53 research outputs found
User needs elicitation via analytic hierarchy process (AHP). A case study on a Computed Tomography (CT) scanner
Background:
The rigorous elicitation of user needs is a crucial step for both medical device design and purchasing. However, user needs elicitation is often based on qualitative methods whose findings can be difficult to integrate into medical decision-making. This paper describes the application of AHP to elicit user needs for a new CT scanner for use in a public hospital.
Methods:
AHP was used to design a hierarchy of 12 needs for a new CT scanner, grouped into 4 homogenous categories, and to prepare a paper questionnaire to investigate the relative priorities of these. The questionnaire was completed by 5 senior clinicians working in a variety of clinical specialisations and departments in the same Italian public hospital.
Results:
Although safety and performance were considered the most important issues, user needs changed according to clinical scenario. For elective surgery, the five most important needs were: spatial resolution, processing software, radiation dose, patient monitoring, and contrast medium. For emergency, the top five most important needs were: patient monitoring, radiation dose, contrast medium control, speed run, spatial resolution.
Conclusions:
AHP effectively supported user need elicitation, helping to develop an analytic and intelligible framework of decision-making. User needs varied according to working scenario (elective versus emergency medicine) more than clinical specialization. This method should be considered by practitioners involved in decisions about new medical technology, whether that be during device design or before deciding whether to allocate budgets for new medical devices according to clinical functions or according to hospital department
Comparte la felicidad, educando sobre sexualidad con ciudadanos y ciudadanas habitantes de calle
Curso de Especial InterésLos habitantes de calle (en adelante CHC) se han convertido en una problemática social debido a la desarticulación, violencia y pobreza de la sociedad colombiana. A partir de esta situación se diseñó y elaboró la cartilla “Comparte la felicidad, educando sobre sexualidad con Ciudadanos y Ciudadanas Habitantes de calle” que aborda los cuatro holones de la sexualidad: Vinculación afectiva, erotismo, género y reproductividad, con el objetivo de promover la salud sexual y reproductiva, y la prevención de Infecciones de transmisión sexual, incluido el VIH/SIDA. Para identificar el contenido de la cartilla se realizó una entrevista estructurada de la cual se obtuvo la información a incluir en la cartilla, posteriormente validada en la unidad OASIS.Curso de Especial Interés1. Resumen
2. Justificación
3. Marco teórico
4. Objetivos de la investigación
5. Métodología
6. Estudio de mercado
7. Resultados
8. Discusión
9. Conclusiones
10. Recomendaciones
11. Referencias
12. ApéndicesPregradoPsicólog
Medically unexplained pain complaints are associated with underlying unrecognized mood disorders in primary care
<p>Abstract</p> <p>Background</p> <p>Patients with chronic pain frequently display comorbid depression, but the impact of this concurrence is often underestimated and mistreated. The aim of this study was to determine the prevalence of unrecognized major depression and other mood disorders and comorbid unexplained chronic pain in primary care settings and to explore the associated factors.</p> <p>Also, to compare the use of health services by patients with unexplained chronic pain, both with and without mood disorder comorbidity.</p> <p>Methods</p> <p>A cross-sectional study was carried out in a sample of primary care centers. 3189 patients consulting for "unexplained chronic pain" were assessed by the Visual Analogue Scales (VAS) and the Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaire.</p> <p>Results</p> <p>We report: a) a high prevalence of unrecognized mood disorders in patients suffering from unexplained chronic pain complaints (80.4%: CI 95%: 79.0%; 81.8%); b) a greater susceptibility of women to mood disorders (OR adjusted = 1.48; CI 95%:1.22; 1.81); c) a direct relationship between the prevalence of mood disorders and the duration of pain (OR adjusted = 1.01; CI 95%: 1.01; 1.02) d) a higher comorbidity with depression if the pain etiology was unknown (OR adjusted = 1.74; CI 95%: 1.45; 2.10) and, e) an increased use of health care services in patients with such a comorbidity (p < 0.0001).</p> <p>Conclusions</p> <p>The prevalence of undiagnosed mood disorders in patients with unexplained chronic pain in primary care is very high, leading to dissatisfaction with treatment processes and poorer outcomes. Consequently, it seems necessary to explore this condition more regularly in general practice in order to reach accurate diagnoses and to select the appropriate treatment.</p
Priority setting: what constitutes success? A conceptual framework for successful priority setting
BACKGROUND: The sustainability of healthcare systems worldwide is threatened by a growing demand for services and expensive innovative technologies. Decision makers struggle in this environment to set priorities appropriately, particularly because they lack consensus about which values should guide their decisions. One way to approach this problem is to determine what all relevant stakeholders understand successful priority setting to mean. The goal of this research was to develop a conceptual framework for successful priority setting.
METHODS: Three separate empirical studies were completed using qualitative data collection methods (one-on-one interviews with healthcare decision makers from across Canada; focus groups with representation of patients, caregivers and policy makers; and Delphi study including scholars and decision makers from five countries).
RESULTS: This paper synthesizes the findings from three studies into a framework of ten separate but interconnected elements germane to successful priority setting: stakeholder understanding, shifted priorities/reallocation of resources, decision making quality, stakeholder acceptance and satisfaction, positive externalities, stakeholder engagement, use of explicit process, information management, consideration of values and context, and revision or appeals mechanism.
CONCLUSION: The ten elements specify both quantitative and qualitative dimensions of priority setting and relate to both process and outcome components. To our knowledge, this is the first framework that describes successful priority setting. The ten elements identified in this research provide guidance for decision makers and a common language to discuss priority setting success and work toward improving priority setting efforts
Ethical and legal implications of whole genome and whole exome sequencing in African populations
BACKGROUND: Rapid advances in high throughput genomic technologies and next generation sequencing are
making medical genomic research more readily accessible and affordable, including the sequencing of patient and
control whole genomes and exomes in order to elucidate genetic factors underlying disease. Over the next five
years, the Human Heredity and Health in Africa (H3Africa) Initiative, funded by the Wellcome Trust (United
Kingdom) and the National Institutes of Health (United States of America), will contribute greatly towards
sequencing of numerous African samples for biomedical research.
DISCUSSION: Funding agencies and journals often require submission of genomic data from research participants to
databases that allow open or controlled data access for all investigators. Access to such genotype-phenotype and
pedigree data, however, needs careful control in order to prevent identification of individuals or families. This is
particularly the case in Africa, where many researchers and their patients are inexperienced in the ethical issues
accompanying whole genome and exome research; and where an historical unidirectional flow of samples and
data out of Africa has created a sense of exploitation and distrust. In the current study, we analysed the
implications of the anticipated surge of next generation sequencing data in Africa and the subsequent data sharing
concepts on the protection of privacy of research subjects. We performed a retrospective analysis of the informed
consent process for the continent and the rest-of-the-world and examined relevant legislation, both current and
proposed. We investigated the following issues: (i) informed consent, including guidelines for performing
culturally-sensitive next generation sequencing research in Africa and availability of suitable informed consent
documents; (ii) data security and subject privacy whilst practicing data sharing; (iii) conveying the implications of
such concepts to research participants in resource limited settings.
SUMMARY: We conclude that, in order to meet the unique requirements of performing next generation
sequencing-related research in African populations, novel approaches to the informed consent process are required.
This will help to avoid infringement of privacy of individual subjects as well as to ensure that informed consent
adheres to acceptable data protection levels with regard to use and transfer of such information
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