JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
Re-profiling today's health care curricula for tomorrow's workforce: establishing an interprofessional degree in Germany.
J Interprof Care
PUBLISHED: 11-13-2014
Show Abstract
Hide Abstract
Abstract Laws regulating education of most health professional groups in Germany today mean that curricula re-profiling in response to changing priorities in the practice environment is a significant challenge. Legally dictated theoretical and clinical requirements for the vocational training of health professionals leaves little room for re-profiling in response to movements such as interprofessional education. An educational innovation was needed that worked within existing structures in Germany. The result was a formal collaboration between the Academy for Health Professionals and the University of Heidelberg allowing students undertaking vocational training to also complete a university degree in parallel. The aim of this article is to describe the curriculum development for the Bachelor of Science - Interprofessional Health Care. This article outlines an evidence-based approach to the process to curriculum development that resulted in a competency-based degree offering comprehensive interprofessional education at undergraduate level for healthcare students based in Germany.
Related JoVE Video
Quality and efficiency of statin prescribing across countries with a special focus on South Africa; findings and future implications.
Expert Rev Pharmacoecon Outcomes Res
PUBLISHED: 10-24-2014
Show Abstract
Hide Abstract
Introduction: Statins are recommended first-line treatment for hyperlipidemia, with published studies suggesting limited differences between them. However, there are reports of under-dosing. South Africa has introduced measures to enhance generic utilization. Part one documents prescribed doses of statins in 2011. Part two determines the extent of generics versus originator and single-sourced statins in 2011 and their costs. Results: Underdosing of simvastatin in 2011 with average prescribed dose of 23.7 mg; however, not for atorvastatin (20.91 mg) or rosuvastatin (15.02 mg). High utilization of generics versus originators at 93-99% for atorvastatin and simvastatin, with limited utilization of single-sourced statins (22% of total statins - defined daily dose basis), mirroring Netherlands, Sweden and UK. Generics priced 33-51% below originator prices. Discussion: Opportunity to increase simvastatin dosing through education, prescribing targets and incentives. Opportunity to lower generic prices with generic simvastatin 96-98% below single-sourced prices in some European countries.
Related JoVE Video
Epidemiology of Injuries in High School Football: Does School Size Matter?
J Phys Act Health
PUBLISHED: 10-21-2014
Show Abstract
Hide Abstract
More than 1 million US high school students play football. Our objective was to compare the high school football injury profiles by school enrollment size during the 2013-2014 season.
Related JoVE Video
Current status of patient recall in U.S. predoctoral dental school clinics.
J Dent Educ
PUBLISHED: 10-05-2014
Show Abstract
Hide Abstract
The Commission on Dental Accreditation (CODA)'s revised standard 2-23, which went into effect in July 2013, requires U.S. dental graduates to be competent in "evaluation of the outcomes of treatment, recall strategies, and prognosis." To assess the way dental schools are implementing this revised recommendation, a survey was conducted to assess the existence of recall systems in the schools' clinics and factors enhancing or hindering the formation of an effective recall system. Surveys were returned from thirty-five dental schools (54.7 percent response rate). Results showed that most institutions had active recall systems and the respondents believed that program effectiveness can be further improved. Suggested improvements included patient education and tracking patient recall appointments. The results indicate that recall systems exist in predoctoral dental education programs, have high student involvement, and vary among schools.
Related JoVE Video
Analysis of the influence of recent reforms in China: cardiovascular and cerebrovascular medicines as a case history to provide future direction.
J Comp Eff Res
PUBLISHED: 10-03-2014
Show Abstract
Hide Abstract
Pharmaceutical expenditure has grown by 16% per annum in China, enhanced by incentives for physicians and hospitals. Hospital pharmacies dispense 80% of medicines in China, accounting for 46% of total hospital expenditure. Principal measures to moderate drug expenditure growth include pricing initiatives as limited demand-side measures.
Related JoVE Video
Retrospective Analysis of Implant Overdenture Treatment in the Advanced Prosthodontic Clinic at the University of Illinois at Chicago.
J Oral Implantol
PUBLISHED: 09-19-2014
Show Abstract
Hide Abstract
Abstract Introduction:The aim of the present retrospective study was to evaluate the clinical outcomes of implant supported overdenture treatment provided by prosthodontic specialty residents.Material and methods: Twenty-three patients with 25 implant supported overdentures (IODs) participated in the study. Seventy four implants were placed by periodontic, prosthodontics, or oral and maxillofacial surgery students. All prostheses were fabricated in the advanced prosthodontics clinic at University of Illinois at Chicago. The implants, prostheses, and the condition of the peri-implant soft tissue were evaluated. Complications and any maintenance were documented. Patients completed an oral health impact profile-14 and semantic differential scale questionnaires. Statistical analyses were performed using SPSS software.Results:Twenty mandibular and 5 maxillary IODs were evaluated. Ninety-seven percent of the attachments were locators (Zest Anchors) and 3% ball attachments. None of the implants had lost osseo-integration but 14 implants (19%) had developed marginal bone loss one-third of the implant length or more. Fourteen (19%) implants had developed dehiscence, which ranged from 1-4mm. A variation in the width of the keratinized tissue, the gingival, plaque, and calculus index was observed. There was a statistically significant relationship between the presence of plaque and the bleeding on probing on the buccal aspect of implants (p=0.012). Incidence of dehiscence is significantly higher on the mid-facial when the keratinized tissue was less than 2mm (p<0.0001). The majority of the complications were prosthetic, such as broken denture teeth (74%) and worn matrices (35%). Debris was observed in 19% of the locator abutments, and 36% of the overdenture were not stable in application of anterior force. Patients were compliant with oral hygiene protocols and their chewing ability was high (mean=8.0). The overall experience was pleasant (mean=7.5); the treatment provided good esthetics (mean=8.3) and great satisfaction (mean=8.5).Conclusion: From an educational and clinical perspective, IOD therapy has been documented to be a successful treatment option. Patients should be informed of the required maintenance and the possible complications related to IOD therapy. Clinical significance: Implant overdenture treatment improves patients' quality of life and overall satisfaction. IOD has a high incidence of broken acrylic teeth and requires maintenance of worn matrices.
