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Suzanne Grant, Bruce Guthrie
Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings...
March 2, 2018: Social Science & Medicine
Inbal Maidan, Freek Nieuwhof, Hagar Bernad-Elazari, Bastiaan R Bloem, Nir Giladi, Jeffrey M Hausdorff, Jurgen A H R Claassen, Anat Mirelman
BACKGROUND: In a randomized control trial conducted in patients with Parkinson's disease, a treadmill training program combined with virtual reality that targeted motor and cognitive aspects of safe ambulation led to fewer falls, compared with treadmill training alone. OBJECTIVE: To investigate if the 2 types of training differentially affected prefrontal activation and if this might explain differences in fall rates after the intervention. METHODS: Sixty-four patients with Parkinson's disease were randomized into the treadmill training arm (n = 34, mean age 73...
March 1, 2018: Neurorehabilitation and Neural Repair
Janya McCalman, Roxanne Bainbridge, Catherine Brown, Komla Tsey, Adele Clarke
Introduction: Spreading proven or promising Aboriginal health programs and implementing them in new settings can make cost-effective contributions to a range of Aboriginal Australian development, health and wellbeing, and educational outcomes. Studies have theorized the implementation of Aboriginal health programs but have not focused explicitly on the conditions that influenced their spread. This study examined the broader political, institutional, social and economic conditions that influenced negotiations to transfer, implement, adapt, and sustain one Aboriginal empowerment program-the Family Wellbeing (FWB) program-to at least 60 geographical sites across Australia over 24 years...
2018: Frontiers in Public Health
Carlos Crivelli, Alan J Fridlund
Based on modern theories of signal evolution and animal communication, the behavioral ecology view of facial displays (BECV) reconceives our 'facial expressions of emotion' as social tools that serve as lead signs to contingent action in social negotiation. BECV offers an externalist, functionalist view of facial displays that is not bound to Western conceptions about either expressions or emotions. It easily accommodates recent findings of diversity in facial displays, their public context-dependency, and the curious but common occurrence of solitary facial behavior...
March 12, 2018: Trends in Cognitive Sciences
Xiayun Zuo, Chaohua Lou, Ersheng Gao, Qiguo Lian, Iqbal H Shah
BACKGROUND: Non-consensual sex (NCS) among young people, an important subject with public health and human rights implications, was less studied in China. This study is to investigate the NCS awareness and victimization of university students in Shanghai, China and whether they were associated with adolescent gender-role attitudes. METHODS: Gender-role attitudes, awareness and victimization of different forms of NCS were examined among 1099 undergraduates (430 males and 669 females) in four universities in Shanghai using computer-assisted self-interview approach...
March 15, 2018: Reproductive Health
Julie A Cohen, Anusha Kassan
This qualitative study explored the cultural identity negotiation of young adult immigrants. Using a grounded theory research design, 10 semistructured interviews were conducted with emerging adult immigrants (EAI), ages 19-27. Results yielded a substantive model of cultural identity negotiation (MCIN) for EAI and posited that One's Motivation and Sense of Agency to Negotiate Cultural Identity is at the core of how participants navigate their cultural identities. This model included 6 major categories: (a) Family Cultural Rigidity ; (b) Connections Specific to Canada ; (c) Connection to a Same Cultured Community ; (d) Sense of Permanency ; (e) Desire to Preserve Culture of Origin ; (f) Desire to Fit in to Canadian Culture , as well as 2 overarching factors ( Dimension of Time and Dimension of Age ), which were found to be influential on participants' cultural identity negotiation...
March 2018: Journal of Counseling Psychology
Fanny Alexandra Jakobsen, Kjersti Vik
AIM: To describe health professionals' perspectives of next of kin in the context of reablement. METHODS: A total of 49 health professionals from different organizational levels participated. Their ages, genders, experiences, and professions varied. A total of 10 focus group discussions were held in two municipalities. The data analysis was conducted using a constructivist grounded theory approach. RESULTS: The core category was identified as negotiating between themselves...
March 15, 2018: Disability and Rehabilitation
Stephanie M Topp, Chanda Mwamba, Anjali Sharma, Njekwa Mukamba, Laura K Beres, Elvin Geng, Charles B Holmes, Izukanji Sikazwe
BACKGROUND: Failure to keep people living with HIV engaged in life-long care and treatment has serious implications for individual and population-level health. Nested within a four-province study of HIV care and treatment outcomes, we explored the dynamic role of social and service-related factors influencing retention in HIV care in Zambia. METHODS: From a stratified random sample of 31 facilities, eight clinics were selected, one urban and one rural from each province...
2018: PloS One
Jordana Salma, Kathleen F Hunter, Linda Ogilvie, Norah Keating
Background Arab immigrants have increasing rates of stroke and uncontrolled stroke risk factors coupled with minimal resources for stroke prevention. Purpose This article describes the results of an interpretive descriptive study about Arab immigrant women's experiences of practicing stroke prevention. We use an intersectionality approach to discuss some of the factors that influenced women's ability to manage their health. Methods Sixteen middle-aged and older Arab Muslim immigrant women were recruited between 2015 and 2016 from two religious centers in an urban Canadian center...
January 1, 2018: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
Anne-Marie Reid, Jeremy M Brown, Julie M Smith, Alexandra C Cope, Susan Jamieson
CONTEXT: For medical education researchers, a key concern may be the practicalities of gaining ethical approval where this is a national or local requirement. However, in qualitative studies, where the dynamics of human interaction pervade, ethical considerations are an ongoing process which continues long after approval has been granted. Responding to ethical dilemmas arising 'in the moment' requires a reflexive approach whereby the researcher questions his/her own motivations, assumptions and interests...
