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Emergency Medical Services Outcomes Project (EMSOP) II: Developing the foundation and conceptual models for out-of-hospital outcomes research

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ANNALS OF EMERGENCY MEDICINE 2001年第6期37卷 657-663页

作者： Spaite, DW Maio, R Garrison, HG Desmond, JS Gregor, MA Stiell, IG Cayten, CG Chew, JL MacKenzie, EJ Miller, DR O'Malley, PJ Univ Arizona Coll Med Div Emergency Med Arizona Emergency Med Res Ctr Tucson AZ USA Univ Michigan Med Ctr Dept Emergency Med Ann Arbor MI 48109 USA E Carolina Univ Brody Sch Med Dept Emergency Med Greenville NC 27834 USA Univ Ottawa Div Emergency Med Ottawa ON Canada Univ Ottawa Loeb Hlth Res Inst Ottawa ON Canada New York Med Coll Inst Trauma & Emergency Care Valhalla NY 10595 USA EMSSTAR Grp Annapolis MD USA Johns Hopkins Univ Sch Hyg & Publ Hlth Baltimore MD USA Hlth Span Transportat Serv St Paul MN USA Allina Hlth Syst St Paul MN USA Massachusetts Gen Hosp Pediat Emergency Serv Boston MA 02114 USA Massachusetts Dept Publ Hlth Emergency Med Serv Children Boston MA USA

Development of methodologically acceptable outcomes models for emergency medical services (EMS) is long overdue. In this article, the Emergency Medical Services Outcomes Project proposes a conceptual framework that will provide a foundation for future EMS outcomes research. The "Episode of Care Model" and the "Out-of-Hospital Unit of Service Model" are presented. The Episode of Care Model is useful in conditions in which interventions and outcomes, especially survival and major physiologic dysfunction, are linked in a time-dependent manner. Conditions such as severe trauma, anaphylaxis, airway obstruction, respiratory arrest, and nontraumatic cardiac arrest are amenable to this methodology. The Out-of-Hospital Unit of Service Model is essentially a subunit of the Episode of Care Model. it is valuable for evaluating conditions that have minimal-to-moderate therapeutic time dependency. This model should be used when studying outcomes limited to the out-of-hospital interval. An example of this is pain management for injuries sustained in motor vehicle crashes. These models can be applied to a wide spectrum of conditions and interventions. With the scrutiny of health care expenditures ever increasing, the identification of clinical interventions that objectively improve patient outcome takes on growing importance. Therefore, the development, dissemination, and use of meaningful methodologies for EMS outcomes research is key to the future of EMS system development and maintenance.

关键词：出院后医疗/组织和管理急救医疗服务/组织和管理治疗过程片断卫生工作重点卫生服务研究/组织和管理模型组织管理年患病率结果评价(卫生保健)/组织和管理规划制订/方法研究设计/标准风险调节/组织和管理存活率分析时间因素美国/流行病学人类

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Introduction: Community action research and the prevention of alcohol problems at the local level

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SUBSTANCE USE & MISUSE 2000年第1-2期35卷 1-10页

作者： Allamani, A Casswell, S Graham, K Holder, HD Holmila, M Larsson, S Nygaard, P Florence Hlth Agcy Alcohol Ctr Florence Italy Univ Auckland Alcohol & Publ Hlth Res Unit Auckland New Zealand Addict Res Fdn London England Prevent Res Ctr Berkeley CA USA STAKES Social Res Unit Alcohol Studies Helsinki Finland Univ Lund Malmo Sweden Aarhus Univ Ctr Alcohol & Drug Res Aarhus Denmark

Many community action projects from around the world exist to reduce alcohol problems at the local level. The role of research within this international movement is discussed within this introduction for the entire special issue on community action research in alcohol problem prevention. Previous community prevention programs have utilized a variety of prevention strategies: (a) an educational approach which focuses on changing behavior through changes in knowledge, attitudes, and information;and (b) an environmental approach which focuses on changing behavior through changes in the social and economic systems within a community. Many projects have used both approaches. This special issue provides a current overview of many types of community action projects from different countries and summarizes what has been learned to date from these experiences.

