael Pullmann S9 SBIRT implementation for adolescents in urban federally qualified health centers: Implementation outcomes Shannon Mitchell, Robert Schwartz, Arethusa Kirk, Kristi Dusek, Marla Oros, Colleen Hosler, Jan Gryczynski, Carolina Barbosa, Laura Dunlap, David Lounsbury, Kevin O'Grady, Barry Brown S10 PANEL: Tailoring Implementation Strategies to Context - Expert recommendations for tailoring strategies to context Laura Damschroder, Thomas Waltz, Byron Powell S11 PANEL: Tailoring Implementation Strategies to Context - Extreme facilitation: Helping challenged healthcare settings implement complex programs Mona Ritchie S12 PANEL: Tailoring Implementation Strategies to Context - Using menu-based choice tasks to obtain expert recommendations for implementing three high-priority practices in the VA Thomas Waltz S13 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Siri, rate my therapist: Using technology to automate fidelity ratings of motivational interviewing David Atkins, Zac E. Imel, Bo Xiao, Doğan Can, Panayiotis Georgiou, Shrikanth Narayanan S14 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Identifying indicators of implementation quality for computer-based ratings Cady Berkel, Carlos Gallo, Irwin Sandler, C. Hendricks Brown, Sharlene Wolchik, Anne Marie Mauricio S15 PANEL: The Use of Technology to Improve Efficient Monitoring of Implementation of Evidence-based Programs - Improving implementation of behavioral interventions by monitoring emotion in spoken speech Carlos Gallo, C. Hendricks Brown, Sanjay Mehrotra S16 Scorecards and dashboards to assure data quality of health management information system (HMIS) using R Dharmendra Chandurkar, Siddhartha Bora, Arup Das, Anand Tripathi, Niranjan Saggurti, Anita Raj S17 A big data approach for discovering and implementing patient safety insights Eric Hughes, Brian Jacobs, Eric Kirkendall S18 Improving the efficacy of a depression registry for use in a collaborative care model Danielle Loeb, Katy Trinkley, Michael Yang, Andrew Sprowell, Donald Nease S19 Measurement feedback systems as a strategy to support implementation of measurement-based care in behavioral health Aaron Lyon, Cara Lewis, Meredith Boyd, Abigail Melvin, Semret Nicodimos, Freda Liu, Nathanial Jungbluth S20 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Common loop assay: Methods of supporting learning collaboratives Allen Flynn S21 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Innovating audit and feedback using message tailoring models for learning health systems Zach Landis-Lewis S22 PANEL: Implementation Science and Learning Health Systems: Intersections and Commonalities - Implementation science and learning health systems: Connecting the dots Anne Sales S23 Facilitation activities of Critical Access Hospitals during TeamSTEPPS implementation Jure Baloh, Marcia Ward, Xi Zhu S24 Organizational and social context of federally qualified health centers and variation in maternal depression outcomes Ian Bennett, Jurgen Unutzer, Johnny Mao, Enola Proctor, Mindy Vredevoogd, Ya-Fen Chan, Nathaniel Williams, Phillip Green S25 Decision support to enhance treatment of hospitalized smokers: A randomized trial Steven Bernstein, June-Marie Rosner, Michelle DeWitt, Jeanette Tetrault, James Dziura, Allen Hsiao, Scott Sussman, Patrick O’Connor, Benjamin Toll S26 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A patient-centered approach to successful community transition after catastrophic injury Michael Jones, Julie Gassaway S27 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - Conducting PCOR to integrate mental health and cancer screening services in primary care Jonathan Tobin S28 PANEL: Developing Sustainable Strategies for the Implementation of Patient-Centered Care across Diverse US Healthcare Systems - A comparative effectiveness trial of optimal patient-centered care for US trauma care systems Douglas Zatzick S29 Preferences for in-person communication among patients in a multi-center randomized study of in-person versus telephone communication of genetic test results for cancer susceptibility Angela R Bradbury, Linda Patrick-Miller, Brian Egleston, Olufunmilayo I Olopade, Michael J Hall, Mary B Daly, Linda Fleisher, Generosa Grana, Pamela Ganschow, Dominique Fetzer, Amanda Brandt, Dana Farengo-Clark, Andrea Forman, Rikki S Gaber, Cassandra Gulden, Janice Horte, Jessica Long, Rachelle Lorenz Chambers, Terra Lucas, Shreshtha Madaan, Kristin Mattie, Danielle McKenna, Susan Montgomery, Sarah