Version brève du DISCERN, une voie d'amélioration de la recherche d'information médicale sur le net [Brief-DISCERN, a possible way to improve patient's search on the health-related web]

Internet is increasingly used as a source of information on health issues and is probably a major source of patients' empowerment. This process is however limited by the frequently poor quality of web-based health information designed for consumers. A better diffusion of information about criteria defining the quality of the content of websites, and about useful methods designed for searching such needed information, could be particularly useful to patients and their relatives. A brief, six-items DISCERN version, characterized by a high specificity for detecting websites with good or very good content quality was recently developed. This tool could facilitate the identification of high-quality information on the web by patients and may improve the empowerment process initiated by the development of the health-related web.

Do brief alcohol motivational interventions work like we think they do?

BACKGROUND: Questions remain about how brief motivational interventions (BMIs) for unhealthy alcohol use work, and addressing these questions may be important for improving their efficacy. Therefore, we assessed the effects of various characteristics of BMIs on drinking outcomes across 3 randomized controlled trials (RCTs). METHODS: Audio recordings of 314 BMIs were coded. We used the global rating scales of the Motivational Interviewing Skills Code (MISC) 2.1: counselor's acceptance, empathy, and motivational interviewing (MI) spirit, and patient's self-exploration were rated. MI proficiency was defined as counselor's rating scale scores ≥5. We also used the structure, confrontation, and advice subscale scores of the Therapy Process Rating Scale and the Working Alliance Inventory. We examined these process characteristics in interventions across 1 U.S. RCT of middle-aged medical inpatients with unhealthy alcohol use (n = 124) and 2 Swiss RCTs of young men with binge drinking in a nonclinical setting: Swiss-one (n = 62) and Swiss-two (n = 128). We assessed the associations between these characteristics and drinks/d reported by participants 3 to 6 months after study entry. RESULTS: In all 3 RCTs, mean MISC counselor's rating scales scores were consistent with MI proficiency. In overdispersed Poisson regression models, most BMI characteristics were not significantly associated with drinks/d in follow-up. In the U.S. RCT, confrontation and self-exploration were associated with more drinking. Giving advice was significantly associated with less drinking in the Swiss-one RCT. Contrary to expectations, MI spirit was not consistently associated with drinking across studies. CONCLUSIONS: Across different populations and settings, intervention characteristics viewed as central to efficacious BMIs were neither robust nor consistent predictors of drinking outcome. Although there may be alternative reasons why the level of MI processes was not predictive of outcomes in these studies (limited variability in scores), efforts to understand what makes BMIs efficacious may require attention to factors beyond intervention process characteristics typically examined.

The effect of patient, provider and financing regulations on the intensity of ambulatory physical therapy episodes : a multilevel analysis based on routinely available data

Background: Many studies have found considerable variations in the resource intensity of physical therapy episodes. Although they have identified several patient-and provider-related factors, few studies have examined their relative explanatory power. We sought to quantify the contribution of patients and providers to these differences and examine how effective Swiss regulations are (nine-session ceiling per prescription and bonus for first treatments). Methods: Our sample consisted of 87,866 first physical therapy episodes performed by 3,365 physiotherapists based on referrals by 6,131 physicians. We modeled the number of visits per episode using a multilevel log linear regression with crossed random effects for physiotherapists and physicians and with fixed effects for cantons. The three-level explanatory variables were patient, physiotherapist and physician characteristics. Results: The median number of sessions was nine (interquartile range 6-13). Physical therapy use increased with age, women, higher health care costs, lower deductibles, surgery and specific conditions. Use rose with the share of nine-session episodes among physiotherapists or physicians, but fell with the share of new treatments. Geographical area had no influence. Most of the variance was explained at the patient level, but the available factors explained only 4% thereof. Physiotherapists and physicians explained only 6% and 5% respectively of the variance, although the available factors explained most of this variance. Regulations were the most powerful factors. Conclusion: Against the backdrop of abundant physical therapy supply, Swiss financial regulations did not restrict utilization. Given that patient-related factors explained most of the variance, this group should be subject to closer scrutiny. Moreover, further research is needed on the determinants of patient demand.

