Villadsensahl2814
Across OECD countries, healthcare organizations increasingly rely on inter-organizational collaboration (IOC). Yet, systematic insight into the relations across different healthcare sectors is lacking. The aim of this explorative study is twofold. First, to understand how IOC differs across healthcare sectors with regards to characteristics, motives and the role of health policy. Second, to understand which potential effects healthcare executives consider prior to the establishment of the collaborations. For this purpose, a survey was conducted among a representative panel of Dutch healthcare executives from medium-sized or large healthcare organizations. Almost half (n = 344, 48%) of the invited executives participated. Our results suggest that differences in policy changes and institutional developments across healthcare sectors affect the scope and type of IOC hospitals generally operate in small horizontal collaborations, while larger and more complex mixed and non-horizontal collaborations are more present among nursing homes, disability care and mental care organizations. We find that before establishing IOCs, most healthcare executives conduct a self-assessment including the potential effects of the collaboration. The extensive overview of policy developments, collaboration types and intended outcomes presented in our study offers a useful starting point for a more in-depth assessment of the effectiveness of collaborations among healthcare organizations.Application of value-based healthcare policies affects all actors in social and health care field, including the Digital Health Intervention (DHI) providers aiming to enter the industry or expand their market. Apparent lack of fit between evidence and expectations inhibits the growth of DHI companies. The companies need efficient and credible methods to access and demonstrate the value of their DHIs. Building on the stage-of-maturity logic presented in World Health Organization's (WHO) guide of monitoring and evaluating digital health interventions and Context-Intervention-Mechanism-Outcome (CIMO) logic, we provide a potential approach for DHI companies to assess the evidence needed in their current situation. The proposed approach takes into account the company's future development goals and the business environment, reflecting for every stage of technology maturity according to the WHO guidelines and through the CIMO lens. The focus is on specific intervention and its fit for different organizational and national contexts. SR-717 order The solution guides the research process of the company to understand which evidence-gathering topics should be addressed. This evidence can be beneficial for companies to enter into, occupy, expand or sustain in the domestic or international market.Meloxicam for intravenous use (meloxicam iv.) is a nanocrystal formulation with improved dissolution properties and shortened time to peak plasma concentrations versus oral meloxicam. In Phase III and IIIb trials, 30 mg once daily relieved pain following pre- or postoperative administration in orthopedic, abdominal and colorectal surgeries. Meloxicam iv. was associated with reduced opioid consumption, the clinical benefit of which remains unclear. The drug may be administered alone or in combination with other non-nonsteroidal anti-inflammatory drugs. In Phase III trials, it demonstrated adverse event profile similar to placebo, with nausea, constipation, vomiting and headache occurring most frequently. Meloxicam iv. does not appear to adversely affect platelet function or wound-healing parameters. No new safety signals were detected in the Phase IIIb studies.
This article describes the incorporation of an evidence-based mental health intervention, the Youth Readiness Intervention (YRI), into a youth entrepreneurship training program in Sierra Leone. A collaborative team approach (CTA) was used as the implementation strategy to address the human resource shortage and related challenges associated with capacity and access to care.
A cluster randomized quasi-experimental pilot trial (N=175) was conducted in one rural district of Sierra Leone. Pilot data assessed implementation feasibility and clinical effectiveness when using a CTA. A larger hybrid type-2 effectiveness-implementation cluster randomized trial is underway (N=1,151) in three rural districts. Findings on feasibility and fidelity, barriers and facilitators influencing the integration of the YRI into the entrepreneurship program, and clinical effectiveness of the YRI are of interest.
Findings from the pilot study indicated that the YRI can be implemented within a youth entrepreneurship program and provide mental health benefits to youths at high risk of emotion dysregulation and interpersonal deficits. Pilot findings informed the ongoing, larger hybrid type-2 trial to understand barriers and facilitators of the CTA and clinical effectiveness of the YRI within youth employment programming.
In fragile postconflict settings, innovative approaches are needed to address the mental health treatment gap. Findings from this study will support efforts by the government of Sierra Leone and its partners to address human resource challenges and increase access to evidence-based mental health services.
In fragile postconflict settings, innovative approaches are needed to address the mental health treatment gap. Findings from this study will support efforts by the government of Sierra Leone and its partners to address human resource challenges and increase access to evidence-based mental health services.
