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Background: Eye care health promotion interventions aim to encourage the adoption of healthy behaviours that impact eye health and vision impairment, as well as increase the use of eye care services. Thus, this study aims to explore and describe the perceptions of eye care coordinators on the implementation of eye care health promotion interventions in rural Limpopo Province. Methods: This exploratory, descriptive qualitative study employed individual in-depth interviews to collect data from 10 district eye health coordinators. Participants were purposely sampled between June and July 2024. Data were analysed thematically using NVivo version 12. Results: The study revealed seven key themes: human resources in eye health, resource management, policy and governance, eye care services, innovation in eye health, community and patient engagement, and coordination and referral systems. Conclusions: In summary, our study offers important insights into the challenges and opportunities in implementing eye care health promotion interventions. A recommendation is made to address identified challenges such as workforce shortages, inadequate infrastructure, fragmented policies and outdated technologies. Policymakers and eye health professionals can work towards achieving the goals of universal health coverage (UHC) in eye health, ultimately improving eye health outcomes. [ABSTRACT FROM AUTHOR]

Objectives Waitlist times for adolescents to be seen for initial assessment for gender-affirming hormone therapy in Manitoba, Canada are often 2 years. The purpose of this study was to understand the experiences of waitlisted youth and to assess the impact of social work contact for accessing relevant resources. Methods A qualitative, semi-structured interview study was conducted. Youth aged 14 to 17 years on the provincial transgender clinic waitlist for 12 to 24 months for gender-affirming hormone therapy assessment and their caregivers were recruited. Eight youth and nine caregivers were interviewed. Separate interviews were conducted for youth and their caregivers. All interviews were virtual, recorded, and transcribed prior to thematic analysis. Results Three themes and eight subthemes were identified. Youth (n = 8) and caregivers (n = 9) described barriers to supported transition in the following three themes: (1) 'In a Black Hole': Describing the lack of communication, relevant resources, and mental health supports, (2) 'Structural Transphobia': A summary term outlining the attitudinal, technological, physical, and architectural barriers faced by the participants, and (3) 'Manitoba: An Information Desert': describing the systemic barriers faced including lack of knowledgeable providers and reliable information within the province. Conclusions Although delays in gender-affirming therapy were noted, youth socially transitioned and accessed existing resources. However, mental health concerns persisted, and participants felt frustrated and unsupported during their extensive wait times. Improved experiences may be achieved by additional communication from the clinic, hands-on assistance with accessing relevant resources, and an improved online presence. [ABSTRACT FROM AUTHOR]

As in other health professions, there is a shortage of skilled labour in the field of occupational therapy in Switzerland. To plan and implement effective measures to counter this shortage, empirical data on the size and structure of the Swiss occupational therapy workforce are needed.

While volunteering is an essential factor in service delivery in many societal areas, the inclusion of volunteers in formal settings can also lead to tensions. In this article, we combine the literature on volunteering and inter-professional collaboration (IPC) to elaborate a framework regarding remedies for tensions between professional staff and volunteers within IPC in health care provision to ensure successful collaboration. Using a dyadic survey design to interview volunteers and volunteer managers, we show that the perspectives of volunteers and volunteer managers on the antecedents of effective IPC differ in paradoxical ways. While volunteer managers apply organizational logic concerning tasks and processes to avoid tensions, volunteers seek solutions on a relational basis. However, rather than trying to resolve these paradoxes, our study indicates that carefully managing tensions arising between volunteers and professional staff may be more successful than trying to resolve all tensions. [ABSTRACT FROM AUTHOR]

The non-governmental but not-for-profit sector seems to bridge the gap apparent in a shortage of government resources and unaffordable for-profit services in the healthcare market of India. Based on a background study about the non-governmental organisation for official health accounts, it was found to be imperative, especially in providing preventive and promotive healthcare services. To the current health expenditure of the country, this sector contributes around 2.1%, with funds generated largely as grants from governments and foreign sources. Indeed, financial contribution is not as imperative as the ability to reach grassroots for providing healthcare, which should be considered as an opportunity to augment the capacity of the health system, especially during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Abstract Background People prefer to age in place and not move into a nursing home as long as possible. The prevention of cognitive and functional impairments is feasible to support this goal. Health services play a key role in providing support for underlying medical conditions. We examined differentials in nursing home admissions between patient sharing networks in Germany and whether potential variations can be attributed to indicators of health care provision. Methods We conducted an ecological study using data of patients of 65 years and above from all 11 AOK statutory health insurance companies in Germany. Nursing home admissions were observed in a cohort of persons becoming initially care-dependent in 2006 (n = 118,213) with a follow-up of up to 10 years. A patient sharing network was constructed and indicators for quality of health care were calculated based on data of up to 6.6 million patients per year. Community detection was applied to gain distinct patient populations. Analyses were conducted descriptively and through regression analyses to identify the variation explained by included quality indicators. Results The difference in the proportion of nursing home admissions between identified clusters shows an interquartile range (IQR) of 12.6% and the average time between onset of care-dependency and admission to a nursing home an IQR of 10,4 quarters. Included quality indicators attributed for 40% of these variations for the proportion of nursing home admissions and 49% for the time until nursing home admission, respectively. Indicators of process quality showed the single highest contribution. Effects of single indicators were inconclusive. Conclusions Health services can support persons in their preference to age in place. Research and discussion on adequate health care for care-dependent persons and on conditions, where nursing home admission may be beneficial, is necessary.

