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https://www.readbyqxmd.com/read/29666145/development-of-sustainable-community-paramedicine-programmes-a-case-study-in-pennsylvania
#1
Yuan-Han Huang, Linlin Ma, Luke A Sabljak, Zachary A Puhala
BACKGROUND: Community paramedicine (CP) models have been applied across rural and urban communities in support of healthcare delivery systems for nearly two decades. However, there is still insufficient information regarding the development of sustainable CP programmes. This study explores the strategies used by active CP programmes and investigates their operational statuses, community demographics, financial models and challenges for programme development. METHODS: A series of interviews was conducted with four CP programmes in Pennsylvania, USA, which are affiliated with a local government, a health system, an ambulance service and an emergency medical service, respectively...
April 17, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29664956/you-pray-to-your-god-a-qualitative-analysis-of-challenges-in-the-provision-of-safe-timely-and-affordable-surgical-care-in-uganda
#2
Katherine Albutt, Rachel R Yorlets, Maria Punchak, Peter Kayima, Didacus B Namanya, Geoffrey A Anderson, Mark G Shrime
BACKGROUND: Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception. METHODS: From September to November 2016, we conducted a mixed-methods countrywide surgical capacity assessment at 17 randomly selected public hospitals in Uganda. Researchers conducted 35 semi-structured interviews with key stakeholders to understand factors related to the provision of surgical care...
2018: PloS One
https://www.readbyqxmd.com/read/29629894/pulmonary-aspiration-in-adjustable-gastric-banding-carriers-undergoing-a-second-surgical-procedure-considerations-on-personal-experience-and-review-of-the-literature
#3
Contardo Vergani, Marco Venturi, Sara Badiali, Barbara Chella, Enrico Mozzi
BACKGROUND: The observation of a relatively high number of pulmonary aspirations (PA) among gastric band (GB) carriers undergoing a second surgery, prompted us to modify our strategy for GB patients candidate to further operation under general anesthesia. MATERIAL OF STUDY AND RESULTS: In January 2013, following the occurrence of PA at the induction of general anesthesia in 1 GB carrier undergoing a further operation, we reviewed our Data Base between January 2005 and 2013, to explore the rate of pulmonary aspiration in patients GB carriers undergoing a second surgery...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29624984/geriatric-intervention-strategy-to-enhance-the-social-roles-of-the-elderly
#4
Marcelo Piña-Morán, María Gladys Olivo-Viana, María de la Luz Martínez-Maldonado, Víctor Manuel Mendoza-Núñez
At the global level, population aging is an issue that is becoming increasingly important due to the great impact it will have on the 21st century society. It is essential to develop policies, strategies and actions aimed at addressing the issues that will arise from the rapid increase in this segment of population. The aim of this paper is to propose the geriatric intervention as a strategy for the development of the older people in their community. We expose the epistemological frame, the theoretical and methodological support and the need to find a language to incorporate the older adult actively to society, in a condition of total equality...
2018: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29624574/need-for-speed-an-optimized-gridding-approach-for-spatially-explicit-disease-simulations
#5
Stefan Sellman, Kimberly Tsao, Michael J Tildesley, Peter Brommesson, Colleen T Webb, Uno Wennergren, Matt J Keeling, Tom Lindström
Numerical models for simulating outbreaks of infectious diseases are powerful tools for informing surveillance and control strategy decisions. However, large-scale spatially explicit models can be limited by the amount of computational resources they require, which poses a problem when multiple scenarios need to be explored to provide policy recommendations. We introduce an easily implemented method that can reduce computation time in a standard Susceptible-Exposed-Infectious-Removed (SEIR) model without introducing any further approximations or truncations...
April 6, 2018: PLoS Computational Biology
https://www.readbyqxmd.com/read/29624140/population-health-management-guiding-principles-to-stimulate-collaboration-and-improve-pharmaceutical-care
#6
Betty Steenkamer, Caroline Baan, Kim Putters, Hans van Oers, Hanneke Drewes
Purpose A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate. Design/methodology/approach The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate...
April 9, 2018: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/29592830/a-community-led-harm-reduction-approach-to-chemsex-case-study-from-australia
#7
Zahra Stardust, Johann Kolstee, Stefan Joksic, James Gray, Siobhan Hannan
Rates of drug use remain substantially higher among gay and bisexual men (GBM) and people living with HIV (PLHIV) in Sydney, New South Wales, Australia. The use of drugs to enhance sexual pleasure within cultures of Party and Play creates opportunities to discuss sexual health, mental health, consent and wellbeing. Community organisations with a history of HIV prevention, care, treatment are well-placed to respond. ACON's (formerly the AIDS Council of New South Wales) multi-dimensional response to 'chemsex' includes: direct client services support for individuals seeking to manage or reduce their use; health promotion activities that support peer education; partnerships with research institutions to better understand cultures of chemsex; and policy submissions that call for drug use to be approached as a health, rather than a criminal, issue...