Nielsen, Jacquelyn Powers, Kim Rainey, Christina Rybak, Michelle Savage, Christina Seelaus, Jessica Stoll, Jill Stopfer, Shirley Yao and Susan Domchek S30 Working towards de-implementation: A mixed methods study in breast cancer surveillance care Erin Hahn, Corrine Munoz-Plaza, Jianjin Wang, Jazmine Garcia Delgadillo, Brian Mittman Michael Gould S31Integrating evidence-based practices for increasing cancer screenings in safety-net primary care systems: A multiple case study using the consolidated framework for implementation research Shuting (Lily) Liang, Michelle C. Kegler, Megan Cotter, Emily Phillips, April Hermstad, Rentonia Morton, Derrick Beasley, Jeremy Martinez, Kara Riehman S32 Observations from implementing an mHealth intervention in an FQHC David Gustafson, Lisa Marsch, Louise Mares, Andrew Quanbeck, Fiona McTavish, Helene McDowell, Randall Brown, Chantelle Thomas, Joseph Glass, Joseph Isham, Dhavan Shah S33 A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: A cluster randomized controlled trial protocol Jane Liebschutz, Karen Lasser S34 Implementing collaborative care for substance use disorders in primary care: Preliminary findings from the summit study Katherine Watkins, Allison Ober, Sarah Hunter, Karen Lamp, Brett Ewing S35 Sustaining a task-shifting strategy for blood pressure control in Ghana: A stakeholder analysis Juliet Iwelunmor, Joyce Gyamfi, Sarah Blackstone, Nana Kofi Quakyi, Jacob Plange-Rhule, Gbenga Ogedegbe S36 Contextual adaptation of the consolidated framework for implementation research (CFIR) in a tobacco cessation study in Vietnam Pritika Kumar, Nancy Van Devanter, Nam Nguyen, Linh Nguyen, Trang Nguyen, Nguyet Phuong, Donna Shelley S37 Evidence check: A knowledge brokering approach to systematic reviews for policy Sian Rudge S38 Using Evidence Synthesis to Strengthen Complex Health Systems in Low- and Middle-Income Countries Etienne Langlois S39 Does it matter: timeliness or accuracy of results? The choice of rapid reviews or systematic reviews to inform decision-making Andrea Tricco S40 Evaluation of the veterans choice program using lean six sigma at a VA medical center to identify benefits and overcome obstacles Sherry Ball, Anne Lambert-Kerzner, Christine Sulc, Carol Simmons, Jeneen Shell-Boyd, Taryn Oestreich, Ashley O'Connor, Emily Neely, Marina McCreight, Amy Labebue, Doreen DiFiore, Diana Brostow, P. Michael Ho, David Aron S41 The influence of local context on multi-stakeholder alliance quality improvement activities: A multiple case study Jillian Harvey, Megan McHugh, Dennis Scanlon S42 Increasing physical activity in early care and education: Sustainability via active garden education (SAGE) Rebecca Lee, Erica Soltero, Nathan Parker, Lorna McNeill, Tracey Ledoux S43 Marking a decade of policy implementation: The successes and continuing challenges of a provincial school food and nutrition policy in Canada Jessie-Lee McIsaac, Kate MacLeod, Nicole Ata, Sherry Jarvis, Sara Kirk S44 Use of research evidence among state legislators who prioritize mental health and substance abuse issues Jonathan Purtle, Elizabeth Dodson, Ross Brownson S45 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 1 designs Brian Mittman, Geoffrey Curran S46 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 2 designs Geoffrey Curran S47 PANEL: Effectiveness-Implementation Hybrid Designs: Clarifications, Refinements, and Additional Guidance Based on a Systematic Review and Reports from the Field - Hybrid type 3 designs Jeffrey Pyne S48 Linking team level implementation leadership and implementation climate to individual level attitudes, behaviors, and implementation outcomes Gregory Aarons, Mark Ehrhart, Elisa Torres S49 Pinpointing the specific elements of local context that matter most to implementation outcomes: Findings from qualitative comparative analysis in the RE-inspire study of VA acute stroke care Edward Miech S50 The GO score: A new context-sensitive instrument to measure group organization level for providing and improving care Edward Miech S51 A research network approach for boosting implementation and improvement Kathleen Stevens, I.S.R.N. Steering Council S52 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - The value of qualitative methods in implementation research Alison Hamilton S53 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Learning evaluation: The role of qualitative methods in dissemination and implementation research Deborah Cohen S54 PANEL: Qualitative methods in D&I Research: Value, rigor