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Isobel E M Evans, David J Llewellyn, Fiona E Matthews, Robert T Woods, Carol Brayne, Linda Clare
There is evidence to suggest that social isolation is associated with poor cognitive health, although findings are contradictory. One reason for inconsistency in reported findings may be a lack of consideration of underlying mechanisms that could influence this relationship. Cognitive reserve is a theoretical concept that may account for the role of social isolation and its association with cognitive outcomes in later life. Therefore, we aimed to examine the relationship between social isolation and cognition in later life, and to consider the role of cognitive reserve in this relationship...
2018: PloS One
Abby L Gold, Keith Bennett, Rick J Jansen, Amy R Mobley, Sandra B Procter, Carol Smathers, Dawn Contreras, Paula Peters, Ann Keim, Renee Oscarson
This research examines the practice of community coaching within coalitions in the Communities Preventing Childhood Obesity project. A quasi-experimental design was used in seven Midwestern states. Each state selected two rural, low-income communities with functioning health coalitions. Coalitions were randomly assigned to be intervention or comparison communities. After 4 years of the coaching intervention, ripple effect mapping served as one method for examining the coalitions' work that may affect children's weight status...
August 17, 2018: Health Promotion Practice
Samantha Husbands, Susan Jowett, Pelham Barton, Joanna Coast
INTRODUCTION: Decision-analytic models play an essential role in informing healthcare resource allocation decisions; however, their value to decision makers will depend on model structures being clinically valid to determine cost-effectiveness recommendations. Clinician involvement can help modellers to develop clinically valid but straightforward structures; however, there is little guidance available on methods for clinician input to model structure. This study aims to provide an in-depth exploration of clinician involvement in structural development, highlighting key issues and generating recommendations to optimise practices...
August 17, 2018: PharmacoEconomics
Nora E Mueller, Trishan Panch, Cathaleene Macias, Bruce M Cohen, Dost Ongur, Justin T Baker
BACKGROUND: Management of severe and persistent mental illness is a complex, resource-intensive challenge for individuals, their families, treaters, and the health care system at large. Community-based rehabilitation, in which peer specialists provide support for individuals managing their own condition, has demonstrated effectiveness but has only been implemented in specialty centers. It remains unclear how the peer-based community rehabilitation model could be expanded, given that it requires significant resources to both establish and maintain...
August 15, 2018: JMIR Mental Health
Roberta Heale, Simone Dahrouge, Sharon Johnston, Joan E Tranmer
Nurse practitioners (NPs) in Ontario work in a number of settings, including physician-led, interprofessional Family Health Teams (FHTs). However, many aspects of NP practice within the FHTs are unknown. Our study aimed to describe the characteristics of NP practice in FHTs and the relationships between NPs and physicians within this model. This cross-sectional descriptive study analyzed NP service and diagnostic code data collected for every NP patient encounter from 2012 to 2015. Encounter data were linked to health administrative data housed at the Institute for Clinical Evaluative Sciences to allow for comparison with physician service and diagnostic codes...
August 15, 2018: Policy, Politics & Nursing Practice
James Milford, Michael R Strasser, Christine A Sinsky
An experimental care delivery model shows how staffing and role adjustments can enrich the health care experience for patients, staff, and physicians.
August 2018: Journal of Family Practice
N C Stefanis, V Mavreas, Ι Νimatoudis, F Gourzis, Μ Sarakouri, A Vgontzas, A Douzenis
The disorders of the psychosis spectrum, with the most severe being schizophrenia, are prevalent and have a great impact on the patients' quality of life. The purpose of this article is to highlight the need for a novel national strategic approach to the management of psychotic disorders in accordance with the international principles of early intervention. Even though outpatient treatment is considered adequate, there is an urgent need to adopt an early and more comprehensive and effective intervention strategy for young patients with psychosis and their families whose clinical and personal needs are clearly not met by the existing infrastructure of our mental health services...