Related JoVE Video
Tools for primary care patient safety: a narrative review.
BMC Fam Pract
PUBLISHED: 06-12-2014
Show Abstract
Hide Abstract
Patient safety in primary care is a developing field with an embryonic but evolving evidence base. This narrative review aims to identify tools that can be used by family practitioners as part of a patient safety toolkit to improve the safety of the care and services provided by their practices.
Related JoVE Video
Experiences of UK health-care services for people with Multiple Sclerosis: a systematic narrative review.
Health Expect
PUBLISHED: 06-02-2014
Show Abstract
Hide Abstract
Multiple Sclerosis (MS) is a chronic, degenerative condition with an estimated UK prevalence of 100 000. Contact with health-care services is frequent and long-term; however, little research has investigated the experiences of health care for MS in the UK.
Related JoVE Video
Dusted community: piloting a virtual peer-to-peer support community for people with an asbestos-related diagnosis and their families.
J Psychosoc Oncol
PUBLISHED: 05-06-2014
Show Abstract
Hide Abstract
Individuals with an asbestos-related diagnosis and their carers face burdens including debilitating and life-limiting physical symptoms and medico-legal stressors. Feelings of social isolation are common. Increasing social connectedness can lead to increased feelings of personal empowerment and may inhibit chronic stress responses. The authors report on the development, via a process of participatory action research, of an online peer-to-peer support group, and the first 30-day test phase of this virtual community. Initial indications are that individuals with an asbestos-related diagnosis and their carers can benefit, in psychosocial terms, from membership of an on-line support group comprised of experientially similar others.
Related JoVE Video
Are predoctoral students able to provide single tooth implant restorations in the maxillary esthetic zone?
J Dent Educ
PUBLISHED: 05-03-2014
Show Abstract
Hide Abstract
The objective of this study was to assess the ability of the University of Illinois at Chicago College of Dentistry (UIC-COD) predoctoral students to provide single tooth implant (STI) prostheses in the maxillary esthetic zone. The patient's esthetic satisfaction and the correlation between prosthodontists' and patients' perspectives were examined. Twenty-seven patients were recruited for recall examinations at the UIC-COD predoctoral implant program and underwent clinical and radiographic examination with clinical photographs of the implant sites. The patients completed a semantic differential scale questionnaire. The collected information was formulated into a PowerPoint presentation for two Diplomate of the American Board of Prosthodontists to use the Pink/White Esthetic Score (PES/WES) to evaluate the esthetic outcome. Descriptive analyses, Cohen kappa test, and Spearman rank correlation coefficient test were performed. The average PES/WES were above 6.0 (out of 10). The median for the patient satisfaction and esthetic outcome questionnaires were 10 and 9, respectively, on a scale with 10=highest. There was a medium and positive correlation between prosthodontists' and patients' perspectives in esthetic outcome. This study found that, with strict guidance and proper selection criteria, predoctoral students were able to provide esthetically acceptable STI prostheses in the maxillary esthetic zone and patients were satisfied with the treatment provided.
Related JoVE Video
Advanced predoctoral implant program at UIC: description and qualitative analysis.
J Dent Educ
PUBLISHED: 05-03-2014
Show Abstract
Hide Abstract
Dental implant education has increasingly become an integral part of predoctoral dental curricula. However, the majority of implant education emphasizes the restorative aspect as opposed to the surgical. The University of Illinois at Chicago College of Dentistry has developed an Advanced Predoctoral Implant Program (APIP) that provides a select group of students the opportunity to place implants for single-tooth restorations and mandibular overdentures. This article describes the rationale, logistics, experiences, and perspectives of an innovative approach to provide additional learning experiences in the care of patients with partial and complete edentulism using implant-supported therapies. Student and faculty perspectives on the APIP were ascertained via focus group discussions and a student survey. The qualitative analysis of this study suggests that the select predoctoral dental students highly benefited from this experience and intend to increase their knowledge and skills in implant dentistry through formal education following graduation. Furthermore, the survey indicates that the APIP has had a positive influence on the students' interest in surgically placing implants in their future dental practice and their confidence level in restoring and surgically placing implants.
Related JoVE Video
Effectiveness of a quality management program in dental care practices.
BMC Oral Health
PUBLISHED: 04-23-2014
Show Abstract
Hide Abstract
Structured quality management is an important aspect for improving patient dental care outcomes, but reliable evidence to validate effects is lacking. We aimed to examine the effectiveness of a quality management program in primary dental care settings in Germany.
Related JoVE Video
Identification of an updated set of prescribing--safety indicators for GPs.
Br J Gen Pract
PUBLISHED: 04-02-2014
Show Abstract
Hide Abstract
Medication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking.
Related JoVE Video
Quality Indicators as a Tool in Improving the Introduction of New Medicines.
Basic Clin. Pharmacol. Toxicol.
