1,721,004 research outputs found
The assumptions of data capture
No full textWithin the field of clinical research, there has been, for manyyears, a move away from the use of paper as a form of datacapture, in favour of electronic data capture, particularly withinindustry. The advent of the use of electronic case record forms(eCRFs) is nothing new from that perspective: what remainsa challenge is the use of electronic data capture (EDC) at site.This article will, I hope, with some broad generalisation, raiseawareness of the issues from the sites’ perspectiv
A rapid review of digital health strategies and policies in response to COVID-19 pandemic
No full textIntroduction: COVID-19 pandemic has imposed unprecedented healthcare challenges, both globally and locally. The application of digital technologies offers great value for overcoming these challenges. However, the adoption itself has not been sufficient, appropriate, or uniform. In this regard, successful digital health strategies and policies adopted during this pandemic may form the basis to form exemplars for digital health adoption in similar situations. This study aims at reviewing the above-mentioned digital health strategies and policies with a view of creating value.Methods: A rapid literature search was done through the Research4Life of Health InterNetwork Access to Research Initiative (HINARI). Search terms included word combinations to capture all publications related to the current pandemic and digital health strategies from the 1st of January to the 28th of May 2020. First, abstracts were examined for relevance. All works with significant content related to digital health strategies were included for full-text screening. Finally, an in-depth scrutiny of significant works was performed.Results: Search results included 44 abstracts with six duplicates. After initial screening, 38 were selected for full-text screening. Only 26 significantly relevant studies were selected for the final analysis. Studies revealed a variety of digital health strategies adopted by countries and healthcare facilities during COVID -19. Telecare was the most conferred strategy globally (mentioned in 14 studies), where teleconsultations were key in remote service provision. Application of mHealth (two studies), electronic medical record (one study), clinical decision support systems (one study), and social media apps (four studies) have also created great value. Clinical applications included oncologic care, ophthalmic practice, geriatric care, dermatology, psychiatry, oral and maxillofacial surgery, otolaryngology, and electrophysiology. The above was in addition to general patient care, teaching, knowledge sharing, and research. Some have questioned the practicality of the above strategies, whereas the others have cited economic disparities, technology issues, information quality, legislation, and other contextual issues. Moreover, deficiencies in digital health policies at the global level were highlighted, emphasizing the need to strengthen global readiness for digital health adoption.Conclusion: This study summarizes strategies used by countries and health facilities to utilize the full potential of digital health applications during pandemics. The above principles may form part of mainstream policies and strategies for delivering healthcare and international corporation in similar situations. The study further highlights the need for an immediate and inclusive global dialogue in this regard
Effectiveness of mathematical and simulation models for improving quality of care in emergency departments: a systematic literature review
No full textThis systematic literature review aims to critically evaluate the use of mathematical and simulation models within emergency departments (EDs) and assess their potential to improve the quality of care. This review emphasises the critical need for quality enhancement in healthcare systems, specifically focusing on EDs. This review incorporates studies investigating the quality of care provided in ED settings, employing assorted mathematical and simulation models for adult populations. Based on the selected studies, a narrative approach was used to synthesise the findings, focusing on outcome classification, simulation, and modelling. There are six outcome dimensions: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. This review analysed 112 studies, uncovering a distinct focus on a set of key performance measures within emergency department (ED) operations, accounting for 222 instances across these studies. Measures assessing timeliness were most frequent, occurring 111 times, indicating a strong emphasis on operational efficiency aspects such as waiting times and patient flow. A total of 75 examinations were conducted on efficiency-related measures, specifically focusing on identifying and addressing operational bottlenecks and optimising resource utilisation. On the other hand, safety, patient-centeredness, and effectiveness were not as commonly represented, with only three, four, and 29 instances, respectively. This review highlights the considerable potential of mathematical and simulation models to enhance ED operations, particularly regarding timeliness and efficiency. However, aspects such as patient safety, effectiveness, and patient-centredness were under-represented, while equity was absent across the studies, indicating a clear need for further research. These findings emphasise the importance of adopting a more thorough approach to evaluating and improving the quality of emergency care. Future research should also concentrate on refining data management practices, incorporating observational studies, and exploring various simulation tools to develop a more balanced and inclusive understanding of these models' applications
Estimating blast exposures from the 2020 Beirut explosion and examining correlation with blast injuries
