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https://www.readbyqxmd.com/read/28175979/mind-the-treatment-gap-a-global-perspective-on-current-and-future-strategies-for-prevention-of-fragility-fractures
#1
REVIEW
N C W Harvey, E V McCloskey, P J Mitchell, B Dawson-Hughes, D D Pierroz, J-Y Reginster, R Rizzoli, C Cooper, J A Kanis
This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into four distinct themes: (1) case finding and management of individuals at high risk of fracture, (2) public awareness of osteoporosis and fragility fractures, (3) reimbursement and health system policy and (4) epidemiology of fracture in the developing world. Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits, are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all...
February 7, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28173918/rural-and-regional-community-health-service-boards-perceptions-of-community-health-a-delphi-study
#2
Diana Guzys, Guinever Threlkeld, Virginia Dickson-Swift, Amanda Kenny
Much has been written about the composition of health service boards and the importance of recruiting people with skills appropriate for effective and accountable governance of health services. Governance training aims to educate directors on their governance responsibilities; however, the way in which these responsibilities are discharged is informed by board members' understanding of health within their communities. The aim of this study was to identify how those engaged in determining the strategic direction of local regional or rural community health services in Victoria, Australia, perceived the health and health improvement needs of their community...
February 8, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28173749/testing-a-systematic-approach-to-identify-and-prioritise-barriers-to-successful-implementation-of-a-complex-healthcare-intervention
#3
Louise E Craig, Leonid Churilov, Liudmyla Olenko, Dominique A Cadilhac, Rohan Grimley, Simeon Dale, Cintia Martinez-Garduno, Elizabeth McInnes, Julie Considine, Jeremy M Grimshaw, Sandy Middleton
BACKGROUND: Multiple barriers may inhibit the adoption of clinical interventions and impede successful implementation. Use of standardised methods to prioritise barriers to target when selecting implementation interventions is an understudied area of implementation research. The aim of this study was to describe a method to identify and prioritise barriers to the implementation of clinical practice elements which were used to inform the development of the T(3) trial implementation intervention (Triage, Treatment [thrombolysis administration; monitoring and management of temperature, blood glucose levels, and swallowing difficulties] and Transfer of stroke patients from Emergency Departments [ED])...
February 7, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28159063/-i-don-t-eat-when-i-m-sick-older-people-s-food-and-mealtime-experiences-in-hospital
#4
Kelti Hope, Maree Ferguson, Dianne P Reidlinger, Ekta Agarwal
BACKGROUND: Inadequate dietary intake is a common problem amongst older acute-care patients and has been identified as an independent risk factor for in-hospital mortality. This study aimed to explore whether food and mealtime experiences contribute to inadequate dietary intake in older people during hospitalisation. METHODS: This was a qualitative phenomenological study, data for which were collected using semi-structured interviews over a three-week period. During this time, 26 patients aged 65 years or more, admitted to medical and surgical wards in a tertiary acute-care hospital, were asked to participate if they were observed to eat less than half of the meal offered at lunch...
March 2017: Maturitas
https://www.readbyqxmd.com/read/28134008/prioritising-patient-care
#5
Helge Skirbekk, Marit Helene Hem, Per Nortvedt
BACKGROUND: There is little research comparing clinicians' and managers' views on priority settings in the healthcare services. During research on two different qualitative research projects on healthcare prioritisations, we found a striking difference on how hospital executive managers and clinical healthcare professionals talked about and understood prioritisations. AIM: The purpose of this study is to explore how healthcare professionals in mental healthcare and somatic medicine prioritise their care, to compare different ways of setting priorities among managers and clinicians and to explore how moral dilemmas are balanced and reconciled...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28132010/patient-preferences-knowledge-and-beliefs-about-kidney-allocation-qualitative-findings-from-the-uk-wide-attom-programme
#6
Andrea Gibbons, Marco Cinnirella, Janet Bayfield, Diana Wu, Heather Draper, Rachel J Johnson, Charles R V Tomson, John L R Forsythe, Wendy Metcalfe, Damian Fogarty, Paul Roderick, Rommel Ravanan, Gabriel C Oniscu, Christopher J E Watson, J Andrew Bradley, Clare Bradley
OBJECTIVE: To explore how patients who are wait-listed for or who have received a kidney transplant understand the current UK kidney allocation system, and their views on ways to allocate kidneys in the future. DESIGN: Qualitative study using semistructured interviews and thematic analysis based on a pragmatic approach. PARTICIPANTS: 10 deceased-donor kidney transplant recipients, 10 live-donor kidney transplant recipients, 12 participants currently wait-listed for a kidney transplant and 4 participants whose kidney transplant failed...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28130505/a-national-evaluation-using-standardised-patient-actors-to-assess-sti-services-in-public-sector-clinical-sentinel-surveillance-facilities-in-south-africa
#7
Pamela K Kohler, Eva Marumo, Suzanne L Jed, Gladys Mema, Sean Galagan, Kenneth Tapia, Erushka Pillay, Julia DeKadt, Evasen Naidoo, Julia C Dombrowski, King K Holmes
OBJECTIVES: Quality concerns in STI service delivery and missed opportunities for integration with HIV testing and prevention services in South Africa have been well documented. This national evaluation aimed to evaluate current utilisation and adherence to national STI guidelines, including partner notification and integration with HIV services, for diagnosis and management of STIs. METHODS: Facility surveys assessed infrastructure and resource availability, and standardised patient (SP) assessments evaluated quality of STI care in 50 public clinics in nine provinces in South Africa...
