Individual Barriers Research Articles

Women on Boards Scale: Cordons and Catalysts to Enter Boardroom

The underrepresentation of women on corporate boards and its influencers is an under-researched area in Asia, with the absence of standard scales measuring the catalysts and cordons for women’s career progression to boards. The research paper aims to develop and validate a multidimensional scale to measure the influences impacting women’s representation on boards in the Indian context. A pool of items was generated after a thorough review of existing literature and discussion with the experts. The Women on Boards Scale (WOBS) was constructed and validated based on a quantitative study of 509 female and male employees working in companies in Delhi and NCR. Exploratory factor analysis and confirmatory factor analysis techniques were applied for the study. The study confirms the structure of major barriers as individual, societal, and organisational barriers, along with the entry barriers that women face during entry or re-entry into the organization and enablers as well for women to reach boards. A comprehensive scale was constructed with significant psychometric properties to measure the barriers and enablers for women to reach boards. The scale provides a robust and useful tool for policymakers and corporations to improve gender diversity on corporate boards.

Time-Series Signals of Affect and Neural Dynamics with Technology to Identify Depression Risk

Despite extensive research documenting the impact of depression on basic human developmental parameters (employment, health, education, social roles, and overall quality of life), multiple individual and systemic barriers limit accessibility to clinical assistance among vulnerable populations. Research-backed digital interventions, such as smartphone applications, may serve as convenient and reliable tools for detecting and monitoring depressive symptoms and attenuate the increasing pressure on conventional mental health resources. This review evaluates the significance of key time-series signals of affect dynamics (average levels, granularity, variability, instability, inertia) and electroencephalographic (EEG) patterns (power spectrum of frequency bands, alpha asymmetry) in predicting critical transitions in depressive symptom severity. An evidence-based prototype for a smartphone application that can reliably integrate multivariate time-series signals of affect dynamics and neural oscillations is proposed, to prospectively anticipate and detect affective abnormalities with greater accuracy in individuals susceptible to depression.

Individual and Systemic Barriers Blocking Community Health Workers from Helping the Seriously Ill.

Background: Palliative care is a valuable component of health care that improves a patient's quality of life, yet its availability to patients with serious chronic illness remains relatively low. Due to their knowledge of community preferences and ability to improve patient education and access to care, community health workers (CHWs) can increase palliative care usage by patients. Notably, barriers to CHWs helping patients with serious chronic illness remain poorly understood. Objective: Explore the perception of barriers CHWs feel they face when attempting to support the health care of patients with serious chronic illness. Design: Qualitative semistructured individual interviews of CHWs and qualitative descriptive analysis. Setting/Subjects: Twelve CHWs who have worked with patients with serious chronic illness were recruited from the Johns Hopkins Healthcare LLC and the Baltimore Alliance for Careers in Healthcare organizations to virtually participate. Results: CHWs perceived both active and passive barriers that obstructed their efforts to work with seriously ill patients. CHWs shared that these barriers were dependent on themselves, their peers, and their work environments. Prevalent themes included interprofessional conflict, poor health care worker understanding of the CHW's role, and lack of access to quality resource organizations. CHWs noted job-specific training, better means to identify needed resources for patients, and inclusive health care teams as solutions to support their professional goals, while helping patients with serious illness. Conclusions: There are multiple perceived barriers to CHWs helping seriously ill patients. CHWs aiding patients with serious illness can be supported through better job training, better resource management tools, and improved communication between health care team members.

Strengthening Primary Healthcare in Jordan for Achieving Universal Health Coverage: A Need for Family Health Team Approach.

Achieving Universal Health Coverage (UHC) is a strategic objective of the Jordanian government and has been prioritized in its strategies and plans. However, there are several challenges affecting primary healthcare in Jordan and the health system in general that prevent Jordan from achieving UHC. This paper highlights the importance of team-based care in the form of Family Health Teams (FHTs) to realize Jordan's goal of achieving UHC. FHTs are a team-based approach that brings together diverse professionals to provide a comprehensive, efficient, patient-centered primary care system that meets the changing needs of Jordan's population and refugees. However, the implementation of FHT may encounter obstacles, including individual, organizational, institutional, and external barriers. To overcome such obstacles, several actions and processes need to be taken, including political commitment and leadership, implementing good governance and policy frameworks, allocating resources and funding, multisectoral collaboration, and engagement of communities and stakeholders. The successful implementation of FHTs requires participation from government officials, parliamentarians, civil society, and influential community, religious, and business leaders. A strategic policy framework, effective oversight, coalition building, regulation, attention to system design, and accountability are also essential. In conclusion, adopting the FHT approach in Jordan's Primary Healthcare system offers a promising path towards achieving UHC, improving healthcare access, quality, and efficiency while addressing the unique challenges faced by the country's healthcare system.

