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https://www.readbyqxmd.com/read/28621206/baseline-population-health-conditions-ahead-of-a-health-system-strengthening-program-in-rural-madagascar
#1
Ann C Miller, Ranto H Ramananjato, Andres Garchitorena, Victor R Rabeza, Djordje Gikic, Amber Cripps, Laura Cordier, Hery-Tiana Rahaniraka Razanadrakato, Marius Randriamanambintsoa, Lara Hall, Megan Murray, Felicite Safara Razanavololo, Michael L Rich, Matthew H Bonds
BACKGROUND: A model health district was initiated through a program of health system strengthening (HSS) in Ifanadiana District of southeastern Madagascar in 2014. We report population health indicators prior to initiation of the program. METHODS: A representative household survey based on the Demographic Health Survey was conducted using a two-stage cluster sampling design in two strata - the initial program catchment area and the future catchment area. Chi-squared and t-tests were used to compare data by stratum, using appropriate sampling weights...
2017: Global Health Action
https://www.readbyqxmd.com/read/28605633/epileptic-vs-psychogenic-nonepileptic-seizures-a-video-based-survey
#2
Danielle Wasserman, Moshe Herskovitz
Psychogenic non epileptic seizures (PNES) are present in up to 30% of patients undergoing video EEG. Delay in PNES diagnosis is an average of 7.2years. Patients are exposed to costly, hazardous medications and other iatrogenic morbidities. Our aim was to investigate the ability to correctly diagnose ES from PNES in different groups and seniorities of medical professionals based on video alone. We showed ten video episodes' recordings (5 PNES, 5 ES) to doctors and nurses from ER, Internal Medicine ward and Neurology department, and inquired about the episodes' nature...
June 9, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28581376/improving-collaboration-between-professionals-supporting-mentally-ill-offenders
#3
Sarah Hean, Atle Ødegård, Elisabeth Willumsen
Purpose Interprofessional collaboration is necessary when supporting mentally ill offenders but little is understood of these interactions. The purpose of this paper is to explore prison officers' perceptions of current and desirable levels of interprofessional collaboration (relational coordination (RC)) to understand how collaboration between these systems can be improved. Design/methodology/approach Gittell's RC scale was administered to prison officers within the Norwegian prison system ( n=160) using an adaptation of the instrument in which actual and desired levels of RC are evaluated...
June 12, 2017: International Journal of Prisoner Health
https://www.readbyqxmd.com/read/28569202/a-health-partnership-to-reduce-neonatal-mortality-in-four-hospitals-in-rwanda
#4
Placide Ntigurirwa, Kathy Mellor, Daniel Langer, Mari Evans, Emily Robertson, Lisine Tuyisenge, Alan Groves, Tom Lissauer
BACKGROUND: A health partnership to improve hospital based neonatal care in Rwanda to reduce neonatal mortality was requested by the Rwandan Ministry of Health. Although many health system improvements have been made, there is a severe shortage of health professionals with neonatal training. METHODS: Following a needs assessment, a health partnership grant for 2 years was obtained. A team of volunteer neonatologists and paediatricians, neonatal nurses, lactation consultants and technicians with experience in Rwanda or low-income countries was assembled...
June 1, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28538427/return-on-investment-of-advanced-practice-medical-degrees-nps-vs-pas
#5
Christopher K Craig, James H Holmes, Jeffery E Carter
As the United States faces a predicted physician shortage over the next 2 decades, physician assistants (PAs) and NPs are expected to fill the void. At the same time, because education is expensive, student loan and tuition increases have many potential applicants assessing differences in reimbursement and wondering about their return on investment (ROI). An analysis compared PA and NP salaries by incorporating national salary data, federal income tax, and student loans for a comparative analysis of each career pathway...
June 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28538139/advanced-musculoskeletal-physiotherapists-are-effective-and-safe-in-managing-patients-with-acute-low-back-pain-presenting-to-emergency-departments
#6
James M Sayer, Rita M Kinsella, Belinda A Cary, Angela T Burge, Lara A Kimmel, Paula Harding
Objective The aim of this study was to compare emergency department (ED) key performance indicators for patients presenting with low back pain and seen by an advanced musculoskeletal physiotherapist (AMP) with those seen by other non-AMP clinicians (ED doctors and nurse practitioners).Methods A retrospective audit (October 2012-September 2013) was performed of data from three metropolitan public hospital EDs to compare patients with low back pain seen by AMP and non-AMP clinicians. Outcome measures included ED length of stay, ED wait time, admission rates and re-presentation to the ED...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28476130/-waiting-for-and-waiting-in-public-and-private-hospitals-a-qualitative-study-of-patient-trust-in-south-australia
#7
Paul R Ward, Philippa Rokkas, Clinton Cenko, Mariastella Pulvirenti, Nicola Dean, A Simon Carney, Samantha Meyer
BACKGROUND: Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals...