January 27, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28118847/the-humanistic-and-economic-burden-of-chronic-wounds-a-protocol-for-a-systematic-review
#8
Krister Järbrink, Gao Ni, Henrik Sönnergren, Artur Schmidtchen, Caroline Pang, Ram Bajpai, Josip Car
BACKGROUND: Chronic non-healing wounds present a substantial economic burden to healthcare system; significant reductions in quality of life for those affected, and precede often serious events such as limp amputations or even premature deaths. This burden is also likely to increase with a larger proportion of elderly and increasing prevalence of life-style diseases such as obesity and diabetes. Reviews of the evidence on the burden of illness associated with chronic wounds have not been comprehensive in scope and have not provided an assessment of the distribution of the health care costs across categories of resource use...
January 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28089082/backcasting-to-identify-food-waste-prevention-and-mitigation-opportunities-for-infant-feeding-in-maternity-services
#9
Yvonne Ryan-Fogarty, Genevieve Becker, Richard Moles, Bernadette O'Regan
Food waste in hospitals is of major concern for two reasons: one, healthcare needs to move toward preventative and demand led models for sustainability and two, food system sustainability needs to seek preventative measures such as diet adaptation and waste prevention. The impact of breast-milk substitute use on health services are well established in literature in terms of healthcare implications, cost and resourcing, however as a food demand and waste management issue little has been published to date. This paper presents the use of a desk based backcasting method to analyse food waste prevention, mitigation and management options within the Irish Maternity Service...
January 6, 2017: Waste Management
https://www.readbyqxmd.com/read/28086812/person-centred-care-in-chronic-kidney-disease-a-cross-sectional-study-of-patients-desires-for-self-management-support
#10
Kathryn Havas, Clint Douglas, Ann Bonner
BACKGROUND: People with chronic kidney disease (CKD) must self-manage their illness to assist with slowing disease-progression, but this is a complex task requiring support from healthcare professionals. Despite the established importance of person-centred care, people with CKD are rarely consulted regarding their desires for self-management support (SMS). METHODS: A cross-sectional survey was conducted face-to-face in a Queensland primary care clinic and distributed Australia-wide via an online interface promoted by Kidney Health Australia during 2015...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28057389/-priority-setting-of-health-interventions-review-of-criteria-approaches-and-role-of-assessment-agencies
#11
Leonor Varela-Lema, Gerardo Atienza-Merino, Marisa López-García
OBJECTIVE: This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting. METHOD: An exhaustive review of the literature was carried out. For this purpose, a search of the main biomedical databases was performed and assessment agency websites were reviewed, among other sources...
January 2, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28032429/under-treatment-of-type-2-diabetes-causes-and-outcomes-of-clinical-inertia
#12
REVIEW
Clifford J Bailey
AIMS: To assess the impact of clinical inertia on type 2 diabetes (T2D) care. METHODS: PubMed database search from January 2000 until December 2015. RESULTS: Clinical inertia, defined as resistance to initiate or intensify treatment in a patient not at the evidence-based glycated haemoglobin goal, is conservatively estimated to occur in at least 25% of patients with T2D. Consequently, many patients with diagnosed and treated T2D experience extended periods, in some cases years, of ineffectively controlled hyperglycaemia, potentially causing serious microvascular and macrovascular harm...
December 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28031208/perception-of-first-respiratory-infection-with-pseudomonas-aeruginosa-by-people-with-cystic-fibrosis-and-those-close-to-them-an-online-qualitative-study
#13
Sally C Palser, Oliver C Rayner, Paul A Leighton, Alan R Smyth
BACKGROUND: People with cystic fibrosis (CF) are susceptible to respiratory infection with Pseudomonas aeruginosa (PA), which may become chronic if initial eradication fails. Environmental acquisition and person-to-person transmission can occur. Respiratory PA infection is associated with increased mortality and more hospitalisations. This may cause patients and families anxiety and lead them to adopt preventive measures which may be ineffectual and intrusive. It is not possible to hold a conventional focus group to explore these issues because people with CF cannot meet together due to the risk of cross-infection...
December 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/28025848/the-influence-of-anglo-american-theoretical-models-on-the-evolution-of-the-nursing-discipline-in-spain
#14
Olga Rodrigo, Jordi Caïs, Cristina Monforte-Royo
In Spain, the introduction of the new Diploma in Nursing in 1977 saw the role of nurses shifting from that of medical assistants with technical skills to being independent members of the healthcare team with specific responsibility for providing professional nursing care. Here, we analyse the evolution of the nursing profession in Spain following the transfer of nurse education to universities, doing so through interviews with the first generation of academic tutors. This was a qualitative study using the method of analytic induction and based on the principles of grounded theory...
