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Elizabeth M White, Jessica G Smith, Rebecca L Trotta, Matthew D McHugh
OBJECTIVES: To investigate whether care in a hospital with more nurses holding at least a Bachelor of Science in Nursing (BSN) degree is associated with lower mortality for individuals with Alzheimer's disease and related dementias (ADRD) undergoing surgery ADRD. DESIGN: Cross-sectional data from 2006-07 Medicare claims were linked with the Multi-State Nursing Care and Patient Safety Survey of nurses in 4 states. SETTING: Adult, nonfederal, acute care hospitals in California, Florida, New Jersey, and Pennsylvania (N=531)...
March 20, 2018: Journal of the American Geriatrics Society
Sally Lindsay, Elaine Cagliostro, Joanne Leck, Winny Shen, Jennifer Stinson
PURPOSE: Many youths with disabilities find it challenging to disclose their medical condition and request workplace accommodations. Our objective was to explore when and how young people with disabilities disclose their condition and request workplace accommodations. METHODS: We conducted 17 in-depth interviews (11 females, six males) with youth with disabilities aged 15-34 (mean age 26). We analyzed our data using an interpretive, qualitative, and thematic approach...
March 20, 2018: Disability and Rehabilitation
Mary H Hayden, Erika Barrett, Guyah Bernard, Eunice N Toko, Maurice Agawo, Amanda M Okello, Jayleen K L Gunn, Kacey C Ernst
Increasing the active participation of professional women in vector control (VC) activities may help promote greater gender equity in the workplace and reduce the burden of vector-borne diseases. This stakeholder survey examined the current roles and perspective of professionals employed in the VC sector in Kenya, Indonesia, India, and other countries. The largest barriers that women face in pursuing leadership roles in the VC sector include lack of awareness of career opportunities, limitations based on cultural norms, and the belief that VC is men's work...
March 19, 2018: American Journal of Tropical Medicine and Hygiene
Charlotte N L Chambers, Christopher M A Frampton, Martin McKee, Murray Barclay
OBJECTIVES: To estimate prevalence of and factors contributing to bullying among senior doctors and dentists in New Zealand's public health system, to ascertain rates of reporting bullying behaviour, perceived barriers to reporting and the effects of bullying professionally and personally. DESIGN: Cross-sectional, mixed methods study. SETTING: New Zealand. PARTICIPANTS: Members of the Association of Salaried Medical Specialists (40...
March 19, 2018: BMJ Open
Iakovos Theodoulou, Akshaya Mohan Reddy, Jeremy Wong
BACKGROUND: Workforce planning in the British healthcare system (NHS) is associated with significant costs of agency staff employment. The introduction of a novel software (ABG) as a 'people to people economy' (P2PE) platform for temporary staff recruitment offers a potential solution to this problem. Consequently, the focus of this study was twofold - primarily to explore the locum doctor landscape, and secondarily to evaluate the implementation of P2PE in the healthcare industry. METHODS: Documentary analysis was conducted alongside thirteen semi structured interviews across five informant groups: two industry experts, two healthcare consultants, an executive director, two speciality managers and six doctors...
March 20, 2018: BMC Health Services Research
Vivian Isaac, Sabrina Winona Pit, Craig S McLachlan
BACKGROUND: Social isolation in medical students is a subjective experience that may influence medical career decision making. Rural self-efficacy has been shown to influence rural career intentions following a rural clinical placement, however its impact on social isolation during a rural clinical placement has not been previously modeled. The objective of this study is to explore whether self-perception of social isolation is associated with rural career intent in rural medical students...
March 20, 2018: BMC Medical Education
Malin Bogren, Sathyanarayanan Doraiswamy, Kerstin Erlandsson, Halima Akhter, Dalia Akter, Momtaz Begum, Merry Chowdhury, Lucky Das, Rehana Akter, Sufia Begum, Renoara Akter, Syeada Yesmin, Yamin Ara Khatun
OBJECTIVE: using the International Confederation of Midwives (ICM) Global Standards for Midwifery Education as a conceptual framework, the aim of this study was to explore and describe important 'must haves' for inclusion in a context-specific accreditation assessment tool in Bangladesh. DESIGN: A questionnaire study was conducted using a Likert rating scale and 111 closed-response single items on adherence to accreditation-related statements, ending with an open-ended question...
February 21, 2018: Midwifery
Kristin J Effland, Karen Hays
Increasing the midwifery workforce requires that aspiring midwives complete education and training, but structural racism and microaggressions impact the lives of underrepresented midwifery students and apprentices, adding stressors and disparities to the usual demanding educational challenges. In order to be resilient, students rely on preceptors, faculty, administrators and institutions to promote equity. Equity-focused learning environments improve student experiences and success rates, and better prepare all students to provide culturally humble and sensitive care to diverse childbearing persons and other essential competencies outlined by the International Confederation of Midwives...
February 15, 2018: Midwifery
Michael L Wilson, Kenneth A Fleming, Modupe A Kuti, Lai Meng Looi, Nestor Lago, Kun Ru
As global efforts accelerate to implement the Sustainable Development Goals and, in particular, universal health coverage, access to high-quality and timely pathology and laboratory medicine (PALM) services will be needed to support health-care systems that are tasked with achieving these goals. This access will be most challenging to achieve in low-income and middle-income countries (LMICs), which have a disproportionately large share of the global burden of disease but a disproportionately low share of global health-care resources, particularly PALM services...