Cope with Confidence - survey of heart failure patient experience

Your views matter - if you have heart failure, or are close to someone who does, please complete our survey by 31st�March 2012 (link below).Heart failure is a common condition affecting at least 20,000 people in Northern Ireland. The aim of this survey is to find out how to increase the confidence of people living with heart failure so they have a better quality of life, and can work in partnership with health care professionals and support services in managing their condition. The findings of this survey will be used to help improve services.Your views are important and we would encourage you to complete the survey. It should only take around 20 minutes. Participation is confidential which means that your identity will not be revealed. You are asked for your age, the first part of you post code and which GP practice you are registered with. This is so the results for different age groups and for different large geographical areas (i.e. Health & Social Care Trust areas) can be compared.� Results will not be examined by individual GP practice.Participation is voluntary i.e. taking part in the study is your decision. Whether you participate or not will have no effect on the medical care you receive from your GP practice or elsewhere. None of the health care professionals involved in your care will know if you participate or not: neither will they see your individual response.Whether you are an adult or a young person living with heart failure, or a partner, care giver, son, daughter, relative or friend, we would like you to share your experiences. This will help us to develop existing services in Northern Ireland to better meet your needs.You can share your experience by completing the survey online, clicking this�link:�http://sg.sensemaker-suite.com/CopewithconfidenceThe survey should be completed by 31st�March 2012.�If you have any queries about the survey, or you would like to request a paper copy to complete, please contact the Public Health Agency (028) 9032 1313 and ask for extension 2487 or email us at copewithconfidence@hscni.netPlease note that the survey team can only assist in survey related questions and will not able to answer questions about heart failure, its treatment or services provided.The Northern Ireland Chest Heart & Stroke Association and The British Heart Foundation can provide information about support available to people with heart failure. Their contact details are:.�Northern Ireland Chest Heart and Stroke Association:� www.nichsa.com, telephone (028) 9032 0184.�British Heart Foundation:� www.bhf.org.uk, telephone 0300 330 3311

Patient Client Experience Standards

Patient Experience is a recognised component of high quality care_. Within the six Health and Social Care Trusts, there is a comprehensive programme of work in place to support the implementation of the Patient and Client Experience standards. Trusts are required to submit quarterly progress reports to the Public Health Agency (PHA) and Health and Social Care Board (HSCB). This report sets out the key findings and highlights the key actions arising from the findings.�

10,000 Voices: Improving the patient experience

Patient experience is recognised as a key element in the delivery of quality healthcare. In line with this, the Public Health Agency (PHA) is carrying out an extensive piece of work across all Health and Social Care Trusts (HSCTs), with the aim of introducing a more patient-focused approach to services and shaping future healthcare in Northern Ireland. This project, called '10,000 Voices', gives patients, as well as their families and carers, the opportunity to share their overall experience and highlight anything important, such as what they particularly liked or disliked about the experience. This leaflet gives participants the information they need before taking part in '10,000 Voices' and answers questions about confidentiality and information sharing.

Patient and Client Experience Annual Report 2012-2013

The Patient and Client Experience Annual Report 2012-13 demonstrates that although healthcare is often highly pressurised, all Health and Social Care (HSC) Trusts are ensuring that patient experience remains a priority.The report provides an analysis of the patient and client monitoring including evidence-based statements from patients; highlights areas of good practice within each of the HSC Trusts and outlines areas where further improvements are required to enhance the experience of patients and clients.The comprehensive programme of work undertaken by the six HSC Trusts in conjunction with the HSC Board and PHA to support the implementation of the Patient Client Experience Standards demonstrates a commitment to learn and an assurance to act upon the experience of patients and clients locally and regionally.

Splenectomy patient leaflet

This leaflet is for patients who have no functioning spleen. It explains their condition and outlines some important information that patients with no functioning spleen need to know.�

Concurrent infection with dengue virus type-2 and DENV-3 in a patient from Ceará, Brazil

Dengue outbreaks have occurred in several regions in Brazil and cocirculating dengue virus type 1 (DENV-1), DENV-2, and DENV-3 have been frequently observed. Dual infection by DENV-2 and DENV-3 was identified by type-specific indirect immunofluorescence assay and confirmed by reverse transcription polymerase chain reaction in a patient in Ceará with a mild disease. This is the first documented case of simultaneous infection with DENV-2 and DENV-3 in Brazil. Sequencing confirmed DENV-2 and DENV-3 (South-East/American) genotype III and (SriLanka/India), genotype III respectively.

Hepatitis C - what now? Patient results factsheet (English and 6 translations)

Factsheet for patients who have tested positive for the hepatitis C virus.

Prevention of Venous Thromboembolism: A Key Patient Safety Priority

Prevention of venous thromboembolism (VTE) is an important part of our strategy to improve patient safety.The Northern Ireland HSC Safety Forum established and facilitated a regional collaborative which developed a single VTE Risk Assessment Tool for N.Ireland.

What happens in the Emergency Department-A patient's guide

A guide for people who have self-harmed or may have mental health/emotional problems

Carbapenemase Producing Enterobacteriaceae/Carbapenemase Producing Organism (CPE/CPO) Patient Information leaflet

Information for patients and visitors on�Carbapenemase Producing Enterobacteriaceae/Carbapenemase Producing Organism (CPE/CPO)