and challenge - Qualitative methods in D&I research Deborah Padgett S55 PANEL: Maps & models: The promise of network science for clinical D&I - Hospital network of sharing patients with acute and chronic diseases in California Alexandra Morshed S56 PANEL: Maps & models: The promise of network science for clinical D&I - The use of social network analysis to identify dissemination targets and enhance D&I research study recruitment for pre-exposure prophylaxis for HIV (PrEP) among men who have sex with men Rupa Patel S57 PANEL: Maps & models: The promise of network science for clinical D&I - Network and organizational factors related to the adoption of patient navigation services among rural breast cancer care providers Beth Prusaczyk S58 A theory of de-implementation based on the theory of healthcare professionals’ behavior and intention (THPBI) and the becker model of unlearning David C. Aron, Divya Gupta, Sherry Ball S59 Observation of registered dietitian nutritionist-patient encounters by dietetic interns highlights low awareness and implementation of evidence-based nutrition practice guidelines Rosa Hand, Jenica Abram, Taylor Wolfram S60 Program sustainability action planning: Building capacity for program sustainability using the program sustainability assessment tool Molly Hastings, Sarah Moreland-Russell S61 A review of D&I study designs in published study protocols Rachel Tabak, Alex Ramsey, Ana Baumann, Emily Kryzer, Katherine Montgomery, Ericka Lewis, Margaret Padek, Byron Powell, Ross Brownson S62 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Model simulation techniques to estimate the cost of implementing foundational public health services Cezar Brian Mamaril, Glen Mays, Keith Branham, Lava Timsina S63 PANEL: Geographic variation in the implementation of public health services: Economic, organizational, and network determinants - Inter-organizational network effects on the implementation of public health services Glen Mays, Rachel Hogg S64 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Implementation fidelity, coalition functioning, and community prevention system transformation using communities that care Abigail Fagan, Valerie Shapiro, Eric Brown S65 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Expanding capacity for implementation of communities that care at scale using a web-based, video-assisted training system Kevin Haggerty, David Hawkins S66 PANEL: Building capacity for implementation and dissemination of the communities that care prevention system at scale to promote evidence-based practices in behavioral health - Effects of communities that care on reducing youth behavioral health problems Sabrina Oesterle, David Hawkins, Richard Catalano S68 When interventions end: the dynamics of intervention de-adoption and replacement Virginia McKay, M. Margaret Dolcini, Lee Hoffer S69 Results from next-d: can a disease specific health plan reduce incident diabetes development among a national sample of working-age adults with pre-diabetes? Tannaz Moin, Jinnan Li, O. Kenrik Duru, Susan Ettner, Norman Turk, Charles Chan, Abigail Keckhafer, Robert Luchs, Sam Ho, Carol Mangione S70 Implementing smoking cessation interventions in primary care settings (STOP): using the interactive systems framework Peter Selby, Laurie Zawertailo, Nadia Minian, Dolly Balliunas, Rosa Dragonetti, Sarwar Hussain, Julia Lecce S71 Testing the Getting To Outcomes implementation support intervention in prevention-oriented, community-based settings Matthew Chinman, Joie Acosta, Patricia Ebener, Patrick S Malone, Mary Slaughter S72 Examining the reach of a multi-component farmers’ market implementation approach among low-income consumers in an urban context Darcy Freedman, Susan Flocke, Eunlye Lee, Kristen Matlack, Erika Trapl, Punam Ohri-Vachaspati, Morgan Taggart, Elaine Borawski S73 Increasing implementation of evidence-based health promotion practices at large workplaces: The CEOs Challenge Amanda Parrish, Jeffrey Harris, Marlana Kohn, Kristen Hammerback, Becca McMillan, Peggy Hannon S74 A qualitative assessment of barriers to nutrition promotion and obesity prevention in childcare Taren Swindle, Geoffrey Curran, Leanne Whiteside-Mansell, Wendy Ward S75 Documenting institutionalization of a health communication intervention in African American churches Cheryl Holt, Sheri Lou Santos, Erin Tagai, Mary Ann Scheirer, Roxanne Carter, Janice Bowie, Muhiuddin Haider, Jimmie Slade, Min Qi Wang S76 Reduction in hospital utilization by underserved