PUBLISHED: 04-01-2014
Show Abstract
Hide Abstract
Quality indicators are increasingly used as a tool to achieve safe and quality clinical care, cost-effective therapy, for professional learning, remuneration, accreditation and financial incentives. A substantial number focus on drug therapy but few address the introduction of new medicines even though this is a burning issue. The objective was to describe the issues and challenges in designing and implementing a transparent indicator framework and evaluation protocol for the introduction of new medicines and to provide guidance on how to apply quality indicators in the managed entry of new medicines. Quality indicators need to be developed early to assess whether new medicines are introduced appropriately. A number of key factors need to be addressed when developing, applying and evaluating indicators including dimensions of quality, suggested testing protocols, potential data sources, key implementation factors such as intended and unintended consequences, budget impact and cost-effectiveness, assuring the involvement of the medical professions, patients and the public, and reliable and easy-to-use computerized tools for data collection and management. Transparent approaches include the need for any quality indicators developed to handle conflict of interests to enhance their validity and acceptance. The suggested framework and indicator testing protocol may be useful in assessing the applicability of indicators for new medicines and may be adapted to healthcare settings worldwide. The suggestions build on existing literature to create a field testing methodology that can be used to produce country-specific quality indicators for new medicines as well as a cross international approach to facilitate access to new medicines.
Related JoVE Video
Tools for measuring patient safety in primary care settings using the RAND/UCLA appropriateness method.
BMC Fam Pract
PUBLISHED: 02-16-2014
Show Abstract
Hide Abstract
The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcare setting and develop a 'toolkit' of feasible patient safety measures for general practices in England.
Related JoVE Video
Dabigatran - a continuing exemplar case history demonstrating the need for comprehensive models to optimize the utilization of new drugs.
Front Pharmacol
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
There are potential conflicts between authorities and companies to fund new premium priced drugs especially where there are effectiveness, safety and/or budget concerns. Dabigatran, a new oral anticoagulant for the prevention of stroke in patients with non-valvular atrial fibrillation (AF), exemplifies this issue. Whilst new effective treatments are needed, there are issues in the elderly with dabigatran due to variable drug concentrations, no known antidote and dependence on renal elimination. Published studies showed dabigatran to be cost-effective but there are budget concerns given the prevalence of AF. These concerns resulted in extensive activities pre- to post-launch to manage its introduction.
Related JoVE Video
Health-related quality of life and risk factor control: the importance of educational level in prevention of cardiovascular diseases.
Eur J Public Health
PUBLISHED: 09-24-2013
Show Abstract
Hide Abstract
This study aimed to describe and to analyse the importance of educational level for controlled risk factors and health-related quality of life (HRQoL).
Related JoVE Video
Reforms and initiatives in Scotland in recent years to encourage the prescribing of generic drugs, their influence and implications for other countries.
Expert Rev Pharmacoecon Outcomes Res
PUBLISHED: 08-28-2013
Show Abstract
Hide Abstract
Scotland has introduced a number of initiatives to enhance the prescribing of low-cost generic drugs versus originators and patent products in a class where these are seen as similar. The objective of this review is to appraise the influence of the various measures on subsequent utilization patterns and expenditure in high-volume classes to provide guidance. This review is principally a narrative review of published studies. The authors found supply-side measures resulted in generic prices as low as 3% of pre-patent loss prices. Multiple demand-side measures resulted in high international non-proprietary name prescribing, and a considerable increase in prescribing efficiency for the proton pump inhibitors, statins, renin-angiotensin inhibitor drugs and selective serotonin reuptake inhibitors. There were no specific activities encouraging the prescription of losartan versus other angiotensin receptor blockers or risperidone versus other atypical antipsychotic drugs following generics and no change in their utilization patterns post generics. The authors can conclude multiple measures are needed to change physician prescribing habits. Authorities cannot rely on any spillover effects to affect future prescribing, even in closely related classes.
Related JoVE Video
Strategies for reducing potentially avoidable hospitalizations for ambulatory care-sensitive conditions.
Ann Fam Med
PUBLISHED: 07-10-2013
Show Abstract
Hide Abstract
Hospitalizations for ambulatory care-sensitive conditions (ACSCs) are seen as potentially avoidable with optimal primary care. Little is known, however, about how primary care physicians rate these hospitalizations and whether and how they could be avoided. This study explores the complex causality of such hospitalizations from the perspective of primary care physicians.
Related JoVE Video
Are prescribing initiatives readily transferable across classes: the case of generic losartan in Scotland?
Qual Prim Care
PUBLISHED: 06-06-2013
Show Abstract
Hide Abstract
There are on-going initiatives in Scotland to improve the quality and efficiency of prescribing in primary care. Activities to enhance prescribing of angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin receptor blockers (ARBs) include prescribing guidance, guidelines, benchmarking, prescribing targets and financial incentives. These measures stabilised reimbursed expenditure for renin-angiotensin inhibitor drugs between 2001 and 2007 despite a 159% increase in volumes. Generic losartan was included in the Drug Tariff from July 2010. As there is no appreciable difference between ARBs, and the prices of generic losartan are falling, health boards should be actively encouraging its prescribing.
Related JoVE Video
Incidence and predictors of stent thrombosis: a single-centre study of 5,833 consecutive patients undergoing coronary artery stenting.
EuroIntervention
PUBLISHED: 05-21-2013
Show Abstract
Hide Abstract
Stent thrombosis (ST) is an infrequent but potentially fatal complication of PCI. The reported incidence of ST varies from 0-5%, due to differences in definition of ST, inclusion/exclusion criteria, and the type of stent and dual antiplatelet therapy used. We aimed to examine the incidence of ST and associated risk factors in this "real-world, all-comers" study.
Related JoVE Video
Multilevel analysis of the influence of patients and general practitioners characteristics on patented versus multiple-sourced statin prescribing in france.