Impact of COVID-19 vaccination on saliva immune barriers: IgA, lysozyme, and lactoferrin.

Understanding the role of salivary constituents, such as lactoferrin, lysozyme, and secretory immunoglobulin A (sIgA), in immune protection and defense mechanisms against microbial invasion and colonization of the airways is important in light of the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The salivary immune barrier in individuals affected by COVID-19 may contribute to disease prognosis. Thus, the aim of the present review is to evaluate the effect of COVID-19 vaccines on the immunological composition of saliva. IgA antibodies generated by vaccination can neutralize the virus at mucosal surfaces, whereas antimicrobial peptides, such as lysozyme and lactoferrin, have broad-spectrum antimicrobial activity. Collectively, these components contribute to the protective immune response of the oral cavity and may help minimize viral transmission as well as the severity of COVID-19. Measuring the levels of these components in the saliva of COVID-19-vaccinated individuals can help in evaluating the vaccine's ability to induce mucosal immunity, and it might also provide insights into whether saliva can be used in diagnostics or surveillance for monitoring immune responses following vaccination. This also has implications for viral transmission.

Multilevel needs assessment of physical activity, sport, psychological needs, and nutrition in rural children and adults.

Physical activity yields significant benefits, yet fewer than 1 in 4 youth meet federal guidelines. Children in rural areas from low socioeconomic (SES) backgrounds face unique physical activity contextual challenges. In line with Stage 0 with the NIH Stage Model for Behavioral Intervention Development, the objective of the present study was to conduct a community-engaged needs assessment survey with middle school children and adults to identify perceptions, barriers, and facilitators of physical activity, sport, psychological needs, and nutrition from a multi-level lens. A cross-sectional survey data collection was conducted with children (n = 39) and adults (n = 63) from one middle school community in the Midwestern United States. The child sample was 33% 6th grade; 51% 7th grade and was 49% female. The adult sample was primarily between 30 and 39 years old (70%) and comprised predominantly of females (85%). Multi-level survey design was guided by the psychological needs mini-theory within self-determination theory and aimed to identify individual perceptions, barriers, and facilitators in line with the unique context of the community. At the individual level, 71.8% of children and 82.2% of the overall sample (children and adults) were interested in new physical activity/sport programming for their school. Likewise, 89.7% of children and 96.8% of adults agree that PA is good for physical health. For basic psychological needs in the overall sample, relatedness was significantly greater than the autonomy and competence subscales. Children's fruit and vegetable intake were below recommended levels, yet only 43.6% of children were interested in nutritional programming. Conversely, 61.5% indicated interest at increasing leadership skills. At the policy-systems-environmental level, the respondents' feedback indicated that the condition and availability of equipment are areas in need of improvement to encourage more physical activity. Qualitative responses are presented within for physical activity-related school policy changes. Interventions addressing children's physical activity lack sustainability, scalability, and impact due to limited stakeholder involvement and often neglect early behavioral intervention stages. The present study identified perspectives, barriers, and facilitators of physical activity, sport, psychological needs, and nutrition in a multi-level context and forms the initial campus-community partnership between scientists and community stakeholders.

Healthy eating and active living policy, systems, and environmental changes in rural Louisiana: a contextual inquiry to inform implementation strategies

