Self-reported Priorities Research Articles

Priorities for health outcomes in glaucoma in an ethnically diverse UK cohort: an observational study

ObjectivesTo assess whether patients from minority ethnic groups have different perceptions about the quality-of-life outcomes that matter most to them.DesignCross-sectional observational study.SettingHigh volume eye centres serving the most ethnically diverse...

Priorities for paediatric critical care research: a modified Delphi study by the Australian and New Zealand Intensive Care Society Paediatric Study Group

Objective: Most interventions in paediatric critical care lack high grade evidence. We aimed to identify the key research priorities and key clinical outcome measures pertinent to research in paediatric intensive care patients. Design: Modified three-stage Delphi study combining staged online surveys, followed by a face-to-face discussion and final voting. Setting: Paediatric intensive care units in Australia and New Zealand. Participants: Medical and nursing staff working in intensive care. Main outcome measurements: Self-reported priorities for research. Results: 193 respondents provided a total of 267 research questions and 234 outcomes. In Stage 3, the top 56 research questions and 50 outcomes were discussed face to face, which allowed the identification of the top 20 research questions with the Hanlon prioritisation score and the top 20 outcomes. Topics centred on the use of intravenous fluids (restrictive v liberal fluids, use of fluid resuscitation bolus, early inotrope use, type of intravenous fluid, and assessment of fluid responsiveness), and patient- and family-centred outcomes (health-related quality of life, liberation) emerged as priorities. While mortality, length of stay, and organ support/organ dysfunction were considered important and the most feasible outcomes, long term quality of life and neurodevelopmental measures were rated highly in terms of their importance. Conclusions: Using a modified Delphi method, this study provides guidance towards prioritisation of research topics in paediatric critical care in Australia and New Zealand, and identifies study outcomes of key relevance to clinicians and experts in the field.

COVID-19 and the Radiology Match: A Residency Program's Survival Guide to the Virtual Interview Season

COVID-19 and the Radiology Match: A Residency Program's Survival Guide to the Virtual Interview Season

Adaptation to climate change in Afghanistan: Evidence on the impact of external interventions

Climate change is a significant obstacle for farmers in the least developed countries like Afghanistan and adaptation support is exceptionally scarce. This paper provides evidence on the impact of the agriculture-related external support on farmers’ adaptation to climate change in the Central Highlands of Afghanistan. To this end, we collected primary data from 1434 farmers whom we interviewed across 14 districts in Bamiyan, Ghazni, and Diakundi provinces. We employ quasi-experimental econometric methods, including an endogenous switching regression analysis, to estimate the treatment effects on various adaptation-related outcomes. We find significant impacts of support interventions on the use of improved types of seeds and farmers’ access to irrigation water. Further impacts on the risk of flood, economic and financial as well as government and institutional adaptation constraints appear to be significant, but sensitive to the existence of unobserved factors. We conclude that farmers perceived changes in the climate, and most of them tried to adapt by employing measures available to them. The impact of external support has been partially effective in addressing immediate and short-term farming challenges related to climate change and extreme weather events. They, however, have not been effective in treating long-term fundamental climate change-related risks. Based on our analysis of the past treatments and farmers’ self-reported priorities, we provide a list of policy recommendations for adaptation to climate change in farming communities in Afghanistan.

ABS-SmartPriority: An Agent-Based Simulator of Strategies for Managing Self-Reported Priorities in Smart Cities

Smart cities still need the appropriate tools for allowing researchers to contribute in this growing field that will change the comfort and qualities of live of citizens. Smart cities can provide services such as informing of the less overcrowded tourist routes, path-finding for avoiding traffic jams, search services for parking, collecting tree branches from streets, and the finding of the nearest available public electric bicycles or cars. The levels of urgencies differ from some situations to others. Examples of urgent matters are the fast transportation critical patients and the removal of obstacles in main roads. Since smart cities are meant to manage huge amounts of requests, priorities should be automated and managed in a flexible way for new scenarios. Smart cities may need citizens to report the service priorities. However, citizens may have different criteria and could abuse the highest priority levels hindering the service performance for really urgent matters. A novel agent-based simulation open-source framework is proposed for testing different policies for normalizing and controlling self-reported priorities, with its simulator called ABS-SmartPriority. This approach is illustrated by simulating two different policies, in which the smart policy outperformed the one used as the control mechanism.

Applicants' Self-Reported Priorities in Selecting a Residency Program.