This article outlines a research protocol for investigating the health care experiences of people living with Myotonic Dystrophy Type 1 (Dytrophia Myotonica; DM1). Introduction: DM1 is a neuromuscular condition of highly variable presentation across the lifespan. It is a complex and variable condition which impacts many body systems. Care consensus, clinical experience and scientific genetic findings dominate much of the literature. Findings from the literature indicate health care input from multiple disciplines is recommended to help identify and prevent or minimise disability and early mortality. It is these recommendations for intense health care input and the perceptions people living with DM1 have of their health care that have prompted this enquiry. Objectives: Investigate the experiences of health care from 3 different groups: people living with DM1, their family members, carers or support people, and health care providers. Potentially illuminating what we as nurses and health care providers do well or not so well. Intended methods: Guided by Merleau-Ponty's phenomenology of perception and triangulate these gathered experiences to ascertain if there is convergence or divergence between health care experiences of recipients and providers. This research will utilise a qualitative approach with methodology drawn from phenomenology. Semi-structured Interviews will be conducted with 3 different groups to gain insight into perceptions, experiences, and outcomes of health care interactions. People living with DM1, family members, carers and friends and health professionals providing services and care for people living with DM1 will be invited to participate. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapeut is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diversity in the lines of public institutions, such as hospitals, schools, and police forces, is thought to improve provision for minority group members. Nonetheless, whether and how diversity in public institutions shapes majority citizens' prejudice toward minorities are unclear. Building on insights from the intergroup contact literature, I suggest that diversity in public institutions can facilitate positive intergroup contact between majority group members and minorities in elevated social positions. Such unique interactions, which exceed the equal status condition for effective intergroup contact, can serve to reduce prejudice and facilitate more inclusive attitudes among majority group members. To test this expectation, I focus on health care provision--a leading sector with regard to minority representation. Leveraging a natural experiment unfolding in 21 Israeli medical clinics where Jewish patients are haphazardly assigned to receive care from Jewish or Arab doctors and embedding prejudice-related questions in a routine evaluation survey, I demonstrate that brief contact with an Arab doctor reduces prejudice. Specifically, contact with an Arab doctor reduces Jewish patients' exclusionary preferences toward Arabs by one-sixth of an SD and increases Jewish patients' optimism about peace by a 10th of an SD. The modest magnitude of these effects is similar to the impact of well-powered interventions recently reviewed in a meta-analysis of prejudice reduction experiments. These findings emphasize how the demographic makeup of public institutions can reduce mass prejudice, even in a context of intractable conflict. [ABSTRACT FROM AUTHOR]

Background: People prefer to age in place and not move into a nursing home as long as possible. The prevention of cognitive and functional impairments is feasible to support this goal. Health services play a key role in providing support for underlying medical conditions. We examined differentials in nursing home admissions between patient sharing networks in Germany and whether potential variations can be attributed to indicators of health care provision.Methods: We conducted an ecological study using data of patients of 65 years and above from all 11 AOK statutory health insurance companies in Germany. Nursing home admissions were observed in a cohort of persons becoming initially care-dependent in 2006 (n = 118,213) with a follow-up of up to 10 years. A patient sharing network was constructed and indicators for quality of health care were calculated based on data of up to 6.6 million patients per year. Community detection was applied to gain distinct patient populations. Analyses were conducted descriptively and through regression analyses to identify the variation explained by included quality indicators.Results: The difference in the proportion of nursing home admissions between identified clusters shows an interquartile range (IQR) of 12.6% and the average time between onset of care-dependency and admission to a nursing home an IQR of 10,4 quarters. Included quality indicators attributed for 40% of these variations for the proportion of nursing home admissions and 49% for the time until nursing home admission, respectively. Indicators of process quality showed the single highest contribution. Effects of single indicators were inconclusive.Conclusions: Health services can support persons in their preference to age in place. Research and discussion on adequate health care for care-dependent persons and on conditions, where nursing home admission may be beneficial, is necessary. [ABSTRACT FROM AUTHOR]