patients through use of a community-medical home Andrew Masica, Gerald Ogola, Candice Berryman, Kathleen Richter S77 Sustainability of evidence-based lay health advisor programs in African American communities: A mixed methods investigation of the National Witness Project Rachel Shelton, Lina Jandorf, Deborah Erwin S78 Predicting the long-term uninsured population and analyzing their gaps in physical access to healthcare in South Carolina Khoa Truong S79 Using an evidence-based parenting intervention in churches to prevent behavioral problems among Filipino youth: A randomized pilot study Joyce R. Javier, Dean Coffey, Sheree M. Schrager, Lawrence Palinkas, Jeanne Miranda S80 Sustainability of elementary school-based health centers in three health-disparate southern communities Veda Johnson, Valerie Hutcherson, Ruth Ellis S81 Childhood obesity prevention partnership in Louisville: creative opportunities to engage families in a multifaceted approach to obesity prevention Anna Kharmats, Sandra Marshall-King, Monica LaPradd, Fannie Fonseca-Becker S82 Improvements in cervical cancer prevention found after implementation of evidence-based Latina prevention care management program Deanna Kepka, Julia Bodson, Echo Warner, Brynn Fowler S83 The OneFlorida data trust: Achieving health equity through research & training capacity building Elizabeth Shenkman, William Hogan, Folakami Odedina, Jessica De Leon, Monica Hooper, Olveen Carrasquillo, Renee Reams, Myra Hurt, Steven Smith, Jose Szapocznik, David Nelson, Prabir Mandal S84 Disseminating and sustaining medical-legal partnerships: Shared value and social return on investment James Teufe
Understanding Gender Inequality in Poverty and Social Exclusion through a Psychological Lens:Scarcities, Stereotypes and Suggestions
Evidence Use, Capacity, and Perspectives in Policymaking about Public Health and Health Systems: an Investigation with a Focus on Health Administrations and Health Services in Switzerland
BACKGROUND:
Limited resources, the pursuit of high-quality and efficient health care, and the vision of a healthy population require the continuous consultation and integration of evidence, that is, verifiable data and analyses, in health policy making. Despite intensive research on evidence-informed policymaking (EIPM), there are many unanswered questions, in part because findings are context-specific, and studies to date have focused predominantly on a few countries or specific forms of evidence, such as evaluations. An overview of qualitative studies on EIPM has been lacking, yet qualitative research approaches in particular can help address the complexity of policymaking. Further lacking are case studies that trace the role of evidence in decision-making processes and deepen understanding of EIPM by policymakers at the cantonal level. Because cantonal administrations have a central role in the governance of health care, it is also important to understand what perspectives and needs administrators have regarding EIPM, how they themselves deal with verifiable data and analyses, and what supports them in their use.
AIM AND OBJECTIVES:
The presented dissertation aims to contribute to a better understanding of the use, capacity, and perspectives regarding EIPM, focusing on policymaking in Switzerland and cantonal health administrations. The specific objectives are to 1) identify and describe existing qualitative literature on EIPM; 2) analyze and describe the role of evidence in the shift from inpatient to outpatient care in Switzerland; 3) assess capacity and understand the perspectives and needs of cantonal health administrations regarding EIPM; 4) outline the relevance of evidence for addressing inefficiencies in health care and the health system in the context of cost containment measures; 5) formulate recommendations for interventions to build EIPM capacity in the administration.
METHODS:
The thesis consists of three empirical research papers, an editorial, and a policy brief framed by an overarching introduction and discussion.
OBJECTIVE 1) was addressed through a systematic review of peer-reviewed academic literature. Qualitative studies that examined the use of research evidence in public health and health system policymaking were included. Nine electronic databases were searched, 11 journals were hand-searched, and references of included studies and previous reviews were systematically reviewed. No restrictions were made based on the language, publication date, or geographic focus of the studies.
