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https://www.readbyqxmd.com/read/28812813/do-management-and-leadership-practices-in-the-context-of-decentralisation-influence-performance-of-community-health-fund-evidence-from-iramba-and-iringa-districts-in-tanzania
#1
Chakupewa Joseph, Stephen Oswald Maluka
BACKGROUND: In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR). The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF), were introduced. While the country's level of enrolment in the CHF is low, there are marked variations among districts...
September 26, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28807480/opportunities-and-challenges-in-screening-for-childhood-sexual-abuse
#2
Deepa L Sekhar, Jennifer L Kraschnewski, Heather L Stuckey, Pamela D Witt, Erica B Francis, Ginger A Moore, Paul L Morgan, Jennie G Noll
Retrospective studies suggest 1 in 4 girls and 1 in 6 boys will experience sexual abuse before 18 years of age, resulting in future morbidity. Successful interventions exist, however, victims are reluctant to disclose. Screening for childhood sexual abuse (CSA) may provide an opportunity to overcome this barrier, yet no current model for universal CSA screening exists. We sought to understand the perspective of key stakeholders on CSA screening through qualitative research. Eight focus groups of 7-10 participants each (n=62) were conducted from April-September 2016...
August 11, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28805082/veterans-transitioning-from-isolation-to-integration-a-look-at-veteran-service-dog-partnerships
#3
Terry K Crowe, Victoria Sánchez, Alyse Howard, Brenna Western, Stephanie Barger
BACKGROUND: This study explored the dynamics of veteran/service dog partnerships by gathering the perspectives of veterans with a history of post-traumatic stress disorder and/or traumatic brain injury. METHODS: Exploratory qualitative methods (focus groups and individual interviews) were used to investigate veteran/service dog relationships related to community involvement, family and friend relationships, self-care, work, and leisure. Nine male veterans, Paws, and Stripes program graduates participated...
August 13, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#4
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28799883/operating-a-motor-vehicle-after-marijuana-use-perspectives-from-people-who-use-high-potency-marijuana
#5
Patricia A Cavazos-Rehg, Melissa J Krauss, Shaina J Sowles, Kidist Zewdie, Laura Bierut
BACKGROUND: With advancing marijuana legalization in the United States, a primary concern is the possible increase in consequences relating to marijuana driving impairment, especially among people who use high potency marijuana (i.e., extracts). In this study we assessed the risk perception and experiences of driving under the influence of marijuana by investigating people who use extracts. METHODS: Participants from two studies were queried about driving after using marijuana...
August 11, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28799269/reported-implementation-lessons-from-a-national-quality-improvement-initiative-productive-ward-releasing-time-to-care%C3%A2-a-qualitative-ward-based-team-perspective
#6
Mark White, Tony Butterworth, John S G Wells
AIM: To explore the experiences of participants involved in the implementation of the Productive Ward: Releasing Time to Care™ initiative in Ireland, identifying key implementation lessons. BACKGROUND: A large-scale quality improvement programme Productive Ward: Releasing Time to Care™ was introduced nationwide into Ireland in 2011. We captured accounts from ward-based teams in an implementation phase during 2013-14 to explore their experiences. METHODS: Semi-structured, in-depth interviews with a purposive sample of 24 members of ward-based teams from nine sites involved in the second national phase of the initiative were conducted...
August 10, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28796530/athletic-trainers-roles-and-responsibilities-regarding-academic-adjustments-as-part-of-the-concussion-management-process-in-the-secondary-school-setting
#7
Cailee E Welch Bacon, Melissa C Kay, Tamara C Valovich McLeod
CONTEXT:   Athletic trainers (ATs) play a vital role in managing the care of student-athletes after a sport-related concussion, yet little is known about their specific involvement in the implementation of academic adjustments as part of the concussion-management plan. OBJECTIVE:   To explore ATs' perceived roles and responsibilities regarding the implementation of academic adjustments for concussed student-athletes. DESIGN:   Qualitative study...
August 10, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28775389/developing-a-sustainable-child-and-family-service-system-after-a-community-tragedy-lessons-from-sandy-hook
#8
Kimberly Eaton Hoagwood, Su-Chin Serene Olin, Nicole M Wang, Michele Pollock, Mary Acri, Elizabeth Glaeser, Emma D Whitmyre, Amy Storfer-Isser, Sarah McCue Horwitz
This paper describes a systematic approach to assessing community services post-Sandy Hook shooting. An evaluation team was invited to develop a sustainability plan for community services in Newtown. Service organizations, providers and families were interviewed. Descriptive statistics were used to characterize the range of services; respondent perspectives were coded using content analysis. We found that Newtown has a broad array of community services, but respondent groups varied in their perceptions of service adequacy...
