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Journal of Healthcare Leadership 2020Competent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system. To improve their... (Review)
Review
OBJECTIVE
Competent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system. To improve their management competence, understanding of management competency requirements is important. The purpose of this study was to synthesize the evidence related to the leadership and management competencies in healthcare organizations through the best-fit method.
METHODS
A systematic review of literature published between 2000 and 2020 was performed to identify studies focusing on confirming and/or identifying the competency requirements of hospital managers. The best-fit framework synthesis method was used to map the identified competencies and associated behavioral items against the validated management competency assessment program (MCAP) management competency framework.
RESULTS
Twelve studies were identified for inclusion in the review. The mapping of the identified competencies and behavioral items generated a competency model for hospital managers that can apply for different healthcare context. The new competency model includes the following seven core leadership and management competencies: evidence-informed decision-making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism.
CONCLUSION
This review and the mapping of the competencies identified in previous studies against the validated MCAP framework has resulted in the recommendation for an extended leadership and management competency framework for health service managers. It provides guidance for the formulation of training and development directions for the health service management workforce in a different healthcare context.
PubMed: 32801985
DOI: 10.2147/JHL.S265825 -
Current Oncology (Toronto, Ont.) Aug 2017This systematic review was completed by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario's Program in... (Review)
Review
BACKGROUND
This systematic review was completed by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario's Program in Evidence-Based Care (pebc). It provides background and guidance for clinicians with respect to exercise for people living with cancer in active and post treatment. It focuses on the benefits of specific types of exercise, pre-screening requirements for new referrals, safety concerns, and delivery models.
METHODS
Using the pebc's standardized approach, medline and embase were systematically searched for existing guidelines, systematic reviews, and primary literature.
RESULTS
The search identified two guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present review provides conclusions about the duration, frequency, and intensity of exercise appropriate for people living with cancer.
CONCLUSIONS
The evidence shows that exercise is safe and provides benefit in quality of life and in muscular and aerobic fitness for people with cancer both during and after treatment. The evidence is sufficient to support the promotion of exercise for adults with cancer, and some evidence supports the promotion of exercise in group or supervised settings and for a long period of time to improve quality of life and muscular and aerobic fitness. Exercise at moderate intensities could also be sustainable for longer periods and could encourage exercise to be continued over an individual's lifetime. It is important that a pre-screening assessment be conducted to evaluate the effects of disease, treatments, and comorbidities.
PubMed: 28874900
DOI: 10.3747/co.24.3619 -
Disability and Rehabilitation 2014Community-based rehabilitation (CBR) must prove that it is making a significant difference for people with disabilities in low- and middle-income countries. Yet,... (Review)
Review
PURPOSE
Community-based rehabilitation (CBR) must prove that it is making a significant difference for people with disabilities in low- and middle-income countries. Yet, evaluation is not a common practice and the evidence for its effectiveness is fragmented and largely insufficient. The objective of this article was to review the literature on best practices in program evaluation in CBR in relation to the evaluative process, the frameworks, and the methods of data collection.
METHOD
A systematic search was conducted on five rehabilitation databases and the World Health Organization website with keywords associated with CBR and program evaluation. Two independent researchers selected the articles.
RESULTS
Twenty-two documents were included. The results suggest that (1) the evaluative process needs to be conducted in close collaboration with the local community, including people with disabilities, and to be followed by sharing the findings and taking actions, (2) many frameworks have been proposed to evaluate CBR but no agreement has been reached, and (3) qualitative methodologies have dominated the scene in CBR so far, but their combination with quantitative methods has a lot of potential to better capture the effectiveness of this strategy.