Appl Health Econ Health Policy
PUBLISHED: 04-24-2013
Show Abstract
Hide Abstract
The French National Health Insurance and the Ministry of Health have introduced multiple reforms in recent years to increase prescribing efficiency. These include guidelines, academic detailing, financial incentives for the prescribing and dispensing of generics drugs as well as a voluntary pay-for-performance programme. However, the quality and efficiency of prescribing could be enhanced potentially if there was better understanding of the dynamics of prescribing behaviour in France.
Related JoVE Video
Practice assistants in primary care in Germany - associations with organizational attributes on job satisfaction.
BMC Fam Pract
PUBLISHED: 04-19-2013
Show Abstract
Hide Abstract
Job satisfaction and organizational attributes in primary care teams are important issues as they affect clinical outcomes and the quality of health care provided. As practice assistants are an integral part of these teams it is important to gain insight into their views on job satisfaction and organizational attributes. The aim of this study was to evaluate the job satisfaction of practice assistants and the organizational attributes within their general practices in Germany and to explore the existence of possible associations.
Related JoVE Video
Job satisfaction of practice assistants in general practice in Germany: an observational study.
Fam Pract
PUBLISHED: 04-19-2013
Show Abstract
Hide Abstract
Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions.
Related JoVE Video
Comparison of physician referral and insurance claims data-based risk prediction as approaches to identify patients for care management in primary care: an observational study.
BMC Fam Pract
PUBLISHED: 04-11-2013
Show Abstract
Hide Abstract
Primary care-based care management (CM) could reduce hospital admissions in high-risk patients. Identification of patients most likely to benefit is needed as resources for CM are limited. This study aimed to compare hospitalization and mortality rates of patients identified for CM either by treating primary care physicians (PCPs) or predictive modelling software for hospitalization risk (PM).
Related JoVE Video
Under-provision of medical care for vascular diseases for people with dementia in primary care: a cross-sectional review.
Br J Gen Pract
PUBLISHED: 04-09-2013
Show Abstract
Hide Abstract
Vascular diseases contribute to the causation and progression of clinical dementia.
Related JoVE Video
Which practice characteristics are associated with the quality of cardiovascular disease prevention in European primary care?
Implement Sci
PUBLISHED: 03-06-2013
Show Abstract
Hide Abstract
Prevention of cardiovascular diseases (CVD) is a major health issue worldwide. Primary care plays an important role in cardiovascular risk management (CVRM). Guidelines and quality of care measures to assess CVRM in primary care practices are available. In this study, we assessed the relationship between structural and organisational practice characteristics and the quality of care provided in individuals at high risk for developing CVD in European primary care.
Related JoVE Video
Precision of individual and composite performance scores: the ideal number of indicators in an indicator set.
Med Care
PUBLISHED: 02-21-2013
Show Abstract
Hide Abstract
In many countries, quality indicators are used to assess the quality of care of family practice. Such assessments need to have an adequate precision, so that the results can be interpreted correctly. However, a small sample size per practitioner can lead to inadequate precision. A possible solution could be to create composite performance scores.
Related JoVE Video
Are family practice trainers and their host practices any better? Comparing practice trainers and non-trainers and their practices.
BMC Fam Pract
PUBLISHED: 02-14-2013
Show Abstract
Hide Abstract
Family Physician (FP) trainees are expected to be provided with high quality training in well organized practice settings. This study examines differences between FP trainers and non-trainers and their practices to see whether there are differences in trainers and non-trainers and in how their practices are organized and their services are delivered.
Related JoVE Video
Personalizing health care: feasibility and future implications.
BMC Med
PUBLISHED: 01-15-2013
Show Abstract
Hide Abstract
Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payers perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients.
Related JoVE Video
Association of SERPINA9 gene variants with carotid artery atherosclerosis: the Atherosclerosis Risk in Communities (ARIC) Carotid MRI Study.
Int J Mol Epidemiol Genet
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
The SNP rs11628722 in the SERPINA9 gene was previously associated with incident ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) study. Centerin, the protein encoded by SERPINA9, is involved in maturation and maintenance of naïve B cells, which play a role in atherogenesis. We investigated whether 21 tag SNPs in the SERPINA9 gene are associated with features of carotid artery atherosclerotic plaque measured by magnetic resonance imaging (MRI). Carotid MRI data were obtained from 1,282 European Americans and 341 African Americans of the ARIC Carotid MRI study, which recruited participants from ARIC by a stratified sampling plan that over-sampled participants with carotid intima-media thickening. Five MRI measures, focused on carotid wall volume, wall thickness, and lipid core, were analyzed. Genetic associations between the MRI measurements and each of the 21 SNPs were analyzed in linear regression models with adjustment for sample weights and traditional risk factors. Rs11628722 was tested a priori. In African Americans, rs11628722 was significantly associated with carotid wall volume (p < 0.05). Among the other 20 SNPs, adjusted for multiple testing, rs4905204, which encodes an Ala to Val amino acid change, was significantly associated with maximum wall thickness (p < 0.000625) and suggestively associated with total wall volume (p < 0.0026) in European Americans. In conclusion, SNPs in the SERPINA9 gene showed race-specific associations with characteristics of carotid atherosclerotic plaques. Replications in other populations are needed to validate findings of this study and to establish the SERPINA9 gene as a candidate in the etiology of carotid atherosclerosis.
Related JoVE Video
Dabigatran - a case history demonstrating the need for comprehensive approaches to optimize the use of new drugs.
