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https://www.readbyqxmd.com/read/28226395/healthcare-professionals-accounts-of-challenges-in-managing-motor-neurone-disease-in-primary-healthcare-a-qualitative-study
#1
Sverre Vigeland Lerum, Kari Nyheim Solbraekke, Jan C Frich
Motor neurone disease (MND) is a progressive neurological disease causing muscle wasting, gradual paralysis and respiratory failure, with a life expectancy of 2-4 years. In order to better understand how MND is managed in the community, we conducted a qualitative study to explore the challenges healthcare professionals encounter when managing MND in primary healthcare. Based on data from 15 semi-structured interviews with primary healthcare professionals in Norway, we found that MND is viewed as a condition that requires exceptional effort and detailed planning...
February 22, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28226393/supporting-self-management-by-community-matrons-through-a-group-intervention-an-action-research-study
#2
Abigail M Barkham, Steven J Ersser
The aim of this study was to examine the feasibility and impact of a group intervention by Community Matrons to support those living with multiple long-terms conditions. Little evidence exists as to how the role of the Community Matron (CM) should be delivered to effectively enhance disease self-management and levels of self-efficacy for the service users. This qualitative participatory action research study explored the use of group work as a method of intervention by CMs. A purposive sample of 29 participants was recruited...
February 22, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28226064/reflections-in-the-light-of-the-complexity-theory-and-nursing-education
#3
Ronny Anderson de Oliveira Cruz, Elidianne Layanne Medeiros de Araujo, Neyce de Matos Nascimento, Raquel Janyne de Lima, Jael Rúbia Figueiredo de Sá França, Jacira Dos Santos Oliveira
Objective: to reflect on nursing education, taking into account the principles of complex thinking proposed by Morin. Method: reflection based on the principles of the complexity theory by Edgar Morin. Results: the application of complexity in teaching proposes an emancipatory education based on questioning and social transformation. It comprises the education of nurses who interact with others as a characteristic of their work. It is necessary to prepare students to develop critical and reflective attitudes and actions to overcome the fragmentation and linearity of knowledge...
January 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28225707/nonadherence-to-antiretroviral-therapy-among-hiv-infected-patients-in-zambia-is-concentrated-among-a-minority-of-patients-and-is-highly-variable-across-clinics
#4
Nancy L Czaicki, Charles B Holmes, Izukanji Sikazwe, Carolyn Bolton, Theodora Savory, Mwanza Wa Mwanza, Crispin Moyo, Nancy S Padian, Elvin H Geng
OBJECTIVES: The distribution of adherence to antiretroviral therapy (ART) can indicates whether barriers are concentrated or more distributed. We quantified the medication possession ratio (MPR) and characterized the distribution of medication nonpossession in a network of clinics in Zambia to identify 'hotspots' and predictors of poorer adherence. METHODS: We analyzed a population of adults on ART for more than 3 months who made at least one clinic visit between 1 January 2013 and 28 February 2015...
March 13, 2017: AIDS
https://www.readbyqxmd.com/read/28225695/how-should-therapeutic-decisions-about-expensive-drugs-be-made-in-imperfect-environments
#5
Leonard M Fleck, Marion Danis
Clinicians must inevitably make therapeutic decisions under nonideal conditions. They practice in circumstances that involve incomplete evidence. They deliver care in health care systems that are complex and poorly coordinated. Each of the patients that they take care of is unique while research offers evidence regarding relatively homogeneous populations of patients. Under these circumstances, many parties-medical scientists, reviewing agencies, insurers, and accountable care organizations-can and should contribute to optimizing the development, approval, funding, and prescription of therapies-particularly expensive and marginally beneficial therapies...