BackgroundHealthy eating and active living policy, systems, and environmental (PSE) changes are implemented across the United States through Cooperative Extension. However, translating multisector PSE changes to practice in community settings is challenging and there is a lack of knowledge about barriers and facilitators to PSE changes among state Extension systems using standardized frameworks. Therefore, a research-to-practice partnership effort aimed to identify Louisiana Cooperative Extension Service Family and Consumer Science (LFCS) practitioners’ barriers and facilitators to implementing PSE changes in rural Louisiana communities.MethodsA qualitative approach using the 2022 Consolidated Framework for Implementation Research (2022 CFIR) was used. Focus group discussions were conducted at five LFCS regional trainings between February and May 2022. All LFCS practitioners with any level of experience implementing healthy eating and active living PSE changes were eligible to participate, with emphasis on understanding efforts within more rural communities. Focus group discussions were audio-recorded and transcribed verbatim. Researchers analyzed qualitative data using the constant comparison method and 2022 CFIR domains and constructs including Inner Setting (LFCS organization), Outer Setting (rural Louisiana communities), Innovation (PSE changes), and Individuals (PSE change implementation actors/partners).ResultsAcross the five regions, LFCS practitioners (n = 40) described more barriers (n = 210) than facilitators (n = 100); findings were often coded with multiple 2022 CFIR domains. Reported Inner Setting barriers were lack of formal or informal information sharing and lack of access to knowledge and information. Outer Setting barriers included sustaining and initiating community partnerships and local environmental or political conditions. Individual barriers included a lack of time and expertise, and Innovation barriers included the complex nature of rural PSE changes. Facilitators were mentioned at multiple levels and included community partner buy-in and practitioners’ motivation to implement PSE changes.ConclusionsImplementation strategies are needed to build on organizational strengths and to overcome multi-level barriers to PSE change implementation among LFCS practitioners. The results from the in-depth contextual inquiry used could serve as a guide for future pragmatic assessment efforts among other state Extension systems or as a model for identifying barriers and facilitators and associated implementation strategies among other public health systems in the U.S. and abroad.

Hypo-osmotic Stress Increases Permeability of Individual Barriers in Escherichia coli Cell Envelope, Enabling Rapid Drug Transport.

Survival of foodborne Gram-negative bacteria during osmotic stress often leads to multidrug resistance development. However, despite the concern, how osmoadaptation alters drug penetration across the Gram-negative bacterial cell envelope has remained inconclusive for years. Here, we have investigated drug permeation and accumulation inside hypo-osmotically shocked Escherichia coli. Three different quaternary ammonium compounds (QACs) are used as cationic amine-containing drug representatives; they also serve as envelope permeability indicators in different assays. Propidium iodide fluorescence reveals cytoplasmic accumulation and overall envelope permeability, while crystal violet sorption and second harmonic generation (SHG) spectroscopy reveal periplasmic accumulation and outer membrane permeability. Malachite green sorption and SHG results reveal transport across both the outer and inner membranes and accumulation in the periplasm as well as cytoplasm. The findings are found to be complementary to one another, collectively revealing enhanced permeabilities of both membranes and the periplasmic space in response to hypo-osmotic stress in E. coli. Enhanced permeability leads to faster QACs transport and higher accumulation in subcellular compartments, whereas transport and accumulation both are negligible under isosmotic conditions. The QACs' transport rates are found to be highly influenced by the osmolytes used, where phosphate ion emerges as a key facilitator of transport across the periplasm into the cytoplasm. E. coli is found viable, with morphology unchanged under extreme hypo-osmotic stress; i.e., it adapts to the situation. The outcome shows that the hypo-osmotic shock to E. coli, specifically using phosphate as an osmolyte, can be beneficial for drug delivery.

Barriers and facilitators of colorectal cancer screening among East African men in Minnesota: a qualitative investigation

ABSTRACT Objective: This study aimed to explore barriers and facilitators to colorectal cancer (CRC) screening among East African men in Minnesota. Design: Six focus groups were conducted in Minneapolis and St. Paul, MN, USA. Participants were asked to describe individual and structural barriers to CRC screening, and discuss strategies that would address individual and structural barriers to screening. Audio-recorded conversations were transcribed verbatim and translated to English. The transcriptions were analyzed using a thematic analysis. Major themes that emerged on individual barriers were lack of knowledge, fear, and privacy. Results: Themes that emerged on structural barriers were distrust in the medical system, lack of health care coverage, and access to the health care system. Education, client reminders, mass media, increased clarity in communication with the provider and translator, and increased access to health care were frequently mentioned strategies to increase CRC screening in the East African community. Participants expressed favorable views toward the concept of patient navigation. Conclusion: Our findings indicate the need to develop culturally appropriate, multi-faced, intervention programs that are aimed at eliminating personal, cultural, and structural barriers.