August 2017: Journal of Community Psychology
https://www.readbyqxmd.com/read/28769833/possession-zone-as-a-performance-indicator-in-football-the-game-of-the-best-teams
#9
Claudio A Casal, Rubén Maneiro, Toni Ardá, Francisco J Marí, José L Losada
Possession time in football has been widely discussed in research but few studies have analyzed the importance of the field area in which possession occurs. The objective of this study was to identify the existence of significant differences in the field zone of ball possession between successful and unsuccessful teams and to acknowledge if the match status modulates the possession model. To this end, 2,284 attacks were analyzed corresponding to the matches in the final phase of the UEFA Euro 2016 France, recording possession time and field zone in which possession occurred...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28766098/perceived-barriers-and-preferred-components-for-physical-activity-interventions-in-african-american-survivors-of-breast-or-endometrial-cancer-with-type-2-diabetes-the-s-u-c-c-e-s-s-framework
#10
Kristin Z Black, La-Shell Johnson, Carmen D Samuel-Hodge, Lavanya Gupta, Aditi Sundaresan, Wanda K Nicholson
PURPOSE: African-American (AA) female cancer survivors share a disproportionate burden of diabetes compared to their white counterparts. Our objectives were to explore the perspectives of AA survivors with type 2 diabetes on perceived barriers to physical activity (PA) and preferences for a PA intervention and develop a framework for a PA program after cancer treatment. METHODS: Trained interviewers conducted semi-structured interviews with AA survivors of breast or endometrial cancer with diabetes (total n = 20; 16 breast, 4 endometrial)...
August 1, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28764687/sustainability-and-scalability-of-a-volunteer-based-primary-care-intervention-health-tapestry-a-mixed-methods-analysis
#11
Monika Kastner, Radha Sayal, Doug Oliver, Sharon E Straus, Lisa Dolovich
BACKGROUND: Chronic diseases are a significant public health concern, particularly in older adults. To address the delivery of health care services to optimally meet the needs of older adults with multiple chronic diseases, Health TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) uses a novel approach that involves patient home visits by trained volunteers to collect and transmit relevant health information using e-health technology to inform appropriate care from an inter-professional healthcare team...
August 1, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28763259/strategies-for-introducing-outpatient-specialty-palliative-care-in-gynecologic-oncology
#12
Casey M Hay, Carolyn Lefkowits, Megan Crowley-Matoka, Marie A Bakitas, Leslie H Clark, Linda R Duska, Renata R Urban, Stephanie L Creasy, Yael Schenker
PURPOSE: Concern that patients will react negatively to the idea of palliative care is cited as a barrier to timely referral. Strategies to successfully introduce specialty palliative care to patients have not been well described. We sought to understand how gynecologic oncologists introduce outpatient specialty palliative care. METHODS: We conducted a national qualitative interview study at six geographically diverse academic cancer centers with well-established palliative care clinics between September 2015 and March 2016...
August 1, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28759998/pharmacist-participation-in-acute-ischemic-stroke-decreases-door-to-needle-time-to-recombinant-tissue-plasminogen-activator
#13
Megan A Rech, Stephanie Bennett, Elisabeth Donahey
BACKGROUND: Pharmacists are an important member of the stroke team and aid in obtaining medication and medical history, providing education, managing blood pressure, reviewing exclusion criteria for recombinant tissue plasminogen activator (rtPA), and facilitating reconstitution and administration of rtPA. OBJECTIVE: To determine if pharmacist presence at bedside during acute ischemic stroke resulted in a reduction in door-to-needle (DTN) times. METHODS: This was a retrospective cohort study between January 1, 2011 and December 31, 2015 of patients who received rtPA for acute ischemic stroke in either the emergency department or hospital...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28756147/defining-and-measuring-decision-making-for-the-management-of-trauma-patients
#14
Amin Madani, Amanda Gips, Tarek Razek, Dan L Deckelbaum, David S Mulder, Jeremy R Grushka
BACKGROUND: Effective management of trauma patients is heavily dependent on sound judgment and decision-making. Yet, current methods for training and assessing these advanced cognitive skills are subjective, lack standardization, and are prone to error. This qualitative study aims to define and characterize the cognitive and interpersonal competencies required to optimally manage injured patients. METHODS: Cognitive and hierarchical task analyses for managing unstable trauma patients were performed using qualitative methods to map the thoughts, behaviors, and practices that characterize expert performance...