CONCLUSIONS
In order to facilitate and improve evaluations in CBR, there is an urgent need to agree on a common framework, such as the CBR matrix, and to develop best practice guidelines based on the literature available and consensus among a group of experts. These will need to demonstrate a good balance between community development and standards for effective evaluations. Implications for Rehabilitation In the quest for evidence of the effectiveness of community-based rehabilitation (CBR), a shared program evaluation framework would better enable the combination of findings from different studies. The evaluation of CBR programs should always include sharing findings and taking action for the sake of the local community. Although qualitative methodologies have dominated the scene in CBR and remain highly relevant, there is also a call for the inclusion of quantitative indicators in order to capture the progress made by people participating in CBR programs. The production of best practice guidelines for evaluation in CBR could foster accountable and empowering program evaluations that are congruent with the principles at the heart of CBR and the standards for effective evaluations.
Topics: Benchmarking; Community Health Services; Data Collection; Disability Evaluation; Disabled Persons; Humans; Outcome Assessment, Health Care; Program Evaluation; Rehabilitation
PubMed: 23614357
DOI: 10.3109/09638288.2013.785602 -
Medical Education Online Dec 2021The authors conducted a scoping review to investigate the structure, content, and potential impact of post-residency medical education fellowships. The authors searched...
The authors conducted a scoping review to investigate the structure, content, and potential impact of post-residency medical education fellowships. The authors searched eight databases to identify English-language articles describing longitudinal, post-residency medical fellowships that both focused on medical education and described the structure and content of the curriculum. The authors summarized the findings of each article and, for those articles that included a program evaluation, assessed the potential impact of the program via the Kirkpatrick's Four-Level Training Evaluation Model and the Medical Education Research Study Quality Instrument. Nine articles, describing a total of ten post-residency medical education fellowships, met inclusion criteria. Half of the programs were dedicated medical education fellowships and half were medical education tracks within a subspecialty fellowship. The content and educational strategies varied, with no two programs having the same curriculum. Most programs most focused on teaching skills, adult learning theory, curricular development, and medical education research/scholarship. Most programs used project-based learning, workshops, and faculty mentorship as educational strategies. Six of the articles included an evaluation of their program(s), all of which suggested positive changes, at least at the level of fellow behavior (Kirkpatrick level 3), and designs limited the strength of any conclusions drawn. This scoping review highlights the variation among medical education fellowships and the need for common curricular components, as well as program evaluation, across and within these fellowships. Additional assessment at higher levels of trainee outcomes will help guide the creation and revision of medical education fellowships, and inform the development of a core curriculum shared across programs. Such a core curriculum could then serve as the foundation for a certification program, by which a medical educator's expertise could be recognized, thus elevating medical education to the stature it deserves within the academic mission.
Topics: Biomedical Research; Curriculum; Education, Medical; Education, Medical, Graduate; Faculty, Medical; Fellowships and Scholarships; Humans; Internship and Residency; Learning; Mentoring; Problem-Based Learning; Program Evaluation; Specialization
PubMed: 33970808
DOI: 10.1080/10872981.2021.1920084 -
Healthcare (Basel, Switzerland) Feb 2021Blockchain technology was introduced through Bitcoin in a 2008 whitepaper by the mysterious Satoshi Nakamoto. Since its inception, it has gathered great attention... (Review)
Review
Blockchain technology was introduced through Bitcoin in a 2008 whitepaper by the mysterious Satoshi Nakamoto. Since its inception, it has gathered great attention because of its unique properties-immutability and decentralized authority. This technology is now being implemented in various fields such as healthcare, IoT, data management, etc., apart from cryptocurrencies. As it is a newly emerging technology, researchers and organizations face many challenges in integrating this technology into other fields. Consent management is one of the essential processes in an organization because of the ever-evolving privacy laws, which are introduced to provide more control to users over their data. This paper is a systematic review of Blockchain's application in the field of consent and privacy data management. The review discusses the adaptation of Blockchain in healthcare, IoT, identity management, and data storage. This analysis is formed on the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and a process of systematic mapping review. We provide analysis of the development, challenges, and limitations of blockchain technology for consent management.
PubMed: 33535465
DOI: 10.3390/healthcare9020137 -
Journal of Graduate Medical Education Feb 2021Wellness initiatives implemented by graduate medical education programs can help mitigate burnout in resident physicians. (Review)
Review
BACKGROUND
Wellness initiatives implemented by graduate medical education programs can help mitigate burnout in resident physicians.
