Search

Using administrative claims and electronic health records for observational studies is common but challenging due to data limitations. Researchers rely on phenotype algorithms, requiring labor-intensive chart reviews for validation. This study investigates whether case adjudication using the previously introduced Knowledge-Enhanced Electronic Profile Review (KEEPER) system with large language models (LLMs) is feasible and could serve as a viable alternative to manual chart review. The task involves adjudicating cases identified by a phenotype algorithm, with KEEPER extracting predefined findings such as symptoms, comorbidities, and treatments from structured data. LLMs then evaluate KEEPER outputs to determine whether a patient truly qualifies as a case. We tested four LLMs including GPT-4, hosted locally to ensure privacy. Using zero-shot prompting and iterative prompt optimization, we found LLM performance, across ten diseases, varied by prompt and model, with sensitivities from 78 to 98% and specificities from 48 to 98%, indicating promise for automating phenotype evaluation. [ABSTRACT FROM AUTHOR]

Demographic ageing implies increased care needs, in which social workers play a key role. However, knowledge about their practice is limited and fragmented. This mixed-methods systematic review integrates evidence from 19 studies published between 2000 and 2022 on the roles of long-term care social workers in Europe and North America. The findings reveal that service and case management, direct support, personalisation of care and community engagement are leading roles. Limitations with implications for practice are also detected, such as lack of specialisation, paperwork burden, and work overload, which should be overcome to maximise social work's contribution to care quality. [ABSTRACT FROM AUTHOR]

Aim: To evaluate a community‐based psychological health and well‐being programme for nurses and midwives. Design: Mixed methods programme evaluation. Methods: Four studies were included: observational descriptive study (cross‐sectional survey) of the health, well‐being and experiences of previous programme participants (Study 1); observational exploratory prospective cohort study (longitudinal survey) of health, well‐being and experiences of participants who engaged in the programme from 2020 to 2023 (Study 2); qualitative descriptive study (interviews) of experiences and perceptions of nurses and midwives who have engaged with the programme as participants or clinicians (Study 3); observational descriptive study (cross‐sectional survey) of experiences and perceptions of programme stakeholders (Study 4). Surveys included validated measures. Data were collected online. Descriptive, repeated measures and thematic analyses were conducted. Results: One‐hundred and fifteen participants completed Study 1: 20% (n = 23) reported stress in the severe‐to‐extremely severe category; 22% (n = 25) reported psychological distress in the moderate‐to‐severe category. Thirty‐one programme participants were followed in Study 2: the effect of the programme on participant well‐being over time was not significant. Sixteen programme participants and eight programme clinicians were interviewed (Study 3). Experiences of nurses and midwives engaging with the programme were highly positive and strong attributes of the programme included (1) shared professional experience of clinicians and participants which supported a common language and facilitated understanding, and (2) effective programme leadership, and autonomy and flexibility in the clinicians' role which enabled and supported a positive working experience. Thirty‐nine broader stakeholders participated in a cross‐sectional survey (Study 4). All stakeholders reported high satisfaction with the programme. Participants considered the programme being 'by nurses and midwives, for nurses and midwives' critical to the programme's success and value. Conclusions: The community‐based psychological health and well‐being programme developed, led and delivered by nurses and midwives, for nurses and midwives, was a highly valued resource. Impact: Levels of stress and burnout in the health workforce are high.A community‐based psychological health and well‐being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives.A programme delivered by nurses and midwives, for nurses and midwives, was considered critical to programme success.Programme leadership, and autonomy and flexibility in the programme clinicians' roles, facilitated and supported a positive working experience for programme clinicians. Implications for the Profession and Patient Care: Quality and safety in patient care is directly impacted by the well‐being of nurse and midwives. A community‐based psychological health and well‐being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives. Reporting Method: Survey findings were reported according to STROBE (von Elm et al. in Lancet, 370:1453–1457, 2007) and qualitative findings according to COREQ (Tong et al. in International Journal for Quality in Health Care, 19(6):349–357, 2007). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Case management (CM) aims to facilitate access to and integration of health care and social services. We investigated the feasibility and effectiveness of CM. Methods: Randomized controlled trial with 219 patients and 114 caregivers randomly allocated to CM (109/59) or care as usual (110/55). CM was based on early and continuous online monitoring of problems and needs. Outcomes were assessed every 6 months with the Hospital Anxiety and Depression Scale (HADS). Secondary outcome domains were participant restrictions, life satisfaction, self-efficacy, caregiver burden, and needs. Multilevel modeling was used. Feasibility aspects were protocol delivery, participants' and case managers' satisfaction, and factors affecting implementation. Results: There were no significant differences between groups. Participation restrictions and unmet needs decreased in both groups within 6 months. Monitoring was successful in 38, and 10 participants asked the CM for support. CM consisted mostly of providing information. Discussion: CM based on early and continuous online monitoring does not have benefit in identifying and addressing problems early after relatively mild injury. Unsuccessful monitoring may have hindered access to the case manager and prevented us from evaluating CM as a complex intervention. It remains a challenge to early identify those who could benefit from care coordination. [ABSTRACT FROM AUTHOR]

The neuropalliative approach in a hospital setting for neuromuscular disorders is essentially multidisciplinary in focus and involves co-ordinated interventions. This case report describes an intensive case management approach through telehealth services provided from a hospital context in South India for psychosocial interventions for an adolescent with Duchenne Muscular Dystrophy. Case management interventions during the COVID-19 pandemic were provided through sixteen sessions over the telephone, focusing on need assessment, service plan development, implementation, co-ordination, and monitoring. Major strategies were crisis management, supportive psychotherapy, and cognitive-behavioural strategies. Adaptations made to meet the challenges of the COVID-19 pandemic using telehealth facilities can be incorporated into routine clinical practice in low-resource settings. IMPLICATIONS Telehealth, which emerged as a viable option for providing effective psychosocial care during the COVID 19 pandemic, could be adopted to complement routine clinical care in low-resource settings. [ABSTRACT FROM AUTHOR]

Objective: Despite the prevalence of clinical case management services in university counseling centers, there is scant research on practices and effectiveness in case management services. The purpose of this brief report is to review the role of a clinical case manager, examine referral outcomes of referred students, and provide recommendations on case management practices. We hypothesized that students who received referrals at an in-person appointment would be more likely to be successfully referred than those who obtained email referrals. Participants: Two hundred and thirty-four students who obtained referrals from the clinical case manager in the Fall 2019 semester. Methods: A retrospective data analysis was conducted to examine success rates of referrals. Results: In the Fall 2019 semester, 50.4% of students were successfully referred. While 55.6% of in-person appointments were successfully referred compared to 39.2% of email referrals, a chi-square analysis revealed no significant association between type of referral and success of referral, x2 (4, N = 234) = 8.36, p =.08. Conclusions: There was no significant difference in referral outcomes based on type of referral. Recommendations on effective case management practices for university counseling centers are provided. [ABSTRACT FROM AUTHOR]

