Plan of care

Sexual and gender minority (LGBT+) populations continue to experience worse health outcomes and reduced healthcare access compared to their cisgender, heterosexual counterparts, perpetuated by a lack of sufficient LGBT+-specific healthcare education within medical schools. Developing educational material that encourages self-reflective, proactive, and affirmative practice has been identified as a mechanism for increasing the quality of doctor-patient relationships and breaking down barriers in healthcare access for LGBT + communities...

BACKGROUND AND OBJECTIVES: Climate change is a major threat to the health of people worldwide. The health care system deals with the immediate health-related effects of climate change and, at the same time, is a major emitter of greenhouse gas. This study aimed to investigate (a) the awareness and perception of climate change among family medicine residency program directors, and (b) the state of climate change education in family medicine residency programs. METHODS: The Council of Academic Family Medicine Educational Research Alliance (CERA) conducted a cross-sectional survey of family medicine program directors in the United States in April 2023...

BACKGROUND: The extant literature suggests that women are more vulnerable to COVID-19 infection and at higher risk for developing long COVID. Due to pandemic mitigation recommendations, social media was relied upon for various aspects of daily life, likely with differences of usage between genders. OBJECTIVE: This study aimed to explore the role and functions of social media in the lives of long-hauler women. METHODS: Participants were purposively snowball-sampled from an online health promotion intervention for long-hauler women with COVID-19 from March to June 2021...

The introduction of mental health collaborative care (MHCC) is one of the strategies to scale up access to mental health care in primary health care in Brazil. This article investigates an experience of mental health collaborative care in the city of Rio de Janeiro, Brazil. It is a qualitative study involving interviews with physicians and mental health professionals working in primary health care units located in the northern part of the city of Rio de Janeiro, Brazil. The aim is to examine the various strategies and negotiations that primary health care professionals deploy to identify mental distress and plan health care interventions...

INTRODUCTION: When out-of-hospital cardiac arrest (OHCA) becomes refractory, extracorporeal cardiopulmonary resuscitation (ECPR) is a potential option to restore circulation and improve the patient's outcome. However, ECPR requires specific materials and highly skilled personnel, and it is unclear whether increased survival and health-related quality of life (HRQOL) justify these costs. METHODS: This cost-effectiveness study was part of the INCEPTION study, a multicenter, pragmatic randomized trial comparing hospital-based ECPR to conventional CPR (CCPR) in patients with refractory OHCA in 10 cardiosurgical centers in the Netherlands...

Prescription drug contracting in the United States has evolved over decades from discounts provided to members of early health maintenance organization plans to rebate contracts to more complex value-based purchasing arrangements. This primer describes the history of contracting between pharmaceutical manufacturers and managed care pharmacy organizations and details the various contracting methods used today.

Prostate cancer is the most common cancer among Swedish men. To get this diagnose is not only a threat to the men's lives but also to their quality of life because the treatment often affects sexuality, bladder function and bowel function. It is therefore particularly problematic that the rehabilitation of men after treatment for prostate cancer often does not reach the standards set out in the national guidelines. Despite the past years' promotion of standardized cancer care pathways to speed up the process of investigating and treating cancer, the lead times for men who are being investigated for a suspicion of prostate cancer, or are waiting for a planned prostate cancer treatment, are the longest in Swedish cancer care...

Advance care planning (ACP) has attracted increasing research attention in recent years. In Japan, extensive training has been conducted to improve communication through workshops, such as role-playing. In training, including trainee-centered work, the facilitator who assists trainee learning plays an important role. However, only a few studies have focused on the training of facilitators. Therefore, we exploratorily analyzed by the mixed method the differences in the approaches of experienced and inexperienced facilitators during workshops and conducted a study that could contribute to facilitator training in the future...

BACKGROUND: Aging populations are driving a shift in emphasis toward enhancing chronic disease care, reflected in Catalonia's regional plan which prioritizes standardized nursing care plans in primary care settings. To achieve this, the ARES-AP program was established with a focus on harmonizing standards and supporting routine nursing clinical decision-making. This study evaluates nurses' perceptions of ARES-AP's standardized care plans for chronic diseases. METHODS: A mixed-methods approach based on an ad hoc questionnaire (n = 141) and a focus group (n = 14) was used...

INTRODUCTION: In the current times, fetal growth monitoring has become readily available with the help of Doppler ultrasound. Identification of pregnancies that are at risk for perinatal morbidity and mortality has been a primary goal of obstetric care. Doppler study is a fast, non-invasive test that provides significant information about the hemodynamic status of the fetus. It is an efficient diagnostic modality to assess fetal compromise, which helps in timely intervention in high-risk pregnancies for better perinatal outcomes...