From the era of William Osler and the paternalistic, hospital-centered practice of medicine up to the present day, a plethora of scientific breakthroughs have radically changed both the biomedical field and the approach of health care providers to patients. A crucial question arises, however, which is whether clinicians and, more broadly, health care providers, are familiar with the modern concepts of leadership theory and the characteristic features of a leader. Here, we attempt to fill this gap in a way that is aimed to assist the health care provider to obtain a deeper literacy in this field. Initially, a historical analysis is provided of the periods and "schools of thought" that shaped, and continue to shape, the characteristic features of a leader. The dialectical "ties" between leadership and management, the main theories of management, and the main theories of leadership are then discussed. Ultimately, this review aims to equip the busy clinician with the conceptual framework and tools relating to leadership and management, in order to assist him(her) in daily work, especially that which "touches upon" the management of health care units, regardless their scale. [ABSTRACT FROM AUTHOR]

Osteoporosis is a frequent comorbidity in rheumatoid arthritis (RA). Due to the improved treatment options for RA, we expect a long-term decrease in osteoporosis as an accompanying disease. Data from the German National Database (NDB) were used to investigate whether the frequency of osteoporosis has changed in the last 10 years. From 2007 to 2017, approximately 4000 patients were documented annually with data on therapy and comorbidity. The cross-sectional data were summarised descriptively. Age, sex, disease duration, disease activity and glucocorticoids were considered as influencing factors. The Cochrane-Armitage test for trend was used to test whether the frequency of osteoporosis at the first visit changed from 2007 to 2017. Osteoporosis frequency in RA patients (mean age 63 years, 75% female) decreased from 20% in 2007 to 6% in 2017 (p < 0.001). The decrease affected women (22% to 17%) and men (14% to 8%) in all age groups and both short-term (≤ 2-year disease duration: 9% to 3%) and long-term RA patients (> 10-year disease duration: 28% to 20%). Patients with high disease activity and patients who took glucocorticoids (GC) were more often affected by osteoporosis than patients in remission or without GC. Drug prophylaxis in patients without osteoporosis increased (20% to 41% without GC, 48% to 55% with GC). Men with GC received less prophylactic treatment than women (48% vs. 57% in 2017). In this cohort, osteoporosis in patients with RA is less frequently observed compared to former years. RA-specific risk factors for osteoporosis such as disease activity and GC therapy have declined but long-term GC use is still present. Assessment of osteoporosis in RA patients should be investigated more consistently by bone density measurement. Male RA patients still need to be given greater consideration regarding osteoporosis drug prophylaxis, especially when GC therapy is needed. [ABSTRACT FROM AUTHOR]

Copyright of Prävention und Gesundheitsförderung is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Migratory processes can affect women's access and use of contraceptive methods. Objective: To describe the use of contraceptive methods by pregnant Venezuelan migrants in two cities on the north coast of Colombia (Barranquilla and Riohacha), between 2018 and 2019. Methodology: A descriptive cross-sectional study was designed. Participants were selected through systematic sampling in hospitals and snowball sampling in the community. A standardized questionnaire allowed the sociodemographic, migration, contraceptive use and other variables to be collected. Results: 552 pregnant, mainly young, women from Venezuela who are married or living with their partner were surveyed. The minority of pregnancies were planned (37.7%), even though the women knew about contraception methods. The condom and the pill were the most well-known methods (94.7 and 96.1%, respectively). Conclusion: Nearly all of the women knew about birth control and where it can be accessed. However, only half managed to get them the last time they looked for them, meaning that most of the pregnancies were unplanned. Guaranteed sexual and reproductive rights, including satisfactory family planning requirements, must be a priority in actions aimed at the migrant population, within the framework of the Colombian- Venezuelan migratory phenomenon. [ABSTRACT FROM AUTHOR]

This article proposes a classification of the different national health care systems based on the way the network of health care providers is organised. To this end, we present two rivalling models: on the one hand, the integrated model and, on the other, the separated model. These two models are defined based on five dimensions: (1) integration of insurer and provider; (2) integration of primary and secondary care; (3) presence of gatekeeping mechanisms; (4) patient's freedom of choice; and (5) solo or group practice of general practitioners. Each of these dimensions is applied to the health care systems of 24 OECD countries. If we combine the five dimensions, we can arrange the 24 national cases along a continuum that has the integrated model and the separated model at the two opposite poles. Portugal, Spain, New Zealand, the UK, Denmark, Ireland and Israel are to be considered highly integrated, while Italy, Norway, Australia, Greece and Sweden have moderately integrated provision systems. At the opposite end, Austria, Belgium, France, Germany, the Republic of Korea, Japan, Switzerland and Turkey have highly separated provision systems. Canada, The Netherlands and the United States can be categorised as moderately separated. [ABSTRACT FROM AUTHOR]