Homelessness among older individuals is increasing and women experiencing homelessness have been previously shown to have poorer health outcomes than their male counterparts. To address these concerns, the Bridges to Elders (BTE) program was developed to improve health and social outcomes for older women experiencing or at risk for homelessness. BTE consisted of a nurse practitioner (NP) and community health worker (CHW) dyad who provided intensive case management services for women 55+ with housing instability. This evaluation used a pretest/posttest design to examine three main outcomes from BTE: change in housing status, enrollment with a primary care provider (PCP), and diagnosis of uncontrolled chronic condition. The sample included 96 BTE participants enrolled from January 2017 to December 2018. The average age of participants was 66 years and had a mean BTE enrollment time of 7.6 months. Statistically significant improvements were achieved in all three outcomes measured: 17% (p <.009) increase in stable housing, 35% (p <.001) increase in PCP enrollment, and 47% (p <.001) decrease in the diagnosis of an uncontrolled chronic condition. The results indicated an NP/CHW dyad improved housing status, primary care access, and targeted health outcomes for older women who are experiencing or at risk for homelessness. Future studies examining the impact of NP/CHW dyads on additional social determinants of health and their impact on health outcomes are recommended. [ABSTRACT FROM AUTHOR]

This study assessed the effectiveness of case management compared to that of standard care in improving treatment outcomes for first-time antiretroviral therapy (ART) patients in Liangshan Prefecture, China. First-time ART patients (total n = 828) were divided into the Standard Care Group (SCG, n = 419) and Case Management Group (CMG, n = 409). At week 48, the CMG showed higher retention rates (97.7% vs. 93.6%), better adherence, and more complete virological responses (84.2% vs. 64.0%) compared to the SCG. These findings suggest that case management improves adherence and virological suppression in resource-limited areas, though further research is needed to confirm its broader applicability. [ABSTRACT FROM AUTHOR]

Following a traumatic event such as intimate partner violence (IPV), survivors often experience stress related to the violence. These high levels of stress related to IPV can be associated with the daily activities of survivors and their relationships with their children, such as maternal–child bonding. The purpose of the current study is to explore the relationship between daily activities, daily stress levels, parenting self-efficacy and behaviors, and maternal–child bonding among survivors living in an IPV shelter using an ecological momentary assessment (EMA) methodology. Twenty-five mothers living in an IPV shelter in two states in the Southern United States completed a baseline survey and completed electronic daily diaries for 14 days. Higher daily stress was associated with the number of times the mothers met with the case manager. Higher daily stress was also related to lower parenting self-efficacy. The number of case management appointments and legal appointments were positively correlated with a higher bonding score. More social support was associated with more positive parenting. IPV and post-traumatic stress disorder symptoms were not significantly associated with maternal–child bonding, parenting behaviors, or parenting self-efficacy. Findings suggest that screening for maternal support may be particularly important for positive bonding and positive parenting. Findings also lend preliminary insight into practical places where service providers could act to protect the bonding process or mitigate risks to impede it. Future research should include objective data about the mother's emotions and her interactive behavior with her child. There is also a need to consider how federal programs fund and incentivize service providers to focus on mother–child dyads and how they can tailor services that promote bonding. [ABSTRACT FROM AUTHOR]

The Healthy Marriage and Responsible Fatherhood grant program is one of the most robust mechanisms supporting fatherhood programming in the United States, with the gold standard of care including fatherhood curriculum (e.g., 24/7 Dad®) and case management services. Despite the fact that fatherhood in the United States is not a monolith and Black fathers make up over 40% of those served through Responsible Fatherhood (RF) program, little research explicitly centers the lived experiences of low‐income Black fathers. The current study used focus groups with fathers (n = 23) and staff (n = 8) enrolled in a RF grantee program. Thematic analysis was used to determine programmatic mechanisms supporting these fathers' success and areas for improvement. Our findings highlight that the creation of a "safe space" by facilitators and the power of the group dynamic were essential elements for fathers' success overall. We also identified numerous programmatic mechanisms supporting Black fathers' success specific to fathering, healthy relationships, and economic stability. Finally, we highlighted important limitations that may impede the success of low‐income, Black fathers related to the 24/7 Dad® curriculum, engagement efforts, and economic stability, and discuss related practice, policy, and research recommendations. [ABSTRACT FROM AUTHOR]

Objectives: There is very little literature examining the workload and impact of nurse practitioners (NPs) working in emergency departments (ED) in regional and rural Australia. The aim of this paper was to review the ED NPs scope of practice in the ED discharge stream and patient outcomes at Cairns Hospital over a 7‐month period. Methods: This retrospective study examined the ED electronic medical record between 14 May 2019 and 31 December 2019. Cases managed by ED NPs, referrals, procedures performed, representations and disposition data were collected. Adverse events were sought from the Qld Health adverse events register (Riskman), the department complaints register and the ED M&M meeting minutes. Results: A total of 1443 patients were treated by NPs, with ages ranging from 0 to 98 years (median 40 years). Australasian Triage Score (ATS) 3 cases made up 30% of the workload. Other than ATS 3 cases, time to being seen was better than the general department. There were very few unexpected representations, complaints or adverse events. Conclusions: This study supports the view that NPs working in a regional emergency department can safely manage a variety of patients outside a fast‐track model, with a wide age range and a variety of triage categories and diagnoses. We believe this has important implications for the provision of emergency care, especially in regional and rural Australia. [ABSTRACT FROM AUTHOR]

Background: There has been significant focus in the past decade on reducing admissions to assessment and treatment units for people with intellectual disabilities experiencing mental health or behavioural concerns. This has included the development of intensive support functions of National Health Service Learning Disability services to bolster community support and treatment for people at risk of admission. However, in recent years, there has been increased consideration of service development to include rehabilitation functions which would aim to proactively provide medium‐term additional input to individuals with a complexity of need. This input would aim to improve future trajectories and support the individuals to remain living a good life in their own community. This review focuses on community and in‐patient approaches to meeting a complexity of need. Method: A scoping review was carried out according to established best practice guidelines. Papers returned from the search were screened by the following inclusion criteria (a) Models or Outcomes of Rehabilitation; (b) Intellectual Disability Population; (c) Sample being 18 or above and (d) longer than short‐term stay/treatment, defined as 6 months or longer; and (e) Mental health and/or behaviour complexities. The search was conducted in electronic databases CINAHL, PsycInfo, Medline, Embase and Social Policy & Practice. Here, 3790 articles were initially identified and 27 were ultimately included in the review. Findings: There are few studies evaluating rehabilitation for people with intellectual disabilities and mental health or behavioural concerns. There was some evidence that accessing assessment and treatment inpatient provision resulted in clinical improvements. Some studies demonstrated initial evidence that longer term rehabilitation was beneficial as a step‐down from inpatient care. Some key principles were identified in terms of rehabilitation approaches: the need for person‐centred creative approaches, suitable staff training, focus on building skills, and a focus on increasing quality of life. Conclusion: There are some indicators of what good rehabilitation services might comprise for people with an intellectual disability, who have rehabilitation needs. However, far more research and guidance are required in this area. In particular, it is unclear whether rehabilitation is best provided within an inpatient or community model, and further detail is required about optimal components of such rehabilitation. Accessible Summary: Some people with an intellectual disability will need extra help with their mental health. People with more complicated needs might need support for a longer period of time.Longer term services can be in hospitals or in the community. These are called rehabilitation services.There is some research to show that rehabilitation services should be person‐centred and help the person learn new skills. The staff should have the right training and should help the person improve their quality of life. Much more research needs to be done on rehabilitation services for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

