Articles: health.
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Randomized Controlled Trial
Simultaneously implementing pathways for improving asthma, pneumonia, and bronchiolitis care for hospitalized children: Protocol for a hybrid effectiveness-implementation, cluster-randomized trial.
Asthma, pneumonia, and bronchiolitis are the top causes of childhood hospitalization in the United States, leading to over 350,000 hospitalizations and ≈$2 billion in costs annually. The majority of these hospitalizations occur in general/community hospitals. Poor guideline adoption by clinicians contributes to poor health outcomes for children hospitalized with these illnesses, including longer recovery time/hospital stay, higher rates of intensive care unit transfer, and increased risk of hospital readmission. A prior single-center study at a children's hospital tested a multicondition clinical pathway intervention (simultaneous implementation of multiple pathways for multiple pediatric conditions) and demonstrated improved clinician guideline adherence and patient health outcomes. This intervention has not yet been studied in community hospitals, which face unique implementation barriers. ⋯ This hybrid trial will lead to a comprehensive understanding of how to pragmatically and sustainably implement a multicondition pathway intervention in community hospitals and an assessment of its effects. Enrollment began in July 2022 and is projected to be completed in September 2024. Primary analysis completion is anticipated in March 2025, with reporting of results following.
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Contraceptive care is an opportunity for providers to help clients achieve their reproductive health goals. Client-centeredness is a core element of quality care; however, evidence suggests that the provision of client-centered contraceptive counseling needs improvement. This systematic review summarizes recent evidence on client preferences related to contraceptive care, including how client-centered approaches inform outcomes. ⋯ The variation in client preferences highlight the importance of offering tailored, comprehensive information that supports decision-making, prioritizes client autonomy, and recognizes positive interpersonal relationships with providers.
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Historical Article
Consequences of Infectious Disease Outbreaks in Ardabil (1925-1941): A Historical Analysis.
Infectious diseases were one of the most important public health problems in Ardabil during the first Pahlavi period (1925-1941 AD). These diseases caused the illness and death of many people. The purpose of this study is to investigate the factors and consequences of the spread of infectious diseases in Ardabil during the first Pahlavi period. ⋯ Poverty, illiteracy, poor public health, lack of medical facilities, and the geographical location were the main factors in the spread of these diseases. Considering the critical nature of the issue, the first Pahlavi government tried to control and prevent diseases by carrying out measures such as public education, establishing health and treatment centers and reforming their structure, sending doctors and distributing medicine, and implementing quarantine and vaccination. The results showed that the efforts of the first Pahlavi government in fighting infectious diseases in Ardabil were relatively successful and reduced the prevalence of some diseases.