Residency recruitment is a high-stakes activity for all participants, yet there is limited information about how applicants choose among programs. This study evaluated the importance applicants place on various residency program attributes; whether applicant priorities vary by sex, race/ethnicity, or specialty choice; and whether the importance of these factors changes over time. Highly ranked applicants to residency programs at 2 academic medical centers were surveyed annually from 2004 to 2012 regarding the importance of 26 characteristics in selecting a program. Mean ratings of importance for each factor were analyzed to assess priority for the overall applicant group, and whether priorities differed for subgroups (by sex, race/ethnicity, and specialty). Of 9669 applicants surveyed, 6285 (65%) responded. The 5 factors with highest rating of importance (overall and across all subgroups) were the program's ability to prepare residents for future training or position, resident esprit de corps, faculty availability and involvement in teaching, depth and breadth of faculty, and variety of patients and clinical resources. Small but significant differences in the ratings of some factors by sex and/or specialty group were identified. Institution-level characteristics, such as call rooms, salary, and benefits, were relatively unimportant. Applicant priorities were stable over the 9-year study period. Highly ranked applicants to competitive residency programs value educational aspects of the program most highly, along with resident morale. Top factors were consistent across subgroups and over the 9years of the study. These findings have implications for resident recruitment strategies.

Changes in Self-Identified Priorities, Competencies, and Values of Recently Homeless Adults with Psychiatric Disabilities

This study examined changes in self-reported priorities, competencies, and values in 73 previously homeless people with psychiatric disabilities who participated in a life skills intervention. Participants living in emergency or single-room occupancy housing enrolled in curriculum modules to increase residential stability (room and self-care, money management, nutrition management, or safe community participation) and completed the occupational self-assessment at baseline, postintervention, and 3 and 6 months later to examine change over time. Mean competency and value ratings and frequency of priorities were compared by time point, as well as between types of housing and primary diagnosis. Managing finances, a place to live, and self-care were consistently rated high in value and as top priorities. At baseline and post-intervention, participants rated themselves more competent on items related to meeting basic needs, however increased competency for more difficult items was observed over time. Individual...

‘With age comes wisdom almost always too late’: older adults’ experiences of T2DM

AbstractBackground: This article describes the results of qualitative work aiming to highlight and understand the experiences of older adults who have lived with type 2 diabetes (T2DM) for approximately 20 years.Methods: Twenty-eight participants (mean age, 70 years) were interviewed using a triangulated research design of in-depth, semistructured interviews, two quantitative questionnaires and the main findings from theoretical frameworks on chronic illness literature. One of the questions that the study sought to address was the advice that participants would give to a person newly diagnosed with T2DM, thereby determining self-reported priorities in the illness trajectory. The research analysis was grounded within an interpretative paradigm with emphasis on a life course approach.Results: Several themes emerged; denial and acceptance were inherent in these older adults’ experiences of being diagnosed with diabetes, as was the need to fight the illness rather than let it take control of their lives. The ...

Self-reported priorities and resources of academic emergency physicians for the maintenance of clinical competence: a pilot study

Medical licensing bodies and professional colleges require their members to maintain a broad spectrum of knowledge, skills and attitudes, which, when taken together, define a competent emergency physician (EP). The objectives of this pilot study were: 1) to determine the resources used by academic EPs to maintain competence and 2) to determine academic EPs' learning priorities. Using a modified Dillman method, we surveyed EPs from 2 Canadian academic tertiary health sciences centres. Thirty-seven (68.5%) of 54 EPs responded. Of those responding, 14 (37.8%) attended grand rounds 3 times or more annually, and 34 (91.7%) attended a medical conference or course at least once annually. Thirty-three (89.2%) respondents read journal articles at least once monthly, with 22 (59.5%) of those reading synopses of original articles. Twenty-three (62.1%) received clinical updates via email, and 11 (29.7%) subscribed to an audio journal or podcast of reviews of original research. Among the CanMEDS roles, Medical Expert, Scholar and Manager were selected as top professional development priorities by more than one-third of respondents. The topics that were not selected as priorities by respondents included patient communication and charting (Communicator); conflict resolution skills and teamwork abilities (Collaborator); advocate for patient and promote health in emergency department populations (Health Advocate) and ethical conflict resolution (Professional). The results of this pilot study suggest that in order to maintain clinical competence in emergency medicine, traditional formats of professional development (e.g., grand rounds, print media and original research) are being substituted for independent study, online media and reviews of original research. This study also suggests a strong preference for Medical Expert topics, while Professional, Health Advocate, Collaborator and Communicator topics are not a reported priority for professional development.

Patient priorities and needs for diabetes care among urban African American adults.

This study was conducted to determine diabetes care priorities and needs in a group of urban African American adults with type 2 diabetes mellitus. One hundred nineteen African American adults with type 2 diabetes, aged 35 to 75, received behavioral/educational interventions from a nurse case manager, a community health worker, or both. Priorities and needs were assessed during 3 intervention visits. The most frequently reported priorities for diabetes care were glucose self-monitoring (61%), medication adherence (47%), and healthy eating (36%). The most frequently addressed diabetes needs were glucose self-monitoring and medication adherence. Most of the intervention visits (77%) addressed non-diabetes-related health issues such as cardiovascular disease (36%) and social issues such as family responsibilities (30%). Participants' self-reported priorities for diabetes care directly reflected the diabetes needs addressed. Needs beyond the focus of traditional diabetes care (social issues and insurance) are important to address in urban African Americans with type 2 diabetes. Interventions designed to address comprehensive health and social needs should be included in treatment and educational plans for this population.