February 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28225500/the-prevalence-of-potentially-preventable-deaths-in-an-acute-care-hospital-a-retrospective-cohort
#6
Daniel M Kobewka, Carl van Walraven, Monica Taljaard, Paul Ronksley, Alan J Forster
Studies estimate that 6% to 27% of deaths in hospitals might be prevented with higher quality care. These estimates may be inaccurate because they fail to account for the uncertainty associated with classifying preventability. The purpose of this study was to measure the prevalence of preventable deaths, accounting for the uncertainty in preventability ratings.We created standardized structured case abstracts for all deaths at a multisite academic teaching hospital over a 3-month period. Each case abstract was evaluated independently by 4 reviewers who rated death preventability on a 100-point scale ranging from 0 ("Definitely not preventable") to 100 ("Definitely preventable")...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28225463/doctors-without-borders
#7
Val Wass, Lesley Southgate
The unprecedented demands of patient and population priorities created by globalization and escalating health and social inequities will not be met unless medical education changes. Educators have failed to move fast enough to create an education framework that meets current population needs. A new common set of professional values around global social accountability is necessary. Education borders must be broken down at three levels-societal-institutional, interpersonal, and individual.At a societal-institutional level, global health must be embraced as part of a philosophy of population needs, human rights, equity, and justice...
February 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28224349/mapping-the-health-information-landscape-in-a-rural-culturally-diverse-region-implications-for-interventions-to-reduce-information-inequality
#8
A Susana Ramírez, Erendira Estrada, Ariana Ruiz
The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin...
February 21, 2017: Journal of Primary Prevention
https://www.readbyqxmd.com/read/28224293/health-without-care-vulnerability-medical-brain-drain-and-health-worker-responsibilities-in-underserved-contexts
#9
Yusuf Yuksekdag
There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue-while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the first step of her defence of emigration restrictions, Brock provides three reasons why skilled workers themselves would hold responsibilities to assist with respect to vital needs of their compatriots...
February 21, 2017: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/28224097/understanding-academic-clinicians-intent-to-treat-pediatric-obesity
#10
Claudia Frankfurter, Charles Cunningham, Katherine M Morrison, Heather Rimas, Karen Bailey
AIM: To examine the extent to which the theory of planned behavior (TPB) predicts academic clinicians' intent to treat pediatric obesity. METHODS: A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes. A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012. Descriptive statistics were used to summarize demographic and item agreement data...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#11
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222904/the-2016-proposal-for-the-reorganisation-of-urgent-care-provision-in-belgium-a-political-struggle-to-co-locate-primary-care-providers-and-emergency-departments
#12
Koen Van den Heede, Wilm Quentin, Cécile Dubois, Stephan Devriese, Carine Van de Voorde
Internationally the number of emergency department (ED) visits is on the rise while evidence suggests that a substantial proportion of these patients do not require emergency care but primary care. This paper presents the Belgian 2016 proposal for the reorganisation of urgent care provision and places it into its political context. The proposal focused on re-designing patient flow aiming to reduce inappropriate ED visits by improving guidance of patients through the system. Initially policymakers envisaged, as cornerstone of the reform, to roll-out as standard model the co-location of primary care centres and EDs...
February 17, 2017: Health Policy
https://www.readbyqxmd.com/read/28222730/trends-of-relative-and-absolute-socioeconomic-equity-in-access-to-coronary-revascularisations-in-1995-2010-in-finland-a-register-study
#13
Sonja Lumme, Kristiina Manderbacka, Ilmo Keskimäki
BACKGROUND: Resources for coronary revascularisations have increased substantially since the early 1990s in Finland. At the same time, ischaemic heart disease (IHD) mortality has decreased markedly. This study aims to examine how these changes have influenced trends in absolute and relative differences between socioeconomic groups in revascularisations and age group differences in them using IHD mortality as a proxy for need. METHODS: Hospital Discharge Register data on revascularisations among Finns aged 45-84 in 1995-2010 were individually linked to population registers to obtain socio-demographic data...
February 20, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28222717/causes-of-death-in-very-preterm-infants-cared-for-in-neonatal-intensive-care-units-a-population-based-retrospective-cohort-study
#14
Tim Schindler, Louise Koller-Smith, Kei Lui, Barbara Bajuk, Srinivas Bolisetty
BACKGROUND: While there are good data to describe changing trends in mortality and morbidity rates for preterm populations, there is very little information on the specific causes and pattern of death in terms of age of vulnerability. It is well established that mortality increases with decreasing gestational age but there are limited data on the specific causes that account for this increased mortality. The aim of this study was to establish the common causes of hospital mortality in a regional preterm population admitted to a neonatal intensive care unit (NICU)...