Abstract 14947: Opportunities to Address Specialty Care Deserts and the Digital Divide: VA’s Virtual Hub-and-Spoke Cardiology Clinic

Introduction: Access to specialty care, including cardiology, in the Veterans Health Administration (VA) varies widely across geographic regions. VA’s clinical resource hub (CRH) model of care offers mostly-virtual specialty care to individuals in low access regions and has recently been implemented in cardiology. Research Question: How does implementation of a predominantly virtual care cardiology program through CRH affect the reach of cardiology specialty care in the VA? Aims: Describe the association between patient characteristics and use of CRH cardiology care in VA’s Sierra Pacific region (Northern California, Nevada, and the Pacific Islands). Methods: We compared patients who used CRH cardiology services between 7/15/2021 and 3/31/2023 to non-CRH Sierra Pacific cardiology patients, then used multivariate logistic regression to estimate the association between patient-level factors and odds of being a CRH user. Results: There were 798 CRH users over the study period with a total of 3,662 cardiology encounters, 1,690 of which were CRH encounters. Of these, 8% of CRH users were women and 41% were ≥75 years, compared to 4% and 48% respectively among non-CRH users [n=25,412 with 95,663 encounters]. Similar proportions in both groups were rural (26% CRH, 25% non-CRH), highly-disabled (48% CRH, 47% non-CRH), and low-income (20% in both groups). In multivariate logistic models, adjusted odds of using CRH were higher for women (adjusted odds ratio [AOR] 1.45 [95% CI 1.09-1.92]) and lower for older Veterans (AOR 0.44 for ≥75 [95% CI 0.0.32-0.61]). Conclusions: The Sierra Pacific CRH cardiology program served a disproportionately high number of women and similar proportions of rural, highly-disabled, and low-income Veterans in its first two years of operation. This predominately-virtual model of cardiology care may be an effective strategy for overcoming access barriers for certain individuals, though targeted efforts may be required to reach older Veterans.

Knowledge, Attitude and Practice Towards Milk Banking and Lactation Aids – Similarities and Differences of Medical and Nursing Staff in a Tertiary Care Hospital in India

Introduction Lactation education is an integral part of healthcare. In order to recognise and address the inconsistencies in perceptions, attitudes and delivery of lactation care, we developed the Lactation Aids and Milk Banking (LAMB) survey. Aim The purpose of the study was to compare the knowledge, attitude and practices of doctors and nurses about human milk banking and lactation aids and to examine institutional and individual barriers to and facilitators of the delivery of lactation care. Methods It was a cross-sectional study, and the survey questionnaire was administered electronically to neonatal physicians and nurses in a tertiary care hospital in India. Results There were 86 participants, including 54 doctors (63%) and 32 (37%) nurses. There was no significant difference in the knowledge score of doctors and nurses ( p = .61), although doctors scored significantly higher on the attitude and practices score as compared to nurses ( p < .0001). Amongst the doctors, the knowledge score was higher for faculty than residents ( p < .0001), though residents scored significantly higher on the attitude and practices score than faculty ( p = .0002). This study highlighted five facilitators and two barriers to LAMB and also revealed that physicians and nurses have relatively inadequate knowledge about lactational aids and milk banking. Conclusion Lactation education for staff can reinforce support for milk banking and lactation aids, thereby achieving the goal of exclusive breastfeeding. It is also important to mitigate barriers by establishing policies and guidelines in the unit for milk banking and the use of lactation aids.

Patient, Parent, and Provider Perceptions of Barriers to Pediatric Inflammatory Bowel Disease Care.

Children with inflammatory bowel disease (IBD) have a significant life-long burden as a result of disease, impacted by environmental and individual barriers. Successful health system interventions require a comprehensive approach, informed by various stakeholders. The main objective was to identify health system barriers and potential solutions from existing patients, families, and providers via focus groups. Participants for the focus groups were existing English-speaking patients (ages 9-18) with IBD, their caregiver(s), and providers including multiple professions (eg, physician, nurse, pediatrician, social worker, care coordinator, scheduler, and psychologist). Separate focus groups were led by experienced personnel for parents, children, and providers, using a standardized interview guide. Sessions were recorded, transcribed, and verified. Using content analysis, we systematically classified data through coding and identified themes. Focus groups comprised (a) 3 patient groups (n = 20, 50% female, including 2 younger; mean age = 11.4 ± 1.5 years) and 1 older group (mean age = 15.6 ± 1.3 years), (b) 3 parent groups (n = 24, 83% female), and (c) 2 multidisciplinary provider groups (n = 19). Families shared several common concerns with providers (eg, school, care delay, psychosocial, and financial) but varied on specifics. Some barriers may be addressable through family or staff education, improved communication (eg, care delay/ access, transition), or training (eg, labs and diet), while others may require change at an institutional or policy level (eg, insurance). This qualitative analysis identified several barriers to IBD care, some shared, some unique to patients, parents, and providers, highlighting the importance of obtaining multiple stakeholder perspectives when exploring barriers to care.

