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This paper demonstrates how a qualitative methodology can be used to gain novel insights into the demands of wheelchair racing and the impact of particular racing chair configurations on optimal sport performance via engagement with expert users (wheelchair racers, coaches, and manufacturers). We specifically explore how expert users understand how wheels, tires, and bearings impact sport performance and how they engage, implement, or reject evidence-based research pertaining to these components. We identify areas where participants perceive there to be an immediate need for more research especially pertaining to the ability to make individualized recommendations for athletes. The findings from this project speak to the value of a qualitative research design for capturing the embodied knowledge of expert users and also make suggestions for "next step" projects pertaining to wheels, tires, and bearings drawn directly from the comments of participants. [ABSTRACT FROM AUTHOR]

Background: Throughout their careers, doctors and other healthcare professionals experience numerous transitions. When supporting transitions, opportunities for development and learning should be maximized, while stressors having negative impacts on well-being should be minimized. Building on our international data, this study aimed to develop a conceptual model of the trainee-trained transition (i.e. the significant transitions experienced by doctors as they complete postgraduate training moving from trainee/resident status to medical specialist roles). Methods: Employing Multiple and Multidimensional Transitions (MMT) theory and current conceptualizations of clinical context, this study undertook secondary analysis of 55 interviews with doctors from three countries (Netherlands, Cananda and the UK) undergoing trainee-trained transitions. Results: Through this analysis, the Transition-To-Trained-Doctor (T3D) conceptual model has been developed. This model takes into consideration the multiple contexts and multiple domains in which transitions take place. Discussion: This model is significant in that it has several uses and is applicable across countries: to remind doctors, managers and medical educators of the complexity of transitions; to frame and facilitate supportive conversations; and as a basis to teach about transitions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Maternal death generates a great impact on public health, and it is recognized that its main cause is postpartum hemorrhage (PPH). Therefore, the objective was to analyze the bibliometric profile of the world scientific production on maternal mortality due to PPH. MATERIALS AND METHODS: Bibliometric study that included original articles indexed in Scopus, identified by means of a search strategy that included MESH terms and logical operators. Bibliometric indicators were estimated with the SciVal tool, and the VOSwiever program was used for co-occurrence networks by key terms and co-authorship by country. RESULTS: There has been an increase in the number of publications in the past 5 years. Regarding co-occurrence, the most frequent terms were "postpartum hemorrhage" and "maternal mortality." The United States and the United Kingdom are positioned as those with the highest density of publications; in addition, Australia evidences collaboration with Canada and South Korea. Publications with national collaboration were more frequent (36%). BMC Pregnancy and Childbirth is the most productive journal, although BJOG: An International Journal of Obstetrics and Gynecology has a higher normalized impact. The authors with the highest scientific output belong to an institution in the Netherlands. Vrije Universiteit Amsterdam and Leiden University are the most productive. CONCLUSION: Scientific activity on maternal mortality due to PPH is increasing and its main means of dissemination are high-impact journals. National collaboration was more frequent, with the active participation of authors and institutions from the Netherlands and the United States. [ABSTRACT FROM AUTHOR]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]