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https://www.readbyqxmd.com/read/29155870/a-modified-delphi-study-to-determine-the-level-of-consensus-across-the-european-union-on-the-structures-processes-and-desired-outcomes-of-the-management-of-polypharmacy-in-older-people
#1
Derek Stewart, Kathrine Gibson-Smith, Katie MacLure, Alpana Mair, Albert Alonso, Carles Codina, Antonio Cittadini, Fernando Fernandez-Llimos, Glenda Fleming, Dimitra Gennimata, Ulrika Gillespie, Cathy Harrison, Ulrike Junius-Walker, Przemysław Kardas, Thomas Kempen, Moira Kinnear, Pawel Lewek, Joao Malva, Jennifer McIntosh, Claire Scullin, Birgitt Wiese
BACKGROUND: Inappropriate use of multiple medicines (inappropriate polypharmacy) is a major challenge in older people with consequences of increased prevalence and severity of adverse drug reactions and interactions, and reduced medicines adherence. The aim of this study was to determine the levels of consensus amongst key stakeholders in the European Union (EU) in relation to aspects of the management of polypharmacy in older people. METHODS: Forty-six statements were developed on aspects of healthcare structures, processes and desired outcomes, with consensus defined at ≥ 80% agreement...
2017: PloS One
https://www.readbyqxmd.com/read/29149317/decision-space-for-health-workforce-management-in-decentralized-settings-a-case-study-in-uganda
#2
Alvaro Alonso-Garbayo, Joanna Raven, Sally Theobald, Freddie Ssengooba, Milly Nattimba, Tim Martineau
The aim of this paper is to improve understanding about how district health managers perceive and use their decision space for human resource management (HRM) and how this compares with national policies and regulatory frameworks governing HRM. The study builds upon work undertaken by PERFORM Research Consortium in Uganda using action-research to strengthen human resources management in the health sector. To assess the decision space that managers have in six areas of HRM (e.g. policy, planning, remuneration and incentives, performance management, education and information) the study compares the roles allocated by Uganda's policy and regulatory frameworks with the actual room for decision-making that district health managers perceive that they have...
November 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29149313/how-do-health-workers-experience-and-cope-with-shocks-learning-from-four-fragile-and-conflict-affected-health-systems-in-uganda-sierra-leone-zimbabwe-and-cambodia
#3
Sophie Witter, Haja Wurie, Pamela Chandiwana, Justine Namakula, Sovannarith So, Alvaro Alonso-Garbayo, Freddie Ssengooba, Joanna Raven
This article is grounded in a research programme which set out to understand how to rebuild health systems post-conflict. Four countries were studied-Uganda, Sierra Leone, Zimbabwe and Cambodia-which were at different distances from conflict and crisis, as well as having unique conflict stories. During the research process, the Ebola epidemic broke out in West Africa. Zimbabwe has continued to face a profound economic crisis. Within our research on health worker incentives, we captured insights from 128 life histories and in-depth interviews with a variety of staff that had remained in service...
November 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29145728/understanding-how-emergency-medicine-physicians-survive-and-thrive-in-rural-practice-a-theoretical-model
#4
Ashra Kolhatkar, Andrea Keesey, Bob Bluman, Brenna Lynn, Tandi Wilkinson
INTRODUCTION: The challenges facing emergency medicine (EM) services in Canada reflect the limitations of the entire healthcare system. The emergency department (ED) is uniquely situated in the healthcare system such that shortcomings in hospital- and community-based services are often first revealed there. This is especially true in rural settings, where there are additional site-specific barriers to the provision of EM care. Existing studies look at the factors that influence rural EM physicians in isolation...
November 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29137511/in-british-columbia-the-supply-of-primary-care-physicians-grew-but-their-rate-of-clinical-activity-declined
#5
Lindsay Hedden, Morris L Barer, Kimberlyn McGrail, Michael Law, Ivy L Bourgeault
Reports of a primary care shortage are ubiquitous in Canada and the United States. We used a population-based, retrospective cohort study to examine the extent to which the feminization and aging of the primary care physician workforce and secular trends may contribute to changes in the availability of primary care services. We used billing data for all primary care physicians in British Columbia for the period 2005-12. We used multivariate linear mixed-effects models to study physician remuneration and activity levels...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29132445/physician-remuneration-for-remote-consults-an-overview-of-approaches-across-canada
#6
Kelly Stanistreet, Jenn Verma, Kirby Kirvan, Neil Drimer, Clare Liddy
While lengthy waits for medical specialists remains a persistent problem across Canada, remote consult presents a strategy to address this issue. Connecting primary healthcare providers to specialists via electronic (eConsult) or telephone consult enables care providers to deliver appropriate, speciality-informed care for their patients in the primary care setting, reducing the time spent waiting for specialists and potentially preventing unnecessary referrals to specialty care. These remote consult models are the focus of a new pan-Canadian quality improvement collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with Canada Health Infoway, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29127851/autonomy-to-health-care-professionals-as-a-vehicle-for-value-based-health-care-results-of-a-quasi-experiment-in-hospital-governance
#7
Kristian Nørgaard Larsen, Søren Rud Kristensen, Rikke Søgaard
Health care systems increasingly aim to create value for money by simultaneous incentivizing of quality along with classical goals such as activity increase and cost containment. It has recently been suggested that letting health care professionals choose the performance metrics on which they are evaluated may improve value of care by facilitating greater employee initiative, especially in the quality domain. There is a risk that this strategy leads to loss of performance as measured by the classical goals, if these goals are not prioritized by health care professionals...