Perceived gender barriers and recommendations for addressing gender inequality in academic leadership: a thematic analysis of MOOC discussion forums

ABSTRACT There is ample evidence of the underrepresentation of women in academic leadership, especially in senior leadership roles. However, there is limited understanding of the barriers they face and the institutional measures that can promote gender equality. This study aims to fill this gap by exploring the perceptions and experiences of academic leaders of different genders and countries. Utilizing a qualitative research approach with a phenomenological design, we analyzed discussions from 75 academic leaders who participated in the LEAD2 MOOC forum on ‘Gender and Academic Leadership’. A thematic analysis of the discussion forum revealed socio-cultural barriers such as gender discrimination, organizational barriers rooted in male-dominated structures, and individual barriers such as work-life conflict. The study also highlights institutional policies and practices, such as unconscious bias training, transparent hiring and promotion criteria, and family-friendly measures, that can mitigate these barriers. The findings not only provide a comprehensive understanding of the challenges faced by women in academic leadership but also offer practical recommendations for policymakers and institutions. Finally, this study can serve as a foundation for future academic leadership development programs aimed at empowering female leaders.

Transgenders Community in India Socioeconomic Health and Psychological Conditions

The transgender community in India has historically been marginalised and discriminated against socially, economically, and politically. Many people view trans people as abnormal or deviant, and they frequently experience abuse and violence on both a physical and emotional level, including sexual assault. Many incidents go unreported due to fear of retribution or a lack of legal recognition. Education is often the primary barrier for transgender individuals, with many dropping out of school due to bullying and a lack of support. Employment is often tricky, with many forced into low-paying jobs or engaging in sex work. Healthcare access is also challenging, with hormone therapy, gender-affirming surgeries, and mental health support often not easily accessible. This paper examined the demographic, socioeconomic, employment, health, psychological conditions, and transgender people’s rights protection acts in India.

A Supportive Heart Failure Care Program to Reduce Hospital Readmissions.

In the United States, heart failure (HF) is the leading reason for hospital readmissions, with 27% of Medicare recipients with HF being readmitted within 30 days The purpose of this quality improvement project was to decrease HF readmissions during their first 30 days of care with our home health agency. The Supportive Heart Failure Care education program was based on the results of a population assessment and included establishment of agency-wide best practices, nursing education sessions, and implementation of best practices focused on evidence-based self-management. After implementation of this project, the hospital readmission rate decreased from 32% to 21%. The nurses who completed the education sessions (N = 35) showed an increase in knowledge of 4.1% from pre-test scores. However, chart audits showed varying levels of documented practice in alignment with best practices. Although results of this project showed a small improvement in nurse knowledge and varied changes to documented practice, the overall project goal of decreasing hospital readmissions was achieved. Understanding individual and systems-level barriers to translating education to practice is needed to better meet the needs of home health nurses and the HF patients they serve.

Digital twins for breast cancer treatment – an empirical study on stakeholders’ perspectives on potentials and challenges

PurposeWith 2.3 million diagnoses and 685,000 deaths annually, breast cancer is the most common cancer in women. The provision of necessary information throughout the whole patient journey is key to minimize the risk of breast cancer, to detect breast cancer as early as possible, and to aid the treatment process. Digital solutions provide abilities to holistically collect, transfer, and sophisticatedly analyze information. Specifically, digital twins in healthcare, as dynamic replicas of human bodies, are promising approaches for monitoring the condition of their patients and predicting tumor developments based on biometric data. However, the acceptance and adoption of such digital twin solutions in healthcare heavily depend on the individual stakeholders of the treatment process. This study aims to identify potentials and challenges of the introduction of digital twins in breast cancer applications from the involved stakeholders’ perspectives.MethodsWe conducted semi-structured interviews with 14 relevant stakeholders from the breast cancer treatment process. The interviews were then analyzed, based on the qualitative content analysis according to Mayring.ResultsThe results show that stakeholders see great potential in digital twin solutions to further facilitate personalized medicine, efficiency increases, and scientific benefits. However, the sensitive nature of healthcare causes numerous potential challenges in the technical, regulatory, user interface, and the strategic domain.ConclusionsThe stakeholders unanimously agreed on the potential benefits of digital twins. However, existing systemic and individual stakeholder-level barriers hamper their introduction in breast cancer settings.