The primary resources available to social workers are themselves, with building and using effective relationships central to the social work task. More than a decade of austerity policies has impacted how social workers practice. The current barriers to relationship-based practice in work with adults are such that we are experiencing a relational recession – that is the inability to practice in a way that prioritises the relationship. The present article will evaluate two key barriers to relationship-based social work: 1) The current context of austerity and new care management, 2) The emotional demands of the role. Practice can emerge from the relational recession through a shift from case management supervision, towards a supervisory relationship which replicates the conditions required for relationship-based practice to flourish. [ABSTRACT FROM AUTHOR]

This retrospective case series investigated the clinical and radiographic outcomes in 19 intrabony defects treated with periodontal regenerative therapy utilizing a combined approach. Placing an amnion-chorion membrane (ACM) as a biologic modifier on the root surface of the periodontally diseased tooth, combined with bone substitutes and an additional ACM as a barrier membrane, the treated sites were examined 8 to 24 months after the therapy. The preoperative (baseline) mean probing pocket depth (PPD) was 7.21 ± 1.08 mm, and the mean clinical attachment level (CAL) was 7.68 ± 1.49 mm. A mean PPD reduction of 4.05 ± 1.22 mm, CAL gain of 3.68 ± 1.34 mm, and 73.91% ± 22.02% of bone fill were recorded postoperatively. Without any adverse events, root-surface application of ACM as a biologic material in periodontal regenerative therapy could be a safe and cost-effective approach. [ABSTRACT FROM AUTHOR]

Background: Sexual well-being is a key part of being human yet often remains shrouded in secrecy and poorly addressed in the clinical setting. The impact of burns and its long-term sequelae often lead to concerns regarding body image disturbance, self-esteem issues, and interpersonal challenges which can impact on an individual's sexual well-being. However, existing post-burn rehabilitation programmes usually lack components addressing concerns regarding sexual well-being. As a part of a larger project, we developed a nurse-led aftercare programme, and this study sought to examine the effects of the programme in addressing the post-burn sexual well-being of adult burn survivors. Methods: A randomised controlled trial approach was used. Sixty burn survivors aged ≥ 18 years with burn size ≥ 10% total burn surface area were assigned to intervention and control groups. Participants in the intervention group underwent the nurse-led aftercare programme which involved pre-discharge support and proactive follow-up support over 8 weeks. The sexuality subscale of the Burn Specific Health Scale-Brief was used to evaluate the outcome of interest. Data were collected at three timepoints: baseline (T0), post-intervention (T1), and follow-up (T2). Results: Using a corrected p value of 0.017, the study observed only statistically significant time effect at both T1 and T2. Both group and interaction effects were statistically insignificant for this outcome. Conclusion: Issues regarding sexual well-being are often considered sacred and may be challenging to discuss. Thus, a longer duration of the intervention may be considered with ongoing training of practitioners to identify and resolve emerging challenges. Despite the non-significant interaction and group effects, including sexual well-being support in post-burns rehabilitation programmes will facilitate access to and utilisation of the service among burn survivors who may need it. Trial registration: Prospectively registered on 14th August 2020. ClinicalTrials.govNCT04517721. [ABSTRACT FROM AUTHOR]

Background: People living in precarious socio-economic conditions are at greater risk of developing mental and physical health disorders, and of having complex needs. This places them at risk of health inequity. Addressing social determinants of health (SDH) can contribute to reducing this inequity. Case management in primary care is an integrated care approach which could be an opportunity to better address SDH. The aim of this study is to better understand how case management in primary care may address the SDH of people with complex needs. Methods: A case management program (CMP) for people with complex needs was implemented in four urban primary care clinics. A qualitative study was conducted with semi-structured interviews and a focus group with key informants (n = 24). An inductive thematic analysis was carried out to identify emerging themes. Results: Primary care case managers were well-positioned to provide a holistic evaluation of the person's situation, to develop trust with them, and to act as their advocates. These actions helped case managers to better address individuals' unmet social needs (e.g., poor housing, social isolation, difficulty affording transportation, food, medication, etc.). Creating partnerships with the community (e.g., streetworkers) improved the capacity in assisting people with housing relocation, access to transportation, and access to care. Assuming people provide their consent, involving a significant relative or member of their community in an individualized services plan could support people in addressing their social needs. Conclusions: Case management in primary care may better address SDH and improve health equity by developing a trusting relationship with people with complex needs, improving interdisciplinary and intersectoral collaboration and social support. Future research should explore ways to enhance partnerships between primary care and community organizations. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis is a common condition that increases the risk of fracture and mortality. In Taiwan, clinical guidelines recommend pharmaceutical therapy for patients with a T-score of ≤ − 2.5; however, Taiwan's National Health Insurance (NHI) only covers these medications for those with a history of fragility fractures. This gap in coverage necessitates a discussion of out-of-pocket treatment options. To address this, we provided an integrated care program with patient education and shared decision-making by nurse case managers specializing in osteoporosis. We evaluated whether education by nurse case managers influences patients with a T-score ≤ − 2.5, who are not covered by the NHI, to choose out-of-pocket pharmaceutical therapy. Methods: We retrospectively reviewed medical records of patients who underwent bone density scanning at our hospital between January 2014 and December 2021. We identified 4,462 patients with a T-score of ≤ − 2.5 who were ineligible for NHI-covered anti-osteoporotic therapy and analyzed trends in out-of-pocket medication use. Since the integrated care program began in 2018, we evaluated whether education by nurse case managers between 2018 and 2021 influenced patients' decisions to pay out-of-pocket for therapy. After the implementation of the integrated care program, we identified 2,910 patients with a T-score ≤ -2.5 who were ineligible for NHI-covered anti-osteoporotic therapy. Of these, 640 opted for out-of-pocket treatment, while 2,270 chose conservative care. After a 1:1 propensity score match based on age and sex, logistic regression was used to analyze the impact of nurse case manager education on these decisions. Results: Between 2014 and 2021, 888 of the 4,462 patients chose out-of-pocket pharmaceutical therapy. Before the implementation of the integrated care program and patient education by nurse case managers (2014–2017), 16% of the patients opted to pay out-of-pocket for anti-osteoporotic therapy. After the program was implemented (2018–2021), the rate increased significantly to 22% (P < 0.001). A multivariate logistic regression model showed that a history of osteoarthritis (adjusted odds ratio = 1.576; P = 0.009) and education provided by the nurse case managers (adjusted odds ratio = 5.044; P < 0.001) were significantly associated with choosing out-of-pocket therapy. Conclusions: Education from nurse case managers significantly increased the likelihood of patients choosing out-of-pocket anti-osteoporotic therapy in our hospital, thereby bridging the gap between clinical guidelines and NHI reimbursement criteria. [ABSTRACT FROM AUTHOR]