BACKGROUND AND AIMS: Diabetes mellitus (DM) can result in detrimental complications which are connected with long-term impairments and disabilities. Chronic complications are well-known consequences of type 2 diabetes mellitus (T2DM) progression, which reduce patient quality of life, place a burden on the healthcare system, and increase mortality. Measures to promote health outcomes for people with DM are scanty; the study therefore aimed at determining the effects of self-management and social support on glycemic control of T2DM with complications in Ghana...

PURPOSE: Nurses have been reported to be at an increased risk for miscarriage and preterm labor. However, there is limited knowledge regarding nurses' preconception health behaviors. Therefore, this study aimed to identify factors influencing these behaviors. METHODS: One hundred sixty nurses, who were planning their first pregnancy within the upcoming year, participated in an online survey from August 11 to October 31, 2021. Data on preconception health behavior, perceived health status, pregnancy anxiety, nursing practice environment, and social support were analyzed using the t-test, Pearson correlation coefficients, and multiple regression analysis...

SUMMARY OF BACKGROUND DATA: Iatrogenic injury of the vertebral artery (VA) in the context of surgical approaches to the cervical spine has been cited as a relatively rare complication with varying degrees of severity ranging from minimal injury to acute stroke and can result in death. It is estimated that ~50% of cases of iatrogenic VA injury are preventable after postoperatively examining a patient's preoperative imaging. Despite the low incidence (<2%) of this complication, the potential associated morbidity demonstrates the importance of meticulous preoperative vascular consideration...

BACKGROUND: The labor supply of nurses, as one of the main healthcare workers, is an important issue in health human resources planning in all health systems. Finding the factors affecting it, could help policymakers to solve the shortage of nursing work supply. The present study aimed to investigating the quantity and factors affecting the nurses' labor supply in Iran. METHOD: In this cross-sectional study, a sample of 598 nurses working in public hospitals of Shiraz (Iran) were selected via proportionate stratified random sampling method...

BACKGROUND: Utilization of telemedicine care for vulnerable and low income populations, especially individuals with mental health conditions, is not well understood. The goal is to describe the utilization and regional disparities of telehealth care by mental health status in Texas. Texas Medicaid claims data were analyzed from September 1, 2012, to August 31, 2018 for Medicaid patients enrolled due to a disability. METHODS: We analyzed the growth in telemedicine care based on urban, suburban, and rural, and mental health status...

BACKGROUND: Substantial work has been done to update or create evidence-based practices (EBPs) in the changing health care landscape. However, the success of these EBPs is limited by low levels of clinician implementation. OBJECTIVE: The goal of this study is to describe the use of standardized/simulated patient/person (SP) methodology as a framework to develop implementation bundles to increase the effectiveness, sustainability, and reproducibility of EBPs across health care clinicians...

BACKGROUND: The aged people who live in nursing home are predicted to keep growing in the following decades. There are both quantitative imbalance and structural imbalance in the utilization of nursing homes in China. This study aimed to analyze old people's preference for nursing homes and help the government optimize resource allocation. METHODS: A discrete choice experiment (DCE) was conducted and six attributes of nursing homes including monthly fee, distance from home, geographical location, medical facilities, environment of nursing homes and nursing staff were determined...

Targeted efforts to better understand the barriers and facilitators of stakeholders and healthcare settings to implementation of exercise and education self-management programmes for osteoarthritis (OA) are needed. This study aimed to explore the barriers and facilitators to the implementation of Good Life with osteoArthritis in Denmark (GLA:D), a supervised group guideline-based OA programme, across Irish public and private healthcare settings. Interviews with 10 physiotherapists (PTs; 8 public) and 9 people with hip and knee OA (PwOA; 4 public) were coded by the Consolidated Framework for Implementation Research (CFIR) constructs in a case memo (summary, rationale, quotes)...

The visual appeal of teeth and smiles significantly influences both how others perceive individuals and their self-image and confidence. The subjective nature of dental esthetics, varying greatly among patients and dental professionals, has made digital smile design tools essential for creating natural and personalized esthetics. Contemporary digital methods and workflows encompass all clinical phases, from diagnosis to the creation of a smile aligned with the patient's facial features, and the completion of the restoratives...

BACKGROUND: Patients with critical illness often survive the intensive care unit (ICU) at a cost of prolonged length of stay (LOS) and slow recovery. This chronic critically ill disease may lead to long-term poor outcomes, especially in older or frail patients. OBJECTIVES: The main goal of this study was to address the characteristics and outcomes of patients with prolonged ICU LOS. Mainly, short- and long-term admissions were compared to identify risk factors for persistent critical illness and to characterise the impact on ICU, hospital, and long-term mortality...