Objective To explore what information sources medical specialists currently use to inform their medical decision-making.Design Qualitative, semistructured interviews.Setting and participants A... Show moreObjective To explore what information sources medical specialists currently use to inform their medical decision-making.Design Qualitative, semistructured interviews.Setting and participants A total of 20 semistructured interviews were conducted with 10 surgeons and 10 internal medicine specialists who work in academic and/or regional hospitals in the Netherlands.Results Medical specialists reported that they primarily rely on their general knowledge and experience, rather than actively using information sources. The sources they use to update their knowledge can be categorised into 'scientific publications', 'guidelines or protocols', and 'presentations and meetings'. When medical specialists feel their general knowledge and experience are insufficient, they use three different approaches to find answers in response to clinical questions: consulting a colleague, actively searching the literature and asking someone else to search the literature.Conclusion Medical specialists use information sources to update their general knowledge and to find answers to specific clinical questions when they feel their general knowledge and experience are insufficient. An important finding is that medical specialists prefer accessible information sources (eg, consulting colleagues) over existing evidence-based medicine tools. Show less
Holst, M. van der; Steenbeek, D.; Pondaag, W.; Nelissen, R.G.H.H.; Vlieland, T.P.M.V. 2020
To investigate health-care use (HCU) and information needs of children aged 0-18 years with neonatal brachial plexus palsy (NBPP), a cross-sectional study was performed. Patients and/or parents... Show moreTo investigate health-care use (HCU) and information needs of children aged 0-18 years with neonatal brachial plexus palsy (NBPP), a cross-sectional study was performed. Patients and/or parents seen in our NBPP clinic were invited to complete a survey comprising questions on HCU due to NBPP and current information needs. Outcomes were described for three age-groups (0-1/2-9/10-18 years), based on follow-up status (early/late/no-discharge). Four hundred sixty-five parents/patients participated (59 in the 0-1, 226 in the 2-9, and 180 in the 10-18-year group). Two hundred ninety-three patients had C5-C6 lesions, 193 were discharged from follow-up, 83 of whom categorized as 'early discharged' (<1 year of age). Over the past year, 198 patients had contact with the expert team (49 in the 0-1, 81 in the 2-9, and 68 in the 10-18-year group) and 288 with at least one other health-care professional (53 in the 0-1, 133 in the 2-9, and 102 in the 10-18-year group). Of the 83 patients discharged early, 34 reported health-care use. Two hundred twenty-eight participants reported current information needs of whom 23 were discharged early. HCU and information needs of Dutch children with NBPP remains considerable even in children who were discharged. Stricter follow-up and information provision for these patients is needed. Show less
Ce rapport présente un aperçu de la littérature sur la démocratisation en Afrique au sud du Sahara (1989-1992). D'abord, les auteurs évoquent un certain nombre de traits dominants de la vie... Show moreCe rapport présente un aperçu de la littérature sur la démocratisation en Afrique au sud du Sahara (1989-1992). D'abord, les auteurs évoquent un certain nombre de traits dominants de la vie politique en Afrique qui forment l'arrière-plan nécessaire à comprendre les changements actuels concernant la démocratisation. Ensuite ils résument le débat scientifique sur la démocratie en Afrique dans la période 1960-1989, qui a ses racines dans les mouvements d'indépendance et se concentre sur l'échec des modèles Westminster/Élysée. Ils décrivent les arguments tels qu'ils ont été employés pour légitimer l'État à parti unique et, finalement, l'État sans parti. Au cours des années 70 on s'inquiéta de la répression grandissante et de l'évolution stagnante dans les pays africains. Ce n'est qu'au cours des années 80 que l'attention se tourna vers la société civile. Dans le contexte économique et politique radicalement changé à la fin des années 80, on attache une plus grande valeur à la démocratie. La question fondamentale de savoir si la démocratie est un concept universel ou purement occidental, et les différentes définitions de la démocratie, ont conduit à des discussions sur l'État et la société civile, la fonction du multipartisme dans la démocratisation, "good governance", la démocratie et le droit et la démocratie et le développement. Finalement, les auteurs font le bilan du processus de démocratisation actuel en Afrique. Show less