Purpose : Despite the increasing number of elder abuse and self-neglect (EASN) cases, many older adults are reluctant to engage with formal support services, such as Adult Protective Services (APS). This study examined the use of motivational interviewing (MI) by advocates, as a component of a larger EASN intervention, RISE (Repair Harm, Inspire Change, Support Connection, Empower Choice), implemented in partnership with APS. Advocates applied MI as part of RISE to help clients explore and resolve ambivalence around pursuing change and ultimately enhance service engagement. Methods: This study conducted qualitative interviews and a focus group with all RISE advocates (n = 4) to understand how MI is applied in the context of an EASN intervention with older adult clients. A descriptive phenomenological approach involving two independent assessors was used to code verbatim transcripts into themes. Results: Three domains were identified: (1) therapeutic relationship, which describes the importance of foundational relationship building in MI to support older adults who have experienced EASN; (2) techniques, which refers to MI strategies advocates apply and adapt in the context of EASN intervention; and (3) implementation challenges, which reflects the difficulties advocates encounter when using MI in cases of EASN. Conclusions: The experiences of advocates suggest MI is a beneficial and amenable approach to help older adults who have experienced EASN navigate issues of ambivalence and explore their motivation for change. This study represents the first in-depth exploration of MI in the context of EASN intervention. [ABSTRACT FROM AUTHOR]

This mixed-methods study explores the incidence, manifestations, and drivers of secondary traumatic stress among service providers who work with Syrian refugees in Istanbul, Turkey. A survey of 104 social workers and other providers working in 17 public and civil society agencies in Istanbul in 2018 demonstrates that 54.81% had Secondary Traumatic Stress Scale scores indicating mild to severe secondary traumatic stress. In total, 28 qualitative interviews showed manifestations and possible drivers of secondary traumatic stress including weak supervision, heavy caseloads, and insecure working conditions. The findings suggest supervision and peer-support should be strengthened to address secondary traumatic stress among providers serving refugees. [ABSTRACT FROM AUTHOR]

This study responded to a recommendation in the independent Duty of Care Report that called for standardised data to be collected and analysed regarding safeguarding cases in sport. A standardised case data tool was developed and piloted before being adopted by National Governing Bodies across England and Wales. An analysis of the first 4 years of data shows that a total of 3129 cases were managed. Overall, 54% of cases concerned behaviour outside of the context of sport. This demonstrates that sport plays an important role in the broader child protection system. In the remaining 46% of cases, the safeguarding concern was related to behaviour in the context of sport. The most commonly reported forms of concern in sport were physical abuse (20%), contact sexual abuse (20%), non‐contact sexual abuse (17%) and emotional abuse (17%). The threshold for cases to be included in the analysis was that the case was judged to be sufficiently serious to involve referral to, or consultation with, the Local Authority Designated Officer (LADO), Children's Services or the Police. There are clearly many cases that did not meet this threshold or were never reported, and hence, these data provide an indication of the safeguarding issues related to sport. The need to expand the tool to collect lower level concerns as well as to include safeguarding concerns regarding adults is advocated. Key Practitioner Messages: A total of 3129 child safeguarding cases were managed across England and Wales between October 2018 and September 2022.Overall, 54% of cases concerned behaviour outside of sport with 46% of cases concerning behaviour in the context of sport.The most commonly reported forms of concern in sport were physical abuse (20%), contact sexual abuse (20%), non‐contact sexual abuse (17%) and emotional abuse (17%). [ABSTRACT FROM AUTHOR]

Background: The circumstances surrounding chronic kidney disease and its impact on families can be complex and difficult to navigate, leading to these cases being labeled "challenging." Case presentation: We present the case of an adolescent with kidney failure due to unremitting systemic illness and multiple complications ultimately resulting in the family's request to forgo dialysis. Medical team members wrestled with meeting the family's needs among internal and external constraints. Conclusion: Past experiences, systemic inequities, differing perspectives, and consequential decision-making within individual belief systems can lead to friction between and among medical team members and families. As pediatric nephrologists, we must shift our focus from the "challenging" patient or family to addressing what is challenging their ability to flourishing. [ABSTRACT FROM AUTHOR]

Background: Some physiotherapists find assessing and managing clients experiencing psychological distress challenging and are uncertain regarding the boundaries of the profession's scope. Objective: To map the approaches recommended for physiotherapists in scholarly literature, with respect to the assessment and management of clients experiencing psychological distress. Methods: A systematic mapping review was conducted. CINAHL, APA PsycINFO, Embase, and Medline ALL databases were systematically searched for secondary and tertiary literature relevant to the research objective. Recommended approaches were extracted from each article and analyzed descriptively and thematically. Results: 3884 records were identified with 40 articles meeting the inclusion/exclusion criteria. Most recommendations related to identifying, assessing, and managing pain-related distress, with depression screening and referral also receiving some attention. Three approaches to detecting and assessing psychological distress were identified: 1) brief depression screen; 2) integrated suicide/nonsuicidal self-harm and depression screen; and 3) multidimensional screen and health-related distress assessment. Regarding the management of psychological distress the main approaches identified were: 1) education and reassurance; 2) cognitive-behavioral approaches; 3) mindfulness; and 4) case management. Conclusion: While assessment and management of health-related distress by physiotherapists is commonly recommended, further guidance is needed to differentiate various forms of distress. [ABSTRACT FROM AUTHOR]

Objective: Case investigation and contact tracing (CI/CT) are fundamental public health efforts widely used during the COVID-19 pandemic to mitigate transmission. This study investigated how state, local, and tribal public health departments used CI/CT during the COVID-19 pandemic, including CI/CT methodology, staffing models, training and support, and efforts to identify or prioritize populations disproportionately affected by COVID-19. Methods: During March and April 2022, we conducted key informant interviews with up to 3 public health officials from 43 state, local, and tribal public health departments. From audio-recorded and transcribed interviews, we used the framework method to analyze key themes. Results: Major adjustments to CI/CT protocols during the pandemic included (1) prioritizing populations for outreach; (2) implementing automated outreach for nonprioritized groups, particularly during COVID-19 surges; (3) discontinuing contact tracing and focusing exclusively on case investigation; and (4) adding innovations to provide additional support. Key informants also discussed the utility of having backup staffing to support overwhelmed public health departments and spoke to the difficulty in "right-sizing" the public health workforce, with COVID-19 surges leaving public health departments understaffed as case rates rose and overstaffed as case rates fell. Conclusions: When addressing future epidemics or outbreaks, public health officials should consider strategies that improve the effectiveness of CI/CT efforts over time, such as prioritizing populations based on disproportionate risk, implementing automated outreach, developing models that provide flexible additional staffing resources as cases rise and fall among local public health departments, incorporating demographic data in laboratory reporting, providing community connections and support, and having a system of self-notification of contacts. [ABSTRACT FROM AUTHOR]