OBJECTIVE 2) Employing a case study, the regulatory policy measures introduced in Swiss cantons since 2017 to substitute inpatient for outpatient care were described and examined in terms of their content, policymaking process, and role of evidence. The data basis consisted of publicly available information and studies as well as two expert interviews.
OBJECTIVE 3) Using an existing and translated questionnaire instrument, six general-secretaries of cantonal health administrations were interviewed on capacity at the administration level regarding available tools and systems to support the engagement with evidence. Semi-structured in-depth interviews with 12 policymakers in leadership positions in health services and planning were used to explore perspectives and needs regarding EIPM.
RESULTS:
Systematic review;
A total of 319 studies were identified, revealing a thematically diverse and rapidly growing research landscape. Although the geographic focus is on a few affluent countries, a growing proportion of EIPM research focuses on low- and middle-income countries. A small but substantial number of in-depth and explanatory case studies were found, as well as analyses that draw on political science theories or frameworks. Few studies with ethnographic research designs were identified, and a minority of studies had elected policymakers as the study's target population. Studies on barriers and facilitators related to EIPM make up a significant portion of the work in this area but by no means the majority. Few studies examined the symbolic use of evidence in policymaking.
Case study;
The case study revealed that policy measures taken by health administrations to address inpatient overuse were motivated by pressure to save costs and that long-standing international evidence on inpatient substitution potential was first used to legitimize the measures. The study underscores that simple, evidence-informed messages can draw attention to the need for reform and that proactive engagement with comparative health care data and evidence from health observatories can be critical for health care governance.
Interview Study;
Swiss health administrations showed moderate capacity for EIPM in with limited organizational support and guidance for EIPM. Internal capacity deficits are compensated with external capacity, for example, through the Swiss health observatory. Administrations seem to place the focus and responsibility for EIPM on individual staff, which are committed to evidence use and need evidence, especially medical data, and statistics, for health services management and planning.
Editorial;
It has been demonstrated that reforms should aim to improve the quality of care and reduce inefficiencies rather than focusing on cost containment. To support this, the conditions for generating and using quality and outcome data and evidence from health services research need to be established, and the EIPM capacity of administrations strengthened.
Policy Brief;
Interventions to build the capacity for EIPM in administrations should be tailored and adapted to the local context. In principle, simple interventions can be as effective as complex, multi-component measures, such as incentives or infrastructure to access scientific literature. An enabling environment for capacity building should be created, and, where possible, participatory approaches should be used to develop and implement interventions.
DISCUSSION:
This dissertation provided insights on the use, capacity, and perspectives regarding evidence, with a focus on the Swiss policymaking context and cantonal health administrations. This thesis was able to reveal a descriptive overview of the geographic, temporal, methodological, and theoretical characteristics of the existing qualitative body of literature, both confirming findings of previous research and unearthing studies that show the field of EIPM research to be broader in scope, more theoretically grounded, and less descriptive than previously thought. The findings of this thesis underscore the importance of new methodological approaches to studying the EIPM field, including qualitative observational methods and meta-syntheses of qualitative studies, as well as quantitative designs to assess the extent to which evidence is used and the capacity to use it. In terms of content, future research efforts could address previously less studied areas of the value of EIPM to elected politicians, the symbolic use of evidence, or the role of health observatories in generating and using evidence. For the Swiss context, the results suggest a moderate level of capacity to engage with evidence in health administrations, but these findings require a more in-depth review. The results also point to a modest role of academic research, particularly international comparative health systems research. On the other hand, local statistics and health care data are of great importance for the design and planning of health care. Still, their availability is partly limited and in need of improvement. The thesis underlines the relevance of symbolic motivation for the use of evidence for administrations, for the legitimization of measures, and for argumentation in political discourse. Given the pressure to save money in the health system and the deadlock in policy reforms, health administrations should make more use of their room for maneuver in policymaking. The governance of the health system should be more proactively aligned with evidence and international developments. To this end, investments to build capacity in the use of evidence are essential, both at the individual level of policymakers and at the organizational level, e.g., through institutionalized exchange with research or embedding the importance of evidence for policymaking in strategic documents and guiding principles of administrations. In addition, conditions must be created for the generation and use of quality and outcome data on health care to be used for governance. This development can be supported by a better exchange between cantons, ensuring access to scientific publications and existing data and statistics, or supporting knowledge generators and brokers like the Swiss health observatory. The examples examined in this thesis in the context of EIPM highlight fundamental issues facing modern health systems: the need for innovation, the quest for data and evidence to monitor and manage health care, and the goal of delivering it in a high-quality, effective, and efficient manner. Investing in EIPM, therefore, is a promising way to strengthen health systems.