关键词：酒精中毒/预防和控制用户参与/方法健康教育/组织和管理健康知识态度实践卫生服务研究/组织和管理组织目标社会环境人类

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Research Priorities Project, year 2000: Establishing a direction for infection control and hospital epidemiology

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AMERICAN JOURNAL OF INFECTION CONTROL 2001年第2期29卷 73-78页

作者： Lynch, P Jackson, M Saint, S Epidemiol Associates Seattle WA USA Univ Calif San Diego Med Ctr Dept Educ Dev & Res San Diego CA 92103 USA Univ Michigan Sch Med Ann Arbor MI USA

Background: The field called "infection control" has expanded beyond hospitals to include many health care locations, some aspects of personnel health, elements of noninfectious complications, and occasionally the epidemiology of other problems that occur in care facilities. A research agenda that addresses these newer segments and provides a framework for answering fundamental questions is essential for the field and for the work of The Research Foundation for Prevention of Complications Associated with Health Care (formerly APIC Research Foundation). Methods: We used a multiple-round iterative consensus process (Delphi technique) with 50 experts and a validation round among participants at the 4th Decennial Conference. Results: The expert panel reduced 102 separate items to 21 high-ranked research priorities. The highest-ranked subject areas involved research to improve compliance 4 with excellent practices, to study antibiotic usage and resistance, to measure the financial impact of complications and value of interventions, to perform surveillance of infectious and noninfectious complications across the spectrum of care delivery, and to study effectiveness of interventions to prevent complications at specific sites. There were differences in education and discipline between the expert panel and the 4th Decennial participants and with respect to ranking some of the individual priorities Among respondents from outside the United States and Canada, occupational health issues were ranked more highly. Conclusions: The research priorities provide a blueprint for future progress and will require a collaborative, multicenter, multinational approach.

关键词：医务工作者的态度费用效益分析德尔菲技术流行病学/组织和管理预测基金会/组织和管理卫生工作重点卫生服务研究/组织和管理感染控制/组织和管理需求估价/组织和管理组织目标研究设计全面质量管理/组织和管理成年人老年人人类中年人

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COMMUNITY COALITIONS FOR PREVENTION AND HEALTH PROMOTION

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HEALTH EDUCATION RESEARCH 1993年第3期8卷 315-330页

作者： BUTTERFOSS, FD GOODMAN, RM WANDERSMAN, A UNIV S CAROLINA SCH PUBL HLTHDEPT HLTH PROMOT & EDUCCOLUMBIASC 29208 UNIV S CAROLINA DEPT PSYCHOLCOLUMBIASC 29208

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CORRELATES OF COALITION EFFECTIVENESS - THE SMOKE-FREE CLASS OF 2000 PROGRAM

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HEALTH EDUCATION RESEARCH 1993年第3期8卷 375-384页

作者： GOTTLIEB, NH BRINK, SG GINGISS, PL HLTHMARK ASSOCIATES WASHINGTONDC 20009 UNIV HOUSTON DEPT HLTH & HUMAN PERFORMANCEHOUSTONTX 77204

Fifty state and local coalitions that carry out the Smoke Free Class of 2000 program of the American Cancer Society, American Heart Association and American Lung Association were surveyed in 1990. Almost all (95%) rated themselves moderately or very active and a total of 88 900 second grade teachers were estimated to have received the materials. The availability of funds, competing priorities, tack of coordination, differences in agency service areas and personnel availability were most frequently cited as areas of concern to the coalitions. Personnel barriers and formality of coalition structure were independently related to perceived coalition effectiveness and, with the number of elementary schools, to perceived coalition activity. General recommendations, that were accepted upon completion of the assessment, included (1) formalization of agreements, mission statements, and goals and objectives, (2) attention to group formation and identification, and (3) clarification of national coalition expectations.

关键词：数据收集/方法卫生保健联合体/组织和管理健康教育卫生服务研究/组织和管理预防卫生服务/组织和管理方案评价戒烟美国志愿卫生机构人类

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Prevention research in field settings: a guide for practitioners

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Prevention in Human Services 1983年第3期2卷 31-48页

作者： Hermalin, Jared A. Weirich, Thomas W. John F. Kennedy CMHC Hahnemann University Philadelphia PA 19102 112 N. Broad Street United States

The need for research in prevention has never been greater, while the support for such research is declining. A partnership between prevention practitioners and researchers is recommended. To play an active role in this resource network practitioners must learn more about the applied research process. This paper describes the major phases of that process and discusses the decisions which practitioners must make at each research step. The paper makes recommendations for conducting research on a shoestring budget and emphasizes special problems encountered in field settings. © 1983 by The Haworth Press, Inc. All rights reserved.