Front Pharmacol
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Background: There are potential conflicts between authorities and companies to fund new premium priced drugs especially where there are safety and/or budget concerns. Dabigatran, a new oral anticoagulant for the prevention of stroke in patients with non-valvular atrial fibrillation (AF), exemplifies this issue. Whilst new effective treatments are needed, there are issues in the elderly with dabigatran due to variable drug concentrations, no known antidote and dependence on renal elimination. Published studies have shown dabigatran to be cost-effective but there are budget concerns given the prevalence of AF. There are also issues with potentially re-designing anticoagulant services. This has resulted in activities across countries to better manage its use. Objective: To (i) review authority activities in over 30 countries and regions, (ii) use the findings to develop new models to better manage the entry of new drugs, and (iii) review the implications for all major stakeholder groups. Methodology: Descriptive review and appraisal of activities regarding dabigatran and the development of guidance for groups through an iterative process. Results: There has been a plethora of activities among authorities to manage the prescribing of dabigatran including extensive pre-launch activities, risk sharing arrangements, prescribing restrictions, and monitoring of prescribing post-launch. Reimbursement has been denied in some countries due to concerns with its budget impact and/or excessive bleeding. Development of a new model and future guidance is proposed to better manage the entry of new drugs, centering on three pillars of pre-, peri-, and post-launch activities. Conclusion: Models for introducing new drugs are essential to optimize their prescribing especially where there are concerns. Without such models, new drugs may be withdrawn prematurely and/or struggle for funding.
Related JoVE Video
Evaluating the quality of colorectal cancer care across the interface of healthcare sectors.
PLoS ONE
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Colorectal cancer (CRC) has a high prevalence in western countries. Diagnosis and treatment of CRC is complex and requires multidisciplinary collaboration across the interface of health care sectors. In Germany, a new nationwide established program aims to provide quality information of healthcare delivery across different sectors. Within this context, this study describes the development of a set of quality indicators charting the whole pathway of CRC-care including data specifications that are necessary to operationalize these indicators before practice testing.
Related JoVE Video
Visualizing the drug target landscape.
Drug Discov. Today
PUBLISHED: 12-07-2011
Show Abstract
Hide Abstract
Generating new therapeutic hypotheses for human disease requires the analysis and interpretation of many different experimental datasets. Assembling a holistic picture of the current landscape of drug discovery activity remains a challenge, however, because of the lack of integration between biological, chemical and clinical resources. Although tools designed to tackle the interpretation of individual data types are abundant, systems that bring together multiple elements to directly enable decision making within drug discovery programmes are rare. In this article, we review the path that led to the development of a knowledge system to tackle this problem within our organization and highlight the influences of existing technologies on its development. Central to our approach is the use of visualization to better convey the overall meaning of an integrated set of data including disease association, druggability, competitor intelligence, genomics and text mining. Organizing such data along lines of therapeutic precedence creates clearly distinct zones of pharmaceutical opportunity, ranging from small-molecule repurposing to biotherapeutic prospects and gene family exploitation. Mapping content in this way also provides a visual alerting mechanism that evaluates new evidence in the context of old, reducing information overload by filtering redundant information. In addition, we argue the need for more tools in this space and highlight the role that data standards, new technologies and increased collaboration might have in achieving this aim.
Related JoVE Video
Exploiting the P-1 pocket of BRCT domains toward a structure guided inhibitor design.
ACS Med Chem Lett
PUBLISHED: 11-03-2011
Show Abstract
Hide Abstract
Breast cancer gene 1 carboxy terminus (BRCT) domains are found in a number of proteins that are important for DNA damage response (DDR). The BRCT domains bind phosphorylated proteins and these protein-protein interactions are essential for DDR and DNA repair. High affinity domain specific inhibitors are needed to facilitate the dissection of the protein-protein interactions in the DDR signaling. The BRCT domains of BRCA1 bind phosphorylated protein through a pSXXF consensus recognition motif. We identified a hydrophobic pocket at the P-1 position of the pSXXF binding site. Here we conducted a structure-guided synthesis of peptide analogs with hydrophobic functional groups at the P-1 position. Evaluation of these led to the identification of a peptide mimic 15 with a inhibitory constant (K(i)) of 40 nM for BRCT(BRCA1). Analysis of the TopBP1 and MDC1 BRCT domains suggests a similar approach is viable to design high affinity inhibitors.
Related JoVE Video
An analysis of prosthodontic research productivity: geographic, economic, and collaborative perspective.
J Prosthodont
PUBLISHED: 10-07-2011
Show Abstract
Hide Abstract
This study evaluated the quantity of prosthodontic literature produced globally by continent in three prosthodontic journals over a 10-year period, 1998-2008. Prosthodontic research productivity relative to economic status of countries and collaboration among countries grouped by economic status was assessed.
Related JoVE Video
Solution properties of murine leukemia virus gag protein: differences from HIV-1 gag.
J. Virol.
PUBLISHED: 09-14-2011
Show Abstract
Hide Abstract
Immature retrovirus particles are assembled from the multidomain Gag protein. In these particles, the Gag proteins are arranged radially as elongated rods. We have previously characterized the properties of HIV-1 Gag in solution. In the absence of nucleic acid, HIV-1 Gag displays moderately weak interprotein interactions, existing in monomer-dimer equilibrium. Neutron scattering and hydrodynamic studies suggest that the protein is compact, and biochemical studies indicate that the two ends can approach close in three-dimensional space, implying the need for a significant conformational change during assembly. We now describe the properties of the Gag protein of Moloney murine leukemia virus (MLV), a gammaretrovirus. We found that this protein is very different from HIV-1 Gag: it has much weaker protein-protein interaction and is predominantly monomeric in solution. This has allowed us to study the protein by small-angle X-ray scattering and to build a low-resolution molecular envelope for the protein. We found that MLV Gag is extended in solution, with an axial ratio of ?7, comparable to its dimensions in immature particles. Mutational analysis suggests that runs of prolines in its matrix and p12 domains and the highly charged stretch at the C terminus of its capsid domain all contribute to this extended conformation. These differences between MLV Gag and HIV-1 Gag and their implications for retroviral assembly are discussed.
