Journal of evaluation in clinical practice
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A positive patient safety culture in maternity units is linked to higher quality of care and better outcomes for mothers. However, safety culture varies across maternity units. Analyses of variation in safety culture using statistical process control (SPC) methods may help provider units to learn from each other's performance. This study aims to measure patient safety culture across maternity units in Oman using SPC methods. ⋯ Generally, the safety culture in maternity units in Oman is below target and suggests that considerable work is required to enhance safety culture. Several maternity units showed evidence of high/low special cause variation that may offer a useful starting point for understanding and enhancing safety culture.
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Converging and accumulating evidence for the cross-communication among the nervous, immune, and endocrine systems, a field of study known as psychoneuroimmunology, implicates immunological dysfunction as a shared and common mechanism of both mental and physical illness. For example, psychiatric disorders like schizophrenia, bipolar disorder, major depression, and anxiety disorders have higher prevalence rates across a spectrum of autoimmune conditions compared to the general population. Additionally, subclinical immunological abnormalities are observed in a variety of psychiatric conditions, with chronic inflammation most extensively studied in the pathophysiology of depression. These observations blur the historical distinctions between mental and physical illness, yet clinical practice remains fragmented and primarily focused on differentially treating individual symptoms. ⋯ Utilizing a psychoneuroimmunological lens, health psychologists and clinicians can reconceptualize healthcare through integrative treatment approaches and advocacy for comprehensive policy-level reform at both the individual-level of care as well as community-wide prevention approaches.
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Despite research being done on spinal tuberculosis, diagnosing this condition at an early stage remains problematic due to its insidious onset and the varying symptoms being associated. Most individuals present to the health care facility with either simple back pain at an early stage or neurological complications at a later stage, when spinal compression and vertebral collapse have occurred as a result of delayed diagnosis. The prevention of secondary complications is therefore dependent on early recognition and diagnosis. The objective of this review was to identify common clinical patterns in case presentations and develop an evidence-based clinical guidance tool to assist clinicians in the early identification of spinal tuberculosis. ⋯ Through the use of an evidence-based clinical guidance tool, the clinician could be guided in the early suspicion and management of individuals with spinal tuberculosis and prevention of secondary complications.
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Data on abortion services are critical for monitoring trends in access and utilization, evaluating policies, and examining a wide range of research questions. Accurate and timely data, however, can be difficult to obtain for abortion services. Oregon is one of several states that use state funds to finance abortion services in their Medicaid programmes. Oregon's Medicaid programme contracts with managed care plans that receive global budgets to provide care. Abortion services, however, must be billed directly to the state through fee-for-service (FFS) billing to ensure that federal funds are not used. In this study, we identify possible abortions using Medicaid insurance claims data from Oregon and categorize identified abortions as high, medium, or low confidence according to convergent validity analysis of FFS billing. ⋯ Research on abortion services using insurance claims has important implications for women's health care and public health policy. A high-quality claims-based measure can facilitate monitoring the provision of abortion services within health systems and evaluation of initiatives to increase equitable abortion access.