Depression is a leading cause of death and disability worldwide, including in low- and middle-income countries (LMICs). Depression often coexists with chronic medical conditions and is associated with worse clinical outcomes. This confluence has led to calls to integrate mental health treatment with chronic disease care systems in LMICs. This article describes the rationale and protocol for a trial comparing the clinical effectiveness and cost-effectiveness of two different intervention packages to implement evidence-based antidepressant management and psychotherapy into chronic noncommunicable disease (NCD) clinics in Malawi.
Using constrained randomization, the Sub-Saharan Africa Regional Partnership (SHARP) for mental health capacity building will assign five Malawian NCD clinics to a basic implementation strategy via an internal coordinator, a provider within the chronic care clinic who champions depression services by providing training, supervision, operations, and reporting. Another five clinics wito enhancing both mental health treatment and implementation science research capacity in Malawi and the wider region.
Cost, distance, and stigma may present barriers to face-to-face treatment for anxiety disorders. Technology can help overcome these barriers. link2 The evidence map presented here provides an overview of technology use in clinical care for anxiety.
Searches in three databases from their inception dates to June 2019 identified published randomized controlled trials (RCTs) examining technology use in anxiety disorder management. Reviewers screened 4,061 records, included 128 RCTs, and extracted data on study characteristics and technology type, function, and effectiveness.
In 88% of the 128 RCTs, the authors reported reduced anxiety symptoms postintervention. Studies of computer technology (66%) and patient self-directed psychotherapy (31%) were most common. Many interventions were studied by only a few RCTs, and many studies had small sample sizes.
Almost all interventions reported improved anxiety symptoms, with computer applications having the largest evidence base. More information is needed to evaluate the role of technology in clinical care for anxiety.
Almost all interventions reported improved anxiety symptoms, with computer applications having the largest evidence base. More information is needed to evaluate the role of technology in clinical care for anxiety.
To describe age-specific cervical cancer incidence rates based on demographic and clinical characteristics.
Women with cervical cancer in the SEER program were grouped into 3 age categories. Demographics, clinical characteristics, and incidence rates were obtained for each age group.
Older women (≥65 years) had higher incidence rates of cervical cancer than women <65 years with the highest rates in black women ≥75 years. Older black women had more adverse factors at diagnosis than similarly aged white and younger black women. There was a higher incidence rate of cervical cancer in women with lower socioeconomic status (SES), with the highest rates in older black women. However, the incidence rates were similar for older black women regardless of SES.
Older black have the highest cervical cancer incidence rates, regardless of SES, suggesting an age and race disparity when compared to younger and white women.
Older black have the highest cervical cancer incidence rates, regardless of SES, suggesting an age and race disparity when compared to younger and white women.Mycoplasma gallisepticum and Mycoplasma synoviae are bacterial pathogens that cause disease in poultry, adversely affecting their health and welfare, and are a financial burden on producers. This manuscript describes the results of the MycoPath project that is the first international antimicrobial susceptibility programme for mycoplasma pathogens isolated from poultry. Improved comparative analysis of minimal inhibitory concentration (MIC) results from participating countries was facilitated by using one laboratory determining all MICs. Chicken and turkey isolates were obtained from France, Germany, Great Britain, Hungary, Italy and Spain during 2014-2016. One isolate per farm was retained. The MIC of seven antimicrobial agents was determined using a broth microdilution method, with Friis Medium (M. gallisepticum) or Modified Chanock's Medium (M. link3 synoviae). Of the 222 isolates recovered, 82 were M. gallisepticum and 130 were M. synoviae. M. gallisepticum MIC50/90 values were 0.12/0.5, 2/8, 0.5/4, 0.12/>64, 0.lues assessed in central laboratory for Mg and Ms from chickens and turkeys.Range of MIC values for 82 Mg and 130 Ms isolates to seven licenced antibiotics shown.Data can be used to help determine Mg and Ms veterinary-specific breakpoints.Hospitalization data provide context to understanding abusive and non-abusive injuries and how these hospitalizations change over time. The purpose of this study was to utilize Texas inpatient hospitalization data to assess age-related differences among infants ( less then 12 months of age) and toddlers (12-59 months of age) in injury trends and patterns of injury among abusive and non-abusive hospitalization encounters over a 15-year time period. For both age groups, pediatric hospitalizations for non-abusive injuries decreased significantly over time; however, hospitalizations for abusive injuries did not. Compared to non-abusive injury hospitalizations, abusive injury hospitalizations were statistically more likely to involve more body regions and were associated with fractures, internal organ injuries, and superficial wounds. Abusive injury hospitalizations had longer lengths of stay and resulted in higher illness severity scores. Toddler injury hospitalizations were associated with most of the body regions, with the exception of traumatic brain injury for which the odds of hospitalization were higher for infants.