March 29, 2018: Sexual Health
https://www.readbyqxmd.com/read/29589998/trends-in-onroad-transportation-energy-and-emissions
#8
H Christopher Frey
Globally, 1.3 billion onroad vehicles consume 79 quadrillion BTU of energy, mostly gasoline and diesel fuels, emit 5.7 gigatonnes of CO2 , and emit other pollutants to which approximately 200,000 annual premature deaths are attributed. Improved vehicle energy efficiency and emission controls have helped offset growth in vehicle activity. New technologies are diffusing into the vehicle fleet in response to fuel efficiency and emission standards. Empirical assessment of vehicle emissions is challenging because of myriad fuels and technologies, inter-vehicle variability, multiple emission processes, variability in operating conditions, and varying capabilities of measurement methods...
March 28, 2018: Journal of the Air & Waste Management Association
https://www.readbyqxmd.com/read/29584502/an-insight-of-world-health-organization-who-accident-database-by-cluster-analysis-with-self-organizing-map-som
#9
Chinmoy Pal, Shigeru Hirayama, Sangolla Narahari, Manoharan Jeyabharath, Gopinath Prakash, Vimalathithan Kulothungan
OBJECTIVE: Road crashes are increasing every year in low- and middle-income countries compared to high-income countries, which show decreasing trends. One theory may be because of differences in enforcement of laws, vehicle safety, road standards, and many other factors. A detailed review was made of 5 death trends (total number of deaths/100,000 population and percentages of 4-wheeler, pedestrian, motorized 2/3-wheeler, bicyclist) and the underlying patterns in different countries and regions across the world...
February 28, 2018: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29582707/decentralisation-of-brazil-s-hiv-aids-programme-intended-and-unintended-consequences
#10
Timothy Frasca, Yves-A Fauré, Laetitia Atlani-Duault
Brazil's response to the HIV/AIDS epidemic was characterised by an innovative alliance of governmental and non-governmental actors inspired by a strong progressive tradition in public health. Brazil eventually moved to decentralise HIV/AIDS programmes to its states and cities, a policy endorsed and supported financially by the World Bank as consistent with the mix of public and private elements central to the country's HIV/AIDS strategy. However, decentralisation has not provided the results anticipated. Through interviews with key informants, government officials and patient advocates as well as observation of treatment sites, we outline how the shift of administration and resources to state and municipal bodies operated in practice...
March 27, 2018: Global Public Health
https://www.readbyqxmd.com/read/29567515/in-hospital-complication-rate-following-microendoscopic-versus-open-lumbar-laminectomy-a-propensity-score-matched-analysis
#11
Takeshi Oichi, Yasushi Oshima, Hirotaka Chikuda, Junichi Ohya, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: The incidence of postoperative complications after microendoscopic laminectomy (MEL) has not been compared with that of open laminectomy in a large study, so it is not clear whether MEL is a safer procedure. PURPOSE: To compare postoperative morbidity and mortality following lumbar laminectomy between patients treated with MEL and open laminectomy. STUDY DESIGN: Retrospective cohort study with propensity score-matched analysis...
March 19, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29562969/equivalence-testing-as-a-tool-for-fatigue-risk-management-in-aviation
#12
Lora J Wu, Philippa H Gander, Margo van den Berg, T Leigh Signal
BACKGROUND: Many civilian aviation regulators favor evidence-based strategies that go beyond hours-of-service approaches for managing fatigue risk. Several countries now allow operations to be flown outside of flight and duty hour limitations, provided airlines demonstrate an alternative method of compliance that yields safety levels "at least equivalent to" the prescriptive regulations. Here we discuss equivalence testing in occupational fatigue risk management. We present suggested ratios/margins of practical equivalence when comparing operations inside and outside of prescriptive regulations for two common aviation safety performance indicators: total in-flight sleep duration and psychomotor vigilance task reaction speed...
April 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29561113/-the-ethical-challenges-of-health-policies-in-benin
#13
R A Houngnihin
Over the past two decades, new challenges in public health have sparked renewed interest in health policy ethics in the world. But in Africa in general and Benin in particular, public health ethics as an approach of intervention, remains embryonic. By aiming the well-being of the population, the health policy in Benin is implicitly ethics. But it is too focused on medical logic and operates at the expense of ethics-oriented approach, clearly expressed in terms of strategies assessed by an independent body before, during and after their implementation, based on the relevance, the efficiency, the equity, the transparency, the social justice...