April 2018: Psychiatrikē, Psychiatriki
R Ryan Reyes, Gavin Parker, Stephanie Garies, Cheryl Dolan, Susan Gerber, Beverly Burton, Tracy Burton, Jeff Brockmann, Rebecca Miyagishima, Neil Drummond
OBJECTIVE: To explore clinical indicators among patients with diabetes in southern Alberta and assess changes over time, and to compare patients with diabetes attending a reference clinic (RC), which had adapted its service model to address the specific needs of the patient population, with patients with diabetes attending comparison clinics (CCs) in the same region. DESIGN: Analysis of longitudinal data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN)...
August 2018: Canadian Family Physician Médecin de Famille Canadien
Paula Tookey, Kate Mason, Jennifer Broad, Marty Behm, Lise Bondy, Jeff Powis
BACKGROUND: Despite the integration of peer workers into harm reduction services, there is little documentation regarding the experience of this integration or of models in which peers are fully integrated as members of health care teams. The purpose of this study was to gain an in-depth understanding of the transition from client to support worker from the perspective of two individuals who received treatment for hepatitis C at a multi-disciplinary, community-based program, grounded in a harm reduction approach to substance use...
August 14, 2018: Harm Reduction Journal
Rachel McKittrick, Rosemary McKenzie
The Australian Government Health Care Homes (HCH) model recently implemented in general practice targets people with chronic complex conditions. Identifying how general practitioners (GPs) and practice nurses (PNs) can work within this model is important given existing health workforce challenges. A narrative review and synthesis has been undertaken to develop a preliminary understanding of this, incorporating literature describing health workforce challenges, GP and PN functions, and team-based care; supplemented by interviews with key informants from within the primary healthcare system...
August 14, 2018: Australian Journal of Primary Health
Andrea L Araujo Navas, Ricardo J Soares Magalhães, Frank Osei, Raffy Jay C Fornillos, Lydia R Leonardo, Alfred Stein
BACKGROUND: Spatial modelling studies of schistosomiasis (SCH) are now commonplace. Covariate values are commonly extracted at survey locations, where infection does not always take place, resulting in an unknown positional exposure mismatch. The present research aims to: (i) describe the nature of the positional exposure mismatch in modelling SCH helminth infections; (ii) delineate exposure areas to correct for such positional mismatch; and (iii) validate exposure areas using human positive cases...
August 13, 2018: Parasites & Vectors
Wiesława Dominika Wranik, Susan Marie Haydt
BACKGROUND: Primary care in Canada is the first point of entry for patients needing specialized services, the fundamental source of care for those living with chronic illness, and the main supplier of preventive services. Increased pressures on the system lead to changes such as an increased reliance on interdisciplinary teams, which are advocated to have numerous advantages. The functioning of teams largely depends on inter-professional relationships that can be supported or strained by the financial arrangements within teams...
August 13, 2018: Human Resources for Health
Cora Janzen, Josh Marko, Michael Schwandt
BACKGROUND: Population health approaches are visible among multidisciplinary methods used in urban design and planning, but attention to health equity is not always an explicit focus. Population and Public Health-Saskatoon Health Region recognized the need for frameworks to prioritize, integrate and measure health equity within local built environments. SETTING: A cross-department healthy built environment (HBE) initiative coordinated activities involving Health Promotion, Environmental Public Health, Public Health Observatory, and Medical Health Officers engaged with municipal, academic and community partners in Saskatoon, Saskatchewan...
August 10, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Justine Orr, Charles N Bernstein, Lesley A Graff, Scott B Patten, James M Bolton, Jitender Sareen, James J Marriott, John D Fisk, Ruth Ann Marrie
BACKGROUND: Within the multiple sclerosis (MS) population, depression and anxiety are highly prevalent comorbidities that are associated with adverse outcomes such as diminished quality of life and disability progression. In the general population, many people who do not meet formal diagnostic criteria for depression or anxiety disorders still identify a need for mental health care. Limited data are available regarding the perceived need for mental health care among persons with MS. OBJECTIVE: We aimed to determine factors associated with a perceived need for mental health care in the MS population...