July 26, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28744847/factors-considered-by-clinicians-when-prognosticating-intracerebral-hemorrhage-outcomes
#15
David Y Hwang, Stacy Y Chu, Cameron A Dell, Mary J Sparks, Tiffany D Watson, Carl D Langefeld, Mary E Comeau, Jonathan Rosand, Thomas W K Battey, Sebastian Koch, Mario L Perez, Michael L James, Jessica McFarlin, Jennifer L Osborne, Daniel Woo, Steven J Kittner, Kevin N Sheth
BACKGROUND: The early subjective clinical judgment of clinicians outperforms formal prognostic scales for accurate determination of outcome after intracerebral hemorrhage (ICH), with the judgment of physicians and nurses having equivalent accuracy. This study assessed specific decisional factors that physicians and nurses incorporate into early predictions of functional outcome. METHODS: This prospective observational study enrolled 121 ICH patients at five US centers...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28738825/broadening-measures-of-success-results-of-a-behavioral-health-translational-research-training-program
#16
Julie A Baldwin, Heather J Williamson, Emery R Eaves, Bruce L Levin, Donna L Burton, Oliver T Massey
BACKGROUND: While some research training programs have considered the importance of mentoring in inspiring professionals to engage in translational research, most evaluations emphasize outcomes specific to academic productivity as primary measures of training program success. The impact of such training or mentoring programs on stakeholders and local community organizations engaged in translational research efforts has received little attention. The purpose of this evaluation is to explore outcomes other than traditional academic productivity in a translational research graduate certificate program designed to pair graduate students and behavioral health professionals in collaborative service-learning projects...
July 24, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28737997/adolescent-and-young-adult-cancer-survivors-experiences-of-the-healthcare-system-a-qualitative-study
#17
Elizabeth A May, Brittany C McGill, Eden G Robertson, Antoinette Anazodo, Claire E Wakefield, Ursula M Sansom-Daly
PURPOSE: To qualitatively examine the experiences of diagnosis and treatment, and attitudes toward ongoing healthcare of adolescent and young adult (AYA) survivors of AYA cancer, to determine barriers to healthcare engagement in the early survivorship period. METHODS: Forty-two participants aged between 15 and 25 years were recruited between February 2013 and October 2015 as part of a larger Australia-wide study. This study analyzed data collected through a semistructured telephone interview...
July 24, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28734561/avoiding-adult-in-hospital-cardiac-arrest-a-retrospective-cohort-study-to-determine-preventability
#18
Gordon Bingham, Irma Bilgrami, Mandy Sandford, Sarah Larwill, Judit Orosz, Carl Luckhoff, Tony Kambourakis
INTRODUCTION: This study had three main aims. Develop a methodology for reviewing in-hospital cardiac arrests (IHCA). Assess appropriateness and potential preventability of IHCAs. Identify areas for improvement within the rapid response system (RRS). DESIGN: A retrospective cohort study of IHCA identified from an existing organisational electronic database of medical emergency (MET) and Code Blue team activation. Potential preventability of IHCA and Code Blue team activation were established by an expert panel based on a standardised case review process with descriptive and content analyses for each IHCA event...
July 19, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28731509/keeping-safe-continuous-glucose-monitoring-cgm-in-persons-with-type-1-diabetes-and-impaired-awareness-of-hypoglycaemia-a-qualitative-study
#19
A F Vloemans, C A J van Beers, M de Wit, W Cleijne, S M Rondags, P H Geelhoed-Duijvestijn, M H H Kramer, E H Serné, F J Snoek
AIM: To further our understanding of individual use and experience of continuous glucose monitoring (CGM) in adults with Type 1 diabetes and impaired awareness of hypoglycaemia, we conducted a qualitative study supplementary to a randomized controlled trial, using semi-structured interviews. METHODS: Twenty-three participants of the IN CONTROL trial were interviewed within 4 weeks after the last study visit. The interview centred around experiences of CGM, taking into account the person's expectations prior to the trial...
July 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28726159/diagnosis-and-treatment-delays-among-elderly-breast-cancer-patients-with-pre-existing-mental-illness
#20
Kristy Iglay, Melissa L Santorelli, Kim M Hirshfield, Jill M Williams, George G Rhoads, Yong Lin, Kitaw Demissie
PURPOSE: This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. METHODS: A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis...
July 19, 2017: Breast Cancer Research and Treatment
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