Krebs in der Schweiz : Zahlen, Weiterentwicklung der Krebsregistrierung und Folgen
Hintergrund Immer mehr Personen erkranken an Krebs. Deren Überlebenschancen nehmen aufgrund verbesserter Diagnostik und Therapie zu. Die betroffenen Personen haben besondere Bedürfnisse, die sich weit über den Abschluss der Therapie hinaus erstrecken. In der Folge wird die Nachsorge der sog. „cancer survivors“ wichtiger. Die Krebsregistrierung liefert die Datengrundlage für evidenzbasierte Entscheide in der onkologischen Versorgung. Methoden Basierend auf den Ergebnissen des Schweizerischen Krebsberichts 2015 wird die Entwicklung von Krebs in der Schweiz (Prävalenz, Inzidenz, Mortalität, Überleben) beschrieben. Daraus abgeleitet werden neue Anforderungen an die Ärzteschaft skizziert und Neuerungen in der schweizerischen Krebsregistrierung erläutert. Ergebnisse Die Krebsinzidenz nahm in der Schweiz über die letzten 30 Jahre stetig zu, aktuell erkranken jährlich um die 42.000 Personen. Die Krebssterblichkeit sank im gleichen Zeitraum um 36 % (Männer) bzw. 27 % (Frauen). Momentan leben in der Schweiz rund 320.000 Personen mit einer Krebserkrankung, darunter viele Langzeitüberlebende. Viele davon haben physische, psychische und soziale Bedürfnisse, die bis anhin wenig beachtet wurden. Die Krebsregistrierung in der Schweiz wird durch ein neues Bundesgesetz modernisiert und internationalen Standards angepasst und kann durch die Untersuchung der Behandlungs- und Versorgungsqualität einen wichtigen Beitrag zur besseren Versorgung von Krebspatienten leisten. Fazit Eine umfassende, koordinierte und nachhaltige Versorgung von Krebspatienten ist notwendig und bedarf neben entsprechenden Angeboten in der Versorgung auch Weiterentwicklungen in der Krebsregistrierung
Improved functional and histochemical outcomes in l-DOPA plus tolcapone treated VMAT2-deficient mice
Parkinson disease is typically treated with L-3,4-dihydroxyphenylalanine (or levodopa) co-prescribed with concentration stabilizers to prevent undesired motor fluctuations. However, the beneficial role of the chronic combined therapy on disease progression has not been thoroughly explored. We hypothesized that tolcapone, a catechol-O-methyl-transferase inhibitor, co-administered with levodopa may offer beneficial long-term disease-modifying effects through its dopamine stabilization actions. Here, we followed vesicular monoamine transporter 2-deficient and wild-type mice treated twice daily per os with vehicle, levodopa (20 mg/kg), tolcapone (15 mg/kg) or levodopa (12.5 mg/kg) + tolcapone (15 mg/kg) for 17 weeks. We assessed open field, bar test and rotarod performances at baseline and every 4th week thereafter, corresponding to OFF-medication weeks. Finally, we collected coronal sections from the frontal caudate-putamen and determined the reactivity level of dopamine transporter. Vesicular monoamine transporter 2-deficient mice responded positively to chronic levodopa + tolcapone intervention in the bar test during OFF-periods. Neither levodopa nor tolcapone interventions offered significant improvements on their own. Similarly, chronic levodopa + tolcapone intervention was associated with partially rescued dopamine transporter levels, whereas animals treated solely with levodopa or tolcapone did not present this effect. Interestingly, 4-month progression of bar test scores correlated significantly with dopamine-transporter-label density. Overall, we observed a moderate functional and histopathological improvement effect by chronic dopamine replacement when combined with tolcapone in vesicular monoamine transporter 2-deficient mice. Altogether, chronic stabilization of dopamine levels by catechol-O-methyl-transferase inhibition, besides its intended immediate actions, arises as a potential long-term beneficial approach during the progression of Parkinson disease
Frontal cortical thickness correlates positively with impulsivity in early psychosis male patients
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