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Access to care

Mohammad Abu-Zaineh, Maame Esi Woode, Rita Giacaman
BACKGROUND: Interest in the Senian capability framework as an alternative approach to wellbeing measurement has increased in recent decades. The aim of this study was to look at the extent to which an individual's capability to achieve wellbeing in one dimension is associated with his or her attempt to achieve wellbeing in another dimension in a fragile setting affected by conflict. METHODS: Capability is defined as the ability to achieve health, knowledge, and wealth and is measured as latent variables using a structural equation model...
February 21, 2018: Lancet
Zoheir Elkahtib
BACKGROUND: Most health-care organisations are increasingly interested in assessing the quality of their services. Patient satisfaction has a central role in the quality assessment in health care because it reflects the appropriateness of services from the clients' perspectives. The aim of this study was to assess the level of satisfaction in patients with non-communicable diseases (mainly diabetes and hypertension) who receive services from UNRWA health centres in Gaza governorates. METHODS: In this cross-sectional study we chose a random sample of participants who presented to the randomly selected six health centres for treatment of non-communicable diseases...
February 21, 2018: Lancet
Zaher Nazzal, Hisham Sholi, Suha B Sholi, Mohammad B Sholi, Rawya Lahaseh
BACKGROUND: Mammography screening is an effective tool for early detection and management of breast cancer. Female health-care workers' awareness of breast cancer screening is important because their beliefs and behaviours could influence other women. The aim of this study was to assess mammography screening uptake by female health-care workers at primary health-care centres and to identify the primary motivators and barriers that affect uptake. METHODS: This cross-sectional study included all governmental primary health-care centres in the West Bank...
February 21, 2018: Lancet
Tiziana Leone, Diego Alburez-Gutierrez, Rula Gandour, Ernestina Coast, Rita Giacaman
BACKGROUND: Armed conflicts can undermine a country's health-care capacity and disrupt the delivery of basic health services. Yet the public health consequences of war remain difficult to quantify, mainly because adequate data do not exist. We hypothesised that the ongoing conflict in the occupied Palestinian territory (including the restrictions on free movement and the strain on health-care services) have had detrimental effects on maternal and child health outcomes. METHODS: We reconstructed data on delivery by caesarean section and diphtheria, pertussis, and tetanus vaccination with pooled data from Demographic and Health Surveys for 2000-14...
February 21, 2018: Lancet
Mohammed K El-Habil
BACKGROUND: Acute poisoning is a major public health problem worldwide and a common cause of patient admissions to emergency departments and intensive care units. The aim of this study was to assess the acute poisoning cases admitted to three hospitals in the Gaza Strip and to assess the need for a poison control and drug information centre in the Gaza Strip. METHODS: All patients diagnosed with acute poisoning between 2010 and 2015 at the emergency departments of Al-Shifa Hospital, European Gaza Hospital, and Al-Nassr Paediatric Hospital in the Gaza Strip were included in this retrospective study...
February 21, 2018: Lancet
Majdi Ashour
BACKGROUND: People living in the Gaza Strip have experienced a protracted political conflict and extreme socioeconomic adversity since 1948. Economic conditions have deteriorated markedly since the onset of the Palestinian Intifada in 1987 and have been exacerbated by the economic siege after 2006. The health system in the Gaza Strip has faced additional challenges. The aim of this study was to assess how Palestinian households in the Gaza Strip experienced health care services during this period of political turmoil, socioeconomic adversity, and challenges to health services...
February 21, 2018: Lancet
Giulia Canali, Victoria Tittle, Akihiro Seita
BACKGROUND: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) estimated that in 2016, 11% of Palestine refugees older than 40 years living in Jordan were diagnosed with diabetes and that the disease is controlled in only 45% of Palestine refugees with diabetes. As medication adherence is one of the most important modifiable self-care behaviours to achieve adequate metabolic control, the aims of this study were to measure medication adherence and to review the factors associated with different levels of medication adherence in patients with diabetes...