Related JoVE Video
Research in prosthodontics: a 10-year observation of trends in topics, collaboration, and funding.
Int J Prosthodont
PUBLISHED: 09-13-2011
Show Abstract
Hide Abstract
The objectives of this study were to investigate the nature of recently published prosthodontic literature, to investigate the types of collaboration and funding as well as their relationship, and to analyze the associations between collaboration and extramural funding.
Related JoVE Video
Influence of demand-side measures to enhance renin-angiotensin prescribing efficiency in Europe: implications for the future.
Expert Rev Pharmacoecon Outcomes Res
PUBLISHED: 08-12-2011
Show Abstract
Hide Abstract
European countries strive to enhance prescribing efficiency. This includes renin-angiotensin drugs following the availability of generic angiotensin-converting enzyme inhibitors (ACEIs).
Related JoVE Video
Evaluation of job satisfaction of practice staff and general practitioners: an exploratory study.
BMC Fam Pract
PUBLISHED: 08-02-2011
Show Abstract
Hide Abstract
Primary care teams job satisfaction is an important issue in quality of care. The purpose of our study was to evaluate the job satisfaction of general practitioners (GPs) and non-physician staff and to explore the elements that may impact on overall job satisfaction for GPs and non-physician staff separately.
Related JoVE Video
Development of prescribing-safety indicators for GPs using the RAND Appropriateness Method.
Br J Gen Pract
PUBLISHED: 08-02-2011
Show Abstract
Hide Abstract
In the UK, a process of revalidation is being introduced to allow doctors to demonstrate that they meet current professional standards, are up-to-date, and fit to practise. Given the serious risks to patients from hazardous use of medicines it will be appropriate, as part of the revalidation process, to assess the safety of prescribing by GPs.
Related JoVE Video
Applicability of the Assessment of Chronic Illness Care (ACIC) instrument in Germany resulting in a new questionnaire: questionnaire of chronic illness care in primary care.
BMC Health Serv Res
PUBLISHED: 07-07-2011
Show Abstract
Hide Abstract
The Chronic Care Model (CCM) is an evidence based, population based approach to improve care for people with chronic conditions. The Assessment of Chronic Illness Care (ACIC) instrument is widely used to measure to what extent within a healthcare system the CCM is implemented. The aim of this study was to translate and culturally adapt the ACIC Instrument for the German healthcare system.
Related JoVE Video
Diagnostic triage and the role of natriuretic peptide testing and echocardiography for suspected heart failure: an appropriateness ratings evaluation by UK GPs.
Br J Gen Pract
PUBLISHED: 07-05-2011
Show Abstract
Hide Abstract
Some UK GPs are acquiring access to natriuretic peptide (NP) testing or echocardiography as diagnostic tests for heart failure. This study developed appropriateness ratings for the diagnostic application of these tests in routine general practice.
Related JoVE Video
Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework.
BMJ
PUBLISHED: 06-30-2011
Show Abstract
Hide Abstract
To investigate whether the incentive scheme for UK general practitioners led them to neglect activities not included in the scheme.
Related JoVE Video
Predictors of health-related quality of life in patients at risk for cardiovascular disease in European primary care.
PLoS ONE
PUBLISHED: 06-29-2011
Show Abstract
Hide Abstract
Cardiovascular risk management plays an important role in primary care. In patients at high risk for cardiovascular diseases (CVD) lifestyle and, where appropriate, medical interventions are recommended in guidelines. Health-related quality of life (HRQoL) is an important outcome in clinical practice. This study aimed to assess the HRQoL of this patient group and to investigate the impact of both patients characteristics and practice quality scores on their assessments of HRQoL.
Related JoVE Video
Identifying unintended consequences of quality indicators: a qualitative study.
BMJ Qual Saf
PUBLISHED: 06-21-2011
Show Abstract
Hide Abstract
For the first 5 years of the UK primary care pay for performance scheme, the Quality and Outcomes Framework (QOF), quality indicators were introduced without piloting. However, in 2009, potential new indicators were piloted in a nationally representative sample of practices. This paper describes an in-depth exploration of family physician, nurse and other primary-care practice staff views of the value of piloting with a particular focus on unintended consequences of 13 potential new QOF indicators.
Related JoVE Video
Recording patient preferences for end-of-life care as an incentivized quality indicator: what do general practice staff think?
Palliat Med
PUBLISHED: 06-16-2011
Show Abstract
Hide Abstract
Since April 2009, indicators for the UK Quality and Outcomes Framework pilot have been developed and piloted across a nationally representative sample of practices. In October 2009 a single palliative care indicator was piloted for 6 months that looked at, the percentage of patients on the palliative care register who have a preferred place to receive end-of-life care documented in the records.
Related JoVE Video
Dental student perceptions of predoctoral implant education and plans for providing implant treatment.
J Dent Educ
PUBLISHED: 06-07-2011
Show Abstract
Hide Abstract
This study aims to identify dental students perceptions of pre-patient care laboratory exercises (PCLEs) and clinical experiences that influence their future plans for providing implant care. One of two questionnaires was administered to dental student classes at one dental school (D2: Survey 1; D3 and D4: Survey 2). Future plans as graduates to provide implant diagnosis and treatment planning (DxTP), restoration of single-tooth implants (STIs), and implant-retained overdentures (IODs) were cross-sectionally assessed along with potential influences such as PCLE, clinical experiences, gender, and class. The majority of students planned to provide implant services after graduation (DxTP 68.9 percent; STI 61.2 percent; IOD 62.1 percent). Bivariately, males reflected more preparedness from PCLEs than females (p=.002) and the D2 students more than D3 and D4 students (p<.001). Multivariate models revealed the perceived preparedness from PCLEs generally had the strongest association with future plans for performing implant therapy. However, this varied by gender and class. These findings indicate that PCLEs are important for their influence on students future plans to provide implant therapy. However, further studies are needed to validate actual PCLEs and clinical implant practices (both longitudinally and for other schools) and to determine educational interventions to optimize the provision of implant care.