Despite the disproportional impact of HIV, Black individuals are benefiting the least from pre-exposure prophylaxis (PrEP). Motivational interviewing (MI) for PrEP uptake (MI-PrEP) is a two-session culturally tailored intervention incorporating MI strategies to improve PrEP motivation and uptake among cisgender Black women. A pilot randomized control trial was conducted in the Southeastern United States, and 41 women were randomized to MI-PrEP (session 1 with PrEP psychoeducation and MI and session 2 with MI and light case management) or enhanced treatment as usual (ETAU; two sessions of PrEP psychoeducation [videos explaining PrEP]). Women completed one follow-up assessment (1 month after visit 2). Measures captured primary (motivation [via contemplation and readiness ruler] and PrEP uptake via medical records) and secondary outcomes (e.g., PrEP knowledge, barriers to PrEP, and speaking to a provider about PrEP). Difference-in-differences analyses comparing MI-PrEP with ETAU as well as t-tests for within-group changes over time were conducted. Women who completed MI-PrEP (90.5% retained) compared with ETAU (100% retained) had a significantly higher likelihood of speaking to a provider about PrEP (OR = 4.42e7, CI [8.55e6, 2.29e8], DiD = 17.60, se = 0.84, p < 0.001). Within the MI-PrEP group, women had significant increases in PrEP prescription, knowledge, and motivation/contemplation, and significant decreases in financial resources as a PrEP barrier and medical mistrust (MMT). ETAU had within-group increases in PrEP prescription and speaking to a provider, no changes in motivation and MMT, and increases in specific barriers to care (e.g., transportation). MI-PrEP shows promise, and a large-scale study may be beneficial to further assess efficacy and examine implementation. [ABSTRACT FROM AUTHOR]

Social workers frequent interprofessional healthcare teams, but few studies examine the day-to-day experiences of these providers on interprofessional teams. Our study utilized semi-structured interviews with 54 medical social workers practicing on interprofessional healthcare teams. A thematic analysis was used to analyze the day-to-day functions of these social workers. The analysis resulted in three primary themes: 1) Social Workers' Self-Perceptions of their Roles within Interprofessional Teams, 2) Social Workers Shifting Roles on Interprofessional Teams, and 3) Interprofessional Team Dynamics that Impact the Role of a Social Worker. Social workers perceived their primary roles as contributing a unique systems approach to interprofessional healthcare teams while emphasizing patient self-determination. These self-perceptions influenced their shifting roles on interprofessional healthcare teams (e.g. clinician, case manager, bridge builder). In addition to individual self-perceptions, the healthcare system infrastructure influenced social work roles. For example, social workers in outpatient settings more frequently assumed the role of a mental health practitioner compared to those in inpatient settings. Last, there was variation in interprofessional communication and workflow assignment based on the healthcare infrastructure. Future research should examine the education and training efforts of social workers and other allied health professions for interprofessional healthcare teams. [ABSTRACT FROM AUTHOR]

High child protection caseworker turnover diminishes care quality. While burnout is acknowledged, the impact of protective factors is unclear. This study examines caseworkers' burnout, individual resilience's protective role, and strategies for curbing turnover and preserving work-life balance. Results indicate that personal, work, and client-related subscales correlate highly. The moderating effect of resilience on burnout was significant yet marginal. Maintaining boundaries was the primary core theme reported in relation to strategies to maintain work-life balance. The results of this study highlight potentially modifiable factors likely to reduce caseworker turnover. Findings support the need for a collective re-evaluation of resilience as an individual responsibility to something that can be supported and fostered within the workplace for increasing employee retention. [ABSTRACT FROM AUTHOR]

Background and Objectives The lack of psychotherapy in nursing homes can be explained by organizational obstacles but also by practitioners' reservations about this patient group and setting. This study aimed to inform practice by qualitatively exploring the experiences of psychotherapists delivering cognitive behavioral therapy to residents of nursing homes diagnosed with depression. Research Design and Methods Semistructured interviews with 6 psychotherapists, who had delivered treatment within the DAVOS project (Depression in the nursing home: a cluster-randomized stepped-wedge collaborative case management approach to improve treatment) were recorded, transcribed, and analyzed using a deductive–inductive content analysis. Results Therapists experienced various difficulties, including practical (e.g. multiprofessional collaboration) and existential issues (e.g. confrontation with their own mortality). Participants described correcting some stereotypical images of older people (in need of care) through their work within the DAVOS project. However, evidence of ageism was still included in their reports. In the interviews, psychotherapists more experienced with older patients addressed more existential issues, whereas more novice therapists tended to focus more on practical difficulties. Discussion and Implications To ensure a more effective implementation of psychotherapeutic treatment in nursing homes, it appears necessary to address important contextual factors that facilitate interdisciplinary collaboration, interference-free treatment rooms, and tele-assisted sessions. Further, more setting-specific training, targeted supervision regarding death and suicide, and interventions that address stereotypical images of age and older people in residential care are needed. Clinical Trial Registration Number DRKS00015686 [ABSTRACT FROM AUTHOR]

Copyright of Zentralblatt fuer Arbeitsmedizin, Arbeitsschutz und Ergonomie 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.)

Palatoplasty is a surgical procedure used to repair a cleft palate. Postsurgery there are times when the healing process is disrupted. Honey has been utilised since ancient times as an antibacterial, anti‐inflammatory, and regenerative treatment for wounds, and it has been shown to expedite the wound healing process by promoting the formation of new tissue. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this analysis is to better understand laws and practices guiding prevention activities in childhood lead poisoning prevention programs funded by the Centers for Disease Control and Prevention (CDC). Methods: In 2022, CDC surveyed 62 funded programs using the Awardee Lead Profile Assessment. Information was collected about childhood lead poisoning-related laws and guidance, surveillance and prevention strategies, and program services including at what blood lead levels (BLLs) various activities are performed. Separately, CDC reviewed state health department websites to obtain information on which states implemented CDC's updated blood lead reference value. Results: Awardee Lead Profile Assessment results are only reported for 47 states, the District of Columbia, and Puerto Rico. Almost all programs (96%) have laws requiring reporting of BLLs, and 51% require BLLs be reported electronically to jurisdictional health departments. Most programs (80%) prioritize areas and populations that are high risk for lead poisoning prevention activities. Approximately half of the programs (51%) have a lead elimination plan or goal. Thirty-nine percent of the programs have already implemented policies, laws, or regulations to achieve lead elimination, and 74% are in the Northeast and Midwest regions of the country. As of March 2023, 71% of the programs have implemented CDC's updated blood lead reference value, and most (65%) did so via guidance for health care providers and laboratories for what BLL should initiate case management and other services for lead-exposed children. Conclusions: Almost all programs have mandatory BLL reporting laws, and about two-thirds of the programs updated their BLLs that trigger public health action. [ABSTRACT FROM AUTHOR]