关键词：卫生服务研究/组织和管理预防卫生服务研究设计美国

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Speaking in tongues: integrating economics and psychology into health and mental health services outcomes research.

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Medical care review 1992年第2期49卷 191-231页

作者： Phillips, K.A. Rosenblatt, A. Center for AIDS Prevention Studies University of California Francisco San94105. United States

Examines the role of psychology and economics in mental and health care services. Indepth look at the integration of psychology in health services; Examples of the potential integration of economics in mental health s... 详细信息

关键词：选择行为经济学卫生服务研究/经济学卫生服务研究/方法卫生服务研究/组织和管理健康状况人类职业间关系精神卫生服务/经济学结果评价(卫生保健)/经济学结果评价(卫生保健)/方法心理学研究设计研究人员专门化治疗结果美国

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Health education in Africa: 1975-2000

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HEALTH EDUCATION RESEARCH 2000年第4期15卷 383-391页

作者： Brieger, WR Adeniyi, JD Parker, KA Oladepo, O Univ Ibadan Coll Med African Reg Hlth Educ Ctr Ibadan Nigeria Univ Ibadan Coll Med African Reg Hlth Educ Ctr Ibadan Nigeria

The past 25 years of health education in Africa has experienced the growth of indigenous health education service, training and research programmes and activities. Research in Africa and by Africans has provided a bas... 详细信息

关键词：非洲健康教育/组织和管理健康教育/发展趋势卫生人员/教育卫生服务研究/组织和管理在职培训/组织和管理

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Midwifery care research: What questions are being asked? What lessons have been learned?

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JOURNAL OF MIDWIFERY & WOMENS HEALTH 2000年第1期45卷 20-36页

作者： Raisler, J Columbia Univ Nurse Midwifery Educ Program New York NY 10027 USA

Purpose: To create and critically evaluate a research database about midwifery care that identifies topics studied, research methods, results, funding, publication data, and implications for a future midwifery research agenda. Methods: Systematic literature review. Studies included were 1) data-based research;2) about midwifery care or practice;3) in the United States;and 4) published between 1984-1998. nle CINAHL and MEDLINE electronic databases were searched using a defined strategy, and relevant journals and bibliographies were searched by hand. Results: This 15-year review identified 140 studies of midwifery care published in 161 papers. A midwife was the lead author on 60%. Sixty percent were published in the Journal of Nurse-Midwifery. Six to 15 studies were published each year, and both the number of publications and funding increased over the time period. The six major areas of focus were: 1) midwifery management, 2) structure of care, 3) midwifery practice, 4) midwife-physician comparisons, 5) place of birth, and 6) care of vulnerable populations. Discussion: Although retrospective descriptive studies still predominate, more prospective studies, randomized controlled trials, multi-site studies, and quasi-experimental designs are being conducted. Qualitative methods are helping to measure nontraditional outcomes. A research agenda should be established based on discussion and debate within the profession. Midwife investigators need to build research teams and collaborate with other disciplines. Key areas for future research include alternative therapies, breastfeeding, cost-effectiveness, cultural studies, gynecology, health policy, menopause, post partum care, substance abuse interventions, and the woman's experience of birth and midwifery care. (C) 2000 by the American College of Nurse-Midwives.

关键词：数据收集卫生服务研究/组织和管理卫生服务研究/发展趋势助产学研究设计女(雌)性人类妊娠

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Focus group positioning and analysis: A commentary on adjuncts for enhancing the design of health care research

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Health Marketing Quarterly 1990年第1-2期7卷 153-168页

作者： Johnson, Brett C. Hospital Group Division National Medical Enterprises Inc. Santa Monica CA 20404 United States

A health care competition increases, and as the penalities for making poor decisions become potentially more devastating, market research continues to play an increasingly important role in the decision-making process for hospitals. Concern over the appropriate use of market research and the costs related to it remains high. As such, efficiency in research design and clarity in research outcome are clearly the goals. This paper examines the focus group process and its adjunctive role in enhancing the overall design of health care market research. Specifically, the function and placement of focus groups within the research plan as well as several methods of creative focus group analysis are considered within the context of an effective research design. © 1990 Taylor & Francis Group, LLC.

关键词：数据收集/方法决策组织卫生服务研究/组织和管理医院管理/方法卫生服务使用研究/方法模型理论同侪集群规划技术研究设计美国

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