Related JoVE Video
Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care.
BMC Health Serv Res
PUBLISHED: 04-07-2011
Show Abstract
Hide Abstract
Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD), patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio), we have developed and tested a set of standardized measures, linked to previously developed quality indicators.
Related JoVE Video
Exception reporting in the Quality and Outcomes Framework: views of practice staff - a qualitative study.
Br J Gen Pract
PUBLISHED: 03-29-2011
Show Abstract
Hide Abstract
Exception reporting allows practices to exclude eligible patients from indicators or an entire clinical domain of the Quality and Outcomes Framework (QOF). It is a source of contention, viewed by some as a gaming mechanism.
Related JoVE Video
Primary care characteristics and population-orientated health care across Europe: an observational study.
Br J Gen Pract
PUBLISHED: 03-16-2011
Show Abstract
Hide Abstract
The number of patients with chronic diseases is increasing which poses a challenge to healthcare organisations. A proactive, structured, and population-orientated approach is needed: the chronic care model (CCM) provides such a framework.
Related JoVE Video
Framework and indicator testing protocol for developing and piloting quality indicators for the UK quality and outcomes framework.
BMC Fam Pract
PUBLISHED: 03-14-2011
Show Abstract
Hide Abstract
Quality measures should be subjected to a testing protocol before being used in practice using key attributes such as acceptability, feasibility and reliability, as well as identifying issues derived from actual implementation and unintended consequences. We describe the methodologies and results of an indicator testing protocol (ITP) using data from proposed quality indicators for the United Kingdom Quality and Outcomes Framework (QOF).
Related JoVE Video
Recording of risk-factors and lifestyle counselling in patients at high risk for cardiovascular diseases in European primary care.
Eur J Prev Cardiol
PUBLISHED: 03-04-2011
Show Abstract
Hide Abstract
Detection and registration of high risk for cardiovascular diseases (CVD) by assessing individuals absolute cardiovascular risk is recommended in clinical guidelines. Effective interventions to reduce cardiovascular risk are available, but not optimally implemented. The aim of this study was to assess the quality of cardiovascular risk-factor recording and lifestyle counselling in high-risk patients in European primary care and to identify factors related to these clinical processes.
Related JoVE Video
Association of the platelet GPIIb/IIIa polymorphism with atherosclerotic plaque morphology: the Atherosclerosis Risk in Communities (ARIC) Study.
Atherosclerosis
PUBLISHED: 01-24-2011
Show Abstract
Hide Abstract
Platelet activation and aggregation play an important role in the pathogenesis of cardiovascular disease. We examined the association of a single nucleotide polymorphism (SNP) in the GPIIIa platelet glycoprotein (Leu33Pro) with carotid artery plaque morphology and with expression of platelet markers using data from the Atherosclerosis Risk in Communities (ARIC) Carotid MRI study.
Related JoVE Video
Is the job satisfaction of primary care team members associated with patient satisfaction?
BMJ Qual Saf
PUBLISHED: 01-24-2011
Show Abstract
Hide Abstract
BACKGROUND Previous research has shown a correlation between physician job satisfaction and patient satisfaction with quality of care, but the connection between job satisfaction of other primary care team members and patient satisfaction is yet unclear. OBJECTIVE To evaluate whether there is an association between patient satisfaction and job satisfaction of the members of patient care teams. DESIGN The study was based on data from the European Practice Assessment and used an observational design. SETTING 676 primary care practices in Germany. PARTICIPANTS 47?168 patients, 676 general practitioners (practice principals), 305 physician colleagues (trainees and permanently employed physicians) and 3011 non-physician practice members (nurses, secretaries). MAIN OUTCOME MEASURES Patient evaluation was measured using the 23-item EUROPEP questionnaire. Job satisfaction was measured using the 10-item Warr-Cook-Wall job satisfaction scale and further items relating to practice structure. Bivariate correlations were applied in which factors of patient satisfaction and practice structure were compared with physicians and non-physicians satisfaction. RESULTS Patient satisfaction correlates positively with the general job satisfaction of the non-physician (r=0.25, p<0.01) and no significant correlation was found for the general job satisfaction of practice principals and physician colleagues. Patients satisfaction with the practice organisation correlates positively with the general job satisfaction of the non-physicians (r=0.30, p<0.01) and their view of practice structure (r=0.29, p<0.01). CONCLUSIONS The correlation between non-physician team member satisfaction and patient satisfaction was higher than the correlation between satisfaction of physicians and patients. Patients seem to be sensitive to aspects of practice structure.
Related JoVE Video
Three-year clinical outcomes of implant treatments provided at a predoctoral implant program.
Int J Prosthodont
PUBLISHED: 01-07-2011
Show Abstract
Hide Abstract
The aim of this study was to evaluate the clinical outcomes from a predoctoral implant clinic over 3 years.
Related JoVE Video
Diuretics for hypertension--an inconsistency in primary care prescribing behaviour.
Curr Med Res Opin
PUBLISHED: 01-06-2011
Show Abstract
Hide Abstract
Internationally there is an ongoing debate on diuretics as first-line therapy for most patients with hypertension. In spite of many arguments against them in antihypertensive monotherapy, the authors of the present study perceived them to be regularly prescribed in combination therapy in Germany. The study objective was to look for this discrepancy in prescribing reality as a contribution from clinical practice to an academic debate.