Federally Qualified Health Centers (FQHCs) are pivotal in delivering healthcare services to underserved populations in the United States. While the number of FQHCs and FQHC look-alikes has been increasing, intensifying competition, limited research has examined the cost implications associated with this growing competition among FQHCs. This study aims to fill the research gap by analyzing the relationship between the level of competition among FQHCs and the cost of care per patient. Understanding this relationship is crucial for managers and policymakers in deriving informed decisions related to the expansion of FQHCs. The study comprehensively analyzed data from FQHCs from 2016 to 2022. The analysis involved examining the cost per patient in relation to the level of FQHC competition, measured by FQHC saturation in the area. The study's findings reveal a positive association between FQHC competition and the cost of care. Specifically, FQHCs in areas with higher levels of FQHC competition reported a higher cost per patient. This relationship underscores the potential financial dynamics influenced by the competitive environment among FQHCs. The results of this study have important implications for healthcare management and policy formulation. FQHC managers are suggested to consider the cost implications of increased competition in their strategic planning and operations. Meanwhile, policymakers should consider the potential cost ramifications of FQHC competition when designing and implementing policies related to FQHC expansion, especially those aimed at optimizing resource allocation and ensuring care affordability. Recognizing the impact of competition on cost can lead to more informed decisions regarding the funding, establishment, and distribution of FQHCs, ultimately contributing to the sustainability and efficacy of healthcare services in underserved areas. [ABSTRACT FROM AUTHOR]

Treatment outcomes for acute malnutrition can be improved by integrating treatment into community case management (iCCM). However, little is known about the cost‐effectiveness of this integrated nutrition intervention. The present study investigates the cost‐effectiveness of treating moderate acute malnutrition (MAM) through community health volunteer (CHV) and integrating it with routine iCCM. A cost‐effectiveness model compared the costs and effects of CHV sites plus health facility‐based treatment (intervention) with the routine health facility‐based treatment strategy alone (control). The costing assessments combined both provider and patient costs. The cost per DALY averted was the primary metric for the comparison, on which sensitivity analysis was performed. Additionally, the integrated strategy's relative value for money was evaluated using the most recent country‐specific gross domestic product threshold metrics. The intervention dominated the health facility‐based strategy alone on all computed cost‐effectiveness outcomes. MAM treatment by CHVs plus health facilities was estimated to yield a cost per death and DALY averted of US$ 8743 and US$ 397, respectively, as opposed to US$ 13,846 and US$ 637 in the control group. The findings also showed that the intervention group spent less per child treated and recovered than the control group: US$ 214 versus US$ 270 and US$ 306 versus US$ 485, respectively. Compared with facility‐based treatment, treating MAM by CHVs and health facilities was a cost‐effective intervention. Additional gains could be achieved if more children with MAM are enrolled and treated. Key messages: Treatment of MAM by CHVs and health facilities involved a lower cost compared with the health facility‐based treatment approach alone.Treatment of MAM by CHVs and health facilities was cost‐effective compared with the health facility‐based treatment approach alone.Greater health and economic gains could be realized if more children with MAM are enrolled and treated by CHVs through the integration of acute malnutrition treatment into iCCM. [ABSTRACT FROM AUTHOR]

Most substance use begins in adolescence. Both childhood trauma and associated post-traumatic stress disorder (PTSD) increase risk for early substance use, which is associated with greater eventual severity of substance use disorders (SUDs). When co-occurring, PTSD and SUD can reinforce and exacerbate each other, necessitating integrated treatment approaches. To systematically review existing literature on interventions for prevention or treatment of SUDs among adolescents (aged 10–24) with a history of trauma, with or without PTSD, we searched databases (PubMed, PsycInfo, CINAHL, Cochrane CENTRAL) using search terms related to substance use, trauma, adolescents, and interventions. Searches identified 8134 unique articles, 68 of which prompted full-text screening. Authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings. Thirty three articles met eligibility criteria, including 13 RCTs. Twenty studies (10 RCTs) evaluated interventions for substance use and co-occurring problems among youth with a history of trauma, predominantly via individual therapy based on cognitive-behavioral principles, although group therapy, case management, and other approaches have also been studied. Interventions with exposure-based components were infrequent but had robust results and minimal adverse outcomes. Thirteen studies examined differential response of youth with a history of trauma to standard SUD treatments, compared to youth without a history of trauma, with mixed findings. Youth with a history of trauma face elevated risk of SUDs and may respond differently to SUD treatments. Several promising interventions have been recently developed. [ABSTRACT FROM AUTHOR]

Introduction: China's rapidly aging population and rise in chronic diseases put immense strain on the country's healthcare system. To address these challenges, Yuhuan People's Hospital established County-level Integrated Health Organization (CIHO) as part of the Healthy China 2030 initiative. Description: Based on the Kaiser Permanente (KP) model, the CIHO takes a multi-disciplinary, collaborative approach to deliver integrated care. It brings together various medical specialties, collaborates with community organizations and companies, and implements reforms in information technology and payment models. Through these efforts, the CIHO has significantly improved healthcare delivery in Yuhuan county. Discussion: Population segmentation relies on data integration and segmentation tools to identify targeted healthcare needs. The allocation and collaboration of health workforce for residents with different health conditions are suggested to be dynamically designed according to both internal and external factors. Corresponding payment mechanism is also an important factor that needs to be taken into consideration. Conclusion: The CIHO's success has provided a model for integrated, efficient healthcare that could be replicated in other regions of China and offer insights for rural areas in other countries facing similar demographic and epidemiological pressures. [ABSTRACT FROM AUTHOR]

Background: Black and Latino youth are disproportionately affected by trauma from community violence, but to date, few data support the benefit of evidence-based treatments for these youth or of including peer support to engage these youth in mental health services. Objective: From 2018 until 2020, a hospital and community-based violence intervention program in Philadelphia pilot tested the integration of home and community-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) with peer services and case management for youth impacted by community violence. This study describes the implementation of this intervention. Method: Data was gathered by querying the program's database. The Child Post Traumatic Stress Symptom Severity Scale (CPSS-SR-5) and the Short Mood and Feelings Questionnaire (SMFQ) were utilized to evaluate the participants' pre- and post-intervention assessment of PTSD and depression. The sample (N = 50) consisted of Black and Latino youth, mean age 14. Results: Twenty-nine (58%) completed TF-CBT, and 82% met peer and case management goals. Youth who completed therapy showed significant improvement in both PTSD and depression symptoms at post-test. Conclusion: To our knowledge, this is the first study describing the implementation of home and community-based TF-CBT with peer support and case management. The study's limitations and need for further research are discussed. Plain language summary: Black and Latino youth are disproportionally affected by violence across US cities. Mental health research is needed to evaluate how to engage these youth in mental health services and provide effective and culturally relevant trauma treatment. This research describes the experiences of 50 children and adolescents (ages 8–18) who participated in this pilot tested health services intervention using their electronic health records to access de-identified information and present youths' demographics, services received, and clinical outcomes. Specifically, we describe ways in which the intervention was culturally relevant to the participants' lived experiences. Services delivered consisted of the integration of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) with peer services and case management for youth impacted by community violence. Services were provided by licensed social workers and certified peer specialists at a hospital and community-based (i.e., youth's home, school) violence intervention program (HVIP). Our results indicate that this intervention shows preliminary efficacy for decreasing post-traumatic stress disorder (PTSD) and depression symptoms for Black & Latino youth impacted by ongoing violence. This real-world study lays out a blueprint for implementing similar programs. The study has several limitations, and we discuss the need for additional research. [ABSTRACT FROM AUTHOR]