No full textOn 4th August 2020, approximately 2750 tonnes of Ammonium Nitrate stored in the port of Beirut ignited, causing a huge explosion that damaged large parts of the city, causing more than 200 deaths and over 7,000 injuries. Injured victims’ locations at the time of the explosion were previously unreported and unknown due to improper documentation. Without such knowledge, a victim’s degree of blast exposure cannot be estimated, preventing further understanding of how blast loading contributed to injury outcomes.As a large, city-scale explosion, a victim’s blast exposure will have been significantly influenced by their location, including distance from the port detonation, their elevation, and proximity to buildings. In the absence of pressure measurements, engineering models can estimate and provide useful insight into the blast conditions likely to have occurred at different distances from the blast epicentre. This paper reports on findings from a first-of-kind forensic study of the 2020 Beirut port explosion that aimed to investigate the relationship between victims’ blast injury patterns and predicted blast exposure based on their location. Patients were selected from existing Beirut blast injury databases and invited to participate in this study. Over 300 participants completed a structured interview administered by telephone which acquired information on the participants’ exact location at the time of the blast, their circumstances, and self-reported injuries alongside clinical records from prior injury databases. Participant locations were determined as precisely as possible and recorded using Google My Maps to obtain corresponding latitude and longitude coordinates. For each location, estimated blast loading parameters were calculated assuming an idealised, hemispherical surface detonation at the port using equivalent charge mass estimates in the literature. Estimated blast loading conditions were analysed against participants’ injury severity scores and reported injury patterns to examine correlation between loading intensity and injury outcomes.Results from this study highlight the capacity and limitations of blast modelling approaches for injury prediction through examination of a real-world urban blast case study. New knowledge can be used to inform disaster management and guide the protection of civilians exposed to urban blasts.<br/
Allocation of funding into blast injury-related research and blast traumatic brain injury between 2000 and 2019: analysis of global investments from public and philanthropic funders
No full textINTRODUCTION: There is little systematic tracking or detailed analysis of investments in research and development for blast injury to support decision-making around research future funding.METHODS: This study examined global investments into blast injury-related research from public and philanthropic funders across 2000-2019. Research databases were searched using keywords, and open data were extracted from funder websites. Data collected included study title, abstract, award amount, funder and year. Individual awards were categorised to compare amounts invested into different blast injuries, the scientific approaches taken and analysis of research investment into blast traumatic brain injury (TBI).RESULTS: A total of 806 awards were identified into blast injury-related research globally, equating to US671.3 m (74.4%) of investment. Brain-related injury research received 138.6 m (15.4%), eye injury 60.5m (6.7%). Blast TBI research received a total investment of 719.3 m (80%).CONCLUSIONS: Investment data suggest that blast TBI research has received greater funding than other blast injury health areas. The funding pattern observed can be seen as reactive, driven by the response to the War on Terror, the rising profile of blast TBI and congressionally mandated research.</p
Sizing up blast injury research - transforming the effectiveness and relevance of blast injury research
No full textThis report details our vision and research agenda to transform blast injury research to address humanitarian civilian health issues caused by landmines, explosive remnants of war (ERW) and conflict.The threat of blast injuries affects millions globally, particularly vulnerable populations within low-to-middle income countries, representing a global humanitarian challenge and a serious and ongoing threat to civilian populations.Blast injury research is an accelerating field, receiving increased interest and considerable funding in recent years. Contemporary blast injury research predominantly aims to improve prevention, protection and treatment of military personnel in defence contexts, despite the vast majority of causalities occurring within civilian populations. Furthermore, humanitarian efforts relating to landmines and ERW have focused on monitoring and demining technologies, with limited research to address or review blast injury victim support and assistance. As a result, there has been limited effort to examine or address the humanitarian health issues pertaining to civilian blast injuries.Investment into blast injury research, and appropriate methodologies, should address relevant, priority injury types to deliver the greatest overall positive impact. There is currently no global database of historic and current research into blast injuries. Blast injury research requires a trans-disciplinary approach but typically remains a clinically-driven field. Many studies report incomplete blast parameters with limited transparency on the blast loading conditions considered or assumed, making it challenging to compare or relate them to real-world blast threats, injury scenarios and the populations concerned. Therefore, despite considerable investment, the current evidence-base to inform research strategies, methodologies, funding decisions and health policy is insufficient and out-of-date. This makes it challenging to assess the clinical and public health impact of blast injury studies, the effectiveness and fairness of funding and how health systems, clinicians and protection engineers can sustainably absorb findings to direct new priority research areas and improve health outcomes.Our vision is to improve the impact, effectiveness, fairness and relevance of blast injury research to address the humanitarian civilian health issues caused by landmines, ERW and conflict. We will bring together expertise in blast engineering, public health, research investments analysis and clinical informatics to undertake novel research-on-research to establish an evidence-base that future blast injury research methodologies and investment reflects priority areas that best translate into improved health outcomes and population health
Examining the state of research: Defining the challenges and opportunities for blast injury research: Workshop Report. March 2019, Cape Town, South Africa.
No full textThe multidisciplinary research challenges of civilian blast injuries were discussed at the International Blast Injury Research Network’s (IBRN) inaugural workshop, ‘Examining the State of Research: Blast Injury Research Workshop’. The IBRN launch workshop was hosted by the Blast Impact and Survivability Research Unit (BISRU) and took place at the University of Cape Town’s (UCT) Mechanical Engineering Department in South Africa on 27 March 2019. This report provides an outline of the presentations and discussions that took place drawing on multidisciplinary experience from South Africa, Zimbabwe and the UK. It highlights current knowledge gaps and participants perceptions about research priorities and potential approaches to address the challenges
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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