May 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28401657/validation-of-a-modified-early-warning-score-linked-situation-background-assessment-recommendation-sbar-communication-tool-a-mixed-methods-study
#8
Debora Burger, Sue Jordan, Una Kyriacos
AIMS AND OBJECTIVES: The objective of this study was to develop and validate a modified Situation-Background-Assessment-Recommendation communication tool incorporating components of the Cape Town Modified Early Warning Score vital signs chart for reporting early signs of clinical deterioration. BACKGROUND: Reporting early signs of physiological and clinical deterioration could prevent 'failure to rescue' or unexpected intensive care admission, cardiac arrest or death...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28385463/clinical-and-social-barriers-to-antimicrobial-stewardship-in-pulmonary-medicine-a-qualitative-study
#9
Jennifer K Broom, Alex F Broom, Emma R Kirby, Alexandra F Gibson, Jeffrey J Post
BACKGROUND: The treatment of pulmonary infections is one of the largest indications for antibiotics in human health care, offering significant potential for antibiotic optimization internationally. This study explores the perspectives of pulmonary clinicians on antibiotic use in hospital pulmonary infections. METHODS: Twenty-eight pulmonary doctors and nurses from 2 hospitals participated in semi-structured interviews focusing on their experiences of antibiotic use...
April 3, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28299540/psychosocial-needs-of-patient-s-relatives-and-health-care-providers-in-a-pediatric-critical-care-unit
#10
Sasidaran Kandasamy, Niranjan Vijayakumar, Rupesh Kumar Natarajan, Thangavelu Sangaralingam, Nedunchelian Krishnamoorthi
OBJECTIVE: To describe the needs of relatives of children admitted to an Intensive Care Unit and compare their needs with the perspectives of doctors, nurses and administrators. METHODS: This is a descriptive comparative study done at a tertiary care PICU from South India. A modified Critical Care Family Needs Inventory (CCFNI) (internal consistency reliability =0.93) was used to assess the needs of 35 family members, 30 nurses, 30 doctors and 30 administrators...
March 16, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28196343/do-abused-young-children-feel-less-pain
#11
Marie-Hélène Drouineau, Elise Guenego, Véronique Sebille-Rivain, Bénédicte Vrignaud, Martine Balençon, Thomas Blanchais, Karine Levieux, Nathalie Vabres, Georges Picherot, Christèle Gras-le Guen
The objective of this study was to investigate whether acute pain in abused children was under recognized by doctors and nurses compared to children evaluated for accidental injuries. We hypothesize that an abused child's reaction to physical pain could be an additional symptom of this challenging diagnosis. For the observational prospective case control study in an emergency department, children were eligible when: younger than six years old, the reported trauma occurred within the previous seven days, the trauma comprised a bone injury or burn, and the child was able to express his or her pain...
March 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28143793/parent-and-provider-experience-and-shared-understanding-after-a-family-centered-nighttime-communication-intervention
#12
Alisa Khan, Jennifer Baird, Jayne E Rogers, Stephannie L Furtak, Kathryn A Williams, Brenda Allair, Katherine P Litterer, Meesha Sharma, Alla Smith, Mark A Schuster, Christopher P Landrigan
OBJECTIVE: To assess parent and provider experience and shared understanding after a family-centered, multidisciplinary nighttime communication intervention (nurse-physician brief, family huddle, family update sheet). METHODS: We performed a prospective intervention study at a children's hospital from May 2013 to October 2013 (preintervention period) and May 2014 to October 2014 (postintervention period). Participants included 464 parents, 176 nurses, and 52 resident physicians of 582 hospitalized 0- to 17-year-old patients...
May 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28125827/do-clinicians-understand-quality-metric-data-an-evaluation-in-a-twitter-derived-sample
#13
Sushant Govindan, Vineet Chopra, Theodore J Iwashyna
OBJECTIVE: Despite significant efforts and cost, quality metrics do not consistently influence practice. While research has focused on improving data through statistical risk-adjustment, whether clinicians understand these data is unknown. Therefore, we assessed clinician comprehension of central line-associated blood stream infection (CLABSI) quality metric data. DESIGN: Cross-sectional survey with an 11-item test of CLABSI data comprehension. Each question assessed 1 of 3 concepts concerning CLABSI understanding: basic numeracy, risk-adjustment numeracy, and risk-adjustment interpretation...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28122614/clinical-decision-making-in-the-recognition-of-dying-a-qualitative-interview-study
#14
Paul Taylor, Dawn Dowding, Miriam Johnson
BACKGROUND: Recognising dying is an essential clinical skill for general and palliative care professionals alike. Despite the high importance, both identification and good clinical care of the dying patient remains extremely difficult and often controversial in clinical practice. This study aimed to answer the question: "What factors influence medical and nursing staff when recognising dying in end-stage cancer and heart failure patients?" METHODS: This study used a descriptive approach to decision-making theory...