Background: The teaching and assessment of clinical-practical skills in medical education face challenges in adequately preparing students for professional practice, especially in handling emergency situations. This study aimed to evaluate the emergency medical competencies of junior doctors using Virtual Reality (VR)-based scenarios to determine their preparedness for real-world clinical situations. Methods: Junior doctors with 0–6 months of professional experience participated in one of three VR-based emergency scenarios. These scenarios were designed to test competencies in emergency medical care. Performance was automatically assessed through a scenario-specific checklist, and participants also completed self-assessments and a clinical reasoning ability test using the Post-Encounter Form. Results: Twenty-one junior doctors participated in the study. Results showed that while general stabilization tasks were performed well, there were notable deficiencies in disease-specific diagnostic and therapeutic actions. On average, 65.6% of the required actions were performed correctly, with no significant variance between different scenarios. Participants achieved an average score of 80.5% in the Post-Encounter-Form, indicating a robust ability to handle diagnostic decisions. Self-assessments did not correlate significantly with objective measures of competency, highlighting the subjective nature of self-evaluation. Conclusion: VR-based simulations can provide a detailed picture of EMC, covering both diagnostic and therapeutic aspects. The findings of this pilot study suggest that while participants are generally well-prepared for routine tasks, more focus is needed on complex case management. VR assessments could be a promising tool for evaluating the readiness of new medical professionals for clinical practice. [ABSTRACT FROM AUTHOR]

Background: The Ryan White Medical Case Management System, which serves more than half of people living with HIV (PLWH) in the USA, is an opportune setting for identifying and addressing depression among PLWH. A growing body of research suggests that interventions that promote positive emotion may lessen symptoms of depression and improve physical and psychological well-being among people experiencing a variety of health-related stress, including living with HIV. Research on how best to integrate standardized mental health screening and referral to evidence-based interventions in Ryan White Medical Case Management settings has the potential to improve the health and wellbeing of PLWH. Methods: This mixed-methods study will enroll up to N = 300 Ryan White clients who screen positive for depressive symptoms in ORCHID (Optimizing Resilience and Coping with HIV through Internet Delivery), a web-based, self-guided positive emotion regulation intervention. The study will be conducted in 16 Ryan White Medical Case Management clinics in Chicago, IL. Following pre-implementation surveys and interviews with Medical Case Managers (MCMs) and Supervisors to develop an implementation facilitation strategy, we will conduct a hybrid type 2 implementation-effectiveness stepped wedge cluster randomized trial to iteratively improve the screening and referral process via interviews with MCMs in each wedge. We will test the effectiveness of ORCHID on depression and HIV care outcomes for PLWH enrolled in the program. RE-AIM is the implementation outcomes framework and the Consolidated Framework for Implementation Research is the implementation determinants framework. Discussion: Study findings have the potential to improve mental health and substance use screening of Ryan White clients, decrease depression and improve HIV care outcomes, and inform the implementation of other evidence-based interventions in the Ryan White Medical Case Management System. Trial registration: ClinicalTrials.gov NCT05123144. Trial registered 6/24/2021 [ABSTRACT FROM AUTHOR]

Background: Falls are directly related to morbidity and mortality of older people. Multifactorial approaches that are individualised and based on fall risk factors are necessary. This study aims to verify the effects of a case management‐based intervention on non‐motor risk factors for falls in community‐dwelling older people with a history of falls. Methods: The intervention applied a multidimensional assessment of risk factors for falls, a discussion about the identified risk factors, the preparation of an individualised plan with the participant, and the application, monitoring and review of the plan. Results: There was a significant interaction between groups and assessments only in the visuospatial domain (P = 0.031). After simple main effects analysis, differences between groups and assessments were not significant, although there was a tendency of worse visuospatial performance in the control group in the follow‐up assessment (P = 0.099). There were no significant differences between groups or between assessments in other variables. Conclusion: The intervention has the potential to maintain non‐motor risk factors for falls in community‐dwelling older people with a history of falls. However, more clinical trials are needed to prove its effects. [ABSTRACT FROM AUTHOR]

Objective: Prior studies and have shown that gaps in care coordination (CC) increase the risk of emergency department (ED) visits among children with special healthcare needs. This study aims to determine if gaps in CC are associated with an increased risk of ED visits among children without special needs (non-CSHCN). Study Design: We conducted a cross-sectional study using the National Survey of Children's Health (2018–2019), representing children up to age 17. A "gap" in CC occurs if the adult proxy reported dissatisfaction with communication between providers or difficulty getting the help needed to coordinate care for the child. Using logistic regression models adjusting for age and sex, we measured the association between a gap in CC and 1 or more ED visits during the past 12 months overall and stratified by any special needs. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated. Results: Between 2018 and 2019, 15% of respondents reported a gap in CC and 19.4% of children had at least one ED visit. Among non-CSHCN, these rates were 11% and 17%. In this population, a gap in CC was independently associated with an increased odds of ED use (AOR: 2.14; 95% CI 1.82, 2.52). Conclusions for Practice: Self-reported gaps in ambulatory CC were associated with increased odds of ED visits even among non-CSHCN children with minor illnesses, suggesting that providers need to be aware of potential pitfalls in CC for all children, and ensure that pertinent information is available where needed. Significance: Prior studies and targeted interventions have shown that poor CC is significantly associated with a higher risk of ED visits among children with special needs. Though extremely important, this focus leaves out nearly 80% of the pediatric population, among whom ED utilization is still high. This study finds a new association between poor CC and ED utilization among children without special needs, which can inform the design of future interventions. [ABSTRACT FROM AUTHOR]

Evaluation of a team-based intervention in primary care that includes cognitive behavioural therapy elements and case management and was supported by eHealth components in patients with panic disorder with or without agoraphobia (PD ± AG) and/or depression. In a two-armed cluster-randomised controlled trial (cRCT), mental health conditions were assessed by the Mental Health Index (MHI-5), Patient Health Questionnaire (PHQ-9), Overall Anxiety Severity and Impairment Scale (OASIS), Panic and Agoraphobia Scale (PAS), Mobility Inventory for Agoraphobia (MIA), and Patient Assessment of Chronic Illness Care (PACIC) at baseline (T0), after 6 months (T1), and after 12 months (T2). Scores were analysed as differences from baseline using a mixed linear model with general practitioner (GP) as a random intercept and treatment, time point, and respective baseline value as fixed factors. The majority of participants (mean age 54 years, SD 12.8 years) were women (n = 40, 67.8%). We found consistent mean effects in favour of the intervention group (MHI-5 index, 6.66 [−7.38; 20.70]; PACIC, 15.92 [4.58; 27.26]; PHQ-9, −3.43 [−5.71; −1.14]; OASIS, −2.89 [−5.41; −0.37]). A cautious interpretation indicates promising effects of the intervention. Obstacles to recruitment included the workload for GPs and medical assistants (MAs), potential reservations regarding eHealth, and the onset of the COVID-19 pandemic. Trial registration: The study was registered at the German Clinical Trials Register (DRKS00016622) on February 22nd, 2019. https://drks.de/search/de/trial/DRKS00016622. [ABSTRACT FROM AUTHOR]

