بایگانی برچسب برای: Intervention

Intervention.Effectiveness.Research.Quality.Improvement.[taliem.ir]

Intervention Effectiveness Research: Quality Improvement and Program Evaluation

This book is intended to be a practical guide designed for those who are embarking on a journey of demonstrating care quality and outcomes the at the intersection of research and practice, alternatively described as intervention effectiveness research, quality improvement activities, and program evaluation. We acknowledge that in this space are dynamically interacting factors that affect all health outcomes at the individual, family, community, and system levels. These factors range from the genome to the political and include physical and mental characteristics as well as social processes within and external to the individual and the health system . Efforts to understand the effectiveness of interventions or programs in relationship to social and behavioral factors will beneft from taking a high-level look at problems in the broad context of population and setting, and taking into account the diversity of intervention factors known to be effcacious for the population . This perspective is conceptualized in the Problem-Intervention-Outcome Meta-Model (PIO MM) described in Chapter 2. Transcending the differences among various worldviews of research, quality improvement, and evaluation allows us to think more clearly about the fundamental concepts and realize our potential to study and act to improve population health.
Cases.in.Structural.Cardiac.Intervention..[taliem.ir]

Cases in Structural Cardiac Intervention

Structural heart disease intervention is a major area of development in cardiology. A desire to minimise the invasiveness of interventions and reduce patient exposure to risk have been the main drivers in developing catheter-based intervention in preference to open-heart surgery. Over the past 9 years, transcatheter aortic valve implantation (TAVI) has become the standard treatment for patients deemed inoperable or high risk for conventional aortic valve replacement, with evidence of its potential in those at intermediate risk. Mitral valve interventions are also moving forward in development. Percutaneous balloon mitral valvuloplasty (BMV) is a catheter-based technique that achieves commisurotomy in the context of pliable mitral stenosis in patients with rheumatic heart disease and has replaced surgery as the favoured approach. BMV also has an important role in patients with signifcant mitral stenosis during pregnancy. Percutaneous mitral valve repair encompasses several catheter-based techniques to either diminish annular dilatation or correct poor mitral valve leaflet coaptation in patients with severe mitral regurgitation at too high risk for conventional surgical mitral valve repair or replacement. In patients who have undergone previous cardiac surgery and valve replacement, paravalvular regurgitation may occur following detachment of the surgical valve ring through stitch failure, wear and tear or after endocarditis. The risk of re-do valve replacement surgery is high and may be prohibitive, leading to a preference for an initial catheter-based strategy of plugging residual gaps external to the sewing ring in order to obtain valve competence.