Search results for " support"
showing 10 items of 1591 documents
The experience of physicians in pharmacogenomic clinical decision support within eight German university hospitals.
2017
Aim: The aim of this study was to assess the physicians’ attitude, their knowledge and their experience in pharmacogenomic clinical decision support in German hospitals. Materials & methods: We conducted an online survey to address physicians of 13 different medical specialties across eight German university hospitals. In total, 564 returned questionnaires were analyzed. Results: The remaining knowledge gap, the uncertainty of test reimbursement and the physicians’ lack of awareness of existing pharmacogenomic clinical decision support systems (CDSS) are the major barriers for implementing pharmacogenomic CDSS into German hospitals. Furthermore, pharmacogenomic CDSS are most effective …
Checking the carotid pulse check: diagnostic accuracy of first responders in patients with and without a pulse.
1996
International guidelines for cardiopulmonary resuscitation (CPR) in adults advocate that cardiac arrest be recognized within 5-10 s, by the absence of a pulse in the carotid arteries. However, validation of first responders' assessment of the carotid pulse has begun only recently. We aimed (1) to develop a methodology to study diagnostic accuracy in detecting the presence or absence of the carotid pulse in unresponsive patients, and (2) to evaluate diagnostic accuracy and time required by first responders to assess the carotid pulse. In 16 patients undergoing coronary artery bypass grafting, four groups of first responders (EMT-1: 107 laypersons with basic life support (BLS) training; EMT-2…
Focus group study to identify the central facets of fear of hypoglycaemia in people with Type 2 diabetes mellitus.
2017
Aims To determine key worries about hypoglycaemia among insulin-using adults with Type 2 diabetes using a focus group approach. Methods Thirteen focus groups were conducted in three diabetes outpatient care units and one peer support group was set up, in Germany. A total of 64 insulin-dependent adults with Type 2 diabetes (36.5% women, mean age 65.2 ± 11.0 years) discussed their worries about hypoglycaemia. The qualitative results were assigned into thematic categories using a bottom-up coding procedure. Participants completed the Hypoglycaemia Fear Survey and demographic measures were recorded. The results of the Hypoglycaemia Fear Survey were contrasted with the focus group findings to ev…
A multiple biomarker risk score for guiding clinical decisions using a decision curve approach.
2011
Aims: We assessed whether a cardiovascular risk model based on classic risk factors (e.g. cholesterol, blood pressure) could refine disease prediction if it included novel biomarkers (C-reactive protein, N-terminal pro-B-type natriuretic peptide, troponin I) using a decision curve approach which can incorporate clinical consequences. Methods and results: We evaluated whether a model including biomarkers and classic risk factors could improve prediction of 10 year risk of cardiovascular disease (CVD; chronic heart disease and ischaemic stroke) against a classic risk factor model using a decision curve approach in two prospective MORGAM cohorts. This included 7739 men and women with 457 CVD …
Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample.
2017
Abstract Background The Generalized Anxiety Disorder Scales GAD-7 and GAD-2 are instruments for the assessment of anxiety. The aims of this study are to test psychometric properties of these questionnaires, to provide normative values, and to investigate associations with sociodemographic factors, quality of life, psychological variables, and behavioral factors. Methods A German community sample (n=9721) with an age range of 18–80 years was surveyed using the GAD-7 and several other questionnaires. Results Confirmatory factor analyses confirmed the unidimensionality and measurement invariance of the GAD-7 across age and gender. Females were more anxious than males (mean scores: M=4.07 vs. M…
Hostility, unemployment and health status: testing three theoretical models.
2003
This study examined three theoretical models of hostility, health and life context. According to the psychosocial vulnerability hypothesis, there is an interaction between hostility and adverse conditions. The increased health risk in hostile individuals is assumed to stem from their lower ability to benefit from existing psychosocial resources. The second hypothesis, called here the social context model, considers adverse conditions as an antecedent of both hostility and health problems. The third model states that hostility is a predictor of being selected to adverse conditions involving risk to health (the selection hypothesis). The results from a survey of a population-based random samp…
Effect of High-Fidelity Simulation on Medical Students' Knowledge about Advanced Life Support: A Randomized Study
2015
High-fidelity simulation (HFS) is a learning method which has proven effective in medical education for technical and non-technical skills. However, its effectiveness for knowledge acquisition is less validated. We performed a randomized study with the primary aim of investigating whether HFS, in association with frontal lessons, would improve knowledge about advanced life support (ALS), in comparison to frontal lessons only among medical students. The secondary aims were to evaluate the effect of HFS on knowledge acquisition of different sections of ALS and personal knowledge perception. Participants answered a pre-test questionnaire consisting of a subjective (evaluating personal percepti…
Symptom dimensions in obsessive-compulsive disorder: differences in distress, interference, appraisals and neutralizing strategies.
2012
Abstract Background and objectives Cognitive proposals about the mediating role of misinterpretations, emotional reactions, and control strategies in the escalation of obsessional intrusive thoughts (OIT) to clinical obsessions have received only partial support. This study aims to examine these variables, taking into account the obsession/OIT contents and the severity of the Obsessive-Compulsive Disorder (OCD). Methods After identifying their most upsetting OIT/obsession, 61 OCD patients and 61 non-clinical individuals assessed the associated distress, interference and appraisals, and the strategies used to control the obsession/OIT. Results Compared with the nonclinical subjects, OCD indi…
Spirituality in patients with advanced illness: The role of symptom control, resilience and social network.
2015
In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end o…
Factors influencing place of death in Germany.
2011
Abstract Context Knowledge about factors influencing the place of death may be very useful for the planning of public health strategies to improve the situation of terminally ill patients. Objectives The aim of our study was to determine where people died in the German federal state of Rhineland-Palatinate in 2008. We further wanted to detect which factors had an influence on the place of death. Methods Our cross-sectional survey was based on a random sample of 5000 inhabitants of Rhineland-Palatinate who had died between May 25, 2008 and August 24, 2008. Relatives of these randomly drawn deceased persons were interviewed by means of a written survey. Results After removing duplicates, 4967…