Background: Implementation science is currently struggling with the challenge to translate its findings into implementation practice in health care. Therefore, it is of interest to explore to what extent advanced trainings are relevant for health care practice to support knowledge circulation, and what needs to be considered in their design., Design of Educational Initiatives and Training: Internationally, numerous initiatives have emerged in recent years to make implementation science more accessible to health care implementers. They focus, in particular, on the development of curricula for actors in health care practice and the widespread implementation of these qualification programs. In German-speaking countries, the interest in health services research is particularly evident at the level of Master's degree programs to make implementation science accessible to health care. However, these efforts need to be complemented by a participatory, needs-oriented and theory-based approach to advanced training for implementers in health care practice. This will enable the required competencies to be addressed on different levels of training and the further development of training formats., Discussion: Recent literature shows that implementers in German-speaking countries can benefit from a training program tailored to their needs. International experience in the field of advanced training in implementation science for health care practice allows us to derive essential components for the development of advanced training for the German-speaking region., (Copyright © 2023. Published by Elsevier GmbH.)

This article explores the physicians' perspective regarding the potential of computerized cognitive behavioral therapies (cCBTs) to overcome inequalities in the context of mental health care provision. The main benefits were related to the ability of cCBTs to provide care in a convenient and efficient manner, enhancing its accessibility. These aspects were perceived more important than cost-effectivity of treatment, which is often claimed to be the key benefit of cCBTs. Age and general acceptance of CBT were the most significant individual-level separators of perceptions, while the sector in which the physician works was seen as the main structural-level separator. [ABSTRACT FROM AUTHOR]

In recent years, many countries have been actively promoting medical tourism to stimulate economic growth. However, the expansion of medical tourism has potentially detrimental effects for the welfare of host countries. In particular, a decline in workers’ productivity could arise as a result of a reduction in public health care provision due to the expansion of the medical tourism sector. By addressing the crowding-out effect on labor productivity, this paper sheds light on the economic impacts of medical tourism on host countries. Our empirical analysis confirms that medical tourism, on average, has a positive effect on host economies’ output growth, particularly in non-OECD countries. Nonetheless, the output contribution of medical tourism is overestimated by an average of 26.8% if the unfavorable indirect productivity effect is not taken into account. [ABSTRACT FROM AUTHOR]

According to received economic theory, vertical integration is mainly justified with the occurrence of productive efficiencies in addition of transaction costs between production stages. The present study aims to confirm the presence of these factors in the health care sector, thus justifying the urgency of vertical integration operations of the different health care stages. It is proposed an analysis of the vertical integration efforts in the Portuguese Health Sector, that comprises an attempt to decipher the benevolence and congruence of its catalysts, solutions and results. In addition, the results obtained with international operations of vertical integration are briefly reviewed and discussed, namely the positive outcomes regarding lifestyle diseases. It is generally expected that vertical integration in the health care sector should deliver more efficient and better health care to the populations, badly needed in low-income countries. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has led to serious challenges and emphasized the importance of using technology for health care operational transformation. Consequently, the need for technological innovations has increased, thus empowering patients with chronic conditions to tighten their adherence to medical prescriptions., Objective: This study aimed to develop a model for a mobile health (mHealth) self-monitoring system for patients with diabetes in rural communities within resource-limited countries. The developed model could be based on the implementation of a system for the self-monitoring of patients with diabetes to increase medical adherence., Methods: This study followed a quantitative approach, in which data were collected from health care providers using a questionnaire with close-ended questions. Data were collected from district hospitals in 3 South African provinces that were selected based on the prevalence rates of diabetes and the number of patients with diabetes treated. The collected data were analyzed using smart partial least squares to validate the model and test the suggested hypotheses., Results: Using variance-based structural equation modeling that leverages smart partial least squares, the analysis indicated that environmental factors significantly influence all the independent constructs that inform patients' change of behavior toward the use of mHealth for self-monitoring of medication adherence. Technology characteristics such as effort expectancy, self-efficacy, and performance expectancy were equally significant; hence, their hypotheses were accepted. In contrast, the contributions of culture and social aspects were found to be insignificant, and their hypotheses were rejected. In addition, an analysis was conducted to determine the interaction effects of the moderating variables on the independent constructs. The results indicated that with the exception of cultural and social influences, there were significant interacting effects on other independent constructs influencing mHealth use for self-monitoring., Conclusions: On the basis of the findings of this study, we conclude that behavioral changes are essential for the self-monitoring of chronic diseases. Therefore, it is important to enhance those effects that stimulate the behavior to change toward the use of mHealth for self-monitoring. Motivational aspects were also found to be highly significant as they triggered changes in behavior. The developed model can be used to extend the research on the self-monitoring of patients with chronic conditions. Moreover, the model will be used as a basic architecture for the implementation of fully fledged systems for self-monitoring of patients with diabetes., (©Mmamolefe Kgasi, Bester Chimbo, Lovemore Motsi. Originally published in JMIR Formative Research (https://formative.jmir.org), 23.10.2023.)