Methods to derive composite indicators used for quality and safety measurement and monitoring in healthcare: a scoping review protocol.

Introduction: Composite indicators of quality and safety in healthcare summarise performance across multiple indicators into a single performance measure. Composite indicators can identify domains and drivers of quality, improve the ability to detect differences, aid prioritisation for quality improvement and facilitate decision making about future healthcare needs. However, the use of composite indicators can be controversial, particularly when used to rank healthcare providers.

Electronic Health Record Prompt to Improve Lung Cancer Screening in Primary Care.

Introduction: Lung cancer is the leading cause of cancer death in the U.S. Combusted tobacco use, the primary risk factor, accounts for 90% of all lung cancers.

23 y/o female with dysphagia--Evaluation, intervention and resolution of symptoms in the Psychiatry consultation setting.

Dysphagia is a symptom shared by many medical and psychiatric conditions. A thorough Psychiatric evaluation could rule in a functional or psychological etiology. If a Psychological etiology is identified, a psychodynamic formulation could help the consultation psychiatrist clarify the origin of the symptom and provide a better explanation to the patient and medical team, resulting in improved care by prevention of unnecessary medical interventions, improvement of symptoms and individualization of the treatment.

Supporting the use of evidence in community nursing: a national strategic approach.

While there is an acceptance across all stakeholders that nursing practice should be informed by evidence, there is a substantial literature on the challenges this creates for nurses in the delivery of services. These challenges are accentuated for nurses in community settings, where accessible, up-to-date research evidence is more problematic because of the decentralised organisation and delivery of these services. Recognising this gap, and the consequent needs of its members, the Institute of Community Health Nursing (ICHN) in Ireland has commenced a national strategic development in this area.

Standards for gynecologic surgery.

There are significant problems to consider when we reflect on "Standards for Gynecologic Surgery." Surely most professional standards are already in place, or are they? Are standards already available, locally, nationally, or internationally? Where those standards are not already available will it be possible set new standards for the multiplicity of operative interventions, performed by an array of trainees, specialists, and colleagues many of whom are outside of our remit and spread over the continents? If we do set standards how do we audit outcomes to gynecologic surgery and insure that the standards are being complied with? How do we tutor our trainees effectively and also insure that established specialists retain their skill base, are up-to-date, and compliant with continuing medical education? It is important to realize that the success or failure of a modern surgical investigation or procedure will now be judged not on the pure surgical outcome alone, but will also need to reflect patient focus through excellence in the areas of communication, patient information, informed consent and confidentiality. The accessibility to services, appropriate environment, and processes being offered by trained and competent staff members-who are supervised when required-should all be included in audits of outcomes set against agreed auditable standards.

Language and the bicultural dialectical self.

We examined the effect of language priming on naïve dialecticism, with special attention paid to effects on dialectical beliefs about the self. European Americans responding in English and bilingual Chinese responding in either Chinese or English completed several measures designed to tap dialectical thinking and dialectical self-perceptions, including tolerance of contradiction, change in thoughts and behavior over time and context, holistic beliefs, and self-concept inconsistency. As expected, those answering in Chinese reported greater dialecticism on most of these measures, relative to those responding in English.

Higher titers of some H5N1 and recent human H1N1 and H3N2 influenza viruses in Mv1 Lu vs. MDCK cells.

Background: The infectivity of influenza A viruses can differ among the various primary cells and continuous cell lines used for such measurements. Over many years, we observed that all things equal, the cytopathic effects caused by influenza A subtype H1N1, H3N2, and H5N1 viruses were often detected earlier in a mink lung epithelial cell line (Mv1 Lu) than in MDCK cells. We asked whether virus yields as measured by the 50% tissue culture infectious dose and plaque forming titer also differed in MDCK and Mv1 Lu cells infected by the same influenza virus subtypes.