March 13, 2018: Perspectives on Medical Education
Christopher A Stevens, Jeroen Daamen, Emma Gaudrain, Tom Renkema, Jakob Dirk Top, Fokie Cnossen, Niels A Taatgen
Training negotiation is difficult because it is a complex, dynamic activity that involves multiple parties. It is often not clear how to create situations in which students can practice negotiation or how to measure students' progress. Some have begun to address these issues by creating artificial software agents with which students can train. These agents have the advantage that they can be "reset," and played against multiple times. This allows students to learn from their mistakes and try different strategies...
2018: Frontiers in Psychology
Richard J Napier, Brendan J Gallagher, Darrin S Wilson
Background: The 1994 Northern Ireland ceasefire heralded a new beginning for the region after 30-years of violence. In the 20-years following the cessation of hostilities, paramilitary punishment attacks continue to occur in breach of the ceasefire. The aim of this study was to review trends in these attacks over the 20-years and their impact on orthopaedic services. Methods: We conducted a retrospective review of patients admitted under orthopaedic services following paramilitary assault across Northern Ireland over the last 20-years...
May 2017: Ulster Medical Journal
Azer Kılıç, İpek Göçmen
This article aims to explore women's decisions to freeze their eggs for non-medical reasons in Turkey. It draws on semi-structured interviews conducted with twenty-one women who were either in the process of freezing their eggs, or had completed the process within the previous year. Being highly educated and holding prestigious occupations, on the one hand, and faced with traditional gender norms, on the other, these women are confronted with a challenging decision. When making such a decision to freeze their eggs, women act under the constraints defined by biomedical paradigms, the society they live in, and the future uncertainty of their lives...
March 7, 2018: Social Science & Medicine
Meagan Tyler, Peter Fairbrother
This paper considers the impact of gendered norms on decision-making for wildfire preparation and response at the household level. Focusing on Australia, it provides a theoretical thematic analysis of data acquired in 107 interviews with residents of nine different localities. It builds on existing research on gender and disaster, as well as on decision-making and wildfires, and analyses the narratives that centre on 'split' households plans (where a male partner plans to stay and a female partner plans to evacuate) and disagreements within heterosexual couples as to an appropriate wildfire safety plan...
March 13, 2018: Disasters
Cary Cuncic, Glenn Regehr, Heather Frost, Joanna Bates
INTRODUCTION: The relationship between preceptor and trainee is becoming recognized as a critical component of teaching, in particular in the negotiation of feedback and in the formation of professional identity. This paper elaborates on the nature of the relationships between preceptor and student that evolve in the context of rural longitudinal integrated clerkships (LICs). METHODS: We drew on constructivist grounded theory for the research approach. We interviewed nine LIC family practice preceptors from three sites at one educational institution...
March 12, 2018: Perspectives on Medical Education
Rupali Soeters, Peter B White, Mary Murray-Weir, Jayme C B Koltsov, Michael M Alexiades, Amar S Ranawat
BACKGROUND: As length of stay decreases for total joint arthroplasty, much of the patient preparation and teaching previously done in the hospital must be performed before surgery. However, the most effective form of preparation is unknown. This randomized trial evaluated the effect of a one-time, one-on-one preoperative physical therapy education session coupled with a web-based microsite (preopPTEd) on patients' readiness to discharge from physical therapy (PT), length of hospital stay, and patient-reported functional outcomes after total joint arthroplasty...
January 2018: Clinical Orthopaedics and related Research
Julia Tasset, Lisa H Harris
Access to abortion in the United States has eroded significantly. Accordingly, there is a growing movement to empower women to self-induce abortion. To date, physicians' roles and responsibilities in this changing environment have not been defined. Here, we consider a harm reduction approach to first-trimester abortion as a way for physicians to honor clinical and moral obligations to care for women, negotiate ever-increasing abortion restrictions, and support women who consider abortion self-induction. Harm reduction approaches to abortion have been successfully implemented in a range of countries around the world and typically take the form of teaching women how to use misoprostol...
March 8, 2018: Obstetrics and Gynecology
Louise E Boyle
This article investigates experiences of Social Anxiety Disorder ('social anxiety') with reference to recent geographical debates on habit. It considers how habit simultaneously captures (un)reflective modes of being in the world and the foreboding disruptive capacity of uncertainty as people attempt to adapt to, negotiate and manage everyday life with social anxiety. Drawing on lived accounts from online questionnaires and online interviews with people diagnosed, or self-diagnosing, with social anxiety, it uncovers the relational and embodied practices-and the inherent spatialities of such practices-that enable individuals to (re)gain control of their socio-spatial surroundings...
March 2, 2018: Social Science & Medicine
David Greenfield, Kathy Eljiz, Kerryn Butler-Henderson
The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, 'standardization' and 'customization,' and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being 'competing' logics in healthcare, standardization and customization are long standing 'colluding' logics...
June 28, 2017: International Journal of Health Policy and Management
Deborah Gleeson, David B Menkes
There is growing international concern about the risks posed by direct-to-consumer advertising (DTCA) of prescription pharmaceuticals, including via the internet. Recent trade agreements negotiated by the United States, however, incorporate provisions that may constrain national regulation of DTCA. Some provisions explicitly mention DTCA; others enable foreign investors to seek compensation if new regulations are seen to harm their investments. These provisions may thus prevent countries from restricting DTCA or put them at risk of expensive legal action from companies seeking damages due to restrictions on advertising...
October 16, 2017: International Journal of Health Policy and Management
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