February 21, 2018: Lancet
Elham Kateeb, Elizabeth Momany
BACKGROUND: Beliefs about oral health during pregnancy demographic factors, such as level of education and socioeconomic status, are associated with an increased risk of oral diseases during pregnancy. The aim of this study was to assess the oral health status of pregnant women and the relation to the women's oral health knowledge, beliefs, behaviour, and access to dental care. METHODS: For this cross-sectional study, pregnant women visiting pre-natal care clinics at the Palestinian Ministry of Health centres in the Jerusalem governorate were invited to complete a structured interview with questions about beliefs about oral health care and their oral hygiene practices...
February 21, 2018: Lancet
Dina Hafez, Laurence F McMahon, Linda Balogh, Floyd John Brinley, John Crump, Mark Ealovega, Audrey Fan, Yeong Kwok, Kristen Krieger, Thomas O'Connor, Elisa Ostafin, Heidi Reichert, Jennifer Meddings
OBJECTIVES: To characterize patterns of emergency department (ED) utilization for ambulatory care-sensitive conditions (ACSCs) among patients with established care within a patient-centered medical home. STUDY DESIGN: Retrospective chart review using Michigan Medicine's (formerly University of Michigan Health System) electronic health record. METHODS: Ten general medicine (GM) physicians reviewed 256 ambulatory care-sensitive ED encounters that occurred between January 1, 2014, and December 31, 2014, among patients of a GM medical home...
March 1, 2018: American Journal of Managed Care
Cuirong Zhao, Chao Wang, Chengwu Shen, Qian Wang
China has undertaken waves of healthcare reforms to keep pace with its rapid economic growth. By 2011, universal health insurance coverage was successfully achieved through the creation of a basic social medical insurance system. Growing economic power, extensive government subsidies, and strategies for program implementation are critical to that achievement. However, the breadth and depth of coverage varies considerably across insurance schemes and localities. The disjointed insurance scheme led to inequality in coverage, accessibility, and affordability of medical services, lopsided allocation of health resources, and increasing medical expenditures, and these remain crucial challenges for healthcare insurance coverage...
2018: Drug Discoveries & Therapeutics
Victoria E Jackson, Helen Hurst, Sandip Mitra
INTRODUCTION: Arteriovenous fistulae remain the gold standard of vascular access in haemodialysis. There is currently no consensus on standardised methods of monitoring arteriovenous fistulae. Assessment techniques and practice remain widely variable. The purpose of this study is to determine whether existing evidence supports physical assessment as an effective tool and a good predictor of arteriovenous fistulae dysfunction to allow for timely intervention and improve outcomes. METHODS: A literature search was performed using CINAHL, PubMed, Medline and BNI databases and relevant search terms...
March 1, 2018: Journal of Vascular Access
Celeste H Claudio, Zoelle B Dizon, Tessie W October
BACKGROUND: Accessible information about palliative care available to the public on the Internet is growing. We do not know whether this information is consistent with the current accepted definition of palliative care. AIM: To identify resources on the Internet and social media regarding palliative care and evaluate the information conveyed. DESIGN: A cross-sectional study of "palliative care" search results. SETTING: Top 10 Google websites, top 10 most viewed YouTube videos, and social media platforms, Facebook and Twitter, were searched...
January 1, 2018: American Journal of Hospice & Palliative Care
John Spiliotis, Nikolaos Kopanakis, Anastasia Prodromidou, Alexis Terras, Anastasia Polichronaki, Christina Koutikova, Anna Gogou, Christina Sidera, Elias Efstathiou
PURPOSE: Home parenteral nutrition (HPN) has been proposed as the treatment of choice in patients suffering from intestinal failure (IF) and has been claimed to improve survival and quality of life either in patients with benign disorders or even in those with malignancies. The purpose of the present analysis was to report characteristics and outcomes of adult patients with IF receiving HPN in Greece. METHODS: Patients that received HPN between 2011 and 2017 were included in this retrospective analysis...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Arnethea L Sutton, Jun He, Megan C Edmonds, Vanessa B Sheppard
Studies indicate that Black patients report higher medical mistrust compared to their White counterparts. However, little is known about factors associated with higher medical mistrust among Black breast cancer patients. We examined predictors of medical mistrust and relationships between medical mistrust, subscales of mistrust, and process of care factors to identify opportunities to promote positive healthcare interactions between the trustees (e.g., providers) and Black breast cancer patients, or the trustors...