July 29, 2018: Multiple Sclerosis and related Disorders
Rebecca Lengnick-Hall, Karissa Fenwick, Benjamin Henwood
Using a case study approach, this study explores the experiences of providers at three organizations identified by county mental health executives as exemplar programs that have received continued and competitive funding to deliver assertive community treatment (ACT) in a large urban county in California. Interviews were conducted with 37 participants including program directors (n = 4), frontline staff (n = 31), and county mental health executives (n = 2). Frontline provider perspectives reveal that, in many ways, teams appear to be working within an ACT model in the absence of detailed explicit knowledge about ACT's core components, frequent or in-depth conversations about ACT, or awareness of fidelity monitoring...
August 9, 2018: Community Mental Health Journal
Paul D E Miller, Alice S Forster, Thushan I de Silva, Hayley Leonard, Chloe Anthias, Michaela Mayhew, Matthias Klammer, Susan Paskar, Erin Hurst, Karl Peggs, Alejandro Madrigal, John A Snowden
OBJECTIVES: Studies exploring vaccination rates among haematopoietic stem cell transplant (HSCT) recipients have focused on physician factors that limit uptake. Understanding the patient factors that determine vaccination intention is crucial to delivering a successful vaccination programme. Using a modified health belief model (mHBM), we conducted a cross-sectional survey with the objective of exploring the sociodemographic and psychological factors that determined autologous and allogeneic HSCT recipients' intention to receive the seasonal inactivated influenza vaccine (SIIV) during the 2015-2016 influenza season...
August 8, 2018: BMJ Open
Randall S Stafford
The recently released 2017 High Blood Pressure Guidelines depart from past guidelines in both their approach and recommendations. Developed by multiple health organizations, including the American College of Preventive Medicine, the guidelines continue to define normal blood pressure as <120/80 mmHg, but now define hypertension as ≥130/80 mmHg (previously ≥140/90 mmHg). This change categorizes 101 million Americans (46% of adults) as hypertensive (compared to 32% previously). The guidelines rely heavily on findings from the Systolic Blood Pressure Intervention Trial (SPRINT)...
August 6, 2018: American Journal of Preventive Medicine
L Snyman, E Venables, L Trivino Duran, E Mohr, V D Azevedo, X Harmans, P Isaakidis
SETTING: Early interventions for patients who interrupt their treatment for drug-resistant tuberculosis (DR-TB) are rarely reported and assessed. A novel, patient-centred intervention for patients at risk of loss to follow-up (LTFU) from DR-TB treatment was implemented in Khayelitsha, South Africa, in September 2013. OBJECTIVE: To explore the experiences and perceptions of patients, key support persons, health care workers (HCWs) and programme managers of a patient-centred model...
September 1, 2018: International Journal of Tuberculosis and Lung Disease
Mark Wareing, Helen Green, Barbara Burden, Sally Burns, Mary A R Beckwith, Fortune Mhlanga, Bob Mann
INTRODUCTION: This paper presents findings from a study that evaluated mental health nursing students' experience of a team mentoring model called Coaching and Peer Assisted Learning (C-PAL). At present there are no published research studies into the effectiveness of team mentorship utilised by nursing students within in-patient mental health settings. AIM: The study utilised an interpretist methodology where the focus was on individuals in their social world. METHOD: Two focus groups were held with fifteen students who had experienced C-PAL in four in-patient wards...
August 8, 2018: Journal of Psychiatric and Mental Health Nursing
Christy Noble, Laurie Grealish, Andrew Teodorczuk, Brenton Shanahan, Balaji Hiremagular, Jodie Morris, Sarah Yardley
BACKGROUND: There is a pressing need to improve end-of-life care in acute settings. This requires meeting the learning needs of all acute care healthcare professionals to develop broader clinical expertise and bring about positive change. The UK experience with the Liverpool Care of the Dying Pathway (LCP), also demonstrates a greater focus on implementation processes and daily working practices is necessary. METHODS: This qualitative study, informed by Normalisation Process Theory (NPT), investigates how a tool for end-of-life care was embedded in a large Australian teaching hospital...
August 8, 2018: BMC Palliative Care
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