Journal of evaluation in clinical practice
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A group of organizations and individuals in the Netherlands collaborated to attempt to improve access to health care and health education for deaf and hard of hearing (DHH) patients in the country. The outcome was the start of a specialized outpatient clinic named PoliDOSH. An independent research group was set up to evaluate the effect of this specialized clinic. Even though the initiative did not succeed and was closed after 2 years, an extensive analysis of the start-up and functioning of the whole process was made. ⋯ There is a great need for facilities to collect and disseminate information to and about DHH patients. The information should be aimed at providing psycho-education for the DHH persons themselves and health care professionals, concerning the specific needs and problems of this patient group. If a similar facility is set up in the future, thorough market research prior to start up is needed to enable the facility to connect with the needs of patients. The start-up period should allow sufficient time for the project to become known and for patients to become familiar with it and trust it.
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Urinary tract infection (UTI) is a common presentation to general practitioners (GPs). There is increasing antimicrobial resistance in urinary pathogens in many healthcare systems. Adherence to principles of antimicrobial stewardship is important to combat this problem. Our aim was to describe the prevalence of presentations of clinically diagnosed new UTI to early-career GPs, to describe management choices made, and to identify associations of prescribing antibiotics at the index consultation for UTI. ⋯ A new UTI is a common presentation to Australian early-career GPs. There is general adherence to guidelines for antibiotic choice in UTIs. Further research is needed, however, to understand some decisions made when managing UTI in children and men. This may reflect diagnostic uncertainty with consequent attention to antibiotic stewardship by deferring antibiotic prescription.
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Trauma Focused-Cognitive Behavioural Therapy (TF-CBT) has been established as an evidence-based treatment for youth with traumatic stress symptoms. The versatility of TF-CBT in conjunction with its established effectiveness has led to its widespread dissemination. However, dissemination efforts have not always translated into sustainability, which has prompted a more thorough investigation into those factors that impact implementation and encouraged the development of strategies that promote sustainability. Toward this end, the aims of this study were to: (1) determine which components of TF-CBT clinicians found the most difficult to implement; (2) explore clinicians' perceptions as to why these components were challenging; and (3) examine whether the use of formalized problem-solving approaches (FPSAs) or training format was associated with implementation outcomes. ⋯ Findings suggest that perceived difficulty of TF-CBT components did not vary by training format, but more extended formats and the use of FPSAs were associated with more favourable implementation outcomes. Implementers should consider ways to utilize FPSAs within training programs, as well as focus on content identified by clinicians as difficult, as this may assist clinicians in developing skills and managing implementation barriers.
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There is a general lack of awareness and understanding of dementia within ethnic minority groups in the United Kingdom. There is also a dearth of research involving ethnic minority caregivers about reducing barriers to accessing services and optimizing engagements with religiously tailored interventions. This paper reports findings from a qualitative study that examined the barriers to health care service use in the Bangladeshi community living in the United Kingdom. ⋯ The findings provide an understanding of the experiences of the Bangladeshi community when seeking to access mainstream UK health care services and may help to provide useful directions for future research.
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Family participation in Intensive Care Unit (ICU) bedside rounds has been advocated as a way to improve communication between families and health care providers; however, the associated impact and modulators have not been fully described. The purpose of this study was to explore benefits, drawbacks, barriers, and facilitators to family participation in ICU rounds in order to inform ways to improve how families are integrated into rounds. ⋯ Our study provides insight into the multiple processes involved in family participation in ICU rounds, along with suggestions for improvement. Our findings may help guide development of a structured approach to family participation in ICU rounds that can be adapted to local contexts.