OBJECTIVE
This systematic review seeks to identify factors that impact the effectiveness of resident wellness interventions and to provide a conceptual framework to guide future interventions.
METHODS
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 6 electronic databases were searched in November 2019 using variations of the keywords "resident physicians," "wellness," and "intervention." Peer-reviewed full-text English-language articles on controlled studies were considered for inclusion. The quality of the studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines.
RESULTS
The initial search disclosed 1196 articles, of which 18 studies enrolling 666 resident physicians met inclusion criteria for qualitative review. Interventions using peer support and individual meditation enhanced well-being. Effective wellness interventions also used educational theory to guide program development, surveyed participants to guide intervention design, incorporated programming into existing didactic curricula, and recruited voluntary participants. The quality of most of the included studies was poor (13 of 18, 72%) and could be improved by using standardized wellness assessments supported by validity evidence.
CONCLUSIONS
This systematic review suggests that future resident wellness initiatives should focus on grounding interventions in educational theory, forging consensus on wellness instruments with validity evidence, and examining the impact of initiatives on patient outcomes. A logic model can provide a framework for designing and implementing effective wellness interventions.
Topics: Burnout, Professional; Curriculum; Education, Medical, Graduate; Humans; Internship and Residency; Physicians
PubMed: 33680302
DOI: 10.4300/JGME-D-20-00359.1 -
BMJ (Clinical Research Ed.) Nov 2009To determine the impact on teenage pregnancy of interventions that address the social disadvantage associated with early parenthood and to assess the appropriateness of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To determine the impact on teenage pregnancy of interventions that address the social disadvantage associated with early parenthood and to assess the appropriateness of such interventions for young people in the United Kingdom.
DESIGN
Systematic review, including a statistical meta-analysis of controlled trials on interventions for early parenthood and a thematic synthesis of qualitative studies that investigated the views on early parenthood of young people living in the UK.
DATA SOURCES
12 electronic bibliographic databases, five key journals, reference lists of relevant studies, study authors, and experts in the field. Review methods Two independent reviewers assessed the methodological quality of studies and abstracted data.
RESULTS
Ten controlled trials and five qualitative studies were included. Controlled trials evaluated either early childhood interventions or youth development programmes. The overall pooled effect size showed that teenage pregnancy rates were 39% lower among individuals receiving an intervention than in those receiving standard practice or no intervention (relative risk 0.61; 95% confidence interval 0.48 to 0.77). Three main themes associated with early parenthood emerged from the qualitative studies: dislike of school; poor material circumstances and unhappy childhood; and low expectations for the future. Comparison of these factors related to teenage pregnancy with the content of the programmes used in the controlled trials indicated that both early childhood interventions and youth development programmes are appropriate strategies for reducing unintended teenage pregnancies. The programmes aim to promote engagement with school through learning support, ameliorate unhappy childhood through guidance and social support, and raise aspirations through career development and work experience. However, none of these approaches directly tackles all the societal, community, and family level factors that influence young people's routes to early parenthood.
CONCLUSIONS
A small but reliable evidence base supports the effectiveness and appropriateness of early childhood interventions and youth development programmes for reducing unintended teenage pregnancy. Combining the findings from both controlled trials and qualitative studies provides a strong evidence base for informing effective public policy.