March 14, 2018: Lancet
Shahin Sayed, William Cherniak, Mark Lawler, Soo Yong Tan, Wafaa El Sadr, Nicholas Wolf, Shannon Silkensen, Nathan Brand, Lai Meng Looi, Sanjay A Pai, Michael L Wilson, Danny Milner, John Flanigan, Kenneth A Fleming
Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs)...
March 14, 2018: Lancet
Laura Arkwright, Susan Edgar, James Debenham
BACKGROUND: Despite increasing workforce numbers, new graduate physiotherapists are reporting short career intentions due to low job satisfaction. Job satisfaction improves retention among allied health professionals, however we have limited understanding of its influence specific to physiotherapists. OBJECTIVES: The aim of this study was to explore factors contributing to the job satisfaction of musculoskeletal physiotherapists working in private practice across different career stages (new graduates, graduates, postgraduates, and owners) in Western Australia...
March 10, 2018: Musculoskeletal Science & Practice
Katharine D Wenstrom, Mary E D'Alton, Daniel F O'Keefe
OBJECTIVE:  To conduct a survey of the members of the Society for Maternal-Fetal Medicine (SMFM) to determine the practice patterns of maternal-fetal medicine (MFM) subspecialists in the United States and to estimate the likelihood that our work force is sufficient to support the proposed MFM staffing requirements for level III and IV maternity centers. STUDY DESIGN:  All regular SMFM members in the United States were invited to answer a 26 question survey by email...
March 16, 2018: American Journal of Perinatology
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
Eugène Zoumenou, Martin Chobli, Bernard le Polain de Waroux, Philippe Louis Baele
Belgium has been collaborating for 20 years with Abomey-Calavi University in Cotonou, Republic of Benin, to train anesthesiologists for Sub-Saharan, French-speaking African countries. With 123 graduates from 15 countries and 46 residents still in training, this program has succeeded in reversing the trend of a decreasing anesthesiology workforce in those countries, thus improving the quality of anesthesia and patient safety. Belgian government sources, as well as hospitals and anesthesia teams, provided most of the financial resources...
April 2018: Anesthesia and Analgesia
Fauzia A Khan, Alan F Merry
The safety of anesthesia characteristic of high-income countries today is not matched in low-resource settings with poor infrastructure, shortages of anesthesia providers, essential drugs, equipment, and supplies. Health care is delivered through complex systems. Achieving sustainable widespread improvement globally will require an understanding of how to influence such systems. Health outcomes depend not only on a country's income, but also on how resources are allocated, and both vary substantially, between and within countries...
April 2018: Anesthesia and Analgesia
Søren Kudsk-Iversen, Naomi Shamambo, M Dylan Bould
The majority of the world's population lacks access to safe, timely, and affordable surgical care. Although there is a health workforce crisis across the board in the poorest countries in the world, anesthesia is disproportionally affected. This article explores some of the key issues that must be tackled to strengthen the anesthesia workforce in low- and lower-middle-income countries. First, we need to increase the overall number of safe anesthesia providers to match a huge burden of disease, particularly in the poorest countries in the world and in remote and rural areas...
April 2018: Anesthesia and Analgesia
C Roger Goucke, Pongparadee Chaudakshetrin
Approximately 80% of the world's population lives in countries with little or no access to pain management. These countries also have 74% of the world's deaths from cancer and human immunodeficiency virus. Appropriate use of oral opioids can control 80%-90% of cancer pain. However, only 6.7% of the world's medical opioids are available in these low-resource countries. With the Lancet Commission on Global Surgery calling for a significant expansion of surgical services, postoperative pain management will need to be an increasing focus of our attention...
April 2018: Anesthesia and Analgesia
Fiona M Nea, L Kirsty Pourshahidi, John M Kearney, M Barbara E Livingstone, Carolina Bassul, Clare A Corish
Background: Approximately 17% of the European workforce is engaged in shift work. How the experience of shift work impacts on the dietary and lifestyle practices of workers is unclear. Methods: Overall, 15 focus groups were conducted by two researchers, with 109 participants. The initial focus group was carried out with both researchers present, to ensure consistency in facilitation. Both researchers thematically analysed all data collected. Results: Shift work was described as affecting many areas of workers' lives...
March 13, 2018: Journal of Public Health
Lauren Brookman-Frazee, Chanel Zhan, Nicole Stadnick, David Sommerfeld, Scott Roesch, Gregory A Aarons, Debbie Innes-Gomberg, Lillian Bando, Anna S Lau
Evidence-based practice (EBP) implementation requires substantial resources in workforce training; yet, failure to achieve long-term sustainment can result in poor return on investment. There is limited research on EBP sustainment in mental health services long after implementation. This study examined therapists' continued vs. discontinued practice delivery based on administrative claims for reimbursement for six EBPs [Cognitive Behavioral Interventions for Trauma in Schools (CBITS), Child-Parent Psychotherapy, Managing and Adapting Practices (MAP), Seeking Safety (SS), Trauma-Focused Cognitive Behavior Therapy (TF-CBT), and Positive Parenting Program] adopted in a system-driven implementation effort in public mental health services for children...
2018: Frontiers in Public Health
George Richard Holt, Kevin Christopher McMains, Randal A Otto
Evaluating and providing global health assistance, humanitarian aid, and medical missions to Middle Eastern countries can be rewarding and challenging. A broad spectrum of financial capabilities supports effective health care delivery and infrastructure. Middle East tension can make obtaining a visa difficult. Personal safety considerations may hinder efforts to develop and carry out clinical and educational programs. Several Middle East countries have sophisticated and modern health care systems. Medical education and specialty training compares with that of Western medicine...
March 12, 2018: Otolaryngologic Clinics of North America
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