This study describes medical interpreters' experiences with behavioral health (BH) services in a primary care clinic. Focus group data with medical interpreters representing multiple languages was analyzed using hybrid inductive-deductive thematic analysis. Themes related to interpreter roles were: (1) case management, (2) patient-interpreter relationship, and (3) patient-provider liaison. Themes related to barriers and facilitators to interpreter-mediated BH care were: (1) cultural factors, (2) patient-provider interactions, (3) BH-specific considerations, and (4) clinic factors. Results illustrate ways that interpreters directly (e.g. interpreter-mediated services) and indirectly (e.g. relationship building) support care. The interpreter-patient relationship reportedly helped improve patient attitudes and buy-in for BH. [ABSTRACT FROM AUTHOR]

Objective: While the number of overdoses in the United States continues to increase, lags in data availability have undermined efforts to monitor, respond to, and prevent drug overdose deaths. We examined the performance of a single-item mandatory radio button implemented into a statewide medical examiner database to identify suspected drug overdose deaths in near-real time. Materials and Methods: The New Jersey Office of the Chief State Medical Examiner operates a statewide mandated case management data system to document deaths that fall under the jurisdiction of a medical examiner office. In 2018, the New Jersey Office of the Chief State Medical Examiner implemented a radio button into the case management data system that requires investigators to report whether a death is a suspected drug overdose death. We examined the performance of this tool by comparing confirmed drug overdose deaths in New Jersey during 2020 with suspected drug overdose deaths identified by investigators using the radio button. To measure performance, we calculated sensitivity, specificity, positive predictive value, negative predictive value, and false-positive and false-negative error rates. Results: During 2020, New Jersey medical examiners investigated 26 527 deaths: 2952 were confirmed by the state medical examiner as a drug overdose death and 3050 were identified by investigators using the radio button as a suspected drug overdose death. Sensitivity was calculated as 96.1% (2837/2952), specificity as 99.1% (23 362/23 575), positive predictive value as 93.0% (2837/3050), negative predictive value as 99.5% (23 362/23 477), false-positive error rate as 7.0% (213/3050), and false-negative error rate as 3.9% (115/2952). Practice Implications: Implementation of a radio button into death investigation databases provides a simple and accurate method for identifying and tracking drug overdose deaths in near-real time. [ABSTRACT FROM AUTHOR]

Working alliance is of particular importance in the treatment of hoarding due to high levels of stigma surrounding the diagnosis and low levels of insight in patients. Furthermore, clinician experiences of frustration when treating individuals with hoarding disorder may be a barrier to creating the necessary working alliance. However, evaluation of clinician experiences has been limited to self-reports or qualitative methods. Sentiment analysis of clinical case notes related to hoarding treatment may provide useful information on the relationship between clinician attitudes and patient outcomes. Sentiment analysis involves computerized scanning of text and subsequent ratings of emotional valence for each text string. The purpose of the current study was to use sentiment analysis to analyze clinical case notes from 41 participants who were enrolled in a clinical trial for hoarding disorder. When analyzed as a whole, sentiments spanned almost the entire possible range of values and showed insignificant changes over time, suggesting a stability in clinicians' overall sentiment towards patients. However, time emerged as a significant effect in specific categories, such that clinician sentiment became more negative across treatment sessions for notes relevant to barriers, successes, and concerns, and more positive for notes describing observations and assessments across sessions. The current study indicated that sentiment analysis of treatment notes is feasible; however, conclusions about working alliance are limited without additional input from clinicians (e.g., follow-up interviews). Future research should investigate which clinical interactions are reflected in clinical note sentiment, and whether change in clinician sentiment is associated with treatment outcomes. [ABSTRACT FROM AUTHOR]

The use of atropine is currently one of the most effective methods used to prevent myopia progression. The purpose of this study was to investigate atropine adherence in preschool children with myopia, to explain the context of treatment through caregivers, and to identify barriers and facilitators of using atropine. We conducted in-depth interviews with 60 caregivers of children (parents, kindergarten teachers and nurses) in four different areas ranging from large cities to rural areas in Taiwan. Based on the social ecological theory model, the recorded text was systematically analyzed, extracted, edited and indexed by NVivo 12 Plus. After interviewing caregivers, we determined the barriers and facilitators at the four levels of influence (children, parents, school, and hospital and society). Barriers included the side effects, parental neglect, lack of understanding of long-term drug use, lack of conducive environment, and lack of friendly medical services. Facilitators included overcoming side effects, parental responsibility, myopia progression on treatment adherence, teacher support, management by nurses, navigation by ophthalmologists, and model learning. Hence, establishing a social support network, discussing the experience of individualized drug use in preschool children, and establishing a friendly medical intervention strategy can raise awareness among parents regarding myopia, and improve atropine adherence in preschool children. [ABSTRACT FROM AUTHOR]

Obesity is a chronic, prevalent, and complex health condition that adversely impairs physical and mental health. The World Health Organization calls for integrating obesity care into existing chronic disease management programs within primary healthcare services. This scoping review aimed to examine registered nurses' roles in the primary healthcare management of individuals with obesity. A scoping review was conducted using the Johanna Briggs Institute methodology framework. Thematic analysis was used to identify and categorize nurses' roles in primary healthcare obesity management of adults. Of 1142 documents included in this review, 15 papers met the inclusion criteria. Thematic analysis yielded the following six themes representing nurses' major roles: patient-centred care, patient assessments, therapeutic interventions, care management, patient education, and professional development. This review identified that the literature on nurses' roles primarily described their focus on lifestyle interventions (mainly nutrition and physical activity), anthropometric measurements, health planning, goal setting, supportive care, monitoring progress, and arranging follow-up. The Discussion highlights the importance of determining RN knowledge gaps and biases. More research is required to determine the need for additional RN pre-and or post-education related to obesity as a complex chronic disease. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. 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.)

Copyright of Spor Hekimligi Dergisi/Turkish Journal of Sports Medicine is the property of Turkish Journal of Sports Medicine / Spor Hekimleri Dernegi 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.)

Although there has been a large body of research conducted on girl and young women victims of commercial sexual exploitation, boy and young men victims do not receive the same attention. The scant research that exists demonstrates mixed findings on the prevalence of boys and young men as victims of commercial sexual exploitation. For example, some studies find they are not as likely to be victims and others find they are victimized equally, or in some cases, potentially even more so than girls and young women, depending on location. ECPAT published a study in 2013 that revealed a lack of awareness and misclassification of boys as victims and the lack of services available to help them. The purpose of this study is to replicate the ECPAT study and determine what changes might have occurred over the past decade. We consulted with key individuals involved in serving boys and young men and conducted a survey of anti-trafficking service agencies to gather current information on the boys/young men being referred to them for care, the dynamics of their victimization, their most pressing needs, the services/programs being offered, and gaps in service in their respective locations. Among other relevant findings, one commonality among the boys and young men served by the responding agencies was a history of sexual abuse. Findings inform service providers and contribute to advocacy efforts and policy recommendations at the local, state, and federal levels. [ABSTRACT FROM AUTHOR]