Topics: Adolescent; Adolescent Health Services; Attitude to Health; Child; Child Health Services; Controlled Clinical Trials as Topic; Data Collection; Female; Humans; Male; Pregnancy; Pregnancy in Adolescence; Program Evaluation; Qualitative Research; Quality Assurance, Health Care; Randomized Controlled Trials as Topic; Social Support; Socioeconomic Factors
PubMed: 19910400
DOI: 10.1136/bmj.b4254 -
Oncotarget Sep 2017Metastasis is the leading cause of cancer-related death and directly associates with cancer progression, resistance to anticancer therapy, and poor patient survival.... (Review)
Review
Metastasis is the leading cause of cancer-related death and directly associates with cancer progression, resistance to anticancer therapy, and poor patient survival. Current efforts focusing on the underlying molecular mechanisms of cancer metastasis attract a special attention to cancer researchers. The epithelial-mesenchymal transition is a complex of molecular program during embryogenesis, inflammation, tissue fibrosis, and cancer progression and metastasis. S100A4, an important member of S100 family proteins, functions to increase the tumor progression and metastasis. The molecular mechanisms of S100A4 involving in the progression and metastasis are diverse in various malignant tumors. Detection of S100A4 expression becomes a promising candidate biomarker in cancer early diagnosis and prediction of cancer metastasis and therefore, S100A4 may be a therapeutic target. This review summarized up to date advancement on the role of S100A4 in human cancer development, progression, and metastasis and the underlying molecular events and then strategies to target S100A4 expression experimentally.
PubMed: 29069865
DOI: 10.18632/oncotarget.18016 -
Iranian Journal of Pediatrics Dec 2014Unrecognized congenital hypothyroidism (CH) leads to mental retardation. Newborn screening and thyroid therapy started within 2 weeks of age can normalize cognitive... (Review)
Review
OBJECTIVE
Unrecognized congenital hypothyroidism (CH) leads to mental retardation. Newborn screening and thyroid therapy started within 2 weeks of age can normalize cognitive development. In this systematic review, the local results of the national CH screening program in different provinces in Iran are reviewed and evaluated.
METHODS
Literature on the CH screening, the national databases including SID, Medlib, Iran Medex, Magiran as well as international databases including PubMed/Medline, ISI Web of Knowledge and web of science, EMBASE, SCOPUS and Google Scholar. Appraisal was guided by a checklist assessing clarity of aims and research questions. The 95% confidence intervals were calculated by I-square models. Meta regression was introduced to explore the heterogeneity between studies.
FINDINGS
We identified 25 samples including 1425124 neonates in our country. Data were Meta analyzed using random-effects models, and we found a TSH levels of 19633 babies in the first sampling were greater than the cut-off level (TSH ≥5mIU/L). The pooled recall rate was 0.014 (95 % CI: 0.013 - 0.015). According to Meta analysis the overall incidence of CH was 2/1000 (95% CI: .002 - .002). The incidence of CH did not appear to be increasing over time (P=0.08).
CONCLUSION
Considering TSH ≥5mIU/L as a cut-off point for recalling neonates and low positive predictive value (14%) of this point shows that more investigation and research is needed for establishing accurate level of TSH as a criterion for recalling patients.
PubMed: 26019769
DOI: No ID Found -
European Eating Disorders Review : the... Mar 2023Day programs have received significant consideration within psychological literature as part of a continuum of mental health services. With increasing attention on the... (Review)
Review
Day programs have received significant consideration within psychological literature as part of a continuum of mental health services. With increasing attention on the prevalence of eating disorders in children and adolescents, and the need for early intervention to minimize the costs and burden of the disorder, eating disorder day programs (also referred as partial hospitalization) have begun to emerge around the world. Despite their widespread use, no reviews to date have examined the efficacy of day programs for the treatment of eating disorders in children and adolescents. The current narrative literature review aims to describe and evaluate the efficacy of day programs for children and adolescents. The literature review was conducted according to the PRISMA guidelines and aimed to explore the outcomes and common program elements of day programs to guide clinical practice and service development. The review found variations amongst the day programs related to program elements, measures utilized and outcomes. Overall, the results suggest that day programs for children and adolescents are effective at restoring body weight, reducing eating disorder symptoms and addressing comorbid mental health concerns.
Topics: Humans; Child; Adolescent; Feeding and Eating Disorders; Body Weight; Mental Health; Mental Health Services; Day Care, Medical
PubMed: 36351879
DOI: 10.1002/erv.2953