Validation of the Identification of Medication Adherence Barriers Questionnaire (IMAB-Q); a Behavioural Science-Underpinned Tool for Identifying Non-Adherence and Diagnosing an Individual's Barriers to Adherence.

To validate the Identification of Medication Adherence Barriers Questionnaire (IMAB-Q) as a tool to guide practitioners to identify patients who require support to take their medicines as prescribed, their key barriers to adherence and select relevant behaviour change techniques. Adults prescribed medication for cardiovascular disease prevention were recruited from nine community pharmacies in England. Participants completed the IMAB-Q comprising 30 items representing potential barriers to adherence developed from our previous mixed methods study (scoping review and focus groups) underpinned by the Theoretical Domains Framework. Participants also self-reported their adherence on a visual analogue scale (VAS) ranging from perfect adherence (100) to non-adherence (1). A subgroup of 30 participants completed the IMAB-Q twice to investigate test-retest reliability using weighted Kappa. Mokken scaling was used to investigate IMAB-Q structure. Spearman correlation was used to investigate IMAB-Q criterion validity compared to the VAS score. From 1407 invitations, 608 valid responses were received. Respondents had a mean (SD) age of 70.12 (9.9) years and were prescribed a median (IQ) 4 (3, 6) medicines. Worry about unwanted effects (n = 212, 34.5%) and negative emotions evoked by medicine taking (n = 99, 16.1%) were most frequently reported. Mokken scaling did not organise related IMAB-Q items according to the TDF domains (scalability coefficient H = 0.3 to 0.6). Lower VAS self-reported adherence correlated with greater IMAB-Q reported barriers (rho = -0.14, p = 0.001). Test-retest reliability of IMAB-Q items ranged from kappa co-efficient 0.9 to 0.3 (p < 0.05). The IMAB-Q is valid and reliable for identifying people not adhering and their barriers to adherence. Each IMAB-Q item is linked to a TDF domain which in turn is linked to relevant behaviour change techniques. The IMAB-Q can therefore guide patients and practitioners to select strategies tailored to a patient's identified barriers.

A rapid evidence assessment of barriers and strategies in service engagement when working with young people with complex needs

Young people with complex needs often have a range of co-occurring challenges that require the support of multiple government agencies and services. Increasingly, government agencies are working with young people who present with co-occurring and comorbid complex needs requiring co-ordinated multi-agency responses. However, agencies and services are often faced with multiple obstacles and challenges to meeting the needs of these young people, placing them at increased risk of poor outcomes during their adolescence and into adulthood. The objective of this Rapid Evidence Assessment (REA) was to provide practice insights as they relate to service engagement for young people with complex needs to highlight ways in which service delivery can be enhanced. Published academic literature as well as relevant material from the grey literature on young people aged 10–25 was synthesized to identify: (a) the principal barriers to service provision, and (b) strategies that facilitate service engagement. A total of 18 papers met the eligibility criteria for review. Papers were assessed using the critical appraisal skills programme (CASP). Individual and system level barriers were identified, including the characteristics of young people and the nature and structure of services. Strategies were identified at the practitioner level (e.g., benefits of relational, structural and empowerment approaches), and the system level (e.g., flexible services, collaborative approaches and improved staffing and resources). The review highlighted the importance of creating a service environment that is structured around the needs of young people rather than one which requires vulnerable young people to adapt to services.

Compass for antibiotic stewardship: using a digital tool to improve guideline adherence and drive clinician behaviour for appendicitis treatment in the emergency department

BackgroundAntibiotic stewardship in the ED is important given the increasing prevalence of multidrug resistance associated with poorer patient outcomes. The use of broad-spectrum antibiotics in the ED for infections like...

Aboriginal children with cancer: The patient and healthcare worker perspective.

There are inequitable health outcomes for Aboriginal children with cancer. A quality improvement audit performed at our institution through interviews with families and healthcare workers has highlighted individual, systematic and cultural barriers to equitable and culturally safe healthcare for Aboriginal patients, in addition to facilitators and recommendations for improvements.