Related JoVE Video
Ten-year longitudinal changes in retinal microvascular lesions: the atherosclerosis risk in communities study.
Ophthalmology
PUBLISHED: 01-03-2011
Show Abstract
Hide Abstract
There are limited data on the natural history and longitudinal changes of retinal microvascular lesions. We examined 10-year changes in retinal microvascular lesions, focusing on those related to hypertension and shown to predict development of cardiovascular disease.
Related JoVE Video
Influences of organizational features of healthcare settings on clinical decision making: qualitative results from a cross-national factorial experiment.
Health (London)
PUBLISHED: 12-22-2010
Show Abstract
Hide Abstract
A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the USA, are discussed.
Related JoVE Video
Changes in patient experiences of primary care during health service reforms in England between 2003 and 2007.
Ann Fam Med
PUBLISHED: 11-10-2010
Show Abstract
Hide Abstract
Major primary care reforms have been introduced in recent years in the United Kingdom, including financial incentives to improve clinical quality and provide more rapid access to care. Little is known about the impact of these changes on patient experience. We examine patient reports of quality of care between 2003 and 2007, including random samples of patients on practice lists and patients with long-term conditions.
Related JoVE Video
Performance of small general practices under the UKs Quality and Outcomes Framework.
Br J Gen Pract
PUBLISHED: 09-21-2010
Show Abstract
Hide Abstract
Small general practices are often perceived to provide worse care than larger practices.
Related JoVE Video
Authorship characteristics in prosthodontic literature: proliferation and internationalization. A review and analysis following a 10-year observation.
J Prosthet Dent
PUBLISHED: 09-04-2010
Show Abstract
Hide Abstract
Author characteristics and the extent of dental literature authorship globalization have not been widely investigated, especially in prosthodontics.
Related JoVE Video
Residents perceptions of implant surgical training in advanced education in prosthodontic programs.
J Prosthodont
PUBLISHED: 08-16-2010
Show Abstract
Hide Abstract
The purpose of this study was to assess residents perspectives on their implant surgical training in Advanced Education in Prosthodontic programs in the United States.
Related JoVE Video
Primary Medical Care Provider Accreditation (PMCPA): pilot evaluation.
Br J Gen Pract
PUBLISHED: 07-03-2010
Show Abstract
Hide Abstract
While practice-level or team accreditation is not new to primary care in the UK and there are organisational indicators in the Quality and Outcomes Framework (QOF) organisational domain, there is no universal system of accreditation of the quality of organisational aspects of care in the UK.
Related JoVE Video
Gender disparities in prosthodontics: authorship and leadership, 13 years of observation.
J Prosthodont
PUBLISHED: 06-22-2010
Show Abstract
Hide Abstract
The purpose of this study was to examine gender disparities in prosthodontics by reviewing the trend of female authorship in prosthodontic journals and exploring the role of female leadership in prosthodontic organizations and Advanced Education in Prosthodontic (AEP) programs.
Related JoVE Video
Developing Quality and Outcomes Framework (QOF) indicators and the concept of QOFability.
Qual Prim Care
PUBLISHED: 06-10-2010
Show Abstract
Hide Abstract
This paper explains the reasons and context behind the introduction of the Quality and Outcomes Framework (QOF) in the UK in April 2004. The QOF is a pay-for-performance scheme covering a range of clinical and organisational areas in primary care. In 2004, 52% of the framework related to clinical care, increasing to 66% in 2006 and 70% in 2009. From April 2009, the National Institute for Health and Clinical Excellence (NICE) has led a new process for developing the clinical QOF indicators. Clinical areas are now prioritised by an advisory committee appointed by NICE; the QOF indicators then undergo a formal consensus procedure followed by piloting in representative practices across England. However, what are the attributes of a good QOF indicator and how do these differ from those of a good quality indicator, such as validity and sensitivity to change? This paper describes the concept of QOFability, which relates to why some areas are, and others are not, prioritised for the QOF. Factors include the prevalence of the clinical issue, the accuracy of data extraction from GP clinical systems, the clarity of diagnosis, the relevance of incentivised actions, the direct attribution to all primary care staff and consideration of any possible unintended consequences of introducing any given indicator. The paper concludes by considering the future direction of the QOF, recommending a focus on creating feasible, valid, reliable and piloted QOFable clinical indicators.
Related JoVE Video
The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.
BMJ
PUBLISHED: 05-13-2010
Show Abstract
Hide Abstract
To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California.
Related JoVE Video
Implementing pay-for-performance in Australian primary care: lessons from the United Kingdom and the United States.
Med. J. Aust.
PUBLISHED: 05-06-2010
Show Abstract
Hide Abstract
We identify key lessons learned from the international experience of pay-for-performance and use them to formulate questions for Australia to consider before such a scheme is introduced. Discussion of lessons learned is based on a narrative review of the literature. We examined international evidence on factors to consider when designing pay-for-performance schemes, and the impact of these schemes on primary care practitioner behaviour and on primary care funding. Pay-for-performance schemes evolve over time, and usually involve several complex interventions including accreditation, education, quality improvement programs, investment in information technology and data collection systems, professional support and regional structures. These are all necessary conditions for linking financial incentives to quality of care. There is a strong argument for changing the existing service incentive payments program and investing the resources into revised outcome payments that provide rewards for annual improvements in numbers of patients receiving completed cycles of care. If pay-for-performance is to be introduced in Australia, several key lessons should be learned from the experiences of other countries. Pay-for-performance should be used as part of a wider strategy for quality improvement; it should not be seen as a panacea. Pay-for-performance should be used to drive quality improvement, not simply to reward those who are already providing high-quality care.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.