November 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29124785/time-to-address-gender-inequalities-against-female-physicians
#8
Suad Hannawi, Issa Al Salmi
Although the health care system depends heavily on female physicians, it discriminates against women and tends to concentrate female physicians' work in lower status occupations. Gender discrimination has structural, social, and cultural dimensions. Such discrimination is perceived differently by various stakeholders and the public. In addition, there is reluctance to publicly acknowledge gender discrimination, especially in the culturally conservative Middle East region. Gender discrimination leads to underrepresentation of female physicians in leadership roles and certain specialties and hence leads to less attention and understanding of the working conditions of female physicians and their roles in the health care system...
November 10, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29120361/variation-in-point-of-care-testing-of-hba1c-in-diabetes-care-in-general-practice
#9
Troels Kristensen, Frans Boch Waldorff, Jørgen Nexøe, Christian Volmar Skovsgaard, Kim Rose Olsen
Background: Point-of-care testing (POCT) of HbA1c may result in improved diabetic control, better patient outcomes, and enhanced clinical efficiency with fewer patient visits and subsequent reductions in costs. In 2008, the Danish regulators created a framework agreement regarding a new fee-for-service fee for the remuneration of POCT of HbA1c in general practice. According to secondary research, only the Capital Region of Denmark has allowed GPs to use this new incentive for POCT. The aim of this study is to use patient data to characterize patients with diabetes who have received POCT of HbA1c and analyze the variation in the use of POCT of HbA1c among patients with diabetes in Danish general practice...
November 9, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29113407/healing-touch-in-radiation-therapy-is-the-benefit-tangible
#10
Jean-Baptiste Guy, Sacha Bard-Reboul, Jane-Chloé Trone, Alexis Vallard, Sophie Espenel, Julien Langrand-Escure, Anis Hamrouni, Majed Ben Mrad, Stéphanie Morisson, Patrick Michaud, Nicolas Magné, Chloé Rancoule
Background: Cancer patients tend to use more and more complementary or alternative medicine concomitantly to radiotherapy. A large part of these patients have recourse to Mind and Body practice, mainly with biofield healers or magnetizers, without any level of evidence. The aim of the present study was to report epidemiologic data on biofield healers in radiation therapy patients, and to assess the possible objective and subjective benefits. Materials and Methods: A retrospective study was conducted in a French cancer institute...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29111298/improving-neonatal-care-with-the-help-of-veteran-resource-parents-an-overview-of-current-practices
#11
Claude Julie Bourque, Sonia Dahan, Ginette Mantha, Kate Robson, Martin Reichherzer, Annie Janvier
Over the past decade, veteran parents who have lived a neonatal intensive care unit (NICU) experience have become increasingly involved as 'resource parents' to provide peer-to-peer support to "new" NICU parents. These parents can provide a unique form of support to new parents. They can also assume other roles in clinical care, research, administration and/or teaching, but those roles are rarely described in the literature. This article reviews many of the activities performed by resource parents in neonatology...
October 27, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29110560/the-job-content-context-and-requirements-of-regulated-home-based-childcare-workers
#12
Mariam Stitou, Ivy-Lynn Bourgeault, Dafna Kohen
Contrary to a large and growing literature on center-based childcare workers, we know little about the work and health experiences of those providing childcare services in their homes. This study examines the job content, context, and requirements of regulated Home-Based Childcare workers in Canada. It is based on the qualitative analysis of eleven individual semistructured interviews. These workers perform business administration tasks and more housekeeping and domestic work than those in the center-based childcare, which affect their health and well-being...
January 1, 2017: New Solutions: a Journal of Environmental and Occupational Health Policy: NS
https://www.readbyqxmd.com/read/29106367/telephone-consultations-in-urology-who-when-where-and-why
#13
Anne-Sophie Blais, Joanie Pelletier, Katherine Moore
INTRODUCTION: Telephone consultations are part of a strategy to allow access to medical expertise. Telephone consultations have been fee-for-services benefits in the province of Quebec since 2012.(1) Recent studies have shown that adequate communication is one of the most common means to prevent disability and death.(2) We sought to determine the characteristics of phone consultations made to a tertiary centre's urologists and to characterize their experience. METHODS: We performed a prospective study using all billing receipts filed by 15 academic urologists for phone consultations received during a 10-month period...
