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Purpose: This scoping review sought to describe how primary care teams including audiologists and speech-language pathologists (S-LPs), embody well-functioning system properties, within the Theory of Systems Change.
Materials And Methods: This review was completed in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis. MEDLINE, Cochrane Central Register of Controlled Trials, Embase and Embase Classic, APA PsycInfo, CINAHL, Scopus, and Web of Science databases were searched for articles focusing on (1) audiologists and S-LPs and (2) primary care teams. Retrieved articles then underwent a screening and extraction process.
Results: Forty-six studies were identified. Considering the components of the Theory of Systems Change, all studies demonstrated evidence-driven action and learning. Forty-two studies discussed adaptation strategies to external challenges. Teams aligned their work with micro, meso, macro, and mega system level considerations. Collaboration occurred through team meetings, information technology, care coordination, role clarification and negotiation, and joint care delivery.
Conclusions: Bridging systems level and clinical theories can provide better context to advocate for the integration of these two professions into primary care teams. Audiologists and S-LPs enable patient/family participation which allows healthcare providers to gather the necessary information through communication focused care that can effectively integrate clinical and systems level frameworks.
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http://dx.doi.org/10.1080/09638288.2025.2546559 | DOI Listing |
JAMA
September 2025
Division of Surgery and Interventional Science, UCL, London, United Kingdom.
Importance: Multiparametric magnetic resonance imaging (MRI), with or without prostate biopsy, has become the standard of care for diagnosing clinically significant prostate cancer. Resource capacity limits widespread adoption. Biparametric MRI, which omits the gadolinium contrast sequence, is a shorter and cheaper alternative offering time-saving capacity gains for health systems globally.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Oncostat U1018, Institut National de la Santé et de la Recherche Médicale (INSERM), Ligue Contre le Cancer, Paris-Saclay University, Villejuif, France.
Importance: Antibiotics, steroids, and proton pump inhibitors (PPIs) are suspected to decrease the efficacy of immunotherapy.
Objective: To explore the association of comedications with overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC).
Design, Setting, And Participants: This nationwide retrospective cohort study used target trial emulations of patients newly diagnosed with NSCLC from January 2015 to December 2022, identified from the French national health care database.
JAMA Netw Open
September 2025
Harvard Medical School, Boston, Massachusetts.
Importance: Research in behavioral economics has demonstrated that people have irrational biases, which make them susceptible to decisional shortcuts, or heuristics. The extent to which physicians consciously might use nudges to exploit these heuristics and thereby influence their patients' decision-making is unclear. In addition, ethical questions about the conscious use of nudges in medicine persist, yet little is known about how physicians experience and perceive their use.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Importance: Lower survival rates among Black adults relative to White adults after in-hospital cardiac arrest are well-described, but these findings have not been consistently replicated in pediatric studies.
Objective: To use a large, national, population-based inpatient database to evaluate the associations between in-hospital mortality in children receiving cardiopulmonary resuscitation (CPR) and patient race or ethnicity, patient insurance status, and the treating hospital's proportion of Black and publicly insured patients.
Design, Setting, And Participants: This retrospective population-based cohort study used the Healthcare Cost and Utilization Project Kids' Inpatient Database (1997-2019 triennial versions).
JAMA Netw Open
September 2025
Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Importance: Survivors of critical illness often have ongoing issues that affect functioning, including driving ability.
Objective: To examine whether intensive care unit (ICU) delirium is independently associated with long-term changes in driving behaviors.
Design, Setting, And Participants: This multicenter, longitudinal cohort study included 151 survivors of critical illness residing within 200 miles of Nashville, Tennessee.