January 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28025716/factors-contributing-to-delays-in-diagnosis-of-breast-cancers-in-ghana-west-africa
#15
Louise Brinton, Jonine Figueroa, Ernest Adjei, Daniel Ansong, Richard Biritwum, Lawrence Edusei, Kofi M Nyarko, Seth Wiafe, Joel Yarney, Beatrice Wiafe Addai, Baffour Awuah, Joe Nat Clegg-Lamptey
BACKGROUND: Late diagnoses and poor prognoses of breast cancer are common throughout Africa. METHODS: To identify responsible factors, we utilized data from a population-based case-control study involving 1184 women with breast malignancies conducted in three hospitals in Accra and Kumasi, Ghana. Interviews focused on potential breast cancer risk factors as well as factors that might contribute to presentation delays. We calculated odds ratios (OR) and 95% confidence intervals (CI) comparing malignances with biopsy masses larger than 5 cm...
February 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/27993924/limited-effectiveness-of-a-skills-and-drills-intervention-to-improve-emergency-obstetric-and-newborn-care-in-karnataka-india-a-proof-of-concept-study
#16
Beena Varghese, Jayanna Krishnamurthy, Blaze Correia, Ruchika Panigrahi, Maryann Washington, Vinotha Ponnuswamy, Prem Mony
OBJECTIVE: The majority of the maternal and perinatal deaths are preventable through improved emergency obstetric and newborn care at facilities. However, the quality of such care in India has significant gaps in terms of provider skills and in their preparedness to handle emergencies. We tested the feasibility, acceptability, and effectiveness of a "skills and drills" intervention, implemented between July 2013 and September 2014, to improve emergency obstetric and newborn care in the state of Karnataka, India...
December 23, 2016: Global Health, Science and Practice
https://www.readbyqxmd.com/read/27855673/gender-and-physician-specialization-and-practice-settings-in-ecuador-a-qualitative-study
#17
Rita Bedoya-Vaca, Kathryn P Derose, Natalia Romero-Sandoval
BACKGROUND: The increasing proportion of women in the medical profession is a worldwide phenomenon often called the "feminization of medicine." However, it is understudied in low and middle-income countries, particularly in Latin America. METHODS: Using a qualitative, descriptive design, we explored the influence of gender and other factors on physician career decision-making and experiences, including medical specialty and public vs. private practice, in Quito, Ecuador, through in-depth, semi-structured interviews (n = 31) in 2014...
November 17, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27825583/barbados-insulin-matters-bim-study-perceptions-on-insulin-initiation-by-primary-care-doctors-in-the-caribbean-island-of-barbados
#18
Charles Grafton Taylor, Gordon Taylor, Anique Atherley, Ian Hambleton, Nigel Unwin, Oswald Peter Adams
AIMS: With regards to insulin initiation in Barbados we explored primary care doctor (PCD) perception, healthcare system factors and predictors of PCD reluctance to initiate insulin. METHODS: PCDs completed a questionnaire based on the theory of planned behaviour (TPB) and a reluctance to initiate insulin scale. Using linear regression, we explored the association between TPB domains and the reluctance to initiate insulin scale. RESULTS: Of 161 PCDs, 70% responded (75 private and 37 public sector)...
April 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/27800154/influenza-vaccination-motivators-among-healthcare-personnel-in-a-large-acute-care-hospital-in-israel
#19
Amir Nutman, Naomi Yoeli
BACKGROUND: Vaccinating healthcare personnel (HCP) against influenza is important to prevent transmission and morbidity among patients and staff. METHODS: We conducted an online survey assessing knowledge, perceptions and attitudes concerning influenza vaccination among HCP. Multivariate logistic regression was performed to identify independent predictors of vaccination. RESULTS: The survey was completed by 468 HCP representing all categories of staff...
2016: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/27760007/monitoring-of-frequency-and-antimicrobial-susceptibility-of-pathogens-on-the-hands-of-healthcare-workers-in-a-tertiary-hospital
#20
Athanasios Tselebonis, Evangelia Nena, Christos Nikolaidis, Theocharis Konstantinidis, Christos Kontogiorgis, Maria Panopoulou, Theodore C Constantinidis
OBJECTIVE: To monitor microbes, focusing on drug resistance, on the hands of the personnel of four departments of a tertiary hospital (ICU, neonatal unit, internal medicine ward and surgical ward) and explore differences between departments, professions and genders. MATERIALS AND METHODS: Hand sampling from 125 healthcare employees was conducted followed by isolation, identification and antibiotic resistance profiling of different microbial species. RESULTS: Staphylococcus spp was the most prevalent microbe (76/125, 60...
September 1, 2016: Folia Medica
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