May 22, 2017: Journal International de Bioéthique et D'éthique des Sciences
https://www.readbyqxmd.com/read/29550393/secure-count-query-on-encrypted-genomic-data
#14
Mohammad Zahidul Hasan, Md Safiur Rahman Mahdi, Md Nazmus Sadat, Noman Mohammed
Human genomic information can yield more effective healthcare by guiding medical decisions. Therefore, genomics research is gaining popularity as it can identify potential correlations between a disease and a certain gene, which improves the safety and efficacy of drug treatment and can also develop more effective prevention strategies [1]. To reduce the sampling error and to increase the statistical accuracy of this type of research projects, data from different sources need to be brought together since a single organization does not necessarily possess required amount of data...
March 14, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29543884/listening-to-the-community-using-formative-research-to-strengthen-maternity-waiting-homes-in-zambia
#15
Nancy A Scott, Taryn Vian, Jeanette L Kaiser, Thandiwe Ngoma, Kaluba Mataka, Elizabeth G Henry, Godfrey Biemba, Mary Nambao, Davidson H Hamer
BACKGROUND: The WHO recommends maternity waiting homes (MWH) as one intervention to improve maternal and newborn health. However, persistent structural, cultural and financial barriers in their design and implementation have resulted in mixed success in both their uptake and utilization. Guidance is needed on how to design a MWH intervention that is acceptable and sustainable. Using formative research and guided by a sustainability framework for health programs, we systematically collected data from key stakeholders and potential users in order to design a MWH intervention in Zambia that could overcome multi-dimensional barriers to accessing facility delivery, be acceptable to the community and be financially and operationally sustainable...
2018: PloS One
https://www.readbyqxmd.com/read/29535651/reduced-frequency-of-cases-with-seclusion-is-associated-with-opening-the-doors-of-a-psychiatric-intensive-care-unit
#16
Lisa Hochstrasser, Alexander Voulgaris, Julian Möller, Tatjana Zimmermann, Regine Steinauer, Stefan Borgwardt, Undine E Lang, Christian G Huber
Background: Implementing an open door policy is a complex intervention comprising changes in therapeutic stance, team processes, and a change from locked to open doors. Recent studies show that it can lead to a reduction of seclusion and forced medication, but the role of the physical change of door status is still unclear. Aims: The aims of this study is to examine the transition from closed to predominantly open doors on a psychiatric intensive care unit (PICU) and its associations with the frequency of seclusion and forced medication...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29530060/mechanisms-of-implementing-public-health-interventions-a-pooled-causal-mediation-analysis-of-randomised-trials
#17
Hopin Lee, Alix Hall, Nicole Nathan, Kathryn L Reilly, Kirsty Seward, Christopher M Williams, Serene Yoong, Meghan Finch, John Wiggers, Luke Wolfenden
BACKGROUND: The World Health Organization recommends that nations implement evidence-based nutritional guidelines and policies in settings such as schools and childcare services to improve public health nutrition. Understanding the causal mechanism by which implementation strategies exert their effects could enhance guideline implementation. The aim of this study was to assess the mechanisms by which implementation strategies improved schools and childcare services' adherence to nutrition guidelines...
March 12, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29523167/organizational-and-system-level-characteristics-that-influence-implementation-of-shared-decision-making-and-strategies-to-address-them-a-scoping-review
#18
REVIEW
Isabelle Scholl, Allison LaRussa, Pola Hahlweg, Sarah Kobrin, Glyn Elwyn
BACKGROUND: Shared decision-making (SDM) is poorly implemented in routine care, despite being promoted by health policies. No reviews have solely focused on an in-depth synthesis of the literature around organizational- and system-level characteristics (i.e., characteristics of healthcare organizations and of healthcare systems) that may affect SDM implementation. A synthesis would allow exploration of interventions to address these characteristics. The study aim was to compile a comprehensive overview of organizational- and system-level characteristics that are likely to influence the implementation of SDM, and to describe strategies to address those characteristics described in the literature...
March 9, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29508685/national-framework-for-the-sustainability-of-health-knowledge-translation-initiatives-in-uganda
#19
Robert Basaza, Alison Kinegyere, Boniface Mutatina, Nelson Sewankambo
OBJECTIVES: The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. METHODS: We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies...
January 2018: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29505461/brazilian-public-policies-on-drugs-an-analysis-considering-the-aspects-of-assistance-prevention-and-supply-control
#20
Jacqueline de Souza, Regina C Fioratti, Maraiza M Macedo, Jaqueline Queiroz de Macedo
Since 2004, Brazilian policy makers have been making some changes in the drug policies. It has prioritized a harm reduction perspective instead of a prohibitionist one. Nevertheless, this latter perspective also persists in some parts of the policies and strategies used to deal with this phenomenon in Brazil. This study aims to analyze the structure of the drug policies in Brazil. It is a documental search of Brazilian mental health legislation (laws, decrees, and ordinances) regarding alcohol and other drugs since 2001...
January 2018: Journal of Addictions Nursing
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