February 21, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28222095/delays-and-loss-to-follow-up-before-treatment-of-drug-resistant-tuberculosis-following-implementation-of-xpert-mtb-rif-in-south-africa-a-retrospective-cohort-study
#15
Helen Cox, Lindy Dickson-Hall, Norbert Ndjeka, Anja Van't Hoog, Alison Grant, Frank Cobelens, Wendy Stevens, Mark Nicol
BACKGROUND: South Africa has a large burden of rifampicin-resistant tuberculosis (RR-TB), with 18,734 patients diagnosed in 2014. The number of diagnosed patients has increased substantially with the introduction of the Xpert MTB/RIF test, used for tuberculosis (TB) diagnosis for all patients with presumptive TB. Routine aggregate data suggest a large treatment gap (pre-treatment loss to follow-up) between the numbers of patients with laboratory-confirmed RR-TB and those reported to have started second-line treatment...
February 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28220518/describing-student-performance-a-comparison-among-clinical-preceptors-across-cultural-contexts
#16
Kerry Wilbur, Noha Hassaballa, Omaima S Mahmood, Emily K Black
CONTEXT: Health professional student evaluation during experiential training is notably subjective and assessor judgements may be affected by socio-cultural influences. OBJECTIVES: This study sought to explore how clinical preceptors in pharmacy conceptualise varying levels of student performance and to identify any contextual differences that may exist across different countries. METHODS: The qualitative research design employed semi-structured interviews...
February 20, 2017: Medical Education
https://www.readbyqxmd.com/read/28220328/the-provision-of-dietary-and-physical-activity-advice-for-men-diagnosed-with-prostate-cancer-a-qualitative-study-of-the-experiences-and-views-of-health-care-professionals-patients-and-partners
#17
Eileen Sutton, Lucy E Hackshaw-McGeagh, Jonathan Aning, Amit Bahl, Anthony Koupparis, Raj Persad, Richard M Martin, J Athene Lane
PURPOSE: To explore the views and experiences of health care professionals (HCPs), men diagnosed with localised prostate cancer and their partners about the provision of advice on diet and physical activity after diagnosis and treatment for localised prostate cancer. METHODS: Semi-structured in-depth interviews with ten HCPs (Consultant Urological Surgeons, Uro-Oncology Clinical Nurse Specialists and Allied Health Professionals: see Table 1) and sixteen men diagnosed with localised prostate cancer and seven of their partners...
February 20, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/28220251/triple-aim-improvement-for-individuals-services-and-society-in-dementia-care-the-dementianet-collaborative-care-approach
#18
M S Nieuwboer, A Richters, M A van der Marck
BACKGROUND: A redesigning of primary care is required to meet dementia patients' needs. In the Netherlands, current dementia care still falls short in areas including ad hoc collaboration, lack of feedback on quality to professionals involved, and insufficient implementation of established multidisciplinary guidelines. OBJECTIVE: DementiaNet is a collaborative care approach, which aims to reduce the burden of the disease on individuals, healthcare services and society via network-based care that encourages collaboration, enhances knowledge and skills and stimulates quality improvement cycles...
February 20, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#19
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28220213/labour-market-marginalisation-subsequent-to-suicide-attempt-in-young-migrants-and-native-swedes
#20
T Niederkrotenthaler, M Wang, M Helgesson, H Wilcox, M Gould, E Mittendorfer-Rutz
PURPOSE: This study aimed to compare young individuals who differed in terms of birth region and history of suicide attempt regarding socio-demographic and healthcare factors, and with regard to their risks of subsequent unemployment, sickness absence and disability pension. METHODS: Prospective cohort study based on register linkage of 2,801,558 Swedish residents, aged 16-40 years in 2004, without disability pension and with known birth country, followed up 2005-2011...
February 20, 2017: Social Psychiatry and Psychiatric Epidemiology
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