December 26, 2016: Nursing Inquiry
https://www.readbyqxmd.com/read/27965851/prioritising-wheelchair-services-for-children-a-pilot-discrete-choice-experiment-to-understand-how-child-wheelchair-users-and-their-parents-prioritise-different-attributes-of-wheelchair-services
#15
Nathan Bray, Seow Tien Yeo, Jane Noyes, Nigel Harris, Rhiannon Tudor Edwards
BACKGROUND: Approximately 95 million children worldwide are disabled; 10 % use a wheelchair. In the UK, an estimated 770,000 children are disabled. National Health Service Wheelchair Services are the largest provider of wheelchairs in the UK; however, recent reports have highlighted issues with these services. This study explores the use of discrete choice experiment methods to inform wheelchair service provision for disabled children based on service user preferences. The aim was to explore how disabled children and their parents prioritise different attributes of wheelchair services...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27933181/what-are-the-pros-and-cons-of-electronically-monitoring-inhaler-use-in-asthma-a-multistakeholder-perspective
#16
Sam Howard, Alexandra Lang, Sarah Sharples, Dominick Shaw
INTRODUCTION: Electronic monitoring devices (EMDs) are the optimal method for collecting objective data on inhaler use in asthma. Recent research has investigated the attitudes of patients with asthma towards these devices. However, no research to date has formally considered the opinions of stakeholders and decision-makers in asthma care. These individuals have important clinical requirements that need to be taken into account if EMDs are to be successfully provisioned, making collecting their opinions on the key barriers facing these devices a valuable process...
2016: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/27931242/achieving-good-outcomes-for-asthma-living-goal-mixed-methods-feasibility-and-pilot-cluster-randomised-controlled-trial-of-a-practical-intervention-for-eliciting-setting-and-achieving-goals-for-adults-with-asthma
#17
Gaylor Hoskins, Brian Williams, Purva Abhyankar, Peter Donnan, Edward Duncan, Hilary Pinnock, Marjon van der Pol, Petra Rauchhaus, Anne Taylor, Aziz Sheikh
BACKGROUND: Despite being a core component of self-management, goal setting is rarely used in routine care. We piloted a primary care, nurse-led intervention called Achieving Good Outcomes for Asthma Living (GOAL) for adults with asthma. Patients were invited to identify and prioritise their goals in preparation for discussing and negotiating an action/coping plan with the nurse at a routine asthma review. METHODS: The 18-month mixed methods feasibility cluster pilot trial stratified and then randomised practices to deliver usual care (UC) or a goal-setting intervention (GOAL)...
December 8, 2016: Trials
https://www.readbyqxmd.com/read/27927657/building-capacity-to-use-and-undertake-research-in-health-organisations-a-survey-of-training-needs-and-priorities-among-staff
#18
Helen Barratt, Naomi J Fulop
OBJECTIVES: Efforts to improve healthcare and population health depend partly on the ability of health organisations to use research knowledge and participate in its production. We report the findings of a survey conducted to prioritise training needs among healthcare and public health staff, in relation to the production and implementation of research, across an applied health research collaboration. DESIGN: A questionnaire survey using a validated tool, the Hennessy-Hicks Training Needs Assessment Questionnaire...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27916749/inequalities-in-receipt-of-mental-and-physical-healthcare-in-people-with-dementia-in-the-uk
#19
Claudia Cooper, Rebecca Lodwick, Kate Walters, Rosalind Raine, Jill Manthorpe, Steve Iliffe, Irene Petersen
BACKGROUND: UK Dementia Strategies prioritise fair access to mental and physical healthcare. We investigated whether there are inequalities by deprivation or gender in healthcare received by people with dementia, and compared healthcare received by people with and without dementia. METHODS: we investigated primary care records of 68,061 community dwelling dementia patients and 259,337 people without dementia (2002-13). We tested hypotheses that people with dementia from more deprived areas, and who are women receive more psychotropic medication, fewer surgery consultations, are less likely to receive annual blood pressure, weight monitoring and an annual review, compared with those from less deprived areas and men...
December 4, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27886946/building-multidisciplinary-health-workforce-capacity-to-support-the-implementation-of-integrated-people-centred-models-of-care-for-musculoskeletal-health
#20
REVIEW
M J Chehade, T K Gill, D Kopansky-Giles, L Schuwirth, J Karnon, P McLiesh, J Alleyne, A D Woolf
To address the burden of musculoskeletal (MSK) conditions, a competent health workforce is required to support the implementation of MSK models of care. Funding is required to create employment positions with resources for service delivery and training a fit-for-purpose workforce. Training should be aligned to define "entrustable professional activities", and include collaborative skills appropriate to integrated and people-centred care and supported by shared education resources. Greater emphasis on educating MSK healthcare workers as effective trainers of peers, students and patients is required...
June 2016: Best Practice & Research. Clinical Rheumatology
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