November 1, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29099981/feasibility-of-using-ecological-momentary-assessment-to-study-unaided-smoking-cessation-in-couples
#14
Jaye L Derrick, Rebecca K Eliseo-Arras, Sana Haddad, Maggie Britton, Courtney Hanny
Introduction: Ecological momentary assessment (EMA) is a valuable method for studying smoking cessation, but feasibility has not been examined in committed couples. The current study examines the feasibility of conducting an EMA study of unaided smoking cessation in single-smoker couples. Methods: Participants were 62 single-smoker couples recruited to participate in a 21-day study of unaided smoking cessation. Quitters and Partners were given instructions to complete one morning report, three signaled reports, and one evening report per day, as well as lapse reports when necessary...
November 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/29072710/economic-situation-and-occupational-accidents-in-poland-2002-2014-panel-data-regional-study
#15
Błażej Łyszczarz, Ewelina Nojszewska
OBJECTIVES: Occupational accidents constitute a substantial health and economic burden for societies around the world and a variety of factors determine the frequency of accidents at work. The aim of this paper is to investigate the relationship between the economic situation and the rate of occupational accidents in Poland. MATERIAL AND METHODS: The analysis comprised data for 66 Polish sub-regions taken from the Central Statistical Office's Local Data Bank. The regression analysis with panel data for period 2002-2014 was applied to identify the relationships involved...
October 26, 2017: International Journal of Occupational Medicine and Environmental Health
https://www.readbyqxmd.com/read/29072474/resource-scarcity-effort-and-performance-in-physically-demanding-jobs-an-evolutionary-explanation
#16
Marko Pitesa, Stefan Thau
Based on evolutionary theory, we predicted that cues of resource scarcity in the environment (e.g., news of droughts or food shortages) lead people to reduce their effort and performance in physically demanding work. We tested this prediction in a 2-wave field survey among employees and replicated it experimentally in the lab. In Study 1, employees who perceived resources in the environment to be scarce reported exerting less effort when their jobs involved much (but not little) physical work. In Study 2, participants who read that resources in the environment were scarce performed worse on a task demanding more (carrying books) but not less (transcribing book titles) physical work...
October 26, 2017: Journal of Applied Psychology
https://www.readbyqxmd.com/read/29052533/establishing-partnership-with-traditional-birth-attendants-for-improved-maternal-and-newborn-health-a-review-of-factors-influencing-implementation
#17
Tina Miller, Helen Smith
BACKGROUND: Recent World Health Organization recommendations recognize the important role Traditional Birth Attendants (TBAs) can play in supporting the health of women and newborns. This paper provides an analysis of key factors that affect the implementation of interventions to develop partnerships with TBAs to promote improved access to skilled care at birth. METHODS: We conducted a secondary analysis of 20 papers identified through two systematic reviews that examined the effectiveness of interventions to find new roles for TBAs on maternal and newborn health outcomes, as well as papers identified through a systematic mapping of the maternal health literature...
October 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29041794/the-views-of-key-stakeholders-in-zimbabwe-on-the-introduction-of-postgraduate-family-medicine-training-a-qualitative-study
#18
Cherifa Sururu, Robert Mash
BACKGROUND: Strengthening primary health care (PHC) is a priority for all effective health systems, and family physicians are seen as a key member of the PHC team. Zimbabwe has joined a number of African countries that are seriously considering the introduction of postgraduate family medicine training. Implementation of training, however, has not yet happened. AIM: To explore the views of key stakeholders on the introduction of postgraduate family medicine training...
September 12, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29040336/characteristics-of-private-partners-in-chiranjeevi-yojana-a-public-private-partnership-to-promote-institutional-births-in-gujarat-india-lessons-for-universal-health-coverage
#19
Veena Iyer, Kristi Sidney, Rajesh Mehta, Dileep Mavalankar, Ayesha De Costa
BACKGROUND: The Chiranjeevi Yojana (CY) is a Public-Private-Partnership between the state and private obstetricians in Gujarat, India, since 2007. The state pays for institutional births of the most vulnerable households (below-poverty-line and tribal) in private hospitals. An innovative remuneration package has been designed to disincentivise unnecessary cesareans. This study examines characteristics of private facilities which participated in the program. METHODS: We conducted a cross-sectional survey of all facilities which had conducted any births between June 2012 and April 2013 in three districts...
2017: PloS One
https://www.readbyqxmd.com/read/29033354/confronting-the-misbeliefs-pertaining-to-blood-donation-and-transfusion-practices-in-india
#20
A Qureshi
India, a country of 1.3 billion is still yearning for just 12 million units of blood and facing a shortage of 10%; this seemingly small number has claimed many lives, particularly in the less developed parts of the country. The root cause of the problem, although not defined clearly, can be ascertained from the survey reports from different parts of the country targeted to analyze the knowledge, attitude and practices related to blood donation. Most of these reports are coherent in their findings and report the existence of the fallacious perceptions about blood donation even after six decades of the initiation of voluntary blood donation practices...
October 12, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
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