March 19, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Melanie R Keats, Kelsey Shea, Louise Parker, Samuel A Stewart, Annette Flanders, Mark Bernstein
Despite support for the provision of a survivorship care plan (SCP) to every cancer survivor, there is a lack of understanding of the needs and preferences of key stakeholders. We examined perspectives of a novel personalized SCP for childhood cancer survivors (CCS), their family, and family physicians (FP). We conducted semi-structured telephone interviews with a purposefully selected sample of CCS, parents/guardians, and FPs. Data included responses to stakeholder cancer care information needs, concerns with or gaps in communication, the perceived role of the FP in the long-term management of CCS care, utility of the SCP, preferred format, and suggestions for improvement...
March 19, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Tammy Toscos, Maria Carpenter, Mindy Flanagan, Kislaya Kunjan, Bradley N Doebbeling
Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These "positive deviant" practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families...
January 2018: Health Services Research and Managerial Epidemiology
Suman Lahiry, Christopher Levi, Joosup Kim, Dominique A Cadilhac, Andrew Searles
Background: In regional and rural Australia, patients experiencing ischemic stroke do not have equitable access to an intravenous recombinant tissue plasminogen activator (tPA). Although thrombolysis with tPA is a clinically proven and cost-effective treatment for eligible stroke patients, there are few economic evaluations on pre-hospital triage interventions to improve access to tPA. Aim: To describe the potential cost-effectiveness of the pre-hospital acute stroke triage (PAST) protocol implemented to provide priority transfer of appropriate patients from smaller hospitals to a primary stroke center (PSC) in regional New South Wales, Australia...
2018: Frontiers in Public Health
Nanjela Chindima, Panji Nkhoma, Musalula Sinkala, Mildred Zulu, Doris Kafita, Marah Simakando, Florence Mwaba, Hamakwa Mantina, Mubanga Mutale
Context: Sickle cell disease is a group of hemoglobin (Hb) disorders resulting from the inheritance of the sickle β-globin gene. It is the most common pathological Hb mutation worldwide with 75% being born in Sub-Saharan Africa. Aims: This study aims to determine if dried blood spots (DBSs) can be used for diagnosis of sickle cell in newborns. In Zambia, there is no neonatal screening program for sickle cell anemia (SCA), yet it has been proved that early diagnosis by newborn screening (NBS) using DBSs and access to comprehensive care results in survival to adulthood of over 96% of sickle cell patients...
January 2018: International Journal of Applied and Basic Medical Research
K M Shivakumar, Snehal Patil, Vidya Kadashetti, Vaishali Raje
Introduction: The individuals suffering from various disabilities form a considerable proportion of the community. The psychological reactions associated with a deformity can be devastating to the disabled, parents, caregivers, and family which often lead to attitudes of hopelessness in the lives of these disabled individuals. Objectives: To assess the oral health status and treatment needs among 5-12-year-old children attending special school in Western Maharashtra, India...
January 2018: International Journal of Applied and Basic Medical Research
Carl A Johnson, Amber L Melvin, Brandon F Lebow, Amanda Yap, Peter A Knight
Aortic valve replacement through minimally invasive access is increasing. These procedures have several advantages over conventional sternotomy including decreased intensive care unit and hospital length of stay and decreased ventilation time. The right anterior mini-thoracotomy (RAM) approach is potentially attractive in that it completely spares the sternum leading to improved cosmesis, reduced blood loss, and improved patient satisfaction. However, this approach is underutilized due to anticipated technical challenges including difficulty with visualization and annular suture placement...
2018: Journal of Visualized Surgery
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